CONTENTS: gold medal lectures
SEXUAL HEALTH AFTER TREATMENT OF PROSTATE CANCER: STILL A PATHWAY TO HAPPINESS? L. Incrocci Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands Prostate cancer (PCa) is the most frequent non-skin male malignancy in Western countries. Its incidence increases due to the trend for increased longevity and the improved level of detection with prostate-specific antigen tests. Sexual dysfunction is often unrecognized, underestimated and untreated. Radiotherapy is together with radical prostatectomy the most effective treatment. Advances in surgical techniques have reduced the number of patients experiencing post-surgery erectile dysfunction (ED). Radiotherapy can be offered as curative option with rates of ED as high as 50%. ED after surgery has a neurogenic etiology with an immediate onset, while this is vascular after radiotherapy. Several studies have shown that up to 79% of men older than 70 years still are sexually active. Intracavernosal injections have been used with satisfactory results in patients with ED, as well vacuum devices. Most patients are nowadays treated with sildenafil, tadalafil and vardenafil, effective in up to 50% of the patients after surgery and radiotherapy. Patients need to be adequately counseled on the effects of cancer on their sexual life, about treatment possibilities and reassured of enjoying a normal sexual life even with a nonrigid penis. Sexual counseling has not become a routine part of oncology care. The new situation after cancer treatment can disturb the sexual relationship. Despite all this, with proper sexual counseling, there is still a pathway to happiness after treatment of PCa.
THE NEW SEXTHERAPIST BETWEEN THERAPEUTIC ENTHOUSIASM AND EROTIC BURNOUT P. Nijs Catholic University Leuven, Leuven, Belgium In the golden sixties a period of therapeutic enthousiasm started when Masters and Johnson introduced their therapeutical programs. However, from the eighties untill now there was an unexpectedshift in sexual complaints : from sexual behaviour disturbances to disorders of sexual desire and sexual violence ( incest, rape and sexual harassment). This shift has become a longlasting task for the sextherapist complicated by problems of compassion fatigue, secondary traumatisation, burnout and even termination of the sextherapeutic activity. The 'Viagra revolution' (1989) failed to give an inadequate answer both for patients and therapists. Sex therapists can only take care of patients if they also take care of themselves and each other. This lecture focuses on the (sexual) health of the therapist. Indeed patients need an optimistic therapist who can enjoy life and therapy with enthousiasm. Skills and life style are described in 6 domains of human vitality which also create therapeutic energy.
MYTHS IN SEX P. Weiss Institute of Sexology, Charles University, Prague, Czech Republic The presentation mentions some of the most common myths in human sexual behavior, e.g. the phallic myth, myth about the simultaneous orgasm, myths about body proportions, penis size, about intercourse, falling in love etc. The author concerns also at the possible consequences of these myths in the real sexual behavior and in sexual emotions of men and women.
master lectures
BRAIN IMAGING & SEXUALITY F. Bianchi Demicheli Psychosomatic Gynecology and Sexual Medicine Unit, Department of Obstetrics and Gynecology Geneva, Switzerland Brain imaging is becoming a powerful tool in the study of human cerebral functions related to sexual function, sexual dysfunction and close personal relationships. fMRI and EEG, combined with standard EEG waveform analyses, may provide a new understanding of the specific brain functions, underlying the human sexual activity in both healthy and clinical populations. On th top of the the subcortical structures thought to be prevailingly involved in reward-related systems, a wide range of neuroimaging studies highlight the prominent role of different cortical networks in human sexual response. By highlighting the complex role of the corresponding brain regions in the entire sexual response, neuroimaging provides a significant step forward to the understanding of sexual physiology and physiopathology. This scientific approach brings a significant knowledge to creation and improvement of the whole-brain models and thus help to transform the scientific findings from laboratory bench to clinical applications. Neuroscience brings a new perspective in the field of sexology and opens a new avenue to the understanding of the highly complex human being’s sexual behavioral cognition.
SEXOLOGY DIAGNOSTIC MANUAL III (SDM III) F.J. Bianco Colmenares, E. Pazmino, B. Baena, S. Guevara, P Correa, H. Revodello, N. Rivero, M. Ortiz, J. Rivero Cippsv Research and Postgraduate Institute, Caracas, Venezuela Objective: to present the english version of the third edition of the Sexology Diagnostic Manual (SDM III) approved by the Latin-American Federation of Sexological and Sex Education Societies (FLASSES) in 1994; endorse by The World Association of Medical Sexology (WAMS) in 2009 and by the International Academic for Medical Sexology (AIMS) in 2010. Design and Methods: several committees have been working in the third edition of the Manual. The Classification of Sex and Sexual Disorders is approached. Each nosological entity is described. Results: The Sexology Diagnostic Manual third edition (SDM III). A manuscript full of symptoms, signs and syndromes related to sex and sexual function. Conclusions: Medical Sexology as a new Specialty in the field of Medicine, present its own classification of Sex and Sexual Function disorders. Tights with the Diagnostic Manual for Mental Disease (DSM Series) done by American Psychiatry Association (APA) must be cut for the benefit of the development the field of Medical sexology. It is important that the International Diseases Classification (IDC) (WHO) study the SDM III (FLASSES. WAMS. AISM) in order to adjust their Classification for the benefits of our patients.
THE TIMING OF THE SEXUAL ACTIVITY S. Caruso 12 1FISS,2 Research Group for Sexology, University> of Catania, Catania, Italy Objective: To study the correlation between sexual behaviour and the hormonal status during the menstrual cycle of women with ovulation defined by sonography. design: Screening phase (gonadal sonography, Sexual History Interview); Study phase: (daily diary for sexual activity, measurement of steroid levels, FSFI) to study the correlation between sexual behaviour and the hormonal status during the menstrual cycle of women with ovulation. Methods: from January 2004 to June 2011, 1657 women were enrolled between. The percentage of sexual activity/ intercourse of women with or without sexual partner and of sexual activity initiated by partner across week days and in relation to the phase of menstrual cycle were studied Results: 1039 (62.7%) women in the age range of 18 to 40 years (mean age 30.1 ± 3.6) provided information to be included in the analyses. Of women that completed the study, 815 (78.4%) had a heterosexual relationship, and 224 (21.6%) did not live with a sexual partner. Total score of women with partner was statistically significant higher than that of women without partner. Women having partner have improvement of sexual activity during week end; women without partner have increased sexual activity during the ovulatory period. Data will present Conclusions: by an accurate evaluation of the timing of ovulation is possible to detect the time of the female sexual activity.
HYPERSEXUALITY AS SEXUAL COMPULSION VERSUS SEXUAL Addiction E. Coleman Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota This presentation will explore the various models of understanding impulsive/compulsive sexual behavior. While the paraphilias are quite defined, there is quite a debate about whether some of these should be classified as mental disorders and, if so there are new proposed changes for DSM-V that are still discussion. The most perplexing is what to call normophilic impulsive/compulsive sexual behavior. It is a paraphilic-related syndrome? Or is it the other end of the continuum of sexual drive - a drive dysregulation phenomenon? Some have suggested that this phenomenon is better explained as a behavioral addiction. This is an unfortunate misnomer. While there has been no agreed upon conceptualization of how to categorize this syndrome, various terms have been proposed to describe it. Most recently, the DSM task force has proposed a new category of Hypersexual Disorder - although it is unclear where this will fit in the schema of sexual disorders. Each model makes assumptions about etiology and treatment and these will be explored.
SEX AS A PLEASURE CYCLE: A HUMAN BRAIN IMAGING PERSPECTIVE J. Georgiadis University Medical Center Groningen - Dept. Neuroscience, Groningen, The Netherlands Sex is a fundamental pleasure, and crucial to the survival of our species. Though not many people would disagree with the proposition that sexual behavior depends on the brain, the neuroscientific study of human sex is still relatively taboo and much remains to be discovered. The recent advent of human brain imaging techniques has opened up numerous possibilities to study the central sexual system, though, and in this lecture I will review some of the evidence from such studies. I will stress that human sexual behavior adheres to the structure of a pleasure cycle, whereby the behaviours wax and wane in frequency over time as different goals are identified, desired and consummated. According to this view, sexual reward, especially orgasm, is pivotal as it reinforces sexual behaviour and drives future expectations about sex (sexual learning), and I will present compelling animal and human data that virtually anything can become a sexual incentive stimulus through coupling with sexual reward. Further, I will present data to prove that, like in similar pleasure cycles (drugs, eating), wanting and liking sex draw upon fundamentally distinct behaviour, brain networks and neurotransmitter systems. Before making some closing comments regarding exciting future directions in this research field, I will argue that the social and moral affiliations of sex determine which sexual incentive stimuli are acceptable to enter the sexual pleasure cycle, and that this moral-sex interaction is potentially strong and measurable at the brain level.
A. Giami INSERM U 1018, Paris, France The project of offering some kind of sexual assistance is currently developed in some European countries such as Switzerland, Belgium or Denmark. The project is based on the assumption that those labeled handicapped individuals have some sexual capacities but are not in the position to fulfill their needs without the help/assistance of a carer. There are currently two types of sexual assistance: (1) physical aid for those who have a partner or want to perform masturbation but encounter mechanical difficulties to perform sexual and body acts and (2) offering direct sexual services for those who do not have a partner and want to engage in sexual partnered acts. This new proposal of sexual assistance is currently the object of important controversies between those in favour of such assistance and those who consider that it is a kind of sex work, which in many European countries is not consider as the best way to perform a healthy sexual life. Until recently there has been little discussion about the similarities of this new form of sexual assistance and the traditional approach of sex surrogates developed in the early sixties in the Masters & Johnson clinics. The presentation will present and analyse the elements of the controversies regarding sexual assistance for thoss labeled handicapped, it will develop the argument that beyond the accuracy of this approach, the use of sexual assistance may favour the reinforcement of the social and institutional barrers limiting the access to sex for those labeled as handicapped.
SEXUALITY, SEXUAL HEALTH AND WELL BEING R. Hernandez Serrano 1, A. Parra Colmenarez 2 1 Universidad Central de Venezuela, Caracas, Venezuela,2 Federación de Psicólogos de Venezuela, Caracas, Venezuela WHO in 1975 produced a brochure on trainning of professionals about Human Sexuality. In 1997, at Valencia, Spain World Congress of Sexology we produced the DECLARATION OF HUMAN SExUAL RIGHTS, later aproved unanimously in WAS WCS Hong Kong, China (1999) PAHO organized a Consultation in Antigua, Guatemala (2000) producing a Document SExUAL HEALTH PROMOTION, Later Amnecy, Geneva and WAS wrote and published a techincal document SExUAL HEALTH FOR THE MILLENNIUM, following the track. These 4 documents in a period of almost 30 years followed the advance of SExOLOGY AND SExUAL HEALTH. However, oscurantism,ignorance,resistances and lack of political will remains in may regions of the world. The data on poverty,adolescents pregnancies, HIV new cases,child trafficking, sexual violence are increasing everywhere. Economic crisis is typical of our world today,neglecting resources in this important area. We have a lot to do. A clear example is the resistance to include sexual health aspects in Q of L scales, ignoring its importance and relevance, in serach of Happiness and Medicine. The Good of Sex was the main theme at CLASES 2002 in Margarita Island. We believed in a paradigm change regarding our Life Mission. Reviewing this scales will be a major step forward in SExUAL HEALTH, good trainning of mental health professionals, postgraduate university Courses, Transcultural Research, Being visible in mass media resources including social networks and lobbying political leaderships to create a good atmosphere regarding our topics. We need consensus strategies in order to overcome these absolute misunderstandings and differences between human beings. We present these figures. Lets go forward.
PLOTS OF SECRET Garden: THE Dimensions OF FEMALE SEXUAL FANTASY CONTENTS K. Klapilova, J. Binter Faculty of Humanities, Charles University, Prague, Czech Republic Objective: The aim of the study was to identify dimensions of female sexual fantasy (SF) contents in sample of Czech women. In contrast with previous authors we separated two main groups of SF contents: 1.) Specific subjects appearing in SFs (e.g. inexperienced man) - we expected inherent evolutionary origin, 2.) SF focused on activities appearing in the fantasy (e.g. you seduce a man) rather gained by previous sexual experience. Methods: We asked 142 heterosexual Czech females (mean age = 23.8 years; 58 students/84 non-students) living in longterm relationship to fill in questionnaires about their sexual life that included checklist of SF contents (based on previous literature) divided to subject-focused SFs (10) and activity- focused SFs (47). These were rated on excitability and usualness on 7-point scales. Factor analysis with Varimax rotation was provided using SPSS 19.0. Results: 3 dimensions of subject-focused SFs were identified: 1. Extra-pair male subject oriented (explains 34.8 % of variability, 7 items, e.g. experienced male), 2. Same- sex subject oriented (13.7%, 2 items, e.g. female), 3. Primary partner oriented (10.8%, 1 item). In case of activity-focused SF, 5 dimensions were identified: sadomasochistic (24.7%, 16 items), exploratory (9.7%, 12 items), intimate (5.6%, 9 items), dominance (4.7%, 4 items), romantic (4.4%, 6 items). Conclusions: In case of activity-focused SFs we confirmed the structure found in previous studies even after subject separation. Findings concerning the structure and frequency of subject-focused SFs are in accordance with evolutionary- psychological assumptions. Participants tended to fantasize more about subjects that bring evolutionary benefits for their reproductive strategy.
PSYCHOSIS AND SEXUAL DYSFUNCTION: GOOD BYE TO LOVE? A.L. Montejo González University of Salamanca, Salamanca, Spain Treatment of severe mental illness (bipolar disorder and schizophrenia) is usually initiated in the acute phase and must be maintained in the long term to provide continued symptom control and enable recovery. Improving adherence as a means of obtaining better outcomes should be a priority for all clinicians working in mental health. Patients with schizophrenia consider the most important adverse effects of antipsychotics to be extrapyramidal symptoms, weight gain, impairment of sexual function, and sedation. To these must be added drug-induced cognitive impairment which may worsen adherence by reducing the patient’s ability to manage their treatment. Second-generation antipsychotics (SGAs) offer similar efficacy. However, they differ markedly in their adverse effect profiles, particularly in the adverse effects considered by patients to be most important. This makes it essential to obtain a balance between efficacy and side effects tailored to the needs of the individual patient. Endocrino- metabolic disease is likely to have a severe impact on the patient’s physical health, but many patients may consider drug-induced impairment of sexual function to be equally important. There are clinically important differences between the available treatments in respect of their propensity to increased serum prolactin levels and sexual dysfunction.
PSYCHOSEXUAL THERAPY: NEW DEVELOPMENTS FROM THE BASIC SCIENCE TO TREATMENT APPROACHES P. Nobre Departamento de Educaçao da Universidade de Aveiro, Aveiro, Portugal In the last two decades, several clinical and laboratorial studies have been emphasizing the role played by psychological and neurophysiological variables on sexual response and functioning. Sexual beliefs (Hawton, 1985; Heiman & LoPiccolo, 1988; Zilbergeld, 1999), efficacy expectations (Bach et al., 1999), cognitive distraction and attentional focus (Dove & Wiederman, 2000; Elliot & O’Donohue, 1997), attributional style (Weisberg et al., 2001), affect (Mitchell et al., 1998; Nobre et al., 2003), and neurophysiological variables (Barlow, et al., 1983; Maravilla, & Yang, 2007; Meston & Gorzalka, 1996; Mouras, 2006; Walter et al., 2008) are among the most studied variables. Despite these diverse contributions little effort has been made to develop integrated comprehensive models that explain the factors involved in predisposing and maintaining sexual dysfunction. In order to cover that gap, the authors have recently conducted a series of studies on the influence of cognitive schemas (Nobre & Pinto-Gouveia, 2010), sexual beliefs (Nobre et al., 2003, 2006a), automatic thoughts (Nobre & Pinto-Gouveia, 2003, 2008), and emotions (Nobre & Pinto-Gouveia, 2003, 2006b) on sexual dysfunction. Results showed the strong influence of cognitive and emotional variables on sexual response and allowed the development of explaining models for sexual dysfunction in men and women (Nobre, 2010a, 2010b). These conceptual models are currently being tested in our SexLab using experimental and longitudinal designs, and a treatment outcome study is also undergoing to test the efficacy of Cognitive behaviour therapy for sexual dysfunction. Preliminary findings from these projects and its implications for treatment will be presented and discussed.
IS THERE A SPACE FOR SEX THERAPY IN THE ERA OF 5PDEIS? M.Sungur Psychiatry Department of Marmara University, Istanbul, Turkey Every time a new physical/pharmacological method of treatment is discovered, predictions are made that sex therapy will no longer have a role to play in the management of erectile dysfunction (ED). The most serious previous threat to sex therapy came from the introduction of the intracavernosal injections (ICE). But predictions did not materialize due to problems of administration, acceptability, discontinuation, potential side effects and production of erections irrespective of sexual stimulation. However introduction of new oral pharmacological drugs poses a new and real threat to sex therapy as it is easy to administer, acceptable with excellent compliance, effective with safety profile and produces a stimulation dependent response. Thus the aim of this presentation is to ask and answer the same question Is there any need for sex therapy in the era of effective oral treatments? Putting too much emphasis on the erect penis and ignoring the person to whom the penis belongs is only a quick fix as achieving an erection and translating that into sexual intercourse with satisfaction are two different things.
MINDFULNESS AND SEXUAL THERAPY S. Vilarinho Aveiro University, Aveiro, Portugal Mindfulness is the practice of intentionally being fully aware of the present moment, watching one’s own thoughts, feelings, and actions as they occur, and giving attention to them in a non-judgmental manner. This practice facilitates the opportunity of responding to events rather than just reacting. The practice of mindfulness has a long history in Eastern tradition, being rooted in Buddhist meditation. In Western, only in recent years mindfulness has made its way into health care but with very encouraging results. Even more recently, mindfulness has been revealing potential and promising effects for sexual health. In a qualitative study with women, extended mindfulness meditation practice (mean practice around 19 years) was found to be associated with an increase in sexual awareness and self-acceptance, and higher levels of sexual satisfaction. In two non-controlled studies, a mindfulness-based CBT in group format (3-sessions) resulted in significant improvements in mood, sexual desire and other domains of sexual response, together with reduced sexual distress in women with sexual desire and arousal problems, and in women with sexual arousal disorder associated with gynecologic cancer. In both studies, mindfulness component was explicitly reported by the participants as being the most valuable aspect of the treatment. In a qualitative study with non-distressed couples, a mindfulness-based intervention revealed to enhance relationship satisfaction and reduced. In general, results revealed that teaching how to practice mindfulness in and out of sexual scenarios may be associated with a beneficial effect to their sexual responses. A summary of empirical evidences will be presented, along with theoretical background considerations.
CHRONIC Disease, AGEING And SEXUALITY K.R. Wylie Porterbrook Clinic, Sheffield, UK Sexual activity continues for many men and women well into older age, and in women the menopause. This has been noted as being considered very important in the general relationship for many couples. A recent study of cohorts of individuals aged 70 years has highlighted that the proportion of 70 year old men and women with higher satisfaction with sexuality, fewer sexual dysfunctions and more positive attitudes to sexuality has increased over recent decades. Ageism and condescension towards older adults no longer has a place in modern society. Clinicians must help people in their later life to have a fulfilling and enjoyable sex life if this is desired and part of managing this will involve finding ways to broach the topic. Whilst increasing degrees of pathology and prescribing medications may lead to a decline in both sexual interest and function in both men, women and their partners, a number of interventions can be helpful in placing men and women in charge of keeping their sexual life alive and well. A move away from this ageist preoccupation by viewing sexuality in the elderly as problematic and not requiring help will encourage the population to seek medical help in a more informed and engaged manner. Interventions that ensure that marital and relationship satisfaction and maintenance of the frequency of desired sexual activity can occur are likely to lead to increased satisfaction within the sexual relationship. speakers’ abstracts
YOUTH SEXUAL HEALTH: SEX EDUCATION ON EGYPTIAN TV R. Abdel Azim Psychiatry Department Cairo University Hospital - Faculty of medicine, Cairo, Egypt In the Northern part of Africa lies some of the arab countries including Egypt, Sudan, Lybia, Tunisia, Algeria, Morocco and Mauritania. Islam is the predominant religion in most of arab community with minorities of other religions mainly christianity however the community follow more or less the same cultural norms. Sex is taboo except for married couples and talking about sex is shameful and often perceived as deviance from norms or even taken for delinquent behaviour. Masturbation, safe sex, virginity, polygamy, incest, use of contraceptives, sexual hygiene, HIV and other STDs, male and female sexual roles and rights for pleasure, sex talk, gender dysphoria and homosexuality are all very debatable hot topics when raised and discussed on Egyptian national Tv, nevertheless; audience interactions interestingly defies a great deal of what was expected from it on the preliminary hypothesis. Still the ill concept of women’s rights as well as violence against them with focus on their bodies,wearing Hijab, sexual harassment, the habit of circumcision, relation between lack of sex education and prevalence of substance use and abuse among youth especially population at risk are topics that need to be tackled from more than one perspective, not only the sexual one. Some interactions on the Tv program will be shown in video during presentation for audience discussion.
PSYCHOLOGICAL METHODS IN THE TREATMENT OF SEXUAL PROBLEMS C. Almas 1, E. Almas 2 1 Psychiatric ward, Sorlandet Hospital, Kristiansand, Norway, 2 Department of psychosocial health, University of Agder, Grimstad, Norway Psychological methods in the treatment of sexual problems will be presented and discussed. The questions that will be addressed are: What is meant by psychological method? How are psychological methods integrated in sexological treatment, and how do they fall outside? We have learned from many studies that a wide variety of professionals are using what is called a psychological method - who are they, and what does it mean?
FROM GENDER DYSPHORIA TO GENDER EUPHORIA, AN ASSISTED JOURNEY E. Benestad Grimstad Mpat-institute, Grimstad, Norway People of unusual gender talents have long been labeled “dysphoric” or as “suffering from”. These labels may at best have worked as tickets to systems where one could get the medical support needed on a path to gender fulfillment. Pathologisations create feelings of dysphoria and will thus contribute to its own justification. This is immoral. In an ambience of transe-, inter-, no gender and/or genderqueer positivity, the path to positive gender belonging will also be a path to gender euphoria. Positive gender belonging is to be perceived and affirmed as gender by others, the same way one perceives and affirms oneself. Ordinarily cultures offer two gender options. This does not reflect all known gendered or non-gendered talents. In order to make it possible for all to reach positive gender belonging, cultures must offer more than two positive gender options. This author is comfortable with offering seven genders, but several of these offers still carry labels of pathology. The path to positive gender belonging involves processes both on inner and outer arenas. The inner process concerns questions of who one might be in the world of gender. An able gender therapist and gender path assistant must have the capacity to know and convey positive images of all the seven options, for the client to be mirrored in an optimal way. Simultaneously the therapist/assistant must work with networks in order for them to be able toperceive and affirm the individual as gender the same way as the individualperceives her/him/hir/sinhir self. Key words: Seven gender options, positive gender belonging, therapeutic assistance.
FJ. Bianco Colmenares, R. Cardenas, E. Pazmino CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela Objective: to describe the Postgraduate Training in Medical Sexology. Material and Methods: Since September of 1986 in Venezuela Medical Sexology is recognized as a Specialty in the field of clinical medicine as is Cardiology, Urology, Internal Medicine, etc. The Sociedad Venezolana de Sexologia Medica (Medical Sexology Venezuelan Society) was founded in December of 1984 and the Postgraduate Training in Medical Sexology started in July of 1985. The Postgraduate Training in Medical Sexology started in 1985, is three-year program which has six academic semester and full time clinical training. During the first year the objective is to learn to make a Medical Sexology History, syndromatic diagnoses and diagnostics procedures. During the Second Year emphasis are done in the different Therapeutic approaches and the learning of the Fundamental Therapeutic Program applied to Medical Sexology During the third year a teaching experience in gain given lectures and class in the Postgraduate Training Program in Sexual Counseling. Skill in Promotion of Sex and Sexual Health, Prevention and Anticipation of sex and sexual diseases are taught. During the entire Residency Program a full exposure to research in mandatory and a final thesis is a requisite for getting the degree of Master in Science mention Medical Sexology. Clinical rotations includes: Psychiatry, Urology, Gynecology, Rehabilitation and Family Medicine. Since 1985 to present 54 Medical Doctors has being trained. Doctors from Ecuador, Colombia and Espana had taken our Program. The Venezuelan’s Public Health System so far has opened 10 positions in seven different hospitals were a Medical Sexology Unit has been created. Five of them are University related.
UPDATE ON DESIRE: “DESEA” PROJECT F. Cabello Santamaria, F. Del Río Olvera Instituto Andaluz de Sexología y Psicología, Malaga, Spain Key words: Sexual Aversion, Hipoactive Sexual Desire Disorder, Introduction: DESEA (DEsire, SExual, Aversion) is the acronym of an ambitious project divided into three parts. The first is the development of a questionnaire designed to asses and differentiates hypoactive sexual desire (HSDD) and sexual aversion. The second part is to develop a scale of disgust. We have evidence from our clinical experience that disgust directly correlates with sexual aversion and HSDD. Third part is the validation of our therapeutic approach with different strategies for HSDD and sexual aversion. In the current study, we have focused on validating a new questionnaire to enhance the sensitivity of the instrument with patients suffering from hypoactive sexual desire disorder (HSDD) and sexual aversion. We have attempted to have a tool with reliability and discriminative validity in premenopausal and postmenopausal women. Aim: To assess the validity of DESEA a new questionnaire for measuring sexual aversion and HSDD in women. Methods: A prospective methodological study carried out at 12 centers in Spain, Venezuela, Cuba, Ecuador and Chile, through a conglomerate sampling, forming two groups: Experimental (females with DSM IV-TR criteria of Sexual Aversion or HSDD) and Control (subjects without sexual dysfunction). Main Outcome Measures: Cronbach’s coefficient alpha was used to measure the internal consistency (0,822) in a first approximation with only a sample of 313 women. The overall proportion of variance explained by the questionnaire was 61.742% (Rotation Sums of Squared Loadings) and from the 15 items composing the questionnaire was only necessary to remove one of them. Results and Conclusions will be show in the lecture of the congress.
FROM EAST TO WEST: RE-IMAGINING YOUTH’S SEXUAL HEALTH A. Castellanos Usigli Youth Initiative Committee, World Association for Sexual Health (WAS), Mexico City, Mexico From the East to the West Hemisphere, young people across the globe are facing various sexual health challenges. Globalization, urbanization, technology and overpopulation are some of the factors that affect youth’s sexual health in both developing and developed nations. Due to the current demographic importance of young people (UNFPA calculates that there are more than 1.8 billion youths), governments and NGOs are developing more sexual health programs targeting them. However, more global efforts are needed to reach consensus about the most important challenges faced by young people in each continent and the most urgent public policies that are needed to enhance their sexual health, as well as efforts to involve young people in the design of proposals for sexual health programs and strategies. Thus, the Youth Initiative Committee (YIC) of the World Association for Sexual Health is undertaking an International Consultation about youth’s sexual health in the 21st century focusing on sexual health challenges, needed public policies and youth-friendly proposals. The process will involve young and adult experts, and it will promote future networking among individuals and organizations to develop effective international responses to the new scenarios of the current century.
RIGHTS OF TRANSSEXUAL PEOPLE M. Castro Espin 12 1 National Commission for Comprehensive Care of Transsexual Persons, Cuba,2 National Center for Sexual Education, Cuba The strategy of comprehensive care of transsexual persons in Cuba has become part of the political transformations of the country, in which for the first time there is an explicit commitment to overcome all forms of social discrimination, including those related to sexual orientation and gender identity. This has made possible for social integration of transsexual persons and the full exercise of their rights to go beyond the individual, family and medical contexts and become the focus of public interest. The strategy is characterized by a social vision with a gender, human rights and diversity approach, contributing to overcome the exclusively biomedical and pathology approach prevailing in the scientific discourse on transsexuality. The disadvantages of transsexual persons are articulated in the universe of social relations and the equality status characterizing a given society. Thus, the experiences of these persons are analyzed within their complex relation with other social and structural aspects such as class, gender, social background, race, territory, religion, among others, with a crosscutting approach. This strategy has come to fill the vacuum of the lack of information and methodological resources indispensable in the political decision-making process committed to defending the human rights of transsexuals.
ATTENTION, CONSULTING SERVICE AND SEX THERAPY FOR PEOPLE WITH Disabilities C. De La Cruz Martín Romo Universidad Camilo José Cela, Madrid, Spain The Sexuality Consultancy for people with disability, professionals and families is a service created by the Leganes Town Council (Madrid.Spain) and it aims to provide with support to disabled people's sexuality, whatever disability it is and whatever their autonomy degree or need of support is: Intellectual disability, physical disability , sensorial disability, cerebral palsy, autistic spectrum disorder, mental illness, rare illnesses...It is a place for personal consultation, free of charge and where you can talk about different aspects related to sexuality : anatomy and physiology, development, contraception, fertility, sexual identity and desire orientation .But it is also a place where you can look for support in view of the difficulties that the people with a disability live: in couple relationships, in sexual relationships, in their experiences ..or where professionals and families find keys and abilities to face situations such as the presence of inadequate behavior, the suspicion of abuse, and the demands or questions of the disabled people. In the first year more than 200 queries have been answered and the Consultancy stands out for the following characteristics: - INNOVATION: It's the first Sexuality Consultancy of the kind) - COORDINATION: The Consultancy does not intend to substitute for other services or compete with them. - INTEGRATED ASSISTANCE: Everybody is helped. - SYSTEMIC: The whole context of disabled people is attended to. - VISIBILITY: The disable people's sexuality is placed on the same level as the rest of the different sexualities. - SPECIFIC: It requires to handle both sexological and disability keys. - PROMINENCE OF THE DISABLED PERSON: We do not attend to demands,” people with demands and needs are attended to”. - ALL KIND OF DISABILITIES: It is aimed at all kind of disabilities.
RESOURCES And CHALLENGES IN EUROPE S. Eleuteri Faculty of Medicine & Psychology Sapienza University of Rome; WAS Youth Initiative Committee, Rome, Italy Youths in the European Region face many challenges with regard to sexual health: rising rates of HIV and other sexually transmitted infections (STI), unintended teenage pregnancies, sexual violence and risky behaviors also connected to the diffusion of new media. Modern media, above all cellphones and the Internet, have in a very short period of time become important sources of information. However, a lot of that information, particularly regarding sexuality, is distorted, unbalanced, unrealistic and often degrading. Therefore, a new sexual health aim has emerged, which is the need to counteract and correct misleading information and images conveyed through the media. Sexual education from early age, new media and the fight against homophobia and transphobia diffuse in many European countries will be explored as some of the resources that could be used to promote youths’ sexual health, discussing existing differences in such themes between European Countries. Children and young people are crucial to the improvement of sexual health in general and have to be seen as the most important resource to reinforce an idea of sexuality as based on gender equality and self-determination. The reinterpretation of youths as active sexual health subjects, instead that only as sexual education recipients, may contribute to a social climate that is tolerant, open and respectful towards sexuality, various lifestyles, attitudes and values.
M.F. Ferreira Lourenco Couple s Clinic Psychiatry and Mental Health Department Alto Ave Hospital Center, Guimaraes, Portugal The influences of culture and social norms are present in different areas of human health, as is the case of reproductive behaviors. Infertility is not only a fault of nature, but it is also something that does not respect the established order, a fact that puts in doubt the truth of the femininity and the masculinity representations prevailing in the culture of many societies. All couples undergoing infertility treatment experienced life changes, which included: lifestyle changes, various physical and emotional changes, and changes in their relationships. There is a perceived loss of control over many aspects of their lives. Men and women are affected by infertility in different ways. Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel and act. In light of data suggesting that psychosexual symptoms may interfere with fertility, success of infertility treatment and the ability to tolerate ongoing treatment should pay attention to them. The dominant values and cultural practices indelibly affect the sexuality of infertile couples. The humanization of the treatment protocols of infertile couples, to be credible, must take into account the problems of intimacy and the sexual health of those people. There will be a reflection on the impact of infertility in couple intimacy, from the perspective of Couple’s Clinic - Department of Psychiatry and Mental Health - Alto Ave Hospital Center, reporting the experience of the last decade.
INTIMACY, POWER RELATIONSHIPS AND SEXUAL SATISFACTION IN YOUNG COUPLES A. Fuertes Universidad de Salamanca. Departamento de Psicología Evolutiva y de la Educación, Salamanca, Spain The study of sexuality and sexual satisfaction requires an examination of the relational context in which sexual behavior takes place. Intimacy needs and dynamics of power are crucial factors that can exercise an important influence on the couple's sexual satisfaction. Attachment theory and research, has shown that securely attached persons have more positive sexual experiences and higher levels of sexual satisfaction in their relationships, compared with insecurely attached persons. Meanwhile, although dynamics of interpersonal power have received less attention, research also shows that perceived equity is associated with relationship and sexual satisfaction. Previous research has been conducted primarily with individuals, but in view of the interdependent nature of these variables it would be preferable and more suitable to study it at the dyadic level of analysis. Our longitudinal study with young couples means a modest contribution in this direction. To do this, measures of attachment anxiety and avoidance in relationship, perception of partner influence and perceived control in decision making were assessed. These variables were measured again ten months later as well as sexual satisfaction. The final sample consisted of 58 young couples aged 20-25 years. Most important results revealed that women’s sexual satisfaction was negatively associated with her avoidance (only concurrently) and her perception of partner influence attempts (concurrently and longitudinally). For men, sexual satisfaction was negatively related to his attachment anxiety and the woman's perception of partner influence (both concurrently and longitudinally) and positively associated with personal and partner perception of control in decision making (concurrently). A RARE CASE OF PRIMARY ANEJACULATION F. García Institut Marqués, Andrology Department. Service of Reproduction, Barcelona, Spain Clinical Case: Man of 34 years-old was referred for infertility study. He reported an anejaculation and anorgasmia since the beginning of his sexual activity, normal libido and erectile function, and occasionally nocturnal emissions. Frequent headaches of unknown origin. Never had consulted about his dysfunctions with a physician. Results on physical examination were unremarkable. Hormone determination revealed normal FSH 1.6 UI/mL (114), low LH 0.5 UI/mL (2-12) and testosterone 7 nmol/L (1052), high Prolactin 1000 ng/mL (2-18). Magnetic resonance imaging of the hypothalamic-pituitary region showed a 4 cm lesion in the pituitary, consistent with a macroadenoma. Was treated with bromocriptine in increasing doses up to 30 mg/day for six months. To solve his infertility problem, the couple decided to undergo for a testicular sperm extraction by punction-aspiration (TESA) and subsequent intracytoplasmic sperm injection (ICSI). A twin pregnancy was conceived after one cycle of ICSI. Due to car accident, he had a cranial trauma and a cerebroespinal fluid fistula was produced. An endoscopic transnasal transsphenoidal was proceeded to the sealing of the fistula and the subtotal resection of the tumor was performed. Bromocriptine treatment was kept 10mg/day. Patient had a normal sexual activity, ejaculation and orgasm after 3 months surgery. Comments and Conclusions: The incidence of anejaculation is low, 0,14% in general population and of 0,39% in men who consults sterility problem. Although the prolactinoma is an uncommon but treatable cause of anejaculation, the prolactin should be measured in any man presenting with anejaculation.
SEXUAL EDUCATION TO OLDER PEOPLE A.D. García Rojas Universidad de Huelva, Huelva, Spain The Classroom Experience is a joint program of the University of Huelva and the Ministry for Equality and Social Welfare of the Government of Andalusia, to promote social and cultural development of people over 55 who are not enrolled in regulated education university. In the 2008/09 presented the project of the subject "Sexuality, gender and relationships" to serve on the Curriculum Classroom Experience, being accepted in the call. Objective: We are used to refer to the sexual experiences of women and men between the ages of youth and adulthood, stretching more for men than for women. This subject aims to raise "another speech," another way to understand, accept and experience sexuality. This is "the value of being and living" as a woman or man, with different desires, desire to be accompanied, to be valued for what it is, feel desire to touch and be touched, caressed, fantasizing possibility for I fantasize that once lived, currently live and want to live. Method: The methodology is active and participatory at all times encouraging reflection and discussion of the students argued. For this, the teacher assumes the role of motivator, and facilitator of learning dynamic. They use different teaching resources (videos, magazines, newspapers, advertising, case studies, etc.). Results and Conclusions: The subject has gone through all the offices of the Classroom Experience at the University of Huelva, forming part of the core subjects of the curriculum, it is currently the highest rated and most requested by students.
THE UNESCO CHAIRE: SEXUAL HEALTH AND HUMAN RIGHTS MISSION, OBJECTIVES AND PERSPECTIVES A. Giami 12 11NSERM U 1018, Paris, France,2 Unesco Chair The Unesco Chair was created in December 2010 under the initiative of late Dr Marc Ganem. After his death, Dr Troussier, Chairperson & Dr Giami Scientific Director, were appointed by the Unesco and the University Paris-Diderot to take charge of the Chair. Chair mission The Unesco Chair mission is based on the promotion of Sexual health and Human rights, free choice for individuals and prevention of sexually related health risks. The major objectives are to increase awareness and provide education on sexual health, among health professionals and build an international policy. Chair sustainable goals Advancing training and research in institutions of higher education to train health professionals (MD, nurses, educators, midwives) and also "relational professionals" such as ecclesiastics, police, legal professions to deal with sexual issues when presented to them and when they are involved in this kind of situation (sexual abuse, sexual crimes, etc.). Most of these professionals have received no training about sexuality and they are not aware of their personal and ideological attitudes towards sexuality, which interfere with the accomplishment of their mission and the benefit of their patient. Chair work process - Educating and increasing awareness and competence among health professionals - Implementing innovation centers: networks of health professionals and NGO's to develop Sexual health and Human rights promotion - Building university networks "UNITWIN network" and cooperation through transfer of knowledge - Upgrading to Excellence Centers: developing research, validation of experience and confrontation between sites - Elaborating international recommendations based on experience and evidence The lecture will present in details the mission of the Chair and its objectives: academic, professional and political. A MULTILINGUAL OPEN ACCESS ONLINE CURRICULUM IN SEXUAL HEALTH E. Haeberle 1, A. Pacheco Palha 2 1 Archive for Sexology, Berlin, Germany 2 University of Porto/ Saint John University Hospital, Porto, Portugal The Archive for Sexology, following WHO guidelines, has created a multilingual “open access” curriculum of 6 courses (6 semesters) for the internet. The complete curriculum is available in English, Chinese, Russian, Czech, and Hungarian. It is also partially available in 6 other languages. Using an ongoing translation into Portuguese as a model, other features of the online Archive will also be presented. Its wider implications for e-learning and the “open access” movement will be discussed. With monthly over 10 million hits (over 400 000 visits) in over 200 countries, the freely accessible curiculum is now the world’s largest sex education project.
NEW INSIGHTS ON FEMALE EJACULATION E. Jannini 1, A. Rubio Casillas 2 1 University of L’Aquila, L’Aquila, Italy,2 Universidad de Guadalajara, Guadalajara, Mexico Introduction: Although there are historical records showing its existence for over 2000 years, the so called female ejaculation is still a controversial phenomenon. A shared paradigm has been created that includes any fluid expulsion during sexual activities with the name of female ejaculation. Aim: To demonstrate that the “real” female ejaculation and the squirting or gushing are two different phenomena. Methods: Biochemical studies on female fluids expelled during orgasm. Results: In this case report we provided new biochemical evidences demonstrating that the clear and abundant fluid, which is ejected in gushes (squirting), is different from the real female ejaculation. While the first has the features of diluted urines (density: 1001.67±2.89; urea: 417.0±42.88 mg/dl; creatinine: 21.37±4,16 mg/dl; uric acid: 10.37±1.48 mg/dl), the second is biochemically comparable to some components of male semen (PSA: 3.99±0.60 x 103 ng/ml). Conclusions: Female ejaculation and squirting/ gushing are two different phenomena. The organs and the mechanisms that produce them are bona fide different. The real female ejaculation is the release of a very scanty, thick and whitish fluid from the female prostate, while the squirting is the expulsion of a diluted fluid from the urinary bladder.
MEDICO-LEGAL SEXOLOGY R. Hernandez Serrano 1, F. Navarro Cremades 2, A. Parra Colmenarez 3 1 Universidad Central de Venezuela, Caracas, Venezuela,2 Universidad Miguel Hernandez, Alicante, Spain,3 Federación de Psicólogos de Venezuela, Caracas, Venezuela Medico Legal, related to Human Sexuality issues are so frequent in Justice Courts. After 40 years of experience in this subject we present the main issues in Latin America regarding the main concern areas: 1. Virginity determination. In Venezuela forced marriage is a way to arranged sexual relations with minors ( under 18 years old ). 2. Paternity Determination 3. Use of DNA in criminal and civil cases 4.Sexual Identity Disorders 5.Sex Reassignation 7. Transexualism. Sex Legal Change. 8. Compulsory Paraphilias treatment 9. Child Sexual Abuse. Victim and Offender Treatment. Kristy Houses and Shelters. 10.Sexual Violence. Rape,Passional Crimes 11. AIDS. Treatment and Couples participation and counselling 12.Informed Consent 13. Human Sexual Rights Treatment and Standards of Care 14. Civil cases: Marriage ,Separation and Caution Issues. Sexual Incompatibility Peyronie Disease Medical Mal Praxis The Law differences according countries legal systems complicates this issues. However we must establish some guidelines in order to avoid Human Sexual Rights violations. Cultural differences are also a very important factor to consider. Clinical and empirical experience is there. Lets make comparisons.
SEXUAL FUNCTION (EVAS): A NEW BRIEF SCALE P. La Calle Marcos 1, I. Fernandez Agis 2, L. Serra Duart 3, R.C. Liñan Baena 3, M. Garcia Cantero 3 1 Dep. Ginecologia Y Obstetricia Ch Torrecardenas, Almería, Spain, 2 Dep. Neurociencias. Universidad De Almería, Almería, Spain,3 Dep. Psicología Social. Univ. De Sevilla, Sevilla, Spain We present Evas-M, a new scale, as seen need of a quick and easy tool for screening and management of female sexual dysfunction in medical practice. This is a short scale consisting of seven items that assess six main domains of female sexual activity. We tested first psychometric properties and reliability on a sample of 144 women obtaining a coefficient Cronbach’s alpha of 0.66. We found a correlation between total scores on the scale and the clinical criteria of 0.586, which is adequate evidence of the validity of the scores of EVAS-M with a statistically significant prognostic capability (R = - .208, Wald X2 = 16.876, p <.001) and a predictive accuracy of 76.1%. We conducted a cross sectional study in a gynecological center of Madrid and we found that prevalence of sexual dysfunction was 7.9% in a population of 620 users who answered all items of questionnaire. Domains most frequently problematic were sexual interest (11.89%) and satisfaction (10.43%). The domain more predictive of sexual dysfunction was difficulty in subjective sexual arousal (PPV 78.1%). Orgasm, pain and sexual interest are related to sexual response (subjective arousal and lubrication) while satisfaction is evaluative domain. In this conference will also present preliminary data validation EVAS- H, version for men.
ULTRASOUND IN THE ASSESSMENT OF FEMALE SEXUAL FUNCTION P. La Calle Marcos 1, M.A. Herraiz 2, P. Coronado 2, J. Montalvo 2, I. Fernandez 3 1 Dep. Ginecologia Y Obstetricia Ch Torrecardenas, Almería, Spain, 2 Dep. Ginecología Y Obstetricia Hu San Carlos, Madrid, Spain, 3 Universidad De Almería, Almería, Spain At the present ultrasound is an essential complementary procedure in urogynecology and therefore in sexual medicine. Perineal or introital ultrasound allows anatomical and functional assessment of the lower urogenital tract. Main utility of this technique is uretral and parauretral pathology diagnosis and as test to value corrective surgical interventions. Perineal ultrasound linear probe through the clitoral artery velocimetry can assess changes in postoperative genital response or efficacy of drug therapies (Caruso, 2006, 2009). However, the genital flow, particularly sexual lubrication has been poorly studied despite that originate structures are clearly visible to ultrasound-vaginal introitus. Recently the glands of ‘female prostate’ have been described by MRI showing that the volume ranged between 2-4 cc in 85.7% of patients with any signs or symptoms suggesting paraurethral secretion (Wimpissinger, 2009). We reported two studies in which ultrasound is associated with genital discharge report. Both studies found a significant association between the perception of women flow and quantity of paraurettral and paravatinal areas anechoic images anechoic. It was also found association between less anechoic images and vaginal dryness in menopause. Nowaday we try to demonstrate the change in urethra volume of the urethra during sexual response of women. Early data suggest that there is a slight increase in size perhaps due to the strong muscular sheath of urethral sphincter. Ultrasound can contribute to debate about anatomy and physiology of erectile female system.
GENOME SEXUAL POLLUTION AND SEXUAL PRACTICES G. Llanos De Ordonex Ecuasex, Quito, Ecuador The sex chromosomes are the first structure of sex.Like all multicellular sexed beings, the human being begins life and history at the time of the union of gametes, sperm and egg, 2 sexually differentiated cells from each other. Each cell has half the genetic material carried by the body’s normal cells. They are different from one another genetically, even those from the same individual. If a sperm carrying an X sex chromosome is attached to the egg, the sex of the resulting cell is female: XX. If a sperm carrying a Y sex chromosome joins the egg, the sex of the resulting cell will be male: XY. Environmental influences the genetic structure of the adaptation processes. In the phylogenetic scale continue sexual differentiation marked by the intrinsic factors that determine a specific chromosome take responsibility for sex determination. It is estimated that the Y chromosome has undergone over evolution genetic deletion does lose much of their genetic material to the Y chromosome with reduced size. The risks are greater now because the virus is very common. It can be transmitted through oral sex and both men and women to become infected. There is increasing oral cancer and more than 25% of cases are linked to HPV. As bleak forecast advocate the need to create vaccines not only for women but for men and demand the need to implement sex education programs in order to prevent viral contamination especially by inadequate sexual practices increasingly common as oral anal group sex and multiple partners.
NON-TRANSMISSIBLE CHRONIC ILLNESS AND SEXUAL FUNCTION M. Lucas Matheu Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.) Objectives: Understand the consequences of non- transmissible chronic illnesses on sexual health. And in turn, comprehend the impact of sexual health on the development of chronic processes. Additionally, learn the implication of attention to sexual health in the protocols of the healthcare processes of chronic diseases. Desing/method: Analyze the different studies on the prevalence and origin of sexual dysfunctions that occur in the principal and most frequent chronic diseases that can affect the organ systems which are involved in sexual response physiology. Analyze the different care protocols of chronic conditions in the Andalusian Public Health System (Spain) to see to what extent attention is paid to sexual health. Results:The prevalence of sexual dysfunction is higher in chronic processes which involve organs and functions that are actively involved in sexual response physiology: nervous system, cardiovascular system, endocrine and metabolic system and genitourinary system. Attention to sexual health is only anecdotal in the protocols of care for healthcare processes of chronic diseases. Conclusion: The high prevalence of sexual dysfunction in chronic illnesses implies the need for care protocols for all of these diseases. Where attention to sexual health is treated as an important element of rehabilitation and improvement in their treatment.
SEXUAL EDUCATION TRAINING IN VIRTUAL WORLDS M. Lucas Matheu Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.) Objective: Sexology is a science which has always been averse to the non-physi- cal, to the amputation of the sensorial and therefore to any training that is not face-to-face. Desing/method: In conjunction with Iavante, sexology professionals have explored virtual sexology training - initially using online platforms, which has enabled access to sexual health training to a large amount of health professionals (2,400 in four years) - and later in the training of a more select minority of sexology professionals in Second Life.?Second Life is a virtual 3D space which allows intense interaction ba- sed on the creation of objects, actions and structures. This interaction is carried out via an avatar that represents the user’s “second self”. Iavante proposed that we carry out a pilot experience using this virtual space and SEIS (Spanish Society for Intervention in Sexology) accepted the challenge, which initially presented many unknown factors and also great creative potential. Results: This is a working in progress. The experience was very enriching for all involved: authors and creators, teachers and students. Despite the te- chnical difficulties related to learning how to use this virtual space and the IT problems with the PCs of some participants, the possibilities for innovation, creation and imagination provide opportunities for creating training scenarios which would be impossible in the real world. Conclusion: The experience opened new fields for teaching activities and combi- ned with on-line training and classic face-to-face sessions, constituted another innovative experience in sexual health training.
EMOTIONAL And SEXUAL dependence A.S. Mansukhani Instituto Andaluz de Sexología y Psicología, Malaga, Spain Introduction: Interpersonal dependence is a major problem from a clinical and social point of view. To the subjective pain suffered by people in disruptive relationships, we have to add the suffering that arises from comorbility of emotional dependence with other clinical problems such as gender violence, substance addiction or sexual dependence, to all of which it is closely related. If we sum up the amount of patients that consult due to emotional dependence directly and those in which this condition is an underlying feature (such as substance addiction, anxiety problems, depression or PTSD) it’s clear that emotional dependence is a condition that health professionals in general and mental health professionals in particular have to know how to asses and treat. At the same time, we observe a lack of integrative models from which professionals can handle this condition. Aims: Our aim in the present conference is to provide mental health professionals with a integrative model, as well as with specific techniques and tools, to asses and treat emotional dependence. Method and Results: After revising the existing scientific literature on interpersonal dependence and major mental health theories relevant to understand this condition (like Attachment Theory, EMDR-AIP, or Structural Dissociation Theory) and based on our case experience, due to more than 15 years working at the Instituto Andaluz de Sexología y Psicologia with this type of cases with a multidisciplinary approach, we will outline a comprehensive and integrative framework to understand, assess and treat interpersonal dependence.
PREMATURE EjACULATION 2012. QUO VADIS? J. Martinez Salamanca Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain Premature ejaculation (PE) is recognized to be one of the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition. Since several years ago we have different treatment options including oral drugs r behavioral therapies or off-label medications. This talk will focus on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.
ERECTILE DYSFUNCTION AND METABOLIC SYNDROME I. Moncada 1, M. Lemos 1 Hospital La Zarzuela, Madrid, Spain Objective: To explore the connection between erectile dysfunction and metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance) which often occur in men with low testosterone levels. Erectile dysfunction is multifactorial and with increasing age is predominantly associated with vascular disease and endothelial dysfunction. However, adequate testosterone concentrations are important for normal sexual function and lower levels affect the central nervous system and peripheral penile erectile mechanisms. Studies suggest that a high proportion of men (~52%) aged 40-70 years have some degree of ED and that approximately 10% of men with ED also have lower than normal testosterone levels. Metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance) occur in men with low testosterone levels. Age-related decrease of testosterone has been well known for many decades, but has only recently attracted considerable interest. The reason for this change has been the understanding that testosterone decrease impacts negatively on the sexual functioning of the male but equally it affects many organs with the presence of a number of co morbidities. In fact, the physical symptoms of testosterone decrease are far more dramatic than the impact on sexuality. Conclusions: Erectile dysfunction can be a warning sign that should lead us to investigate the possibility of low testosterone levels which in turn are directly related to metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance). Keywords: testosterone deficiency, erectile dysfunction, metabolic syndrome.
F. Navarro Cremades 1, R. Hernández Serrano 2, J. Rodriguez Marín 3, P. Vinci 4 1 Faculty of Medicine UMH. Departament of Clinical Medicine, San Juan (Alicante), Spain,2 Central University of Venezuela, Caracas, Venezuela, 3 Faculty of Medicine UMH. Departament of Health Psychology, San Juan (Alicante), Spain, 4 CMT Association. Italy, Rome, Italy Objective Main: To describe and to discuss the sexual rights as parts of the human rights (HHRR) in connection with the human values of dignity, liberty and equality of the natural person, relating the human and sexual rights with the legal system (mainly the european legal system). Objective Secundary: To define and to evaluate the presence of the triadic construction Law-Sexual offender-Victim, mainly from a forensic and penal point of view. Design and method Using a social sciences methodology of legal technical opinion including the access to main legal sources and related psychological and sexological aspects, rationally interconnected. Results: 1.Sexual rights are described as parts of the human rights (HHRR). Human rights are recognized in national and European (as EUCFR) laws, international human rights documents (as UDHR) and other. HHRR include the right of all persons to sexual health, sexuality education and its legal recognition (as the National Constitutions and European Treaties). 2. Its current protection (mainly by the penal system) presents differences within the different countries mainly regarding to the sexual offender and the victim. Conclusions: 1.Despite the recognition and the protection of human and sexual rights by the International standards and national Law systems its effective satisfaction is far of the general harmonization of these rights at a desirable top level. 2. Is need to enhance the prevention function of the penal system; and the sexual offender’ rehabilitation and the full assistance to the victim, including the broad forensic aspects.
A. Pacheco Palha University of Porto/Saint John University Hospital, Porto, Portugal The main purpose of this lecture is to try to define some sexual problems of diabetic patients, to stress the importance of a better attention to their problems by the health professionals, and to insist in the implementation of a biopsicosocial approach to them. It is present the socio psychological impact of this chronic disease and its consequences at somatic and psychic levels. It is comments the results of studies on the sexual health of diabetic patients and some data of an portuguese outpatients sexologic clinic.
THE NON-SEXUAL FUNCTIONS OF SEX W. Pasini AISPA, Milan, Italy For many centuries, sex was considered indispensable for procreation. Later on, sexuality was considered helpful for eroticism. Many people make sex for other reasons. Sexuality has many therapeutic functions: sleeping drug, tranquillizer, antidepressant. Sexuality serves to reinforce the identity and is a good way to communicate. Sexuality makes money for some people and is a good vector of publicity. C. Pol Bravo Central Médica de Sexologfa - Colombia, Bogota, Colombia The clinical and academic significance of new knowledge is always well-founded. It is necessary to enrich our experience, even more in medical sexology, since, through disinformation and lacking education, much is done without knowledgeable directions. Venus, embodying the woman herself, has always sought for knowing her body, her sensitivity, her sensuality. In contrast, the negative millenary transculturality has tried to prevent this. New legitimate academic, non-moderating theories are adequate. Ernst Grafenberg, father of the IUD, spoke first of this pleasure core, which later Beverly Whipple called G-point. Nevertheless, Aristotle considered the existence of the female ejaculation, and the currently called G-spot. The thesis and its antithesis, unveiling legitimate concepts, confirming and denying the existence of the G-spot, connect with the physiological function of the feminine ejaculation, prime fundament of women’s sexuality, as the studies of Dr. Cabello Santamaría show. The G-spot is still bound to its embryological origin, as the extension of the clitoris. The G-spot neurophysiology and its concept of erogenous sensitivity, stimulation and potentiators confront quiet actualized terms. Within the antithesis, myths, legends, and clinical and socio-cultural aspects drive to conclusions that prevent its universalization. Even less should it be turned into the greatest possible factor of feminine pleasure, preventing misunderstandings and frustrations in the woman seeking for the Venus’ dream, and her partner. Sex is not only physiological pleasure, but desire, tenderness, education and communication, among other indispensable factors for the optimal sexual quality of life of women and for the couple. The controversy is open.
UPDATE ON THE CLINICAL MANAGEMENT OF TESTOSTERONE DEFICIENCY SYNDROME (TDS) J. Pomerol Monseny Instituto de Andrología y Medicina Sexual (IANDROMS), Barcelona, Spain TDS id defined as a biochemical syndrome associated with advancing age and characterized by a deficiency in serum androgen levels with or without a decreased genomic sensitivity to androgens. It may result in significant alterations in the quality of life and adversely affect the function of multiple organ systems. According to different studies, the prevalence of TDS varies between 2 and 40% in men older than 40 years of age, being more frequent in the last decades of life. The most frequent signs and symptoms of TDS are: reduce libido, erectile dysfunction, gynecomastia, loss of body hair, reduced muscle mass, decreased energy, depression, poor concentration, increase body fat, lowered bone mineral density and mild anemia. The diagnosis of TDS is based on clinical symptoms and biochemical serum investigations ( total T, calculated free T, FSH, LH and prolactin). Testosterone replacement therapy (TRT) should be considered when clinical complaints are accompanied by decreased hormone levels. Transdermal T gels and patches applied daily or to alterning days, as well as intramuscular injections (Testosterone undecanoate) every 3 months are the TRT used more frequently. Currently available preparations of testosterone are safe and effective. The presence of prostate cancer or male breast cancer is an absolute contraindication for TRT. The follow-up of the treatment has to be done every 3-4 months and later once a year, by means of biochemical serum investigations (hormonal, lypidic profile, PSA) and digital rectal examination.
CLINICAL CASE: ERECTILE DYSFUNCTION R. Prieto Castro Andrology Unit. Hospital Regional Reina Sofía, Córdoba, Spain A 66-year-old patient, who comes to our office sent by Reumatology Service, because of an erectile dysfunction for 4 years. To stand out in his personal history: -No Allergies -Obesity -Hypercholesterolemia -Osteopenia -Severe depression in treatment with SSRI and Lormetazepam for 2 years -Hip fracture with placement of prosthesis 1 year ago -Smoker (40 cigarettes daily). No alcohol. Current Disease: He recounts inability to achieve an erection with enough quality to penetrate for 4 years, with a slow and progressive beginning. He is only able to get certain degree of tumescence. There is an absence of morning and night erections and he does not get erection in special situations. The patient has diminished libido and it makes him depressed. Clinical Examination: -Obesity - abdominal perimeter: 165 cms. -Genital examination (penis and testicles) without alterations. Rectal exam: volume I-II/IV without signs of pathology. -Femoral and pedis pulses are present with normal extent. Complementary Examinations: -Blood test: Glucose 237 mg/dl Cholesterol 291 mg/dl Triglycerides 358 mg/dl Insulinemia 22 mU/L Haemoglobin A1C 10.8% Testosterone 1,50 ng/dl PSA 4,6 (total PSAT/free PSA: 23% ) -Urine and semen culture: negative -Prostate biopsy: glandular hyperplasia with areas of chronic prostatitis. What can we do with our patient? We start the treatment with Testosterone and the patient was referred to the cardiologist without iPDE5 treatment, because we considered this patient had an intermediate cardiovascular risk. Later, the patient underwent a cardiac catheterization, which demonstrated a critical arterial stenosis with 3 stent placements. Comment: With this information, we must think about the METABOLIC SYNDROME and a DEFICIT OF TESTOSTERONE SYNDROME. a) Metabolic syndrome according to the WHO. Criteria: The WHO indicates that is needed the presence of Resistance of insulin and / or alteration in the glucose tolerance for the diagnosis of Metabolic Syndrome. To this one, it must be added at least two of the following: arterial hypertension, dyslipidemia, obesity, microalbuminuria. It is important to emphasize that the microalbuminuria is for the WHO an important predictor of cardiovascular risk. b) What cardiovascular risks have these patients? According to the information of the study Framingham, the cardiovascular risk for males with metabolic syndrome is between 10-20 % in 10 years and for women would be below 10 %. Therefore, those patients with established Cardiovascular Disease, whom the risk in 10 years is superior to 5 %. (System score) and / or Diabetes, will be considered of high cardiovascular risk and they will receive priority interventions.
PHALLOPLASTY FOR FEMALE TO MALE GENDER DYSPHORIA D. Ralph St. Peters Andrology Centre, London, UK The final stage of gender reassignment in female-to-male gender reassignment is phalloplasty of which there are various types. All patients should be fully counselled, shown photographs of the techniques and, if possible, discuss with patients who have had the various operations. The main objectives are to stand and void, have penetrative sexual intercourse and to have a good cosmetically acceptable phallus. The various types include a metatoidioplasty which involes bringing the urethral meatus forwards to the tip of the clitoris, extending the clitoris to allow patients to stand to void only. Approximately 50% of patients can manage this. A total phalloplasty can be either raised from the abdominal skin (pubic) or from the arm (forearm free flap). The superior phalloplasty with regards to urinary function is the forearm free flap phalloplasty, which has a better cosmetic appearance and is sensate. The urethral complications with this procedure is far less than with the pubic variety, although scars with the latter are hidden below the belt. Both types of phalloplasty will allow the insertion of a penile prosthesis for penetrative sexual intercourse and it is important that an inflatable variety is used, as this will reduce post-operative complications such as erosion. Testicular implants improve the cosmetic appearance as does sculpture of the glans penis to give a reliable looking phallus. Over 200 pubic phalloplasties and 50 forearm free flap procedures have now been performed and the results and complications will be discussed.
SEX EDUCATION AND PEOPLE WITH DISABILITY. TEACHING / PEDAGOGICAL RESOURCES M.V. Ramírez Crespo Asociación LaSexologia.com Provided that the objectives of Sex Education, offering knowledge, procedures and attitudes which allow you to live the fact that everybody has inherent sex characteristics and with reference to the sexological framework of the Human Sexual Fact, we would cover all kind of sexual behaviour and in every period of life. In our presentation we will try that the disabled learn how to express their erotica in such a way that it turns out to be pleasant and their quality of life is improved. We must not forget that Sex Education is not exclusively risk prevention. It is aimed to every kind of people ....men and women , including disabled people, ignoring which their erotica activity is or whether they show interest in it or nor . In the current paper, we will talk about Pedagogical Programs, resources, materials, environment,. adapted to different groups, adapted to people, to every person with disability ( person-centred planning). Design, carrying out and adaptation of materials, resources, support as well as technical help to educate, support and attend to disabled people's sexuality.
SEXUAL QUALITY OF LIFE OF INDIVIDUALS WITH 46,XY DISORDERS OF SEX DEVELOPMENT- RESULTS FROM THE HAMBURG STUDY H. Richter-Appelt Department of Sex Research, University Hospital, Hamburg, Germany There has recently been a growing acceptance that it is not only heterosexual functioning of surgically adjusted genitalia which should be considered when measuring the treatment outcome of persons with disorders of sex development (DSD) but also their overall sexual quality of life (SexQoL). At the Instituts for Sex Research in Hamburg, Germany, a comprehensive cross-sectional investigation of SexQoL of persons with 46,XY DSD was conducted. Forty-seven persons with 46,XY DSD (age 17-60 years) were examined by means of a questionnaire on various aspects of SexQoL. Scores were compared to a nonclinical convenience sample consisting of 145 women. Data were analyzed separately for diagnostic subgroups. Furthermore, persons whose external genitalia had been surgically corrected were compared with persons whose genitalia had been left unaltered. The Multidimensional Scale of Sexuality, the German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS), items on sexual dysfunctions according to DSM-IV-TR and self-constructed measures on sexual-activity history (e.g., previous sexual experience), sexual anxieties, and satisfaction with overall sex life and sexual function comprised the standardized assessment instruments. Compared with the nonclinical group, persons with 46,xY DSD had more often no partner, felt more insecure in social and sexual situations, and were less satisfied with overall sex life and sexual function. Results were inconsistent with regard to sexual-activity history (e.g., previous sexual experience). Participants who underwent genital surgery showed less dyspareunia but more fear of injuries during intercourse than those whose genitals were left unaltered. SexQoL of persons with 46,XY DSD may be impaired. Differences in SexQoL between diagnostic subgroups, effect of corrective genital surgery, and the influence of gender assignment will have to be further investigated in future studies.
AWARENESS AND KNOWLEDGE IN SEX EDUCATION R. Rossi 1, L. Pierleoni 1, V. Cosmi 1, C. Simonelli 2 11nstitute of Clinical Sexology, Rome, Italy,2 University “Sapienza”, Rome, Italy Objective: The boundaries between different models of sex programs are not strict and mainly depend on definition and strategies of application. The evidence based research shows that integrated sex programs have positive effects on: relevant knowledge, awareness of risk, values and attitudes, self efficacy, and intentions. On the other hand, traditional sex education programs lent to focus solely on student acquisition of knowledge not involving any skills development related to that knowledge. This work describes sex programs characteristics as focused by the Standard for Sexuality Education in Europe, comparing different kind of them; also, pays attention to gender variability in the acquisition of awareness and knowledge of school-going adolescents. Methods: A brief and focused literature review on this matter was made. We selected sex education models based on different type of programs in developing and developed countries, with a specific focus on gender difference. Results: Many studies on adolescent sexual behaviour found that the rate of sexual intercourse increased for both genders as age increased. Sex programs are often based on strategies male focused and do not extrapolate well to young women who face pregnancy risk and rigid social gender norms which rule sexual behaviour. The main difference between developing and develop countries is the lack of information for the firsts and that knowledge does not always translate into behavioural change in the seconds. All over the world, school is the institution attended by most young people on regular basis, but in developing countries, not all youth ever attend school and not all youth remain in school until they initiate sex. Conclusion: A comprehensive approach to effective sexual health education emphasizes the shared responsibility of the community including parents, peers, places of worship, schools, health care systems, governments and the media. Educational basis for the programs asserts that learning follows from action. The students need to actively participate in role-play situations simulating those that they are likely to confront in the real life. Also, it may be interesting, for future studies, focus on behavioural outcome changes.
ATTENTION, EDUCATION AND PROVIDE SUPPORT SEXUALITY PEOPLE WITH DISABILITY N. Rubio Arribas 12 1 Fundación Aspanias, Burgos, Spain,2 Asociación Estatal Sexualidad per Discapacidad, Spain The sexuality of disabled people is a fact, ignored in many cases. In this presentation it is intended to take it back to the place it deserves, which is the same as the rest of sexualities. In order to get it, apart from offering theoretical contents about sexuality and disability, strategies will be offered onhow to tackle situations where the sex fact goes into action, and in front of which silence or ignorance is useless: questions, behavior, demands, needs, The current proposal of intervention in Sex Education for disabled people is all part of the State Training Plan in Sexualities and Disabilities. A program aimed at and adapted to all kind of Disabilities (Intellectual Disability , Cerebral Palsy, Acquired Brain Injury, Mental Illness, Sensorial Disabilities: visual and auditory, Physical Disability, Autism and ADSs,...) for all kinds of people. With the nuances and peculiarities of every Disability case, for every age and evolutionary moment, with their needs, intensity and frequency in support. It is intended not to forget any kind of sexuality or evolutionary stage. We consider from childhood to adulthood and from those people who need a higher frequency and intensity in support to those ones who may get a more autonomous life. It is taken for granted that when confronting the sexuality of disabled people, it is not ignored the role that families play as well as the essential coordination among professionals and other mediators such as volunteers. Its objective is to make interventions transversal in an easier way. Our participation is always directed to the fact that the disabled person , the same as any other person , learns to get to know themselves, to accept themselves and to express their sexuality in a pleasant way.
MAPPING THE SEXUAL REVOLUTION OF EUROPEAN YOUTH C. Savoie Pérez Statal Federation of Lesbian, Gay, Transexual and Bisexual, Madrid, Spain Time, youth, the ways we express ourselves and also the ways we manage our sexuality have changed. This has had an influence on how young people have taken care of our own sexual health, so right now, it is our turn to reflect on the mistakes and the achievements of our predecessors, to analyze the present situation of our sexual health as European youth and design the guidelines for an unprecedented sexual revolution, to be a milestone in our sexual health. This speech means the start of that cartography process, just notes to be taken into account in the sexual revolution that is supposed to be led by the European young people to make us visible, to empower ourselves and to take the reins of our sexuality to make a necessary change on the way we handle the prevention and de promotion of our sexual health.
CLINICAL CASE: PREMATURE EJACULATION A. Segura Paños Adrology Unit. Hospital General Universitario, Alicante, Spain 34-year-old patient, without history of illness, who comes to our office for Primary Premature Ejaculation. He told us he used to ejaculate before or immediately after penetration. He had no problem with his erectile function nor with the rest of sexual sphere (libido and orgasm). Sexual History: The beginning of his sexual relations was at the age of 16. Steady partner for 6 years. They had not desires of descendants and used feminine hormone pills as a birth control method. Sexual relations were frequent: every 15 days. Physical Exploration: General and genital exploration without outstanding findings. Diagnostic and Therapeutic Plan and Evolution: The patient underwent treatment in other medical clinic. He was prescribed Imipramine 75 mg. There was a clinical improvement (delay of the ejaculation to 15 days of the beginning of the treatment) but with side effects (hand quake), which lead him to leave it. Furthermore he went to see a sexology specialist, following a therapy during 3 months without clinical improvement. When he came to our consultation, we advised him to start treatment with Dapoxetine 60 mg on demand and to increase his sexual relations frequency. After 2 months of treatment with 2 weekly pills, he stops again the treatment due to side effects, like nausea, general discomfort and stress for loose of spontaneity (to programme the relations). Then we stopped Dapoxetine and we began with Sertraline 50 mg (1 pill daily) for 4 months with good medical response. After 6 months of non-stopping treatment, we initiated Sertraline withdrawal and restored Dapoxentine 30 mg on demand, with good clinical evolution at this time.
YOUNG SEXOLOGISTS: WHERE WE COME FROM? WHERE ARE WE GOING? C. Silvaggi Institute of Clinical Sexology/ “Tor Vergata” University,, Rome, Italy The 90s of last century saw both the beginning of the “Viagra era” and the evolution of the debate to overcome the biology- culture dichotomy through a paradigm shift to a broader interdisciplinary study of human sexuality. The failures derived from sequential approaches and the sharp division of languages and skills of different specialists, have increasingly led professionals to suggest treatments of sexual dysfunction involving the integration of models and techniques. Combination or integrated treatment is the logical extension of the biopsychosocial model. In spite of a growing demand for help in the sexual field, there is paradox regarding the professional figure of the sexologist. In many European countries neither a specific university degree nor a professional register exists, so the position of the sexologist is that of title without legal protection. Even more at risk is the status and professional practice of sexologists who are not physicians. Sexology sometimes appears as a part of some specialization courses in the Faculty of Medicine, or as an exam in the Faculty of Psychology. Therefore, professional training in this field is traditionally left up to the initiative of private institutes or associations, that “independently” establish the training requirements for the figures of sex educator, sex counsellor, clinical sexologist or specialist in sexual medicine. Establishing standard criteria of appropriate training is therefore another important challenge that the most prestigious sexological associations are still facing.
INTEGRATIVE APPROACH C. Simonelli “Sapienza” University of Rome, Rome, Italy Challenging perspectives on integration are the future of sexology. The available evidence in our Federation about different experts working together is a great resource for 3 different but connected areas: clinical work, research and training/education. During the past three decades, integration in sexology between specialists, models and intervention techniques has decidedly increased, both in clinical practice, in educational programs and in international research contributions and guidelines. The training of the sexologist, a figure often not officially recognized in spite of growing client demand, is still a critical issue. The Italian situation through more than 20-year experience of Rome’s Clinical Sexology Institute in training doctors and psychologists, is a very special experience strictly connected with clinical work both in a private and in a public context. Adjournment and research of the ICS team serves as a natural basis for transmitting flexible theoretical and technical knowledge, as required by the integrated approach. We have to underline the limits and resources of this approach, a modality which ideally takes into consideration and puts on the same level of importance body, mind and relationship. This model allows targeted and tailor-made interventions but, at the same time, this flexibility can also be a weakness: without any standard protocols the risk of errors can be higher, even if that could be limited by appropriate training of experts. Progress and selection of the clinical options allow clinicians to combine both psychotherapeutic and medical practice and the evidence base for such a combination of approaches will be challenged. Frequent dialogue and confrontation with other important scientific societies in the field seem necessary for a fruitful future of sexology. Currently in Madrid we will share this great opportunity. workshop abstracts
SEXUAL TECHNIQUES USED IN MEDICAL SEXOLOGY. STATE OF THE ART FJ. Bianco Colmenares CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela 27 techniques used in the treatment of Sexual Disorders are described. Each Technique is approached as follow: Author(s) Definition Constructs Fundament Objective Methodology Evaluation Indications Contraindications Observations Recommendation Bibliography Among the Techniques described are: Perineal muscles exercises, Observation, Vaginal Blind Exploration with Dilatation. Little Paper Technique, Digit Palmer Auto Massage Technique, Coitus program, Orgasmic Channing, Mirror Technique. Each Technique will be demonstrated and practice by the attendance.
ORGASMIC CHAINING FJ. Bianco Colmenares, R. Cardenas, B. Baena, C. Quijada, E. Mejias, E. Pazmino, M. Guache, S. Guevara, P. Correa, J. Rivero CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela Objective: To teach women to have an orgasms using the pubococcygeal muscles, the pelvic movements, the respiratory rate and verbalization. Design and Methods: 20 women with orgasmic dysfunction were taught the Orgasmic Chaining Technique and compare with 20 women that achieve orgasms regularity that learn the Orgasmic Chaining Technique.. A Electrovaginogram was taken prior, during and after the experimental process. Results: 8 women with orgasmic dysfunction syndrome learn to achieve orgasms, using the Chaining Technique. They improved their pubococcygeal muscle strength, the coordination of the pelvic movements, the respiratory rate and the vocalization. Conclusion: Is possible to obtain and improve the orgasmic phase of the sexual response using the Orgasmic Chaining Technique. The electrovaginogram is an acceptable tool for the measurement of the strength of the pubococcygeal muscles.
SEXO SABIO - WISE SEX A. Bolinches i Sanchez Institut Psicológic Antoni Bolinches, Barcelona, Spain Wise Sex is not just the title of one my best known books. It is also the summary of a sexual behavior model that allows keeping sexual interest within the stable couple context for longer than if the model were not applied. To accomplish such effect, one must practice sexuality from a relationship model that allows decreasing risk factors that inhibit sexual desire in long-term relationships. The most relevant risks are saturation in the initial phase of the relationship, and routine and paraphilia after the third or fourth year of living together. To lessen their harmful effects we propose three major strategies. First, to always practice sexual intercourse from the golden rule created by the author. Second, to know and correctly apply the four principles that make a good sexual attachment possible. And third, to incorporate in a self-regulated, desired, and mutually consented way the adaptive paraphilic variants that maintain sexual interest.
APPROACH TO THE EXPERIENCE OF PREGNANCY, CHILDBIRTH, POSTPARTUM WOMEN BLIND OR VISUALLY IMPAIRED M. Chacón Sánchez 1, E. Sanchez Raja 1, M. Honrubia Perez 2 1ANSSYD, Barcelona, Spain,2 UB, Barcelona, Spain Objectives: • Meet the experience of pregnancy, birth and puerperium in women with disabilities visual. • Discuss that information get in pregnancy, childbirth and puerperium. • Describe sources of information. • Assessing satisfaction Method: Qualitative methodology Phenomenology. Women with visual disabilities from 17 to 44 with one child from 0 to 4 years, associated with the National Organization for the blind in Barcelona (ONCE). Collection of data with semi-structured in-depth interview: experiences and perceptions with regard to pregnancy, childbirth, and postpartum period. Information received, sources of information and degree of satisfaction. Interviews recorded and transcribed. With the results on a report on the needs of these women. Results and Conclusion: Pregnancy: concern about the stigma of disability in his son, fear of having a baby with Visual problems, not knowing how to take care of the baby, loneliness and lack of support without a partner. Limitation of autonomy at the end of the gestation. All with a less satisfactory experience. Birth: Emotion in the expulsion, fear of pain, early nervousness decreases when advances dilation, anxiety to find one before delivery, need to explore the baby reborn to internalize his image, lived as a traumatic birth. Postpartum: 1 woman was found badly after being in the room, alteration in the welfare and comfort, unpleasant lack of information. They had not received enough information during pregnancy, childbirth and puerperium. Different experiences. Sources of information: midwives, medical, rehabilitative, nurses, books, magazines, videos.
SEXUALIDAD EN SITUACIONES ESPECIALES E. Cladellas ICS, Canovelles, Spain The main objective: to demonstrate the usefulness of the intervention on sexuality in primary care consultation in person with special situations such as cancer. Sexuality in consultation is still underserved and is one of the most important areas of people, especially in situations of cancer disease. These guidelines and work with women and their partners (workshops on sexuality in women with breast cancer), have motivated my interest to go ahead and research in this field. An analysis of the intervention with brief interview about sexuality and its relation to those diseases that most affect physical and emotional impact to the person. We analyzed the sexuality in cancer: breast, liver, prostate, colon ..). The query is performed from a single i / or with a partner who consults with emphasis on the fundamental aspect of the person and his complaint. The initial focus is medical surge. We aim to detect possible additional problems and often hidden, after a slight or negligible demand for them, which may affect their relationship and sexual function. Presented by PowerPoint. The result shows that addressing the situation allowed them to face the illness with less anxiety and are able to incorporate the world of work or activities of daily living early. Conclusion: a preventive approach allows early action lines for the situation. Patients are informed of the impact it may have sexually, treating it better. The workshops have given excellent results. The intervention from primary care is key, giving normalization of sexual approach in medical practice.
SUB CLINICAL DEPRESSION AND SEXUAL FUNCTION R. Hernández Serrano Universidad Central de Venezuela, Caracas, Venezuela Depression and Sexual Function are extremely related. From clinical point of view to determine which one is first is usually a dilemma. The problem is more severe when you have to make a differential diagnosis with several entities usually not discussed in scientific papers, journals, or textbooks. -Masked depression -Depressive Personality Disorders -Hypotimia and Dysthimia. -Stress Disorders -Anxiety Depression -Mood Disorders due to a General Medical Condition -Substance Induced Mood Disorders: Alcohol, Amphetamines, Cocaine, Hallucinogens, Opioids, etc. -Melancholia -Post partum Depression' -Schizoaffective Disorders -Bipolar Disorders, types I and II DSM IV establishes some diagnostic criteria for some of these entities. However the Sexual Function is generally ignored. The Monoamine Hypothesis of Depression, involving Dopamine, Norepinephrine and Serotonin may be a pharmacological explication of symptoms. This paper establishes the differences between Diagnosis and Treatment of these issues. Ref: Psychiatry and Sexual Health, Mezzich JE,Hernandez SR, WPA. Jason Aronson Ed (2006).
LOOK AT THE SEXUAL AND REPRODUCTIVE RIGHTS IN THE PEOPLE WITH FUNCTIONAL DIVERSITY M. Honrubia Perez 1, E. Sanchez Raja 2, M.D.G. Chacón Sánchez 2 1 University of Barcelona, Barcelona, Spain, 2 University Autonoma Barcelona, Barcelona, Spain - Know the sexual and reproductive rights. - Explain these sexual and reproductive rights of persons with disabilities. - Determine how you can exercise the sexual and reproductive rights. - To involve professionals in the development of the sexual and reproductive rights of the people in their care. Method: From the exhibition on the sexual and reproductive rights there will be mentioned how the persons with disability can request to enjoy a satisfactory sexuality being adapted to the severity grade and like (as) putting at its disposal the necessary mechanisms so that they enjoy her(it). On the other hand it will be exhibited from the current legislation, the duty of the professionals to advise,to educate and to inform about the sexual and reproductive health the persons with disability. Conclusion: The World Health Organization (WHO) in the year 1975 defined and stated the importance of having a satisfactory sexuality in human behaviour. In 2002 extended this statement, adding that it was a health indicator and therefore directly implicate the professionals of the health and education to help their development. In persons with disabilities or in special situations in which their sexuality is altered and denied, increases the importance of having the support of trained professionals to ensure compliance with these guidelines.
CORPORAL DYNAMIC IN MEDICAL SEXOLOGY M. Lucas Matheu Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.) Objective: To define the protocols and therapeutic tools used in the sexual therapy, related techniques of body dynamics. Desing and Method: For four years, discusses the different techniques of body dynamics, they could bring positive effects in sex therapy. A group of 12 professionals of Sexology is a research group in Sexual communication (GICS), which you are in work of experiential groups for 1,100 hours, techniques were lived, analysed and evaluated. Results: Four areas of the body dynamics were identified as really useful for application in sex therapy: bioenergetics, relaxation, body expression and sensitive massage techniques. Techniques of bioenergy for dysfunctions Orgasmic, muscle relaxation and knowledge of the body schema, to vaginismus and premature ejaculation, sensitive massage for hypoactive sexual desire and erectile dysfunction. On the other hand, other techniques, such as many Oriental techniques were discarded. In the case of the Oriental techniques that use isolated, without forming part of a lifestyle, not they considered applicable. Conclusion: Body and mind are often considered to be two separate entities. This is an artificial separation, as the mind - which includes our thoughts, emotions, perceptions and fantasies - is located in the brain and is therefore part of our body, as well. Body dynamics is an essential instrument in sex therapy, to improvements in sexual dysfunctions, in a shorter period of time can be. - - CONTROVERSIES AND CHALLENGES OF XXI CENTURY SEXOLOGY R.M Montaña Hernández 1, J.R Landarroitajauregi Garai 2, E. Domínguez del Brío 3, R. Carbajal Martinez 3 11SESUS (Instituto de Sexología Sustantiva), Valladolid, Spain, 2ISESUS (Instituto de Sexología Sustantiva), Bilbao, Spain,3 Hospital Rio CARRION, Palencia, Spain With more of less accuracy, we come building a New Sexual Order in which we're redefining close and public relationships between sex. Thus, the biggest challenge for the XXI century in the occidentals democracies, is the lack of culture in this new order. This cultural company requires a moral, social, politic and scientific reformulation that allows men and women to coexist, to be respected, to share, to understand... with respect, consideration and valorization. There's no doubt that for arrive at good port in this profit it's essential to invest energy and resources. Therefore, those of us that dedicate to this discipline have some responsibility in offer the culture some kind of knowledge around this challenge. For it, we've to clear ourselves and produce a quality sexology, a discipline that try to understand the sexes, their identities, their differences, their mixtures and their interactions. All this, lead us to the need to resolve our deficits and to aboard some of our controversies. One definition of Sexology could be: “A scientific discipline dedicate to the sex”. The controversy begins at the time to define: “What sex is?, what discipline is?, what scientific is? and what is to dedicate?" The Science has been interested for the three kinds of sexes: a sex “that is”, a sex “that is had” and a sex “that is made”. But there's a way to make a sexology that deserves that name, if this restricts to a “fucklogy”, with its corresponding moral treatment, hygienic, docent and sanitary. Nor that to say that behind this bets underlies an epistemological controversy not resolve yet: “Sexus versus genus”. On a second place, sexology has been define as a: self and specific discipline; an specialization area of an other discipline; an interdisciplinary gap; a multidisciplinary amalgam. Lately has prevailed the “sexological sanitization” to the point that sexology and sexual health have been taken as synonyms. Nor that to say that each one of this produce well opposed results. As much it's that today syncretically coexist the sexual knowledge, the “parasexologic”, the “perisexologic”, the “asexologic” (even the antisexologic”). On a third place, scientific can be understand as a methodological question or epistemological. Thus, can be to consider sexological any study about sex that follows the scientific method; or that one that takes place inside a epistemic frame properly sexological. On a fourth place, in terms of dedication, have prevailed transforming, sanitary and demographic bets over the comprehensive ones. Therefore, we put in front the action over the reflexion, the strategy over the epistemology and to transform over to understand. At last, XXI sexology has to resolve several issues around the singular and plural; it has to bet for the plural sexes, leaving the singular sex, it has to leave the plural sciences, to produce a singular discipline, specific and proper, it has to leave the isomorphy to understand the intersexual multiform” and finally it has to resolve the “sexual centrisms” by means of “intersexual eccentricity.
TREATMENT OF FEMALE SEXUAL DYSFUNCTIONS BY PAIN: VAGINISMUS, DYSPAREUNIA J.A. Navas Expósito Censepsan, Cordoba, Spain Both dysfunctions can be encompass within the socalled disorder of penetration. The vaginismus affects 2-3% of women. Among the women who have sexual dysfunctions, vaginismus is 25 per cent it is estimated that 34 % of women suffer from genital pain in their first.In postmenopausal women the figme is higher than 45,3%. Thetreatment has been evolucionando over time. If there is just cause organic, it should be dealt with. Have multiple media employee teraeuticos from drugs (anxiolytics, botulinum toxin),quirurgicos, sex education with assignement of tasks, hypnotherapy, fooding, sexual therapy with substitutes: but most of us agree that the sex therapy is the treatment for greaten efficiency, in practice consists of a systematic desensitization, which carries the individual coaching.
HOMOSEXUALITY LOOK AT DISABILITY E. Sánchez Raja 1, M. Honrubia Pérez 2, M.D.G. Chacón Sánchez 3 1 ANSSYD, Barcelona, Spain, 2 UB, Barcelona, Spain, 3 ANSSYD, Barcelona, Spain Abstract: The sexual development of people with disabilities evolve in environments where personal relationships are with the family and the professionals who serve them, both from the health aspect as the teacher. Therefore, addressing the issue of affectivity and sexuality is difficult and delicate. General Objective: To explore from the perspective of LGBT (Lesbians, Gays, Transsexuals and Bisexuals) disabled and perceive their sex life. Specific Objectives: 1) Knowing how these people feel about the social environment. 2) To describe sexual behaviour based on their disability and orientation of desire. Design: A qualitative descriptive methodological perspective study from the point of view of ethnography. Study subjects: Disabled LGBT sexual orientation that is associated with the National Association of LGBT disabled. For the ethnographic study will be a sampling LGBT men and women with disabilities. Information collection: It will be through focus group with a semi structured interview that asks to explain how they live and have perceptions about their sexuality. The recorded session was transcribed to establish the categories. With the results obtained is performed a report that can generate knowledge about a topic. Conclusion: Considered asexual beings, the acceptance of homosexuality is much more complex for people with disabilities. Recognize homosexual orientation with a disability is more difficult because of the physical and emotional dependence, greater isolation and a fear of losing the support and affection of parents and carers.
SEXUAL DYNAMICS AND HUMAN SEXUALITY D. Trotta , T. Strepetova ISA, Istituto italiano disessoanalisi, Salerno, Italy, ACTS, Associazione Clinica e Terapia in Sessuologia, Salerno, Italy Sexuality is the final outcome of multiple and interactive force. Among them drive, motivational forces, and wish desire. Forces not necessarily in the same direction: while in some cases they share a common path, in other they are completely in contrast. Conflict are, in many cases inevitable. Psychosexual causes of sexual problems are many. The most common and known among them are the superficial causes, like minor anxieties (i.e. anticipatory negative anxiety and performance anxiety), cognitive behavioral factors or cultural factors. The less common and known are the deep causes. In some cases, specific sexual aspects connected to the identity, to the relationship one individual has with the other man or woman, and to the sexual dynamic, are the basis of sexual disturbances.The sex oriented dynamic approach focuses on the importance of early childhood experiences and aims at determining potential underlying unconscious sources of difficulties. Main areas of interests are gender identity, relation with intimacy, erotic dynamic and pathway. Clinical disturbances. The disturbances range from inability to penetrate to sexual anhedonia, delayed ejaculation or other ejaculatory difficulties, desire disorders and scarce or absent interest for sex and sexual penetration.Gender inadequacy is a feeling of uncertainty and insecurity about sexual identity. Men doubt about their manhood and project their uncertainties on their penises. Fear of intimacy. Fear towards the other sex is normally present, at least at an unconscious level, in every man. Dystonic erotisation refers to an erotic desire not accepted by the individual. It is a condition characterized by having an attraction that is at odds with one's personal beliefs, values and norms. Sex is associated with danger, guilt, shame and other negative thoughts and feelings.
CONNECTING AND FEELING THE SEXUALITY. APPLICATIONS OF THE CHARACTER-ANALITIC PSYCHOTHERAPY J. Vilchez Cambronero Spanish School of Reichian Therapy (Es.Te.R), Valencia, Spain Objectives: The connection with the emotional level is important to reach sexual health and harmony in our relationships. When connecting with the body and being aware of what we really feel here and now, we can transform the consequences of sexual experiences gained in our history. Design and Methods: The Character-Analytic Psychotherapy originates from Wilhelm Reich, and we have continued to develop it in the Spanish School of Reichian Therapy (Es. Te.R.). Using psychological and body techniques, we explore and expand our capacity to feel and connect with ourselves and with others. We loosen up our sexual blocks (energy, emotional, mental, physical and behavioral) and change the way we function. Results: We achieve returning to our natural tendency toward pleasure and love, restructuring and updating our identity, daring to make the changes necessary to overcome internal and external constraints that condition us. Conclusions: We enable creativity and openness to other ways of functioning and find more pleasurable, loving and healthy ways enjoying our sexuality. We help to create more humanized and ecological relationship systems . Keywords: Character-analytic psychotherapy, sex therapy, emotional health, sexual health, human ecology. symposia abstracts
ERECTILE DYSFUNCTION IN EGYPT: COUPLE AND FAMILY PROBLEMS S. Abdel Azim Psychiatry Department - Cairo University Hospital Faculty of Medicine, Cairo, Egypt ED in Egypt is a disorder handled by gynecologists, andrologists, urologists, psychiatrists and psychologists. Patients usually go to andrologists or urologists first where they are treated medically using PDIS or other procedures as ICI up to penile prosthesis, and unfortunately the integration of psychological procedures is not usual with poor referrals. Not all psychiatrists and psychologists are oriented and familiar enough with sexual disorders or know how to manage, as well as many patients are unaware of the role of psychological intervention. In middle and uppder social strata, they often do not seek sexual therapy early enough, deliberately choosing to endure the problem which usually presevere and may grow to mount to marriage failure. The role of families of both partners is important. many cases of vaginismus can me responsible for non-consummation marriage and the negative role of women during the sexual act is as well significant in depicting the nature of the couple sexual relation affecting directly and indirectly the dynamics in between the couple in everyday life.
TRANSGENDER AND ORIENTATION ISSUES IN A MUSLIM COUNTRY S. Abdel Azim Psychiatry Department - Cairo University Hospital Faculty of Medicine, Cairo, Egypt Transgender and orientation disorders are not uncommon in muslem countries, where patients of primary types atart their complaints early in childhood, but not declared overtly; and can be detected later in adolescence. Orientation problems although not accepted in muslem religion and as well among christians in Egypt, no punishment by law except if they are expressed in public. So gay people can socially mix but only covertly. They also come for medical and psychological therapies and are treated differently according to beliefs and attitudes of therapists. Transgender patients usually go to plastic surgeons and andrologists or urologists before they are referred to psychiatrists, but the final decision to undergo a sexual reassignment surgery is left to medical syndicate who still refuses to approve of these operations except for cases of intersex.
WISDOM FROM THE THERAPY ROOM - STORIES OF COMPLEXITY E. Almas 1, E. Benestad 2, A. Lindskog, R. Pristed 34, A. Skrautvol 5 1 University of Agder, Grimstad, Norway,2 Grimstad Mpat-Institute, Grimstad, Norway,3 Jysk Sexologisk Klinic, Randers C, Denmark, 4 Agder University, Sexologiutdannelsen, Grimstad, Norway 5 Institute of Clinical Sexology and Therapy It is important to keep in mind the fact that methods that are used in “evidence-base research” address only one aspect of the process that therapy is about. Research to find evidence for the effectiveness of therapy focus on methods that must be described in a therapy-manual, repeated the same way independent of the therapist. The problems are described by diagnostic criteria, based on symptoms. The ideal model behind this research is the bio-medical treatment model where one single agent (antibiotics) alleviates a symptom (infection). There are both medical and psychological problems that can be treated by this model, but many problems require more complex treatment approaches. Evidence-based practice in psychology is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences (American Psychological Association). It is a challenge for therapists to present experience from the therapy room that describe what is clinical expertise, what is the importance of the therapeutic relationship, the resources and the motivation of the client? The need for therapeutic expertise increases as problems become deeper and more complex. The presenters in this symposium are asked to describe therapeutic experience (in ten minutes each!) in an effort to acknowledge and utilize this wisdom, which often is developed and practiced, locked inside the therapy room.
TRANSGENDER AND HORMONES: MYTHS, FEARS AND REALITY IN THE 21ST CENTURY H. Asscheman HAJAP, Amsterdam, The Netherlands Objective: To analyze the myths (beliefs), the fears (side effects) and the reality of cross-sex hormone treatment in transgender persons and to give a science-based realistic response. Design: Review of published literature, internet-based questions and personal experience in over 2000 transgender subjects. Method: Search of scientific papers, internet fora and questions asked in clinical practice. Results: Many myths surround the effects of cross-sex hormones, magic bullets that transform a body into the desired physical shapes. More hormones are not always better and effects are limited. “Natural” hormones are not devoid of side effects and not more effective than synthetic hormones. Progestative agents are not necessary for optimal breast development. Injections are not more “powerful” than oral or transdermal administration. Also a lot a fears, from subjects but even more from society and physicians, regarding side effects are expressed like estrogens cause breast cancer to testosterone causes myocardial infarction. Cancer risk is not clearly increased in cross-sex hormone-treated transgender subjects. Breast cancer has been described in MtF subjects with high dose synthetic estrogen therapy in the 1980s but is rare. Other cancers are occasionally seen but appear not increased compared to the natal sex if corrected for age and risk factors. Mortality in MtF is 1.5 times higher but this is due to suicide and AIDS. Current ethinyl estradiol (EE) use is associated with increased cardiovascular mortality but past use of EE is not. Conclusions: Optimal cross-sex hormone treatment is an effective therapy to obtain the desired physical changes
UNTOLD STORIES FROM THE THERAPY ROOM E. Benestad 12 1 University of Agder, Grimstad, Norway2 Grimstad MPAT-Institute, Grimstad, Norway It has been shown that many, if not all, varieties of therapy do work. Some “schools” have, however, invested more in proving their efficiency than others and thus reached a higher level of bureaucratic credibility. This has rendered health bureaucrats power to impose “evidence based” strategies into the therapy room. Many therapists have remained silent, not always knowing how to express these insights and give them transfer value. These are the untold stories from the therapy room. This presenter has extensive experience as a family doctor, as a family therapist, as a sex and gender therapist and is knowledgeable concerning several therapeutic methods. On the background of how one can work with individuals who are gender or transe-gifted, the presenter will describe and discuss some elements from the therapy room that can give insight not only to what might be useful for this special and heterogeneous group, but useful also in other therapeutic settings and senses. One common denominator for this therapist is to move into the clients’ subjective space, explore the clients narrative, qualify the clients’ talents, leave out the diagnostic manuals and pathologizations and focus on leaving insights and viewpoints for the clients to explore within their own subjective frameworks.
VAGINISMUS AND DYSPAREUNIA: THE ABILITY TO DIFFERENTIALLY DIAGNOSE THE TWO DISORDERS R. Bernorio Associazione Italiana Sessuologia Psicologia Applicata, Milan, Italy Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object, despite the woman’s expressed wish to do so. Dyspareunia is commonly described as a persistent or recurrant genital pain associated with sexual intercourse. There are a number of studies which try to differentiate vaginismus from dyspareunia on a variety of muscle and nonmuscle spasm based measures or methods. According to the proposed revision of dsm V, the two dysfunctions should be addressed to the same diagnostic category. They are, on the contrary, representative of two markly distinct problems, with different models of therapy and different end points. The aim of the presentation is to show the clinical evidence of this difference through the analysis of exemplificative clinical cases supported by the vision of direct in-vivo gynaecological examination videos.
F. Cabello Santamaria Instituto Andaluz de Sexología y Psicología, Malaga, Spain Introduction: The sexual interest in prepubescent children is one of the strongest social problems. A deep revision of bibliography on the issue shows that about 20% of de children have suffered some kind of sexual abuse. Aims: To describe the features of the pedophilic men an our model of treatment. Method: An assessment of the clinical histories of men meeting all the criteria of Pedophilia (DSM IV-TR) coming to Instituto Andaluz de SexologAa y PsicologAa (N=32). Results: Pedophiles showed significantly shorter empathy with children, they had a big compulsivity, perfectionism, and usually lie about the process, despite they come to our center after being denounced (except three cases who come for own decision). The most common traits in MILLON was in decreasing order compulsivity, phobic and esquizoide personality. Conclusions: Despite some methodological limitations usual in the clinical work, the best results in the treatment of pedophilic men was a combination of behaviour therapy (cognitive approaches do not work in our experience) with antiadrogens and ISRS plus topiramato. In case of pedosexual offense recidivism we add atypical antipsychotics. Keywords: Pedophilia, sexual abuse Paraphilia, Sex Offenders, Antiandrogen Therapy.
CORRELATES OF SEXUAL INTEREST AMONG MEN FROM THREE EUROPEAN COUNTRIES A. Carvalheira 1, T. Bente 2, A. Stulhofer 3 1 University Institute of Applied Psychology, Lisbon, Portugal, 2 University of Tromso, Tromso, Norway, 3 University of Zagreb, Zagreb, Croatia The main goal was to evaluate the predictors of men’s low sexual interest. We examined associated distress, and comorbidity. A total of 5,255 men from three countries completed a web- based survey of previously pilot-tested items: 2863 from Portugal, 1735 from Croatia, and 657 from Norway. All analyzes were performed with a sample of men who reported an exclusively heterosexual behaviour during last five years (82.4%). Overall, 20.3% of men reported lacking interest in sex for a period of 2 months or longer in the year prior to the survey. From those, 69.2 reported personal distress. The most prevalent comorbidity was erectile difficulty (37.9%), and premature ejaculation (27.1%). A logistic regression (excluding men who were taking antidepressants) revealed that men with a higher educational level (odds ratio [OR] = 1.21, p < .05), having children (OR = 0.71, p < .05), with a lower rate of confidence in getting or keeping an erection (OR = 1.56, p < .001), with higher rates of anxiety and depression (OR = 1.06; p < .001), with a problematic use of pornography (OR = 1.19; p < .001), and with a lower body self-image (OR = .97, p < .05), were more likely to report lack of sexual interest. The overall model was found to be significant in the three country samples. Results revealed significant predictors of men’s lack of sexual interest. Interestingly, having children and body selfimage was associated to men’s sexual desire, both variables considerably demonstrated in female sexual response but not yet investigated among men.
PATTERNS OF MALE SEXUAL FUNCTIONING: CONTRIBUTIONS TO DSM-V DIAGNOSTIC CRITERIA J. Carvalho, A.L. Vieira, P. Nobre Universidade de Aveiro, Aveiro, Portugal Strong debate has been brought out around the upcoming editions of the International Classification of Diseases (ICD, World Health Organization), and the Diagnostic and Statistical Manual of Mental Disorders (DSM, American Psychiatric Association) regarding new criteria for sexual dysfunction. Although criteria for male sexual dysfunction have been supported by traditional models of sexual response (Kaplan, 1979; Masters & Johnson, 1966), recent data suggest that male sexual functioning could be conceptualized differently, offering new directions for diagnostic and assessment tools. Aim: The aim of this study was to test, through structural equation modeling, four conceptual alternative models of male sexual response. Methods: A total of 1558 men from the Portuguese population participated in the study. Participants were divided into two groups according to the presence or absence of sexual difficulties. A modified version of the International Index of Erectile Function was used, assessing sexual desire, erectile function, orgasmic function, and premature ejaculation. Results: Findings suggested different factor solutions for men with and without sexual difficulties. Male sexual response of men with sexual difficulties was best characterized by a two- factor structure: 1) a general sexual function factor (including sexual desire, erectile function, and orgasmic function); and 2) premature ejaculation; while a three-factor solution was the model that best fitted the data regarding men without sexual difficulties: 1) sexual desire, 2) erectile and orgasmic function (which merged into a single dimension), and 3) premature ejaculation. Discriminant validity between factors was strongly supported, suggesting that these dimensions measure distinct phenomena in both samples.
SEXUAL RIGHTS OF PERSONS WITHOUT RIGHTS: OLD PEOPLE, HANDICAPPED, MENTALLY ILL A. Casaubón Alcaraz 12 1 Academia Española de Sexología y Medicina Sexual, Spain, 2 FLASSES, Montevideo, Uruguay If the first sexual revolution, was linked to women's access to contraception, the second revolution hatched with the access of women to the enjoyment ... the third will take shape with access to all human beings to sexual rights, this revolution being the more fundamental social and human. And unfortunately, in the twenty-first century access for the entire world population to sexual rights, is the unfinished business of health systems, social and education in most of the world. This absence of the opportunity to enjoy these rights, it becomes a utopia for certain sectors of the population: Elderly / Mentally Ill / Disabled. As raised in 1978 Masters and Johnson: "Repressive attitudes of the Western tradition (Christianity, Puritanism) have been applied more intense for the disabled, chronically ill and the elderly." This inability to access the sexual rights of these populations, acquire a special drama to be a limitation of one's physical and emotional development of stigmatized groups to prioritize the false beliefs, fears and repression against the basic needs of individuals of affection, closeness, pleasure and love. Get in the general population harmonious development of their sexual health as defined by the Antigua meeting in 2000: "Sexual health is the experience of an ongoing process of physical, psychological and socio-cultural related to sexuality." Thus the "asexuación" that forced these populations, not only curtails their sexual rights, but hinders the harmonious development of the individual both physically, and psychologically, socially and spiritually.
TRANSSEXUALS SENSITIVITY AND SEXUALITY AFTER SURGERY F. Courtois 1, N. Morel Journel 2 1 UQAM, Montréal, Canada,2 Hospices civils de Lyon, Lyon, France Forearm free flap and suprapubic phalloplasties differ in terms of techniques but lack comparisons amongst themselves and controls. Objective: Compare forearm free flap and suprapubic phalloplasty against controls on penile sensitivity and sexual outcomes. Materials and Methods: Twelve control men compared to fourteen transsexuals with forearm free flap (n=6) and suprapubic (n=7) phalloplasty on penile sensitivity, medical complications, psychological well-being and sexual function. Results: Sensitivity decreased compared to controls on glans penis and froenulum (glans M=0,21g Co, M=2g supra, M=1,7g forearm; Froenulum M=0,23g Co, M=3g supra, M=3g forearm), but not at the base of the penis for suprapubic phalloplasty (M=0,19g Co, M=0,5g supra, M=3,5g forearm). Both phalloplasties yielded similar complication rates (M=2,8 supra vs M=3 forearm). Suprapubic phalloplasty revealed better satisfaction than forearm free flap on appearance (M=8,9 supra vs M=7,3 forearm), happiness (M=4,3 supra vs M=3,8 forearm) optimism (M=4,4 supra vs M=3,8 forearm) and Beck Depression Inventory (M=0,6 supra vs M=4,3 forearm). Sexuality was improved in forearm free flap (Sexual repertoire M=10,6 PreSurg vs M=18,2 PostSurg; Fantasies M=3,7 PreSurg vs M=4,2 PostSurg; Orgasm (M=8,3 PreSurg vs M=13 PostSurg), but unchanged in suprapubic (Sexual repertoire M=10,6 PreSurg vs M=7 PostSurg; Fantasies M=1,9 PreSurg vs M=2,3 PostSurg; Orgasm M=7,6 PreSurg M=7,0 PostSurg). Conclusion: Suprapubic phalloplasty maintains comparable sensitivity to normal at the base of the penis, but better sensitivity than forearm freeflap. Complication rates are similar, but suprapubic phalloplasty yields better psychological functioning, while forearm free flap better sexuality.
PROFILES OF BATTERED WOMEN AND ABUSIVE MEN IN CASTILLA Y LEÓN (SPAIN) M.A. Cueto 1, Y. Fernández 2, B. Pérez 2, N. Merino 1, D. Cueto 3 1 Cepteco, León, Spain, 2 Centro Psicológico, León, Spain, 3 Univ. Oviedo, Oviedo, Spain Objective: 134 subjects (96 women and 38 men) from the Emotional Support Program for Battered Women (since 2001) and Fénix Program for Abusive Men (since 2005) were observed by analysing descriptive variables, sociodemographic characteristics and personality profiles prominent in battered women and abusive men. The objective was the study of the more likely personality profiles to carry out or receive abuse. Consejería de Familia e Igualdad de Oportunidades de la Junta de Castilla y León (España) sponsor both. Design and method: Using interviews and questionnaires to battered women and abusive men made the descriptive study. The personality profiles were assessed with Millon Clinical Multiaxial Inventory II (MCMI-II). All these data were scaled, tabulated and analysed statistically with the program SPSS 15.0. Results: The conclusion is that both the men and the women of the study, at any age, may happen to abuse or to be abused. Neither most of abusive men nor most of battered women come from a family where there has been ill treatment during childhood. The frequency of the compulsive-dependent disorder is very high both in abusive men and battered women. The longer women have been battered the more liable they are to become more dependent. Conclusions: Everything hints at the necessity of deepening in the study of the role that personality plays in the psychological response and of considering specific personalities as a prominent aspect to be taken into account in the different preventive and therapeutical approaches used with the victims of this violence.
MALE SEXUAL PAIN DISORDERS: NEW APPROACH G. Del Noce Societa Piemontese di Sessuologia Clinica, Turin, Italy The male sexual pain in DSM IV TR has something to do with Dyspareunia. But I can say by experience very few men feel pain during penetration and if sometimes it happens it is always due to organic causes. If we look Vulvodinia up in the Web we find about 200.000 items, but if we look penodinia up we can find only 640 items, wich are above all due to dermatologic causes. In reality, in andrologic surgery activities, male genital sine materia pains are very often referred and enphasized and I think they can be divided into several groups. The first group, wich is the most frequent, hits above all testicles, persist for a lifetime and it is often correlated to a positive anamnesis for surgical operation (Hypospadia, Cryptorchidism,.) and/or frequent genital medical examination in pediatric age. It may be considered as a defensive reaction to what I think is a “controlled sexual abuse”. The pain sometimes appears only when the palpation is made by foreign hands and not by the subject himself. A second group may be related to a very real penodinia. The patient shows his discomfort above all during his digital glans uncovering, wich is almost never executed. Not always he shows pain, but very often he feels discomfort and sometimes vomiting sensation. Sexual intercourses are allowed and, paradoxically, during sexual intercourses few symptoms are manifested. The patient very often undergoes andrologic examination to perform circumcision, wich has usually postoperative complications. A third group may be compared to a very real vaginismus. The patient does not even tolerate the approaching of a hand to his penis and make the same actions and movements of a vaginismic female. The patients cannot have sexual intercourses owing to this inconvenience. This symptom causes a very important psychological distress, but that is fortunately relatively rare. The fourth and last group may be defined as a real male Dyspareunia. The patient complain pain during sexual intercours and, above all, during ejaculation. The symptom is felt in pelvic-perineum area and it is often diagnosed as prostatis, but in reality no organic therapy is effective at all. Finally, I think that, up to now, male sexual pain has been studied in a superficial way and that there are many aspect that need to be further investigated and reported.
ABUSE OF DRUGS AND SEXUAL DYSFUNCTION F. Del Río Olvera Instituto Andaluz de Sexologia y Psicología, Málaga, Spain Sexual health, for drug abuser people, is one of the therapeutic targets in this population, although it is one of the areas neglected at the same time. From adolescence to adulthood is often to find together fun, sex and drugs. Recent studies indicate that taking drugs increases 10 times the risk of erectile dysfunction over the not consuming population. There have been studies on consumption from the analysis of the effects at low doses and short-term, to studies with higher doses of consumption and more time consuming, which shows the devastating effects on sexual function. The Instituto Andaluz de Sexología y Psicología has made an investigation where 28 drug treatment centres in 27 Spanish provinces have participated. It has been done with an experimental group of people who have a history as addictive substances user (1054 people) and a control group who have not consumed addictive substances ever (211 people). The results show that the experimental group presented higher percentages than the control group in erectile dysfunction (36.7%> 15.9%), premature ejaculation (44.3%> 15.9%), anorgasmia (13.2%> 2.3%) and vaginismus (65.1 %> 39.5%), with significant differences between groups. As a conclusion, taking drugs has very negative influence on sexual health.
SEXUALITY AND COUPLE SATISFACTION IN CHRONIC ILLNESS A. Fabrizi Institute of Clinical Sexology, Rome, Italy Sexuality is integral to a person’s identity and is an important contributor to quality of life in many patients with chronic illness and their partners. All illness and related treatments have the potential to affect sexuality and sexual function and can impact on all phases of sexual response. This may result from impaired body function or alterate body image or from the emotional and psychological distress that often accompany diagnosis and treatment. Many chronic illness patients may appreciate the opportunity to discuss psychological issues of sexuality and intimacy with a trusted health professional and want to learn about the implication of the treatment and medication on their sexuality. But health professional struggle to accept that people with chronic illness continue to be sexual being, so patient sexuality and intimacy are widely medicalised. Sexual counselling offer useful tools to address sexuality and sexual health and provide a graded approach that allow doctors and nurses to deal with sexual issues at their own level of expertise and comfort.
A. Faix Clinique Beausoleil, Montpellier, France In a society where appearances have became the norm and many women have resorted to plastic surgery - with those that can be seen (breasts, face, figure), but also those that cannot (Nymphoplasty, amplification of the G-spot) - men increasingly seek to improve their appearance, and in particular their genital organs. Support should be primarily psychological, not only scholarly scientific society providing specific criteria or surgical intervention is indicated. The size of the penis (length and width) should be evaluated together with anatomical criteria, but also with a psychological evaluation team before considering surgery. Lengthening techniques consist essentially in the sectioning of the suspensor ligament that brings increased length mainly at rest, with potential drawbacks. Enlargement techniques are also random, with varying results and random durability. Support must therefore be collegiate (surgeon, psychiatrist, sexologist) with several consultations and sufficient time for reflection for the patient. Satisfaction studies are few and contradictory, as it lacks a reference to an anatomical and psychological standardized therapy for patients seeking this treatment. A CLINICAL TARGET: MANAGEMENT OF ANTIDEPRESSANT- INDUCED SEXUAL DYSFUNCTION M.F. Ferreira Lourenco Couple Clinical - Psychiatry and Mental Health Department- Alto A ve Hospital Center, Guimaraes, Portugal Depression is a clinical entity increasingly frequent as a result of economic difficulties and the profound changes affecting modern societies. This pathology is present in the profissional life of all doctors. It is present as a primary entity or as a result of another health problem.While not always verbalized by patients, sexual problems can be a direct consequence of the use of antidepressants. One of the great ironies of depression treatment is that while depression can rob the desire for sex, the drugs that treat it can be much worse, causing not only low libido, but also erectile dysfunction and difficulties with orgasm. Sexual dysfunction is a relatively common adverse effect of many of the antidepressants in common use today. Rates of sexual dysfunction observed in clinical practice may be higher than those reported in the product information for several agents. Selective serotonin-reuptake inhibitors (SSRIs) appear to be the class of antidepressants most likely to cause sexual dysfunction. Published studies suggest that between 30% and 60% of SSRI-treated patients may experience some form of treatment-induced sexual dysfunction. In this communication we discuss the mechanisms by which antidepressants cause sexual dysfunction and established some guidelines to manage this clinical problem. Physicians should monitor their patients for antidepressant-induced sexual adverse effects, as these may affect compliance with therapy and ultimate treatment success.
TRATAMIENTO DE LAS TRASTORNOS DEL DESEO J. Florido 1, E. Martinez Lopera 1 University of Granada, Department Obstetrics And Gynecology, Granada, Spain Desire disorders are the most common sexual problems among women but also more complex treatment. At present there has been progress in understanding the pathophysiology of this disorder such as neuroimaging techniques (NMR active) that are enabling the emergence of new medical treatments. Desire disorders tend to explain in this day based on three pillars: psychological, hormonal and neurotransmitter changes, from which activacionals factors and inhibitors of desire will be enhanced and inhibited, (Dual theory of Jenssen and Bancroft). Drugs that can act on the desire to be hormonal (androgens and tibolone), the _ neurocentral action (dopamine, serotonin and melanocortin agonists) and last but by indirection the peripheral _. Special interest has been in recent years the description of androgen insufficiency syndrome, especially related to oophorectomy, which Allow the development of specific medication for it. But in the future is likely to appear new drugs _ as the ill-fated neurocentral action flibanserin or gespirona-ER or perhaps bromelanotido. However, in no other field and desire disorders need an individualized approach of the couple and to address psychosocial and relationship factors. The drugs were helpful but not a panacea.
CYBERSEX ADDICTION: MYTH OR REALITY? AN APPROACH TO ITS CONCEPTUALIZATION, ASSESSMENT AND TREATMENT F. Fora Eroles Centro Médico Teknon, Barcelona, Spain Sexual addiction is not catalogued as pathological behaviour by any international psychiatric classification, in spite of the fact that they appear in the literature each time more studies about the subject. The current version of DSM, published in 2000 (DSM-IV-TR), does not mention sexual addiction as a mental disorder and this diagnosis has been rejected for inclusion in the DSM-V, expected out in 2013. Sexologists have not reached any consensus regarding whether sexual addiction exists or if it is a psychiatric condition, which can be better explained in terms of sexual compulsivity or sexual impulsivity. While some experts believe that sexual addiction is directly analogous to drug addictions, other experts claim that it is only a myth, a product of social influences that can be a way of projecting social stigma onto patients. Furthermore, it is unclear to what extent Internet has created a new category of sex addicts or simply has provided a new way of expression to the existing ones. The aim of this presentation is to raise the debate that involves the conceptualization of this disorder and to approach us to its diagnosis, assessment and treatment.
WHO ARE THE TRANS INDIVIDUALS? RESULTS OF A 2010 SURVEY CARRIED IN FRANCE A. Giami INSERM U 1018, Paris, France Introduction: Demographic data on the transgender population in France are scarce. The Inserm carried out a survey on Trans individuals in order to identify their sociodemographic characteristics, their medical and psychological transition processes, and some mental health issues. Material and Method: A questionnaire has been elaborated and circulated from July to October 2010 in partnership with transgender NGOs, public hospital practitioners and private practice practitioners. Results: 381 individuals responded the self-administered questionnaire and sent it back anonymously to the research team. Sex assigned at birth and gender identification, which was expressed by the individuals in their own words, were the two key variables that enabled to outline different profiles, medical transition pathway and mental health problems. Socio-demographic profiles of the transgender population vary according to the sex assigned at birth, and the participation in the medical transition process also varies according to the sex at birth but mainly according to gender identification. Discussion and Perspectvives: This survey is innovative insofar as it used a sampling methodology that was based on partnerships with the Trans individuals’ main networks of socialization, and partly based its analyze on gender selfidentification categories. The results highlight the diversity of the Trans population and the necessity, in future research, to take into account the differences between its subgroups. The possibility to develop such such a project on a European scale will be discussed.
MDS III DIAGNOSTIC MANUAL OF SEXOLOGY THIRD EDITION R.J. Hernández Serrano 1, FJ. Bianco Colmenares 2 1 Universidad Central de Venezuela, Caracas, Venezuela,2 CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela Diagnosis in Clinical Sexology: B. At the process of Sexual Function B3. Sexual Response Phase In Men At the Sexual Response Phase in Men: Mixed Excitability Disorder (know as Erectile Dysfunction) Subjective Excitability Disorder Subjective feeling of “not feeling much” with functional erection and ejaculation Excess Excitability Disorder (excess lubrication) Excitability Persistent Disorder Glands Hypersensitivity Orgasmic Disorder: Ejaculatory Incompetence (previously known as Masculine Orgasmic Dysfunction) Coital Ejaculatory Incompetence Masturbatory Ejaculatory Incompetence Orgasmic Anhedonia Painful Orgasm/Ejaculation Ejaculatory Incompetence due to Urinary Incontinence Resolution Phase Disorder: Postcoital Dysphoria Refractory Period-Related Postcoital Symptomatology: - Headache - Fever Pain Disorders: Superficial Penile Pain Genital pain during intercourse Genital pain after intercourse Pain during masturbation Acute testicular pain Painful Orgasm Case: At level of sexual function in men. 55 year old male PMH: Type II Diabetes II. Hypertension, Prostatectomized CC: “I have Sexual Impotence” HPI: Patient refers that after surgery, 2 years ago, he has had difficulties obtaining and maintaining the erection during the ESF with a partner, as well as during the auto-ESF, which worries him, also been recriminated by his partner PE: BP: 150/90. CP normal. Genitals weak bulbocavernous reflex Intracavernous Injection: Positive DI: Erectile Dysfunction.
SCIENCE-BASED SEXUALITY EDUCATION F. Hurtado Murillo 12, M. Pérez Conchillo 12, E. Rubio Aurioles, R. Coates, E. Coleman, E. Corona Vargas, R. Mazín, P. Horno Goicoechea 1 Centro De Salud Sexual Y Reproductiva Fuente De San Luis De Valencia, Valencia, Spain 2 Departamento Dr. Peset. Agencia Valenciana D, Valencia, Spain Madrid Consensus Paper. Recommendations of an International Expert Group. Summary. In order to ensure the development of healthy sexuality, free of discomfort, risks, suffering, guilt, and shame, sexual rights must be recognized, promoted, respected, protected, and defended by all societies, through all available means. Sexual rights include the right to comprehensive science-based sexuality education which fosters the right to make free, responsible reproductive decisions, and the autonomous exercise of other sexual rights. In recent years, professionals and institutions working on sexual health have found that: Sexuality education is still a work in progress in many countries. Many practitioners, institutions, and groups involved in sexuality education face barriers and stumbling blocks in carrying out their work. In some cases, far from progress, there appear to have been setbacks in many of the victories achieved in the realm of sexual rights and sexual health. In order to get an education for science-based sexuality as a basic strategy for moving the sexual rights agenda forward and, with this in mind, it was decided to make a World Meeting of Sex Education Experts. The meeting of experts was organized and convened by the Spanish Academy of Sexology and Sexual Medicine (AESMES); the Spanish Association of Sexology Specialists (AEES); the World Association for Sexual Health (WAS); the Latin American Federation of Sexology and Sexual Education (FLASSES); the Modular Sexual Health Program of the National University of Distance Education (UNED); and the Institute of Sexology and Psychotherapy (Espill). The Ministry of Health, Social Policy and Equality of Spain lent its support to the meeting, which included the participation of the following international organizations: Regional Office for Europe of the World Health Organization (WHO); Federal Centre for Health Education (BZgA) of Cologne (Germany); Pan American Health Organization (PAHO); United Nations Educational, Scientific and Cultural Organization (UNESCO); International Planned Parenthood Federation (IPPF); United Nations Population Fund (UNFPA); University of Minnesota Program in Human Sexuality, University of Alberta (Canada); National Pedagogical University of Mexico; and the Universities of Salamanca and Vigo in Spain. The objective of the World Meeting of Experts on Sex Education was to develop a document that would serve as a reference and source of support for practitioners and institutions working on sexuality education, and to propose specific, consensus-based strategies and actions geared towards implementing science-based sexuality education with a view to attaining the full exercise of sexual rights. The document is divided into two sections.The first section describes the conclusions of the meeting of experts, which set out the basis for sexuality education and strategies needed to promote it, including advocacy strategies, and strategies to obtain the necessary resources and to implement programs. The second section offers relevant information and reflections to promote science-based sexuality education. This section includes standards for sexuality education, general and specific factors for the success of education programs that have been carried out in different regions of the world, and technical guidance on sexuality education that describes the characteristics of effective programs and the learning components of comprehensive sexuality education. A POSITIVE APPROACH TO SEXUALITY BEFORE PUBERTY: SEXUAL ABUSE TO THE DIFFERENT FORMS OF SEXUAL ABUSE F. López Sánchez University of Salamanca, Salamanca, Spain We expose the need to adopt a positive focus about prepuberty sex, with the goal of favoring present and future wellbeing of minors, and the need to change the international taxonomy of battering, presenting a new taxonomy in which, apart from the sexual abuse to minors, we include as new forms the following: sexual mutilation of girls, non acceptance of sexual identity in cases of problems in the identity in childhood and transsexual identity in adolescence, non acceptance of homosexuality, forced marriages in prepuberty minors, etc. On the other hand, we will analyze forms of neglect in sexual education that should be considered child mistreatment. This new classification will serve the purpose of a better defense of childhood against the familiar, social and educational sexual mistreatment, aiding professionals in defense of childhood and favoring a better sexual education.
MANAGEMENT OF SEXUAL DYSFUNCTION IN PERIMENOPAUSAL WOMEN F. Molero Rodriguez1-2 1 Federación Española de Sociedades de Sexologia, Malaga, Spain, 2 Institut de Sexologia de Barcelona, Barcelona, Spain Introduction: Sexual problems are highly prevalent in women. Female sexual dysfunction takes different forms, including lack of sexual desire, impaired arousal, inability to achieve orgasm, pain with sexual activity, or a combination of these issues. Treatment must be tailored to the sexual dysfunction diagnosis or diagnoses and to underlying physical and psychological factors. The management of female sexual dysfunction will be reviewed here. Many of the sexual problems of the women are not dysfunctions. It is indeed the existence of personal malaise associated to the sexual problem one that determines if it is dysfunction or complaint An abnormal sexual function without the upheaval presence can exist, if come together with personal distress .Only one part of the women with sexual difficulty does not appear sexual dysfunction It is difficult to determine the prevalence accurately. The studies use different diagnoses criteria and very heterogeneous populations Objective: Bibliographical search revision is to know which are the most effective treatments in the conduct of the sexual dysfunctions of the perimenopausal woman Methods: We have evaluate de available bibliographical information by consulting the data bases from 2000 to 2012 years Results: The prevalence of female sexual dysfunction was found to be 43%. Although the experts believe that this percentage is oversized. The sexual complaint commonest in the women is the low desire, although sometimes she is secondary to sexual discrepancies with the pair, upheavals of the excitation and aversion to sex. Secondly we would have the upheavals of orgasm Therapeutic approach. Currently available pharmacologic therapies for female. Sexual dysfunctions are of limited efficacy and associated with side effects and potential risks, non-pharmacologic options should comprise the initial treatment for most women. Counseling. Sexual Therapy. Surgical and pharmacological treatment. Conclusion: Sexual disorders can be complex and their treatment can be time intensive and require special expertise. With the patient’s consent, communication and management decisions should be shared between the patient’s clinician and other health care providers who treat the patient. In addition, for women with partners, the partner must be involved in the treatment. It must become on individualized a treatment with an integrating approach. The first step is to offer objective information and appropriate to the language of the patient on anatomy and physiology of the sexual answer and positive messages. On many occasions are erroneous beliefs and myths that generate dysfunction. To offer positive messages and of well-being, recognition of the right to the pleasure and promoting the sexuality not only based on the genitality. To make a careful evaluation of the problem and the expectations lives of the patient as far as which it wants to obtain. Optimize the psychic and physical health. Improve climacteric symptomatology and make pharmacologic treatments when it is necessary. It is very important to maintain a good state of vaginal health: local estrogens and hydration and lubrication.
SEXUALITY IN PERIMENOPAUSE F. Molero Rodriguez 12 1 Federación española de Sociedades de Sexologia (FESS), Malaga, Spain, 2 Institut de Sexologia de Barcelona, Barcelona, Spain Abstract: Perimenopause is a time of anatomic, physiological and psychological changes that often influence in the sexuality of female. It is a time of change, which is related to an evolutionary crisis where in addition to all known hormonal changes, psychological and relational changes occupy a prominent place. A sexual history is probably the most important aspect in the diagnostic and treatment of sexual problems. Sexual functioning is an important aspect of health and wellbeing. Doctors should have a holistic approach about the sexuality. They advise on sexuality at this stage and treat the symptoms that may impair sexual satisfaction. Objective: The objective of the present exposition is to evaluate the sexuality in perimenopause. Methods: We have evaluate de available bibliographical information by consulting the data bases from 2000 to 2012 years. Results: Main factors associated with female sexual function are: - The availability of a couple The quality of the relationship Emotional satisfaction with partner was strongly associated with sexual satisfaction - the perception by women of their physical and psychological. Depression and its treatments on all SSRIs, are factors related to sexual dysfunction. The symptoms associated with menopause such as hot flashes and vaginal dryness, dyspareunia by were associated with less excitement, less physical pleasure and emotional satisfaction lower. - importance of sex, age and attitudes toward aging and menopause Conclusion: Women live in a very variable its climacteric. Psychological factors, socio-cultural, health, relationships, information or experiences ... which influence this experience. A positive attitude to adapt to changes and make responsible decisions is what promotes health and wellbeing. Women consider sex important in your life's and their sexual functioning, however this decreases with age, leading to debate on the contribution of menopause on sexual functioning in women. Most studies in this area are transverse, and are not large enough to separate the effects of menopause, chronological age and other variables for which there is evidence of that influence female sexual function. Factors that are often more decisive than ovarian function.
N. Morel Journel 1, F. Courtois 2, J. Terrier 1 1 Centre Hospitalier Lyon Sud, Lyon, France, 2 Uqam, Montreal, Canada There are a lot of techniques in the sex reassignement surgery. In our work, we wanted to analyze several items: Sex reassignment surgery is a very challenging surgery. Surgeons helped by a multidisciplinary team have to be skilled not only in plastic and reconstructive surgery, but also in functional urology and psychology. This type of surgery has to be adapted for each patient because they have very different demands. For female to male (FtM) transformation, main surgical challenges are the following: maintaining sexual sensitivity, aesthetic, functional phalloplasty and aesthetic mastectomy. The huge number of surgical techniques for phalloplasty is probably explained by the fact that none reaches all the “ideal goals” they should reach. However, among these techniques, two seem to emerge: antebrachial phalloplasty and abdominal phalloplasty. For male to female more plastic surgery procedures are necessary face, throat, breast, and of course vaginal and vulva construction. There are also big functional challenges: clitoris sensitivity, vaginal functional length and width and urinary function. Losing sight of patient due to there huge mobility made study and evaluation difficult. Despite difficulties of evaluation, vaginoplasty with inversion of penile shaft and scrotal skin graft is still the referential treatment but secondary techniques like colic vaginoplasty are possible. To help patients’ and physicians’ decision making we propose algorithms. The huge diversity of techniques and the lack of good evaluation should encourage us to standardize evaluation of patients. Evaluation can’t be only physical, we have to cross results from sexual, psychological, physical and sociological view points.
WHAT PREDICTS MEN'S LEVEL OF DISTRESS WHEN EXPERIENCING LOW SEXUAL DESIRE? P. Pascoal 1, N. Pereira 2 1 Faculty of psychology, University of Lisbon, Lisbon, Portugal, 2 Universidade Lusofona, Lisbon, Portugal Introduction: There is scarce research about levels of distress experienced with low sexual desire in the male population. However, distress is a central feature for the diagnosis of Male Hypoactive Sexual Desire Disorder (MHSDD) according to the APA new criteria proposed for DMS-5. Objective: The aim of this study was to examine the extent to which aspects of individual and relationship variables predict distress with MHSDD. Method: A total of 1656 heterosexual men in a relationship completed an anonymous online survey. The survey included a socio- demographic questionnaire and a set of questionnaires assessing individual and relationship related variables. We used level of distress with low sexual desire as outcome variable. As predictors we used the Global Body Dissatisfaction Subscale of the Body Attitudes Test (GBD); Cognitive Distraction Scale (CDS), Rosenberg Self-Esteem Scale (RSES), the Global Measure of Relationship Satisfaction (GMREL); the Inclusion of Other in Self Scale (IOS), level of distress with partner’s sexual functioning, cohabitation with romantic partner and relationship length. Results: Multiple regression using stepwise method indicated that level of distress with partner's sexual problem, CDS, RSES and cohabitation significantly predicted distress with low sexual desire. The variance explained, after controlling for health, medication and psychological adjustment was 42% (R2= .42). Distress with partner’s sexual problem was the strongest predictor ( = .332). Conclusions: Our results support that a combination of individual and relationship factors contribute to the level of distress with low sexual desire in men. E. Pazmiño, FJ Bianco Colmenares Centro de Investigaciones Psiquiátricas Psicológicas y Sexologicas de Venezuela, Caracas, Venezuela Objective: Evaluate 46, XX Ovotesticular Disorder of Sex Development (DSD) in a patient from the pediatrics ward at Baca Ortiz Hospital, Quito. Method: Case study, 1 year-old patient. Reason for consultation: "difficulty urinating" since birth. Physical examination: Genitals: presence of an aprox 2,5 cm-long, small phallus, with a ventral incurvation, asymmetrical, with glandular hypospadias, midline fusion of scrotal tissue, left cryptorchidia, rest of physical examination appears normal. Results: Genitography: previous ecographic study demonstrated the presence of gonads within the inguinal canals, did not show the presence of uterus, testosterone <0.020 ng/ml, 17-OH progesterone 1.24 ng/ml, testosterone after hCG situmulus 2.11 ng/ml. Caryotype: 46,XX/XY, exploratory laparotomy does not show müllerian elements, left gonad biopsy: ovaric and testicular tissue. Right gonad: testicular tissue. After interdisciplinary medical board, and according to the more masculinized clinical features of the patient, it is decided the assignation of a masculine expression phenotype. Conclusion: 46, XX Ovotesticular DSD presents in 12,8% of these cases, therefore its frequency is low. Verification of caryotype and gonadal biopsy are determinants for diagnosis. This will depend on the patient's clinical situation as well as clinical and behavioral evaluation, in order to define surgical conduct. Nevertheless, nowadays surgical approach of this cases most be very careful, since it is evident that the sexual behavior pattern the patient will develop as an adult is unknown, and behavioral expression may manifest towards man or woman, according to how the individual identifies during its process of social construction.
MEN’S SEXUAL DESIRE - SPONTANEOUS AND ALSO RESPONSIVE? M. Peixoto, P. Nobre, S. Vilarinho Departamento de Educagao da Universidade de Aveiro, Aveiro, Portugal The classical models of human sexual response conceptualized sexual desire as spontaneous sexual thoughts and biological urges. Several studies have been revealing that women in long-term relationships, even if satisfying, frequently report the lack of spontaneous desire. According to Basson’s circular model of sexual response, most women consciously decide to engage in sex based on reasons that are not primarily sexual; more common motives for sexual involvement usually include enhancement of emotional closeness, bonding, commitment, desire to increase a sense of attractiveness and attraction to a partner, and desire to share physical sexual pleasure. In men’s sexual desire, biological factors are generally more emphasized. Some empirical work suggests that men experience sexual desire more frequently and for different reasons than do women. However, sex differences in motivation and cues for sexual desire, particularly as a relationship progresses, have received less investigation. Our main goals are to explore gender differences regarding cues to sexual desire as a relationship progresses; and to examine how different cues to sexual desire are related to frequency and sexual functioning in men and women. Participants are men and women drawn from general population, ages between 18 and 75, and relationship for 6 months or more. Questionnaires assess: medical condition (MHF); relationship adjustment (DAS-7); cognitive-affective variables (SMQ; PANAS); sexual activity; fantasies, focus of attention and worries during sexual activity; cues for sexual desire (CSDS-P); and sexual functioning (IIEF, FSFI and SIDI). The study is cross-sectional. Findings will be discussed in terms of men’s desire and motivation for sex, as compared to women.
ED MANAGEMENT IN THE PRACTICE SETTING: SATISFYING BOTH THE COUPLE AND THE DOC H. Porst European Society for Sexual Medicine (ESSM), Hamburg, Germany As a rule of thumb manifestation of ED in men < 40 years has often a more psychogenic background with dominance of performance anxiety and increased sympathetic tone resulting in elevated adrenalin and noradrenalin concentrations. On the opposite men with ED > 40-45 years often have a more organic etiology such as arterial and/or veno- occlusive insufficiency. In addition testosterone deficiency (hypogonadism) , contributing to ED, is found in about 30 % of men with ED 45 years. Typical other risk factors for ED are BPH (Benign Prostate Hyperplasia - risk for ED 70-80 % !), diabetes mellitus (risk for ED 50-70 %), hypertension (risk for ED 50-70 %), dyslipidemia (risk for ED > 50 %), coronary artery disease (CAD - risk for ED 70 to 80 %) and depression (risk for ED > 70 %). Moreover many medications may cause or aggravate ED such as SSRIs, tricyclic antidepressants, diuretics and non-selective R-blockers ,with some of the cited drugs causing hyperprolactinemia and in addition libido-and ejaculatory disorders. Besides a thorough sexual history a detailed risk factor analysis covering all the typical risk factors and medications is highly recommended in all men with ED. In the own institute each man with ED is subject to a thorough history , physical evaluation including the genitals and prostate as well as focused lab exams (serum glucose, testosterone, prolactin and cholesterol). Information about the sexual partner is always collected and questions focusing on the partner’s general interest in sexual activities and the partner’s sexual health should complete the sexual history. The findings and the consequences of the diagnostic work-up are discussed with the patient and where possible with the partner too. If hypogonadism (total T < 3,5 ng/ml or 12,4 nmol/l) is present T-replacement therapy must be initiated followed by prescription of a PDE 5 inhibitor if T-replacement therapy alone is not able to solve the ED problem. Many men/ couples with hypogonadism need both T-substitution and PDE 5 inhibitor therapy to be satisfied with the outcome. Changes in life-style with regular physical activity where sedentary lifestyle is prevailing, active risk factor managements such as good diabetes control (HbAIC < 7 %!) and reconsideration of antihypertensive drugs with preference of erection protective drugs such as sartans or nebivolol can contribute to better erectile function or may improve the efficacy of PDE 5 inhibitors. Finally besides on demand therapy with PDE 5 inhibitors daily dosing with tadalafil 5 mg has been proven in own hands to be the treatment of choice where either performance anxieties are prevailing (young patients with psychogenic ED), regular sexual activities are anticipated or endothelial dysfunction is highly suspected (diabetes mellitus, CAD or hypertension).
USEFULNESS OF A PSYCHIATRIC ASSESSMENT BEFORE SEXUAL SURGERY R. Porto, A. Gorin Lazard AIUS, Marseille, France Purpose: The aim of our contribution is to propose a reflection concerning the relevance of a psychiatric evaluation before sexual surgery. Design and Method: Our work is based on a review of the current literature as on our clinical experience. Results: The body image is eminently subjective, so much for the patient who suffer of his inadequacy than for the expert who gives a positive opinion on the relevance of a corrective surgery. In the field of sexuality, the difficulties of the patient concerning his body image can be the indicator: - of a lack of assurance and self-confidence, which requires to be treated before every surgical gesture, - of a gender identity disorder (GID) with feeling of incongruence which requires a surgery of sexual reassignment. Between these two extremes, it is necessary to carefully seek dysmophophobic problems which can leads to detect-in particular with young subjects-a schizophrenia onset. Thus, before any sexual surgery, it is advisable to carefully assess the psychological factors concerned and benefit-risk ratio. Conclusions: The sexual surgery is a medical field often confronted with vulnerabilities of the personality and emotional sphere often underestimated. Their tracking enables us to avoid unrealistic waitings, source of disappointment and/or depression in the event of insufficient evaluation. The particular problems of the GID, which implies “ heavy “ and irreversible surgery, needs even more vigilance specially in detecting the differential diagnosis, source of regrets
THE IMPORTANCE OF SAR, AND DISTINGUISHING BETWEEN MORALS AND ETHICS IN SEX THERAPY R. Pristed 12 1 Jysk Sexologisk Klinik, Randers C, Denmark,2 Agder University, sexologiutdannelsen, Grimstad, Norway In Norway, we find that SAR (Sexual Attitude Restructuring/ Reassessment) is a very important part of the education of future sexological counsellors. Adultery, polyamori, genderbending, groupsex, fetishes, S/m, prostitution. These are among subjects that stir reactions in most people, and that many people, including therapists, have predjudices about. But as therapists I believe we have an ethical obligation, not to judge clients who come to us with these and other issues. Some might say that this is obvious, but for some it is neither obvious nor easy to see when we are lead by our own moral standards and feelings, and when we take en ethical viewpoint. SAR invites the students to reflect upon, and encounter some of these things, and find out how they are influenced by them, before meeting them in the therapy- room. It is definitely my impression that most practitioners take pride in doing therapy in an ethical way. But for many people, including therapists, no matter how good their intentions are, moral values often get mistaken for ethical values, and are used to judge others as “strange”, “abnormal”, “wrong”. This is of huge importance in the therapeutic setting, as it is important for establishing and maintaining contact, trust and alliance with clients. SAR attempts to help future sexologists to identify and distinguish between moral reactions, and ethical considerations, and is therefore a very important contribution in the training of sex-positive sexologists.
SEXUAL SATISFACTION IN INDIVIDUALS WITH GENDER IDENTITY DISORDER AFTER SEXUAL REASSIGNMENT SURGERY: A CASE REPORT F. Quattrini 1, R.S. Calabro 2, M. Fulcheri 3 1 Department of Biomedical Sciences University “G. D’Annunzio”, Chieti, Italy,2 RCCS Centro Neurolesi “Bonino-Pulejo”,3 University “G. D’Annunzio”, Chieti, Italy In order to obtain adequate and consistent data, studies on the Gender Identity Disorder (GID) have paid attention to an early diagnosis, to the association between GID and personality disorders and traits, including homoerotic sexual orientation. Moreover, interesting studies dealing with new GID medical (hormones) and surgical techniques have also been described. To the best of our knowledge, only few studies have attempt to evaluate sexual and relational well-being after Surgical Sex Reassignment (SSR). Aim of the present study is to critically review the current and relevant literature dealing with the erotic and sexual representation after SSR, focusing on the orgasmic pleasure in individuals with GID (with regard to Male to Female transexuals). A possible and promising psycho-clinical approach in MtF individuals is the possibility to enable them, before SSR, to reach a greater self awareness of their body and sex, internalizing their orgasmic experience and avoiding the denial of pleasure originating from the same genitalia. Thus, the psychodynamic and psycho-bodily psychotherapy, during the entire real life test, may be considered a useful approach leading to an important reinforcement of the “orgasmic pleasure consciousness.
TREATMENT CONSIDERATIONS IN PEYRONIE DISEASE D. Ralph St. Peters Andrology Centre, London, UK This lecture will concentrate on the new issues in managing patients with Peyronie’s Disease in 2012. There have not been any major advances in the oral medical management of the disease but the use of interferon and latterly intralesional injections of collagenase seem promising. Extrcorporeal shockwave therapy is now a historical treatment once again but the use of the vacuum devices to mechanically stretch and straighten the penis is gaining popularity. Many patients have vascular disease and therefore are at risk of developing erectile dysfunction (ED) post-operatively. Grafting techniques, that have a 15% risk of causing ED, should therefore be reserved for patients that do not have vascular disease and have a complex or significant curvature ( > 60degrees). Patients with vascular risk factors or ED should have either a Nesbit operation or a penile prosthesis implantation, particularly if a significant penile shortening is an issue.
COMBINED MODALITIES FOR THE TREATMENT OF PREMATURE EJACULATION (PE) Y. Reisman Men’s Health Clinics, Amstelveen, The Netherlands PE cannot be considered purely a psychological or “lifestyle” problem but rather a multidimensional disorder involves the integration of physiological, psycho-behavioral, cultural, and relationship dimensions. PE is more than just a shortened time to ejaculation, its affects in addition sexual satisfaction, well-being, and relationship. PE. The relative contribution of these dimensions may vary across individuals and situations and all elements need to be considered in the etiology and treatment of PE. Numerous treatments with varying degrees of efficacy have been used; behavioral, cognitive, and sex therapy techniques, and pharmacologic management with antidepressants, phosphodiesterase-5 inhibitors, and topical anesthetics. Psychotherapy is best when the partner is involved and strategy can be tailored to the needs of the individual. Overall, there is weak and inconsistent evidence regarding the effectiveness of psychological interventions for the treatment of premature ejaculation. Three of the four included randomized controlled studies of psychotherapy for PE reported pour primary outcome (Improvement in IELT) and have a small sample size. The early success reports (97.8%) of Masters and Johnson could not be replicated. The approach most likely to provide success is a combination of cognitive and sex therapy with a pharmacologic agent of proven efficacy that has an easy-to-follow dosing regimen. Future studies combining psychological therapies with pharmacologic agents developed specifically for PE may treat the dysfunction more effectively and immediately, while also enabling couples to achieve a more mutually rewarding sexual and general relationship.
ENCOURAGING CURIOSITY AND PLAYFULNESS IN THE CLIENT THROUGH BODY WORK A. Skrautvol Institute of Clinical Sexology and Therapy, Oslo, Norway Wilhelm Reich and other contributors made us aware of how the body also constitutes a form of protective ‘armour’, and is an important part of - and home to - our defense mechanisms. Findings from research on mirror neurons and imitation, in turn, are excellent sources of ideas and inspiration as to working with the body in the therapy room. Insights from this field can provide valuable information about the client and the client’s problems and resources. Approaching sexuality and sexual problems through concrete techniques where the clients manipulate their body in ways they are not used to, is a useful tool that can be used in addition to more traditional sexological techniques - and of course the general thereapeutic framework of the therapist. Such work may for example include experimenting with breathing, posture, walking, and imitating different role models that represent different qualities the client aspires to possess. Encouraging a degree of curiosity and playfulness in this regard is always helpful. In my experience, this approach gives an additional leverage. I have found it to be particularly useful for the groups of overly empathic clients, who are so preoccupied with pleasing others that it has almost eliminated their own authenticity. Playing with ways of carrying themselves that signal confidence and hightened body awareness can quickly lead to big changes, both in how they view themselves and in how they relate to others - and ultimately arrange their lives and sexuality.
PSYCHOTHERAPY, RELIGION AND SEX THERAPY: DOES BEING A MUSLIM CHANGE THE PRACTICE OF SEX THERAPY M.Sungur Medical School of Marmara Universtiy, Faculty of Psychiatry Istanbul, Turkey Religion and mental disorders always had some kind of troubled historical relation. Further collaboration on certain dimensions between religion and behavioural sciences is therefore needed for human betterment. As religion is the most popular form of voluntary organizations and few human concerns are taken more seriously than religion, it may not be realistic to leave religion out of the scope of our routine psychotherapy practices. Sex therapists do not practice in an ideal standard world. Therefore, they must be flexible enough to adapt their interventions to the needs of different cultures and religions. Societies with different religions (even in same religion) differ about what sexual behaviours will be accepted or tolerated and thus sexual problems and their management are not free from religion and culture. It is therefore crucial to tailor and modify sex therapy programmes to the needs of the people and value systems of their culture and religion, if religious and cultural factors do influence the way sex therapy is offered and welcomed. This presentation will address some of the challenges that the religious dimension presents on sex therapists. It will also addresses the views of a therapist coming from a secular Muslim country on the effects of religion in sex therapy practice.
D. Trotta 12, T. Strepetova 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione Clinica e Terapia in Sessuologia, Salerno, Italy Male orgasm is the result of a complex interaction among several biological, psychological, and phylogenetic components. For men orgasm is a common experience for most of their life and is usually associated with pleasure and satisfaction. Sexual desire is a crucial component of male orgasm. It facilitates - when lively and sparkling, male final sexual response, it precludes or hampers its occurrence when low or troubled. Male orgasm can be impaired in several conditions. Premature ejaculation is when ejaculation occurs before the desired time. If a man is unable to ejaculate in a timely manner after prolonged sexual stimulation, in spite of his desire to do so, it is called delayed ejaculation or anorgasmia. An orgasm that is not accompanied by ejaculation is known as a dry orgasm. Male orgasmic disorders can be impaired by a broad range of medical and psychological conditions. While more attention has been dedicated to premature ejaculation and ejaculation in aging men less known are the clinical conditions associated with male delay or difficulty to ejaculate. The presence of a dystonic erotisation should be taken into consideration when a young and otherwise healthy man is complaining of an incapacity to ejaculate or has an history of unpleasurable orgasms. individuals using gender services.
THE IMPACT OF THE WPATH GUIDELINES ON STANDARDS OF CARE WITHIN GENDER SERVICES K.R. Wylie Porterbrook Clinic, Scheffield, UK The seventh version of the WPATH standards of care document was published in September 2011. The latest guidelines outline a safe and effective pathway of care for transsexual, transgender and gender non-conforming individuals to achieve lasting personal comfort with their gendered self. The outcome should be improvement in overall health, quality of life and psychological well-being as well as ensuring self-fulfilment and overall satisfaction. A necessity of global guidelines is that they have widespread applicability whilst recognising differences within society and cultures and recognising that many, often unstated, environmental factors may have an influence on overall impact and effectiveness. This presentation will explore how different countries have adopted the guidelines and explore the meaningfulness that this may have for individuals seeking care. It will explore some of the potential barriers to more widespread acceptability of the guidelines and consider how service users, advocates and providers of care may influence the overall impact for oral presentations 01
OP.01.01 EXPLORING THE FORMATION OF SEXUAL FANTASIES WITH FUNCTIONAL MAGNETIC RESONANCE IMAGING L. Sánchez Sánchez 1, C. Modroño 2, C. Luciano 1, D. Barnes Holmes 3, M. Mas 2, J.L. González 2 1 Universidad de Almería, Almería, Spain,2 Universidad de La Laguna, Tenerife, Spain,3 National University of Ireland, Maynooth, Ireland Objective: To explore the influence of the rebound effect of the thoughts suppression on the formation of sexual fantasies compared to other kinds of fantasies. Design: A1-B-A2-C-A3, being A1 a fantasy of a breakfast, B an adequate sexual fantasy, A2 a fantasy of theft, C an inadequate sexual fantasy and A3 a fantasy of enjoying oneself in a pub. Every “A” is a control fantasy. The groups were counterbalanced with respect to B and C. Method: 20 participants were assigned to one of two groups. They fulfilled questionnaires about sexual fantasies (Sexual Daydreaming Scale, Sex Fantasy Questionnaire and Hurlbert Index of Sexual Fantasy) and one about their tendency to suppress (White Bear Suppression Inventory). After, they carried out the task inside a functional magnetic scanner. Participants had to imagine, suppress and concentrate successively, on each fantasy. Later, they answered questions about their performance in this task. Results: Suppression was a statistically significant more active process (especially, anterior cingulated) than concentration in both “A” and “C”, but in “B” the reverse occurred. However, the dorsolateral prefrontal cortex was only active in “C”. This last area is closely related to executive control mechanisms, which could be activated when there are intrusive thoughts that want to be suppressed. Conclusions: The rebound effect of thoughts suppression could influence the formation of our most taboo sexual fantasies, but there is less influence for more politically correct fantasies.
OP.01.02 PREDICTIVE FACTORS IN JEALOUS TACTICS AND GENDER VIOLENCE IN ADOLESCENCE RELATIONSHIPS S. Sáez 1, A. Sánchez, 2 1 Amaltea, Instituto de Sexología, Zaragoza, España, 2 lunives; Instituto Universitario de Sexología de La Univ. Camilo José Cela., Madrid, España This piece of work is the result of a doctoral thesis which was presented at Camilo José Cela University The study starts from a sample of over 700 Aragonese young people between 16 and 19 years old. This research tries to find an answer to some questions among many of the possibilities. About adolescence relationships. Our interest was focused on the rules of behavior that young people follow on their interactions so as to contrast the influence of different variables when using those relational rules attending to quantity. The theoretical basis of the study is divided in four big blocks: Adolescence, Adolescence changes, Violence and gender violence, Young couples The second part of this research is a wide empirical piece of work with clear objectives and hypothesis 1. Analysis with the general sample. We will take into account if the strategies used in conflicts, and the prevailing and jealous strategies (as dependent variables) show any differences according to other independent variables. Age / level of couple engagement perceived / Degree of couple satisfaction / Future expectations in the present engagement relationship............................. 2. Dividing the sample depending on the sex variable. In the subject we are addressing (engagement relationships); we think that this division is absolutely decisive. We will consider if every independent variable offers different results when dividing the sample by the sex variable. 3. Predictive variables. We will consider the possible predictive models about violence usage in engagement relationships. We will also pay special attention to possible predictive results, dividing the sample by the sex variable.
OP.01.03 BODILY, SEXUAL AND SOCIAL BEHAVIOR, OF TEEN SCHOOL OF NORTHERN JALISCO, MEXICO. F. Quinonez, M. Perez Avalos Universidad de Guadalajara, Jalisco, Mexico Objective: Wanted to describe bodily, social and sexual behavior, of school teenagers in the northern zone of Jalisco, Mexico. Method: Quantitative-descriptive, it makes use of frequency analysis with SPSS 19. Used a sample of 261 students in second and third year of high school, in the municipalities of Villa Guerrero, San Martin de Bolanos, Colotlan, and Bolanos, located in the northern region of Jalisco, Mexico. Results: The 58.6% of teens want to be alone with the person who is attracted. The 55.2% posted their feelings. The 56.7% was concerned about being attractive. The 58.2% have sought to conquer the person. The 58.6% has called by phone and left messages. The 60.2% has hold hands with the person that attracts. Conclusions: There is an average of 10.7% difference between men and women regarding sexual social and bodily behavior, the most frequently correspond to the social domain. Behaviors that are most prevalent among women are having penetrative intimate contact with or without ejaculation inside. The behaviors that predominate in men are having wet dreams or exciting, masturbation, fondling the breasts over the clothes, fondling above and below the clothes her private parts.
BOOK PRESENTATION: AN ESSAY ON SEXOLOGY IN JOSÉ SARAMAGO’S WORK O. Aranda Viso Atseginez, Bilbao, Spain This essay comprises Jose Saramago’s contribution to the science of sexology by means of his work. His novels are populated with endless examples, situations, quotes and aphorisms that approach the human sexual reality in such a mild and genuinely human way and with such clarity that they claimed to be united in one single text. Each chapter focuses on a particular insight of a specific fact, which goes from the characters’ special ability to seduce and get seduced to the way they love and are loved; the kiss as a whole independent entity with merging power; their view on love and infatuation; the different roles women and men play in the loving game; desire and its incarnation in a particular body; the importance of beauty; ars amandi and its specificities; the phenomenon of prostitution along the centuries and a fierce criticism of any form of violence against women for later exploring break-ups, infidelities and lack of love. In short, we end up with a sum of the author’s abilities to tackle the crucial task of conveying, interpreting and taking a standpoint about the basic nature of the human sexed body.
OP.01.05 WHO ARE THE SEXOLOGISTS IN NORWAY? 2001-2011 C. Almas 1, E. Almas 2 1 Psychiatric Ward, Sorlandet Hospital, Kristiansand, Norway, 2 University of Agder, Faculty of Health and Sport Sciences, Kristiansand, Norway Based on the studies on Who are the sexologists? initiated by Giami & Colomby in 1999, two studies have been performed about Who are the sexologists? in Norway, in 2001 and 2011. The results from the study in 2011 will be presented and and compared with the study from 2001. Questions that will be discussed are: professional background; sexological education; professional identity; sexological pratice; what are the most frequent problems they see in their clients, and what treatment methods do they use? There has been a major change in the situation in Norway, as a further education in sexological counselling started at the University of Agder in 2001. This has resulted in a major change in the distribution in professionals in the sexological field. While the largest group of professionals in 2001 was physicians, nurses have now become the largest group. The problems that are presented seem to be quite similar in the two studies, but there are some interesting changes that will be discussed. Psychotherapy is the preferred mode of treatment. It may be of some worry that the number of physicians has decreased so much that necessary sexual medical treatment may not be available.
SEXUALITY IN WOMEN AFFECTED WITH A NEUROLOGICAL DISEASE (CMT) F. Navarro Cremades 1, P. Gargiulo 2, P. Vinci 2, A.H. Rellini 3 1 Faculty of Medicine Umh. Departament of Clinical Medicine, San Juan Alicante, Spain,2 Cmt Association, Rome, Italy,3 University of Vermont, Burlington, USA Objective: To evaluate the presence of sexual dysfunction in a sample of 57 Italian women (age 18-60 years) affected with Charcot-Marie-Tooth disease (CMT), a genetic neuropathy (prevalence 1 : 2500) causing physical disability. Design and Method: We used the validated Italian version of the McCoy Female Sexuality Questionnaire (MFSQ-IT), to discriminate between women with and without sexual dysfunction. MFSQ-IT consists of 14 items grouped in two factors labeled Sexuality (S) and Partnership (P). A t-test was performed to assess score differences between patients and controls, subdivided in 4 age groups. Results: Since 17 women (29,8%) reported not to have had a sexual intercourse in the previous four weeks, analysis was conducted on 40 questionnaires. A statistically significant difference (p<0.001) was found in the youngest age group (18-30 years) for both MFSQ-IT factors, which indicates sexual dysfunction. Conclusions: Both organic (reduction of sensation, muscle weakness, cramps, fatigability) and psychological (alteration of physical aspect with low auto-esteem and difficulty relating with the partner, fear of procreating children with the same disease, fear of STD) factors may affect sexuality in CMT patients. However psychological factors probably play a major role, as sexual function did not result affected in mature women despite physical impairment worsens with age.
OP.01.07 SEXUALITY AND ANTICONCEPTION IN A SAMPLE OF SPANISH FEMALE UNIVERSITY STUDENTS F. Navarro Cremades 1, R. Hernandez Serrano 2, J. Rodriguez Marin 3, P. Vinci 4, A.H. Rellini 5, P. Gargiulo 4, V. Gil Guillen 1, A. Palazon Bru 1, J.M. De La Fuente 6 1 Faculty of Medicine Umh. Departament of Clinical Medicine, San Juan Alicante, Spain, 2 Central University of Venezuela, Caracas, Venezuela, 3 Faculty of Medicine Umh. Departament of Health Psychology, San Juan Alicante, Spain, 4 Cmt Association, Rome, Italy,5 University of Vermont, Burlington, USA,6 Hôpital Psychiatric, Lannemezan, France Objective: We aimed to determine the prevalence of the use of ACs among female students of a public spanish University and to identify the factors associated with this use. Main Objective: To assess the use of different AC methods in a Spanish university sample. Secondary Objectives: The data analysis of the relevant factors related with the use of these AC methods Design and method: For the purpose of this survey, we used an original CPA questionnaire with a good general psychometric characteristics to assess the use of the different ACs and the major factors related with this use in a female university sample of nearly six hundred women, from years 2004 to 2009. Method: descriptive, cross-sectional epidemiologic study Results: ACs mainly used: Condom 58.8% (valid % 63.1). OCs 16.1% (valid % 17.3). None 8.8% (valid % 9.4) and others ACs. Condom is used by 59.5% of heterosexual women; and 63.6% of bisexual female. Condom is used by 60.2% of single women, 55.6% of married female and 41.7% of others Conclusions: Despite of many studies showing that OCs are the most commonly used method of contraception for women in developed countries, in our sample, however, condoms have been shown to be the method of choice, followed by the pill, in all years from 2004 to 2009.
OP.01.08 A GENDER BASED LEARNING ADVENTURE. REMARKS ON A TRAINING EXPERIENCE C. Scandurra, A. Zurolo, A.L. Amodeo University of Naples Federico II - Department of Theories and Methods of Human and Social Sciences, Naples, Italy Objectives: This paper illustrates a training experience in the framework of the project Hermes Linking Network to Fight Sexual and Gender Stigma, addressed to NGOs, Schools and Institutions engaged in fighting gender and sexual stigma. Workshops were organized to empower knowledge about gender issues, stereotypes and norms influencing human relationships and causing violent behaviors and discriminations towards women and GLBTQI population. Design and Method: Different clinical methodologies were used such as Social Dreaming Matrix, Role Playing, “Roulette of identities”, Application Group. One or two observers were involved. Surveys pre- and post- have been administered to participants to evaluate intervention efficacy. Results: Participants’ mental representations about gender issues came out. Possibilities of sharing experiences, thoughts and good practices found space, in the perspective of a concrete application of them into each one’s working context. Conclusion: The training experience has been a successful chance to detect resources and problems related to the work in the field of women and LGBT people’s health, as well as using methods to share and transfer knowledge and good practices. The techniques used constitute a virtual setting where every participant can act different roles. The implicit “as if” allows a double transformative chance for participants: fiction enhances a distancing view of particular problems and provides the opportunity to express emotional processes. This publication has been produced with the financial support of the Daphne III Programme of the European Commission. The contents of this publication are the sole responsibility of the author and can in no way be taken to reflect the views of the European Commission. oral presentations 02
L.N. Hernández Coterón 1, C.N. Méndez Gómez 1, L. Rojas Zuasnabar 2 1 Centro Nacional de Educación Sexual (Cenesex), Havana, Cuba, 2 Communitarian Center of Mentalhealth Playa, Havana, Cuba We presented/displayed a descriptive, longitudinal study made in the Clinic of the Adolescent, from 1993 to the present time diagnosed like Upheaval of Identity of Sort. In this period 31 444 cases are received, of them 1382 are sent to consultation of Sexology and 254 are diagnosed like children, children and adolescents you do not conform to its identity of sort and dysphoria of sort of. The age of beginning in consultation fluctuated between the 3 and 7años ones, followed until the 18 years of age. To these cases neurophysiology studies were made to him conventional and quantitative (Brain mapping), psychological, endocrinology evaluation and genetic. In the sample we found that 64 adolescents initiated sexual relations with pairs of their same sex and 1 their relations have been heterosexual. The hormonal, conventional electroencephalograph and genetic endocrines studies; they were normal in all the cases. Electroencephalograms quantitative (cerebral cartography or brain mapping) reported a significant fall of the absolute and relative power of the energy for all the bands in more of 67% of the studied cases. In the genetic study made exhibit in 4 cases polymorphism of the chromosome 9qh, without any clinical value. Of the 254 cases valued in this period, 3 of them already considered people maintained Transsexuals woman in the time until the present time and the present moment with surgical adjustment, 2 Transsexual men and 1 Transgénero person.
OP.02.02 QUALITY OF SEXUAL LIFE AND BODY IMAGE DURING SEX REASSIGNMENT PROGRAM: A PILOT STUDY M.T. Molo 123, C. Crespi 23, V. Mineccia 23 1 Fondazione Carlo Molo Onlus, Turin, Italy,2 Cerne, (Centro Ricerche Neuroscienze), Turin, Italy, 3 Centro Interdipartimentale Disturbi dell’identita di Genere Molinette - A.o.u. San Giovanni Battista, Turin, Italy Objective: Gender Identity Disorder (GID) represents the most severe form of the Gender Spectrum Disorders. The sexual life during the sex reassignment program is poorly investigated in the literature and the body image undergoes some changes as a consequence of the cross-sex therapy. The aim of the present study was to investigate both the quality of sexual life and variations of the body image in a sample of GID subjects. Design and Method: The study sample was composed of 50 GID subjects (25 Male-to-Female and 25 Female-to-Male) referred to our Gender Team to undergo Sex Reassignment Surgery. Subjects were evaluated at the beginning of transition program and after one year of cross-sex hormonal treatment. The general physical conditions and the Body-Mass-Index were evaluated and clinical interviews were made to assess sexual orientation, sexual intercourses and the general quality of sexual life. The World Organization Quality of Life Questionnaire (WHOQOL-100) was administered by considering the scores of these subscales: Quality of Sexual Life, Body Image and Interpersonal Relationship. Results: The results pointed out that one year after crosssex therapy most of the subjects showed a better body image and an improvement of the quality of sexual life according to WHOQOL-100 scores. At the same time our results highlighted some important differences between MtF and FtM related to age, Body-Mass-Index and the presence of a stable relationship. Conclusions: Several aspects like physical conditions, body image and presence of a stable relationship could predict sexual satisfaction in GID subjects during the transition program.
OP.02.03 GENDER IDENTITY DISORDER AND PSYCHIATRIC COMORBIDITY: A DESCRIPTIVE STUDY A. Gualerzi, C. Crespi, G. Zullo, D. Munno, L. Rolle, C. Manieri, M.T. Molo, V. Villari, F. Bogetto, D. Fontana 1 C.i.d.i.ge.m. A.o.u. S. Giovanni Battista, Turin, Italy,2 Dipartimento di Neuroscienze e S.m. A.o.u.S. Giovanni Battista, Turin, Italy Objectives: Aim of this study is to investigate - with standardized diagnostics - sociodemographic features and to assess current and lifelong psychiatric comorbidity in subjects with GID. Materials and Method: Sample was composed by 191 subjects (MtF 74,2%; FtM 25,3%; mean age = 33,42±10 years) attending C.I.D.I.Ge.M - a GID Public Health Service in Turin, Italy - in order to enter the programme for SRS, from 2005 to 2012. According to all standards of care, the patients underwent an accurate diagnosis about gender disorder by two mental health professionals, with clinical and SCID I-II interviews. Statistical analysis were conducted using IBM SPSS Statistics 20. Results: MtF subgroup showed positive history of prostitution and abuse. We found direct correlation among prostitution, age and low level of education. Preliminary data show that 58.1% reported positive psychiatric anamnesis. The current positive comorbidity is 43,2% on Axis I and 20% on Axis II. 83% reported GFR values greater 61. The comparison of psychiatric characteristics between the two groups did not differ significantly. Conclusion: GID is an indipendent clinical condition and comorbidity is often a reaction to GID. Our data show a higher percentage of psychiatric comorbidity than in literature. This could be explained by our assessment methods and also by the sensitivity of professionals, able to diagnose and treat subthreshold disorders.
OP.02.04 NEUROPHISIOLOGYCAL POST-OP VARIATIONS IN MTOF TRANSSEXUALS M.T. Molo 1, M. Falcone 2, E. Galletto 2, L. Rolle 2, L. Castelli 1, B. Grosso 1, P. Perozzo 1, S. Vighetti 1 1 Fondazione Carlo Molo Onlus, Turin, Italy,2 Universita degli Studi di Torino, Urologia II, Turin, Italy Objective: To assess neurophysiological variations in MtoF transsexuals undergoing to sex reassignment surgery in order to lead new biological evidence of the phenomenon. Design and method: Twelve MtoF transsexuals looked at 60 slides (20 positive, 20 negative and 20 neutral) from the International Affective Picture System-IAPS, before and after surgery treatment. During the slide presentation, the P300 was recorded from scalp according to the 10-20 International System and the back-averaging methodology. Results: Our results show a statistically significant variation of the P300 in the post MtoF for the negative slides only. This variation consists in an increase of the area below the P300 recording in Fz, Cz and Pz electrodes. Instead, we haven’t found any variations concerning the latency and the amplitude of the P300. Conclusion: Our preliminary study underlines an increased value of the P300 in the post MtoF during negative slides presentation but only for the rectified area and not for the latency and the amplitude parameters. This is in accordance with the literature confirming a difference between genders: women are more sensitive to affective valence of emotional stimuli whereas men to arousal level. We suppose that the increase of sensitivity to strong emotions in MtoF transsexuals might be due to a feminizing cerebral effect after surgery. 0P.02.05 PSYCHODYNAMIC GROUP PSYCHOTHERAPY AND GENDER DYSPHORIA S. Ahmad, A. Davies West London Mental Health Trust, London, UK Objective: The Charing Cross Gender Identity Clinic (CXGIC) always held a group for patients with gender dysphoria. This was reviewed in 2010 and we aimed to develop a new psychodynamic group. Design and Method: We used group analytic principles to set up a fortnightly slow-open group lasting 75 minutes. Two cofacilitators and eight patients, with 20 sessions available to them, form the group. Patients are referred by clinicians at CXGIC if they need more intensive input. We have implemented six-weekly supervision in addition to co-facilitator reflection. Results: We have successfully held 34 group sessions so far and have seen a throughput of patients. Patients attending are either struggling with dysphoria or progression along the transition pathway. Several themes have emerged: external factors such as family, work and anxiety about social presentation; internal factors such as rigid gender perspectives, avoiding emotional material, loneliness and the concept of a ‘real self’. Anxiety about stigma and being ‘dualrole’ has been a pervading topic. Some patients have used the group space concretely as their primary vehicle for transition. Our reflection is that the group can be used as a vessel to contain anxiety. Conclusions: The group has highlighted the complex heterogeneity of this subset of patients attending the CXGIC. We have noticed how the group quickly achieved a cohesive space where patients can be helped to look at the internal as well as the external. 0P.02.06 CROSS-SEX HORMONE TREATMENT IN TRANSGENDER SUBJECTS AND SOMATIC CO-MORBIDITY H. Asscheman 1, J. Feldman 2, L.J. Gooren 3 1 Hajap, Amsterdam, The Netherlands, 2 Dept of Family Medicine and Community Health, Un. of Minnesota, Minneapolis, Usa, 3 Androconsult, Chiang Mai, Thailand Objective: To describe side effects and somatic co-morbidity in transgender subjects receiving cross-sex hormone treatment (CSHT) and the management of CSHT in those cases. Design: Based on published papers, small unpublished studies (MtF >50 years of age starting CSHT ), and >30 years experience in the field with > 3000 subjects treated, the authors report their expert opinion. Results: Major side effect in estrogen-treated MtF subjects are venous thromboembolism and cerebrovascular disease, and probably also cardiovascular death, all more frequent during current ethinyl estradiol or oral contraceptive use. The effect of CSHT on diabetes, hyperlipemia and hypertension is not well studied but some indirect negative effect is probable (weight increase?). Except for hormone-dependent neoplasms, no increased total mortality of malignancies has been shown, but a decrease in colon cancer (also observed in postmenopausal women on estrogen) and an increased number of hematological malignancies have been reported. Many minor side effects are reported which can be managed by adapting CSHT. Age and unhealthy life style might be important contributing factors to the occurrence of side effects, particularly in MtF persons. In FtM, who are much younger when starting CSHT, acne (20%) and weight increases (>10% in 17%) are the most frequent side effects of testosterone therapy. Modifying androgen therapy and life style interventions can be of help for latter two and other, minor side effects on androgen treatment. Conclusions: Cross-sex hormone treatment of transgender persons carries certain health risks but these are largely preventable and manageable.
OP.02.07 THE 7th VERSION OF CARE STANDARDS OF WPATH. A DIFFERENT APPROACH THAT GOES BEYOND SEXUAL DIMORPHISM AND GENDER M. Fernández Rodríguez 1, E. Garcia Vega 2, P. Guerra Mora 2, B. Ures Villar 1 1 Servicios de Salud del Principado de Asturias. Salud Mental, Aviles, Spain, 2 Universidad de Oviedo, Oviedo, Spain Since Harry Benjamin defined transsexualism as pathological entity, attention to this collective has been directed mainly to start a reassigment process, establishing a sequence towards a sex reassigment. The aim of this presentation is to analyze the many significant changes brought in the Care Standards of the 7th version of WPATH (World Professional for Transcender Health) and to reflect about its involvements. In an attempt of depathologization, the Gender Identity Disorder diagnosis is replaced by Gender Identity Dysphoria. The population focus of attention is expanded, as well as the treatment options are diversified. The sex reassigment is no longer the ultimate aim for people with Gender Identity Dysphoria. The eligibility and disposition criteria, essential on the other hand, become an only and less restrictive criteria block. It is not a prerequisite to carry out the real life experience and/or psychotherapy for the hormone treatment. The obligation to carry out the hormone treatment for the breast surgery is removed and the psychiatric comorbidity doesn’t necessarily exclude the hormonal and surgical therapy access. One of the most controversial section is probably the one devoted to children and teenager treatment. The new standards involve an overcoming of the traditional dycotomic model (male man and female woman), setting that gender, felt and expressed, does not need to be inextricably linked to biological sex.
MALE SEXUAL PROBLEMS AND SEXUAL ORIENTATION: RESULTS FROM A MULTI-COUNTRY STUDY A. Carvalheira 1, A. Stulhofer 2, B. Traen 3 1 University Institute of Applied Psychology, Research Unit of Psychology & Health, Lisbon, Portugal,2 Faculty of Humanities and Social Sciences, Department of Sociology, Zagreb, Croatia,3 University of Troms0, Troms0, Norway Little research has been carried out on sexual problems in homosexual samples. The aim of this study was to explore the incidence of sexual problems and significant correlates among men with an exclusively homosexual behavior, and to make comparative analysis with exclusively heterosexual men. This study is part of a large web-survey carried out on Portugal, Croatia, and Norway. Participants were 3,500 exclusively heterosexual men and 228 men with sexual partners exclusively of male gender in last five years. Gay men and straight reported different frequency of sexual problems for at least two months or longer during the previous year with associate personal distress, respectively: 27.4%/22.2% was erectile difficulty; 24.6%/ 20.5% lack of sexual interest; 25%/18.4% anxiety about performance; 20.3%/23.4% early ejaculation; 12.6%/9.6% unable to experience orgasm. Comorbidity of sexual problems was frequent. Gay men had significantly higher frequency of use of pornography compared to straight, t(270) = -8.7, P < 0.001. Gay men had significantly lower level of confidence to achieve and maintain an erection compared to straight, t(3785) = -2.04, P < 0.05. Gay men had significantly higher level of depression compared to straight, t(239) = -3.57, P < 0.001, and higher levels of anxiety, t(237) = -2.9, P < 0.01. The incidence of sexual problems among exclusively homosexual men was higher. Erectile difficulty and lack of sexual interest were the most common. oral presentations 03 G. Mori, R. Bernorio, P. Boccardi, S. Di Santo Associazione Italiana Sessuologia Psicologia Applicata, Milan, Italy Pubic hair removal appears nowadays to be an important aspect of expressing women’s sexuality and seductiveness. A sample of 400 Italian women were randomly evaluated by two gynaecologists during a common routine examination. The shape of pubic hair was classified in 7 typologies and each typology was cross-linked with age, schooling, relationship status, obstetric history and assumption of contraception pill. The results will be discussed; they express a significant change in the Italian women’s attention and attitude to their genital image.
I. Hattat 1, E. Hattat 2, H. Hattat 3, F. Gultekin 2 1 European Sexual Health Alliance Turkey, Istanbul, Turkey,2 Hattat Uro-andrology Clinic, Istanbul, Turkey 3 Family Health Research Association, Istanbul, Turkey Introduction: Turkey is one of the most interesting countries in terms of sexuality, as it is a Muslim,male dominant mediterranean country, where sexuality is a very important but taboo subject. In fact, the Sexual Health in Anatolia goes back B.C. Periods.The oldest tablets found are from Ancient Hittite civilization 1800 BC.We can divide the time frame into 5 main periods:Ancient times, Mythology,Selcuk Period: 14th century, Ottoman Empire and Andrology in Modern Turkey. Aim: The aim of this study is to show the historical development of Sexual Health from Hittite Civilization to 21th century, showing the importance of Sexual Health help lines in the current socio-cultural state. Methods: The study shows the widest and most colourful summary of sexual health practices in Anatolia starting from preserved tablets clearly documenting the ritual andrological practices, to spiritual formulas, mythology, 14 th century Selcuk period and Ottoman Empire. The modern times after 1970’s are also summarized, followed by the help line statistics of European Sexual Health Alliance Turkey office. This is a summary of a total of 39000 telephone callers, who called for sexual concerns to ESHA Turkey helpline during a 10 year period, 55% 18-35 years old, and 82% being male callers.The major inquiries are erectile dysfunction (30%) premature ejaculation (19%)and lack of desire for men (20%), and vaginismus(31%) and lack of desire(24%) for women. Conclusion: Considering the historical background, the sexual help lines fill an important void for the sexual health patients, who don’t apply for health services for various reasons.
OP.03.03 GENDER DIFFERENCES IN SEXUAL DYSFUNCTIONS IN A GROUP OF FIRST-EPISODE PSYCHOSIS PATIENTS G. Ciocca 1, S. Ochoa 2, M. Dolz 3, E. Limoncin 1, B. Sánchez 3, A. Barajas 2, E. Huerta 2, A. Farreny 2, E.A. Jannini 1, J. Usall 2 1 University of L’Aquila - Department of Experimental Medicine, L’Aquila, Italy,2 Parc Sanitari Sant Joan de Déu, Barcelona, Spain, 3 Sant Joan de Déu Hospital, Barcelona, Spain Objective: This study mainly aims to investigate gender differences in sexual dysfunctions in people with first episode psychosis. Design and Method: 40 males and 37 females with first episode psychosis took part in the study. We administered a psychiatric protocol composed of PANSS and UKU along with SCID- DSM-IV diagnosis. We also took into account the influence of antipsychotic treatment and prolactinemia. Results: 42.5% of men and 37.8% of women were found to be affected by sexual dysfunction. The logistic regression showed that the influence of drugs and prolactin levels on sexual dysfunctions was not statistically significant. In males erectile dysfunction was associated with ejaculatory alteration (r=.670;p<0.0001). Both these dysfunctions were related to orgasm alteration (r=.735;p<0.0001) and (r=.929;p<0.0001) respectively. In females, alteration of vaginal lubrication was related to decrease in desire (r=.526;p<0.01) and with orgasm alteration (r=.733;p<0.0001); in turn decrease in desire was related to orgasm alteration (r=.648;p<0.0001). The correlation between sexual dysfunctions and psychopathology has revealed the association between positive symptoms and decrease in desire in males (r=306;p<0.05). In females, general psychopathology and positive symptoms were linked to the alteration of vaginal lubrication (r=.547;p<0.05) and (r=.485;p<0.01), even though decrease in desire and orgasm alteration were also associated with psychopathological symptoms in women. Conclusions: The association between sexual dysfunctions and psychopathology in males has been found only in the desire phase, while in females it was present in the entire sexual response cycle. Additionally, in the initial phase of the treatment, prolactin levels and antipsychotic drugs did not influence sexuality.
CHILD SEXUAL ABUSE AND THE COURSE OF THE BORDERLINE PERSONALITY DISORDER K. Peichert 123 1 Autonomous University, Barcelona, Spain, 2 Udai-tlp, Fundacio Sociosanitaria de Barcelona, Hospital Duran I Reynals, Barcelona, Spain,3 Rozmawiajmy O Seksie - Foundation for Promoting of Sexual Health and Preventing from Sexual Pathologies, Poznan, Poland Objectives: The objective is to describe the impact of child sexual abuse for the latter course and the functional outcome of the borderline personality disorder (BPD). Design and method. Participants: 105 outpatients diagnosed with BPD attended in a psychiatric hospital unit, collaborating with the research group of the Autonomous University of Barcelona, specialised in diagnosis and treatment of BPD. Procedure: Adult patients are screened through a clinical psychiatric interview and included in the study if they meet BPD criteria according to DSM-IV-TR. Furthermore, the SCID-II, and the Temperament and Character Inventory- Revised are applied, as well as the Semistructured Clinical Interview for the presence of specific antecedents (Childhood and Adulthood Traumatic Life Events). The course of disorder is observed by: frequency of hospitalizations, the number of suicidal attempts, worsened global functioning scale and comorbidity of other mental health problems (measured by SCID-II questionnaire). Results: The preliminary results of the study show that the course of the BPD is different in the group of patients with the history of child sexual abuse than within the group of patients who did not face such events in their childhood. Conclusion: On the basis of the preliminary results, we can conclude that the history of child sexual abuse in the group of patients with BPD predicts worse functional outcome and more severe course of the disorder. This sheds light to the importance of the prevention and the follow-up of the victims of child sexual abuse in the view of latter consequences in their mental health.
OP.03.05 SEXUAL RISK BEHAVIOR MALE AND FEMALE PSYCHIATRIC PATIENTS E. Van Drunen 1, J.G. Griffioen 1, J. Van Lankveld 2 1 Ggz Breburg, Tilburg, The Netherlands,2 Open Universiteit, Heerlen, The Netherlands Objectives: Literature study has shown that no research has been done in the Netherlands on sexuality in psychiatric patients with substance abuse, combined with psychiatric disorder. The present study aimed to explore sexual risk behavior of these patients. Design: A quantitative, cross-sectional design. Method: 33 patients (male N=20, female N=13) completed the questionnaire ‘Relaties en Seksualiteit’ about their sexual behavior. Results: Patient ages between 20 and 54 years (mean = 38 years). About half of the patients with a relationship (=39,4%) also reported sexual contacts with others than their steady partner. Of the male patients almost 50% did not use contraceptives, including condoms. Fewer male than female patients used a condom with a new partner. A minority of patients reported using condoms during vaginal or anal intercourse. About 20% of the male and 25% of the female patients ever had sex for money or drugs and about 60% of the male patients ever paid for sex with a prostitute. Knowledge about STDs/ HIV and contraceptives was reasonably accurate, although some extraordinary beliefs were reported about the use of contraceptives. The majority of the patients reported having been tested for STDs/HIV at least once. Conclusion: While the knowledge about STDs/HIV and contraceptives was reasonably accurate, rates of sexual risk behavior were found to be high.
OP.03.06 SEXUAL PROBLEMS IN PATIENTS WITH COMBINED PSYCHIATRIC PROBLEMS AND ADDICTION T. Griffioen 1, E. Van Drunen 1, J. Van Lankveld 2 1 Ggz Breburg, Tilburg, The Netherlands, 2 Open University, Heerlen, The Netherlands Objectives: To investigate the prevalence and nature of sexual problems in patients with a combination of addiction and severe psychiatric problems. Design: A quantitative, cross-sectional design. Method: Medical records (and treatment strategies) of 180 psychiatric patients with double diagnosis were scanned for any references to sexual problems and sexuality. A subgroup of 75 patients was invited to participate in a paper-and-pencil survey that was completed by 33 patients (male N=20, female N=13). Results: Age range was 20-54 years (mean 38 years). DSM- IV-TR diagnoses (N=180) were: affective disorders: 24,6% (M), 55% (F); personality disorders: 65,1% (M), 83,5% (F); psychotic disorders: 33,8% (M), 4,1% (F). Based on the literature we expected PTSD-diagnoses in 33-50% within this patient group PTSD-diagnoses were found in only 4,6% (M) and 20,4% (F). Although unconfirmed by medical records, most of our sample reported having sexual dysfunctions in the survey. Unexpectedly, normal levels of sexual desire were reported, compared with the general Dutch population. Treatment strategies never even mentioned sexuality in general terms, neither were contraceptives. Conclusion: Psychiatric patients with dual diagnosis appear to have normal appetite for sex but al substantial proportion of them also report suffering from sexual dysfunctions. We cannot distinguish if this is due to substance abuse, psychiatric issues or medication. Based on the absence of references to sexuality care providers appear unaware of the sexual needs of these patients. This illustrates the urgency to educate staff about patients’ sexual needs and how to address this issue.
PROSTITUTION USE - HEDONISTIC CHOICE, PEER GROUP STANDARD AND STRATEGY AGAINST DEPRESSIVE SHYNESS? CASE REPORT OF A PSYCHIATRIC OUT PATIENT F. Gysin, Private Practice, Lisbon, Portugal Objective: A shy depressed 30 year old male relates on questioning to be a frequent ego-syntonic indoor prostitutionconsumer in small peer groups though in individual use. Several distinctive non-sexual functions of this habit are identified. Design and Method: Material consists in written notes from 14 psychiatric sessions of 55 minutes in private practice setting over six months. The Arizona Sexual Experience Scale was applied to compare subjective appraisal of paid sex and sex in love relation. Results: An easy victory over shyness, this kind of prostitution use has myriads of other non-sexual functions. It consists in a current, ritualized and expected local peer group behaviour. To the patient it works as a proud male life style item reinforcing fragile identity. The efect on self esteem is similar to his practice of kick-boxing. Asserted as group standard it is practiced even with frequent erectil disfunction and when sex with a stable romantic partner is more enjoyable and satisfying. The therapeutic atitude of a female psychiatrist, with her own ethic values, was a starting point to understand its intrapsychic function as a coping mechanism against depressive feelings. Conclusions: Exploring and understanding prostitution consumption patterns in young men benefit treatment of psychiatric disorders in private practice. It is the psychiatrists task to investigate the patients hidden and unaware motives behind paid sex use and to help him to greater inner and relational freedom.
SEXUAL HEALTH IMPROVEMENTS: NEW INTERVENTIONS IN LOW SOCIAL STATUS WOMEN J. Poyato Galán, J.J. Piruat De Pareja, M.J. Rita Acosta, F. J. Torres Gómez Hospital de Alta Resolución de Utrera, Sevilla, Spain Objective: Poverty and low social status put women at risk for negative Sexual Health (SH) outcomes, making minority/ marginalized women most vulnerable for reaching equality. Gender-based insolidarity, cultural discrimination, strict religious norms and lack of education restrict women's access to information, prescribing them a more passive role in decisions on their sexual life, undermining female autonomy. The present study shows new interventional tools to promote access to SH support and improve women's quality of life. Design and Methods: Between January'11-January'12 women were randomly selected from Nursing, Gynecology and Urology Departments by filling the Female Sexual Function Index (FSFI) and social-cultural questions; informed-consent was recruited. Information about female/couple relations focusing on equity, respect, sane Sexuality and female empowerment was given. Participatory methods, role-play situations, contacts with community leaders were also used, but Internet resources were discharged due to absence of population web accessibility. After 3-month follow-up FSFI + short opinion questionnaire were filled again. Study is still on the run. Results: 415 (14-75yo) women were selected. Results were: FSFI 0-10=10.12%, FSFI 10-20=70.36%, FSFI 20-36=19.51%. Low FSFI scores associated elder women while high scores younger ones. After social/educative interventions results were: 76 women left the study (18.31%), FSFI 0-10=8.84%, FSFI 10- 20=62.24%, FSFI 20-36=28.61%. Conclusions: Low social status women undergoing SH educational programmes improve their general quality of life through their sexual quality of life. oral presentations 04
OP.04.01 SEXUAL FUNCTION IN ITALIAN COUPLES: DIFFERENCES RELATED TO AGE AND COUPLE COHESION M. Panzeri Padua University, DepartmentofSocialandDevelopmentalPsychology, Padua, Italy Objective: Sexual functioning has not been studied often within the couple. This study aims to compare male and female sexual functioning within the couple in order to assess the most recent model of female sexual response (cp. Basson, 2000). Method: The Italian version of the Brief Index of Sexual Functioning (BISF) for Women (Panzeri et al., 2009) and for Men (Panzeri et al., 2008) and of Perceived Relationship Quality Components Inventory (PRQC; Cusinato et al., 2009) have been administered to 176 Italian couples aged between 18 and 69 yrs. Internal consistency was calculated by means of Cronbach alpha coefficients for each factor. A MANOVA was performed on BISF 4 factors (Panzeri et al., 2004) and 7 dimensions (Mazer et al., 2000) with gender and age as factors. An ANOVA was performed on BISF c-score (Mazer et al., 2000) with same factors. BISF factors, dimensions and c-score have been correlated with PRQC factors. Results: Self-Eroticism, Anal Sexuality, Relationship Satisfaction, Desire, Initiation, Orgasm and c-score for women were significantly greater (p < .001) than for men, while Problems for women were significantly lower (p < .001) than for men. Other scores were comparable in both genders. In women Love correlated with Sexuality of the Couple, Dissatisfaction, c-score and all dimensions, in men only with Sexuality of the Couple, Frequency and Orgasm. In women Arousal correlated with all PRQC factors, in men with none. Conclusions: This research provides further validation of Basson’s female sexual response model, especially regarding to arousal modality.
F. Iacono, D. Prezioso, A. Ruffo, E. Illiano Department of Urology University Federico II, Naples, Italy Objective: Infertility is regarded as a major life crisis that has the potential to threaten the stability of individuals and relationships. The ability to reproduce is intimately tied to sexuality, self-image and self-esteem.We studied the impact of a natural compound (Tradamix®) the support of male sexual life during assisted reproduction technique (ART). Design and Method: A double-blind study:60 patients married or cohabitant couples, submitted on ART were enrolled. Mean age was 36.4 years.They were randomly separated in 2 groups A-B of 30 pts. To group A was administered twice a day Tradamix® (150 mg of Alga Ecklonia Bicyclis, 396 mg of Tribulus Terrestris and 144 mg of D-Glucosamine)while Group B received placebo.Patients completed two self-administered IIEF, and SEAR questionnaires after 60 days treatment. Results: The IIEF scores in dimension ’’Intercourse Satisfaction” were significantly more favourable after treatment in group A ( item6:4,3±0,59; item7:5,22±0,49;item8:4,23±0,50) then group B (item6: 4,10±0,71; item7:2,13±0,68; item 8:2,16±0,53),(p<0,05).Also the IIEF scores in dimension “Sexual desire” and in dimension “Overall satisfaction” were improved after treatment in group A(item11:4,13±0,34;item1 2:3,56±0,67;item13:4,03±0,18; item14:3,93±0,36) then group B(item11:1,70±1,06;item12:1,66±0,47;item13:1,76±0,43; item14:1,66±0,47) ),(p<0,05).The SEAR scores in dimension “Self-esteem” were significantly more favourable in group A (item9:1,51 ±0,50; item10:1,61 ±0,50;item11:4,31 ±0,5 4,item12:4,31±0,59)then group B(item9:3,72±0,75;item 10:3,31 ±0,47;item 11:2,13±0,58 ,item 12:3,75±0,63) ),(p<0,05). Conclusions: Tradamix® demonstrated interesting significant efficacy like the support of male sexual life during (ART),improving in a natural way the male saxual function, the intercourse satisfaction, the sexual desire, and self esteem due its antioxidant,androgen mimectic synergistic action.
A. Sierra Femxy - Fundación Sauce - Sdad. Sexólogica de Madrid, Madrid, Spain The fusion of three worlds: Sexuality, Humour and Erotic Toys, this would lead us to theoretical and practical workshop full of fun, experimentation and learning. ‘Make laugh’ offers a Holistic Sexual Growth. It is a brilliant opportunity to work our physical and emotional health, together with communication between partners, desire and pleasure through laughter, humor and sex toys as allies. Our objective here is to have fun. Also to meet and find several games and ways to have an emotional-sexual growth introducing naturally the use of sex toys where couples can easily use them to enhance their sex life. The workshop is designed by experts in several areas like Humor, Psycho-Sexuality and Erotic Toys. This makes the result is an enriching experience and fun. The workshop methodology is mainly participatory, of made garments and techniques based on Laughter Therapy and Laughter Yoga fused with effective Sex Education and Erotic Toys. As a result, we will discover and work with feelings and emotions about our own sexuality. Resulting in .a playful way to learn and enjoy introducing erotic toys in our lives In conclusion, I personally think it is a vital and rewarding workshop, since is encourages sensory contact, personal and interpersonal, communication between couples as well as it provides with the knowledge of innovative instruments to achieve all this. Definitely a pleasurable way of learning and at the same time improving our own wellbeing! 0P.04.04 SEXUALITY IN RHEUMATIC PATIENTS: THE ROLE OF PARTNER C. Silvaggi 1, M. Silvaggi 1, F. Tripodi 1, C. Simonelli 2 1 Institute of Clinical Sexology of Rome, Rome, Italy, 2 University Sapienza of Rome, Rome, Italy Objective: Sexuality is an often neglected area of quality of life in patients with rheumatic diseases. Manifestations and symptoms of disease can impair sexual functioning, but this can be much improved by adequate intervention and counselling. The aim of this work is to show importance of partner’s role and couple’s dynamics in addressing sexual difficulties. Methods: Review of articles on this subject published in the Medline (PubMed) database, selected according to their scientific relevance. Results: Dynamics of the relationship are important in addressing physical factors (pain, fatigue, stiffness, functional impairment, drug treatment), emotional problems (depression, anxiety, negative body image), and related to disease stress, as well as contextual aspects due to complications in employment, family and social areas, contribute to a less active and satisfactory sex life. The percentage of patients with RD who experience sexual problems ranges from 10 to 80% in different studies and varies from one disease to another. Despite the distress that this condition involves in both partners, less than 30% of men with ED calls for professional help, and does so mainly because he sees their relationship at risk. Conclusion: Sexual functioning can be much improved by understanding and consideration of the dynamic factors in couple and the involvement of partners in the therapeutic process.
SEXUAL DESIRE VS SEXUAL FEARS T. Strepetova 12, A. Di Marco 12, L. Otranto 12, E. Fattorusso 12, A. Triuzzi 12, R. Bochicchio 12, E. Arduino 12, E. Troiano 12, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: For the majority of men women are essential and a world without women is impossible even to imagine. But male- female relationship is not always easy and straightforward. Sometimes attraction between the sexes can turn to suspicion, fear and sometimes also hatred. Our goal is to understand the origins of that fear and its impact on male sexuality. Design and Method: We compared different sources telling us that fear of women has ancient origins and continues to be a problem also nowadays: mythology, Old and New Testament, popular sayings, urban legends and clinical cases. We report data from clinical cases, that were treated with a sexodynamic approach, that focuses on the aspects connected to the identity, to the relationship with the other, and on erotic attraction. Results: We discovered that small and moderate doubts and fears towards the other sex are normally present in every man, at all times. They justify many contradictions of the male-relationship with women. Severe fears, instead, play a disruptive role in male sexual life and are a cause of major sexual problems. Conclusions: The range of disturbances caused by sexual fears is large: from inability to penetrate to sexual anhedonia, delayed ejaculation or other ejaculatory difficulties, desire disorders and scarce or absent interest for sex and sexual penetration. Our approach helps understand major sources of sexual difficulties. 0P.04.06 IS VIDEO MATERIAL AN USEFUL ADJUNCT WITHIN COUPLES THERAPY? K.R. Wylie 1, S. Walters 2, K. Bohane 3, R. Mcfarland 1 Porterbrook Clinic, Sheffield, UK,2 University of Sheffield, Sheffield, UK,3 University of Leicester, Leicester, UK Interventions: A project developed two culturally sensitive self-help videos for couples with relationship problems. These were evaluated against a no treatment 12 week waiting list for couples referred to a couples and sexual problems clinic. Outcomes: GRIMS, GRISS, BDI, and DAS collected at baseline and 12 weeks post randomisation. Results: 8 couples were randomised to the video group and 10 to the no video control group. Recruitment was difficult from natural referrals to the clinic as well as from primary care practices despite the opportunity of rapid access to self help materials. The study was suspended due to low recruitment numbers. We calculated the average baseline and follow-up scores and used these in the subsequent analysis. There were no statistically significant differences between the video and control groups at baseline or at follow-up. Even by adjusting for the baseline score there were still no statistically significant differences between the video and control groups at follow-up. Conclusions: Although the results suggest that use of self help visual instructional material did not produce any significant differences, this may have been due to low recruitment alone as only 8 couples were randomised to video. A number of key learning points were identified and suggestions are presented for future studies of a similar nature. These include the opportunity of making the materials more easily accessible to couples using smart phone technology and via internet access as well as providing support through telephone and internet technologies to improve recruitment and participation. Funding: Marriage & Relationship Support Grant Programme.
LACK OF SEXUAL DESIRE - WAYS TO USE DIFFERENT THERAPEUTIC TOOLS TOGETHER U. Pasini Aspsc Swiss Psychological Association of Clinical Sexologists, Genève, Switzerland 1. Possibilities to assess the situation - the 5 circles of W. Pasini 2. Considering a primary or secondary lack of sexual desire and selecting among different therapeutic tools now available. The therapeutic tools can be the systemic couple therapy, the emotional-focuses couple therapy according to S. Johnson, the sexotherapeutic bodily approach according to JY Desjardins, the sexoanalysis according to C. Crepault, the erotic approach according to E. Perel or the EMDR therapy according to F. Shapiro. 3. Clinical examples of different types of lack of sexual desire. 4. 5. FROM LOVE TO ABUSE IN COUPLES D. Cueto 1, M.A. Cueto 2 1 Univ. Oviedo, Oviedo, Spain,2 Cepteco, León, Spain Objective: It provides a functional explanation to try to analyze the process that goes from falling in love to abuse within a couple. Design and Method: We have revised research papers which study the role that oxytocin plays in the development of intensive loving bonds that avoid reasoning, which, after some time, would help to recognize the abuse in a traumatic relationship (Dutton and Painter, 1981). We have also looked into the development of cycles of violence to subdue and control the partner (Walker, 1979). Furthermore, we have considered the evolution of deficits of variables of communication that point out that refraining anger produces resentment (Harburg, 2003). And finishing with the processes of interaction which develop in a progressive, harmonious or unpredictable way that would lead to abuse (Jacobson and Gottman, 1998). Result and Conclusions: After a lot of observational studies of different couples, we think that a combination of personality variables, environmental or personal circumstances and the progressive interaction would help to predict more easily the fact that abuse could take place in couples relationships. oral presentations 05
OP.05.01 GENDER IDENTITY AND SEXUAL ROLES IN ADOLESCENTS C. De La Cruz Martín Romo 1, A. Sánchez Burón 2, M.P. Fernández Martín 2 1 lunives-facultad de Ciencias de la Salud, Madrid, España, 2 Departamento de Psicología. Facultad de Ciencias de La Salud, Madrid, España The androgyny model considers that masculinity and femininity are independent features and both men and women can develop them (Bem, 1974; Lewine et al., 2006). According the theory of ambivalent sexism, hostile and benevolent co-exist within gender ideology which evolves from the hostile position, in childhood, to the ambivalent position, in adulthood (Glick and Fiske, 1996, Glick and Hilt, 2000). The aim of this study is to identify the gender identity and individual differences by sex. For this purpose, the Questionnaire BSRI (Bem, 1981) and the ISA Inventory (Lemus et al., 2007) were applied to 817 students (50.1% males and 49.9% women) belonging to the four courses of ESO (compulsory secondary education), in three schools in the Community of Madrid. For data analysis we used ANOVA, with the dimensions of gender stereotypes: hostile sexism, benevolent sexism and total sexism, as the dependent variable and the gender identity: androgyny, masculinity, femininity, and undifferentiated, as between-subjects factor. In order to obtain the post hoc contrasts, we used the Scheffé test. Results indicate significant differences in gender stereotypes, and more specifically in benevolent sexism: masculinity vs femininity, masculinity vs undifferentiated and androgyny vs femininity, and in hostile sexism: masculinity vs femininity, masculinity vs undifferentiated, androgyny vs undifferentiated and androgyny vs femininity. Women differ in androgyny and femininity, both related only to benevolent sexism and total sexism. 0P.05.02 SEXUAL ATTITUDES AND BEHAVIOUR AMONG SECONDARY SCHOOL ADOLESCENTS IN NIGERIA M.P. Inyang 1, I. Obonganyie 2 1 University of Port Harcourt-department of Human Kinetics and Health Education, Port Harcourt, Nigeria,2 University of Debrecen Medical and Health Centre, Debrecen, Hungary Culture of silence prevails on sexual issues in Nigeria. Sexuality education is not yet a part of the school curriculum. Studies show that adolescents are sexually active globally with varying age of sexual initiation. Designing intervention programmes that are capable of preventing unwanted pregnancies and sexually transmitted infections require the knowledge of sexual attitude and behavior. Sexual attitude and behavior of secondary school adolescents in Nigeria was studied. An analytic descriptive survey design was used in this study. All public secondary schools within the study area constituted the population. Multistage sampling technique was used in selecting 2,500 adolescents within the age range of 10-19years for the study. The instrument of self structured questionnaire titled questionnaire on secondary school adolescents’ sexual attitude and behavior (QSSASAB) was used for data collection. Focus group discussion was used to complement the questionnaire. Hypotheses were formulated and tested. Frequency counts, percentages and Chi-Square were used for data analysis. More than half of the respondents were sexually active. The earliest age of first sexual intercourse was 10years. Contraceptive measures used included condoms, daily pills and withdrawal methods. Others never used any form of contraception. Sexual behavior of these secondary school adolescents is risky. This could lead to sexually transmitted infections, unwanted pregnancies, abortions, new HIV infections and cervical cancer due to infection with human papillomavirus. Early, age appropriate and school based sexuality education tailored towards restraining adolescents from risky sexual practices is needful. Keywords: Adolescents, secondary school, sexuality, education, behavior, attitude. 0P.05.03 SPANISH MINORS’ EXPOSURE TO ONLINE PORNOGRAPHY: PREVALENCE, MOTIVATIONS AND CONTENTS E. González Ortega, B. Orgaz Baz Faculty of Psychology, University of Salamanca, Salamanca, Spain Objective: Since Internet has made pornographic materials more accessible, there is a need for more research on the extent and characteristics of children’s and adolescents’ exposure to them. We examined the prevalence of minors’ exposure to online pornography, the reasons for exposure, and the types of images seen, as reported by college students. Design and Method: All students from the University of Salamanca received a survey request by e-mail distribution list. A total of 494 students responded an anonymous online survey used to collect retrospective reports. Results: According to analysis, boys (63.2%) are significantly more likely than girls (30.2%) to report exposure to online pornography before age 18. The mean age of first exposure is 15, with no significant difference by gender. Boys are more likely to report deliberate consumption and sexual excitement seeking, whereas girls are more likely to report involuntary exposure. Both genders remember viewing a variety of images, including contents of bondage, child pornography and rape. Conclusions: Exposure to online pornography seems to be relatively common among Spanish minors, but still far from being normative. It appears to be a considerable diversity in the extent, reasons and types of exposure. A matter of concern is that a remarkable proportion of adolescents have easy access to deviant or criminal pornographic contents, often inadvertently, what supports the need for developing comprehensive sexual education.
OP.05.04 PAST, CURRENT AND PROSPECTIVE SITUATION OF SPANISH TEACHERS’ TRAINING IN SEX EDUCATION E. González Ortega 1, J.L. Mártinez Álvarez 1, B. Orgaz Baz 1, A.A. Fernández Fuertes 2, R.J. Carcedo González 3 1 Developmental and Educational Psychology Department, University of Salamanca, Salamanca, Spain, 2 Department of Education, University of Cantabria, Santander, Spain, 3 Developmental and Educational Psychology Department, University of Salamanca, Zamora, Spain Objective: Although sex education is a cross-curricular subject in Spain, the lack of appropriate preparation of teachers has been identified as a major obstacle to incorporating sexuality issues in the classroom. Therefore, this study aims to analyze the level of sex education training of Spanish teachers in the past, present and near future. Design and Method: Firstly, we review the university and continuous training offered in recent decades. Secondly, we examine the current level of training of 3760 preschool, primary and high school teachers throughout the country by using an on-line questionnaire. Thirdly, we review the new curricula of the degrees in Preschool and Primary Education resulting from the adaptation to the European Higher Education Area. Results: In the past, sexual education training was lacking, heterogeneous, non comprehensive, and generally offered as an optional subject. Currently, a low percentage of teachers have university (12%) or continuous training (25%), with male, older and high school teachers being less trained. Prospective possibilities of training are also scarce since only three universities offer explicit and specifically this subject in the new degrees. Conclusions: Teachers' training in sex education should be improved at college level, especially in psychology, education, and pedagogy degrees, as well as in teacher training centres. However, this might not happen until a more concrete and stricter law is enforced.
OP.05.05 INTEGRATING SEXOLOGY EDUCATION INTO PSYCHIATRY RESIDENCY TRAINING: PERSPECTIVES FROM THE USA D. Lin Beth Israel Medical Center and Albert Einstein College of Medicine, New York, Usa This oral presentation will focus on how sexology and psychosexual medicine education can be integrated into psychiatry residency training. The Psychosexual Medicine Program currently being implemented at Beth Israel Medical Center, Department of Psychiatry and Behavioral Sciences in New York, NY will be described. An argument will be made why it is important to teach sexology in psychiatry residency training and how psychiatrists are uniquely positioned to be good sexologists. It will be recommended that sexology education become an integrated part of psychiatry residency training everywhere in the USA and the world.
OP.05.05 NIGERIAN SECONDARY SCHOOL ADOLESCENTS’ PERSPECTIVE ON ABSTINENCE ONLY SEXUALITY EDUCATION AS AN EFFECTIVE TOOL FOR PROMOTION OF SEXUAL HEALTH M.P. Inyang 1, I. Obonganyie 2 1 University of Port Harcourt-department of Human Kinetics and Health Education, Port Harcourt, Nigeria,2 University of Debrecen Medical and Heath Centre, Debrecen, Hungary The success of any type of sexuality education programme depends on the knowledge and preparedness for practice by the adolescents. A new study has found ‘abstinence only’ sexuality education programme effective in reducing sexual activity among youths. Knowledge of abstinence only sexuality education and preparedness for practice as an effective tool for promotion of sexual health among Nigerian secondary school adolescents was studied. An analytic descriptive survey design was used for the study. Research population comprised of all public secondary schools in three South- South geopolitical zone of Niger Delta Region of Nigeria. Multistage sampling technique was used in selecting 2000 senior secondary school (SS1- SS3) students as sample for the study. Self designed questionnaire titled Questionnaire on Nigerian Secondary School Adolescents Perspective on Abstinence Only Sexuality Education (QNSSAPAOSE) was used in eliciting information from respondents. Hypotheses were formulated and tested. Frequency counts, percentage and Pearson Product Moment Correlation were used in analyzing data. A greater proportion of secondary school adolescents in this study lacked knowledge of sexuality education. About 80% of the respondents could not define sexuality education. Respondents also showed unwillingness to practice abstinence only sexuality education. There is poor knowledge of sexuality education which is probably responsible for unwillingness to practice abstinence only sexuality education. Sexuality education should be introduced into the secondary school curriculum and taught by well prepared teachers for an informed decision on practice.
PREDICTIVE MODELS OF VIOLENCE IN DATING RELATIONSHIPS AMONG ADOLESCENTS S. Sáez Sesma 1, A. Sánchez Burón 2, M.P. Fernández Martín 2, M.A. Pérez Nieto 2 1 I uni ves. Facultad de Ciencias de la Salud.ucjc, Madrid, Spain, 2 Departamento de Psicología. Facultad de Ciencias de la Salud.ucjc, Madrid, Spain The dating violence is explained by Renee (2007) through two models: the feminist model (male is the perpetrator and woman is the victim) and the relational model (youth exposed to violence in the original family usually develop relationships which are defined by fear and insecurity). The aim of this study is to confirm which variables predict violence in dating relationships. For this purpose, the following questionnaires: Modified Conflict Tactics Scale, MCTS, (Straus, 1979, 1990), validated and adapted to the Spanish young people (Munoz- Rivas, Andreu, Graña, O’Leary y González, 2007), Dominating and Jealous Tactics Scale (Kasian and Painter, 1992), Anger Expression Inventory Status-Feature (STAXI-2) (Miguel- Tobal, Casado Morales, Cano-Vindel and Spielberger, 2001) and the Questionnaire BSRI (Bem, 1981), were applied to 777 students (54.7% women and 45.3% male) aged between 16 and 25. For data analysis we used a multiple regression analysis using the stepwise procedure, considering different MCTS factors as the criterion variable and the other instruments factors as predictive variables, Dominating and Jealous Tactics Scale, STAXI-2, BSRI. The two most powerful models refers to the perpetrator psychological aggression (R-squared= .374) and mean physical agression (R-squared = .313) both related to women. Physical aggression is explained by six variables related to jealousy (dominant and jealous tactics), anger (verbal expression) and gender identity (masculinity). Psychological aggression incorporates anger temperament and eliminates gender identity. 17 18 OP.05.08 ATTITUDINAL ANALYSIS IN THE FORMATION OF SEX THERAPIST A. Sierra Femxy - Fundación Sauce - Sdad. Sexólogica de Madrid, Madrid, Spain Attitudes modulate our values, beliefs and actions. They are essential in our lives and can both facilitate and hinder our personal and professional development. The purpose of this oral presentation, is to show my professional experience as a psychologist-sexologist and forming sexual and relationship therapists, specialized in attitudinal analysis of future professionals in this field. The proposed design will show how they actually affect our work as sexologists and yet, now, are not usually taken into account this type of attitudinal analysis in most professional training. The methodology is both theoretical and practical case studies, showing on my teaching experience in the analysis of attitudes sessions in groups of university education, postgraduate and master. Therefore, this will facilitate theoretical understanding of the information shown and will emphasize as well the importance of personal work and development in the training of future professionals in sexology. As a result of this work attitude sex, therapists acquire a greater commitment to our mission, being more objective and providing a more comprehensive personal process of each patient who comes to us. In conclusion, I think it would be necessary for professionals to work on a personal level our attitudes about sexuality, before coming to treat our patients. This might provide us with a large degree of effectiveness in our therapies as well as increase both, patient and ours, satisfaction.
OP.05.09 TRAINING OF MIDWIVES IN SEXUAL HEALTH H. Viñas Llebot 12, E. Vela 2, L. Alcaraz 2, A. Amorós 2, B. Bobi 2, V. Bueno López 2, M. Hernández 2, G. Olivera 2, D. Patricio 2 1 University of Barcelona, Dept, of Public Health, Mental Health and Perinatal Nursing, Barcelona, Spain,2 Catalan Association of Midwives Board, Barcelona, Spain Background: The Catalan Association of Midwives (ACL) is a scientific organization which aims, among others, provide training to improve professional practice. The ACL has done so far five editions of the postgraduate course Sexuality and Reproductive Health for professionals in this specialty. Currently we are organizing a new edition of the course following the recommendations of the National Strategy for Sexual and Reproductive Health (2010) promulgated by the Ministry of Health and Social Policy, which includes a strategic focus on professional training in sexual health. Objectives Meet the needs on sexual health training of midwives. Develop proposals for training for midwives. Design and Method: The study is a part of the interpretive paradigm, and data collection techniques quantitative and qualitative will be employed. The subjects will be midwives of Catalonia, a group that performs professional counseling and health education in sexual and reproductive health. Data collection: Discussion group to assess advantages and disadvantages, causes, conditions and variables of training, concluding with a reconciliation of different views. Questionnaire on-line self-administered, validated for health professionals which will modify some items made from the categories taken from the discussion group. Results: The analysis of the results will be done by triangulation strategy in the last quarter of 2012. Conclusions: The study will contribute to the planning of training proposals, and to improve the professional competence of midwives in promoting health care and sexual health care. REDUCING SEXUAL COERCIVE BEHAVIOURS: AN INTERVENTION FOR YOUNG SPANISH STUDENTS I. Vicario Molina 1, A.A. Fernández Fuertes 2, B. Orgaz Baz 1 1 University of Salamanca, Salamanca, Spain, 2 University of Cantabria, Santander, Spain Objective: Due to sexual coercion and assault are serious problems among adolescents and young people relationships, it is necessary to evolve effective prevention strategies and evaluate them. The main aim of this study was to develop and assess a sexual coercion prevention program. For that, both the change produced in certain factors associated with sexual coercion, and the decrease in sexually coercive behaviour were evaluated. Design and Method: The program’s contents included knowledge and information about sexual coercion, beliefs, myths and expectations, and risk factors associated with coercive behaviours, as empathy toward victims and communication and negotiation abilities. A before-and- after design was developed. Before treatment, an initial measurement was taken, and two more after the intervention (three weeks and eight months). Participants of the study were high school students ranged in age from 16 to 18 years-old. Results: Results indicated that the program achieved and acceptable level of success at promoting greater sensitivity toward victims, and identifying a sexually coercive situation, but didn’t improve negotiation and communication abilities. Moreover, participants indicated a high level of satisfaction with the program and considered that the intervention was very useful to prevent sexual coercion. Conclusions: Although the program achieved an acceptable level of success, it is necessary to consider limitations of the intervention. In order to develop more effective interventions, future lines of research and treatment are discussed. oral presentations 06
OP.06.01 EFFECTS OF SEXUAL MYTHS TO FEMALE SEXUAL DYSFUNCTION OF TURKISH WOMEN I. Hattat 1, E. Hattat 2, H. Hattat 3, F. Gultekin 2 1 European Sexual Health Alliance Turkey, Istanbul, Turkey,2 Hattat Uro-andrology Clinic, Istanbul, Turkey, 3 Family Health Research Association, Istanbul, Turkey Introduction: Recent reports suggest that sexual myths play a role in female sexual health problems. False expectations about sexual behaviors are related to lower sexual selfconfidence, lower levels of sexual experience. Aim: The aim of this study was to assess the effects of sexual myths on the sexual functioning of Turkish women. Methods: European Sexual Health Alliance Turkey sent a questionnaire including sexual believes ,the FSFI,consisting of 43 questions to 3000 internet members between March 2011 and August 2011. 2400 women (25-56 years old) participated. Results: 64% believe that “to reach orgasm at the same time” is the most important goal of intercourse, 39% that any sexual problem is the woman’s fault and responsibility, 23% that women who start sexual intimacy are corrupt, 32% that sexual fantasies are forbidden,53% that virginity is very important,92% that all female sexual problems are psychological . Out of 1536 women with the goal of orgasm , 62% had less than 3 points in the sexual desire domain of FSFI, 72% in the orgasm , 68% in the satisfaction , compared to the remaining group with 39% less than 3 points in the sexual desire domain , 37% in the orgasm , 38% in the satisfaction domain. Out of 936 women who believe that sexual problems are the woman’s fault, 73% had less than 3 points in the sexual desire domain , 74% in the satisfaction domain. Conclusion: Expectations from sexuality, sexual knowledge and level of exposure to sexual myths are important determinants of female sexual health problems.
OP.06.02 SEXUAL DYSFUNCTION IN PATIENTS MONITORED FOR COCAINE USE DISORDER A. Romaguera, J.A. Navarro, F. Eiroá, L. Grau López, C. Roncero, M. Casas Unitat d’Aguts Hospital General de Granollers - Hospital de Dia de Granollers - Germanes Hospitaláries del sagrat Cor de Jesús, Benito Menni - Complex Assistencial en Salut Mental, Barcelona, Spain Introduction: Although cocaine is seen as a powerful aphrodisiac by the drug user population, it has been shown in previous studies that chronic use adversely affects sexual function. Objective: To analyse the structure of sexual function and prevalence of Sexual Dysfunction in patients monitored for Cocaine Use Disorder and the evolution of Sexual Dysfunction during the time of consumption and abstinence. Design and Method: A cross-sectional study was conducted in a 37 sample of male patients consulting for Cocaine Dependence. Sexual function was assessed using the CSFQ- 14 scale and the ASEX , the latter applied retrospectively 4 times (previous to consumption, during acute consumption, during chronic use and during abstinence). Results: The CSFQ-14 showed very good internal consistency ( = 0.9), showing in these patients a different structure of sexual function from other populations. According to the CSFQ-14, 21.6% of patients in the study presented sexual dysfunction. Using the ASEX it was observed in patients that previous to consumption they presented better sexual function (mean = 10.08 ± 2.40) than during acute consumption (mean = 13.32 ± 3.99) and that this worsened further during chronic use (mean = 15.46 ± 5.43), and that in times of abstinence the mean improved when compared with chronic use (mean = 13.13 ± 3.85). Conclusions: The study shows that acute consumption of cocaine and especially chronic use impair sexual function, which can be partially recovered if abstinence is achieved. Sexual dysfunction may be a factor in the initiation, maintenance, relapse or cessation of cocaine consumption.
C. Cicero, S. Caruso, M. Romano, L. Lo Presti, B. Ventura, C. Malandrino Azienda Ospedaliero-Universitaria Policlinico di Catania, Department of Medical and Surgical Specialties, Catania, Italy Objective: Type 1 diabetic women may be affected by sexual dysfunction, mainly due to peripheral vascular disease.The objective of our study was to determine whether daily tadalafil 5 mg is effective in type 1 diabetic premenopausal women affected by sexual genital arousal disorder. Design and Method: Thirty-three volunteers were enrolled in a 12 week prospective study performed by the Research Group for Sexology of the Department of Medical and Surgical Specialties, School of Medicine, University of Catania. The efficacy of daily tadalafil 5 mg on sexual genital arousal (primary endpoint),desire, orgasm, enjoyment, frequency of sexual activity and genital pain (secondaryendpoints) were assessed (a) subjectively by the Short Personal Experiences Questionnaire(SPEQ) and (b) objectively by Translabial Color Doppler sonography of clitoral blood flow.Moreover, the Short Form-36 (SF-36) questionnaire was used to assess Quality of Life (QoL). Results: Twenty-nine women completed the study. Women reported a QoL improvement at the 12th week follow-up (p<.05). Tadalafil improved the experience of sexual genital arousal and orgasm, sexual enjoyment, satisfaction by frequency of sexual activity, and frequency of sexual thoughts or fantasies (p<.05). Finally, dyspareunia decreased with respect to baseline (p<.001). After tadalafil administration, the mean peak systolic velocity increased and the mean diastolic velocity decreased from baseline (p<.001). Moreover, the mean resistance index and the mean pulsatility index were significantly higher compared with baseline values (p<.001). Conclusions: Daily tadalafil 5mg treatment seems to improve subjective sexual aspects and could be used to treat genital arousal disorder of premenopausal women with type 1 diabetes. 0P.06.04 SEVERE TRAUMATIC BRAIN INJURY AND SEXUALITY CHANGING IN PATIENTS AND THEIR PARTNERS U. Bivona 1, F. Rizza 2, G. Antonucci 1'2, F. Leoni 1, R. Formisano 1 1 Irccs Fondazione Santa Lucia, Rome, Italy, 2 Sapienza Universita di Roma, Rome, Italy Aim of the Study: To investigate the possible relationship between a severe traumatic brain injury (TBI) and the onset of sexual disorders in the patients and their partners. Design and Method: Partecipants: a cohort of 25 severe TBI patients and their relatives, and a cohort of 25 control couples (without TBI). Measures: Sex relation Evaluation Schedule Assesment Monitoring (SESAMO) (Boccadoro e Perillo., 1996); Hamilton Depression Rating Scale (HDSR) (Hamilton et al., 1960); State-Trait Anxiety Inventory (STAI) (Spielberger et al., 1983); Awareness Questionnaire (AQ) (Sherer et al., 1998) and Neuropsychiatryc Inventory (NPI) (Cummings et al., 1994), for the evaluation of: the sexual, mood, self awareness and behavioural disorders. Results: The study showed after the onset of TBI a statistically significant higher frequency of TBI patients’ pathological answers at the SESAMO, than in the control subjects, in 6 of 9 SESAMO sub-areas. Similarly, the TBIs’ partners gave a significant higher frequency of pathological answers than control partners in the SESAMO as a whole. Moreover, the patients showed mean pathological scores lower than their partners. Conclusion: The onset of a severe TBI seems to determine a sexual worsening in both patients and their partners. In particular, probably due to low self-awareness in TBI’s, this changing seems to be better perceived by the partners than the patients. The study suggests the opportunity of a specific assessment of sexual disorders after a TBI, in order to include this kind of disorders into the rehabilitation project, with the aim of improving the outcome of the patients.
THE EFFECTS OF SEXUAL THERAPY INTERVENTIONS FOR SEXUAL PROBLEMS IN WOMEN: A SYSTEMATIC REVIEW B. Landmark, E. Almas, D. Sorensen, H. Aars, W. Fjeld, W. Haaland, K.G. Brurberg, L.M. Reinar Gj0vik University College, Gj0vik, Norway A systematic review commissioned by the Norwegian Directorate of Health in 2006 has resulted in a 250 page report on the extant evidence base for sexual therapy. We did systematic literature searches in Cochrane Library, Medline, Embase, CINAHL, Psycinfo and Swemed and retrieved 320 articles in fulltext, written in 10 different languages. The effect, benefits or risks, of sexological interventions for sexual problems in women, has been reviews and are presented in meta-analysis. Altogether 101 separate studies on the sexual dysfunctions of women were covered in four previous reviews. We have quality graded and included a further 12 studies on hypoactive sexual dysfunction, lack of genital response, orgasmic dysfunction, mixed dysfunctions and pain disorders. We found and included four recent studies on sexual dysfunctions after cancer, and no controlled studies on sexual dysfunction after other diseases. Studies on women after sexual abuse had outcome on posttraumatic stress symptoms, and although all state that sexual dysfunction may ensue, there were no treatment effects reported on sexual dysfunctions. We will present the first metaanalysis of these studies and report on the efforts to summarize the results. 0P.06.06 SEXUAL FANTASIES AND SEXUAL PROBLEMS D. Trotta 12, T. Strepetova 12, E. Fattorusso 12, A. Crudele 12, G. De Maio 12, E. Troiano 12, L. Otranto 1 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: The importance of sexual fantasies in human sexuality, in the physiology as well as in the sexual pathology, is often under evaluated. Anyway, the erotic and sexual imaginary, is a pillar of male and female sexuality and has a central role in every man and woman’s sexual life. Design and Method: Typical fantasies. Sexual fantasies are present in most men and women. Most typical male fantasies are centered on identity affirmation and consolidation, sexual domination, woman detachment, phallic aggressiveness. Most common female fantasies regard sexual power and erotic fascination, exhibitionism and sex without direct involvement and consequent sense of guilt. Submission fantasies, competitive as well as degradation fantasies are also common in men and women. Importance of sexual imaginary. The study of erotic imaginary is important to understand sexual health and to treat sexual limits and sexual pathology; especially in structured and complex cases which are often difficult to understand. Systematic observation of sexual and erotic imaginary helps go beyond the gaps left empty by otherwise meaningless behavior. This is the case when only objective and observable behavior is considered. Results: The analysis of sexual fantasies and dreams is a very useful tool, when used on its own or with other therapeutic aids, like medicaments and behavioral -cognitive therapy. Conclusions: There is a strong relationship between sexual fantasies and sexual behavior. The study of imaginary is also a powerful prognostic tool in clinical practice
M. Nasim Nasim Fertilty Center, Lahore, Pakistan Introduction: Non consummated marriage is very common in societies where sex and sex education is a taboo due to religious and socio cultural factors. Early recovery in matter of days or few weeks is required to save the marriage. Male factor was cause in 100% cases and female factor was responsible in 80% cases. In Dr Farooq model of treatment by combining sex therapy with pharmacotherapy 100% success is achieved in 2-3 weeks by restoring sexual functions. Objective: To introduce a new treatment model by combining sex therapy and pharmacotherapy in non consummated marriage, that gives early recovery and best accepted by patients and time saving.(specially suitable for subcontinent culture) Material and Methods: 3050 patients of non consummated marriage were treated at Nasim Fertility Center Lahore, Islamabad and Faisalabad during 1999-2011. 58% of the males complained of having good erection to enter vagina but ejaculated outside vagina. 24% complained on having good erection but erection failed on entering vagina entry. 18% of patients had no erection on going to wife. In female vaginismus was present in 74% cases and 26% had dysparunia with other sexual dysfunction. In Dr Farooq vaginal intercourse was sure in 10-15 days in 90% cases after two sessions of sex therapy and administering pharmacological agents (SSRI, Benzodiazipines) to balance autonomic nervous system necessary for normal sexual response and excitement in males and females. Another 10% having severe vaginismus recovered in 3-4 weeks in 3-4 sessions of sex therapy vaginal desensitization is achieved by encouraging the male to enter the vagina with fingers progressively and in severe cases vaginal dilatation and hymenectomy was performed. By sex education and explaining easy intercourse positions the couple was encouraged first intercourse by using I/C injection or vacuum therapy device. The treatment continued for 10 weeks with weekly sessions and pharmacotherapy to remove associated performance anxiety and normal sexual life was restored. Result: 100% success was achieved in restoring normal sexual activity in short time as compared with other models of treatment. Conclusion: Dr Farooq model of treatment for Non Consummated marriage is best suited due to short treatment time and full reward to patient as compared with other models of treatment for non Consummated marriage.
D. Trotta 12, T. Strepetova 12, E. Fattorusso 12, A. Di Marco 12, G. De Maio 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: Sexual problems are common in men. They can interfere with the erectile and ejaculatory function. In other cases sexual desire is involved. Desire problems are less known and usually difficult to explore and to “understand”. Our presentation focuses on eroticism and its disorders. Design and Method: Dystonic erotisation refers to an erotic desire not accepted by the individual. It is a condition characterized by having an attraction that is at odds with one’s personal beliefs, values and norms, causing anxiety and sexual disturbances. For these persons sex is associated with danger, guilt, shame and other negative thoughts and feelings. Our presentation explores the world of dystonic erotisation as seen and lived in clinical patients. Patients are explored by investigating his behavioral sexual activity and by exploring his sexual imaginary. Results: Sexual disorders caused by a disturbed erotisation can be related to the gender identity, to the relationship one individual has with the other, man or woman, and to the sexual dynamic. They can affect not sexual desire as well as excitatory and ejaculatory response. Conclusions: Dystonic erotisation is a symptom of deep rooted sexual disturbances. Therapists should take it into consideration in cases of poor response to traditional cognitive-behavioral therapy.
OP.06.09 SEXUAL DYSFUNCTIONS - A SYSTEMATIC REVIEW OF SEXOLOGICAL TREATMENTS B. Landmark 1, D. Sorensen 2 1 UniversityCollege ofGj0vik, Gj0vik, Norway2 Norwegian Knowledge Centre for the Health Services, Oslo, Norway The effects of sexual therapy interventions for sexual problems have been subjected to a systematic review commissioned by the Norwegian Directorate of Health. The review was limited to psychological, psychosocial and educational interventions, within the context of information, counseling and treatment for sexual dysfunction. We excluded studies of sex offender treatment. After appraisal in full text, relevant articles were critically appraised concerning methodical quality. We identified 2805 unique titles of which nine systematic reviews and 33 randomised controlled trials were included in the final report. The review included all languages, and includes updated systematic searches to 2011. In addition to published systematic reviews for sexological interventions in men we found four randomized, controlled trials, and in addition to four systematic reviews we found 12 randomised controlled trials on the effects of sexological interventions in women. Many of the included studies were of moderate methodological quality. For many comparisons it was not possible to pool the results and we could only report from single studies. We have pooled results in metaanalyses, but the total study population is small. There is an overall positive effect across interventions and populations. This is shown for both a broad spectrum of populations and sexual problems. However, we can not rule out a possible publication bias in the material. Interventions in the research literature do not appear to be entirely representative for the array of treatment methods that are offered for sexual problems and dysfunctions in men and women.
OP.06.10 VAGINISM AND SEXODYNAMICS R. Bochicchio 12, T. Strepetova 12, L. Otranto 12, A. Di Marco 12, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: Vaginismus is one of the most important disorders of female sexuality. From the functional point of view consists in an involuntary and uncontrollable contraction of the vulvoperineal muscles that oppose to any attempt of vaginal penetration. Design and Method: The classic therapeutic approach to vaginismus is based on use of cognitive behavioral techniques that are based on body techniques capable of acting on the pelvic floor and vaginal muscles. The purpose is negotiating an obstacle to the mechanical penetration and the achievement of the coital capacity. Vaginismus can be primary or secondary and have phobic or fusional characteristics. Results: A sexodinamical approach to vaginismus allows a better understanding of motivations and the thickness of the disorder as well as a distinction between different types of difficulty or inability to penetrate. Thus dropouts during treatment can be reduced as well as the therapeutic escapes. Conclusions: An integrated sexological approach that takes into account aspects of bodily, emotional and cognitive factors that contribute to the development and maintenance of vaginismus has best chance to remove disturbance and to avoid the appearance of recurrence even in the short time.
SEXUALITY, HYPNOSIS AND SEXOANALYSIS L. Otranto 12, T. Strepetova 12, R. Bochicchio 12, E. Troiano 1-2, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: The speech analyzes the relations between hypnosis and sexuality and its relationship with the sexoanalytical approach. If the latter has as privileged subject of its attention the sexuality, we have to take into consideration the role of the eroticism into the hypnotic field. Materials and Methods: Since the first hypnotic experiences of Charcot and Bernheim, several authors of the hypnotic school (DL Araoz, HG Beigel, P Cantafio et al.) were concerned with the comprehension and the treatment of the different sexual problems. Hypnosis, through the trance, the induction of a relaxation state and the reduction of the conscious resistance, eases the access at the individual’s inner world, with the intent to modify the cognitive and emotional dynamics that cause the sexual dysfunction. The main aim of the sexoanalysis is the erotic dynamics comprehension. For this purpose it makes use of the systematic observation of the dreams and of the erotic fantasy. Results and conclusions: Hypnosis and sexoanalysis share the treatment of the erotic imagery. In the sexoanalysis, the disturbed imagery’s modification, that in some kinds of hypnosis is influenced by the therapist’s intervention, is entrusted to the patient.
oral presentations 07 sexually transmitted infections and sexual rights
L. Leal, E. Fernández, C. Ligero, A. León, B. Torres, L. Moreno, J. Gatell, F. García Hospital Clinic I Provincial de Barcelona. Infectious Diseases Department - Hiv Unit, Barcelona, Spain Objective: In Spain there are no protocols for HIV or STD contact tracing. The objective for this study was to investigate HIV and other STD transmissions among sexual contacts of newly diagnosed and describe the characteristics and practices of a group in high risk for HIV infection. Design and Method: We trace the sexual contacts of persons recently diagnosed with HIV infection (< 6 months) coming to our service from 2008-2011. We included the index case and at least 1 unprotected sexual partner. They were interviewed for demographic characteristics, sexual practices and tested for STD. Results: There were 559 patients recently diagnosed, most of them men (90% n=506) and MSM (82% n=461), solely 4% (n=20) had a known HIV partner. A 7% (n=39) reported never use condoms and 5% (n=28) were sexual workers. We could only trace 43 sexual contacts of which 9 (20%) had a positive result for HIV, 1 (2%) for VHB and 1 (2%) for Syphilis. They were mostly men (74% n=32), almost half of them reported never been tested for HIV before and never use condoms (45% n=17), a considerable 17% (n=4) had a STD history. Conclusions: High risk sexual practices are still a major issue in our community. Contact tracing was difficult in this study; this could mean missed opportunities to diagnose HIV or STD. It is a priority to develop an adequate contact tracing system in Spain.
OP .07.02 SEXUAL LIFE IN WOMEN WITH HPV INFECTION C. Malandrino, C. Cicero, L. Lo Presti, M.T. Bruno, G. Musumeci, S. Caruso Dipartimento di Specialitá Medico-Chirurgiche. U.o. Ginecologia e Ostetricia. P.o.g. Rodolico, Universitá di Catania, Catania, Italy Objective: HPV infection is one of the most common sexually transmitted diseases. Studies on women who have had anomalous Pap Test results have highlighted psychological consequences like anxiety, fear of cancer, sexual problems, changes in body image, difficulty in reproductive functions, changes in the relationship with the partner, a sense of neglect, anger, and fear of being stigmatised and labelled. The objective of our study was to evaluate changes of the sexual function of women before and after receiving diagnosis of HPV infection. Design and Method: We enrolled 121 women with Pap test cytologic atypia suspicious for HPV infection. They undergone HPV Dna test and colposcopy. It was administrated the FSFI questionnaire to evaluate the quality of their sexual life before and three months after the communication of the HPV dna test results. 86 women were HPV positive and 35 were HPV negative. Results: There was an important reduction of the total FSFI score of all of the women receiving the diagnosis of HPV infection. The items more affected were sexual desire, lubrication and dysperunia (p< 0.01) in both the positive women before and after diagnosis. Conclusions: HPV diagnosis caused emotional reactions as fear and anxiety in most subjects of our sample. Our study has shown significant changes of the sexual life of the women affected by HPV infection.
OP .07.03 GLOBALIZATION, SEXUAL POLITICS & THE FUTURE OF SEXUAL ETHICS T. Claes 123 1 Ghent University, Department of Philosophy and Moral Science, Ghent, Belgium, 2 Ghent University, Center for Ethics and Value Inquiry, Ghent, Belgium,3 International Network for Sexual Ethics and Politics, Ghent, Belgium Recent developments in the wake of the globalization of sexualities can and should reorient sexual ethics. In this paper I argue that a sexual rights and health agenda, realized in and through global sexual activism and politics, should inform and be the basis of any globally viable sexual ethic. I start with a review of some of the main issues and themes in contemporary sexual ethics. Next, I will document and evaluate, using Ritzer’s model of gl/robalization, the ethical significance of recent thinking and global activism on sexual rights and health. Following up on this I will show how this sexual rights and health agenda enables us to formulate and safeguard an emancipatory as well as pluralistic outlook on how ethically to deal with and think about global sexual issues and the diversity of sexual repertoires, identities, relationships, meanings, etc. Further development of the notions and formulations of sexual rights and health is called for - from tools for the prevention of harm, to levers and ideals for positive and emancipatory sexual empowerment. Recent thinking and developments concerning ‘global sexual citizenship’ can bolster these developments. I will also discuss some of the mechanisms (e.g., Benhabib’s ‘democratic iterations’ and Kurasawa’s notion of human rights as practices) that frame and canalize these ongoing processes. I conclude with a SWOT analysis of the proposed model, reviewing issues like universalism, (ethical) imperialism, traditionalism, religion and culture. oral presentations 08
OP .08.01 A CROSS-CULTURAL STUDY OF BOTH POSITIVE AND NEGATIVE ASPECTS OF BEING NON-HETEROSEXUAL J. Strizzi, I. Fernández Agis, T. Parrón Careño, R. Alarcón Rodríguez University of Almería, Department of Neuroscience and Health Science, Almería, Spain Objective: The final aim is cross-cultural study on the positive and negative aspects of being gay, lesbian and bisexual in the United States and Spain. The authors seek to repudiate the tendency to study non-heterosexual sexual orientations from a marked pathological viewpoint and create a method which more adequately represents GLB experiences. Design and Method: 10 scales were selected, all validated in English by other authors. Those not previously validated in Spanish were translated and in validation process at the time of abstract submission. Positive aspects are operationally defined as social support, self-esteem, social activism/justice, and sexual satisfaction. Negative aspects are defined as: violence, social stigma, homo/bi negativity, and depression (measured through subjective happiness). Results: The negative psychological sequelae due to social stigma and victimisation have been well document within US populations. As the GLB movements of two countries have had differing trajectories (gai vs gay) and currently have disparate legislative same-sex marriage statuses. Furthermore, adversive therapies are not used in Spain as they are in the US. The authors hypothesise that place of residence (state in USA or gay ghetto in Spain) will be a key variable. Conclusions: While there claiming a causal relationship is imprudent, if the data show important differences between US and Spanish populations, it could be interpreted that the legal recognition of GLB couples in Spain has positive psychological influences.
OP .08.02 THE POSITIVE ASPECTS OF BEING GAY, LESBIAN OR BISEXUAL J. Strizzi, R. Alarcón Rodríguez, T. Parrón Careño, I. Fernández Agis University of Almería, Department of Neuroscience and Health Science, Almería, Spain Objective: An alarming quantity of academic literature has studied sexual orientation from a negative or pathological point of view, fuelling detrimental stereotypes. The goal of this study was to develop a questionnaire and collect data about non-heterosexual sexual orientations based on a positive psychological view point to identify the positive aspects of being gay, lesbian or bisexual. Thus, provide data of positive experiences of non-heterosexual sexual orientation. Design and Method: An online survey based on the findings of Riggle, Whitman, Olson, Rostosky and Strong’s 2008 qualitative study “Positive Aspects of Being Gay or Lesbian” was developed. There were 150 participants from various GLB associations in Spain. Results: The results showed that more than 63% of the participants believe that there are positive aspects of being gay, lesbian or bisexual. While, 75,4% affirmed that being their sexual orientation is only part of who they are, therefore does not imply anything either positive or negative. Conclusions: It was concluded the participants believe that living an “out” life is a political act, and by living their lives “out of the closet”, their lives reflect their socio-political ideals. After “coming out”, they reported enjoying a feeling of wellbeing due to the sincerity with one’s self, the ability to be his / herself, freedom to live a satisfactory and unique lifestyle, and honesty with one’s self.
C. Moleiro, A. Delgado, N. Pinto Lisbon University Institute Iscte-lul, Psychology Department, Lisbon, Portugal Recent literature has focused not only on overt discriminatory attitudes and behaviors towards Lesbian, Gay and Bisexual (LGB) persons, but also on more subtle forms of microaggressions in everyday life and their effects (Sue, 2010). Some researchers have highlighted that these microaggressions occur even in clinical settings, in particular in mental health practice (e.g. Sheldon & Delgado-Romero, 2011), recognizing that clinicians display uneven responsiveness to LGB clients and issues despite the increased visibility, training opportunities and affirmative- treatments available. These aggressions range from overt forms of discriminatory practices such as conversion therapy, to subtle and covert forms of heterosexism, oftentimes unconscious and unintentional, including microassaults, microinsults an microinvaliations (Sue, 2010). The present study uses a mixed qualitative and quantitative approach to identify and describe the experiences of microaggressions of LGB clients in Portugal. To be included in the study, participants (i) had to be 18 or over, (ii) identify as LGB and (iii) have had at least one session with a mental health professional such as a psychologist, psychotherapist, psychiatrist, sexologist, counselor, or marriage and family therapist. Recruitment was conducted in clinical and non-clinical settings, through LGBTQ community associations and networks. A web-based questionnaire was developed, with closed and open questions, and data was collected. Participants were asked the degree to which they had experienced a number of identified sexual orientation microaggressions, and also to describe a salient microaggression in clinical context and its effects. Results will be discussed in light of international literature, including implications for practice and training. oral presentations 09 education, social sciences and theory of sexuality
S. Parrado Chamorro 1, L. Alonso 1, A. Parrado 2, F. Calzado 3, P. Garcia 1, N. De La Fuente 3, J.C. Garcia 3, E. Chico 1, N. Martinez 1, M. Alvarez 4 1 Sacyl, La Baneza, Spain, 2 Ministerio Sanidad, Avila, Spain, 3 Consejeria Educacion Leon, Leon, Spain,4 None, La Baneza, Spain How did thIs passion arise? Because both parents and teachers felt that teenagers had aun urgent necessity about their sexual education. Objectives: Providing some place and time to encourage the pupils and parents to live their affective and sexual life in a positive way. Raising the pupils' awareness about their need to get certain knowledge, attitudes and behavior that help them lead a healthy private life. Methods: It has been implemented through an active and participative methodology, Taught by professionals from the Health Centre in collaboration with teachers. There are 31 one-hour-long workshops of one hour over 9 years for children aged 8 to 17, with specific activities for the parents. From the initial workshops and interpersonal approach, with games and group dynamics, to pregnancy prevention workshops and STDs, to those working the field of emotions, and the anatomical and physiological knowledge about sexuality. Results: ad hoc satisfaction survey of students, parents and teachers Ad hoc evaluation test based on previous studies validated on habits attitudes and knowledge acquired by students Complacency felt and perceived by the professionals who perform the workshops ... Story of a Passion. Export program to other schools in the state and a twinned school in France Gennevilliers Conclusions: Validity of sexual affective education as continuing education within the public schools of the city. Efficiency of the program because they have no costs. Simplicity and portability of the program.
M. Nasim Nasim Fertility Center, Lahore, Pakistan Objective: This study is designed to elaborate the need for sex education in conservative Muslim society where masturbation is a taboo and considered to be the cause of different sexual dysfunctions, and it is not religiously allowed. Introduction: Masturbation is a taboo and prohibited by Islam. There is wrong information in society by quaks and Hakims (unani medical parishioners) that masturbation destroys the sexual health and weakens the muscles if penis required for normal erection and sexual activity. Due to this masturbation is most important cause (as perceived by patient) of sexual dysfunction in conservative Muslim society like Pakistan. Large proportion of sexual dysfunction can be prevented by right sex education on masturbation. Material and Methods: Patients of sexual dysfunctions were treated at Nasim fertility center, Lahore, Islamabad, & Faisalabad. The patients suffering from early ejaculation impotence and giant were 54%, 32% and 10% respectively. All the patients attributed masturbation as the cause of dysfunction. Scientist explanation oof masturbation and sex organs and sexual response cycle in humans removed the preconceived idea of masturbation as cause of sexual dysfunction. Conclusion: Guilt feeling to masturbation due to Islamic restrictions and wrong information by quacks and hakims that masturbation destroys the sexual health and muscles of penis leads to sexual neurosis and is underlying major cause of common sexual dysfunction. By providing sex education on masturbation much of sexual dysfunction can be prevented in conservative Muslim society like Pakistan.
OP.09.03 SEXUAL DOUBLE STANDARD IN A PORTUGUESE MASCULINE SAMPLE: A TRANSGENERATIONAL POINT OF VIEW N. Marques, R. Xavier Vieira Faculty of Medicine, Lisbon, Portugal The purpose of this study was to analyze the evolution of the sexual double standard and its relations with sexual satisfaction into the Portuguese context. To do so, two different age heterosexual male samples were compared: group 1(N=132,X=23.9±2.4 , ranging 20-30 years) and group2 (N= 130,X=46.3±3.1, ranging 40-50 years), considering the possibility of a certain transgenerational effect in transmitting sexual standards. In this study, the Questionnaire for the Evaluation of the Sexual Double Standard (QADPS) and the Index of Sexual Satisfaction (ISS) were applied to 262 males living in Lisbon area. Results show that sexual satisfaction is not correlated with the personal acceptance of the sexual double standard, and that we are in a time of transition concerning the latter: we are abandoning the sexual double standard in order to establish a more igualitarian one. However, this transition has not been made on an effortless way: although both groups recognize the social pervasiveness of the sexual double standard, younger men are more attached to the sexual double standard, when compared to older ones (t=2.04,p.05). Such results can be seen a possible resultant of a certain masculine fear about women’s emancipation, and the need of a social adequateness from man, according to what is socially expected from them. In the end, some suggestions are made considering the results. However, in order to understand more accurately the extension of these phenomena, further studies are needed to better understand them. 0P.09.04
SEXUALITIES: DESIRE, REPRESENTATIONS AND REALITIES. AN APPROACH TO SEXUALITIES IN THE CONTEXT OF HUMAN RIGHTS FROM A GENDER AND SOCIOLOGICAL POINT OF VIEW D. Mieville Manni Mekare, Gender&Enviromental Solutions, Madrid, Spain In our changing times, spearheaded by social vertigo, a person is forced to de-construct and then reconstruct themselves over and over. It’s therefore essential to ask ourselves how sexualities fit in our daily lives and how we live them out. Existential vertigo in it’s most intimate manifestation: sexuality and sexualities. I propose a micro/macro approach to sexualities, to see how and if existing texts, studies and rights coincide with reality in order to contribute to our professional practice in a more comprehensive and less theoretical way. To achieve this, I propose a three-part analysis: A-Corporeal Symbology: A brief analysis of desire (female desire in particular) represented in film and social discourse. Female desire as a response to male desire. Male desire as mandatory. Representations are performatives, that is to say they take precedence over personal experience creating a preconceived idea of what one should desire, what is in fact desirable and what isn’t. B-The sexual body as a ‘body of rights’ and a ‘rightful body’. Difference between legal equality and actual actuality. C-Why sexuality continues to be ‘a problem’ and the emerging problems of sexuality and sexualities. Autonomy, independence, identity and sense of belonging are some of the key points to be analysed. The aim is to apply a macro-social and micro social approach to understanding and pursuit of well-being. To discover whether it is possible a single autopoiesis within social realities. Key words: Gender, Sexology, Feminism, Cooperation, Human Rights, Diversity.
ATTITUDES TOWARDS SEX AND SEXUALITY AMONG ROMANIAN WOMEN-AN EXPLORATORY STUDY R. Florea 1, B. Radu 2, O. Rus 3 1 University of Medicine and Pharmacy, Cluj-Napoca, Romania, 2 Babes-Bolyai University, Cluj-Napoca, Romania, 3 Emergency Hospital for Children, Cluj-Napoca, Romania In this paper, we aim to unravel the intricate ways in which women in Romania conceptualize, evaluate and approach their sexuality. This is the first kind of research on how women conceptualize sexual freedom carried out in Romania, a post communist country with a traumatizing history of state regulated sexual and reproductive policies. After 1989 abortion became legal, and women in Romania re-established possession over their own bodies. More than twenty years after the end of communism, we investigate how women in Romania perceived and evaluate sexual freedom and the behavioral consequences deriving from it. More specifically, we explore whether different measures of socioeconomic status influence conceptualizations and perceptions of sexual freedom. We collected primary data reflecting the views of several hundred women in Romania resulting in a representative sample. Through univariate and multivariate analysis we analyze quantitative individual data that allow us to relate variables measuring attitudes towards sexual freedom and core beliefs on sexuality with socioeconomic indicators. The main objective is to be able to ascertain how different social and economic status measurements and broad beliefs on society, religion and politics influence one’s view of her own sexual identity, liberties and practices. 0P.09.06
RAPE IN FEMALE EROTIC IMAGINARY. LOOKING FOR A COMPREHENSIVE APPROACH A. García Mañas Universidad Complutense de Madrid, Madrid, Spain Nowadays we find a lot of different approaches which try to explain feminine rape fantasies. Most of them assume blaming- or-victimizing attitudes towards women who enjoy these erotic imaginary: on the one hand we find theories which assert that women secretly want to be raped, on the other; some authors claim women are just internalizing a male-domination system that oppresses them. This way, rape fantasies are always considered as a shameful (conscious or unconscious) desire or as a pathology symptom, but since it is a specific feminine experience, it is disregarded by science, its inner value hardly ever been taken into account. I aim at a critical review of the subject, analyzing both intervention therapy and educational programs derived from each theoretical frame. With this information, I intend to offer a theoretical/practical proposal from the sexological perspective, including a more comprehensive approach to the experience. A MODEL OF INTEGRATION BETWEEN SEXOLOGY AND SYSTEMIC PSYCHOTHERAPY D. Markovic Regent’s College, London, UK The author who is a systemic and psychosexual therapist, supervisor and principal lecturer, has created a Model of integration between systemic psychotherapy and sexology based on her longstanding and diverse professional practice. The Model proposes an integration of the fields of sexology and systemic psychotherapy at the levels of: theoretical ideas; ethical principles; professionals’ role and interventions. Although in many ways this particular integration can be seen as a synthesis of incompatible opposites the author proposes its high relevance for working with a wide range of presenting sexual issues. Its usefulness both for the medical fields of sexology and the wide range of psychotherapy approaches will be illustrated by examples from clinical practice. oral presentations 10 0P.10.01
CULTURE, WORKPLACE, AND HOME THEY ALL MATTER: JOB-RELATED STRESS AND SEXUAL HEALTH DIFFICULTIES AMONG HETEROSEXUAL MEN FROM THREE EUROPEAN COUNTRIES A. Stulhofer 1, B. Traen 2, A. Carvalheira 3 1 University of Zagreb, Zagreb, Croatia,2 University of Oslo, Oslo, Norway,3 University of Lisbon Institute of Applied Psychology, Lisbon, Portugal Clinical literature has suggested a link between job-related stress and sexual difficulties in men. However, epidemiological evidence for the association is largely lacking and little is known about the factors that may mediate or moderate the impact of workplace strain on sexual health. Data from a large-scale online study carried out in 2011 on convenience samples of Portuguese, Croatian, and Norwegian men was used to assess the association between job-related stress and sexual health disturbances, as well as to explore possible mediating and moderating effects. Participants with job-related concerns reported lower sexual satisfaction than those without. Multivariate regression analysis confirmed the association between job-related and sexual health disturbances: the odds of experiencing one or more sexual health difficulties in the past 12 months were about 1.8 times higher among men who reported highest levels of workplace concerns than in men who had no such concerns. In addition to culture-specific effects on sexual health, income, emotional intimacy with one’s partner, and having children significantly reduced the likelihood of reporting sexual health disturbances. In all three countries, the relationship between job-related and sexual health difficulties was mediated by negative mood (state anxiety and depression), but the moderating role of emotional support (intimacy and fatherhood) was not supported. The findings are discussed in the context of a multidimensional understanding of the etiology of male sexual health disorders. 0P.10.02
EROTIC VOICES OF THE ELDER WOMEN: A QUALITATIVE PERSPECTIVE S. González Serratos Faculty of Psycholgy, Unam, Mexico City, Mexico Erotic sexuality of elderly women has been repressed, punished, ideologized, stigmatized, denied and, last, always experienced as something inherent to both women and men in different and discriminatory circumstances from the perspective of genre. Research was generated from the interest of knowing something about which very little is known, something about which even less has been researched, rounded by false ideas: sexuality, erotism and sensuous pleasures of aged women, a big pending issue within the field of feminism. This job analyzes what three elderly women stated regarding their sexuality and erotism, how they experience it in their present days, what they feel and think, opening a way from their own voices. The survey was constructed by means of qualitative methodology as an instrument of research, by interviewing three women: 62, 70 and 80 years old, respectively. A biographical sketch was made for each of them. The analysis was then performed, where categories and units of meaning were generated, which were connected to both epistemological and theoretical-referential conceptual frameworks, so that data will be coherent, significant and consistent. Accordingly, both direct and real knowledge was achieved about these elderly women and their erotic sexuality. Conclusion, these elderly women started to find themselves within their already changing bodies, turned into a renewed identity and placed their erotism in fields which are more fruitful for spiritual creativity and sensuous pleasure, beyond the mere use of genitals, i.e., by eroticizing their lives. 0P.10.03
TEACHERS TRAINING TO PREVENT HOMOPHOBIC BULLYING IN SCHOOLS. AN ACTION-RESEARCH PROJECT IN AN ITALIAN HIGH SCHOOL C. Scandurra 1, A.L. Amodeo 1, A. Cuccurullo 2 1 University of Naples Federico II - Department of Theories and Methods of Human and Social Sciences, Naples, Italy,2 University of Naples Federico II - Center of Athenaeum Sinapsi, Naples, Italy Objective: This work reports a research experience carried out in Naples, promoted by the Centre “SInAPSi” Section “Bullismo Omofobico” of the University of Naples “Federico II” aimed to prevent homophobic bullying in schools. The main purpose is to train teachers about issues associated to sexual orientation, gender identity, homophobia and homophobic bullying, sexual and gender stigma, in order to provide them with skills useful to cope with potential questions, doubts and difficulties arising from students. Design and Method: the intervention has been structured in six weekly sessions of two hours. Each one included both face-to-face education and discussions, and e-learning activities. Results: the intervention has highlighted a fundamental lack of information about the topics and the necessity, clearly expressed even by the teachers themselves, of an in-depth training. In reply to this request, all lessons have been collected into a brief manual for the dissemination within the whole school. Conclusions: the results have led to reflect on the general condition of Italian school context. This seems not to have an appropriate attitude towards embracing the “differences”, due to its deep prejudicial roots. It is important to think about interventions on different levels of the “school as a system”. Working with teachers, who should be reference points for students, allows us to lay the foundations for a “culture of differences”, rooting out all forms of prejudices, stereotypes and discriminations based on sexual and gender stigma.
OP.10.04 YOUNG PEOPLE: WE DO AND WE PROTECT OR NOT? M. Caballero Jauregui, I. Santamaria Sanchez, J. Madrid Gutierrez, E. Escarpa Besga, T. Nogales Berlana, P. Zueco Perez, M.D. Hernandez Martin, L. Alvarez Castel, S. Carlavilla Saez Cms Joven Madrid Salud, Madrid, Spain Objective: Knowing the adolescents’ perception of risk of transmission of sexually transmitted infections through cunnilingus and its comparison with other practices. Results: We present the results regarding the type of sexual practices and erotic repertoire of adolescents and risk perception of the different practices and preventive measures they use, or otherwise, in each case, and differences in gender. Shown results regarding vaginal penetration, Masturbation, Anal Penetration, fellatio, cunnilingus. Design and Method: This is cross-sectional study conducted in a sample, or incidental nonrandom convenience of the user population of the Youth Center City of Madrid, between the months of June, July and August 2011, captured from the consultations that were administered a questionnaire of 56 questions. We analyzed sociodemographic variables, sexual history, type of practice, knowledge of preventive measures, extent of use of such measures and difficulties and barriers to their use. Conclusions: There is a lack of preventive measures and a low perceived risk of cunnilingus. Protective measures in this regard seem to be unreal. Should we ask the search for alternatives and a change of strategy by the sexologists?
OP.10.05 BODY IMAGE AS AN IMPORTANT DETERMINANT IN SEXUAL FUNCTION: A COMPARATIVE STUDY BETWEEN TURKISH MEN AND WOMEN E. Hattat 1, I. Hattat 1, H. Hattat 2, F. Gultekin 3 1 European Sexual Health Alliance Turkey Office, Istanbul, Turkey, 2 Family Health Research Association, Istanbul, Turkey,3 Hattat Uro- andrology Clinic, Istanbul, Turkey Introduction: Recent reports suggested that negative body image is related to lower sexual self-confidence, lower levels of sexual experience, sexual avoidance . Aim: The study assessed the effects of body image on the sexual lives of Turkish women compared to Turkish men. Methods: European Sexual Health Alliance Turkey Office sent 2000 questionnaires to it’s internet members between February 2011 and July 2011. 326 men (25-59 years old) and 412 women (32-56 years old) accepted to participate. Main outcome measures were International Index of Erectile Function, Female Sexual Function Index and Body Esteem Scale (Franzoi &Shields, 1984). Results: 61% of men and 79% of women scored moderate to extreme negative for physical and sexual attractiveness. There are false believes regarding ideal body type and sexual expectations. Physical attractiveness is associated with being more social (85%), better in communication (71%). Out of 199 men with moderate to extremely negative physical attractiveness scores, 72% had moderate to severe overall dissatisfaction, out of 330 women with moderate to extremely negative weight concern scores 72% had less than 3 points in the sexual desire domain of FSFI. 89% believe that a good image means to have a satisfactory sexual life. 62% wants to have a better body image for the partner, 78% would prefer an aesthetic surgery for a better body image. Conclusion: Body image effects sexual satisfaction and sexual functions both in men and women. However, this effect is higher in the case of women where the weight concern is an additional determinant.
OP.10.05 RELATIONSHIP BETWEEN THE SEXUAL DOUBLE MORAL, ATTITUDES TOWARD SEXUAL FANTASIES AND SEXUALITY IN HEALTH WORKERS E. M. Quesada Bravo 1, P. Pedro Lacalle 2, I. Fernandez Agís 3 1 Nursery Department of Poniente Hospital, Almería, Spain, 2 Ginecology Department of Torrecárdenas Hospital, Almería, Spain, 3 Neuroscience and Health Sciences Deparment, Almería, Spain Health workers are used to questions about health in general. However, questions about sexuality are the questions most feared, as in the topic of sex, come into play many factors inherent to themselves such as their own attitudes toward sexuality, their own myths, beliefs, morals, education... Main Objetct: To study relationship between double sexual moral, attitudes toward sexuality and sexual fantasies in health workers. Method: 168 health workers participated in the study, all of them doctors, nurses and nurses assistant. For data collection we ran a structured survey, voluntary and anonymous. The independent variables were sex, age, profession and religion. For the double sexual moral we used the Double Standard Scale (DSS) (Caron et al., 1993), to check the degree of conservatism and liberalism ran a scale of attitudes towards sexuality (ATSS-28items), to know the degree of erotophobia/ erotophilia was used the Sexual Opinion Survey (SOS) (Fisher et al., 1988) and for the type of sexual fantasies the Sexual fantasies Questionnaire (SFQ) (Wilson, 1988). Main results: Differences were statistically significant (p <0.05) in the values of the scale exploratory DSS and fantasies based on gender. We found an indirect correlation of all scales with age. We found statistically significant differences in all scales according to the profession except in impersonal fantasies. Statistically significant differences were found in all the scales in terms of religion. Conclusions: Health professionals should focus on a personal and liberalizing sexual model that understand sexuality as a positive human fact.
SEXUAL HEALTH. A COMMUNITY APPROACH A. Antona, M.A. Andrés, M.D. Hernández Martin Madrid Salud, Madrid, Spain Objective: To promote access to sexual health services (SS) in the city of Madrid to the most vulnerable population groups from a community intervention strategy. Design and Methods: The primary goal of the Program of Sexual and Reproductive Health is to facilitate access to the socially vulnerable population. Technical criteria are created SS intervention specific to the target population (PD): Rapid Diagnostic Tests, Sexual Counseling, Preferred Care, Sex Education (SE) for and with groups at risk of exclusion. It focuses on work in the neighborhoods-census tracts and centers of formal and informal education with increased susceptibility. Enabling a community strategy with associations and organizations working with the PD. Spaces are created Sexual Counseling, Council on STDs and reproductive health and demand immediate attention. Educational materials are created (ES) ad hoc. Results: Increase of users under 20 years and social vulnerability. The population that attends to inquiries from SS has changed in profile. Of note is the gradual increase of foreign young people. Conclusions: When working with the community and prioritizing the most vulnerable, reducing barriers to access, increase demand and improve the quality of care. Sex education aimed at specific groups at risk of social exclusion has been shown to be a highly effective and efficient tool. 0P.10.08
QUALITY OF SEXUAL LIFE OF WOMEN ON ORAL CONTRACEPTIVE EXTENDED-REGIMEN C. Cicero, S. Cianci, C. Malandrino, F. Ciancio, M. Cariola, S. Caruso Dept,ofMedicalandSurgicalSpecialties,UniversityofCatania,Azienda Ospedaliero-Universitaria Policlinico di Catania, Catania, Italy Objective: To date women may use flexible oral contraceptive regimens. The objective of the study was to evaluate the quality of sexual life of healthy women on extended regimen oral contraceptives (OCs). Design and Method: The Female Sexual Function Index (FSFI) and the Short Form-36 (SF-36) questionnaire were used to investigate, respectively, sexual behavior and the quality of life (QoL) of women on 20 pg EE and 3mg DRSP OC for 72 days with a 4-day hormone-free interval, for two cycles. Both the FSFI and the SF-36 were administered before starting OC intake, at the 1st (72-82 days) and the 2nd (144-154 days) follow-up. Results: Of the 40 women constituting the sample for clinical evaluation, 5 women discontinued during the 1st cycle of OC intake due to bleeding or spotting. The total FSFI score obtained at the 1st follow-up detected a worsening with respect to baseline total score (p<.05). The score obtained at the 2nd follow-up detected an improvement with respect to both the baseline and the 1st follow-up total scores (p<.05). QoL improved at the 1st follow-up only as regards body pain (p<.05); and at the 2nd follow-up as regards: physical role, body pain, general health, vitality, and social function (p<.05). Conclusions: The use of extended regimen OCs is able to improve the quality of sexual life for women with sexually active lifestyles. 0P.10.09
SEXUALITY IN ADOLESCENTS - THE IMPACT OF MORAL EMOTIONS AND FAMILY ENVIRONMENT IN HE DEVELOPMENT OF AGGRESSION IN SEXUAL MANIFESTATION IN ADOLESCENTS FROM 12 TO 18 T. Lopes Lino 1, S. Bahia 2, R. Xavier Vieira 2 1 Faculty of Medicine, University of Lisbon, Lisbon, Portugal,2 Faculty of Psychology University of Lisbon, Lisbon, Portugal The objective of this study was to measure the impact of moral emotions and family environment in the development of aggression in adolescent sexual manifestation. We applied two psychometric instruments, the Kidscreen-52© and RMGI - adapted to a random sample of 92 youths, 35 boys and 57 girls between 12 and 18. We found that girls felt more guilt in the dimensions of sex guilt, hostility, guilt and morality-conscience than boys. Adolescents living with both parents tended to have a less positive perception of themselves. Older adolescents with more education feel less sex-guilt. We concluded that the moral emotions were present in female adolescent with older and higher educational level and in terms of perception of quality of life and family adolescents give greater emphasis to health and physical activity, feelings, free time and autonomy, family and home environment, economic issues, the general mood and self-perception. 0P.10.10
ETHICALLY JUSTIFYING SOCIO-EROTIC HEALTHCARE S. Geuens 1 2 3 4, T. Claes 2 1 General Hospital St. Elisabeth, DepartmentofPatientcare, Herentals, Belgium,2 Centre for Ethics & Value Inquiry, Ghent University, Ghent, Belgium,3 Ggz Advice & Help and the Practice for Sexology, Tilburg, The Netherlands,4 Multidisciplinary Therapeutic Practice Mol, Mol, Belgium Socio-erotic healthcare is the umbrella concept for intimate, erotic and/or sexual care for people with a mental, physical, social and/or psychiatric disability, for which - if wanted and deemed necessary - close collaboration between the client and the socio-erotic healthcare professional (m/f), the service organisations and other health care professionals connected to the client can be sought in order to facilitate the total care process and/or the socio-emotional process of care giving and receiving. Whether one calls it socio-erotic health care, sex-work, prostitution or paid love, the exchange of sex for money remains a problematic subject. With the concept of socioerotic health care a new dimension was added to the debate on ‘paid sex’. Ethically justifying socio-erotic health care - sensu stricto a form of paid sex - has proven especially difficult. First, this paper explores both a ethical teleological and an ethical deontological approach towards socio-erotic healthcare. Next the relevance of the WAS Declaration of Sexual Rights specifically in regard to the concept of socioerotic health care will be examined. Finally the possibility of a ‘third way’ towards an ethical justification of socio-erotic healthcare will be presented, starting from a life course perspective on sexual desire.
OP.10.11 SEXUAL HEALTH IN YOUNG MALES: A PREVENTIVE INTERVENTION BY ANDROLOGISTS AND PSYCHOSEXOLOGISTS V. Duretto 1, G. Barbero 1, F. Lanfranco 2, C. Manieri 2 1 Associazione della Scuola di Sessuologia di Torino - Asst, Turin, Italy, 2 Division ofEndocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Turin, Italy Objective: The Androlife campaign has been organized by the Italian Society of Andrology and Sexual Medicine (SIAMS) with the aims to: promote the primary prevention of the reproductive tract pathologies in males, inform young boys on the importance of controlling risk factors for male infertility, sensitize public awareness of male reproductive health, collect data on lifestyle, habits and general health status of young males aged 18 to 30 years, and diagnose possible andrological pathologies. Aim of this study was to sensitize young male subjects of male sexual health according to recent standards of the “Sexual Health for the Millennium. A Declaration and Technical Document” (WAS 2008). Design and Method: During the Androlife campaign in March 2012, a team of andrologists and clinical sexologists performed free andrological and psychosexological consultations to young males aged 18 to 30 years. Andrologists used a standard case history to collect personal and medical data. A psychosexological consultation was suggested. The psychosexological consultation included a semistructured interview with the possible use of the International Index of Erectile Function-5 test. The mean duration of each consultation was 45 minutes. Results: 192 young males underwent clinical andrological evaluation. 10% of them accepted to undergo the psychosexological consultation as well. Conclusions: When appropriately informed and sensitized, young males feel the need to take care of their sexual health addressing to qualified professionals, realizing how partial the information they receive through the media are.
COMMUNICATING FOR CHANGE: A CUBAN EXPERIENCE M.M. Ramírez Cenesex - Depto. Comunicación Social y Relaciones Públicas, Vedado, Cuba The media plays diverse roles in any society: they are, among other things, a place for debate, disseminator of information, a vehicle for cultural expression, a public watchdog, and a constituent in the democratic process. Media can serve to reinforce the power of vested interests or exacerbate social inequalities. The key question is how to nurture a media framework and practice which contributes to overarching goals to de Development, even in a socialist country where the media are state property. In this regard the National Center for Sexual Education (by its Spanish acronym, CENESEX), leader of the National Sexual Education Programme (ProNES), develops a communication strategy based on communication for the diffusion and communication for development, from a perception study applied to the rural and the city population of Havana (in a first part), and interviews with external audiences, among which are included journalists, actors of international cooperation and policy makers. The result has established a media plan based on the interests of this population and C4D actions in communities and other spaces, which include online social networks, to give voice to people and allow access to Sexual Education. oral presentations 11 paraphilias and sexual psychotherapy
OP.11.01 RISK FACTORS AND MORAL DISENGAGEMENT IN DETAINED SEX AND NON-SEX OFFENDERS: A PILOT STUDY F. Tripodi 1, I. Petruccelli 2, C. Simonelli 3, C. Barbaranelli 3, S. Grilli 4 11nstitute of Ciinicai Sexology,, Rome, Italy,2 Kore University, Enna, Italy, 3 Sapienza University, Rome, Italy,4 Centre for Forensic Psychology, Rome, Italy Objective: Sexual abuse is a heterogenic phenomenon. The literature on sexual offenders has considered risk factors in the individual or familial history as well as precursors such as cognitive distortions, defence mechanisms and moral disengagement mechanisms. With particular reference to the concept of moral disengagement (Bandura, 1986), this pilot study investigates cognitive distortions in sex offenders and also the moral disengagement mechanisms they mostly use and those which mainly characterize their sexual scheme, thus distinguishing them from non-sex offenders. Design and Method: The study sample numbered 358 males: a control group of 264 non-offenders, a group of 42 detained sex offenders and a group of 52 detained non-sex offenders (N=358. Subjects were administered a socio-demographic data Grid (De Leo et al., 2004) and the Moral Disengagement Scale (Caprara et al., 1996). Results: Results at one-way ANOVA show significantly different means between the three groups, (F(2,355)=36.85; p<.001, h2=.172); controls yield the lowest moral disengagement scores (M=65.86), sex offenders the highest (M=90.24) and non-sexual offenders intermediate ones (M=80.81), significantly different from those of the other groups, as revealed by Tuckey’s HSD Post-hoc test. Conclusions: Conclusions are discussed with particular reference to significant differences between the three groups regarding the moral disengagement mechanisms they use.
OP.11.02 SEXUAL VIOLENCE AND ACCULTURATIVE STRESS IN A SAMPLE OF HISPANIC IMMIGRANTS I. Vicario Molina, A. Fuertes University of Salamanca, Salamanca, Spain Objective: Acculturative stress or the struggles related to the process of adapting to the new country is associated with negative outcomes for immigrants. Moreover, previous research suggests that stressors have negative effects on marital relationships, even intimate partner violence. In order to know if acculturative stress experienced by immigrants is related to sexual violence, the main aim of this study is to explore if there are differences in levels of acculturative stress between victims and aggressors of sexual violence. Design and Method: Sample of the study consisted of 240 Hispanic married immigrants (50% female) residents in Madrid and Salamanca. Participants answered and anonymous questionnaire that included information about acculturative stress and different marital and relationship variables. Results: Preliminary results indicate that a significantly higher percentage of male participants reported have sexually abused their partner in the previous year, and that a higher proportion of females than males reported have been sexually abused. Males who recognized have been perpetrators endorsed significantly higher levels of acculturative stress. For females, significantly higher levels of acculturative stress were found on victims of sexual violence. Conclusions: Results suggest that acculturative stress is somehow related to sexual violence, and that relationship is different for women and men. Two possible explanations are discussed: Does acculturative stress increase the likelihood of experience sexual violence? Do sexual violence and acculturative stress emerge from the same sources (e.g.: gender roles)? To answer these questions, further research is required.
OP.11.03 DATING VIOLENCE: WOMEN WHO DEFINITELY BREAK THE ABUSIVE RELATIONSHIP M. Favero 1, S. Tulha 1, F. Ferreira 1, A. Del Campo 2 1 Unidep/ismai, Maia, Portugal, 2 Universidad de Salamanca, Salamanca, Spain Objective: This research aimed to characterize the experiences and beliefs of young women victims of dating violence who broke definitively with the abusive relationship. In this work, it is also intended to know how it starts and runs the rupture process along with the factors that lead to permanent break. More specifically we aim: i) to characterize the experiences of dating violence; ii) to understand the process of transition from violence to a permanent rupture, iii) to analyze the rupture process, iv) identify the social, psychological, emotional and personality led these women to a permanent rupture, v) to characterize the attitudes, opinions and beliefs about violence in dating relationships. Design and Method: This study involves four young women who broke definitively with the abusive relationship for at least eighteen months. To collect the data we used semi-structured interview (Favero & Tulha, 2010). Results: The content analysis having met the following categories: Violence in General; Physical Violence, Psychological Violence, Sexual Violence, Dating Violence, Gender and Dating Violence, Experience of Victimization; Break; Self-Evaluation Compared to Women Who do not Break; Chance of Living Similar Situations. Conclusion: The results demonstrated the crucial role played by social and family context in relation to the decision to break the abusive relationship. The experiences and beliefs on violence are consistent with those described in the literature. We found that, although the break does not occur following an assault, its process does not appear isolated, but together with a prior consideration on its consequences. 0P.11.04
CHILD SEXUAL OFFENDERS: A NEUROPSYCHOLOGICAL PERSPECTIVE M. Favero 1, P. Pombo 2, M. Perez Fernandez 3 1 Unidep/ismai, Maia, Portugal, 2 Universida de Da Beira Interior, Covilha, Portugal,3 Universidad de Salamanca, Salamanca, Spain Objectives: The aim of the present study was to analyze the neuropsychological performance in men convicted for child sexual aggression. In this sense, we wanted to compare the neuropsychological performance of sexual abusers with the normative population. Design and Method: To compare both groups we used MRI to 13 sexual offenders and the following neuropsychological tests to 70 men (25-51 years old), 32 sexual offenders and 38 from control group: Luria Graphic Series (Form A, B) (Luria, 1979), Clock Drawing Test (Shulman, 2000), MMSE (Folstein, 1975); Rey Complex Figure (Bennett-Levy, 1984); Verbal Fluency Test (Abwender, et al., 2001); WAIS-digit test (Wechsler, 2009); Trail Making Test (form A, B) (Bowie & Harve, 2006). Results: We found that sexual offenders showed, compared to control group, neuropsychological changes in short term memory, attention/concentration, working memory, visual discrimination and visual-constructive ability, language (writing), executive functions (problem solving and more complex functions, tasks underlying the slowing of frontal functions and information processing). Was not found morphological changes nor brain parenchyma signal on the MRI of 13 sexual perpetrators. By the way, we should be taken into consideration for future researches that 6 offenders showed changes on the brain parenchyma. Conclusions: Our results lead us to think that child sexual offenders have deficits in brain areas that justify sexual assault by a group of them, results on which we must continue to investigate. 0P.11.05
RESULTS PSYCHOLOGICAL SUPPORT PROGRAM TO BATTERED WOMEN AND ABUSIVE MEN (2001-2011) I. M. Andrés 1, R. Carracedo 2, E. Montes 1, J.D. Valdivieso 1, M.A. Cueto 3, D. Cueto 4 1 Cop Castilla y León, Valladolid, Spain,2 Junta de Castilla y León, Valladolid, Spain,3 Cepteco, Leon, Spain,4 Univ. Oviedo, Oviedo, Spain General characteristics of the program: - This program can be developed thanks to an agreement of co-operation between the Junta de Castilla y León and the Colegio Oficial de Psicólogos de Castilla y León. - From 2001 to 2011, 4,136 subjects have taken part in the study (2,984 women, 506 minors and 646 abusers). - It is a comprehensive study of violence: assistance to women - men - minors. - It is carried out in urban and rural environments. - Coordinated and integrated in the network of Atención a la Mujer de Castilla y León of the Administración Regional. - It is homogenous in its methodology and in how the intervention is performed. - Integral in the objectives with specific methods of intervention: crisis -individual - group. - High quality in the professional intervention: continued formation. Objectives: - Attention to the consequences of ill treatment in battered women and in minors in charge. - Prevention of violence by working with abusers through the Programa Fénix. Results: There is a regular study of the psychosocial descriptive variables of the subjects who participate in the program, of the characteristics of the abuse, consequences, psychological diagnosis, areas of intervention and degree of achievement in the psychotherapeutic objectives. Averages of achievement of 75.53 % in women, 72.40 % in abusers and 73.35 % in minors. Conclusions: These results show a high degree in the adequacy of the program both in the pursued objectives and in the methodology. 0P.11.06
SEXUAL AND COUPLE THERAPY: THE USE OF FILMS SCENES AND EDUCATIVE VIDEOS M.A. Cueto 1, D. Cueto 2 1 Cepteco, León, Spain,2 Univ. Oviedo, Oviedo, Spain Objective: Modelling is a very useful technique in couple and sexual therapy. It is an observational training process in which the behaviour of a couple, seen in scenes of films or educative videos, is a stimulus to generate similar behaviours, thoughts or attitudes in the couples observing this modelling. Most of the human behaviour is learnt with this observational training. Design and Method: This method consists of observing efficient and inefficient interaction ways, so that they will be able to differentiate between them and learn to express themselves assertively. This viewing makes the learning of interaction, communication, respect and sexuality processes easier. They focus their attention on the actors, which helps them understand those processes better, due to the emotional distance as being emotionally involved implies more difficulties. Results: These films scenes help to get a variety of new behaviours or skills, the inhibiting or disinhibiting of behaviours that the subject already had, the achievement of behaviours not fulfilled because of the lack of stimuli, and the increase of environmental and affective stimulation in the couple, by providing them greater control on the emotional activation. Conclusions: It is possible to learn active listening, communicative styles, to take decisions and to reach agreements, auto and hetero control of aggressive behaviours, to refute cognitive thoughts that make communication difficult. Likewise, it is very useful in sexual therapy since it helps analysing sexual response in other couples, visualising strategies for the improvement of sexual dysfunctions and teaching psychological techniques related to these pathologies.
OP.11.07 MINDFULNESS AND MODIFIED BODY SENSITIZATION IN A DYSPAREUNIA CASE STUDY L. Sánchez Sánchez Universidad de Almería, Almería, Spain Objective: To treat a case of dyspareunia plus a very restrictive sexual education with a modified body sensitization and mindfulness. Design: A case study A-B-A and a six months follow-up. Method: Participant (F.Q.) and her partner fulfilled a sexual satisfaction questionnaire (Women Sexual Activity Scale, EVAS-M, and Men Sexual Activity Scale, EVAS-H) pre, post-treatment and in the six months follow up. Combined treatment was carried out during four months: starting with Mindfulness treatment for two months and, later, combined with body sensitization for other two months. One hour a weekly session. Results: F.Q. improved the scored in EVAS-M, like her partner, and started to do much behaviour that she had never done before. For example, masturbation, practising oral sex, a satisfactory intercourse, go to the gynaecologist after her surgery, etc. These results were maintained on six months follow-up. Conclusions: Sometimes, body sensitization alone is not enough to improve dyspareunia, especially, when the patients had a very restrictive sexual education and/or traumatic events related to sexual relation. In these cases, is necessary combined this one with Mindfulness or another third wave psychological treatment.
NEW AND NON-PATHOLOGIZING WAYS OF PERCEIVING SEXUAL TURN-ON PATTERNS E. Benestad 2, E. Almas 1 1 University of Agder, Grimstad, Norway,2 Grimstad Mpat-Institute, Grimstad, Norway Special turn-on patterns are performed, despised, and enjoyed. Patterns can be subtle, playful, well cultivated, but also poorly administrated. Nevertheless a common denominator for these patterns is a search for joy and relief. Turn-on patterns that lay outside strict cultural norms for decent behaviour have been labelled as pathological, sinful and illegal. Psychologists and psychiatrists have made these patterns into a playground for guesswork, and they have issued therapies to little avail. This misconduct has added to the feelings of guilt and shame in the realm of special turn-on talents. One consequence is that many have moved in behind closed curtains and into secret spaces of the minds. The presenters offer an alternative understanding of how the plethora of turn-on patterns may develop. Based on clients’ stories, we can see and propose a co-incidental and non- pathological route to the different endpoints. As we have inborn talents to absorb inputs relevant for language, it seems that we also have talents apt to pick up erotic inputs. As it is quite accidental what language we learn, it seems likewise accidental what kind of turn-on pattern we might develop. Clients suffering from guilt, shame and stigmatization find relief in this way of thinking. That gives rise to therapeutic alliance, which in turn gives access to the content and meaning of the patterns, and thus also to therapeutic work that can cultivate the pattern into less disturbing administrations. oral presentations 12 sexual dysfunctions 2 and sexual medicine 0P.12.01 CLINICAL STUDY OF TESTOSTERONE GEL AS ADJUNCTIVE THERAPY TO TADALAFIL IN HYPOGONADAL MEN WITH ERECTILE DYSFUNCTION S. Hakobyan Yerevan State Medical University, Dept, of Sexology,, Yerevan, Armenia Purpose: We compare the efficacy of testosterone gel (T-gel) versus placebo as adjunctive therapy to tadalafil in hypogonadal men with erectile dysfunction who do not respond to tadalafil alone. We have recently shown that, in men with erectile dysfunction (ED), free testosterone (FT) directly correlates with penile arterial inflow. Laboratory experiments indicate that the nitric oxide erectile pathway is testosterone-dependent. In humans, testosterone therapy improves erectile function in men with hypogonadism. However, the efficacy of testosterone monotherapy may not be adequate because of the multifactorial nature of the pathophysiology of ED. Materials and Methods: A randomized, placebo controlled, double-blind, parallel group, multicenter study was performed. All patients with arteriogenic ED as evaluated by dynamic colour duplex ultrasound (D-CDU) studies, normal sexual desire but testosterone (T) and FT in the lower quartile of normal range (low-normal), not responding to tadalafil treatment (10mg) on six consecutive attempts. Measurements: All patients had D-CDU, hormonal [LH, prostate-specific antigen (PSA), total and free testosterone, sex hormone-binding protein (SHBG), oestradiol], biochemical [haematocrit, low-density lipoprotein (LDL) and HDL cholesterol, triglycerides], and sexual evaluations [International Index of Erectile Function (IIEF)] before and after 1 month of therapy with transdermal testosterone (5 mg/day, n = 10) or placebo along with tadalafil treatment on demand. A total of 75 hypogonadal men (18 to 80 years old, morning serum total testosterone 400 ng/dl or less) with confirmed lack of response to tadalafil monotherapy were randomized (1:1) to receive a daily dose of 1% T-gel or 5 gm placebo gel as adjunctive therapy to 10 mg tadalafil during a 12-week period. Subjects were evaluated for sexual function, primarily based on the International Index of Erectile Function (IIEF), quality of life and serum testosterone levels at baseline and weeks 4, 8 and 12. Results: Testosterone treated subjects had greater improvement in erectile function compared to those who received placebo, reaching statistical significance at week 4 (4.4 vs 2.1, p = 0. 029, 95.1% CI 0.3, 4.7). T-gel significantly (p < or =0.004) increased total and free testosterone levels throughout the study, although no significant correlations were made between testosterone levels and the IIEF at end point. In addition testosterone administration induced a significant increase in arterial inflow to cavernous arteries measured by D-CDU (32 +/- 3.6 vs. 25.2 +/- 4 cm/s, P < 0.05), with no adverse effects. Conclusions: In patients with arteriogenic ED and low-normal androgen levels, short-term testosterone administration increases T and FT levels and improves the erectile response to tadalafil likely by increasing arterial inflow to the penis during sexual stimulation. The combination of testosterone plus PDE5 inhibitors may be considered for the treatment of ED in men with low to low-normal testosterone levels, who had inadequate response to prior treatment with PDE5 inhibitors alone. So, in hypogonadal patients with ED, androgen supplementation is first-line therapy
OP.12.02 ALEXITHYMIA AND DELAYED EJACULATION: PRELIMINARY RESULTS S. Eleuteri 1, P.M. Michetti 2, M. Giuliani 3, R. Rossi 3, C. Leonardo 2, G. Franco 2, C. De Dominicis 2, C. Simonelli 1 1 Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy,2 Urology Department, Sapienza University of Rome, Rome, Italy,,3 Institute of Clinical Sexology,, Rome, Rome, Italy Objectives: Alexithymia construct characterizes individuals who have difficulty in identifying or reporting their specific emotions. Researchers have found high or moderate alexithymia levels in men with Erectile Dysfunction (ED) and Premature Ejaculation (PE). The goal of this study was to investigate the presence of alexithymia in men with Delayed Ejaculation (DE), comparing such results with data found from other Male Sexual Dysfunctions (MSD). Design and Methods: 48 patients with DE, age range 20-63, were administered Toronto Alexithymia Scale (TAS-20) and an ad hoc questionnaire to evaluate clinical features of the symptom. Results: 10.4% of patients could be categorized as alexithymics, 6.3% of them as bordeline, while 83.3% of the sample were found to be non-alexithymic. The overall average score of TAS- 20 was 45.33. Preliminary results show that alexithymia is not correlated with DE, differently from other MSD, where this condition was found in more than 40% of patients. Conclusions: Presented data seem to suggest that DE, not being correlated to alexithymia construct, is related to other psychogenic features such as hyper-control configuration. No difficulty in identifying and communicating emotions in our sample is probably connected to the greater social acceptance of DE than PE and ED. As the symptom doesn’t affect the core male identity, cultural approval may be considered as an important protective factor from creating or exacerbating high levels of alexithymia. These results suggest to carry out more researches on this aspect, in order to identify possible specific implications and ameliorate the standard clinical practice of the DE.
PENILE REAUGMENTATION SURGERY USING BOVINE PERICARDIUM COLLAGEN IMPLANT J. Kim Phiiip and Paul Medical Institute, Department of Plastic Surgery, Seoul, South Korea Objective: Recently, penile augmentation surgery has been performed in cases where the patient suffers from psychological and sexual complexes caused by his small penis. However, in some cases when the patient has a higher expectation, secondary reaugmentation may be necessary. This study reports on the use of a xenograft material in reaugmentation surgery Methods: For the xenogenic implant, type I collagen extracted from bovine pericardium. Through a transverse incision of 4 - 6 cm at the distal penis, girth enhancement was performed. After separating the existing grafted area from the Buck’s fascia and obtained a widened space to the prepubic junction. Results: Penile reaugmentation procedures performed between July 2005 and July 2009. This study included 67 patients with the following first augmentation surgery in the past: autologous dermal fat graft(43.3 %); silicon injection(26.9 %); xenograft such as bovine collagen(13.4 %); autologous fat graft(7.5 %); allograft(4.5 %); hyaluronic acid injection(3.0 %); restorative scaffold(poly lactic-co-glycolic acid) insertion(1.5 %). The diameter of the penis had increased by 5.6 ± 1.2 mm after surgery. Active treatment was required in 2 cases(3 %): removal of the graft because of infection. Conclusions: Penile reaugmentation surgery with xenogenic type I collagen has the advantages of being a simple surgical procedure and fewer complications. For the patient group that received penile augmentation surgery with diverse materials in the past, The use of xenogenic type I collagen in this procedure also demonstrated a effective profile.
OP.12.04 SEXUAL SATISFACTION IN PATIENTS WITH PEYRONIE’S DISEASE F. Tripodi 1, R. Rossi 1, S. Sansalone 2, P.M. Michetti 3, D. Tienforti 4, G. Gambino 1, C. Silvaggi 1, V. Rossi 1, C. Simonelli 5 1 Institute of Clinical Sexology, Rome, Italy, 2 Department of Urology, School of Medicine Tor Vergata University of Rome, Rome, Italy, 3 Department of Urology, Sapienza University of Rome, Rome, Italy, 4 Urologic Surgery,, Catholic University Medical School, Rome, Italy, 5 Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy Objective: to analyze factors related to sexual satisfaction measured through frequency and quality of intercourse in patients affected by Peyronie’s Disease (PD). Design and Methods: 85 patients diagnosed with PD, without prior pharmacological, physical or surgical therapy, were recruited. They were administered a self-report questionnaire about their socio-demographic data, medical history and sexual satisfaction, the Visual Analogic Scale (VAS) to assess pain presence and severity, the International Index of Erectile Function (IIEF-15), and the General Health Questionnaire 12- item reduced version (GHQ-12) to investigate their level of psychological distress. Results: 80 patients completed the questionnaires. Mean age was 53 (range 27-72) and mean duration of symptoms 18 months (range 1-72). All patients showed normal GHQ values, 46 patients (57.5%) had erectile dysfunction (IIEF<25), while orgasm, desire, satisfaction during intercourse and overall satisfaction dysfunctions were reported by 46 (57.5%), 64 (80%), 78 (97.5%), and 66 (82.5%) patients respectively. Frequency, quality of relationships and perceived partner’s satisfaction did not statistically correlate significantly with GHQ scores, VAS values and disease duration. IIEF and overall satisfaction values strongly correlated with higher frequency and better quality of sexual intercourse as well as with higher perceived partner’s satisfaction (<0.001). Conclusions: Our study showed that PD has a deeply negative impact on overall sexual satisfaction and relational areas of men affected. In these patients the presence of associated erectile dysfunction seems to be the most important factor affecting frequency and quality of sexual activity, as well as perceived partner’s satisfaction.
OP.12.05 TREATMENT OF MALE SEXUAL DYSFUNCTION: A SYSTEMATIC REVIEW H. Aars 1, E. Almas 2, K.G. Brurberg 3, W. Fjeld 4, W. Haaland 4, K.A. Hammerstram 3, K.O. Svendsen 3, D. Sorensen 4, L.M. Reinar 3, B. Landmark 3 11nstitute of Clinical Sexology and Therapy, Oslo, Norway,2 University of Agder, Grimstad, Norway,3 Norwegian Knowledge Centre for the Health Services, Oslo, Norway,4 Gj0vik University College, Gj0vik, Norway The Norwegian Knowledge Centre for the Health Sciences has produced a systematic review of the literature. An extensive, systematic search yielded 2805 unique titles of which 320 articles were retrieved in full text. There were no language restrictions. Pharmaceutical, surgical and technical aids were not included. We have summarized results from nine systematic reviews and 33 randomized, controlled trials, of which one review and four RCTs evaluated the effects of sexological interventions in men. No studies on desire, delayed ejaculation, orgastic dysfunction or pain problems in men met the inclusion criteria. Despite male sexual dysfunction being fairly common, men have been reluctant to seek help. The advent of PDE5-inhibitors (sildenafil) improved this situation. There is some documentation on group therapies, while clinical experience in Norway has mostly faced individual therapies. Treatment effects are shown for overall effects and by treatment modality. Our results will be presented compared to other published reviews, and single studies We also found one systematic review and seven RCTs on the treatment effects on sexual problems for men after chronic disease. Five RCTs were on treatment for dysfunctions after cancer of the prostate or testicles, and two studies were on therapy effects after heart attack or spinal chord injury. We found no controlled studies or previous reviews on sexual dysfunctions among gay men or gender identity orders or on sexual dysfunction among males having suffered previous sexual abuse. Results, sexual response models and metaanalysis will be presented in the light of a lifetime of clinical experience. 0P.12.06 IS TRANSURETHRAL RESECTION OF PROSTATE AMONG PATIENTS WITH BENIGN PROSTATE HYPERPLASIA RISK FACTOR FOR ERECTILE DYSFUNCTION? Z. Marshania Enmedic Clinic, Faculty of Psychology of the Georgian National University, Tbilisi, Georgia Objective: More prospective studies are needed to assess the impact of transurethral resection of prostate (TURP) in patients with benign prostate hyperplasia (BPH) on erectile function. Design and Method: 36 Georgian men from 51 up to 70 years of age were evaluated. TURP was performed in 24 cases of BPH. Erectile function and low urinary tract symptoms (LUTS) were assessed based on the international index of erectile function (IIEF-15) questionnaire and international prostate symptom score (I-PSS). Results: Some characteristics of erectile function according to IIEF-15 (mean score in orgasmic function) after TURP was statistically significantly (P<0,05) less than before surgery as well as decrease of I-PSS scores was observed. We also indicated after TURP a statistically significant (P<0,05) decrease of other characteristic of erectile function (sexual desire) in patients with BPH in comparison to control group. It is our belief that erectile dysfunction (ED) after TURP was associated with severity of postoperative retrograde ejaculation (RE) so far as we observed postoperative RE in 58,3% of our cases. It was confirmed by results of comparison the IIEF-15 characteristic of patients with BPH pre and post-operatively as well as by comparison of erectile function of these patients with control group. Conclusion: RE after TURP is linked to risk of ED among patients with BPH. ED always causes more negative impact on the quality of life than RE. Therefore in patients with BPH after TURP ED may be prevented by more careful preoperative psychological counseling concerning RE. 0P.12.07 SYNCHRONOUS TREATMENT OF LUTS AND DE WITH A EW NATURAL COMPOUND ALONE AND IN COMBINATION WITH ALPHA BLOCKERS D. Prezioso, F. Iacono, E. Illiano, A. Ruffo Department of Urology University Federico II, Naples, Italy Objective: Benign prostatic hyperplasia (BPH) is a condition often associated with lower urinary tract symptoms (LUTS) and also sexual dysfunction(SD).LUTS,especially the bother symtoms have a negative impact on health-related quality of life. The aim of this study is to investigate the effectiveness of a new natural compound (Tradaprost®) in treating men with LUTS. Design and Method: A double-blind study:84 patients (mean age of 52 years) presenting BPH( Qmax<10 ml/sec; PVR>50 ml;BOOI>40) and LUTS symptoms were enrolled. They were randomly separated in 2 groups A-B of 42 pts. To group A was administered once a day Tamsulosin 0.4 mg plus Tradaprost ® (Alga Ecklonia Bicyclis 80 mg ,Tribulus Terrestris 100 mg and D-Glucosamine 100 mg, Serenoa Repens 320 mg)while Group B received once a day Tamsulosin 0.4 mg for 3 months.Physical examination, uroflowmetry, urinary system ultrasonography and PVR, a self-administered IQoL, IPSS, IIEF questionnaires were evaluated at baseline and after 90 days of treatment Results: An improvement in symptom score, storage symptom score, Qmax ,PVR, voiding efficiency, IPSS , IQoL, questionnaire was observed in all patients, but a good therapeutic response with improved IIEF score and bother symptoms was observed in 62,7% of the patients in only group A. Conclusions: Tradaprost® can be used to improve the male sexual function due its antioxidant, anti-aging action, and the bother symptoms due its anti-inflammatory action. Infact it neutralizes the action ROS,LPS,COx2,NFk-beta,reducing the concentrations of TNF-alpha ,MMP-1also. 0P.12.08 COGNITIVE-BEHAVIORAL INTERVENTION FOR RETARDED EJACULATION D. Wattelman 12 1 Beit Berl College, School of Education, Kfar Saba, Israel,2 Rambam Healthcare Campus and Clalit Health Services - Center for Improved Sexual Function, Haifa, Israel Objective: Success rates when treating Retarded Ejaculation (RE) are relatively low and in order to overcome therapeutic difficulties and increase success rates, it is highly important to create precise therapeutic protocols. The presentation will describe an integrative therapy aimed at increasing successful treatment outcomes. Design and Method: Ten married clients with primary RE and no biological etiology underwent sex therapy at a private clinic in Tel Aviv, Israel. Clients participated in 15-18 sessions of 50 minutes each. Various techniques were utilized during the therapeutic process - anxiety reduction techniques, masturbation moratorium, changing hands while masturbating, sexual fantasy reconstruction and changing idiosyncratic masturbatory patterns. Participation of clients’ partners in the therapy process and home assignments was mandatory. Results: seven of the ten clients reported full recovery (the ability to ejaculate in the vagina during coitus). The three clients whose partners did not fully cooperate in the treatment process failed to resolve their RE. Most clients had difficulty implementing the sexual fantasy reconstruction. Conclusions: Partner participation and cooperation constitute an essential condition for successful therapy. Therefore, it seems reasonable to make an extra effort in the intake process to ensure partner cooperation during the treatment. Implementing ‘sexual fantasy reconstruction’ does not appear to provide the anticipated benefits and may increase resistance not only to that technique but to the whole therapeutic process. Limitations of the work presented and future recommendations for research and therapy will be discussed.
OP.12.09 ERECTILE DISFUNCTION IN YOUNG PEOPLE S. Frago Valls Instituto Amaltea de Sexología, Zaragoza, España Introduction and Objectives: After an extensive professional experience in sexual counselling , I am prepared to present the professional body experts my most relevant conclusions on how to deal with the erectile dysfunction in young couples using the pharmacological therapy as a therapeutic strategy . The basic objective of the paper is to show the etiology / biographical /sociological key which explains the high frequency of ED with the young, as well as to present the way to move from pharmacological therapy to sexual therapy . Design and Method: The Annual Reports of the Sexology Counselling Service of the University of Zaragoza in the last 6 years show that the most common complaint among the university community are erectile dysfunctions in the relation aspect. We will see the use of pharmacotherapy both as a resource and as a strategy in the framework of a non-organic etiology ED among young couples. I will also comment on how the fact of using medicines to solve their erotic problem is experienced by the young couple and how to get the therapeutic adhesion. Results and C onclusions: The results show the usefulness of pharmacotherapy as a way to break the persistent fact of “erectile failure” of non-organic etiology. Pharmacologic therapy as a resource and sexual therapy as an objective make up the best strategic design with this kind of young patients.
OP.12.10 SEXUALITY AFTER PROSTATE CARCINOMA: A MAN OR COUPLE ISSUE? C. Silvaggi 12, F. Tripodi 1, C. Simonelli 3 11nstitute of Clinical Sexology, Rome, Italy,,2 University Tor Vergata, Rome, Italy,,3 University Sapienza, Rome, Italy Objective: SD especially ED, following prostate cancer, is a common complication. ED, which affects 33-98% of men diagnosed with prostate cancer is a frequently compromised aspect of patient quality of life .The goal of this work is to compare results and to highlight the implication for sexological treatment. The Authors will comment results in the light of their own clinical experience. Design and Method: Review of articles on this subject published in the Medline (PubMed) database, selected according to their scientific relevance. Results: A number of effective treatments have been developed for ED. Despite a high success rate of these treatments, evidence indicates that many men do not continue to utilize these treatments; one explanation for this drop-off is that the treatment for ED does not lead to resumption of satisfactory sexual relations for all couples. It was shown that the intimacy and affection between the partners are the most important predictors of sexual satisfaction. Studies suggest that successful coping efforts often occur within the context of the relationship and frequently include a process of adjusting one’s concept of sexual function and activity through shifting to thoughts and behaviours that based on intimacy and sexual activities other than intercourse. Conclusion: sexual functioning can be much improved by adequate couple’s counselling and intervention. An integrative approach is recommended
OP.12.11 CHRONIC PAIN AND EROTICISM IN THE COUPLE S. Frago Valls Instituto Amaltea de Sexología, Zaragoza, España Introduction and Objectives: The sexuality of people with chronic pain is a reality, rather frequently ignored. In this presentation we try to take it back to the place where it should be, which is the same game place as in the rest of sexualities. The basic objective of the communication/ paper is to make a professional journey from Sexual Medicine and Sexology to the Pain Unit and reconcile and administer the triangle Pain - Pleasure - Love Go and seek the erotic visibility of people who coexist with chronic pain. Design and Method: The clinical experience of the Sexual Medicine Service in Amaltea Institute shows that the person suffering from chronic pain shows different erotical and relation difficulties which come from the actual painful process and the pharmacological iatrogenesis. I will present the erotic features of the people suffering from chronic pain. Apart from that, I will comment on how the partner living with the person who suffers from chronic pain copes with the the erotic detriment of his /her partner. Results and Conclusions: The results show the usefulness of the sexual and couple therapy as a way to break the persistent way of sexual dysfunction and, as a result, to make the couple’s erotic life more dynamic. poster display 01-08
PD.01.01 SEXUAL ADDICTION QUESTIONNAIRE (SAQ). VALIDATION PROOFS: CONFIRM AND EXPLORATION OF THE SEXUAL ADDICTION CONSTRUCT F. Quattrini 1, M. Spaccarotella 2, R. Sarracino 2, F. Palpini 2, R.S. Calabro 3 1 Department of Biomedical Sciences, Chieti, Italy,2 Italian Institute of Scientific Sexology, Rome, Italy,3IRCSS Neurolesi, Messina, Italy Objective: Following the preliminary data presented to the World Congress for Sexual Health (Goteborg 2009); we were aimed to continue the SAQ validation proofs in a wider sample. To verify the questionnaire’ utility as a clinical- diagnostic support, we wanted to give the SAQ a higher level of validity, with regard to the Sexual Addiction construct. Method: Using the online version of SAQ, which was available at the Italian Institute of Scientific Sexology’s website from January 2010 to December 2012, 1000 subjects entered the study. However, because of missing data, only 714 subjects (Male 56% and Female 44%; average age M 33.3 sd 10; F 26,5 sd 7) were included in the statistical analysis. In particular, data analysis was conducted using factorial analysis, and the extraction of principal components has been realized with VARIMAX rotation method. Results: Eleven factors were found to underlie the Sexual Addiction construct. Each factor established what links exist among behaviors investigated by the 65 items of SAQ. Interestingly, four (30%) of these 11 factors were shown to play a key role, i.e. Control and Persistence, Centrality of Sex, Consequences and Craving. The other seven factors were useful to support interesting hypotheses for future investigations and possible structural changes of the SAQ. Conclusions: Our findings demonstrated that the main factors of this questionnaire may be pathognomonic of the sexual addiction construct. Nevertheless, further studies using comparative “gold standard” tests should be fostered in large clinical samples, in order to highly support the validity of this promising test.
PD.01.02 EVALUATION OF QUALITY OF LIFE AND SEXUAL SATISFACTION IN WOMEN SUFFERING FROM ENDOMETRIOSIS V. Cosmi 1, L. Pierleoni 1, M. Giuliani 1, R. Rossi 1, A. Recine 1, M. Pieroni 1, C. Simonelli 2 1 Institute of Clinical Sexology, Rome, Italy, 2 University Sapienza, Rome, Italy Objective: Endometriosis is a chronic gynaecological disease that has had a growing rate over last years. It mainly affects females during reproductive years and it is strongly associated with pelvic pain. The aim of the present study is to evaluate quality of life and sexual satisfaction in an Italian group of women affected by endometriosis. Design and Method: 60 participants who had been diagnosed with endometriosis were recruited at the Endometriosis Outpatient Clinic at the Policlinico Agostino Gemelli of Rome from January to March 2012. The controls were 60 healthy women, matched for age and relational status. The WHOQOL- Bref and the Italian version of McCoy Female Sexuality Questionnaire (MFSQ) were administered to participants. Data were analyzed using SPSS 19.0 for Windows. Results: Clinical group (EG) had lower score than control group (CG) both in MFSQ (sexuality and relationship domains) and WHOQOL areas (physical, psychological and social relationship domains). Instead of that, environmental factor seems do not influence women perception of their quality of life. 68.4% of the EG reported pain in more than half of their sexual intercourse, versus 13.6% of the CG. Conclusions: Results indicate that women with endometriosis perceived lower level in quality of life and sexuality than healthy ones. Our data seem to underline that pain is one of major patients concerns; its effect on quality of life is more important than endometriosis per se.
PD.01.03 REQUEST ASSISTANCE OF THE IMMIGRANT POPULATION IN SEXUAL HEALTH AND GENDER F. Hurtado Murillo 1, F. Donat Colomer 1, R. Pellicer Faro 1, A. Royo Martinez 1, M. Alcaraz Quevedo 2, J. Cantero Llorca 3 1 Centerfor Sexual and Reproductive Health Fuente San Luis. Hospital Department Dr. Peset. Agencia Valenciana de Salud, Valencia, Spain, 2 Directorate of Public Health, Valencia, Spain, 3 Directorate of Primary Care. Hospital Department Dr. Peset. Agencia Valenciana de Salud, Valencia, Spain Objective: Determine the demand for care in sexual health and sexual habits of the immigrant population and whether there are differences with the autochthonous population and between sexes. Design: Observational study, cross-sectional analytical components. Method: Audit of 829 medical records of users of different origin, which in 2008 requested assistance at the Center for Sexual and Reproductive Health (CSSR). Study variables: origin, age, sex, reason for consultation and sexual habits. Descriptive analysis was performed and the differences by chi-square for qualitative variables and Student’s t in quantitative. Results: The mean age of coital onset is 17.92 years. There are differences in sexual desire by origin (X2=32.688; p=0.000), more normal rate of immigrants. Men have more sexual desire (80.3%) than women (57.1%). The differences in sexual satisfaction, by origin are minimal and not significant, they are significant gender (X2=1.358; p=0.000), women report higher rates than men (76.2% vs. 41.6%). Demand for health care there are differences according to origin and with a higher rate for autochthonous the two main reasons (X2=49.868; p=0.000): sexual dysfunction and transsexuality. Between sexes, the differences are significant (X2=4.219; p=0.000), highlighting the demand for sexual dysfunction in men accounted for 75.8% and females 40% Conclusions: The first cause of consultation for Spanish was the sexual arousal disorder, premature ejaculation for immigrants. Men outnumber women in arousal disorder. Women outnumber men in inhibited sexual desire and orgasmic dysfunction.
PD.01.04 SEXUAL DYSFUNCTION IN PARKINSON’S DISEASE: FACTS OR FANCIES? V. Raoli 1, R. Ferrucci 2, F. Cogiamanian 3, P. Barone 4, L. Bertolasi 5, A. Padovani 6, M. Panzeri 7, L. Ronconi 7, M. Ciocca 8, A. Priori 8 1 Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,2 Fondazione IRCSS Ca’ Granda - Universita degli Studi di Milano, Milan, Italy 3 U.O. di Neurofisiopatologia - Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy, 4 Dipartimento di Medicina e Chirurgia - Universita degli Studi di Salerno, Salerno, Italy,5 Unita di Neurologia - Azienda Ospedaliera Universitaria di Verona, Verona, Italy, 6 Dipartimento di Scienze Mediche e Chirurgiche - Universita degli Studi di Brescia, Brescia, Italy,7 Dipartimento di Psicologia - Universita degli Studi di Padova, Padua, Italy, 8 Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico - Universita degli Studi di Milano, Milan, Italy Objective: To assess sexual dysfunction (SD) in Parkinson’ s disease (PD). Methods: 121 patients with idiopathic PD and 123 controls were recruited from four Italian Movement Disorders Clinics. To assess sexual function in PD we used the Brief Index of Sexual Functioning, the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Also Beck Depression Inventory (BDI).was assessed. Results: Scales of sexual function did not significantly differ between the two groups. BDI score in PD patients was significantly higher than in controls. Regarding the interaction of drug therapy, only MAOI-B appeared to increase sexuality both in male (IIEF: MAOI-B: 54.7ı14.0, without MAOI-B 39.4ı20.3, p<0.05) and female patients (BISF-W: MAOI-B: 20.9ı12.60, without MAOI-B 9.2ı11.3, p<0.05). Discussion: Though considered a non motor symptom in PD, our study overall fails to detect SD in patients. Previous studies, concluding for the presence of SD in PD, differ from the present for evaluation scales, types of patients, sample size and, therefore, are difficult to be compared. Despite patients have overall normal scores, within the PD group there is a correlation between sexual function and specific classes of drugs. Drug effects on sexual function could therefore lead to an underevaluation of SD and partly explain the difference between this research and the previous studies. Conclusion: Sexual function is comparable in patients with PD and in controls subjects. Nonetheless specific antiparkinsonian drug classes could positively influence sexual function in PD patients, thus leading to an undervaluation of SD in PD.
PD.01.05 EVOLUTION IN THE FIRST COITAL INTERCOURSE E. Sueiro Dominguez 12, A. Lopez 12, J.L. Dieguez 12 1 Faculty of Science of Education - Vigo University, Ourense, Spain,2 C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain Objective: To know about how the first coital intercourse have changed in recent years. Material And Method: A cross descriptive study on students of the first and last year of all degrees from Vigo University (Ourense), in 97-98 (5594) and 2007-08 (2284). They all answered a structured survey designed to check their age and identity variables related to their first coitus. The data were analyzed with the SPSS. Results: The average age of the student body in 1997-1998 is 20,71 years old, in 2007-2008 is 21,13. The 59,2% and the 61,6% of the first and last course, respectively, are women. We found significant differences (p<.05) between the student in 97-98 and 07-08 in the percentage of people with different sexual practices, the age of beginning, and several variables related to the 1th coitus. Conclusions: These results make it necessary to design interventions seeking for the prevention and reduction of the risks associated with the sexual practices before such behaviours take place and/or once they have taken place.
PD.01.06 EVOLUTION OF THE LAST COITAL INTERCOURSE E. Sueiro Dominguez 12, A. Lopez 12, J.L. Dieguez 12 1 Faculty of Sciences of The Education - Vigo University, Ourense, Spain,2 C.o.f. “Novoa Santos" (Sergas-ourense), Ourense, Spain Objective: To know about the evolution the several variable related to the last coital intercourse. Material and Method: A cross descriptive study on students of the first and last year of all degrees from Vigo University (7878), in 97-98 and 2007-08 courses. They all answered a structured survey designed to check identity variables of aged and related to their last coitus. The data were analyzed with the SPSS. Results: The average age of the student body in 1997-1998 is 20,71 years old, in 2007-2004 is 21,13. The 40,1% and the 37,6% of the first and last year, respectively, are men. We found significant differences (p<.05) between the student in 97-98 and 07-08 in several variables related to the last coitus. Conclusions: These results make it necessary to make Sexual Education since the first ages.
EVOLUTION OF SEVERAL SEXUAL BEHAVIORS IN UNIVERSITARY STUDENTS MEN AND THEIR AGE OF BEGINNING E. Sueiro Dominguez 12, A. Lopez 12, J.L. Dieguez 12 1 Faculty of Sciences of The Education - Vigo University, Ourense, Spain,2 C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain Objective: To know about the changes in several sexual behaviors of the men and their of the beginning. Material and Method: A cross descriptive study on men students of the first and last year of all degrees from Vigo University (Ourense, Pontevedra and Vigo), in 97-98 (2197) and 2007-08 (824). They all answered a structured survey designed to check the age and the variables related to several sexual practices and their beginning age. The data were analyzed with the SPSS. Results: The average age of the student men in 1997-1998 is 20,85 years old and in 2007-2004 is the 21,42. We found significant differences (p<.05) between the men student in 97-98 and 2007-08 in the percentage of people with different sexual practices and the age of beginning. Conclusions: These results make it necessary to design interventions since the first ages and since all educative agents.
EVOLUTION OF SEVERAL SEXUAL BEHAVIORS IN UNIVERSITARY STUDENTS WOMEN AND THEIR AGE OF BEGINNING E. Sueiro Dominguez 12, A. Lopez 12, J.L. Dieguez 12 1 Faculty of Sciences of The Education - Vigo University, Ourense, Spain,2 C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain Objective: To know about the changes in several sexual behaviors of the women and their age of beginning. Material and Method: A cross descriptive study on women students of the first and last year of all degrees from Vigo University (Ourense, Pontevedra and Vigo), in 97-98 (3223) and 2007-08 (1362). They all answered a structured survey designed to check the age and the variables related to several sexual practices and their beginning age. The data were analyzed with the SPSS. Results: The average age of the student women in 1997-1998 is 20,61 years old and in 2007-2004 is 20,96. We found significant differences (p<.05) between the women student in 97-98 and 2007-08 in the percentage of people with different sexual practices and the age of beginning. Conclusions: These results make it necessary to design interventions seeking for the prevention and reduction of the risks associated with the sexual practices before such behaviour take place. poster display 09-11
PD.01.09 EXPLORING GENDER AND CLASS INEQUALITIES IN THE BEDROOM: WOMEN’ PERCEPTIONS OF THEIR SEXUALITY THROUGH AN IN-DEPTH INTERVIEW STUDY V. Alarcao 1, A. Beato 1, L. Roxo 1, F. Miranda 1, M. Carreira 1, A. Galvao Teles 12 1 Faculty of Lisbon, Lisbon, Portugal,2 Endocrinology, Diabetes and Obesity Unit, Lisbon, Portugal Objective: To present the findings of a qualitative study undertaken with the aim of exploring female perceptions of their sexuality, women and men perceptions of female sexual problems and their experiences of dealing with their perceived sexual difficulties in day-to-day life. Methods: Part of a multi-methods approach and data triangulation, with a sample of Sexual Dysfunction Observational Study in Portugal participants. This subset consists of 15 in-depth interviews with women with and without sexual difficulties complemented by 3 interviews with (unrelated) men whose partners had experience of sexual problems, conducted by female and male researchers, respectively. Results: Data was catalogued according to broad themes: Female perceptions of Normal Sexual Functioning and of Sexual Satisfaction; Sexual Goals; Men perceptions about their partners’ sexual difficulties. A multiple variety of perceptions and representations attached to sexual roles and a diverse range of sexual experiences emerged from the participants’ dialogues. Women’s sexuality was more complex and less genitally focused than men’s. In general, women want relationships and mutually satisfying sex, and more and more women want sexual agency and self love. All women want consensual sex, being this an ultimate for sexual health and liberation. Men whose partners had experience of sexual problems where more challenging of normative sexuality and more focused on couple satisfaction. Conclusions: Conceptions of desire, arousal, and satisfaction are complex constructions that are impacted by age, education and class. Shifting sexual roles could potentially contribute to decrease gender inequity in sexual and social arena, for both men and women.
PD.01.10 RELATIONSHIP SATISFACTION AND SEXUALITY DURING THE TRANSITION TO PARENTHOOD A. Silva, C. Duarte Faculdade Psicologia Universidade do Porto, Porto, Portugal, Aims: The perception of satisfaction in marital relationship during the transition to parenthood in articulation with patterns of sexual relationship were examined in this study. Another aim was also assess the prevalence of psychopathological symptoms during this period in women and men and analyze their impact on marital and couple sexuality. Method: A sample of 100 couples, first time parents, filled DAS (Dyadic Adjustment Scale; Spanier 1976) and BSI (Brief Symptom Inventory, Derogatis & Spencer, 1982) in the period between the first and second baby's year. These measures were related to socio-demographic and couple’s sexual relationship factors during the same period. Conclusion: Although transition to parenthood is usually described as a period marked by a decrease in couple's satisfaction also provides, in same relationship, an opportunity to intensify and enhance the emotional connection of the couple. It is expected that the perception of greater satisfaction with sexuality and no significant levels of psychopathological symptoms act as protective factors for this decline in marital satisfaction.
PD.01.11 SEXUALITY IN THE POSTNATAL PERIOD C. Leon Ortega 1, V. Bueno López 1, A. Teva Calahorro 1, E. Gili Jauregui 1, P. Amorós Ferrer 2, C. Maján Sesmero 2, M. Calveiro Hermosilla 1, M. Campos Almeda 1, M. Matas Granados 1, M. Caubet Gualdo 1 1 Midwife of Maternal and Child Hospital Vall D'Hebron, Barcelona, Spain,2 Midwife of Women s Health Centre La Riera, Badalona, Spain Introduction: Female sexuality should be investigated considering the uniqueness of the experiences in the different stages of life. The postnatal period is still a vulnerable time which has not been researched thoroughly. Objectives: - To understand the experiences of women’s sexuality during the postnatal period. -To describe the factors that complicate sexuality in this period. Material and Methods: Literature review. Results: The type of delivery and the complications of childbirth may have a strong influence on women’s sexuality during the postnatal period. 83% of women experience sexual problems during the first 12 weeks after giving birth. 15% of women having sexual problems in the postnatal period need to visit a health professional. Conclusions: The sexuality of a couple can be affected after childbirth. The postnatal visit with the midwife should be 6 weeks after giving birth. Within this period women have been able to identify sexual difficulties so it should be the best time to provide some information and to give the right advice. poster display 12-15
PD.01.12 PSYCHOLOGICAL, MEDICAL AND SURGICAL MANAGEMENT IN GENDER IDENTITY DISORDER: A PICTURE OF EUROPEAN CENTERS M.T. Molo 123, C. Crespi 23, M. Mineccia 23 1 Fondazione Carlo Molo Onlus, Turin, Italy, 2 Gender Team C.i.d.i.ge.m. San Giovanni Battista Molinette Hospital, Turin, Italy,3 CE.R.NE. (Centro Ricerche Neuroscienze), Turin, Italy Objective: In the occasion of the first European Meeting on Transsexualism held in Turin on may 2012, a questionnaire was sent to all European Centers dealing with transsexualism. The aim of this was to get a picture of the European situation about care and treatments offered to transsexual, transgender and gender non conforming people (WPATH 7th version of Standards of Care, September 2011). Design and Method: European centers that answered the questionnaire were: Sweden, Netherland, Spain, UK and Switzerland. We also included the Italian centers. The questionnaire is composed of 36 items to investigate criteria of taking in charge, diagnosis, RLE, medical and surgical treatments, number and qualification of professionals. Results: All centers except one are public; their activities exist from a minimum of 4 to a maximum of 38 years; people taken in charge range from a minimum of 50 up to 730; only one center accepts self-diagnosis; WPATH Standards are followed in most centers, although with some adjustments; diagnosis is based on clinical interviews, questionnaires, DSM and ICD10 criteria; all centers require a psychological evaluation to authorize hormone therapy; most centers require psychological support except in one case. RLE is required from a minimum of 8 to a maximum of 24 months. All centers offers Sex Reassignment Surgery, but only some of them other type of surgery. Conclusions: Social and cultural differences in countries didn’t show a significant difference of intervention: they affect the application of SOC, although shared.
PD.01.13 EXPERIENCE ABOUT CREATING A GROUP: LOOKING TO IMPROVE TRANSGENDER PERSONS WELL-BEING S. Morell Capel, L. Leal, S. Vega, R. Prieto Castro Casal Lambda, Barcelona, Spain Objective: To create a multidisciplinary team in order to develop a protocol to intervene in transgender persons from a constructivist point of view Material and Methods: During 2010 and early 2011, in several meetings about transgender persons and the inclusion of gender identity differences as disorder in DSM V, a clinical psychologist with 25 year experience supporting gay, lesbian, bisexual and transgender persons started looking for professionals to share experience and create the group. The professionals included had to meet certain demographic characteristics and an ideology. Results: After considering 12 candidates, we started the group with 5 persons: 4 women and 1 man, 3 were Spanish and 2 were Latin-Americans and all 5 have completed university studies in the health field. In regard to the ideology one of the members was not entirely convinced and left the group after the first meeting. There have been 20 (2 hours) meetings, 80% (16) to develop several tools and establish a new protocol to intervene in the well-being of transgender persons and make a statement about not considering transgenderism as a mental disorder. The remaining 20% (4) were to elaborate a workshop for the II European Meeting of Families LGBT-Catalonia 2012. Until April 2012 we developed a questionnaire about identity and starting evaluation in next June. Conclusions: It is difficult to create a group with a common ideology and develop tools to establish a new intervention protocol.
PD.01.14 GENDER IDENTITY DISORDER IN LISBON’S PSYCHIATRIC HOSPITAL CENTER M. Goncalves 1, D. Goncalves 2, C. Soares 1, R. Novo 2 1 Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal, 2 Faculdade de Psicologia - Universidade de Lisboa, Lisboa, Portugal Objective: The author’s intend to study the population with gender identity disorder in follow-up in Sexology consultation. Methods: Data collection from the patients and hospital information. Discussion: socio-demographic data, psychological evaluation and access to consultation. Conclusion: possible impact of the recent Portuguese law on gender identity on the search for sexology consultation and consequently in the approach to these population.
PD.01.15 GENDER ROLES AND SEXUALITY R. García Sánchez 1, C. Almendros 1, N. Salazar 1, J.A. Carrobles 1, M. Gámez Guadix 2 1 Área de Personalidad y Tratamiento Psicológico. Universidad Autónoma de Madrid (AUM), Madrid, Spain,2 Universidad Autónoma de Madrid (AUM), Madrid, Spain Prior literature indicates an association between gender stereotype and identity and own sex performance perception. The aim of this paper is to deepen into the analysis of this relationship, using new instruments so far not used with Spanish populations and examining their relationship with other variables of interest. The study sample consisted of 362 university students (74.03% women) with a mean age of 23.98 (SD = 6.04). The participants responded to a battery composed of the following instruments, the two first in process of Spanish adaptations for our study: Hoffman Gender Scale (HGS; Hoffman, 1996; Hoffman, Borders & Hattie, 2000); Gender Role Conflict Scale Short Form (GRCS- SF; Wester, Vogel, O’Neil & Danforth, 2011); Cuestionario de Actitudes hacia el Género y la Violencia (CAGV; Diaz-Aguado & Martinez, 2001); Bem Sex Rol Inventory (BSRI; Bem, 1974); Multidimensional Sexuality Questionnaire, (MSQ; Snell, Fisher & Schuh, 1992; Snell, Fisher & Walters, 1993); WHO-Five Well-being Index (WHO-5; OMS, 1998); Brief Symptoms Inventory (BSI; Spanish version by Pereda, Forms & Pero, 2007); Cuestionario Exploratorio de Personalidad - III (CEPER-III; Caballo, Guillén, Salazar & Irurtia, 2011). Overall, results indicated that assuming more traditional gender stereotypes lead to a worse sexual performance. The relationship of the new constructs in adaptation process and other variables of interest related to well-being, distress and personality styles, were all as expected. poster display 16-18
PD.01.16 A CONTRIBUTION TO THE HISTORIOGRAPHY OF SEX EDUCATION IN BRAZIL: LOCATION, DESCRIPTION AND ANALYSIS OF DOCUMENTS FROM THE COLONY TO OUR DAYS P. Ribeiro, A.C. Maia Bortolozzi, C. Cestari, R. Bedin Unesp - Sao Paulo State University. Nusex - Center of Sexuality Studies, Araraquara, Brazil Objective: The authors located and examined works and documents from Brazil since the Colonial Period until the first decades of the twentieth century. Method: The books and documents were studied and from descriptive analysis and interpretive researchers the authors started to describe a history of sex education including the concepts of sex and sexuality, popular constitution of the sexual knowledge, the assimilation of information, customs and values acquired during the cultural formation of Brazil, and the institutionalization of sexual knowledge by doctors, psychologists, educators and social scientists that have given support to an official and legitimate discourse and propositions of educational or pedagogical practices in the field of sex education. Results: These documents contain reports, information and descriptions about sexual attitudes and behaviors in Brazil, which congregated chronologically confirm six different historical moments of sex education. Discussion and Conclusions: The authors described the followed periods: the colonial period (1500-1822), the Empire (1822-1889); the beginning of the Republic and the first decades of the twentieth century (1889-1950); the 1960s and early intervention in schools; the period of recoil as a result of the coup d’état of 1964 (1968-1978); the official initiatives of sex education (1978-1990); the present time (1997-2012).
PD.01.17 SEXOLOGY IN BRAZIL AT BEGINNING OF 2OTH CENTURY: THE WORK OF DOCTOR HERNANI DO IRAJÂ AND THE HISTORIOGRAPHY OF SEXUAL EDUCATION C. Cestari, P. Ribeiro, R. Bedin Unesp - Sao Paulo State University. Nusex - Center of Sexuality Studies, Araraquara, Brazil Objective: This study has the objective of analyse the work of Doctor Hernani do Iraja, one of the pioneers of Sexology in Brazil. He specialized in artistic nudes and , participated in numerous shows and exhibitions. In his books the authors found descriptions about sexual attitudes and behaviors in Brazil in the early decades of the twentieth century. Method: The authors located and examined works and books published by Iraja. These documents contain reports, information and descriptions about sexual attitudes and behaviors in Brazil at the first decades of 20th Century. Results: This work shows that the consolidation of Sexology in Brazil occurred in the first decades of 20th Century, from the action of doctors and educators that created extensive work divulged in books, defended theses in the colleges of medicine and presented communications in scientific associations. Discussion and Conclusions: Pioneers like Hernani do Iraja promoted a movement to stamp prophylactic intense, organized, bold and still unknown today, with publications of books of sex education, the foundation of cultural entities responsible for speeches and public disclosure about sexuality and sex education.
PD.01.18 THE INSTITUTIONALIZATION OF SEXUAL KNOWLEDGE AS THEME FOR RESEARCH AND EDUCATION IN BRAZILIAN UNIVERSITIES AND THE WORK OF SOME RESEARCH GROUPS R. Bedin, L. Muzzeti, P. Ribeiro Unesp - Sao Paulo State University. Nusex - Center of Sexuality Studies, Araraquara, Brazil Objective: The present work describes and analyzes the institutionalization of sexual knowledge and the consolidation of sexual education as a subject of research and training at some Brazilian universities and the role of research groups in this process. Method: We interviewed coordinators and members of six groups of UNESP and six groups from other universities, and the responses were grouped into categories based on the fundamental issues that could meet the objectives proposed in the study. We created ten categories of analysis to know each research group: 1) Working Group. 2) Training of researchers in the area of Sexuality and Sexual Education. 3) Contribution to the systematization of knowledge on sexuality. 4) Importance of the group at his university. 5) Contributions to the development of students. 6) The perception of the current studies on sexuality and sexual education in Brazil. 7) Relationship between the members of the Group. 8) Work together with students of undergraduate and postgraduate courses. 9) Dissemination of research work undertaken by the Group. 10) Internationalization. Results: The analysis enabled collect data and information on the structure, functioning and achievements of each group, allowing we showed its way since its inception and check the current situation, the academic and scientific production and how occurred the process of institutionalization of these groups. Discussion and Conclusions: Brazilian universities has contributed for research, teaching and publication of articles and books about sexual education in Brazil. poster display 19-25 paraphilias and sexual aggression
PD.01.19 CHILDHOOD AND ADULTHOOD SEXUAL ABUSE VICTIMS: THEIR RELATIONSHIP WITH POSITIVE AND NEGATIVE SEXUAL COGNITIONS M. Moyano, R. Granados, M.M. Sánchez, P. Santos Iglesias, P. Vallejo Medina, J.C. Sierra University of Granada, Granada, Spain Objective: A broad research area has focused on the influence of childhood and adulthood sexual abuse on sexual behavior. However, the studies that analyze whether sexual abuse experiences have an impact on cognitive aspects of sexuality (schemas or sexual fantasies) are still scarce. The main goal of this study is to examine whether people who have experienced sexual abuse during childhood and adulthood have a higher frequency of sexual fantasies. Moreover, it is important to consider the emotions and content of the sexual fantasies that are more frequently experienced. For this reason, we will consider the more general term “sexual cognition” and the distinction between Positive Sexual Cognitions (PSC) (pleasant, enjoyable and acceptable) and/or Negative Sexual Cognitions (NSC) (unpleasant, not enjoyable and unacceptable). Design and Methods: The sample was made up by 60 participants (20 individuals who have suffered child sexual abuse, 20 participants who have suffered sexual abuse during adulthood and 20 without any sexual abuse experience). These questionnaires were administered: The subscale “Sexual Assault Screeners” from the Juvenile Victimization Questionnaire (Hamby; & Finkelhor; 2001, 2004); the Sexual Experiences Survey (Koss; & Gidycz, 1985) and the Sexual Cognitions Checklist (Renaud; & Byers, 1999). Results: Victims of sexual abuse had a higher frequency of positive and negative sexual cognitions related to exploratory content. Higher frequencies of positive sexual cognitions were also reached for sadomasochistic fantasies. Conclusions: It is important to consider the negative emotions that are associated to sexual abuse experiences, in order to replace them in a therapy framework.
PD.01.20 THE SEXUAL ATTRACTION TOWARDS DISABILITIES: AN INTERNET-BASED STUDY E. Limoncin 1, R. Carta 1, G.L. Gravina 12, E. Carosa 1, G. Ciocca 1, A.M. Isidori 2, A. Lenzi 2, E.A. Jannini 1 1 School of Sexology, Course of Medical Sexology, Department of Experimental Medicine, University, Of L’Aquila, L’Aquila, Italy, 2 Section of Endocrinology,, Department of Experimental Medicine, 1st University of Rome, Sapienza, Rome, Italy Objectives: to evaluate if devotism, a sexual attraction towards disability, is a paraphilia, we studied whether or not this condition meets the diagnostic criteria according to DSM-IV-TR or the forthcoming DSM-5. Design and Method: Two-hundred-nineteen participants were selected from online devotee-communities. A semistructured questionnaire explored social/sexual relationships as well as perceived discomfort of devotees. Results: we identified two different populations. The first population was more attracted by the way people with disabilities deal with their condition. The second population comprises subjects more sexually interested in people with disabilities than those without them. They were often unable to become sexually aroused in the absence of the fetish and report discomfort due to their condition. Significant differences (p<0.0001) between these sub-populations (subpopulation 1 versus 2) were identified regarding (i) perceived discomfort (29%; 13/55 vs 65.2%; 90/138) (ii) sexual intercourse with anyone with a disability (54.5%; 30/55 vs 30.6%; 45/138) (iii) lasting relationship with anyone with disability (74.5%; 41/55 vs 31.9%; 44/138) and (iv) sexual intercourse with an able bodied person (94.5%; 52/55 vs 60.8%; 87/138). While the first sub-population does not fulfill the criteria for paraphilia accordingly with DSM-IV-TR, the second one could be classified as “paraphilic” or affected by a “paraphilic disorder”, on the basis of DSM-5. Conclusions: As with several unusual sexual interests, devotism probably covers a wide array of conditions, ranging from unambiguously pathological to more blurred clinical pictures. This could have a significant impact on future criteria for inclusion of this condition in the large family of paraphilias.
PD.01.21 PARTNER ABUSE AMONG SPANISH MEN AND WOMEN: A STUDY FROM A LONG NON-REPRESENTATIVE SAMPLE R. Granados, P. Santos Iglesias, J.C. Sierra, P. Vallejo Medina, N. Moyano, M.M. Sánchez University of Granada, Granada, España Objective: Partner violence has been traditionally studied among women. However, different studies noted that men also suffer partner violence from their female partners. In this regard there seems to be a qualitative difference in partner abuse between men and women, since women suffer more physical and violent forms of abuse. Based on this, the main aim of the present study was to analyze rates of partner abuse in a Spanish sample of men and women. Design and Methods: This descriptive study was carried out on a sample of 1,500 men and 1,500 women from Spanish general population. They ranged in age from 18 to 77 years old (M = 40.20). They responded to the Spanish version of the Index of Spouse Abuse, which assess the frequency of physical and non-physical partner abuse. Results: Results showed that most men and women have suffered at least one experience of partner abuse in their lives. However, they did not suffer partner abuse frequently. Comparisons between men and women showed that men experienced more non-physical abuse and controlling behaviors, while women experienced more physical abuse. Conclusions: This results show that partner abuse exists among Spanish men and women. Women suffer more violent forms of abuse, which have the more detrimental consequences. On the other hand, men also suffer partner abuse but, in this case, it is less dangerous, violent and has less serious consequences.
PD.01.22 EARLY MALADAPTIVE SCHEMAS AS VULNERABILITY FACTORS FOR AGGRESSIVE SEXUAL BEHAVIOR V. Sigre Leiros, J. Carvalho, P. Nobre Departamento de Educagao, Universidade de Aveiro, Aveiro, Portugal Objective: Although the influence of adverse early attachment experiences on the development of aggressive sexual behavior has been demonstrated, there is a gap in the literature regarding the conceptualization of this behavior according to developmental psychopathology models. The purpose of the present study was to investigate a potential association between Early Maladaptive Schemas (EMSs) and aggressive sexual behavior. Design and Method: A total of 166 male college students participated in the study. Participants were divided into two groups according to data from the Sexual Experiences Survey - Short Form Perpetration (SES-SFP): Group of individuals with history of aggressive sexual behavior (n = 37) and Group of individuals without history of aggressive sexual behavior (n = 129). All participants completed the SES-SFP and the Young Schema Questionnaire (YSQ-S3). Results: Results showed that students who have committed any form of sexually aggressive behavior exhibited significantly higher levels of EMSs from the Disconnection and Rejection domain (namely, Mistrust/Abuse schema), from the Impaired Autonomy and Performance domain (namely, Dependence/ Incompetence schema), and from the Overvigilance and Inhibition domain (namely, Negativity/Pessimism schema). Conclusions: Overall, these preliminary findings suggest that the EMSs were associated with aggressive sexual behavior, but further investigation is warranted.
PD.01.23 SEX OFFENDERS’ EMOTIONAL PROFILES J. Carvalho, P. Nobre Universidade de Aveiro, Aveiro, Portugal Deficits in emotional and behavioral regulation have been related to several forms of criminal behavior. Objective: The aim of the present study was to evaluate how the structure of affect (positive vs negative affect) and impulsiveness (motor/planning vs cognitive impulsiveness) characterize specific forms of sexual violence. Methods: Thirty-two men convicted for rape, 31 men convicted for child sexual abuse (study 1), and 37 male college students reporting sexual violence against women (study 2) were assessed according to the Positive and Negative Affect Schedule (PANAS) and the Barrat Impulsiveness Scale (Bis- 11). Results: Results (study 1) indicated that negative affect and motor/planning impulsiveness characterized individuals convicted for rape with regard to the control group, whereas child sexual molesters presented significantly lower positive affect than controls. On the other hand, college students reporting sexual violence against women (study 2) presented higher motor/planning and cognitive impulsiveness than the control peers, but did not differ from peers in relation to affect. Conclusions: Data suggested that the three forms of sexual violence (rape, child sexual abuse, and sexual coercion among college students) may be related to different etiological pathways.
PD.01.24 PERSONALITY TRAITS IN SEXUAL OFFENDERS: EVIDENCE ON THE FIVE FACTOR MODEL J. Carvalho, P. Nobre Universidade de Aveiro, Aveiro, Portugal Despite numerous studies using the five-factor model (FFM) of personality as theoretical background, few studies have been conducted on the topic of the FFM and sexual aggression. Objective: This study explored how the big five dimensions characterize different forms of sexual violence. Methods: In study 1 (convicted sex offenders), 32 men convicted for rape, 31 for child sexual abuse, and 30 community men (control group) were assessed; in study 2 (non convicted sexual aggressors), 108 male college students, among which 37 reported sexual coercion of women, were evaluated. Participants completed the Five Factor Personality Inventory (NEO-FFI). Results: Results showed that individuals convicted for rape and child sexual abuse presented significantly more neuroticism than controls, and that child molesters presented significantly less openness than the control group. Additionally, male college students that had sexually coerced against women presented lower levels of conscientiousness and agreeableness than peers. Conclusions: Findings suggested that four of the five general dimensions of personality could be potential vulnerability factors for sexual violence.
PD.01.25 THE MEDIATING ROLE OF PSYCHOPATHOLOGY IN THE RELATIONSHIP BETWEEN COGNITIVE STYLE AND SEXUAL AGGRESSION V. Sigre Leiros, J. Carvalho, P. Nobre Departamento de Educagao, Universidade de Aveiro, Aveiro, Portugal Objective: According the available literature, EMSs play a role in the development and maintenance of various forms of psychological distress. Recent research shows that EMSs are associated with aggressive sexual behavior. Furthermore, several studies have shown that sexual aggressors present diverse psychopathological conditions, mainly emotional disturbance. The aim of the present study was to investigate the relationship between EMSs and aggressive sexual behavior, through the mediating effects of psychopathology. Design and Method: A total of 166 male college students answered the Sexual Experiences Survey - Short Form Perpetration (SES-SFP), the Young Schema Questionnaire (YSQ-S3), and the Brief Symptom Inventory (BSI). Results: Results showed that phobic anxiety and somatization partially mediate the relationship between Dependence/ Incompetence schema and aggressive sexual behavior. Conclusions: These preliminary findings contribute to support the role of psychopathological conditions, namely anxiety and related symptoms, in mediating the relationship between cognitive style and sexual aggression. poster display 26
PD.01.26 PERSISTENT SEXUAL DYSFUNCTIONS IN YOUNG PATIENTS AFTER FINASTERIDE TAKING TO PREVENT HAIR LOSS: A CLINICAL ANALYSIS F. Sandri 1, C. Trombetta 1, G. Mazzon 2, G. Liguori 2, G. Ollandini 2, G. Toffoli 4, E. Checchin 5, C. Di Loreto, S. Cauci 3 1 UniversityofTrieste, Trieste, Italy,2 UniversityofTrieste Dep. ofClinical Urology, Trieste, Italy,3 University ofUdine Dept. ofBiomedical Studies and Technologies, Udine, Italy, 4 Cro. Dep. of Pharmacogenetics Research, Aviano, Italy,5 Cro. Dept, of Pharmacology, Trieste, Italy FDA (Food and Drug Administration) approved Finasteride for the treatment of benign prostatic hyperplasia (BPH) and male pattern baldness (MPB) for androgenetic alopecia (AGA). Finasteride is a synthetic 5-alpha-reductase inhibitor of the enzyme that converts testosterone to dihydrotestosterone (DHT). After the use of Finasteride there have been reported cases of persistent decreased libido, ejaculation disorder or erectile dysfunction, even after the patients ceased using the drug. During multiple randomized trials with placebo controls, finasteride has been related to an increased rate of sexual dysfunction. Apprehension regarding this kind of dysfunction related to the drug deters dermatologists from prescribing finasteride and patients from taking the drug for androgenetic alopecia. In April 2012, the FDA decided to approve Merck’s proposal from 2011 only after the warning label was further strengthened to include reports of libido disorders, ejaculation disorders, orgasm disorders, and decreased libido. This study took into consideration 78 male patients from 24 to 54 years old treated with finasteride to cure androgenic alopecia (AGA) and experiencing persistent side effects after finasteride discontinuation. We sought strongly emphasize the duration of persistent sexual side effects in otherwise healthy men who took finasteride for male pattern hair loss (MPHL). poster display 27
PD.01.27 SEXUAL COUNSELING IN VAGINAL LUBRICATION PROBLEMS N. Benayas Pérez 1, R. Gonzalez Segura 2, R. Benayas Perez 2, M. Jodar Martin 3, M.D. Jimenez Lechuga 3, S. Valladolid Benayas 3 1 Chare Poniente Institute El Ejido, Almería, Spain,2 Out of Work, Almería, Spain,3 Comarcal Institute Melilla, Melilla, Spain Introduction: Vaginal lubrication is a composite of plasma flowing through the walls of the vagina, if there are no emotions or feelings, it does not reach the plasma filter. Because of some pathologies (diabetes, dialysis, cancer, serious illness, or drugs used) lubrication can be altered. Lubrication is not caused by taxation. On many occasions by different pathologies we can see that it is not lubricated, there is even pain with intercourse. Medications also influences this procedure ; they often make you less reactive to external stimuli. Objectives: Methods for women hinders their lubrication problems. Design and Method: extensive literature review of recent years. Results, Conclusions: When we find a condition that involves medication, physical changes, emotional, etc ... we need to know that this greatly affects sexual desire that this leads to a decrease in vaginal lubrication. Guidelines: • Couple has to be more sensitive, kiss, caress and stimulate his partner in more special and different ways to start the lubrication before the introduction of the penis. • If there is desire, the vagina is dry. If you insist, dryness will tend to worsen. • Women should be obsessed with it; otherwise they will enter into a vicious circle. • If the vagina is dry, do not attempt intercourse. It can become painful. Begin to perform other sexual games until the lubrication is optimal. Lubrication is very important to have a satisfying sexual relationship and intercourse the previous games make a great role to relax the environment and let go.
poster display 28-32 psychiatry and sexual health
PD.01.28 SEXUALITY OF PATIENTS WITH AFFECTIVE DISORDERS R. Kowalczyk 1, D. Dudek 2, M. Siwek 2, W. Merk 3, I. Krupka Matuszczyk 3, C. Golawski 4, J. Borowiecka Kluza 2, M. Lew Starowicz 5, B. Grabski 2 1 Department of Sexology in Andrzej Frycz Modrzewski Cracow University, Cracow, Poland, 2 Jagiellonian University, University Hospital, Cracow, Poland,3 Medical University of Silesia, Department of Psychiatry and Psychotherapy, Katowice, Poland, 4 Department of Cardiology, Hypertension and Internal Medicine, 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland,5 Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland The functioning of patients with affective disorders in diagnosis as well as the influence of pharmacotherapy they are subject to on the occurrence of sexual dysfunctions, within that particular group, has recently become an issue widely addressed in a number of research studies. Objective: The aim of the hereby-presented multi researchcenter studies is the description of how frequent sexual impairments touch the patients with affective disorders in diagnosis, as well as the assessment of illness’ and pharmacotherapy’s influence on their occurrence. So far (as of 31 March 2012) 207 patients aged 18-65 have been examined. During the forthcoming conference we will present the initial results of our research based on the data gathered so far. Design and Method: The research was based on a number of standardized questionnaires: The BSP Questionnaire (Pole’s Sexuality Research), Female Sexual Functioning, Male Sexual Functioning, the Hamilton Rating Scale for Depression and the Young Mania Rating Scale. The above-mentioned questionnaires were then supplemented with data on patients’ social and economic status (education, professional activity) as well as a number of other health conditions that might influence the quality of sexual life (associated somatic diseases, drugs influencing the cycle of sexual responses). Additionally information was gathered on the course of illness itself, duration of episodes and types of pharmacological treatment. Results and Conclusions: As of now the research authors will present initial, selected results of how the affective disorders, their duration and type of treatment, and the socio-economic and psycho-behavioral factors influence a number of aspects of human sexuality, as well as the percentage of sexual disorders diagnosed among the patients under scrutiny, all based on analyses of the aforementioned questionnaires and other documentation. Objective: The relationship between trait-affect, depressed mood, and sexual functioning has been studied; however the nature of that relation is not yet known. According to the Tripartite Model, trait-affect is conceptualized as a latent variable which constitutes a vulnerable factor for depression. Additionally, depressed mood is associated to difficulties in sexual functioning. The aim of the present study was to analyze: 1) the predictor role of depressed mood and trait- affect on sexual functioning; 2) and to test the mediator role of depressed mood in the relationship between trait-affect and sexual functioning. We hypothesized that trait-affect and depressed mood would be good predictors of sexual functioning, and we also expected that depressed mood would mediate the relationship between trait-affect and sexual functioning. Design and Method: A total of 205 men and 222 women from the general population participated in the study and completed self-reported measures assessing trait-affect (Positive Affect - Negative Affect Scale), depressed mood (Beck Depression Inventory), and sexual functioning (International Index of Erectile Function; Female Sexual Functioning Index). Results: Regression analysis showed that negative trait-affect and depressed mood were significant predictors of male sexual functioning and negative trait-affect was a significant predictor of female sexual functioning. Moreover, mediation analyses indicated that depressed mood partially mediate the relationship between negative trait-affect and male sexual functioning; and depressed mood partially mediate the relationship between negative and positive trait-affect and female sexual functioning. Conclusions: Findings support the role of trait-affect and depressed mood on male and female sexual functioning.
PD.01.30 SEX ADDICTION: MYTH OR REALITY D. Lin, A. Bergal, E. Gerz Beth Israel Medical Center, New York, USA Objective: To determine whether hypersexual behavior can appropriately be characterized as an addiction, or rather, a symptom or manifestation of a co-existing Axis I or Axis II Disorder. Design and Methods: A literature review is being conducted to explore these opposing viewpoints. Articles published from the year 2000 to present relating to the topic of sex addiction/ hyper-sexuality/sexual compulsivity/impulsivity are reviewed. Results: The concept of sexual addiction was introduced in the 1970’s. Two schools of thought have. Proponents of sex ‘addiction’ argue that the neurochemical changes associated
THE RELATIONSHIP BETWEEN TRAIT-AFFECT, DEPRESSED MOOD, AND SEXUAL FUNCTIONING IN MEN AND WOMEN M. Peixoto, P. Nobre Departamento de Educagao, Universidade de Aveiro, Aveiro, Portugal with hypersexual behavior are quite similar to that of drug addiction. They argued that sex ‘addicts’ can experience a psychological withdrawal as experienced by those addicted to drugs of abuse. Some proponents of sex addiction even advise a 12-step treatment program. Critics of sex addiction argue that increased sexual activity is a way of alleviating affective symptoms, or is reflective of the impulsivity, associated with concomitant Axis I or Axis II pathology. They postulate that treating the underlying psychiatric disorder would ameliorate hypersexual behavior. Discussion: Despite standard, and even increasing use of the term ‘sex addiction’ in media and popular culture, mental health professionals remain divided in regards to this subject. The proposed inclusion and subsequent rejection of hypersexual disorder in DSM-V highlights this existing debate. The notion of hypersexual behavior as an addiction warrants further exploration, especially since how it is defined may dictate treatment modality.
PD.01.31 EFFECTIVENESS OF MANAGING STRATEGIES FOR ANTIDEPRESSANT-RELATED SEXUAL DYSFUNCTION. THE SALSEX-II STUDY. INTERIM ANALYSIS A.L. Montejo González 12, S. Majadas 1, J. De La Gándara 13, P. Álvarez Lobato 14, F. Alonso 15, R. Martínez 16, M.A. Albarrán 7, M.A. Espiñeira 8, L. Pacheco 9, S. Project Working Group 1 Spanish Association of Sexuality and Mental Health (aesexsame), Salamanca, Spain,2 University Hospital of Salamanca. University of Salamanca, Salamanca, Spain, 3 Service of Psychiatry. Complejo Asistencial de Burgos, Burgos, Spain,4 Mental Health Centre I Este, Valladolid, Spain, 5 Mental Health Of Benavente, Zamora, Spain, 6 Service of Psychiatry Hospital Virgen del Mirón, Soria, Spain,7 Mental Health Centre of Ventorrillo, A Coruña, Spain,8 Dep of Psychiatry - Universidad de Santiago de Compostela, Santiago de Compostela, Spain,9 Mental Health Center Bombero Echániz, Bilbao, Spain Despite the high incidence and relevance of antidepressant- related sexual dysfunction (AD-SD), managing strategies in clinical practice haven been barely explored to date. Objective: To describe therapeutic interventions for AD-SD and their outcome in usual clinical practice. Design and Method: Multicentric prospective naturalistic study. Patients in antidepressant treatment developing secondary SD were included. The AD-SD managing strategy selected by the clinician was recorded and a second follow-up visit was performed in the 2-6 months period post-baseline. The outcome variable was the mean change from baseline to endpoint in the global score of the Psychotropic Related Sexual Dysfunction Questionnaire (PR-Sex-DQ-SALSEX). Results: 251 out of 2000 patients recruited completed the follow-up visit to date and resulted eligible for the analysis. Mean length of follow-up period was 13.58 weeks (DT: 7.08). Antidepressant switching was the most frequent strategy reported (38.65%), followed by waiting for SD spontaneous remission (25.10%) and antidepressant dosage reduction (20.72%); 6.77% choose “weekend holidays”, 5.58% associated another antidepressant or a phosphodiesterase-5 inhibitor (PDE-5-I) and 3.19% discontinued the antidepressant. Agomelatine and bupropion were the antidepressants most frequently selected for the switching strategy. Changing the antidepressant or adding a new antidepressant or a PDE-5-I were selected in those patients with more severe SD when compared to waiting for SD spontaneous remission or dose reduction. According to the SALSEX score reduction after 2- 6 months, AD-switching and treatment discontinuation resulted the most effective strategies (p<0.01). Conclusions: Given its high incidence and relevance, effective therapeutic strategies to manage antidepressant-related sexual dysfunction have been proved.
PD.01.32 FREQUENCY OF ANTIDEPRESSANTS-RELATED SEXUAL DYSFUNCTION. RESULTS FROM A MULTICENTRIC STUDY WITH 2163 PATIENTS IN SPAIN: THE SALSEX-I STUDY A.L. Montejo González 12, J. Calama 2, S. Majadas 1, D. Ciprian 2, A.I. Hernández 2, S.P. Working Group 1 Spanish Association of Sexuality and Mental Health (AESEXSAME), Salamanca, Spain,2 University Hospital of Salamanca, University of Salamanca, Salamanca, Spain Study Objective: Evaluation of the prevalence and severity of sexual dysfunction (SD) in 2163 patients (876 males, 1202 females) following antidepressant treatment. Design and Methods: Cross-sectional, multicentric, naturalistic study in different outpatient settings in Spain. Inclusion criteria: Adult patients following antidepressant treatment for at least 2 months, sexually active and without previous sexual dysfunction (SD). We used the validated Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-Salsex) (a 5 item questionnaire evaluating the different domains of SD) and the severity Clinical Global Impression Scale. Results: 79,2% of the patients experimented SD. Only 40,5% communicated SD spontaneously. Risk of discontinuing treatment was showed by 17, 8% of patients with SD (showing bad to very bad tolerance of SD, measured with item 5 of PR-Sex-DQ). ISRS (69,75%) SNRIs (75,1%) and Clomipramine (76,20%) were associated to high rates of moderate to severe SD. Non serotonergic antidepressant (bupropion, agomelatine and mirtazapine) showed a much better profile compared with SSRI, SNRI and Clomipramine (p < 0,05 ). ODS ratio serotonergic versus non serotonergic drugs was = 6,17. There weren’t statistically significant gender differences. More depressed patients and older patients were more likely to present SD (p< 0,05). The statistical model showed that the treatment with serotonergic drug was related to SD appearance. Conclusions: Near 20% of the patients were at risk of treatment withdrawal due to SD. This highlights the need of consideration by clinicians on the individual patient’s perception of sexual life and the profile of tolerability of each antidepressant before and after initiating any antidepressant treatment. poster display 33-53 PD.01.33 SEXUAL SELF-CONSCIOUSNESS IN A SAMPLE OF MEN AND WOMEN WITH AND WITHOUT SEXUAL DIFFICULTIES: AN EXPLORATORY STUDY A. Quinta Gomes, P. Nobre Aveiro University, Aveiro, Portugal Objective: Sexual self-consciousness refers to the dispositional propensity for self-consciousness as experienced in sexual situations and it has been proposed as a vulnerability factor for the development and maintenance of sexual dysfunction (van Lankveld, Geijen, & Sykora, 2008). The aim of the present study was to explore gender differences in sexual self-consciousness in a sample of undergraduate Portuguese men and women. Design and Method: 154 men and 164 women (M = 22 years; SD = 4.7) from a Portuguese University participated in this study. All the participants were informed about the purpose of the study and clarified about anonymity and confidentiality issues. Four groups were constituted according to men’s and women’s level of sexual function, using the cut-off points of the International Index of Erectile Function and the Female Sexual Function Index. Results: A 2 (Gender: male vs. female) X 2 (Group: high sexual functioning vs. low sexual functioning) MANOVA indicated a significant gender effect for sexual self-focus with men reporting higher levels of self-focus than women during sexual activity (p < .001). A significant group effect was found for sexual embarrassment with individuals with low sexual functioning reporting higher levels of sexual embarrassment compared to individuals with higher sexual functioning (p < .001). No interaction effects were found. Conclusions: Our findings suggest that men and women with or without sexual difficulties demonstrate different propensities for sexual self-consciousness during sexual activity.
PD.01.34 THE ROLE OF MINDFULNESS FACETS IN WOMEN’S SEXUAL PAIN C. Oliveira, P. Nobre, S. Vilarinho Universidade de Aveiro, Departamento de Educagao, Aveiro, Portugal The aim of the present study was to evaluate the influence and predictive capacity of several mindfulness facets (paying attention, describing, non-judging) in women reporting sexual pain in comparison with women with chronic pain, sexual dysfunction, and sexually healthy women from general population. A total of 1129 women participated in this study: sexual pain group (N = 355), chronic pain group (N = 146), sexual dysfunction group (N = 105), and healthy control group (N = 523). Participants answered to a set of questionnaires online: MAAS (Brown & Ryan, 2003), FFMQ (Baer et al., 2006), FSFI (Rosen et al., 2000) and SF- MPQ (Melzack, 1987). Findings indicated that women with sexual pain, chronic pain, and sexual dysfunction present a significantly lower tendency to be attentive and aware of the present moment in daily life (p <.001) compared to women from the control group. More specifically, women with sexual pain presented lower scores on the describing facet (p <.001) than women from the chronic pain and control groups, and lower scores on the non-judging facet (p <.001) than women from the control group. The total of MAAS was a significant predictor of the pain intensity for the sexual pain group ( =-.24, p<05). Results supported the role played by the capacity to be mindful in the daily life in women with sexual pain and have several clinical and treatment implications.
PD.01.35 MALE SEXUAL FUNCTION AFTER ACUTE MYOCARDIAL INFARCTION TREATED WITH PERCUTANEOUS CORONARY ANGIOPLASTY C. Golawski 1, R. Kowalczyk 2, E. Kostarska Srokosz 1, J. Syska Suminska 1, M. Janiszewski 1, E. Wujek Krajewska 1, M. Dluzniewski 1 1 Medical University of Warsaw - Department of Cardiology, Hypertension and Internal Medicine, Warsaw, Poland,2 Department of Sexology in Andrzej Frycz Modrzewski Cracow University, Cracow, Poland Objective: In Poland approximately 140.000 patients/year are hospitalized due to acute myocardial infarction (AMI). The majority of them are treated with percutaneous coronary angioplasty (PCI), which enables rapid return to professional and social activity. Still not much is known about their sexual functioning. Thus the aim of this study was to determine changes in male sexual function after AMI treated with PCI. Design and Method: The study was prospective and were done in the Department of Cardiology, Hypertension and Internal Medicine in 2nd Faculty of Medicine of Medical University of Warsaw, Poland. For further analysis 60 patients aged 29 to 68 were enrolled. The study proceeded in two stages. First: during hospitalization for AMI, the second: 5-6 months after discharge. Demographic and clinical data was collected, concerning current medical history, lifestyle, smoking history, pharmacotherapy and participation in cardiological rehabilitation. For further analysis some laboratory results have also been selected, e.g. the serum levels of testosterone, estradiol, prolactin and left ventricular ejection fraction. To dermine changes in sexual functions two questionnaires were used: Changes in Sexual Functioning Questionnaire (CSFQ) and International Index of Erectile Function (IIEF). Results: The mean score obtained in the CSFQ prior AMI was 50.08 points., and in the follow-up: 49.18 points, while in the IIEF respectively: 39.35 points and 41.57 points. Interesting results were found in the further analysis of sexual functions and clinical parameters. Conclusions: In males treated for AMI with PCI sexual function vary depending on numerous parameters.
PD.01.36 DIFFERENCES ON GENITAL AND SUBJECTIVE AROUSAL BETWEEN MEN WITH AND WITHOUT SEXUAL DYSFUNCTION WHEN PRESENTED TO SEXUAL EXPLICIT FILMS P. Laja, P. Nobre Universidade de Aveiro, Aveiro, Portugal Objective: Men with sexual dysfunction tend to respond with lower levels of sexual arousal (particularly subjective arousal) when exposed to erotica, compared to sexually healthy controls (Beck & Barlow, 1986). Cognitive distraction has been presented as a main explaining factor, but less is known about the content of the cognitions during exposure to erotica. The main goal was to investigate the role of cognitive schemas and automatic thoughts in explaining the differences on sexual response between men with and without sexual dysfunction during exposure to sexually explicit films. Design and Methods: A total of 40 individuals (20 men without sexual dysfunction and 20 men with sexual dysfunction), were exposed to sexually explicit films. Genital arousal was assessed by indium gallium gauges (changes in penile circumference). All data were collected using a MP100 system (BIOPAC) with Acknowledge software. After each film, participants answered to a list of measures assessing subjective sexual arousal, affect (PANAS), cognitive schemas (QCSASC), and automatic thoughts (SMQ). Results and Conclusions: We expect to find differences between the groups in their sexual response to erotica. Moreover, we also expect that negative cognitive schemas and automatic thoughts would be significant predictors of the differences between the clinical and control groups. Preliminary results will be presented in the summit.
PD.01.37 SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF 3381 SUBJECTS REFERRED TO A SEXUAL DYSFUNCTION CLINIC IN TURKEY C. Incesu 1, F. Simsek 2, O. Ozdemir 3, E. Orhan 4, B. Goksan Yavuz 5 1 Acibadem University, Department of Psychiatry, Istanbul, Turkey, 2 Marmara University, Department of Urology, Istanbul, Turkey, 3 Pasabahce Hospital, Department of Psychiatry, Istanbul, Turkey, 4 Acibadem Hospital Bakirkoy, Department of Psychology Istanbul, Turkey, 5 Acibadem Hospital Maslak, Department of Psychiatry, Istanbul, Turkey Objective: To determine socio-demographic and clinical characteristics of subjects referred to a multidisciplinary sexual dysfunction outpatient clinic in Turkey. Method: This study which was conducted between January 2000 and December 2009 comprised of 3381 patients who referred to the multidisciplinary sexual dysfunction clinic in Acibadem Health Institutions, Istanbul, Turkey. A standart data form was used to record socio-demographic characteristics and data such as diagnosis, treatments and results of all referrals. Any problem that was defined as a sexual dysfunction was diagnosed according to DSM-IV. Result: 66% (n=2208) of the participants were male and 34% were female (n=1139). Male subjects were significantly older than the female participants (37.65±11.08 vs 29.59±5.83). 77.6% of the subjects were married. The most common sexual dysfunctions in male subjects were erectile dysfunction (47.5%), premature ejaculation (30%) and hypoactive sexual desire disorder (7.4%). The most common sexual dysfunctions in female participants were vaginismus (60%), hypoactive sexual desire disorder (15%), dyspareunia (10.3%) and orgasmic dysfunction (6.7%). Hypoactive sexual desire disorder was significantly higher in female participants compared to male participants (15% vs 7.4%). Conclusion: Erectile dysfunction was the most common disorder in male presenters and vaginismus was the most common dysfunction in female subjects. Various psychosocial and cultural factors such as perception of sexuality, lack of a formal sexual education and sexual experience in Turkey play role in the emergence of sexual problems.
PD.01.38 SECONDARY SEXUAL DYSFUNCTION AS A RESULT OF ANTIHYPERTENSIVE TREATMENT; AN OBSERVATIONAL AND MULTI-APPROACH EPIDEMILOGICAL STUDY A.L. Montejo González 12, G. Llorca Ramón 12, B. Buch Vicente 12, J.A. Martin Oterino 12, L. García Ortiz 2, E. Rodriguez 2, S. Majadas 2, M. Gómez Marcos 2, M.A. Puente Del Rey 2, Grupo Español de Trabajo 2 1 Universidad de Salamanca, Salamanca, Spain, 2 Grupo Español de Trabajo Para el Estudio de Disfunción Sexual Secundaria a Antihipertensivos, Salamanca, Spain Background: Hypertension is a relevant public health issue being one of the main cardiovascular risk factors. Available treatments lead to common adverse events deteriorating patient quality of life, adherence and effectiveness. Antihypertensive-related Sexual Dysfunction (SD) including arousal, desire and orgasm difficulties seems to be quite frequent although very often under reported. Objectives. 1) To evaluate frequency and severity of SD associated to each different antihypertensive in 89 patients treated in Spain. Methods and Design: an observational, naturalistic, transversal (cross-sectional) epidemiological study in patients suffering for chronic hypertension has been carried out. Inclusion criteria: males and females up to 18 years old showing an adequate sexual response prior to taking antihypertensive drugs after at least 2 months of treatment. Data was obtained throughout a structured interview and using the SALSEx questionnaire (Montejo et al 2000) evaluating sexual dysfunction after the beginning of the treatment (spontaneous communication, arousal, desire and orgasm difficulties.) Tolerability to SD and non compliance risk was also obtained with SALSEX . Results: Majority of patients suffered for SD (72, 9%) mainly in those receiving ad-on treatment with diuretics. Spontaneous communication was low. Mono-therapy different from diuretics (mainly ARA II) reported fewer cases of sexual dysfunction in comparison with treatments combining diuretics. Conclusions: Doctor should openly interview their patients about SD to avoid under estimation and quality of life deterioration. Some strategies should be investigated to cope with this frequent adverse event. Well-controlled studies with bigger samples are needed.
PD.01.39 ERECTILE DYSFUNCTION AND EDMS: RESULTS OF AN ITALIAN RESEARCH IN A PUBLIC HOSPITAL G. Gambino 1, V. Gentile 2, C. Silvaggi 1, F. Tripodi 1, L. Pierleoni 1, V. Cosmi 1, M. Giuliani 1, C. Simonelli 2 11nstitute of Clinical Sexology, Rome, ITALY,2 Sapienza University, Rome, ITALY Objective: Erectile Dysfunction (ED) is the most common sexual disorder that affects male intimacy and identity. The scientific community recognized the psychogenic factors role in symptom onset and maintenance, but most patients prefer a pharmacological solution as a first step of treatment rather than an extensive deeper testing evaluation. This study investigates the previous use of Erectile Dysfunction Medications (EDMs) among subjects that attend a public psycho-sexual counselling service. The aim is to verify the efficacy of an integrated approach in contrast to a medical/ pharmacological treatment only. Design and Method: 119 subjects (age range 20-71, |j=39.22, sd=12.61), were recruited at Policlinico Umberto I, Gynaecologic-Obstetrics and Urologic Science Department between 2009-2011. Data were collected by a semi-structured interview including socio-demographic information, medical history, relationship and sexual-affective satisfaction, current sexual functioning, EDMs use. Results: Data showed that more than 70% of the subjects is healthy (without organic and urological pathologies). About 80% of our sample have consulted a doctor before attending our psycho-sexological service and 35% of these have used at least one EDMs (Cialis®, Viagra® or Levitra®). Conclusions: The majority of men with ED have consulted a medical structure at first, hoping to receive a pharmacological solution for the symptom. Nevertheless, our results stress the only use of EDMs do not completely help male patient to walk over the dysfunction. Combined treatment for ED, considering both organic/pharmacological and psychological/sexological aspects, seems to be the right way to manage this kind of disease.
THE ROLE OF TRAIT-AFFECT, SEXUAL BELIEFS, AND AUTOMATIC THOUGHTS ON WOMEN’S SEXUAL PAIN C. Oliveira, P. Nobre, S. Vilarinho Universidade de Aveiro - Departamento de Educagao, Aveiro, Portugal The aim of this study was to evaluate the role of trait affect, sexual beliefs, and automatic thoughts in women reporting sexual pain when compared with women reporting chronic pain, sexual dysfunction, and sexually healthy women from the general population. A total of 1129 women participated in this study: sexual pain group (N = 355), chronic pain group (N = 146), sexual dysfunction group (N = 105), and healthy control group (N = 523). Participants answered to a set of questionnaires online: the PANAS-X (Watson & Clark, 1994), SDBQ (Nobre & Pinto-Gouveia, 2000), SMQ (Nobre & Pinto-Gouveia, 2002), FSFI (Rosen et al., 2000) and SF- MPQ (Melzack, 1987). Findings indicated that women with sexual pain and sexual dysfunction presented significantly more failure thoughts (p <.001) and lack of erotic thoughts (p <.001), when compared with women from the chronic pain and control groups. No significant differences were found regarding trait affect and sexual beliefs. Failure thoughts were also the best predictors of pain intensity in the sexual pain group ( =.30, p<001), while negative trait-affect was the most significant predictor in the chronic pain group ( =.56, p<001). Results supported the role played by negative automatic thoughts on sexual pain and other sexual dysfunctions in women. These findings have important clinical implications suggesting the need to address cognitions during the treatment process.
PD.01.41 PSYCHOSEXUALITY AND MULTIPLE SCLEROSIS: AN ITALIAN PRELIMINARY STUDY J. Grisolaghi 1, L. De Santi 2, C. Stefanile 3, G. Digangi 4, P. Bramanti 4, R.S. Calabro 4 1 Faculty of Psychology - University of Florence, Florence, Italy, 2 Department of Neurological, Neurosurgical and Behavioural Sciences, University ofSiena, Siena, Italy,3 Department of Psychology, University of Florence, Florence, Italy, 4 IRCSS Centro Neurolesi Bonino-Pulejo, Messina, Italy Introduction: Sexual dysfunctions (SD) are very common in patients with a diagnosis of Multiple Sclerosis (MS). Indeed, MS can directly affect the neurophysiological process of psychosexual function. This study was aimed at investigating the prevalence of SD in a hospital cohort of MS patients compared to a control group. Methods: All the subjects were asked to fill a proper questionnaire built to explore patient psychosexual life with regard to frequency and kind of sexual intercourse, kind of sexual dysfunction and couple relationship. The clinical group also completed a scale to measure the relation between sexuality and MS, and the Expanded Disability Status Scale (EDSS) to evaluate the physical disability. Results: Preliminary results showed that the clinical population differs significantly from the control group. Sixty- nine % of the patients complained at least a SD, and in 22% the disorder was reported as frequent. Forty-two % of patients presented a reduced libido, the most frequent SD, in the year before the observation. Libido and self-esteem showed a significantly negative correlation with disability but not with the disease duration. Conclusions: Our findings showed a high prevalence of SD in patients with MS, compared to our control group. The diagnosis of MS determines a psychological distress with an important reduction in self-esteem. Disability seems to restrict sexual behavior. Since preventive strategies are needed, it is necessary to increase the focus on psychosexual aspects when counselling MS patients.
PD.01.42 FEMALE SEXUAL DESIRE: THE ROLE OF PSYCHOSOCIAL FACTORS ON SPONTANEOUS VERSUS RESPONSIVE DESIRE P. Nobre 1, L. Junot Rocha 2 1 Utad, Vila Real, Portugal,2 Universidade de Aveiro, Aveiro, Portugal Aim: The purpose of this study was to evaluate the role of psychosocial variables in women with difficulties in spontaneous versus responsive sexual desire: sexual beliefs, psychopathology, sexual functioning, dyadic adjustment and automatic thoughts during sexual activity. Methods: A total of 107 women participated in the study, 34 women in the Control Group (without sexual problems), 43 in the Low Spontaneous Desire Group and 30 women in the Low Global Desire Group (Low Spontaneous and responsive Sexual Desire). The participants answered to different questionnaires: Sexual Dysfunction Inventory (SDI; Sbroco, 1992), Brief Symptom Inventory (BSI; Derogatis, 1982), Female Sexual Function Index (FSFI; Rosen et al., 2000), Dyadic Adjustment Scale (DAS; Spanier, 1976), Sexual Modes Questionnaire (QMS; Nobre & Pinto-Gouveia, 2003) and Sexual Dysfunctional Beliefs Questionnaire (QCSD; Nobre & Pinto-Gouveia, 2003). Results: The results showed that women in the Low Global Desire Group exhibit significantly lower rates of dyadic adjustment and higher sexual dysfunctional beliefs regarding the body, age and sexual conservatism, compared to the Control and the Low Desire Spontaneous Group. Additionally, women in the Low Global Desire Group showed significantly higher levels of psychopathology, namely depression, paranoid ideation, anxiety, and hostility when compared to the Control Group. Finally, these women also presented with lower levels of sexual functioning and higher frequency of negative automatic thoughts during sexual activity when compared to the control and the low spontaneous desire group. Conclusions: These results suggest that women with low spontaneous sexual desire but without difficulties in responsive sexual desire are closer to women without sexual problems than to women with low global sexual desire, supporting the DSM-V proposal for the exclusion of this first group of women from the Sexual Interest/Arousal disorder.
PD.01.43 GENDER DIFFERENCES IN SEXUAL SELF-ESTEEM IN A SAMPLE OF UNDERGRADUATE STUDENTS WITH AND WITHOUT SEXUAL DIFFICULTIES A. Quinta Gomes, P. Nobre Aveiro University, Aveiro, Portugal Objective: Sexual self-esteem is the tendency to evaluate positively one’s ability to relate sexually with a partner. The aim of the present study was to explore gender differences in sexual self-esteem in a sample of undergraduate Portuguese men and women with and without sexual difficulties. Design and Method: 154 men and 164 women (M = 22 years; SD = 4.7) from a Portuguese University participated in this study. All the participants were informed about the purpose of the study and clarified about anonymity and confidentiality issues. Four groups were constituted according to men’s and women’s level of sexual function, using the cut-off points of the International Index of Erectile Function and the Female Sexual Function Index. Results: A 2 (Gender: male vs. female) X 2 (Group: high sexual functioning vs. low sexual functioning) MANOVA indicated a significant gender effect for sexual self-esteem with men reporting higher levels of sexual self-esteem than women (p < .01). A significant group effect was also found for sexual self-esteem with individuals with lower levels of sexual functioning reporting a poorer sexual self-esteem (p < .001). No interaction effects were found. Conclusions: Our findings suggest that men and women with or without sexual difficulties differ in how they evaluate themselves as sexual partners.
PD.01.44 PSYCHOSOCIAL FACTORS OF SEXUAL DYSFUNCTION IN HETEROSEXUAL, GAY AND LESBIAN: THE ROLE OF COGNITIVE, AFFECTIVE, EMOTIONAL, AND RELATIONSHIP VARIABLES M. Peixoto, P. Nobre Departamento de Educagao - Universidade de Aveiro, Aveiro, Portugal Objective: Research on heterosexual sexual functioning has grown exponentially, however studies about gay and lesbian sexual functioning are limited. Sex risk-taking and HIV have been the main topics on research about gays; while lesbian studies have been focused on intimacy and sexual desire. Therefore, little is known about the central similarities and differences regarding to heterosexual, gay and lesbian sexual functioning, as well as cognitive, affective, emotional and relationship factors associated. The present study aims to analyze heterosexual, gay and lesbian sexual (dys)function. Additionally, we aim to study the role of cognitive, affective, emotional, and relationship variables on heterosexual, gay and lesbian sexual functioning. Design and Method: A total of 600 adult volunteers from the general population will participate in the study (150 heterosexual men, 150 gay men, 150 heterosexual women and 150 lesbian). Participants will complete the following self-reported measures in order to assess: Personality (NEO- Five Factor Inventory); Psychopathology (Brief Symptom Inventory); State-affect (Positive and Negative Affect Scale); Relationship satisfaction (Dyadic Adjustment Scale); Sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire); Cognitive schemas (Questionnaire of Cognitive Schema Activation in Sexual Context); Automatic thoughts (Sexual Modes Questionnaire); and Sexual functioning (International Index of Erectile Function; Female Sexual Functioning Index). Results and Conclusions: We expect that the results of this exploratory study contribute to a better understanding of the similarities and differences between heterosexual, gay, and lesbian sexual functioning. Additionally, we also expect to explore the role of psychological vulnerability and maintenance factors for sexual dysfunctions, in order to adjust treatment approaches.
PD.01.45 CLINICAL RESULTS OF VENOUS LIGATION SURGERY IN ERECTION J. Kim Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea Objectives: According to the American Urological Association clinical guidelines panel is not justified for routine use. Although penile venous surgery has almost been abandoned and the venous factor eliminated as a contributing factor to erectile dysfunction, new concepts of erection related veins has recently been described and reported in literature. We are to report clinical result of venous ligation surgery. Materials and Methods: They were evaluated using the International Index of Erectile Function(IIEF-5) scoring system. In the dorsal area of penis, 1-2 cm from the subglans was incised with depth sufficient to expose the Buck’s fascia and was then bluntly dissected. The incised area was widened, so that the prepubic area could be seen. We ligated deep deep dorsal vein, cavernosal veins and para-arterial veins. Results: Retrospective investigation was done for this study with 13 cases from January 2007 to September 2010. Median patient age at surgery was 45.2 years (range 22 to 54) and mean follow up was 13 months (range 2 to 39). Pre-operation average IIEF-5 score was 11 and post-operation average IIEF- 5 score was 17. 1 case of infection was reported. Conclusions: Though the patients group was small in number, this venous drainage reduction surgery as the modified venous ligation surgery appears to deliver reasonable positive results with low morbidity. Patients showed improvement of IIEF-5 score by this surgery. The results obtained in this limited number of patients are promising and justify trials in larger groups. 6 7 HYPNOSIS AND SEX THERAPY: ERECTILE DISFUNCTION A. Cernuda Lago Universidad Rey Juan Carlos, Madrid, Spain Introduction: Sexual problems that benefit by enhancing self esteem and confidence are prime candidates for success with hypnosis; by facilitating change and allowing for the release of negative or limiting habits and associated ideas and by identifying triggers that summon negative behavior or feelings; and by learning to manage the internal processing of hurt feelings, anger and stress. Most sexual problems have a strong psychological component, hence hypnotism can be a method to overcome anorgasmia, impotente and premature ejaculation. Changing the way the subconscious responds can produce dramatic results. Hypnotism, as part of a multimodal approach that includes medical treatment and/or psychological treatment is the right choice. According to the British Journal of Urology, hypnosis improved the sexual function of men with no organic cause for their impotence at a rate of 80%. The interesting part about this study is that hypnosis outperformed testosterone Objectives: The aims of the study are to verify the efficiency of the hypnosis in sexual dysfunction Design and Method: In the present communication as example of the usefulness of the hypnosis, one presents an analysis of the efficiency of the hypnosis therapy with 35 men with erectile dysfunction Results: Of 35 treated men, 11 solved successfully his problem, 17 improved his situation, and 7 did not feel any benefit. Conclusions: The hypnosis is a therapeutic tool very to bearing in mind in the sexual problems, for his positive contribution for therapists and affected persons.
PD.01.47 SEXUAL IMAGINARY, SEXUAL BODY AND SEXUAL DYSFUNCTIONS IN WOMEN R. Bochicchio 12, T. Strepetova 12, A. Di Marco 12, L. Otranto 12, E. Arduino 12, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: Vaginismus is a condition that affects a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons and/or menstrual cups, and the penetration involved in gynecological examinations. Design and Method: The woman does not directly control or ‘will’ the tightness to occur; it is an involuntary pelvic response. She may not even have any awareness that the muscle response is causing the tightness or penetration problem. We correlate the bodily components of vaginismus to its the mental counterpart and in the same time we take into consideration the voluntary as well as the unconscious aspect of this classical female sexual dysfunction. Result: Vaginismus is better understood and treated when a body approach is coupled with a cognitive one. The ability and willingness to explore the imaginative world of the vaginismic woman is also important in the understanding and treatment of the dysfunction. It is also useful in the prevention of relapses. Conclusion: Vaginismus is highly treatable and a full recovery from vaginismus is the normal outcome of treatment. Successful vaginismus treatment can be incremented by a clinical approach focusing on both the corporal and affective aspects of the dysfunctions.
PD.01.48 DIALOGUES ABOUT SEXUAL (DYS)FUNCTION: UNDERSTANDING SEXUAL (C0N)TRADI(C)TI0NS THROUGH AN IN-DEPTH INTERVIEW STUDY V. Alarcao 1, A. Beato 1, L. Roxo 1, F. Miranda 1, M. Carreira 1, A. Galvao Teles 1 2 11nstitute of Preventive Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal,2 Endocrinology, Diabetes and Obesity Unit, Lisbon, Portugal Objective: Using a qualitative analysis, our aim was to explore male attitudes towards, and experiences of, sexual problems. Design and Method: This study is part of a multi-methods approach and data triangulation, with a sample of Sexual Dysfunction Observational Study in Portugal participants. In order to maximize the variation in sexual function experience individuals were recruited from four different groups: Problematic, Functional; Dissatisfied; Contradictory. This subset consists of 10 in-depth interviews with men with and without sexual difficulties complemented by 5 interviews with (unrelated) women whose partners had experience of sexual problems, conducted between July-September 2011 by a male and a female researcher, respectively. Results: Data was catalogued according to broad themes: Sexual Dysfunctions and Sexuality Representations; Beliefs about Treatments; Intimacy and Sexual Satisfaction; Masculinity Perceptions; Women perceptions about their partners’ sexual difficulties. A multiple variety of perceptions and representations attached to sexual difficulties and a diverse range of treatment experiences emerged from the participants’ dialogues. It seems though that despite their comprehensive views concerning sexuality and the fact that medical constructions of ‘normal’ and ‘healthy’ sexuality were frequently questioned, causes for sexual problems and, therefore their treatments, remained part of the medical domain, being psychological, social and cultural aspects less considered. Conclusions: Results seem to indicate that men discourses on sexuality are more challenging of the biomedical model than their perceptions of the treatment options for sexual difficulties, that remain dominantly biological, reinforcing sexual naturalism.
LOGOTHERAPY FOR SEXUAL DYSFUNCTION R. Sgambato 12 11SC, Roma, Italy,2ISUE, Naples, Italy Objective: Dysfunctional sexuality, if not properly treated, in his persistence and worsening, can invalidate personal and interpersonal dynamics. The purpose of this article is to discuss the applicability of the techniques of logotherapy, more specifically “paradoxical intention” and “dereflection”, in the treatment of male and female sexual dysfunction. Logotherapy is based on the meaning-focused existential philosophy of Viktor E. Frankl (1905-1997). Literally, logotherapy means “therapy through meaning”. Whilst Freud says humans have a “will to pleasure” and Adler “a will to power”, Frankl says humans have a “will to meaning”. Design and Method: Psychogenic sexual disorders a central role is played by anxiety, full of meaning, even from a sociocultural perspective. This work describes 2 techniques of logotherapy, paradoxical intention and dereflection, utilizing a number of case reports; both can be used to treat sexual disorders in which the patient’s fight for sexual pleasure becomes an obstacle to achieving it. The dereflection and paradoxical intention can be considered elective tools to break the vicious circle that keeps certain psychogenic disorders of sexuality (especially male erectile impotence) and change the wrong attitude to the problem of patient compliance. Results: A review of the existing literature reveals that the essential outcome of treatment is to effect a change in attitudes of the patient perceives the source of sexual pathology existential distress. Conclusions: Logotherapy can be a valid and efficient tool in the treatment of sexual dysfunctions restoring appropriate value to sexuality.
PD.01.50 SEX THERAPY AND SEX COUNSELLING PROGRAM AT THE UNIVERSITY OF ALICANTE V. Briet García, R. Suriá Martinez C.A.E:. Student Support Center (university of Alicante), Alicante, Spain Psycological counselling and clinical intervention in the field of sexuality are nowadays more and more requested by young people. In response to this interest the University of Alicante has developed a program to provide students, staff and teachers with the knowledge needed to help them improve their sexual health by means of sex therapy and professional counselling. Aims: To describe the type of queries received in our department according to clinical parameters. Methods: Our analysis will be descriptive. Frequencies and percentages of the study will be calculated. The chi-square test will be used to check the dissimilarities between the different groups. All the cases attended in our department since 2003 will be analysed and classified according to the sexual dysfunction criteria normally used in clinical practice. The number of cases studied will range from 400 to 600. Results: The collected data will be assessed at the end of this academic year, when the percentages of the different types of sexual dysfunctions and sex related problems will be defined. Conclusion: The conclusions will be presented at the end of the academic year, after the analysis of the collected data.
PD.01.51 COGNITIVE INTERFERENCE AND SEXUAL DYSFUNCTION: TESTING THE MODIFIED STROOP EFFECT ON MEN WITH AND WITHOUT ERECTILE DYSFUNCTION P. Laja 1, P. Nobre 2 1 Universidade de Aveiro, Aveiro, Portugal,2 Universidade de Aveiro, Aveiro, Portugal Objective: The role of cognitive interference on sexual dysfunction is strongly supported, with findings indicating that men with sexual dysfunction differ from sexually healthy men on attentional focus and affect during sexual events (Barlow, 1986, Nobre, 2010). Despite this, there is a lack of studies using the modified stroop task with clinical samples. The aim of this research project was to examine the differences between men with erectile dysfunction and sexually healthy men, when presented to a modified stroop test after exposure to erotica. Design and Methods: A total of 40 individuals (20 men without erectile dysfunction and 20 men with erectile dysfunction), participate in this study. After being presented to a series of sexual visual stimuli, both groups performed a modified stroop test, where they were presented to a series of words with neutral, positive valence, global negative valence, and specific negative sex valence. Results and Conclusion: We expect to find a stroop effect (longer time in naming a colour word) in men with sexual dysfunction, mainly in those words specially related to sex content. Preliminary results will be presented in the summit.
PD.01.52 SEXUALITY IN MALE WITH SPINAL CORD INJURY: AN OVERVIEW F. Quattrini1 3, C. Pastura 2, S. Romano 3, V. Conti Nibali 2, P. Bramanti 2, R.S. Calabro 2, 3 1 Dipartimento di Scienze Biomediche, Université di Chieti-Pescara, Chieti, Italy,2 IRCSS Centro Neurolesi Bonino-Pulejo, Messina, Italy, 3 Istituto Italiano di Sessuologia Scientifica, Rome, Italy Despite advances in the field of medicine, injury to the spinal cord remains a devastating problem. Spinal cord Injury (SCI) often results in permanent neurological deficit and, depending on the level of injury, may leave the patient severely disabled. SCI has a dramatic emotional impact on the patient and his family and represents a high burden to society. Moreover, patients with SCI have a poor quality of life (QoL), often worsened by the presence of sexual dysfunction (SD), which is really dramatic especially at a young age. Ejaculation and erection are mostly autonomic reflex with specific spine-located centers, coordinated by cortical and brainstem pathways. Thus, it has been shown that level and completeness of spinal cord damage determine the extent to which erectile and ejaculatory capacity is affected. However, since individuals with SCI are often sexually active, a proper counselling, diagnosis and treatment of SD is needed in order to improve their sexuality, and thus QoL. Nowadays, the mainstay of SD therapy is the use of PDE- inhibitors; but individuals with SCI and their partners may realize a sex life that is less genitally-focused, more creative and mutually rewarding, and physicians should discuss about sexual issues while approaching SCI patients, since sexuality is a fundamental part of any individual’s life. Indeed, it is important to continue counselling and education in this area to prevent health professionals perpetuating the myth that disabled persons are asexual.
PD.01.53 A NEW TREATMENT FOR VAGINISMUS L.M. Roque Ortega, M.D. Maurisset Moraguez, A. Cordove Maurisset Hospital de Dia - Mental Health Community Center - “Maria Elisa Rodriguez Del Rey Bocalandro”, Havana, CUBA We understood for vaginismus a feminine sexual dysfunction, that’s consist in the involuntary contraction of the muscles that belongs to the exterior of the feminine genitals, a disease that’s affect women of any age and with different grades of intensity. In extreme cases, the vaginismus may be so apparatus than the vaginal aperture closed complete, not allowed the coitus realization or the simple insertion of a finger. There is another vaginismus, not so grave, but anyway produces considerable’s molests because all tentative to do the coitus produce pain. Experts estimate that 2 or 3 % of the woman suffer vaginismus. We intent, in this presentation, prove the efficiency of draw in the treatment of resistant vaginismus. The use of drawing and painting in diagnostic and treatment has a long and voluminous history, most usual are the human figure for diagnostic objectives, to explore personality. In this case we present a new utilization as a therapeutic resource. poster display 54-60
PD.01.55 NEW METHODS FOR PENILE AUGMENTATION USING ACELLULAR HUMAN DERMAL TISSUE WITH INJECTION J. Kim Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea Objectives: Penile augmentation surgery with tissue grafts through incision so far has been performed ; however, there might be adverse effects such as a wound problem. Another augmentation method is the injection of chemical filler or fat but there is the disadvantage of histological instability and a high reabsorption rate. We are to introduce new methods for penile augmentation using acellular human dermal tissue with injection. Methods: Under the local anesthesia, according to the size of the penis and the augmentation size the patient desired, about 3- 6cc of dried acellular particulate dermal matrix (BellagenTM, MegafillTM) combined with 1.5-1.8cc of lidocaine and 0.3cc of gentamicin per 1cc of the tissue were injected into the subcutaneous tissue. Results: Retrospective investigation was done for this study with 126 cases from December 2007 to Jan 2012. 4cc of tissues on average were used for a one-time injection and the average surgery time was 20 minutes. 2 cases of local skin necrosis was reported but it was treated through the conservatory treatment. No other adverse reaction was occurred. There was little migration of the injected tissues after the graft. Conclusions: This surgical method does not require an incision and resulting in short operation and rapid recovery time. There are few side effects. Therefore, for the men who experienced difficulty with penile augmentation surgery with the pre-existing techniques, this surgical method could be recommended . It also may be considered a new technique that can be applied for partial augmentation, correction of deformity, and reconstructive surgery as well.
PD.01.55
EVIDENCE OF IMPLICIT EFFECTS OF TESTOSTERONE ON SEXUAL DESIRE MECHANISMS USING EYE-TRACKING AND BEHAVIORAL MEASURES IN A MALE PATIENT WITH HYPO- ACTIVE SEXUAL DESIRE DISORDER M. Bolmont 1, F. Bianchi Demicheli 2, J.T. Cacioppo 3, S. Cacioppo 1 1 University of Geneva, Geneva, Switzerland,2 University Hospital of Geneva, Geneva, Switzerland,3 University of Chicago, Chicago, USA Objective: The main aim of the present study was to investigate the implicit influence of testosterone on sexual desire mechanisms in a 58 year-old heterosexual male patient with hypo-active sexual desire disorder. Design and Method: To address this question, we combined eye-tracking and behavioral measures, while the patient performed a behavioral desire inference paradigm using a before/after design. Self-report questionnaires, investigating subjective levels of sexual desire, perceived social isolation, inclusion of other-in-the-self, anxiety and depression, were also performed. Patient was tested before and four weeks after the administration of testosterone (TOSTRAN; 50 mg/day). Results: Behavioral results revealed faster sexual desire- related reaction times (p < .05) after treatment than before treatment. Eye-tracking results expanded these behavioral findings. Before treatment, when asked to decide whether (or not) he could desire the stimuli, the patient had less (and shorter) eye fixations on the body (than the face) of the stimuli, while no significant difference was observed between body and face after treatment. In other words, the patient showed more (p < .001) and longer (p < .01) eye fixations on the stimuli body after than before treatment, which reinforces the importance of bodily cues for sexual desire-related decision making. Significant differences were observed in self-report questionnaires after treatment, as follows: higher sexual desire scores (p < .001) and lower depression scores (p < .05). Conclusions: Testosterone administration affects not only consciously experienced feelings of sexual desire but also subconscious mechanisms. This finding opens a new avenue to better understand the desiring mind.
PD.01.56 POSTOPERATIVE MANAGEMENT TO REDUCE COMPLICATION RATE AFTER PENILE ENHANCEMENT SURGERY S.Jang Lj Genitourinary Surgery institute, Seoul, South Korea Objective: Following penile enhancement surgeries, postoperative managements are performed differently. We aimed to develop better methods to reduce complication rates. Design & Method: We have experienced 2200 penile enhancement surgery. We adopted a pre-pubic minimal incision and dissected penile shaft. Inserted graft materials were Allograft dermal grafts which were fixed at the Buck’s fascia. And we dissected fundiform ligaments and sutured transversely pre-pubic dead space with PDS 2.0. For the dressing, we used Peha-haft (very soft and thin elastic bandage) to cover the penile shaft in 1620 cases. Post-op dressings were done at POD 1 or 2 (1st), 3~4 (2nd), 11 or 12 (3rd). At 1st and 2nd dressing, we checked bleeding, skin status such as bruising, swelling and body temperature. At 3rd dressing, wound healing was checked and aspiration under penile skin was done to check collected fluid that might cause delayed infection around inserted graft. Results: Our experiences showed that our method could completely prevent skin necrosis that might be caused by a bandage being too tight. Delayed infection was completely prevented by follow-up aspiration under penile skin. Postoperative wound infection occurred at 1.4% and all cases were completely fixed. Conclusions: Our follow-up schedule and method after 3m penile augmentation surgery was considerably effective to prevent complication that includes such as skin necrosis and delayed graft infection.
PD.01.57 EXPERIENCES OF SIMULTANEOUS FOREIGN MATERIAL REMOVAL IN PENIS AND PENILE ENHANCEMENT SURGERY S.Jang Lj Genitourinary Srugery Institute, Seoul, South Korea Objective: Many people who wish to have a larger penis have undergone insertion or injection of several kinds of foreign material into the penis. We try to introduce our experiences that could remove these materials and simultaneously perform penile enhancement surgery. Design and Method: From 2007 to 2010, we experienced 52 cases of simultaneous foreign material removal and penile enhancement surgery. 48 cases previously underwent insertion of silicon prosthesis and 4 cases had inserted unknown plastic-like material. Under local anesthesia, we performed a minimal incision on the pre-pubic area. Dissecting procedure using fingers and electro-cauterization were done from pre-pubic subcutaneous tissue to penile skin covering the penile shaft. At the same time, we removed previously inserted foreign material and epithelized capsulation tissue was dissected and detached. And then we fixed artificial dermal graft (cadaveric dermis or bovine collagen) on the bucks’ fascia. After dissecting the fundiform ligament, transverse multiple sutures were done in the deep pre-pubic space. Results: We followed up 6 months on average (3 months to 13 months). 2 cases had a wound inflammation and wound dehiscence and could be fixed within 2 weeks. The rest of the cases had no complications. Postoperative penile length at last follow-up was 6.6±0.4 cm compared with preoperative length of 5.0±0.6 cm. Conclusions: Simultaneous foreign material removal and penile enhancement surgery could be performed safely and effectively.
PD.01.58 INFLUENCE OF THE CONSTRICTIVE PENILE BAND AND THE PENILE CIRCUMFERENCE J. Kim, P.B.M. Kim Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea Purpose: The penile constrictive band is commonly observed on the penis of men who were not circumcised. In the event that a serious constrictive band was created clinically, it is often observed that circumference around the band is thinner than other areas. The authors aim to report the influence of constrictive bands on the penile circumference of men who were not circumcised. Method: The circumference of the penis was measured in three areas: it was measured at the back of the distal penis that is 1.5-2.0 cm from the glans corona; on the constrictive band area and on the front area of the proximal penis that is 1.5cm from the penopubic junction. Results: The number of subjects were 18 and the average age was 41.6 years old. As to the circumference of the three measured areas, it was 7.4 cm of the penile distal area; 7.1 cm of the constrictive band area; and 7.9 cm of the penile proximal area. The circumference of the proximal area was longer than that of the distal area. Conclusions: This study confirmed a decrease in the circumference of the constrictive band. Although more research is required to confirm these conclusions, considering the possibility that a serious constrictive band may deter the growth of the penis, circumcision may be considered in a positive light in order to insure preventive effects, Furthermore, the circumference of the distal penis is shorter than that of the proximal penis in phimosis.
PD.01.59 MEDICATION IN THE INTEGRATED TREATMENT METHOD OF SEXUAL DYSFUNCTIONS G. Barbero 1, G. Cociglio 1, C. Manieri 2, S. Allasia 2, F. Lanfranco 2 1 Scuola Superiore di Sessuologia Clinica di Torino, Turin, Italy,2 S.s. Andrology, S.c.d.u. Endocrinology, Diabetology and Metabolism, S. G. B, Molinette Hospital - University of Torino, Turin, Italy Introduction and Aim: The authors agree with integration between bio-drugs (hormones, pro-erectogenic vasoactive drugs) and psychotherapy in treating sexual dysfunctions as currently widespread practice (bi-integration), but they support the use of a triple integration as a further therapeutic interaction between bio-drugs, psychotherapy and psychiatric medications. The latter, which have so far been rarely used in sexology, may be decisive in treating psychogenic sexual disorders. Moreover, they often prove to be extremely useful in those conditions of prevalently organic aetiology. Antidepressant drugs act on phobic and depressive factors, ansiolitic drugs on anxiety, neuroleptic medication on aggressive or delirious symptoms, which may be present in organic sexual disorders. Case Report: A 60 year old patient had attended the andrologist’s for a secondary organic erectile dysfunction (metabolic syndrome and hypogonadism). Initially the andrologist-endocrinologist treated the patient with a diet, increased physical exercise, testosterone replacement therapy, and pro-erectogenic medication when needed. A psycho-sexologist also assisted the patient with sexual therapy for somatopsychic and relational distress relapses. A good success was achieved by integration with Bupropione prescribed by a psychiatrist. Conclusion: Integration with psychiatric medications is desirable when it is necessary to treat aspects not responsive to other therapeutic approaches. This co-treatment has to be managed by psychiatrists with training in sexology and who are skilled in the receptor spectrum at the single molecule level in order to avoid inhibitor side effects and to encourage those which activate sexuality.
PD.01.60 NURSING ROLE OF POSSIBLE CHANGES TO SEXUALITY IN BURNED PATIENTS F. Ramos Aliaga, A. Baena Morales, E.M. Quesada Bravo Empresa Publica Hospital de Poniente, Almeria, Spain Our work is about how nursing has a vital role in the diagnosis and early treatment of major burns in which they can affect sexuality, focusing on increasing self esteem, and to minimize any possible fears arising from the new body image. Main Objetct: Identification and definition of the role of nursing to potential sexual changes in burn patients, and care planning aimed at resolving possible sexual dysfunction. Materials and Methods: They carry out a nursing care plan related to changes in sexuality experience the burn patient. This care plan was based on three pillars: diagnosis, NIC interventions and NOC outcome objectives. This is intended that the functional pattern of sexual reproduction according to Gordon, is seen positively completely covered by the burn patient. Results: The identification, diagnosis and nursing interventions to a problem of sexuality derived from a burn patient, will take place as soon as possible, showing an improvement in these patients. Lowering the barriers that hinder their sexuality. This will cause the alteration of body image look significantly minimized. Conclusion: Early sex education in These Patients to Cope with possible changes file in the area of sexuality is essential, nurses Being Very Important in This Education. poster display 61-63
PD.01.61 HOMOPHOBIC BULLYING AT SCHOOL: OUTLINING BULLIES’ AND VICTIMS’ PSYCHOLOGICAL PROFILES S. Picariello, M.C. Coppola, M.R. Nappa University of Naples - Department of Theories and Methods of Human and Social Sciences, Naples, Italy Objectives: Assuming the numerous evidences about severe effects of homophobic bullying on psychological wellbeing, and keeping the concept of minority stress in our mind, we can thus consider homophobic bullying as a strong predictor of psychological distress and psychopathological risk. School context and peer groups have been considered central potential protective factors from such a risk, while few researchers have taken into account more intra-personal dimensions. The main purpose of the study is to investigate which psychological features can be attributed respectively to perpetrators and victims of homophobic bullying, with regard to personality dimensions, adherence to universal values, use of specific defensive mechanisms. Design and Method: 318 11-18-year-old adolescent (46,2% males and 53,8% females) were randomly recruited in two colleges in Naples. They were administrated a battery of self-report questionnaire in two sessions (pre- and postintervention): Homophobic Content Agent Target (HCAT, 2010); Big Five Questionnaire Revised (BFQ-R, 1996); Response Evaluation Measure (REM-71, 2009); Portrait Values Questionnaire (PVQ, 2001, 2005). Bivariate correlations between HCAT items and each one of other scales, and linear regressions were carried out. Results: Several significant results let us identify specific characteristics with regard to all three factors considered, pertaining bullies and victims of homophobic bullying. Some unexpected similarities between each other were found. Conclusions: Just such similarities between bully’s and victim’s profiles lead to reflect about common psychological dynamics and characteristics that make them two sides of the same coin and that should be further investigated.
PD.01.62 PEER-EDUCATION TO PREVENT HOMOPHOBIC BULLYING IN SCHOOLS. AN INTERVENTION IN AN ITALIAN HIGH SCHOOL S. Picariello, L. De Gennaro Aquino, C. Ricci, E. Micillo University of Naples - Department of Theories and Methods of Human and Social Sciences, Naples, Italy Objective: This work describes an experience carried out within an action-research project promoted by Centre SInAPSi - Section “Bullismo Omofobico”- of the University of Naples “Federico II”, aimed to prevent homophobic bullying at school. The main purpose was to train some students to become peertrainers on sexual orientation, gender identity, homophobia and homophobic bullying, sexual and gender stigma. Design and Method: This study involved 4 classroom from a Neapolitan high school and used peer-education method, based on experiential activities, such as role playing, focus groups, game sessions . Four students from each classroom were selected and trained by two psychologists through 6 meetings of the duration of two hours each one. Then, each classroom, helped by its peer-educators, has been invited to create a message to prevent homophobic bullying, choosing themselves the medium. Results: Peer-educators took part at every meeting, learning information about project’s topics and improving their relational skills. As products of the project, two classrooms chose to make a video and the other two chose to make a comics. Conclusion: Peer-education was an excellent method to train the students and to pass on information about sexual orientation, gender identity, homophobia and homophobic bullying, sexual and gender stigma.
PD.01.63 MIDWIFE PROFESSIONAL CARE BEFORE THE TEEN VTOP R. Gonzalez Segura 1, N. Benayas Perez 2, R. Benayas Perez1, M. Jodar Martin 3, M.D. Jimenez Lechuga 3, S. Valladolid Benayas 3 1 Out of Work, Almeria, Spain, 2 Chare Hospital Poniente El Ejido, Atmeria, Spain,3 Hospital Comarcal Melilla, Melilla, Spain Introduction: Adolescence is the period when sexual relations are usually initiated, making teenagers a risk group of unwanted pregnancies. Voluntary termination of pregnancy (VTOP) is an important decision by the emotional duty involved. It is therefore necessary the midwife performance, which begins before VTOP and continues through VTOP griefing process. Objectives: The midwife must get to know the professional skills before the teen VTOP, and protecting the adolescent rights. Tools and method: Extensive literature review of recent years in data base: Pubmed, Cochrane, Ime, Cuiden y Preevid. Results: With the entry into effect in 2010 of the new VTOP law, women aged 16 and 17, can consent by themselves. Healthcare professionals directly involved in VTOP will have the right to exercise conscientious objection, but they will always give appropriate care for women before and after the VTOP. In reviewed studies it was found that midwives’ attitudes towards adolescents seeking VTOP are mostly positive. Various international organizations agreed on the importance of the midwife role in the pre and post-VTOP. Conclusions: Every woman has the right to decide about her reproductive health and impartial information to make an informed decision, so we must support with a non-judgmental, respectful and empathetic character, without leading the patient to our own ideology or convictions. poster display 64-65
PD.01.64 SEXUAL ADDICTION AND ITS TREATMENT A. Cismaru Inescu 1, R. Andrianne 2, J.M. Triffaux 3 1 University of Liège, Liège, Belgium,2 Chu Liège, Liège, Belgium, 3 Hôpital de Jour La Clé, Liège, Belgium Objectives: The sexual addiction is an abnormal sexual practice. It becomes the center of the subject’s existence, by depriving him from other investments and without bringing him real satisfaction. This research project intends to explore the field of sexual addiction and a possible treatment for it. Several studies on sexual dysfunction treated with psychotherapy and virtual reality have shown that we obtain better results than if we use just the psychotherapy. Through this study we would like to test the efficiency of virtual reality on patients treated with virtual reality and CBT. Better results should be registered in this group of patients than in the other, treated just with the CBT. Design and Methods: Acoustic therapy (a CD with two voices that tell a story) Cognitive behavioral therapy (CBT) Virtual Reality (PC, joystick, headset) 2 groups-25 patients treated with CBT -25 patients treated with CBT and Virtual Reality Estimated Results: Given the proven effectiveness of virtual reality on other psychopathological disorders, our study aims to evaluate the therapeutic effect of virtual reality in patients treated with CBT and virtual reality compared to patients treated only by CBT. The use of virtual reality should accelerate the process, should improve the person’s condition until complete remission of symptoms Conclusions: Normally after 25 sessions of CBT and virtual reality, we should see better therapeutic results than with CBT alone. The only side effect found in studies of psychotherapy and virtual reality on sexual dysfunction was the dizziness. This can occur due to long exposure to virtual reality.
PD.01.65 REEDUCATION OF COUPLES WITH A HYPOACTIVE SEXUAL DESIRE R. Gonzalez Segura 1, N. Benayas Perez 2, R. Benayas Perez 1, M. Jodar Martin 3, M.D. Jimenez Lechuga 3, S. Valladolid Benayas 3 1 Out of Work, Almeria, Spain,2 Chare Hospital Poniente El Ejido, Almeria, Spain,3 Hospital Comarcal Melilla, Melilla, Spain Introduction: is the absence or the decrease of feelings or sexual fantasies as an interest by starting a sexual meeting, in the presence of a person external expert to help to work on desire, having into account the life cycle. Objectives: To have the power to intimate with a person. Design and Method: Extensive literature review of recent years. Discussion and Conclusions: There are several therapeutical modelsWe are going to work with the model Instituto Andaluz de Sexología y Psicología which offers a wider and safer version at the moment of exposing it to women. It consists on: 1. A short evolved HSD without any loathing components: The one who feels more desire must not pleasure the other and does not take the initiative. Increase of tolerance and understanding the situation. Focusing on helping to facilitate the external supporters of desire: • To work on sexual fantasies • To use readings, films or any other erotic tool. • To Change our appareance, visiting other erotic shows, etc... • Autoestimulation 2. If the woman masturbates regularly and in a pleassuring way, it is recommended to have erotism with the couple, genital erotism and orgasmic erotism. 3. Long evoluting DSH: Erothophilia potenciation, development of therapy for couples focused on the interexchange of nice behaviours and generating a proper level of intimacy, and in the end, a sistematic desensibilization of imagination must stimulate the desire leadings. Women learn how to be desired and are able to interact with their couples in a quiet and sensual way to reach full sex.
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PD.01.66 SEXUALITY AND GENDER OF TEENAGERS STUDENTS, IN TEACHER’S CONSIDERATIONS A. Oliveira, A.C.B. Maia State University of Sao Paulo, Bauru, Brazil Objective: This descriptive-qualitative research investigated the views of teachers about sexuality and gender considering their teenage students. Method: eleven teachers, eight female and tree male, aged between 32 and 64 years who answered a questionnaire with open questions for content analysis. Results: 1) Concept of Sexuality: concept of sexuality was related to sexual activity and knowledge of the body involving pleasure and love linked to the heterosexual relationship. 2) The noted sexual attitudes of students: students’ expression of sexuality in school was remembered by affective behaviors, body touches and verbalization, in addition, was also highlighted the growth of body and sex and love interest. Gender questions were highlighted in the expressions of sexuality, and the vulgar interest in sex something common in boys and seduction and sensuality something related to girls. 3) Gender: Gender has been defined mainly as the characterization of biological and social differences between men and women. Some believe that girls are more interested, sensitive and obedient in school than boys; other teachers consider the individual performance of each student regardless of gender. Discussion and Conclusions: In general, teachers have a vision centralized in the genitals and heteronormative sexuality and gender. There is a belief that there are gender differences in academic achievement in advantage to girls. It is concluded that teachers should receive training on sexuality and opportunities to discuss social gender issues, thus minimizing sexist education also in the school environment.
PD.01.67 MASTURBATORY BEHAVIOUR AS A METAPHORIC CHANNAL SYMBOLIZED PULSIONS IN CHILDREN WITH AUTISTIC DISORDER F. Sandri 1, F. Pavissich 2 1 University of Trieste, Trieste, Italy,2 University of Paris, Paris, France Sexuality includes much more than just sexual behavior. It includes the representation of the self, the emotional component, the value system, the behavioral attitudes, the system of beliefs, the relationships; as communication and social interaction levels are strongly interfered in autistics, sexuality for this patients is manifested as a container of significants, as a metaphoric canal through which are symbolized different pulsions which don’t necessarily have erotic significance. The bibliography regarding the sexuality of individuals with autism is very fragmented. In people belonging to the autistic spectrum disorder (ADS) social and communication difficulties affect significantly the expression of sexuality; understanding and managing emotions and stress are sometimes manifested through different patterns to their non autistics peers, it means, with a higher involvement of the erogenous path. It is important to remember and understand that masturbation may be the individual’s only way of appropriately relieving normal sexual urges, and give vent to the tensions embodied. We intend to review specifically the masturbatory behavior, not just in its condition of erogenous release, but also under the connotation of its most hidden significants: autoerotic action can be the way to handle relational anxiety, the anguish of emptiness and of the outside world. It could be a compulsion to repeat or a way to define self-sufficiency, a behaviour to define their self-esteem or an attempt to construct. Our work aims to give an interpretive analysis performed in base to the data from the literature extant, and integrating them to the deductions outcoming from the observation of children and teenagers with Autism Spectrum Disorders. The goal is to give some alternative interpretations than erotic to the masturbation of children with autism, providing caregivers, educators, doctors and sexologists, which can interpret the different aspects of its significance.
PD.01.68 DISCREPANCY BETWEEN SELF-PERCEIVED KNOWLEDGE AND ACTUAL KNOWLEDGE ON SEXUALITY E. Garcia Vega 1, E. Menéndez Robledo 2, P. Fernández García 1, A. Menéndez Robledo 3 1 University of Oviedo - Department of Psychology, Oviedo, Spain, 2 Servicio Público de Salud Principado de Asturias, Oviedo, Spain, 3 Principado de Asturias, Oviedo, Spain Introduction: Information campaigns about sexual and reproductive health care for adolescents doesn’t have been effective, and unwanted pregnancies or AIDS/ sexually transmitted diseases, are growing. The objective of the study is to know the difference between the knowledge about sexuality that the adolescent have and the knowledge they think they have. Methods: Self-reported questionnaires were distributed to 815 teenagers between 13 and 19 years (52.8% of girl and 47.2% of boys), from a state school in Spain. The questionnaire was designed to appraise self-perceived knowledge about sexuality and the real knowledge they had about this topic. Pupils were asked if they thought that they had good knowledge about sexuality (physiology, sexuality, contraception and sexually transmitted diseases), about their real knowledge and about their sources of information. The data were analyzed according to gender. We use the SPSS statistical program. Results: Almost 76% of teenagers reported they had good or very good knowledge about sexuality. Of the students who said to be well or very well informed, a 44.2% showed a poor knowledge. Girls showed better knowledge than boys, especially about contraception and sexually transmitted diseases. Young people who had the best scores had obtained their knowledge of their experience and health professionals. Discussion: Student believed to be better informed of what they really are. Girls have more knowledge than boys on issues of sexuality, especially contraception and sexually transmitted diseases.
PD.01.69 SEX LIFE EDUCATION M. Jodar Martin 1, R. Gonzalez Segura 2, N. Benayas Pérez 3, R. Benayas Perez 2, M.D. Jimenez Lechuga 1, S. Valladolid Benayas 1 1 Comarcal Melilla Hospital, Melilla, Spain,2 Out of Work, Almeria, Spain,3 Chare Poniente El Ejido, Almeria, Spain Introduction: Sexuality throughout life has been essential; it is an experience of emotional exchange and communication between people. It is a dynamic process that changes over along our lives. A process where the body, emotions, feelings, knowledge we have about our lives and the society we live in are involved. Objectives: Learning to get to know ourselves, accept ourselves, live and express our eroticism to get happiness. Design and Method: Extensive literature review of recent years Results and Conclusions: Sexuality is an important part of people's lives that affects their welfare. Human sexuality encompasses three main aspects: -Reproduction: ensuring the continuity and survival of the species. -Sexual pleasure desire: the search for erotic pleasure. -Communication of affections: it is a way of communication, expression of feelings, which tends to seek physical and psychological fusion with another person For a proper sexual development, it is essential to establish a basis of values, which have some emotional ties, between the couple who must share sincerity and tenderness, communication and responsibility. It is important to have a sexual health training in order to have a full well-being, because sexuality has been forgotten and has been a taboo for many years. Educating young people is very important for the knowledge of their body, prevent STDs and unwanted pregnancies. Educating and teaching teens in a broad and clear way will make much easier to promote and create a healthy sex life without any complex and love their personalities.
DISCUSSION GROUP ABOUT SEXUALITY, GENDER AND MEDIA: CONTRIBUTIONS FOR THE FORMATION OF PSYCHOLOGY AND COMMUNICATION STUDENTS A. Oliveira, A.C.B. Maia, M. Pastana State University of Sao Paulo, Bauru, Brazil Objective: The Project “Discussion Group about Sexuality, Gender and Media” was based on the importance of the dialogue about how issues like sexuality and gender have been represented in the media. It was aimed to create a space of dialogue between the areas of Psychology and Communication, with discussions about academic researches and materials from the media like magazines, newspapers, television and radio programs, movies, advertisements, websites, with discussions and reflections that contributed to the formation of students of both areas. Design and Methods: Ten students of the graduation courses of Communication and Psychology from a Brazilian University participated of 17 meetings, with the duration of one hour and a half every week in the second semester of 2011. Results: The discussion were mainly about how the media produces and reproduces normative patterns, stereotypes, prejudices and a repressive comprehension of sexuality and gender, thinking together about possible ways of approaching this thematic considering the plurality, diversity and multiplicity of human sexuality. It was also reflected about the participants’ process of sexual education, the personal and professional trajectory and their influence in the construction of materials about sexuality and gender. Conclusions: The presentation, discussion and reflection about how sexuality, gender, sexual education, sexual repression, sexual diversity, heteronormativity are presented in the media were important for a broader comprehension of sexuality considering the historical, cultural and social factors
PD.01.71 SEX EDUCATION TO YOUNG DEAF AND DEFBLIND WEB SEXEJOVES ACCESIBLE AND ADAPTED (WWW.SEXEJOVES.GENCAT.CAT) C. Leon Ortega, G. Falguera Puig, D. Guix Llistuella, P. Soteras Guasch, M. Villanueva Guevara, I. Sombrero Torres, S. Abajo Llamas, S. Morell Capel, E. Barnés Sarra, D. Costa Sempere Institute Calana Of Health. Department of Health, Catalonia, Spain Introduction: Sexejoves web takes cares of the sexual&affective care of the young people since 2006. Necessary changes have been implemented to the sexual&affectivity virtual care web in order to make it accessible and reach out to all possible spectra of young people, hence including functional and sensorial diversity young population. Methodology: By means of the translation and interpretation of the contents to the Catalan signs language (LSC), adapting the IT for the deaf and blind people, or improving the accessibility of the web (antaviana), a pioneering educational tool was obtained in the area of sexual and reproductive health. Results: Outstanding results were obtained after a counter was installed on the website accounting for all the hits to the videos translated to LSC; 19900 visits were registered in 43 days, (from the first of February to fifteenth of March 2011). Conclusions: The professionals that constitute the deaf community (professors, care personnel, parents etc.) have shown their interest for this pioneering initiative. Being a unique initiative has made the deaf linguistic community agree on new terminology or update signs that were overlooked due to under use. The fact that a phenomenon does not have tangible evidences (inquiries from young deaf individuals) does not mean there is not a realistic need. Sometimes the professional has to follow a reverse path; provide the tool to allow the manifestation of the problem or need.
PD.01.72 REQUEST ASSISTANCE OF IMMIGRANT POPULATION IN REPRODUCTIVE HEALTH F. Hurtado Murillo 1, F. Donat Colomer 2, L. Margaix Fontestad 2, R. Pellicer Faro 1, A. Royo Martínez 1, M. Alcaraz Quevedo 3 1 Centro de Salud Sexual y Reproductiva Fuente de San Luis de Valencia. Departamento Dr Peset. Agencia Valenciana D, Valencia, Spain,2 Universitat de Valencia, Departament d'infermeria, Valencia, Spain, 3 Dirección de Salud Pública de Valencia. Conselleria de Sanitat, Valencia, Spain Objective: To determine the demand for services and identify the health practices of the immigrant population in the reproductive area. Design: Observational study, cross- sectional of analytical components. Method: We analyzed 829 medical records of immigrants from different backgrounds who have come in 2008 a Centre Sexual and Reproductive Health. Study variables are: geographical origin, age, sex, reason for consultation and breeding habits .Descriptive analysis was performed analyzing the differences, by chi-square for the qualitative variables and student's T for the quantitative. Results: The main demand of both groups is contraception. (52,3% immigrants vs 30,8% Immigrants use more methods of low effectiveness. High efficacy, condom use (53.9%) less than the autochthonous (73.9%).Hormonal methods more than the Spanish (47.4 and 33.6%) and IUD more than the Spanish (18.9 vs. 6.2%). All these differences are statistically significant .. Regarding the number of pregnancies significant difference, being higher immigrants. The IVES present significantly higher rate of immigrants. (16,6% vs 5,4%) As for STI. the average rate is low (5.5%) higher in immigrants (6.8%) than in Spanish(3.7%). Least in the genital herpes, the immigrant group exceeds that in all STIs. By gender, the overall rate is higher in women (5.7%) than men (3.9%). None of these differences showed statistical significance. Conclusions: Contraception and IVE, more demand rate among immigrants. Preferred method of contraception condom, well over by the Spanish .In the other methods, immigrants outnumber the Spanish use. Overall rates of STIs are low, slightly higher for immigrants, and among women
PD.01.74 EDUCATION WOMAN WITH VAGINISMUS N. Benayas Pérez 1, R. Gonzalez Segura 2, R. Benayas Perez 2, M. Jodar Martin 3, M.D. Jimenez Lechuga 3, S. Valladolid Benayas 3 1 Chare Poniente Institute El Ejido, Almería, Spain,2 Out of Work, Almería, Spain,3 Comarcal Institute Melilla, Melilla, Spain Introduction: Involuntary contraction of the perineal muscles of external tertiary vagina, against the introduction of the penis, fingers, tampons, specula, etc. It is common to be associated with other dysfunctions such as anorgasmia, hypoactive sexual desire disorder, Sexual Aversion Disorder and excitability disorder.The disorder is chronic. Objectives: Methods for women to enjoy a full sexual life. Design And Method: extensive literature review of recent years. Results and Conclusions: If there are any erotic games, an intercourse is not necessary, but in some couples some disorders appear after the impossibility of penetration. Guidelines: • Boosting of erotophilia: Elimination of negative attitudes, exercises of kege, autoestimulation. • Individual vaginal permeabilization: Prohibited the penetration, masturbation is allowed and taking advantage of the lubrication, the woman must introduce a finger first; later two and soon a vaginal expander. • Vaginal permeabilization in pairs: Position non plaintiff: both seated, supported her on his chest. She will take one of his fingers and will introduce it into her vagina, he won’t make any movement. Getting over this point, she will take a finger and will introduce it in her vagina. Having passed this step, he will do the same with the expander. • Introducing the expanders in different positions is advised especially at riding. If this step had been already done, they are advised to move with short rhythms and improving it until getting a natural movement. • If the woman doesn’t have difficulties to follow our instructions, a progressive introduction of expanders would be carried out.
SEX EDUCATION IN PATIENTS COLOSTOMIZE: ROLE OF THE HOSPITAL NURSE A. Baena Morales, F.J. Ramos Aliaga, E.M. Quesada Bravo Empresa Publica Hospital de Poniente, Almeria, Spain Colostomy surgery makes it possible to see altered body image and self esteem, leading to possible changes in the patient’s sexual health colostomy. It is at this point that the hospital nurse has a key role in sex education to mitigate and minimize any sexual fears related to colostomy and educate the patient to adapt the new situation. Main Objetct: provide sex education necessary to ensure proper adaptation to possible changes in sexuality arising from the colostomy. Materials and Methods: They undertake a plan of nursing care colostomy patient, focusing on sexual function. This plan will be implemented immediately and individualized to the patient’s arrival to the ward. You will conduct an interview and was complimentara complete a sexual history to see what their concerns, doubts, fears .... and from data collection to conduct an individualized care plan based on the diagnostic NANDA, NIC, NOC. This claim that the functional pattern of Gordon: sexuality reproduction looks positively covered. Results: With the identification and early diagnosis of potential sexual problems in the colostomy patient is achieved that the possibility that these patients have impaired sexual function reproduction is significantly lower, making the sex education is appropriate to the new situation and psychological body. Conclusion: With good sex education and individualized care plans by nurses will ensure that sexuality is not disrupted and we will get a high state of satisfaction by the individual colostomy.
PD.01.75 DATING VIOLENCE DURING THE TEEN AND YOUNG OF THE DEGREE OF MEDICINE UNIVERSITY OF HEALTH SCIENCES UNIVERSITY OF GUADALAJARA S. Lerma Partida, J.V.M. Lara Velez Center for Health Science, University of Guadalajara, Guadalajara, Mexico Summary: We performed a study on dating violence in the University Center for Health Sciences at the University of Guadalajara, Jalisco, Mexico. In adolescents and young people aged 14 to 23 years of age. This study used an instrument designed in 2007 by the National Institute of Statistics and Geography (INEGI) on violence. Methods: We performed in this research is quantitative, descriptive and cross, with a sample of 220 undergraduate students of medicine, which have or had a dating relationship. The type of sample used was stratified two-stage assessments. Objective: To diagnose dating violence among youth and young university and determine the type of violence most commonly used in this area: psychological, physical or sexual. Results: We found that dating relationships among adolescents and young participants is affected by violence in more than 60%, the most frequent psychological type, followed by physical violence and ultimately ended by sexual violence. Conclusions: As we conclude that dating violence is a phenomenon existing in this population and unfortunately you guys are learning risky behavior, coming to regard as a normal way of relating to their romantic partners, so that indispensable to develop intervention models that promote healthier dating and free of violence in this age group.
PD.01.76 IMPLEMENTATION OF SEXUAL EDUCATION IN THE 2ND CYCLE OF BASIC EDUCATION IN FRANCISCO ARRUDA SCHOOL IN LISBON I. Xavier Vieira 1, C. Nabais 1, J. Rodrigues 1, N. Marques 1, R. Leitao 1, V. Nobre 1, R. Xavier Vieira 2 1 Escola Francisco de Arruda, Lisbon, Portugal, 2 Faculdade de Medicina de Lisboa, Lisbon, Portugal For the implementation of Sexual Education in Francisco de Arruda School in Lisbon, during the school year 2010-2011, in accordance with applicable law (Administrative Rule n.° 196-A/2010 of April 9 that regulates Law n.° 60/2009 of 6 August), the coordinator of Health Education invited in July 2010, a group of teachers from various disciplines of the 2nd cycle of basic education to collaborate in the analysis of that legislation and draw up plans and diagnostic tests (based on content issued by the Ministry of Education). The hours devoted to sexual education should be adapted to each level of education and each class, and can not be less than six hours per year for the 2nd cycle, distributed evenly over the year by the school. The contents of sexual education can be addressed in disciplinary curricular areas or in not disciplinary curricular areas.The aim of this study is to provide a broad discussion on this topic at the 2nd cycle.
PD.01.77 RELIGIOUS PRINCIPLES AND SEXUALITY AND MASTURBATION CONCEPTIONS: OPINIONS OF YOUNG UNIVERSITY STUDENTS P. Pereira 1, A.C.B. Maia 2 1 Unesp - Universidade Estadual Paulista - Department of Psychology of Education, Araraquara, Brazil,2 Unesp - Universidade Estadual Paulista - Department of Psychology, Bauru, Brazil Masturbation is a cultural construction, so consonant with the values and social behavior that have a strong influence of religious morality. This study investigated the connexion between the importance of religious principles among college students and their views about masturbation and sexuality. Data were collected through a questionnaire, which involved 232 college students. The open questions were categorized using content analysis. The results indicate that participants who attributed greater importance to religious values perceived sexuality as a synonym for Loving Relationship. Among individuals who religious principles are very important there's no understanding of the practice as healthy and necessary, like there's in the group that give low or medium importance to religion values. The group of participants who religious values are important presents higher number of participants who indicated discomfort face the practice, also showed the greatest number of abstentions. In general, it's possible to realize that for this sample there is an indication that religious principles tend to influence the individual’s conceptions about sexuality and masturbation. While sexuality is not perceived as a wide concept and its expression is conditioned by affective relationship with a partner, masturbation appears as less legitimate form of sexual expression-generating constraints and discomforts. Understanding the determinants in the formation of opinions and attitudes related to sexual behavior is fundamental to creating more emancipatory education projects
PD.01.78 LEARNING THROUGH PLAY: THE TUPPERSEX AS AN EDUCATIONAL TOOL, THERAPEUTIC AND SEXUAL HEALTH PROMOTION M. González Veiga 1-2-3 1 Con Mucho Gusto! Centro de Sexología, Santiago de Compostela, Spain, 2 Sociedade Galega de Sexoloxía, Pontevedra, Spain, 3 Asociación Galega de Comunicación de Cultura Científica e Tecnolóxica, Santiago de Compostela, Spain The aim of this poster is to present the tuppersex meetings from therapeutic and educational approach, understood as a powerful tool for education and sexual health promotion. A tuppersex is a meeting at which articles erotic are shown to group of people or a couple who request and is usually performed in a private home or in a specialized center. The tuppersex raised from a professional approach from sexology can treat many issues related to sexuality like the relationship with the genitals and knowledge of sexual body, pelvic floor health, menstruation, desire, communication, fantasies, difficulties and sexual dysfunctions, etc... Attitudes can be worked th and break taboos and myths. We can work with adult audiences of all ages from 18, in a playful and relaxed environment. It is a tool that can also work in consulting, especially in couples therapy. In this poster the methodology is applied in regular work at Con Mucho Gusto! Center for Sexology. The tuppersex, is a powerful mobilizing emotions, it is important to manage them properly. Tuppersex meetings have great potential both at school and in therapy, and is a tool to be considered by professional sexology, to promote positive sexuality and sexual health among adult audiences.
SEXUALITY IN A GROUP OF ADOLESCENTS IN VENEZUELA C. Cotiz Editorial Nuevo Dia, Coro, Venezuela Sexuality is a very complex aspect of life of every adolescent to build the essential dimension of the person and it is present since the moment of conception fulfilling the individual in a profoundly personal reality that makes adolescents become adults. It is adolescence when the sexual phenomenon arises due to the need to reaffirm sexual and personal identity, what guides adolescents to have a greater interest on erotic and sexual topics, searching for information about sexual organs development, reproduction and sexual intercourse among others. There are many authors who consider that, nowadays, adolescents have a variable information, distorted and insufficient about sex coming from different sources as other adolescents, significative adults for them, television, and internet, but this information does not result in preventive behaviors of young people in their sexual practices, showing a non deniable reality: adolescents are beginning their sexual lives in a more premature way as time goes by and, if measures are not assumed, adolescent pregnancy ratios, STD’s (specially HIV/AIDS) and risky abortion will continue being frequent in youth. In the state of Falcon, Venezuela, a study was performed in adolescents attending school in the third phase of basic education which main objective was to determine sexuality in this sample of adolescents. It is descriptive field study. The sample was compound by 1170 adolescents and sampling was performed randomly. Interestingly, the study concludes that, however the instrument was anonymous, almost half of the surveyed adolescents denied to answer most questions related to sexuality, probably due to social prejudices through which they focus sexuality . Nevertheless, answered questions related to sexual education, sexual function, sexual physiological variants, contraceptive methods and relationship are very worrying and confirm what it has been already discussed on ignorance, false believes and lack of communication on the sexual topic between parents and their adolescent children.
PD.01.80 IMPLEMENTATION OF SEXUAL EDUCATION IN THE 1ST CYCLE OF BASIC EDUCATION IN SCHOOLS GROUPING FRANCISCO DE ARRUDA IN LISBON I. Xavier Vieira 1, C. Nabais 1, M. Joao Alves 1, E. Ribeiro 1, C. Costa 1, S. Santos 1, D. Silva 1, A. Gomes 1, C. Santiago 1, R. xavier Vieira 2 1 Escola Franciusco De Arruda, Lisbon, Portugal, 2 Faculdade de Medicina de Lisboa, Lisbon, Portugal For the implementation of Sexual Education in Schools Grouping Francisco de Arruda, Lisbon, in school year 2010 2011, in accordance with applicable law (Administrative Rule n.° 196-A/2010 of April 9 that regulates Law n.° 60/2009 of 8 August), the coordinator of Health Education invited in July 2010, a group of teachers of the 1st cycle of the different schools that make up the group to collaborate on the analysis of this same legislation and draw up plans and diagnostic tests (based on the contents emanated by the Ministry of Education). The hours devoted to sexual education should be adapted to each level of education and each class, and may not be less than six hours per year in this cycle, evenly distributed by the various periods of the year. The aim of this study is to provide a broad discussion on this topic. poster display 81-94
PD.01.81 PORTUGUESE WOMENS SEXUAL SATISFACTION AND AGEING: THE ROLE OF SEXUAL BELIEFS S. Vilarinho, P. Nobre Aveiro University, Aveiro, Portugal Objective: Our aim was to compare Portuguese women with different ages with regards to sexual satisfaction and its predictors. Additionally, we wanted to investigate the relationship between age and sexual beliefs. Design and Method: Participants were women from the general population distributed by age into 3 groups: 15-35 (N=259), 36-45 (N=103), 46-75 (N=123). Questionnaires assessed: menopause status; relationship (GRIMS and relationship duration); life satisfaction (SWLS); affect (PANAS-x); sexual beliefs (QCSD); sexual self-esteem (SSEs); sexual satisfaction (GRISS); sexual functioning (FSFI). Results: Results for women aged 15-35, revealed sexual functioning (=.52, p<001) as the main predictor of sexual satisfaction; positive affect during sexual activity (=.18, p<001) and relationship status (=.17, p<001) were also significant. Best predictors for women aged 36-45, were sexual functioning ( =.42, p<001), less negative affect ( =-.28, p<001) and relationship status (=.17, p<001). For women aged 46-75, relationship status (=.27, p<001), less sexual beliefs ( =-.25, p<.001), sexual functioning (=.24, p<05) and less negative affect (=-.21, p<.001) emerged as significant predictors. Older women scored higher on all dimensions of sexual beliefs, with major group differences for sexual conservatism and sexual desire as sin. Results evidenced significantly higher levels of sexual satisfaction in younger women. However, after controlling for sexual beliefs, religion and education, no significant differences between groups were found. Conclusions: Overall, findings supported the important role played by sexual functioning in younger women’s sexual satisfaction and the principal role of relationship and cognitive-afective factors mostly in older women’s sexual satisfaction.
PD.01.82 AN ANALYSIS OF SEXUAL SATISFACTION AND ITS RELATIONSHIP WITH HEALTH M. Sánchez Fuentes, P. Santos Iglesias, J.C. Sierra, N. Moyano, P. Vallejo Medina, R. Granados Faculty of Psychology - Department of Personality, Evaluation and Psychological Treatment/University of Granada, Granada, Spain Objective: Studies report that sexual satisfaction is an important element of sexual health and sexual health is a key factor for the well being of people. However, few studies examining the relationship between sexual satisfaction and health. Therefore, the aim was to examine sexual satisfaction and its relationship with physical and psychological health status in a Spanish sample. Design and Methods: Ex post facto study. Using quota sampling 1,500 subjects were evaluated. Participants were divided into three age ranges: 18-30, 31-54 and from 55 and older. All the participants maintained a relationship for at least 6 months and they had sexual activity. The assessment instruments were: socio-demographic questionnaire, the Spanish adaptation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire, the Spanish version of the Health Questionnaire SF-36 and the Spanish adaptation of the Symptom Assessment-45. The participants were selected through incidental sampling of the general population. Results: Using partial correlations controlling for relationship satisfaction, it was found that sexual satisfaction was positively and significantly related with vitality and negatively with somatization. That is, greater vitality was associated with higher levels of sexual satisfaction and greater somatization was associated with lower levels of sexual satisfaction. In addition, the obtained results from regression analysis, controlling for relationship satisfaction, showed that sexual satisfaction was explained by relationship satisfaction, vitality, somatization and interpersonal sensitivity. Conclusions: Relationship satisfaction and mental health, specifically, vitality, somatization and interpersonal sensitivity are factors that contribute to the level of sexual satisfaction of Spanish adults.
PD.01.83 SEXUAL FUNCTION IN WOMEN AFTER MASTECTOMY: A SURVEY OF POLISH PATIENTS R. Kowalczyk 1, Z. Lew Starowicz 2, I. Glogowska 3, K. Krzemieniecki 4, A. Bialek 5, M. Krzystanek 5 1 Department of Sexology in Andrzej Frycz Modrzewski Cracow University, Cracow, Poland,2 Department of Sexual Rehabilitation, AcademyofPhysicalEducation, Warsaw, Poland,3 Maria Sklodowska- Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland,4 DepartmentofClinical Oncology, Cracow University Hospital, Cracow, Poland, 5 Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland Objective: As various studies show, women after mastectomy are accompanied by many problems in the sexual sphere; it considerably lowers their quality of life. Goal of the study is to describe the relationship between the illness as well as the treatment of choice and the sexuality of Polish patients. Another goal is a comparison of the study results with results obtained in similar studies in Europe. Design and Method: The target group of 300 women after mastectomy is in the process of assessment (to be completed by July 2012). The subjects are recruited among Polish patients diagnosed and treated at the Department of Clinical Oncology, Cracow University Hospital in Cracow, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw and its branches in Katowice and Cracow.The following questionnaires are used: Changes in Sexual Functioning Questionnaire (CSFQ - F - C), Body Image Questionnaire (KOC-BR), Sexual Interaction Inventory (SII), Quality of Life Questionnaire QLQ - BR23. Questionnaires were supplemented by questions related to social-economic status and oncology treatment. Results: The hypotheses tested are: 1) Polish women after mastectomy (PWAM) experience a decline of sexual functioning in comparison to the time before the surgery. 2) Body image of PWAM influences their sexual functioning depending on type of treatment involved. 3) Experience of mastectomy induces changes in relationship with sexual partners. 4) Quality of life decreases after mastectomy depending on treatment type. 5) Polish women of mastectomy experience similar changes in sexual functioning as women in Europe.
PD.01.84 ASSESSMENT OF LIVING AND SEXUAL SATISFACTION IN WOMEN WITH FIBROMYALGIA I. Lopez Cobos 1, R. Alarcon Rodriguez 2, E.M. Quesada Bravo 1 1 Nursery Department Of Hospital Poniente, Almería, Spain,2 Health Sciences Deparment, Almería University, Almería, Spain Fibromyalgia was defined as a painful condition that primarily affects non-articular muscles, expressed as widespread musculoskeletal pain and multiple tender points in the absence of other changes which would explain your symptoms. (Martinez, Gonzalez and Crespo, 2003). The published data suggest that there is a sexual dysfunction in women with FM. The phase of sexual response that is most affected, mainly, the phase of desire. The symptoms associated with fibromyalgia have a negative impact on women’s sexual satisfaction. Main objective of this study is to describe and characterize the experience and sexual satisfaction of women with fibromyalgia. Methods: The study sample consists of 63 women FM diagnostic region of the West and the city of Almeria. Each participant answered two questionnaires. The first evaluator of sexual function in women (FSM). The second evaluator GRISS sexual satisfaction for women. It also took into account the descriptive variables of age, number of children, marital status and occupation. Main Results and Conclusions: According to the results obtained in our sample, over 50% rated without disorder, all domains of sexual response evaluators (58% in desire, arousal 62%, 78% in orgasm). Regarding GRISS questionnaire, 51% of the sample show the absence of dissatisfaction, a condition observed in the frequency range is more evident, with 80.3% and 78% avoidance problems.
PD.01.85 SEXUALITY AND FEMININITY IN WOMEN WITH TREATMENT FOR BREAST CANCER M. Ciendones Carbonell 1, E. Juan Linares 1, S. Parrado Chamorro 2 1 Hospital Sant Pablo, Barcelona, Spain,2 Sacyl, La Baneza, Spain Summary: Women diagnosed with breast cancer often express adverse effects on your sex life and their body image negatively impacting their quality of life. The shock of diagnosis, vulnerability, surgical treatment (mastectomy, tumeroctomy) chemotherapy, radiotherapy and induced menopause, will affect their sexuality. Objective: To explore the effects on sexuality and femininity of women undergoing cancer treatment for breast cancer. Design and Method: The study group included 117 women who were followed up at the Hospital Sant Pau in Barcelona. Aged ranged between 27 and 85 years in treatment since January 2011. The sample data were collected using the EORTC C30 and BR23 questionnaires, completed confidentially. The collection of data was made twice: the first at the beginning of treatment with hormone inhibitors and the second one year after. Biomedical data were also collected and processed using SPSS 19. Results: All the treatments caused significant side effects on sexuality and femininity, and perception of decrease in the quality of life. Conclusions: Women treated with breast cancer need educational and emotional support and specific recommendations regarding sexuality to improve their quality of life and perception of body image.
PD.01.86 SEXUAL FANTASIES IN THE PERSONAL HEALTH: GENDER DIFFERENCES E. M. Quesada Bravo 1, I. Lopez Cobos 1, I. Fernandez Agis 2 1 Nursery Department of Poniente Hospital, Almeria, Spain, 2 Neuroscience and Health Sciences Deparment, Almeria University, Almeria, Spain Sexual fantasies are a core element in the process of stimulation of sexual behavior. Also contribute to the induction, emergence and empowerment of sexual desire, which is taken as a real emotional and cognitive readiness of the subject (Strong, 1995) Objective: To describe the differences in sexual fantasies of men and women in the health field. Methods: 168 respondents, divided into three categories: medical / as, nurses / as, technical nursing care. For data collection the questionnaire was SFQ (Wilson, 1988) (Adaptation of Sierra, 2005). Main Results: Statistically significant differences were observed between men and women in the exploratory type of sexual fantasies (p <0.05), men earned an average of 6.7 points on the exploration of sexual fantasies and women an average of 3.79. Conclusions: As stated in Fisher (2000) most men fantasize about having sex with people who do not know and have sex with different races (exploratory fantasies). Similar to the results obtained in our study, men have an average higher than women in the exploratory fantasies, these differences were statistically significant. However, Plaud and Bigwood (1997) to compare men and women indicate that men are significantly more exploratory fantasies, intimate and impersonal. In our study only statistically significant differences in exploratory sexual fantasies.
PD.01.87 SEXUALITY AND VULNERABILITY: ANALYSIS OF THE REPORT OF YOUNG PEOPLE WITH INTELLECTUAL DISABILITIES A.C.B. Maia Sao Paulo State University Unesp. Cnpq and Fapesp, Bauru, Brazil Objective: These work is a case study and the authors investigated the emotional and sexual issues of people with disability. Method: Qualitative research in which a man and a woman with acquired spinal cord injury responded to an interview for content analysis. Results: 1) Perception of body and beauty. The concept of beauty refers more personal characteristics than physical. The body bothered more by not meet the standards of aesthetics than for the non-functionality; 2) Affective and sexual life. After the injury, the man separates from his wife and has a new partner also deficient; tells about feel desire, but erection occurs only with medication and does not feel orgasm. The woman was a virgin before the accident but nowadays has dated and sexual intercourse; she reported feeling little desire and arousal, and she does not feel orgasm. Both subjects related that the romantic relationship requires intimacy and trust with the partner. They don't receive sexual guidance by doctors and get their sex information with friends. Discussion and Conclusions: Spinal cord injury can affect people’s sex lives, although the expression of sexuality is always preserved. The stereotypes exacerbate the difficulties of loving and sexual relationship when the person has an acquired disability. The data are not generalizable, but are in line with the literature. The authors appoint sexual education is important and necessary in rehabilitation programs.
WOMEN’S SEXUAL FUNCTIONING: THE ROLE OF SEXUAL BELIEFS, FOCUS OF ATTENTION, SEXUAL FANTASIES AND WORRIES DURING SEXUAL ACTIVITY S. Vilarinho, P. Nobre Aveiro University, Aveiro, Portugal Objective: The aim of this study was to investigate the role of cognitive variables, particularly sexual beliefs, focus of attention, sexual fantasies and worries during sexual activity, in women’s sexual functioning. Design And Method: A total of 497 women from the general population participated in this study. Questionnaires assessed: demographics; medical condition; psychopathology (BSI); sexual beliefs (QCSD); sexual activity, worries, focus of attention and sexual fantasies (QAS); sexual functioning (FSFI). The study was cross-sectional. Results: Resulted revealed that women with higher levels of sexual functioning presented significantly lower levels in all dimensions of sexual beliefs (p<.001), particularly “sexual desire as sin” (partial 2=.15); less worries (p<.001), and more sexual fantasies during sexual activity (p<.001); and tended to focus more their attention on own and partner’s sexual pleasure (p<.001) and own and partner’s sexual behavior (p<.001). A multiple regression analysis, considering all the cognitive variables assessed, revealed a significant model for women’s sexual functioning (explaining 40% of the variance) with focus of attention on own pleasure during sexual activity (=.28, p<.001) and absence of worries regarding pain or physical discomfort during sexual activity ( =-.22, p<.001) as main predictors. Conclusions: Results reveal the important role played by cognitive variables, particularly the more proximal ones namely focus of attention and absence of distraction (by worries) during sexual activity. Findings will be discussed in terms of implications for promotion/protection of sexual functioning.
PD.01.89 FIBROMYALGIA AND SEXUALITY: RESULTS OF LITERATURE REVIEW VS OUR SAMPLE RESULTS I. Lopez Cobos 1, R. Alarcón Rodriguez 2, E.M. Quesada Bravo 1 1 Nursery Department of Poniente Hospital, Almería, Spain,2 Health Sciences Deparment, Almeria University, Almeria, Spain Following the literature review that relates Fibromilgia and sexual dysfunction in women, we get these conclusions: The dysfunction is often severe, affecting all areas of sexuality. There is evidence that depression may be the main factor affecting the phase of desire and arousal, decreased experience of orgasm and increased pain during intercourse. Objective: Comparison of the results of the studies reviewed and the results of our sample. Method: Pubmed literature search of studies that link women with fibromyalgia and sexual dysfunction. Our sample consists of 63 women diagnosed with FM who responded to the questionnaires: FSM evaluator and GRISS for women). Main Results and Conclusion: There are discrepancies between the data obtained in our sample and published studies. Depending on the sample of Garcia and Alba (2004), there is a 90% relationship little or very poor, with the median frequency of intercourse, 1coito/2meses. In our sample included all sexual activity, not just intercourse, obtaining 20.6% of female respondents had not had sex in the last 4 weeks. It also highlights the differences in sexual satisfaction. According to Print (2006), the number of women studied, not differ in arousal and orgasm, compared with a control group of healthy women between 21-54 years. Yes they do about desire and satisfaction. In our sample, however, yields a 80% overall sexual satisfaction.
PD.01.90 SEXUALITY AND SPINAL CORD INJURY: A CASE STUDY A.C.B. Maia, P. Ribeiro 1 Sao Paulo State University Unesp. Cnpq and Fapesp, Bauru, Brazil, Objective: These work is a case study and the authors investigated the emotional and sexual issues of people with disability. Method: Qualitative research in which a man and a woman with acquired spinal cord injury responded to an interview for content analysis. Results: 1) Perception of body and beauty. The concept of beauty refers more personal characteristics than physical. The body bothered more by not meet the standards of aesthetics than for the non-functionality; 2) Affective and sexual life. After the injury, the man separates from his wife and has a new partner also deficient; tells about feel desire, but erection occurs only with medication and does not feel orgasm. The woman was a virgin before the accident but nowadays has dated and sexual intercourse; she reported feeling little desire and arousal, and she does not feel orgasm. Both subjects related that the romantic relationship requires intimacy and trust with the partner. They don't receive sexual guidance by doctors and get their sex information with friends. Discussion and Conclusions: Spinal cord injury can affect people’s sex lives, although the expression of sexuality is always preserved. The stereotypes exacerbate the difficulties of loving and sexual relationship when the person has an acquired disability. The data are not generalizable, but are in line with the literature. The authors appoint sexual education is important and necessary in rehabilitation programs.
SEXUALITY WITH CERVIX CANCER M. Jodar Martin 1, R. Gonzalez Segura 2, N. Benayas Perez 3, R. Benayas Perez 2, M.D. Jimenez Lechuga 1, S. Valladolid Benayas 1 1 Comarcal Hospital, Melilla, Spain,2 Out of Work, Almería, Spain,3 Chare Poniente Hospital El Ejido, Almeria, Spain Introduction: Sexuality accompanies us from birth to death and starts manifesting and transforming throughout our lives. When a disease process such as cervical cancer, patients face a change in their quality of life while this disease also affects their partners. Cervical cancer is the second most frequent women's neoplasm in the world, so it is so important their reaction to sexuality. Objectives: Publicizing the problems of having sexual intercourse after a hysterectomy due to cervical cancer. Design and methods: Extensive literature review of recent years Results and Conclusions: When a surgery such as hysterectomy in this type of cancer, you have to interrupt sex from four to eight weeks, depending also on the recovery of each woman. Sexual desire and the ability to have sex are not affected by hysterectomy. In general, hysterectomies in a period of six or eight months usually do not imply any consequences for women’s sexuality. Women are not physically altered so that makes the body image it is not affected. The only affectation is psychological. To avoid disturbances, it is necessary to prepare pre-and postoperative preparation, because some women think in cervix lost as a fact of losing the capacity to have children. It is important to support the couple and the strengthening of the multidisciplinary team will be with the patient all along this process.
PD.01.92 WOMEN WHO DO NOT HAVE SEX (VAGINAL INTERCOURSE). CLINICAL CHARACTERISTICS AND REASONS J. Lopez Olmos Centro de Especialidades de Monteolviete - Ginecología, Valencia, Spain Objective: To study the clinical characteristics and reasons of women who abstain from sexual intercourse. Design and Method: We present a series of 54 women who never had sexual relations of vaginal intercourse, older of 20 years, and were attended during 2009 in gynecologic clinics of the author. They represent the 0,78 % over 6839 consultations. Results: The mean age was 39 years. In 12 cases they were menopausal women. The BMI in 53,70 % of them was normal. In 59,25 % there were medical antecedents, and in 48,14 % there were surgical antecedents. In 72,72 % there were gynaecologic antecedents: oligomenorrheas, in 20,51 %; amenorrheas and metrorrhages in 10,25 %, respectively. We can divide the series in two groups, first (A) with the more affected by diseases and deformity, and second (B), the more normals. No significant differences were found in the age nor the tabac habit. But, there were significant differences in not having studies, p =0,02 (more in group A ), in having universitary studies, p = 0,02 ( more in group B ), and in not having job, p < 0,05 ( more in group A ). Conclusions: The reasons for not having intercourse were: self diseases in 19 cases (35,18 %), and not having found an adequate partner in 19 cases (35,18 %). The religious factor was found in 5 cases (9,25 %).
PD.01.93 EFFECT OF CIRCUMCISION ON PENIS SENSITIVITY J. Kim, P.B.M. Kim Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea Purpose: Circumcision may cause edema and histologic changes and there might be a decrease in sensitivity in the distal penis. This study aims to report the correlation between circumcision and a decrease in penile sensitivity. Method: A biothesiometry test was conducted on men who have phimosis and those who were circumcised. For those who have phimosis, it was measured on the distal penis that is 1.5-2.0 cm from the corona and on the proximal penis that is 1.5-2.0 cm from the penopubic junction. For those who were circumcised, it was measured at the area between the corona and the incision line and on the the proximal penis that is 1.5-2.0 cm from the penopubic junction. Results: The average age of men having phimosis(22cases) is 41 years old. The threshold from the distal penis and that from the proximal penis was 6.4 and 6.3. The average age of men (81cases) who were circumcised is 39 years old. The threshold from the distal penis and that from the proximal penis was 5.6 and 6.1. Conclusion: This study showed that the sensitivity that was expected to decrease turned out to be more sensitive on the distal area than on the proximal area. On the other hand, the men who were uncircumcised showed less sensitivity on the distal area than on the proximal area. It is assumed from the findings that circumcision would not have any influence on a decrease in sensitivity of the penis.
PD.01.94 STUDY ON THE NURSING BELIEFS AND KNOWLEDGE OF THE PREGNANT WOMEN DURING PREGNANCY AND THEIR INFLUENCE ON SEXUAL ACTIVITY J. Garcia González, M. Ventura Miranda, J. Valdivieso Pérez, Y. García González, M. García Chalud, F. Villanueva Millán, I.M. Jodar López, M.R. Sanchez Navarro, V. Fernández Puerta, S. Hernández Vivancos Hospital Rafael Mendez, Lorca (Murcia), Spain The present study has as objectives (a) to know if the beliefs on the consequences of pregnancy influence the activity of sexual practice; and (b) to obtain information on the knowledge that pregnant women have about sexual activity. 115 gestating women participated. The results obtained from the information received about the consequence of pregnancy in sexual activity highlights that 60% of the puerperal women indicated that “they have not told me anything”. The time that they plan to abstain the gestating ones from maintaining sexual relationships after childbirth 57.4% think that she enters 0 = < 3 months. Majority of the gestating ones say that they have a decrease in sexual fantasies during pregnancy. Also, 65.22% say changes took place in their sexual fantasies during pregnancy, generally in the second trimester. And most of the gestating ones, describe sexual activity as “coitus” (74.8%). 5.2% only report “complicity with my couple” and “pleasure,” and 1.7% “caresses/ kisses” and “oral sex”. This discusses the importance of controlling the formation of false beliefs on sexual activity in gestating women.
PD.01.95 SEXUAL HEALTH OF DEMENTIA PATIENTS DIAGNOSED WITH LEWY BODIES N. Pardo 1, T. Garcia 1, P. La Calle Marcos 2, I. Fernandez 3 1 Neurologic Clinic Neurodem, Almeria, Spain, 2 Gynecology Department of Torrecardenas Hospital, Almeria, Spain,3 Neuroscience and Health Sciences Department, Almeria, Spain Sexuality in old age is still a taboo today surrounded by myth, if we add to this, age-related diseases such as dementia, we face a world virtually unknown in terms of sexual health. In our study we have analyzed global and sexual health of participants diagnosed of dementia and specially diagnosed of Dementia with Lewy Bodies. We observed that the group of patients diagnosed with Lewy Body dementia showed worse global health, we observed significant differences in dimensions of Mental Health and Vitality, energy or fatigue. In addition, women showed sexual dysfunction but we didn't observe any difference in sexual health in men. Therefore, we conclude that sexuality in dementia diseases may be affected. Nowadays we are increasing sample to know better sexual health of these patients and trying to explain differences in terms of brain damage areas in this kind of dementia. poster display 96-97 sexually transmitted infections
PD.01.96 BALANCE PSYCHO-SEXUAL CHANGES IN A SAMPLE OF WOMEN WITH HPV INFECTION. A PRELIMINARY STUDY A. Fabrizi 1, A. Criscuolo 2, G. Morosetti 2, M. Pazzola 2, C. Simonelli 3 11nstitute of Clinical Sexology, Rome, Italy,2 Department of Surgery, Section of Gynecology, Tor Vergata University Hospital, Rome, Italy, 3 “Sapienza” University, Rome, Italy Introduction: Human papillomavirus (HPV) is actually considered the main cause of cervical cancer. Several studies showed that women with an abnormal result at cervical screening may head for anxiety and distress. Such situation is generally solved after a correct diagnosis and treatment. However, it is quite evident that HPV testing may result in adverse psychosocial impact. Aims: The purpose of the study was to assess the psychosocial impact of HPV testing. Methods: 20 HPV-DNA positive women were recruited at the Colposcopy and Cervical Pathology Clinic of “Tor Vergata”University Hospital of Rome, Rome, Italy. The mean age of women was 29.75 years. Mean age of menarche and mean age at first sexual intercourse were 11.35 and 16.25 years, respectively. Contraception methods were used by 13 women. The most prevalent HPV genotypes were: HPV 16 (8), HPV 39 (4), HPV 18 (3) and HPV 6 (2). Data about HPV risk factors were collected by an oral interview. After the communication of the diagnosis of viral infection several questionnaires to evaluate some psychosocial variables were administered. The General Health Questionnaire (GHQ-28) was administered to assess the psychological distress over the past few weeks. A cut off score of 4 was considered to estimate the probable cases of affective disorders among the tested women. Spielberger State-Trait Anxiety Inventory (STAI) was used to assess both the state and the trait anxiety levels. At least, McCoy questionnaire was administered to evaluate the sexual satisfaction of women. Results: Somatic symptoms were generally more prevalent among women with HPV 16 infection. Intermediate levels of anxiety were reported by women with HPV 16 and HPV 39 infection. Three women with HPV 39 infection reported the presence of sexual dysfunction. In total, 7 women revealed to have sexual dysfunctions while 2 women reported alterations of the affective relationship. Conclusions: No association between HPV and severe depression was found. However, somatic symptoms and intermediate levels of anxiety were reported by several women. Finally, only 7 women revealed to have impairment of psychosexual activity. The differences with the literature may be due to the low number of the analysed patients. A follow up study could reveal if the persistence of HPV may cause alteration of the psychosexual balance of women.
PD.01.97 VAGINAL INFECTION BY TRICOMONAS AND CELLULAR ATYPIAS IN THE CERVICOVAGINAL CYTOLOGY J. Lopez Olmos Centro de Especialidades de Monteolivete. Ginecología, Valencia, Spain Objective: to study the vaginal infections by Tricomonas and cellular atypias in the cervicovaginal cytology. Design and Method: We present a series of 380 cytologies with the diagnostic of vaginal infection by Trichomonas vaginalis. They represented the 0,31 % of 121688 cytologies in a ten-years period (2000-2009). We compared them with a control group of 535 cytologies. Results: The cytology with Trichomonas is more inflammatory, and there were mixed infections in 36 cases ( 9,47 % ). We found atypias in 19 cases ( 5% ). Conclusions: In our study, the vaginal infection by Trichomonas in the cytology was associated significantly with bacterial vaginosis, p<0,05, and atypias of undetermined significance, ASCUS, p< 0,01. poster display 98-104
PD.01.98 ATYPICAL ONLINE SEXUAL PREFERENCES IN SWEDISH AND ITALIAN YOUNG ADULTS M. Giuliani 1, S. Eleuteri 2, F. Tripodi 1, S. Livi 2, K. Daneback 3, R. Rossi 1, C. Simonelli 2 11nstitute of Clinical Sexology, Rome, Italy,2 Faculty of Medicine & Psychology, Sapienza University of Rome, Rome, Italy,3 University of Gothenburgh, Gothenburgh, Sweden Objectives: In the last years, the Internet has become an important medium through which to experience own sexuality as people can easily and without embarrassment explore and enhance their sexual fantasies, coming into contact with atypical sexual behaviours. The aim of the current study was to evaluate atypical online sexual preferences in a large selected population of Italian and Swedish young adults. It was examined the association between preferences, online sexual behaviour, sexual compulsivity, and a set of sociodemographic variables. Design and Methods: Data were collected in Italy and Sweden in a 1 year period through a pen and paper questionnaire. The population comprised 421 Italians and 426 Swedes heterosexual university students aged 20-30 and had an equal sex distribution. Participants completed a set of measures regarding their sociodemographic characteristics, Internet sexual behavior (ISST), sexual compulsivity (SAST-A) and atypical online sexual preferences (AOSePreQ). Results: Scatophilia, gangbang, spermatophagia and spanking were seen by more than half of the participants; bondage, tattoos and stuffing by 40-50%; exhibitionism, fisting and fetishism by 30-40%; the other scenes were seen by less than 30% of participants. Gender appears the most important intercultural variable, related both to online seen scenes and the excitement connected to them. Conclusions: Atypical online sexual preferences have been found to be quite diffuse in our population. To be male is a predictor of viewing and to feel excited for all the different atypical sexual behaviors analyzed, while relationship status has not a significant impact.
PD.01.99 NEGATIVE ATTITUDES TOWARD MASTURBATION INVENTORY: PSYCHOMETRIC PROPERTIES OF A REDUCED VERSION J.C. Sierra, P. Santos Iglesias, N. Moyano, M. Sanchez, R. Granados, P. Vallejo Medina Universidad De Granada, Granada, Spain Objective: The Negative Attitudes toward Masturbation Inventory (NAMI) in one among the scarce self-reports developed to assess attitudes toward masturbation. The present study aims to examine its factorial structure through confirmatory factorial analysis (CFA), but also to analyse its reliability and give evidences about its convergent and discriminant validity. Design and Methods: A sample made up of 1,083 adolescents (13-17 years old) responded to the NAMI, the Sexual Opinion Survey, and the Hurlbert Index of Sexual Fantasies. Results: Exploratory factor analysis yielded three factors, but one of them was eliminated because of its poor psychometric properties. Later CFA supported the resulting two-factor structure, showing appropriate internal consistency values, and good convergent and discriminant validity evidences. Conclusions: This reduced version of the NAMI is reliable an valid for use in Spanish adolescents.
PD.01.100 SELF-SILENCING AND SEXUAL SUBJECTIVITY IN YOUNG FEMALES M. Nekic, A. Moric, I. Macuka University of Zadar, Department of Psychology, Zadar, Croatia Objective: Viewing development of sexuality in adolescence trough normative perspective created new body of research especially on the development of sexual self-conception (sexual subjectivity). Sexual subjectivity is multidimensional phenomenon which is often defined as having a sense of entitlement to sexual pleasure and sexual safety - interacted with intraindividual and psychological well-being. Previous studies showed that among adolescent girls, sexual subjectivity was associated with higher self-esteem and resistance to sexual double standards. Purpose of this study is to examine relation between dimensions of sexual subjectivity and self-silencing in Croatian sample of young women. Design and Method: In this study 141 female college students between the ages 19 to 26 were assessed with Self-silencing scale, the Female sexual subjectivity inventory and Sexual experience scale. Results: All participants were sexually active. Average age of sexual initiation was 18, which is slightly later than in other similar studies. It was found that self-silencing is in significant negative correlation with four dimensions of sexual subjectivity; with sexual body-esteem, sense of entitlement to sexual pleasure from partner, self-efficacy in achieving sexual pleasure, and sexual self-reflection. Further, dimensions of sexual subjectivity are in positive relations. Hence, sexual body-esteem correlates positively only with self-efficacy in achieving sexual pleasure, while intercorrelations of other dimensions of sexual subjectivity are positive and significant. Conclusions: It seems that in general if young women silence their feeling, thoughts and actions in close relationships they will experience low level of sexual subjectivity. GENDER DIFFERENCES IN SEXUAL EXPERIENCE AND RESPONSIBLE BEHAVIOUR IN ADOLESCENCE M. Nekic, I. Jakelic, I. Tucak Junakovic University of Zadar, Department of Psychology, Zadar, Croatia Objective: Sexuality in adolescence may include some aspects of unsafe sexual activities such as, engaging in sex under alcohol and opiates, not using condoms, etc. These sexual irresponsible behaviours can make adolescents vulnerable to numerous negative health consequences. So in this study we focus on a sexual responsible behaviour and differences in sexual experience between male and female adolescents. Design and Method: In this study 310 high school and college students (158 females and 152 males) between the ages 16 to 23 were assessed with Sexual responsible behaviour scale and Sexual experience scale. Results: It was found that age of sexual initiation differ between males and females. Age of first sexual intercourse for females was 18, and for males 16. Main reason for sexual initiation for young females was being in love, while curiosity and pleasure were for males. 15% of females and 3% of males had some health problems caused by risk sexual activities. Females are using almost always contraceptives while male adolescents occasionally. Further, female adolescents have higher result on Sexual responsible behaviour scale than males. It seems that continuous using of contraceptives is in significant positive correlation with sexual responsible behaviour, as well as later sexual initiation. Conclusions: Some gender differences were found in sexual experience and in sexual responsible behaviour. Sexual initiation for males is earlier than for females. It seems that more females are prone to act responsible in sexual domain; at the same time more females had health issues caused by sexual risk activities.
PD.01.102 APPROACH OF NURSING OF SEXUALITY IN THE ELDERLY. EXPERIENCE M.I. Ventura, J. Garcia, J. Valdivieso, Y. Garcia, M.R. Sancez, M.I. Garcia, F. Villanueva Hospital Rafale Mendez, Lorca, Spain The present study aims: to know how they perceive the sexuality in the age of health professionals. Identify the perspective of health care professionals about sexuality (sexual activity and practice, sexual desire, fantasies, needs/ sexual patterns and aspects physiological, psychological and social needs of sexuality), in old age. And discuss the myths and false beliefs of the existing nursing professionals, about sexuality in the elderly. Through a workshop carried out in the Hospital where Rafael Mendez came 12 professional’s aide. The results obtained were knowledge deficit of nursing professionals (nurses and auxiliary/os) in terms of concepts related to sexuality (sex, gender, sexuality, erotica and sexual activity). In regard to the definition given on sexual activity, a whole sample, the defined as sexual intercourse or sexual intercourse. And sexuality was related by the majority with the organic (reproductive organs, sexual intercourse, hormones) without giving importance to the communication. However showed an adequate knowledge about the sexual desire and the fantasies. In general, there were myths and false beliefs of the nursing professionals in regard to sexuality during the life cycle: the old age.
PD.01.103 LOVES AND SEX: MYTHS AND ART R. Bochicchio 12, A. Crudele 12, L. Cleffi 12, G. De Maio 12, S. Sakiev 12, M. Infante 12, T. Strepetova 12, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2 ACTS, Association of Clinics and Therapy in Sexology, Salerno, Italy Objective: Love and sex have always been subject that inspired artists. Sexuality is always present in Greek and Roman myths. The most fantastic and mysterious myths has become an ideal for the formulation of images evasive and ambiguous in some cases and sexually explicit in others. The erotic fantasy of an uncountable number of authors over the centuries has given birth to all form of arts in an endless repertoire of themes and forms. Design and Method: Our work investigates this aspect of the human body and soul, presenting a select group of works loaded with strong loving and mischievous feelings. Through a comparison of different art crafts, we try to show their erotic significance, seen from the modern point of view. Results: Throughout the work of artist we can better understand sex and sexuality. Like with so many mythological loves where stories of happy and mutual loves alternate with unfortunate and unilateral ones. Conclusions: Art and myths exercise and continue to exercise a strong attraction and fascination in every human being and in every moment of human life. They also represent a better way to relate to ourselves and our sexual feelings and emotions.
PD.01.104 EROTICS, IMAGINATION AND ART T. Strepetova 12, R. Bochicchio 12, L. Otranto 12, A. Di Marco 12, E. Arduino 12, D. Trotta 12 11SA, Istituto Italiano Sessoanalisi, Salerno, Italy,2ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy Objective: Erotic art can be defined as, art with a sexual content, and especially to art that celebrates human sexuality.” The imagery can be “either explicitly or implicitly sexual. Psychoanalytical discoveries in the 20th century had a major effect on art and how nudity in art was interpreted. Our goal is to see the unconscious sexual meaning of some artistic works. Design and Method: Inspired by Freud’s argument that sexuality lay at the root of all creativity, we tried to understand how could be the sexuality of artists whose works are presented. We interpreted sexual imaginary of authors using the sexodynamic approach. Results: Artists create and express in their work their sexual needs, desires, anxieties and conflicts. It is possible in many cases to trace in the works of many artists fantasies and dreams they are commonly shared by large groups of people. Conclusions: The study of erotic artistic production can give us, in many cases, a clue for understanding many aspect of human sexuality. authors
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