Background An increasing number of studies are concerned with various aspects of cybersex addicti... more Background An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life. Objective The aim of this study was to assess potential links between the outcome variable cybersex addiction, assessed with the Compulsive Internet Use Scale (CIUS) adapted for cybersex use, and several psychological and psychopathological factors, including sexual desire, mood, attachment style, impulsivity, and self-esteem, by taking into account the age, sex, and sexual orientation of cybersex users. Methods A Web-based survey was conducted in which participants were assessed for sociodemographic variables and with the following instruments: CIUS adapted for cybersex use, Sexual Desire Inventory, and Short Depression-Happiness Scale. Moreover, attachment style was assessed with the Experiences in Close Relationships-Revised questionnaire (Anxiety and Avoidance subscales). Impulsi...
Pavlovian and instrumental conditioning are fundamental processes helping organisms learn about s... more Pavlovian and instrumental conditioning are fundamental processes helping organisms learn about stimuli that predict rewards in the environment and actions that lead to their obtainment. The interplay between these two forms of learning notably exerts a strong impact on reward-seeking behaviors. However, mechanisms modulating this impact are not well elucidated. Here, we examined whether the influence of Pavlovian cues on instrumental action for sexual rewards is determined by their relevance to the individual’s sexual concerns in humans. In two experiments, we manipulated the relevance of sexual outcomes in a Pavlovian-instrumental transfer paradigm by recruiting heterosexual and homosexual men and selecting sexual stimuli for each sexual orientation. Results showed that Pavlovian-instrumental transfer effects were enhanced in response to the cue that was associated with the most relevant sexual outcome to participants’ sexual orientation compared to the cue associated with the les...
Two situations found in everyday gynecological practice demonstrate how a trustworthy doctor-pati... more Two situations found in everyday gynecological practice demonstrate how a trustworthy doctor-patient relationship is built. This relationship helps to uncover what is concealed behind physical symptoms, which can perturb daily life (couple, social, family life) beyond a purely medical approach. To understand what is really happening rarely leads to a rapid solution. A stable chronicity that does not involve too many treatments, including surgical ones, can already be considered a success.
Evidence on sexual function of women living with female genital mutilation (FGM) and on clitoral ... more Evidence on sexual function of women living with female genital mutilation (FGM) and on clitoral reconstruction after FGM is limited. Such surgery is performed in case of chronic clitoral pain, clitoral dyspareunia or for female identity reasons. In this article we summarize the anatomical, psychosexual and sociocultural factors that influence sexual function of women with FGM and the available data on clitoral reconstruction. Surgical resection of the fibrous tissue around the clitoris, with eventual excision of painful post-traumatic neuromas, could improve pain and sexual function. In asymptomatic women, multidisciplinary non-surgical management could be equally or more beneficial and less risky than surgery.
Sexuality is a natural function, part of global health and has to be evaluated in every patient. ... more Sexuality is a natural function, part of global health and has to be evaluated in every patient. When difficulties or dyfunctions happen in this domain, a specific mangement should be proposed. Sexual medicine is a « young » transversal discipline developping these last years in the french-speaking area of Switzerland. We present in this article a short history of sexual medicine in Lausanne and the recent activity in the Sexual Medicine Consultation of the Maternity in the CHUV.
Sexual health is a critical aspect of quality of life and is also influenced by medical condition... more Sexual health is a critical aspect of quality of life and is also influenced by medical conditions and health care interventions, particularly when gynaecological disorders are involved. Dyspareunia is a common symptom of endometriosis, a cause of personal distress and a main raison for seeking treatment. Endometriosis negatively affects different domains of sexual function and specific biopsychological variables (chronic pain, recurrence, infertility) may further worsen quality of sexual function and relationship. Consequences of endometriosis treatment on global sexual functioning have not been featured prominently in the available literature, assuming wrongly that sexual pain improvement was always translated into a recovered sexual health.
A recent study by Cheval et al (J Sex Med 2016;13:825-834) found that individuals high in homopho... more A recent study by Cheval et al (J Sex Med 2016;13:825-834) found that individuals high in homophobia look significantly less long at sex-related photographs, regardless of their nature (ie, homosexual or heterosexual). Because viewing time is under some conscious control, this result could indicate that individuals high in homophobia have a low sexual interest in any sexual stimuli or are consciously motivated to avoid sexual material in line with their conscious values. To determine the mechanism underlying shorter viewing time of sex-related photographs in individuals high in homophobia using pupil dilatation, which is considered a spontaneous, unconscious, and uncontrollable index of sexual interest. Heterosexual men (N = 36) completed a questionnaire assessing their level of homo-negativity and then performed a picture-viewing task with simultaneous eye-tracking recording to assess their pupillary responses to the presentation of sexually related or neutral photographs. Non-line...
Sexual function is an important aspect of health and quality of life and is influenced by both me... more Sexual function is an important aspect of health and quality of life and is influenced by both medical conditions and health-care interventions, especially when gynecologic disorders are involved. Coital pain is among the main factors that affect sexual functioning, and this symptom is reported by almost half of women suffering from endometriosis. However, sexuality is a complex phenomenon driven by social, psychological and biological/hormonal factors and the presence of endometriosis might further affect domains of sexual function and the quality of a sexual relationship. The objective of this report is to review the current state of knowledge on the impact that endometriosis and its treatments have on the sexual function of women and their sexual partners. A systematic literature search was performed to identify studies evaluating sexual function in endometriosis patients, and a narrative analysis of results is presented. The review discusses relevant quantitative and qualitative...
Obstetrics and gynecology specialists should be women's favoured interlocutors when talking a... more Obstetrics and gynecology specialists should be women's favoured interlocutors when talking about their sexuality. Indeed every day they assess their patient's intimacy, they manage pathologies that have a potential but well-known impact on sexuality, and they are very early aware of a more global approach like psycho-somatic. Furthermore, women are going to meet their obstetrician and gynecologist through all ages, from adolescence to post-menopause. At every step sexual problems can occur that can be searched, investigated and mostly managed by this specialist. The relationship between female sexual medicine and obstetrics and gynecology is undeniable and deserve to be favoured and consolidated.
The purpose of this study was to assess whether the detection of atherosclerotic aortic plaques b... more The purpose of this study was to assess whether the detection of atherosclerotic aortic plaques by transoesophageal echocardiography (TEE) could be used as a marker of coronary artery disease (CAD), relying on their number, cross-sectional surface, depth and localisation. The thoracic aortas of 102 consecutive patients (77 men, mean age 67 +/- 12 years) undergoing elective cardiac surgery were assessed by TEE. Atherosclerotic plaques were defined as > or = 5 mm thick focal hyperechogenic zones of the aortic intima and/or lumen irregularities with mobile structures or ulcerations. All patients had undergone prior coronary angiography. Thoracic aortic plaques were present in 73 patients, 66 of whom had CAD. The presence of aortic plaques detected by TEE identified significant coronary artery disease with a sensitivity of 90% and a specificity of 76%. The maximum transverse cross-sectional plaque area, the maximum plaque depth and the total plaque number all correlated significantly...
Study the impact of termination of pregnancy on women sexuality, contraceptive behaviour and coup... more Study the impact of termination of pregnancy on women sexuality, contraceptive behaviour and couple relationship. Prospective qualitative and quantitative study. 103 women requiring induced abortion by vacuum aspiration who were interviewed one to three weeks before the operation and again six months later. The interview was performed by a questionnaire including open and closed questions and psychological tests (Locke-Wallace and Horowitz' IES). A majority of women (n = 101) had already used contraception. During the cycle that had resulted in pregnancy, more than a half (n = 58) had actually used contraception and 1/3 had not use any contraception at all. Six months later, the majority (n = 86) used contraception, while only 16 did not. Condom was only rarely used (n = 11). After termination of pregnancy, 14 couples of 84 separated. The majority of women (n = 72) did not report changes in their sexual behaviour. On the other hand, 1/5 of women presented a decrease in sexual desire and orgasm troubles. About 1/3 described psychosomatic symptoms, but a majority (n = 92) was not traumatised. The great majority of women seems to tolerate well the termination of pregnancy. A minority presents sexual dysfunction, psychosomatic symptoms, which persist six months after intervention. As per contraception, the majority of women does protect herself from pregnancy but a percentage still does not protect itself at all or only in a noneffective or less effective way. After termination of pregnancy, the issue of protection from AIDS and sexuality-transmitted diseases seems to be less important.
The premenstrual dysphoric disorder corresponds to a severe form of the premenstrual syndrome tha... more The premenstrual dysphoric disorder corresponds to a severe form of the premenstrual syndrome that mainly shows psychiatric symptoms. The incidence is about 3 to 8% of women in the reproductive age. The essential characteristics are depressive mood, a marked anxiety, emotional instability, and decrease of activity, appearing during the luteal phase and ceasing in the follicular phase of the menstrual cycle. Several factors are implied in the pathogenesis of this disorder. Neurobiological and psychobiologic effects concerning the metabolism of serotonin and the melatonin play a role. Several therapies were proposed. The most effective treatment seem to be the selective inhibitors of the of serotonin reuptake.
Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology
Background An increasing number of studies are concerned with various aspects of cybersex addicti... more Background An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life. Objective The aim of this study was to assess potential links between the outcome variable cybersex addiction, assessed with the Compulsive Internet Use Scale (CIUS) adapted for cybersex use, and several psychological and psychopathological factors, including sexual desire, mood, attachment style, impulsivity, and self-esteem, by taking into account the age, sex, and sexual orientation of cybersex users. Methods A Web-based survey was conducted in which participants were assessed for sociodemographic variables and with the following instruments: CIUS adapted for cybersex use, Sexual Desire Inventory, and Short Depression-Happiness Scale. Moreover, attachment style was assessed with the Experiences in Close Relationships-Revised questionnaire (Anxiety and Avoidance subscales). Impulsi...
Pavlovian and instrumental conditioning are fundamental processes helping organisms learn about s... more Pavlovian and instrumental conditioning are fundamental processes helping organisms learn about stimuli that predict rewards in the environment and actions that lead to their obtainment. The interplay between these two forms of learning notably exerts a strong impact on reward-seeking behaviors. However, mechanisms modulating this impact are not well elucidated. Here, we examined whether the influence of Pavlovian cues on instrumental action for sexual rewards is determined by their relevance to the individual’s sexual concerns in humans. In two experiments, we manipulated the relevance of sexual outcomes in a Pavlovian-instrumental transfer paradigm by recruiting heterosexual and homosexual men and selecting sexual stimuli for each sexual orientation. Results showed that Pavlovian-instrumental transfer effects were enhanced in response to the cue that was associated with the most relevant sexual outcome to participants’ sexual orientation compared to the cue associated with the les...
Two situations found in everyday gynecological practice demonstrate how a trustworthy doctor-pati... more Two situations found in everyday gynecological practice demonstrate how a trustworthy doctor-patient relationship is built. This relationship helps to uncover what is concealed behind physical symptoms, which can perturb daily life (couple, social, family life) beyond a purely medical approach. To understand what is really happening rarely leads to a rapid solution. A stable chronicity that does not involve too many treatments, including surgical ones, can already be considered a success.
Evidence on sexual function of women living with female genital mutilation (FGM) and on clitoral ... more Evidence on sexual function of women living with female genital mutilation (FGM) and on clitoral reconstruction after FGM is limited. Such surgery is performed in case of chronic clitoral pain, clitoral dyspareunia or for female identity reasons. In this article we summarize the anatomical, psychosexual and sociocultural factors that influence sexual function of women with FGM and the available data on clitoral reconstruction. Surgical resection of the fibrous tissue around the clitoris, with eventual excision of painful post-traumatic neuromas, could improve pain and sexual function. In asymptomatic women, multidisciplinary non-surgical management could be equally or more beneficial and less risky than surgery.
Sexuality is a natural function, part of global health and has to be evaluated in every patient. ... more Sexuality is a natural function, part of global health and has to be evaluated in every patient. When difficulties or dyfunctions happen in this domain, a specific mangement should be proposed. Sexual medicine is a « young » transversal discipline developping these last years in the french-speaking area of Switzerland. We present in this article a short history of sexual medicine in Lausanne and the recent activity in the Sexual Medicine Consultation of the Maternity in the CHUV.
Sexual health is a critical aspect of quality of life and is also influenced by medical condition... more Sexual health is a critical aspect of quality of life and is also influenced by medical conditions and health care interventions, particularly when gynaecological disorders are involved. Dyspareunia is a common symptom of endometriosis, a cause of personal distress and a main raison for seeking treatment. Endometriosis negatively affects different domains of sexual function and specific biopsychological variables (chronic pain, recurrence, infertility) may further worsen quality of sexual function and relationship. Consequences of endometriosis treatment on global sexual functioning have not been featured prominently in the available literature, assuming wrongly that sexual pain improvement was always translated into a recovered sexual health.
A recent study by Cheval et al (J Sex Med 2016;13:825-834) found that individuals high in homopho... more A recent study by Cheval et al (J Sex Med 2016;13:825-834) found that individuals high in homophobia look significantly less long at sex-related photographs, regardless of their nature (ie, homosexual or heterosexual). Because viewing time is under some conscious control, this result could indicate that individuals high in homophobia have a low sexual interest in any sexual stimuli or are consciously motivated to avoid sexual material in line with their conscious values. To determine the mechanism underlying shorter viewing time of sex-related photographs in individuals high in homophobia using pupil dilatation, which is considered a spontaneous, unconscious, and uncontrollable index of sexual interest. Heterosexual men (N = 36) completed a questionnaire assessing their level of homo-negativity and then performed a picture-viewing task with simultaneous eye-tracking recording to assess their pupillary responses to the presentation of sexually related or neutral photographs. Non-line...
Sexual function is an important aspect of health and quality of life and is influenced by both me... more Sexual function is an important aspect of health and quality of life and is influenced by both medical conditions and health-care interventions, especially when gynecologic disorders are involved. Coital pain is among the main factors that affect sexual functioning, and this symptom is reported by almost half of women suffering from endometriosis. However, sexuality is a complex phenomenon driven by social, psychological and biological/hormonal factors and the presence of endometriosis might further affect domains of sexual function and the quality of a sexual relationship. The objective of this report is to review the current state of knowledge on the impact that endometriosis and its treatments have on the sexual function of women and their sexual partners. A systematic literature search was performed to identify studies evaluating sexual function in endometriosis patients, and a narrative analysis of results is presented. The review discusses relevant quantitative and qualitative...
Obstetrics and gynecology specialists should be women's favoured interlocutors when talking a... more Obstetrics and gynecology specialists should be women's favoured interlocutors when talking about their sexuality. Indeed every day they assess their patient's intimacy, they manage pathologies that have a potential but well-known impact on sexuality, and they are very early aware of a more global approach like psycho-somatic. Furthermore, women are going to meet their obstetrician and gynecologist through all ages, from adolescence to post-menopause. At every step sexual problems can occur that can be searched, investigated and mostly managed by this specialist. The relationship between female sexual medicine and obstetrics and gynecology is undeniable and deserve to be favoured and consolidated.
The purpose of this study was to assess whether the detection of atherosclerotic aortic plaques b... more The purpose of this study was to assess whether the detection of atherosclerotic aortic plaques by transoesophageal echocardiography (TEE) could be used as a marker of coronary artery disease (CAD), relying on their number, cross-sectional surface, depth and localisation. The thoracic aortas of 102 consecutive patients (77 men, mean age 67 +/- 12 years) undergoing elective cardiac surgery were assessed by TEE. Atherosclerotic plaques were defined as > or = 5 mm thick focal hyperechogenic zones of the aortic intima and/or lumen irregularities with mobile structures or ulcerations. All patients had undergone prior coronary angiography. Thoracic aortic plaques were present in 73 patients, 66 of whom had CAD. The presence of aortic plaques detected by TEE identified significant coronary artery disease with a sensitivity of 90% and a specificity of 76%. The maximum transverse cross-sectional plaque area, the maximum plaque depth and the total plaque number all correlated significantly...
Study the impact of termination of pregnancy on women sexuality, contraceptive behaviour and coup... more Study the impact of termination of pregnancy on women sexuality, contraceptive behaviour and couple relationship. Prospective qualitative and quantitative study. 103 women requiring induced abortion by vacuum aspiration who were interviewed one to three weeks before the operation and again six months later. The interview was performed by a questionnaire including open and closed questions and psychological tests (Locke-Wallace and Horowitz' IES). A majority of women (n = 101) had already used contraception. During the cycle that had resulted in pregnancy, more than a half (n = 58) had actually used contraception and 1/3 had not use any contraception at all. Six months later, the majority (n = 86) used contraception, while only 16 did not. Condom was only rarely used (n = 11). After termination of pregnancy, 14 couples of 84 separated. The majority of women (n = 72) did not report changes in their sexual behaviour. On the other hand, 1/5 of women presented a decrease in sexual desire and orgasm troubles. About 1/3 described psychosomatic symptoms, but a majority (n = 92) was not traumatised. The great majority of women seems to tolerate well the termination of pregnancy. A minority presents sexual dysfunction, psychosomatic symptoms, which persist six months after intervention. As per contraception, the majority of women does protect herself from pregnancy but a percentage still does not protect itself at all or only in a noneffective or less effective way. After termination of pregnancy, the issue of protection from AIDS and sexuality-transmitted diseases seems to be less important.
The premenstrual dysphoric disorder corresponds to a severe form of the premenstrual syndrome tha... more The premenstrual dysphoric disorder corresponds to a severe form of the premenstrual syndrome that mainly shows psychiatric symptoms. The incidence is about 3 to 8% of women in the reproductive age. The essential characteristics are depressive mood, a marked anxiety, emotional instability, and decrease of activity, appearing during the luteal phase and ceasing in the follicular phase of the menstrual cycle. Several factors are implied in the pathogenesis of this disorder. Neurobiological and psychobiologic effects concerning the metabolism of serotonin and the melatonin play a role. Several therapies were proposed. The most effective treatment seem to be the selective inhibitors of the of serotonin reuptake.
Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology
Uploads