Paul Enzlin

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• Full Professor
• Professor (Full) at KU Leuven

Sexual desire has often been conceptualized and studied as an individual trait. However, empirical evidence suggests that there is also value in studying it as a state and dyadic construct. Through a daily diary study with a randomized controlled experimental design, we aimed to explore (i) how the roles that partners fulfill in dyadic interactions...

While the relational context of sexual desire is receiving increasing attention in research, generated insights remain fragmented. The Dyadic Interactions Affecting Dyadic Sexual Desire (DIADICS) model integrates such empirical findings, but the model as a whole has not been empirically tested yet. We conducted an online questionnaire study with 18...

Background Due to the lowering of circulating estrogens symptoms of genitourinary syndrome of menopause (GSM) may arise with premenopausal breast cancer patients who become menopausal due to breast cancer treatment. Clinical signs of GSM are i.a. vaginal dryness, dyspareunia, loss of libido, dysfunction of arousal and/or orgasm: this may negatively...

Introduction In a previous cross-sectional study to determine the prevalence of ED among artisanal mineworkers, we found a significant association between aphrodisiacs consumption and erectile dysfunction (Musa et al. under review). Objective This study aimed at investigating the main reasons of aphrodisiacs consumption and their possible health e...

Background In a previous cross-sectional study to determine the prevalence and determinants of erectile dysfunction (ED) among artisanal mineworkers, we found a significant association between ED and consumption of locally produced plant-derived aphrodisiacs. Aim We aimed to investigate the type and mode of consumption of aphrodisiacs, their possib...

Background The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Aim We aimed to investigate factors that are possibly associated with erectile dysfunction (ED) in metal miners in the former Katanga province of the Democratic Republic of the Congo. Methods In a cross-sectional study of 138...

Introduction The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Based on a preliminary case-control study of erectile dysfunction among mineworkers in the former Katanga province of the Democratic Republic of Congo (Musa et al. Occupational and Environmental Medicine 2020), Objective We f...

In this qualitative study, we explored women’s and men’s experience of sexual desire for their romantic partner and its link to dyadic interactions. During interviews and focus group discussions, our participants described sexual desire as ‘elusive’, ‘conditional’, ‘responsive’ and ‘malleable’. The subtheme ‘elusive’ refers to sexual desire having...

Objectives The postpartum period is a challenging period for a couple's sexuality and is accompanied by changes in sexual behavior. However, the study of sexual behavior in this period has mostly focused on (resuming) vaginal intercourse. Other sexual behaviors and their associations with sexual function and satisfaction have as yet not received mu...

Background: While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been adequately studied. Objectives: Our aim was to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy. Material and met...

While several studies suggest that traditional gender ideologies are strongly embedded in Latino populations, little is known about the way they operate in adolescent’s romantic relationships. This mixedmethods study was carried out with adolescents in Cuenca, Ecuador. In the quantitative component, we assessed adolescents’ support for traditional...

This article presents a new conceptual framework that shows how dementia may affect the sexual relationship between partners, and how different actors become progressively more involved in 'managing' the sexual relationship during consecutive phases of dementia, i.e., the premorbid, preclinical and clinical phases. Each phase challenges couples in...

Objective: Sexual assertiveness (SA), i.e., the ability to communicate thoughts and desires that may be translated into satisfying sexual activity within an intimate relationship, is important for safe and satisfying sexual behavior. In an attempt to unravel which cultural, relational, and individual variables are related to the development of SA i...

Dementia is increasingly being recognised as a public health priority and poses one of the largest challenges we face as a society. At the same time, there is a growing awareness that the quest for a cure for Alzheimer's disease and other causes of dementia needs to be complemented by efforts to improve the lives of people with dementia. To gain a...

In most theoretical models, sexual desire for one’s partner is predominantly conceptualized from an individual perspective. There is, however, a growing body of empirical evidence on the dyadic aspects of sexual desire. That evidence is as yet not well-integrated into theoretical conceptualizations of sexual desire. Aiming to fill this gap, we pres...

The minority stress model is used to explore the development of mental health disparities experienced by transgender adults. However, research so far has focused on the harmful impact of distal minority stressors, leaving proximal minority stressors understudied. This study aimed to examine the associations between mental health difficulties of tra...

Background and aims The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables. Methods Adults with diabetes (n=756) comp...

Objective: To compare adnexectomy by vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) versus laparoscopy. Design: Parallel group, 1:1 single-centre single-blinded randomised trial, designed as non-inferiority study with a margin of 15%. Setting: Belgian teaching hospital POPULATION: Non-pregnant non-virgin women with an intact...

Introduction Suite à une étude cas-témoin ayant montré une association entre la dysfonction érectile et le travail dans le secteur minier (Musa et al. Occ Environ Med 2020), nous avons étudié cette association au moyen d’une étude transversale dans l’ancienne province du Katanga, une région riche en mines de cuivre et de cobalt. Méthodes Nous avon...

Different pain types may be encoded in different brain circuits. Here, we examine similarities and differences in brain processing of visceral and somatic pain. We analyze data from seven fMRI studies (N = 165) and five types of pain and discomfort (esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure) to e...

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated socio-demographic, relational, and health...

The aim of this paper was to present a literature review on sexual assertiveness (SA), on factors and life experiences that are associated with its development, and on its function in human sexuality. It was found that demographic variables (e.g., age, education, gender), sexual experiences (e.g., type of partnership, sexual victimization), psychos...

Purpose The purpose of this study is to examine the association between parental migration and adolescents’ styles of close relationships with parents, friends and romantic partners. Design/methodology/approach In total, 197 adolescents from Cuenca (Ecuador) participated in the study, of which 35% reported a background of parental migration. The B...

Pain is a primary driver of motivated behavior and learning. Different varieties of pain may be encoded in different brain circuits, but the neural similarities and differences across different types of pain are not well understood. Here, we examine the similarites and differences in brain processing of visceral and somatic pain, one of the most fu...

See a video as Linked Data or on the YouTube channel on Self-Modeling Networks here: https://www.youtube.com/channel/UCCO3i4_Fwi22cEqL8M_PgeA. This paper presents a first study to apply a computational approach to Genito-Pelvic Pain/Penetration Disorder (GPPPD) using a Fear Avoidance Model. An adaptive temporal-causal network model for fear avoidan...

Introduction The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Anecdotal reports of erectile dysfunction (ED) among mineworkers in the area led us to conduct an explorative study to investigate the possible association between ED and working in mining-related jobs. Methods We included 42...

Different forms of sexual expression can be beneficial to health and quality of life of older adults. While research on sexual well-being and aging has focused primarily on negative dynamics, this approach may not fit well the sexual reality of aging men and women. We used data from a probability-based survey carried out in 2016 among men and women...

Although palliative care nurses are identified as key players in supporting couples during advanced illness, there is a lack of evidence about their knowledge and experiences with this particular role. The aim of the study was to explore palliative care nurses’ attitudes, roles, and experiences in addressing relationship functioning of couples in d...

In an attempt to extend our understanding of how social contexts co-create female sexuality in Latin America, the aim of the current study was to explore the beliefs, views, and ideas about sexual assertiveness in Latino emerging adult women. Seventeen women between 22 and 30 years old living in Cuenca, Ecuador, participated in focus groups. A cons...

Background: Pubic hair removal (PHR) is a widespread practice that entails certain health risks; however, there remains a lack of scientific information on the prevalence and antecedents of PHR, as well as on its association with sexual behavior and relational satisfaction. Aims: To explore women's and men's attitudes regarding PHR and their PHR...

In psychosocial migration literature, the perspective of ambiguous loss has been relevant to articulate personal and relational experiences in the context of transnational families and ongoing separation. Most studies have focused on adult members' experiences of transnational families, but research exploring ambiguous loss in adolescents whose par...

Multimodal neuroimaging studies provide support for a role of alterations in sensory processing circuits and endogenous pain modulatory systems in provoked vestibulodynia (PVD). In this study we tested the hypotheses that PVD compared to healthy controls (HCs) would demonstrate gray matter volume (GMV) alterations in regions associated with sensori...

While the interactive nature of sexual desire in women is increasingly recognized, dyadic factors affecting it, including partner interactions, have as yet received little research attention. In this cross-sectional study, we examined the associations among intimacy, celebrated otherness, and object-of-desire affirmation and explored how they compl...

Objective: To compare hysterectomy by Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) versus total laparoscopic hysterectomy (TLH) as a day-care procedure. Design: Parallel group, 1:1 randomised single-centre single -blinded trial, designed as a non- inferiority study with a margin of 15%. Setting: Belgian teaching hospit...

This article explores what (working with) matter can tell us that language cannot or does not completely tell, about becoming a sensual, sexual woman free to move smoothly in and with her body. It explores how (working with) matter can transform living in, with and through a body, and how it affects and is affected. The text is centred around “touc...

Besides erectile difficulties, age-related prevalence rates of male sexual difficulties remain inconsistent. Moreover, apart from erectile and premature ejaculation, epidemiological studies that provide detailed age-related prevalence rates of other sexual difficulties (e.g. lack of sexual desire) in men are rare. Prevalence rates of sexual dysfunc...

While not all sexual difficulties cause distress, research and clinical experience suggest that, apart from personal distress, partner and relational sexual distress are also often an important reason to seek professional help. The current study explored the associations between personal, perceived partner, and relational distress that men and wome...

Aim To explore palliative care nurses’ attitudes, roles and concrete experience with regard to addressing sexual issues in their daily practice. Background Patients and their partners in palliative care might experience dramatic changes in their sexuality and want nurses to provide the opportunity to address them. Moreover, it is argued that the h...

Introduction Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) ve...

Aims: The identification and discussion of sexual care needs in people with type 2 diabetes mellitus (T2DM) in primary care is currently insufficient. The objective of this study was to determine the prevalence of sexual dissatisfaction, sexual problems and need for help by using a screening instrument among people with T2DM in primary care. Meth...

Objective In DSM-5, pain-related fear during anticipation of vaginal penetration is a diagnostic criterion of Genito-Pelvic Pain/Penetration Disorder (GPPPD). We aimed to investigate subjective and brain responses during anticipatory fear and subsequent induction of vestibular pain in women with GPPPD. Methods Women with GPPPD (n = 18) and age-mat...

This article presents the results of a study of knowledge and attitudes in sexuality and sex education applied teachers of 17 public schools in the city of Cuenca, Ecuador. The impact of a training course on sexuality planned by the VLIR-UOS project "Promotion of sexual health in adolescents" of the University of Cuenca-Ecuador was evaluated. To th...

Introducing a new and improved vulvagesiometer.

In line with the idea that cancer and sexuality are in fact “relationship issues,” this chapter focuses on an often forgotten but important special group: the partner. For those in a partner relationship, the cancer diagnosis suddenly confronts not only the patient but also the partner with an unexpected and threatening event that creates uncertain...

This chapter focuses on couple-based interventions for sexual rehabilitation in the context of cancer.

In our daily lives, we tend to put people - others and ourselves - in boxes (such as social categories, professional conduct, research participant samples, braces), especially when variation becomes associated with unruliness and triggers the reflex to manage/control/contain to prevent further deviation. This leaves little space for listening, crea...

Recent studies increasingly demonstrated that gender differences are linked with macro-cultural factors. The stereotypes in Latin America that shape gender roles are machismo and marianismo. In contrast, with the ample publications on the importance of machismo, empirical research on machismo and certainly marianismo is still in its infancy despite...

Behavior research revealed that attitudes are important in understanding the roots of violence. People acquire those attitudes by social learning, particularly in adolescence, because in this stage of life is the influence of social environment strongest. This study aimed to assess adolescents’ attitude toward violence and their related factors. Th...

Introduction Although impaired sexual function is relatively common, not all sexual impairments are associated with distress. To date, most studies on protective and risk factors for sexual distress have asked about distress in a more general manner and have failed to distinguish different dimensions of sexual distress. Aim To examine the associat...

Aim: The aim of the current paper was to provide an overview of literature on sexual function and sexual difficulties in older adults. Method: We conducted a narrative review of papers published in English between January 2005 and July 2015 based on an extensive search in PsycINFO. Results: The review showed that while common biological changes may...

Aim: the aim of the paper is to provide an overview of the literature published 2005–2015 on sexual satisfaction and body image in older adults. Method: A narrative literature search using the PsycINFO database was conducted. Results: Although women in general seem less satisfied with their bodies than men, particularly in sexual contexts, older wo...

Although the transnational migration and its impact on families and society has received considerable attention from scholars, still little is known about its effects on the family members who stay in their home country. The aim of this qualitative study was to explore adolescents’ experiences of close relationships in the context of transnational...

Introduction Natural orifice transluminal endoscopic surgery (NOTES) uses natural body orifices to access the cavities of the human body to perform surgery. NOTES limits the magnitude of surgical trauma and has the potential to reduce postoperative pain. This is the first randomised study in women bound to undergo hysterectomy for benign gynaecolog...

Introduction: Because severity and duration of sexual impairment and any distress caused by the sexual impairment are not assessed in most epidemiologic studies on sexual dysfunction, the available prevalence rates are probably an overestimation. Aims: To provide prevalence estimates of severe and persistent sexual difficulties that cause personal...

Previous studies have indicated that women with diabetes mellitus are at higher risk to develop sexual dysfunctions. In the current study, we hypothesized that lower genital arousal response-as a consequence of diabetes-related damage to nerves and blood vessels-might play a part in these higher prevalence rates. Vaginal blood flow, subjective sexu...

Background Sexual dysfunction is prevalent in patients with type 2 diabetes mellitus, but remains one of the most frequently neglected complications in diabetes care. Both patients and care providers appear to have difficulty with discussing sexual problems in diabetes care. A sexual counselling model for care providers, such as the PLISSIT model,...

This study aimed to: (a) investigate whether, and if so which, sexual problems are present in people with a limb amputation; (b) analyze how they experience their sexuality; and (c) investigate whether sexuality was discussed with them during their rehabilitation process. In total, 301 participants completed a survey consisting of a questionnaire o...

Sexual dysfunction is highly prevalent among patients with type 2 diabetes; yet, little is known regarding these patients' needs and preferences for care for sexual problems. A cross-sectional survey and 25 semi-structured interviews were therefore conducted among 40-75 year old type 2 diabetes patients to explore this. We learned from the survey a...

Introduction: While there is increasing interest in studying aspects of communication processes in sex research, the association between dyadic sexual communication and relationship and sexuality outcomes has not yet been examined in pre-menopausal women with dyspareunia. Aim: To examine the associations between dyadic sexual communication and p...

Introduction: Endometrial cancer (EC) can affect sexual functioning based on anatomical, physiological, psychological, and relational mechanisms. Aim: The aim of this study was to prospectively investigate sexual adjustment of women with EC during a follow-up period of 2 years after surgical treatment and to compare the results with women who un...

Introduction: Although age-related prevalence rates of female sexual difficulties, i.e., difficulties with sexual desire, arousal, orgasm, or pain have occasionally been studied-with mostly inconsistent results-the age-related prevalence rates of female sexual dysfunctions, i.e., sexual difficulties that are associated with sexual distress, have n...

Abstract This study aimed to assess the prevalence and correlates of sexual dysfunction in a sample of Dutch men and women with type 2 diabetes mellitus (T2DM). Patients with T2DM, aged 40-75 years, from four Dutch diabetes centers were asked to complete self-report questionnaires covering socio-demographic characteristics, medical characteristics,...

Objective: Women with cervical cancer (CC) may be faced with changes in sexual functioning resulting from the cancer itself and/or its surgical treatment. The aims of this study were to prospectively investigate sexual adjustment of CC patients during a follow-up period of 2 years after radical hysterectomy without adjuvant treatment and to compar...

Introduction: Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). Methods: In this prospecti...

Purpose: Following a lower limb amputation, people may experience limitations in performing sexual activities. However, only little research efforts have been devoted to unravel how people experience their sexuality after such an amputation. Therefore, the purpose of the current study is to describe how people with a lower limb amputation experien...

While lack of sexual attraction, lack of sexual behavior, and self-identification as asexual have been used as criteria to define asexuality, it is not known how much they overlap in describing the same group of people. This study aimed to assess how many individuals could be identified as asexual based on each of these criteria and on combinations...

Although research that takes into account partner and relationship factors in dyspareunia is slowly emerging, little is known about how these couples communicate about their sexuality. Additionally, partner psychosexual adjustment has not been examined in a controlled fashion. This study aimed to compare dyadic sexual communication, dyadic adjustme...

While there has been considerable inquiry into how religion may help Christians deal with stressful life events (SLEs), only limited research has been conducted on the impact SLEs might have on religion. This study's purpose was to provide an in-depth analysis of this relationship in a sample of highly religious Christians of Chinese origin. In-dep...

Abstract This study aimed to explore how asexual women experience their asexual identity, sexuality and relationships. Participants were recruited through the website of the Asexuality Visibility and Education Network and posts on several health- and lifestyle related websites. Interviewees were 9 women between 20 and 42 years old. Data were collec...

Vulvectomy for vulvar malignancy can affect sexual functioning based on anatomic, physiologic, psychologic, and relational mechanisms. The aims of this study were to prospectively investigate sexual adjustment of women with vulvar malignancy during a follow-up period of 1 year after vulvectomy and to compare the results with healthy control women....

Romantic relationships are a central aspect of the life of adolescents and have an important influence on the socio-affective and sexual development. This paper presents a review of the scientific literature on romantic relationships during adolescence and aims to unravel the ongoing debate in the literature and to identify possible gaps. The revie...

To describe the impact of patients' lower limb amputations on their partners' sexual functioning and well-being. Annually, about 3300 major lower limb amputations are performed in the Netherlands. An amputation may induce limitations in performing marital activities, including expression of sexual feelings between partners. However, up until now, l...

El objetivo de esta investigación fue el de explorar las actitudes, conocimientos y creencias de los adolescentes sobre la violencia de pareja. La información fue recolectada a través del desarrollo de doce grupos focales con adolescentes varones y mujeres de colegios de la ciudad de Cuenca. La discusión en los grupos fue dirigida a partir de una g...

As most epidemiological surveys on sexual problems have not included assessment of associated distress, the principal aim of this study was to provide prevalence estimates of both DSM-IV-TR-defined (American Psychiatric Association [APA], 20002. American Psychiatric Association . ( 2000 ). Diagnostic and statistical manual of mental disorders , (4t...

Parents' contribution to sex education is increasingly receiving research attention. This growing interest stems from recognition of the influence that parental attitudes may have both on young people's sexual attitudes and behaviour, and on school-based sex education. Studies regarding parental attitudes towards sexuality are, however, still rare....

Introduction Although it is known that women with dyspareunia suffer from impaired psychological and sexual functioning, the study of the various dimensions of sexual self-schema and their associations with these outcomes has been neglected. Aim To examine whether self-image cognitions about vaginal penetration, body image, and feelings and belief...