No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Dramatic Improvement in Sexual Function Induced by Intranasal Oxytocin
Abstract
A variety of sources indicate that oxytocin has beneficial effects on several components of sexuality. This is a case report on a male who had significant, broad-spectrum improvements in sexual function during a course of intranasal oxytocin treatment for social anxiety.
To document a case of diverse, salutary effects of oxytocin on sexual function.
The patient was in individual treatment for a variety of difficulties, including social avoidance and relational problems. A biopsychosocial evaluation ruled out medical conditions and substance-related issues as a cause of sexual difficulties. After obtaining informed consent, an off-label trial of intranasal oxytocin was administered targeting his social anxiety and relational avoidance.
Oxytocin positively impacted a number of components of sexual function, including libido, erection, and orgasm, and was well tolerated.
This is the first case we are aware of documenting broad-spectrum benefits of chronic intranasal oxytocin on male sexual function. Future trials of oxytocin for psychiatric indications should specifically monitor its effects on sexuality, and trials directly investigating oxytocin's impact on aspects of sexual function are warranted.
... The intranasal administration of OT (INOT) has the advantage of being a non-invasive method; OT can reach the brain directly and improves welfare by reducing the stress response under certain social contexts [3][4][5]. Some studies in humans evaluated effects of INOT on sexual behaviour in men [6,7]. However, to the best of our knowledge, there are no studies that have evaluated whether INOT administration modifies sexual behaviour in ruminants. ...
... During sexual activity OT is released into the blood stream [1,15], and on the other hand, the administration of oxytocin stimulates sexual activity in various species [1]. However, studies on the effects of INOT administration on sexual behaviour have been focused on humans [6,7], and no studies have been done in ruminants. Our results show that INOT improved the sexual behaviour of the young rams. ...
... In addition, it is noteworthy that both mounting attempts and mounting also increased because of intranasal oxytocin, which, although not significant, had a large effect size. These positive results of the INOT treatment on sexual behaviour agree with others reported in humans [6,7]. In rams, the behaviours of ano-genital sniffing, lateral approaches and flehmen are part of the "courtship" repertoire, while mounting attempts, mounting and mounts with ejaculation are part of copulation [16]. ...
... Oxytocin plays a pivotal role in numerous physiological and psychological processes including parturition, lactation, memory, and sexual performance. [9][10][11][12][13] Beyond its physiological functions, oxytocin influences diverse facets of human behavior, and thus social interactions, fostering pair bonding, increasing trust, attraction, and alleviating stress. 14,15 Oxytocin, while primarily released from the hypothalamus, is additionally synthesized and released from epidermal keratinocytes. ...
... 34,43 Remarkably, oxytocin also appears to mask negative personality perceptions that masculinized faces tend to elicit, changing preferences from more feminine facial shapes to slightly more masculine ones, and underscoring its multifaceted role in shaping human behavior and relationships. 44 While oxytocin studies are most commonly performed with intranasal administration, 9,45,46 our topically formulated application after 8 weeks of use created corroborating results. In the present study, OX users were 87.5% (7/8) more likely to find random individuals of the opposite sex attractive, whereas the placebo group only found 12.5% (1/8) of random individuals more attractive. ...
Background
Improved skin appearance is closely linked to higher self‐esteem, favorable first impressions, and enhanced quality of life, with skincare products often being formulated with biostimulatory and regenerative ingredients to both enhance skin health and provide psychological benefits. Certain components, such as phospholipids and botanicals, may not only improve skin quality, but also impact mood, romantic bonding, and sexual attraction.
Aims
To assess whether a novel topical skin care product formulated with a proprietary combination of proteins, lipids, and botanical derivatives, can potentially result in a robust psycho‐social‐dermatological benefit via modulation epidermal oxytocin and pheromonal pathways.
Patients/Methods
In this single‐center prospective, randomized, controlled, double‐blinded study, 40 female subjects were randomly assigned to use of either active novel skincare products, or placebos, for 4–8 weeks. Skin assessments, standardized photography, first impression ratings, and questionnaires on confidence and sexual satisfaction were conducted.
Results
Thirty‐nine subjects completed the study and demonstrated a statistically significant improvement in skin quality following 4 and 8 weeks of use, with improvements of greater magnitude demonstrated with a longer duration of use. Product users projected a better first impression and appeared on average 3 years younger than their actual age, with 86% of subjects reporting increased confidence. Product users found random people of the opposite sex to be more attractive 88% of the time and reported improvement in sexual satisfaction in 90% of the categories.
Conclusions
The use of this novel topical product culminated in statistically significant improvements in skin quality, confidence, sexual relationship satisfaction, perceived attractiveness, and youthfulness, highlighting its potential in anti‐aging and mood enhancement.
... Biomarker analysis (cortisol, α-amylase, and heart rate) also indicated moderate psychophysiological activation, but these were not significantly affected by intranasal oxytocin [312]. However, against the conclusions of the above studies, which show very modest effects of intranasal oxytocin on sexual intercourse, a dramatic enhancement in several elements of sexual behavior (libido, erection and orgasm) produced by intranasal oxytocin in a patient under individual treatment for several problems, including social avoidance and relational problems, has been recently reported [313]. In this patient, biopsychosocial evaluation allowed medical conditions and substance-related complications to be excluded as sources of sexual problems [313]. ...
... However, against the conclusions of the above studies, which show very modest effects of intranasal oxytocin on sexual intercourse, a dramatic enhancement in several elements of sexual behavior (libido, erection and orgasm) produced by intranasal oxytocin in a patient under individual treatment for several problems, including social avoidance and relational problems, has been recently reported [313]. In this patient, biopsychosocial evaluation allowed medical conditions and substance-related complications to be excluded as sources of sexual problems [313]. Thus, whether oxytocin may actually improve sexual behavior in men is still far from being assessed. ...
A continuously increasing amount of research shows that oxytocin is involved in numerous central functions. Among the functions in which oxytocin is thought to be involved are those that play a role in social and sexual behaviors, and the involvement of central oxytocin in erectile function and sexual behavior was indeed one of the first to be discovered in laboratory animals in the 1980s. The first part of this review summarizes the results of studies done in laboratory animals that support a facilitatory role of oxytocin in male and female sexual behavior and reveal mechanisms through which this ancient neuropeptide participates in concert with other neurotransmitters and neuropeptides in this complex function, which is fundamental for the species reproduction. The second part summarizes the results of studies done mainly with intranasal oxytocin in men and women with the aim to translate the results found in laboratory animals to humans. Unexpectedly, the results of these studies do not appear to confirm the facilitatory role of oxytocin found in male and female sexual behavior in animals, both in men and women. Possible explanations for the failure of oxytocin to improve sexual behavior in men and women and strategies to attempt to overcome this impasse are considered.
... Oxytocin has also been implicated in the contraction of the prostatic urethra, ejaculatory duct, and bladder neck [78]. There have been case reports of successful treatment of AO and improvement of sexual function with administration of intranasal oxytocin [79,80]. Conversely, a prospective randomized study of 102 healthy men showed no significant difference in mean time to ejaculation between men who received intranasal oxytocin (n = 49, 10.24 min) compared to the control group (n = 53, 10.74 min; p = 0.53) [81]. ...
Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. Given the multifactorial complex nature of this disorder, a thorough history and physical examination represent the most critical components of patient evaluation in the clinical setting. Treating DO/AO can be challenging due to the lack of standardized FDA-approved pharmacotherapies. There is no standardized treatment plan for DO/AO, though common treatments plans are often multidisciplinary and may include adjustment of offending medications and sex therapy. In this review, we summarize the etiology, diagnosis, and treatment of DO/AO.
... sex, genotype) factors [269]. The above remains relevant when considering trigger factors for migraine headaches; however, potential positive, indirect, effects on headaches may also be connected to improvement in sexual functions [270] and social interactions, which positively affect the quality of life. ...
Migraine is a severe neurovascular disorder of which the pathophysiology is not yet fully understood. Besides the role of inflammatory mediators that interact with the trigeminovascular system, cyclic fluctuations in sex steroid hormones are involved in the sex dimorphism of migraine attacks. In addition, the pituitary-derived hormone prolactin and the hypothalamic neuropeptide oxytocin have been reported to play a modulating role in migraine and contribute to its sex-dependent differences. The current narrative review explores the relationship between these two hormones and the pathophysiology of migraine. We describe the physiological role of prolactin and oxytocin, its relationship to migraine and pain, and potential therapies targeting these hormones or their receptors.In summary, oxytocin and prolactin are involved in nociception in opposite ways. Both operate at peripheral and central levels, however, prolactin has a pronociceptive effect, while oxytocin appears to have an antinociceptive effect. Therefore, migraine treatment targeting prolactin should aim to block its effects using prolactin receptor antagonists or monoclonal antibodies specifically acting at migraine-pain related structures. This action should be local in order to avoid a decrease in prolactin levels throughout the body and associated adverse effects. In contrast, treatment targeting oxytocin should enhance its signalling and antinociceptive effects, for example using intranasal administration of oxytocin, or possibly other oxytocin receptor agonists. Interestingly, the prolactin receptor and oxytocin receptor are co-localized with estrogen receptors as well as calcitonin gene-related peptide and its receptor, providing a positive perspective on the possibilities for an adequate pharmacological treatment of these nociceptive pathways. Nevertheless, many questions remain to be answered. More particularly, there is insufficient data on the role of sex hormones in men and the correct dosing according to sex differences, hormonal changes and comorbidities. The above remains a major challenge for future development.
... The titles and abstracts of all o r a n y w h e r e articles were carefully studied and 22 articles were chosen for the full-text review, out of which seven articles have used intravaginal oxytocin as an intervention [24][25][26][27][28][29][30]. Three studies have covered case studies [31][32][33]. One of the studies was with two distinct titles but completely similar content [34]. ...
Background
Intranasal oxytocin can be used as a promising moiety for the treatment of sexual disorders.
Objective
This study was carried out to systematically review the effect of intranasal oxytocin on sexual function in men and women.
Methods
We systematically searched databases (e.g., Cochrane Central Register of Controlled Trials Library, MEDLINE, Web of Science, Scopus, ProQuest, Google Scholar and Persian databases). All types of published clinical trials comparing different doses of intranasal oxytocin sprays with placebo sprays were included in the study. The primary outcome was sexual function and secondary outcomes were endocrine and cardiovascular measures and also side effects.
Results
A total of six studies were ultimately eligible for inclusion in the study. Though intranasal oxytocin improves various parameters of sexual function in men and women, according to the sexual response cycle, these changes are not statistically meaningful compared to the control group. Only one study revealed a meaningful impact on orgasm parameters and after orgasm, especially in men. In all studies, intranasal oxytocin administration has significantly and transiently increased plasma concentrations of oxytocin with no meaningful effect on other endocrine hormones. A study showed that the heartbeat is increased transiently during the arousal and orgasm stages, and such increase is meaningfully higher in men than in women.
Conclusion
Intranasal oxytocin administration fails to meaningfully affect the classical parameters of sexual response, but it improves the orgasmic and post-orgasmic dimensions, especially in men. To evaluate the effects of intranasal oxytocin administrations, we need more long-term clinical trials.
... (e.g., Denes, 2018). Although relatively little is known about the role of oxytocin in sexual interactions between partners (Behnia et al., 2014), the limited literature on individuals' sexual behavior suggests that oxytocin contributes to sexual functioning, intensifies sexual episodes, and produces more intense orgasms (Anderson-Hunt & Dennerstein, 1994;MacDonald & Feifel, 2012;Zhang et al., 2015). This research has focused predominantly on individuals' sexual experiences, as opposed to couples' interactions, and has investigated oxytocin in response to sexual behavior primarily in lab settings, rather than naturally occurring hormonal changes during sexual activity in the home environment. ...
This study explored the role of the hormone oxytocin in 49 emerging adult couples’ communication after sexual activity. Guided by the post sex disclosures model, the findings indicated that post sex oxytocin levels, but not increases in pre to post sex oxytocin, were associated with men's general assessments of the benefits and risks of disclosing after sexual activity (measured separately from the sexual episode). Additionally, women's and men's benefit assessments were positively associated, and their risk assessments were negatively associated, with positive disclosures after sex. The findings offer the first known test of couples’ oxytocin levels during a naturally occurring sexual episode in the home environment and have implications for researchers interested in the links between oxytocin and human behavior.
... In particular, we found that oxytocin systemic treatment significantly shortened the latency to the first mount, intromission and ejaculation, suggesting an increase in sexual activity. In men, it is suggested that an increased oxytocin level in the circulation influences libido, penile reflexes, and orgasm [21][22][23]. In male rats, oxytocin levels in cerebrospinal fluid doubled 5 minutes after ejaculation and tripled 20 minutes after ejaculation [24]. ...
Oxytocin is produced in the hypothalamus and stimulates uterine contraction and milk ejection. While many people consider oxytocin to be a female hormone, it is reported that, in men, the plasma oxytocin level increases markedly after ejaculation. However, this aspect of oxytocin physiology is poorly understood. The spinal ejaculation generator (SEG), which expresses the neuropeptide, gastrin-releasing peptide (GRP), can trigger ejaculation in rats. Therefore, we focused on systemic effects of oxytocin on the GRP/SEG neuron system in the lumbar spinal cord controlling sexual activity in male rats. We found that systemic administration of oxytocin significantly shortened the latency to the first mount, intromission and ejaculation during male copulatory behavior. In addition, the local oxytocin level in the lumbar cord was significantly higher in males than in females. Histological analysis showed that oxytocin-binding is apparent in spinal GRP/SEG neurons. We therefore conclude that oxytocin influences male sexual activity via the SEG.
... Sexual Desire Sexual desire was originally considered primarily a biological and physiological function (Beach, 1956;Masters & Johnson, 1966), comprising hormonal mechanisms such as dopamine (Pfaus, 2009), norepinephrine (Meston, Gorzalka, & Wright, 1997), and oxytocin (MacDonald & Feifel, 2012). More recently, research has also suggested that sexual desire is formed from psychological and social factors, such as negative sexual beliefs (Nobre, 2009), mindfulness (Brotto, Basson, & Luria, 2008), sexual scripts (McCarthy & McDonald, 2009), education (Laumann, Paik, & Rosen, 1999), and relational context (Basson, 2001(Basson, , 2003. ...
Previous scholars have found that when individuals feel that pornography use is uncontrollable, it is linked to more extreme negative outcomes than frequency of use. With a Mechanical Turk sample of 1421 individuals, we used structural equation modeling to evaluate how multiple aspects of sexual desire (sexual drive and dyadic desire) and multiple aspects of sexual passion expression (harmonious, obsessive, and inhibited) were associated with both pornography use frequency and perceived compulsivity to pornography. In general, sexual desire was more connected to pornography use and sexual passion was more connected to perceived compulsivity. Specifically, sexual drive was associated with higher pornography use, whereas both obsessive and inhibited sexual passion were associated with higher perceived compulsivity. The study should help scholars, clinicians, and policy makers to identify factors that can help to overcome potentially problematic pornography use and approach this subject with more nuance.
... While early investigations in humans centered on the effects of prolonged exposure to OT in the context of labor and post-partum (Bell et al., 2014;Gimpl and Fahrenholz, 2001), recent work has more broadly investigated OT modulation of sexual function and behavior (Behnia et al., 2014;Burri et al., 2008;Carter, 1992). Single-dose trials and case reports indicating an association between OT administration and enhanced sexual function have warranted investigations on chronic OT administration as a potential treatment for sexual dysfunction (Anderson-Hunt and Dennerstein, 1994;IsHak et al., 2008;MacDonald and Feifel, 2012). ...
Oxytocin (OT) subserves various physiological, behavioral, and cognitive processes. This paired with the ability to administer OT with minimal and inconsistent side effects has spurred research to explore its therapeutic potential. Findings from single-dose studies indicate that OT administration may be beneficial, at least under certain circumstances. The state of the field, however, is less clear regarding effects from chronic OT administration, which more closely resembles long-term treatment. To address this gap, this review synthesizes existing findings on the use of chronic OT administration in animal and human work. In addition to detailing the effects of chronic OT administration across different functional domains, this review highlights factors that have contributed to mixed findings. Based on this review, a basic framework of interrelated regulatory functions sensitive to chronic OT administration is offered. The paper also identifies future research directions across different contexts, populations, and outcomes, specifically calling for more systematic and standardized research on chronic OT administration in humans to supplement and expand what is currently known from preclinical work.
... Recently, Oxt draws much attention for its therapeutic potential to treat hyperphagia and obesity, as well as autism [10] and social anxiety disorder [11]. Notably, not only central [8,12] but peripheral (intraperitoneal (IP) and subcutaneous) infusion of sub-chronic Oxt decreases food intake and body weight in high fat diet-induced obese mice and rats [12,13] and obese subjects [14] including Prader-Willi syndrome patients [15] when administered nasally. ...
... [5][6][7] Moreover, OXT seems to be positively related to the intensity of muscle contraction of the pelvic floor in women during orgasm. [5][6][7][8][9] Individual case observations reporting pronounced sexual arousal in females, 10,11 occurrence of an orgasm in anorgasmic males, 12 and improvement in sexual function in a male patient with social anxiety 13 give reason to assume a facilitating role of OXT in terms of sexual experience and function. More generally, it is assumed that OXT has an effect on sexual satiety. ...
Purpose:
The neuropeptide oxytocin (OXT) has a variety of physiological functions in maternal behavior and attachment including sexual behavior. Based on animal research and our previous human studies, we set out to investigate intranasal administration of OXT and hypothesized that OXT should be able to modulate sexual function in women.
Methods:
In a double-blind, placebo-controlled, crossover laboratory setting, the acute effects of intranasal administered OXT (24 international units) on sexual drive, arousal, orgasm, and refractory aspects of sexual behavior were analyzed in 27 healthy females (mean age ± SD, 27.52 ± 8.04) together with physiological parameters using vaginal photoplethysmography.
Findings:
Oxytocin administration showed no effect on subjective sexual parameters (eg, postorgasmic tension; P = 0.051). Physiological parameters (vaginal photoplethysmography amplitude and vaginal blood volume) showed a response pattern towards sexual arousal but were not affected by OXT.
Implications:
Using a well-established laboratory paradigm, we did not find that intranasal OXT influences female sexual parameters. Also, sexual drive and other functions were not affected by OXT. These findings indicate that OXT is not able to significantly increase subjective and objective parameters of sexual function in a setting with high internal validity; however, this might be different in a more naturalistic setting.
... Oxytocin is a nanopeptide associated with social affiliative behaviors, including intimacy and sexual behavior. Oxytocin has been shown to improve male sexual function and arousability (Burri et al., 2008;MacDonald and Feifel, 2012), but its role in female sexual function is complex and poorly understood. Preclinical studies demonstrated oxytocin administration increases sexual receptivity in female rats (Lee et al., 2010). ...
... While effortful control was negatively associated with oxytocin, a positive control was found with orienting sensitivity. Oxytocin positively impacted a number of components of sexual function, including libido, erection, and orgasm (MacDonald & Feifel, 2012), and future research should address whether it is related to CSB as well. Skuse et al. (2014) highlighted the connection between oxytocin and social recognition abilities, with polymorphism in OXTR (oxytocin receptor) playing a conserved role in modulating social recognition abilities across perceptual boundaries through evolution, from rodents to humans. ...
Background:
Adolescent compulsive sexual behavior (CSB), and its associations with other personality predispositions (attachment orientations, temperament), gender, religiosity, and psychopathological tendencies. Five alternative empirical models were examined, all based on current theory and research on CSB.
Methods:
The sample include 311 high-school adolescents (184 boys, 127 girls) ranging in age from 16 to 18 (M = 16.94, SD = .65) and enrolled in the eleventh (43.4%) and twelfth (56.6%) grades completed self-report measures tapping CSB and the above-mentioned variables.
Results:
One model was found to be compatible with the data, indicating that CSB is an independent disorder from other psychopathological tendencies and associated with religiosity, gender, temperament, and attachment orientations.
Conclusions:
Findings have implications for understanding the meaning of adolescent CSB as a psychological disorder and treating it differently from other disorders.
... 4 In addition, many urologists have become interested in oxytocin, which has been shown to have some value in sexual function, and is used sublingually and intranasally, and, of interest here, particularly because only compounders can provide these preparations. 5,6 Also, there are reports that yohimbine, compounded as an oral dose has been shown to enhance the orgasmic experience in men. In men with ejaculation disorders, yohimbine was started at 20-mg doses titrated up to 40-mg in 5-mg increments. ...
There are a lot of options that pharmacists, including compounding pharmacists, can offer urologists to assist their patients. Compounding pharmacists are in a great position to offer unique, effective preparations for many of the conditions urologists treat on a daily basis. It would be well worth the time to learn a little about the conditions these specialists treat and become familiar with what you can offer.
... Oxytocin has also been associated with smooth muscle relaxation with an estrogenic effect in the penis which contribute to detumesence after orgasm in rabbits [117]. The use of oxytocin as a nasal or sublingual administration have been tried with various success [118][119][120]. ...
Ejaculation is a complex event that involves the autonomic, somatic, and central nervous systems working together with physiologic coordination of muscular contractions. With such a complex array of intricate processes, many things can go awry.
Delayed ejaculation (DE) is overall a very poorly understood ejaculatory disorder with low quality data in terms of incidence, pathology, diagnosis, and treatment. In this chapter, we summarize the proper assessment of DE patients and highlight not only the medical conditions contributing to the disorder but also the psychologic ailments. Treatment is outlined based on pathology and an algorithm will be presented for treatment of ejaculatory disorders. With appropriate treatment many of those afflicted will be able to find relief. Nonetheless, ongoing DE research is still needed.
... Pharmacologic interventions may help with reaching orgasm. Taking the hormone oxytocin intra-nasally during sexual activity, shortly before desired time of orgasm, helps some men with achieving orgasm [29,30], though larger randomized controlled trials have not found consistent evidence for efficacy [31]. The drug cabergoline may also help orgasmic function by interfering with the release of prolactin, a hormone that has a role in governing a man's refractory period, or time between orgasms [32,33]. ...
An estimated 14 million new cases of cancer occur each year worldwide. Over 15 million people in the United States are cancer survivors. Reintegrating sexuality and intimacy is a challenge for many survivors and is the focus of this chapter. The two most common cancers in the US, breast and prostate cancers, directly affect sexual organs, and many other common cancers have direct or indirect effects on sexuality and sexual function. Treatment providers at all levels of oncology care have a role in assessing and addressing concerns related to sex and intimacy. Recent studies in oncology settings indicate a discrepancy between patients’ interest in addressing sexual concerns with their providers, and actually receiving care for such concerns. This chapter addresses (a) barriers to health care providers’ addressing sexual concerns as well as language, resources, treatment options, and referrals that will allow providers to feel more comfortable in discussing sexual topics; (b) common sexual concerns for men and women surviving cancer; and (c) risk factors, assessment, and physical/medical and psychosocial intervention strategies for common concerns.
... Oxytocin is increasingly being explored as a possible treatment for a number of psychopathologies and psychiatric disorders, including autism (Guastella et al., 2010(Guastella et al., , 2015Hollander et al., 2007), social anxiety disorder (Guastella et al., 2009;MacDonald and Feifel, 2012), Prader-Willi Syndrome (Einfeld et al., 2014), schizophrenia , alcohol withdrawal and drug addiction (McGregor and Bowen, 2012;Pedersen et al., 2013). Treatment typically involves intranasal, or sometimes intravenous injection of the peptide due to the lack of viability of oral peptide administration (MacDonald and Feifel, 2013;Neumann et al., 2013). ...
Peripherally administered oxytocin induces a wide range of behavioural and physiological effects that are thought to be mediated by the oxytocin receptor (OTR). However, oxytocin also has considerable affinity for the vasopressin 1A receptor (V1AR), such that various oxytocinergic effects may in fact be mediated by the V1AR rather than the OTR. Here we used c-Fos immunohistochemistry to determine the extent to which the regional pattern of neuronal activation produced by peripheral oxytocin involves the V1AR. Male Wistar rats were administered oxytocin (1 mg/kg, IP) alone, or following pre-treatment with the V1AR antagonist SR49059 (1 mg/kg, IP), and were assessed for locomotor activity changes and for c-Fos expression across a number of brain regions. Oxytocin reduced the distance travelled by rats during a 70 min test session, and this inhibitory behavioural effect was prevented by SR49059. Consistent with previous reports, oxytocin increased c-Fos expression in a number of brain regions. In several of these regions − the supraoptic and paraventricular (PVN) nuclei of the hypothalamus, locus coeruleus and nucleus of the solitary tract − the c-Fos response was prevented by SR49059 pre-treatment. Notably, SR49059 inhibited the c-Fos activation in oxytocin-synthesising magnocellular neurons in the PVN. However, c-Fos expression in the central amygdala to oxytocin was unaffected by SR49059. The current findings add to an increasing body of research suggesting that many of the functional effects of oxytocin may be V1AR mediated.
... Oxytocin cell bodies located in the hypothalamus are involved in the lordosis response of female rats and the ejaculation response of male rats. Anecdotal evidence from a single case study has suggested that intranasal administration of oxytocin significantly increased sexual desire in a male receiving the drug for treatment of anxiety (MacDonald & Feifel, 2012). ...
... However, it should be noted that, with few exceptions, 10,11,18 these studies were performed in rodents, and to our knowledge, no human studies relating oxytocin and serotonin measurements with sexual function are available. Two single cases of male sexual dysfunction (not caused by SSRIs) were reportedly improved by intranasal oxytocin 22,23 ; however, when intranasal oxytocin was administered to 10 male volunteers, a moderate but significant delay of ejaculation was recorded. 11 ...
Introduction: Serotonin reuptake inhibitors (SRIs) are widely used for the treatment of psychiatric disorders, including obsessive-compulsive disorder (OCD). SRIs commonly cause delayed orgasm, the mechanism of which is poorly understood. Oxytocin is involved in sexual function and is interconnected with serotonin within the brain. SRIs are reported to affect the oxytocin system, but possible relations between SRI-induced changes of sexual function and oxytocin are unexplored in humans. In a randomized, double-blinded, placebo-controlled trial of OCD, the anti-obsessive efficacy and adverse events of SRIs and oxytocin measurements were studied.
Aims: To identify possible correlates between oxytocin levels and sexual function; find out whether sexual side effects correlate with levels of oxytocin and/or paroxetine and clomipramine; and test whether changes in sexual functioning are related to an anti-obsessive response.
Methods: Reported sexual function and oxytocin plasma levels at rest were studied in 31 adults (15 men and 16 women) with OCD who participated in a randomized, double-blinded trial comparing the SRIs clomipramine and paroxetine with placebo. Sexual adverse effects were quantified by a clinician-administered semistructured interview. Anti-obsessive response was based on the Yale-Brown Obsessive-Compulsive Scale.
Main Outcome Measures: Ratings on the Sexual Symptom Checklist, plasma oxytocin, serum paroxetine and clomipramine levels, and Yale-Brown Obsessive-Compulsive Scale scores.
Results: Baseline oxytocin levels were positively correlated with baseline OCD severity, but not with sexual functioning. Impaired orgasm at week 6 was reported by 73% of SRI-treated and 20% of placebo-treated patients (P = .03). Impaired orgasm was related to higher oxytocin levels after 4 weeks of SRI treatment (P < .01) but not to SRI concentrations. In men, an association between impaired orgasm and anti-obsessive treatment response was found (P = .028).
Conclusion: This pilot study suggests that some collateral effects of SRIs, particularly delayed orgasm, might be influenced by changes within the oxytocinergic system and are related to anti-obsessive mechanisms. Early-onset delayed orgasm in SRI-treated patients could serve as a predictor for OCD treatment response.
... 56 Two case reports described improvement in orgasm with the use of oxytocin, one man with social avoidance and relational problems and the other with anorgasmia. 57,58 Afibrinogenemia and syndrome of inappropriate antidiuretic hormone secretion are significant side effects associated with this medication. ...
Introduction:
Delayed ejaculation (DE) is a poorly defined disorder that entails the delay or absence of orgasm that results in personal distress. Numerous causes of DE exist, and management must be tailored to the specific etiology to maximize treatment success. Management strategies include psychological and sexual therapy, pharmacotherapy, and penile vibratory stimulation.
Aim:
This article intends to review the pathophysiology and treatment options for DE discussed in the literature to date.
Methods:
A review of the literature was performed to identify and evaluate the existing data on treatment success for the various forms of DE management.
Main outcome measures:
Each treatment option was evaluated for method of administration, data supporting its success for DE, and potential risks or side effects.
Results:
Different psychosexual therapy strategies have been described for DE but with limited data to describe efficacy. There is no medication for DE approved by the United States Food and Drug Administration. The quality of evidence supporting the off-label use of medications for DE is low. However, there are numerous medications reported in the literature suggested to treat the condition. Cabergoline and bupropion are the two most commonly used. In addition, penile vibratory stimulation has been described as an adjunct treatment option for DE.
Conclusion:
There are different treatment options reported for DE, all with limited evidence supporting their efficacy. Identifying the etiology of the DE is important to appropriately target therapy. A multimodal approach combining psychosexual therapy with medications and/or penile vibratory stimulation will likely provide the best outcomes.
... Another intriguing potential clinical implication is the possibility of intranasal OT administration as a treatment for separation anxiety in youth. Studies have preliminarily examined the potential efficacy of intranasal OT for anxiety disorders, with mixed results, but have not yet focused on youth or on separation anxiety disorder (Feifel, 2011;Guastella et al., 2009;MacDonald and Feifel, 2012).OT administration is also being explored as a possible treatment for other disorders characterized by abnormal interpersonal behavior, such as autism (Andari et al., 2010). Replication of the current results would suggest the possibility of exploring OT administration as an independent or adjunct treatment strategy for youth with separation anxiety, particularly in cases of high family accommodation. ...
... Circulating levels of oxytocin are known to increase during sexual arousal and orgasm in both men and women (122). It is interesting that intranasal oxytocin was reported to increase libido and related sexual behavior in a male subject (123). ...
Mast cells (MCs) are ubiquitous in the body, but they have historically been associated with allergies, and most recently with regulation of immunity and inflammation. However, it remains a puzzle why so many MCs are located in the diencephalon, which regulates emotions and in the genitourinary tract, including the bladder, prostate, penis, vagina and uterus that hardly ever get allergic reactions. A number of papers have reported that MCs have estrogen, gonadotropin and corticotropin-releasing hormone (CRH) receptors. Moreover, animal experiments have shown that diencephalic MCs increase in number during courting in doves. We had reported that allergic stimulation of nasal MCs leads to hypothalamicpituitary adrenal (HPA) activation. Interestingly, anecdotal information indicates that female patients with mastocytosis or mast cell activation syndrome may have increased libido. Preliminary evidence also suggests that MCs may have olfactory receptors. MCs may, therefore, have been retained phylogenetically not only to "smell danger", but to promote survival and procreation.
... A rise in oxytocin following affectionate touch may explain findings that duration of foreplay is associated with orgasm frequency and consistency (Brody and Weiss 2010;Gebhard 1966;Singh et al 1998). Furthermore, oxytocin induces and maintains sexual receptivity in rodents (e.g., Arletti et al. 1990;Benelli et al. 1994;Caldwell 1986;Cushing and Carter 1999;Pedersen and Boccia 2002), and may facilitate sexual arousal and orgasm in humans as well (Anderson-Hunt and Dennerstein 1994;IsHak et al. 2010;MacDonald and Feifel 2012). Thus, though the oxytocin surge experienced at orgasm likely increases the emotional closeness a woman feels with her partner, oxytocin also appears to facilitate sexual responsivity and orgasm. ...
The difficulty of inducing orgasm in women, its variability between women, and the lack of an obvious relationship with women’s reproductive success have led some researchers to conclude that female orgasm is a nonfunctional by-product of developmental pathways that women share with men. Other researchers have presented evidence that orgasm is an adaptation in women. In this chapter, we review the evidence for these opposing points of view and find that a functional hypothesis receives greater support. First, we discuss the phenomenological, anatomical, and neurological correlates of women’s orgasm, which are generally inconsistent with the idea that female orgasm is a by-product. We then present evidence that female orgasm enhances the likelihood of conception, and we summarize evidence that female orgasm functions as a mechanism for choosing mates of high genetic quality, investment potential, or both. Finally, we outline directions for future research that will help to resolve the debate about the functionality of orgasm in women.
... However, a group of OXT neurons originating from the PVN and projecting to extra-hypothalamic areas might be accepted to control penile erection and ejaculation in male rats [7,[36][37][38][39]. OXT has also been reported to positively impact upon a number of components of sexual function in men, including libido, erection, and orgasm [40][41][42]. Intracerebroventricular administration of OXT induces a dose-dependent increase in the number of penile erections and yawning episodes in male rats [43]. Because penile erection and yawning induced by either OXT or apomorphine were antagonized by pretreatment with OXT antagonists in a dose-dependent manner, dopamine may induce these responses by releasing OXT [43]. ...
Neural circuits underlying male sexual function comprise several nuclei located in the brain and spinal cord. We have previously demonstrated in rats that the gastrin-releasing peptide (GRP) system influences spinal centers promoting penile reflexes. Moreover, a group of oxytocin (OXT) neurons, situated in the parvocellular part of the paraventricular nucleus of the hypothalamus, project into the spinal cord and control penile reflexes. Therefore, it has been hypothesized that OXT is transported by long descending paraventriculospinal pathways and activates proerectile spinal centers. Consequently, we have shown that in rats, axonal distribution of OXT in the lumbar spinal cord exhibits a male-dominant sexual dimorphism. Furthermore, OXT binding is observed in the spinal GRP neurons. Thus, OXT axons may secrete OXT from spinal axonal terminals and regulate male sexual function via an OXT receptor-mediated mechanism in spinal GRP neurons. Future studies should address the relationship between the hypothalamic OXT and spinal GRP systems. Identification of the male-specific brain-spinal cord neural circuit that regulates male sexual behavior may provide new avenues for therapeutic approaches to masculine reproductive dysfunction, including erectile dysfunction and/or ejaculation disorder.
... 56 Two case reports described improvement in orgasm with the use of oxytocin, one man with social avoidance and relational problems and the other with anorgasmia. 57,58 Afibrinogenemia and syndrome of inappropriate antidiuretic hormone secretion are significant side effects associated with this medication. ...
Delayed ejaculation (DE) is a challenging disorder to treat. Many clinicians are not comfortable dealing with DE due to a lack of treatment approaches supported by evidence-based medicine. In this review, we discuss the most common treatments and the latest studies that support each DE treatment. The goal of our review is to help clinicians identify and treat patients who present with this disorder. An integrative approach using medications, penile vibratory stimulation, and sexual counseling is important for successful treatment of DE. We propose an algorithm for DE treatment to help guide clinicians. However, an individualized treatment plan should be developed for each unique case due to the multifactorial etiology of DE.
... Oxytocin release seems to play a further role in social interactions and intimate bonding. In studies of sexual function, oxytocin was shown to increase the sympathetic outflow in men during sexual events with a subjective perception of increased arousability (5), to improve male sexual function including ejaculation (6,7), and to promote sexual arousal in lactating women, as reported in few cases (8). Recently, the acute effects of intranasal oxytocin administered to heterosexual couples were investigated and resulted in increased intensity of orgasm, contentment, and sexual satiety in men (9). ...
To assess the effect of on-demand intranasal oxytocin administration on female sexual function and activity.
Randomized, prospective, double-blind, placebo-controlled, crossover trial with duration of 22 weeks.
Academic medical center.
Thirty pre-and postmenopausal women with sexual dysfunction.
Over 8 weeks, intranasal oxytocin (32 IU) or placebo self-administered by women within 50 minutes before sexual intercourse; after a washout period of 2 weeks, crossover with patients switched to the alternate group for another 8 weeks.
Primary outcome parameter: Female Sexual Function Index (FSFI); secondary outcome parameters: Female Sexual Distress Scale (FSDS), Sexual Quality of Life-Female (SQOL-F), Sexual Interest and Desire Inventory-Female (SIDI-F), and Hamilton depression scale (HDS).
After oxytocin and placebo, the FSFI score increased by 26% and 31%, SQOL-F score by 144% and 125%, and SIDI-F score by 29% and 23%, respectively (repeated measures analysis of variance between groups). After oxytocin and placebo, the FSDS score decreased by 36% and 45%, respectively (repeated measures analysis of variance between groups). There was no statistically significant treatment, sequence (placebo first/second), or interaction effect.
Long-term intranasal oxytocin and placebo administration both improved sexual function and symptoms of depression in women over time with no treatment, sequence (placebo first/second), or interaction effect.
NCT02229721.
Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
... It was unexpected that oxytocin would increase VTA activation to sexual images as it did not increase subjective arousal to sexual images. However, intranasal oxytocin has been shown to improve sexual functions such as libido, erection and orgasm in males (MacDonald and Feifel, 2012) and is released during rewarding sexual activity (paced mating) in female rats (Nyuyki et al., 2011) and orgasm in humans (Blaicher et al., 1999). Oxytocin may play a role in the rewarding aspects of sex or at least in the processing of sexually explicit material. ...
After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother-infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual desire was positively correlated with VTA activation to sexual images and with SES. Our findings show that postpartum decreases in sexual desire may in part be mediated by VTA activation, and oxytocin increased activation of the VTA but not NAc in response to sexual and infant stimuli. Oxytocin may contribute to the altered reproductive priorities in postpartum women by increasing VTA activation to salient infant stimuli.
Copyright © 2014. Published by Elsevier Inc.
... On the other hand, it is well accepted that a group of OXT-ergic neurones originating in the PVN and projecting to extrahypothalamic areas (e.g., hippocampus, medulla oblongata and spinal cord) control penile erection and sexual behaviour in male rats [5]. It has been reported that OXT positively impacted on a number of components of sexual function, including libido, erection, and orgasm in men [6][7][8]. The intracerebroventricular administration of OXT also induced a dose-dependent increase in the number of penile erections and yawning episodes in male rats, suggesting a physiological role of hypothalamic OXT in the regulation of such responses [9]. ...
... However, it is intimately involved in normative social and psychological functions including maternal behaviors, attachment and affiliation associated with pair bonding, depressive mood, anxiety, memory, appetite, sexual function and stress regulation [e.g., [23][24][25][26][27][28][29][30][31][32][33][34]. Clinically, OXY has been used in the treatment of autism [35], sexual dysfunction [36], migraine [37], schizophrenia [38], drug addiction [39] and other CNS dysfunctions [40]. Extensive clinical use in experimental studies has identified few toxicities of OXY treatment [41] apart from those associated with accidental overdose [42,43] or use with co-morbidities such as gastroparesis [44]. ...
The treatment of chronic pain arising from deep tissues is currently inadequate and there is need for new pharmacological agents to provide analgesia. The endogenous paracrine hormone/neurotransmitter oxytocin is intimately involved in the modulation of multiple physiological and psychological functions. Recent experiments have given clear evidence for a role of oxytocin in the modulation of nociception. The present article reviews the existent human and basic science data related to the direct and indirect effects of oxytocin on pain. Due to its analgesic, anxiolytic, antidepressant and other central nervous system effects, there is strong evidence that oxytocin and other drugs acting through the oxytocin receptor could act as multifunctional analgesics with unique therapeutic value.
Oxytocin, known as the "love hormone," is believed to influence mating behavior significantly. This study investigates the intricate relationship between oxytocin levels and mating behavior among women aged 24-30 in Ilorin, Nigeria, using a multifaceted approach. Through biochemical assays, self-report questionnaires, and qualitative interviews, the research explores how oxytocin shapes mating behavior and its broader implications for social and reproductive functioning.
In the past decade, there has been an increased focus on the role of physiology in interpersonal interactions, resulting in a surge of research exploring topics related to communication in close relationships. This growing line of research has explored topics such as affectionate communication, forgiveness, communication apprehension, and social support. Contributing to the increase in physiological research on communication processes is a greater recognition of the bidirectional nature of the associations among communication and the body. Researchers studied both the physiological outcomes of communication episodes (e.g., stress responses to conflict conversations) and the effects of physiology on the communication process (e.g., the influence of hormones on postsex communication). The Oxford Handbook of the Physiology of Interpersonal Communication offers a comprehensive review of the most prolific areas of research investigating both the physiological outcomes of interpersonal communication and the effects of physiology on interpersonal interactions. This edited volume serves as a resource for both researchers and students interested in investigating the mutual influence of physiology and communication in close relationships.
Premature ejaculation (PE) can be a very distressing condition and has been studied for many years. However, there exists confusion about the definition, incidence, and management of this condition. Treatment through pharmacotherapy has been focussed on topical agents along with oral antidepressant medications. The use of sexual psychology can also play a role in treatment of PE, often when added to medical therapies. Other alternative medical treatments have also been used with mixed outcomes. Although there is no perfect treatment for PE that works for every patient every time, there is ongoing research for the optimal therapy for men who complain about this problem. A review of the current understanding and medical management of PE will be set in this paper along with potential future treatments.
Sexuality is an important component of human life that can be experienced and expressed in various ways. The interplay of biological, psychological, and social elements has an impact on sexuality. Because sexuality is a multi-causal, multidimensional complex phenomenon, sexual health and dysfunction should be addressed through a multidisciplinary biopsychosocial framework. The biopsychosocial model (BPS) is a paradigm that allows a clinician to explore the cause of a condition or disease based on a combination of biological, psychological, and social factors, and if so, to guide the diagnosis, education, and treatment process using as much evidence-based information as possible. The main principles of the BPS model and the algorithm for the management of sexual dysfunction are discussed in this chapter. When it comes to rare sexual medicine disorders, where evidence and knowledge are scarce, using a BPS approach is a must, as it can lead to a better understanding of the factors at play and, at the very least, allow treatments to be tailored to the patient’s needs.
It is always a challenge to encapsulate water-soluble peptides in polymer nanoparticle (NP) systems. We establish and validate our newly developed non-aqueous nanoprecipitation method to encapsulate neuro-peptides drugs such as oxytocin and Luteinizing hormone-releasing hormone (LHRH) in poly(sebacic anhydride) (PSA) NPs. NPs were prepared by a solvent-antisolvent process under a strict anhydrous environment to obtain high drug loading and to avoid premature PSA degradation and drug release. Dynamic light scattering (DLS) and Scanning Electron Microscopy (SEM) reveal the size for both drug loaded PSA NPs to ∼300 nm. The drug loaded NPs were dispersible and spherical in shape with uniform morphology. The in vitro release profile of oxytocin from PSA NPs occurs with the burst release of ∼50% within the first hour in the aqueous release medium, whereas LHRH release is comparatively slow. Thus, looking into the fast degrading properties of PSA and drug release behavior, the developed NPs can be used for direct delivery of the neuropeptides to the olfactory epithelium using a refillable nasal atomizer that deposits mist onto the olfactory neuro-epithelium. We also applied our developed method to prepare NPs of poly(lactic-co-glycolic acid) (PLGA), polylactic acid (PLA), and poly(ε-caprolactone) (PCL). A Thyrotropin releasing hormone (TRH) was used as the sample neuropeptide drug to validate our non-aqueous method. The results reveal the formation of TRH loaded PLGA, PLA and PCL NPs with 100% drug loading. TEM analysis shows the formation of spherical NPs, having similar release properties as those of PSA NPs. Overall, we report that our developed method is suitable for co-encapsulating hydrophilic drugs in polymer NPs with high drug loading and release properties.
Introduction:
As survival rates for women with breast cancer (BC) continue to improve, sexual dysfunction including low sexual desire is becoming more prevalent. BC diagnosis, treatment, and treatment-induced changes have been shown to affect sexual desire in BC survivors. Understanding low sexual desire and current treatment options will allow practitioners to address it efficaciously to allow for an improved quality of life in women with BC.
Objectives:
To review the literature regarding the prevalence, predictors, and current treatments for low sexual desires in BC survivors.
Methods:
We performed a PubMed search for English-language articles in peer-reviewed journals between 2005-2021. We used the following keywords: "breast cancer" and "sexual function," "sexual dysfunction," "hypoactive sexual desire disorder", "sex drive" or "sexual desire." Articles featuring a study or survey that evaluated sex drive in women BC survivors or patients, its identification, management or treatment, were reviewed.
Results:
A total of 37 studies that evaluated the relationship between BC, its treatments and treatment-induced effects on BC survivors and sexual desire were included. Studies indicate that low sexual desire persists throughout the timeline of BC survivors, from BC diagnosis to after treatment. Surgical treatment, body image, and adjuvant hormone therapy are a few factors that influence low sexual desire in BC survivors. Treatment options are efficacious at varying levels and include non-pharmacologic, pharmacologic, and hormonal therapies.
Conclusions:
Low sexual desire is prevalent in BC patients and survivors. More research is needed to better evaluate the safety and efficacy of treatment options, particularly pharmacologic and hormonal therapy. Luo F, Link M, Grabenhorst C, et al. Low Sexual Desire in Breast Cancer Survivors and Patients: A Review. Sex Med Rev 2022;10:367-375.
Oxytocinergic neurons in the paraventricular nucleus of the hypothalamus that project to extrahypothalamic brain areas and the lumbar spinal cord play an important role in the control of erectile function and male sexual behavior in mammals. The gastrin-releasing peptide (GRP) system in the lumbosacral spinal cord is an important component of the neural circuits that control penile reflexes in rats, circuits that are commonly referred to as the “spinal ejaculation generator (SEG).” We have examined the functional interaction between the SEG neurons and the hypothalamo-spinal oxytocin system in rats. Here, we show that SEG/GRP neurons express oxytocin receptors and are activated by oxytocin during male sexual behavior. Intrathecal injection of oxytocin receptor antagonist not only attenuates ejaculation but also affects pre-ejaculatory behavior during normal sexual activity. Electron microscopy of potassium-stimulated acute slices of the lumbar cord showed that oxytocin-neurophysin-immunoreactivity was detected in large numbers of neurosecretory dense-cored vesicles, many of which are located close to the plasmalemma of axonal varicosities in which no electron-lucent microvesicles or synaptic membrane thickenings were visible. These results suggested that, in rats, release of oxytocin in the lumbar spinal cord is not limited to conventional synapses but occurs by exocytosis of the dense-cored vesicles from axonal varicosities and acts by diffusion—a localized volume transmission—to reach oxytocin receptors on GRP neurons and facilitate male sexual function.
Das Problem der verzögerten Ejakulation ist so etwas wie das Stiefkind unter allen sexuellen Funktionsstörungen. Die verzögerte Ejakulation ist sicher die seltenste sexuelle Dysfunktion des Mannes, doch wiederum auch nicht so selten, dass es sich nicht lohnen würde, sie besser zu erforschen und neue Behandlungsstrategien zu entwickeln. Aufgrund ihrer relativ geringen Prävalenz und ihres Rufs, eine schlechte Therapieprognose zu haben, ist sie jedoch weder bei Therapeuten noch bei Sexualforschern besonders „beliebt“, und der Kenntnisstand ist deutlich begrenzter als bei der vorzeitigen Ejakulation (EP). Anders als bei der EP, bei der durch repräsentative Erhebungen und Expertenkonsens praktikable Definitionen und Grenzwerte entwickelt worden sind (s. Kap. 14), liegen eine solche Datenbasis sowie konsentierte operationalisierte Merkmale bei der verzögerten Ejakulation nicht vor. Hinzu kommen Unschärfen in der Klassifizierung und Terminologie und wechselnde diagnostische Kategorisierungen. So wurde diese Dysfunktion im DSM-IV noch als „männliche Orgasmusstörung“ codiert, während DSM-5 sich für den in der somatischen Medizin gebräuchlicheren Terminus „verzögerte Ejakulation“ entschied, welcher die Variante der fehlenden oder ausbleibenden Ejakulation inkludiert. Beide Klassifikationen ermöglichen keine Differenzierung zwischen Orgasmus und Ejakulation, die zwar beim Mann in der Regel synchrone Vorgänge sind, aber gleichwohl auf verschiedenen nervalen Schaltkreisen und unterschiedlichen Transmittersystemen beruhen (Waldinger und Schweitzer 2005). Wir werden in Abschn. 15.3 die aktuelle Störungsdefinition und ihre Vorzüge und Probleme genauer betrachten. In der sexualtherapeutischen Praxis steht der Aspekt der ausbleibenden oder nur selten möglichen Ejakulation meist dann im Fokus, wenn ein Kinderwunsch besteht, während der fehlende oder zumindest nicht beim Geschlechtsverkehr mögliche Orgasmus des Mannes bei jeder sexuellen Begegnung als Manko erlebt wird, welches mit der Zeit immer tiefere Spuren hinterlässt und zu einer zunehmenden Belastung für Sexualität und Paarbeziehung wird. Wir werden daher im Folgenden neben dem Terminus „verzögerte Ejakulation“ auch den Begriff „Orgasmushemmung“ (wobei der Begriff „Hemmung“ ohne ätiologische Implikation benutzt wird) sowie die international gebräuchlichen Abkürzungen DE (für delayed ejaculation) und IE (für inhibited ejaculation – eine Bezeichnung, die in der Regel für die fehlende Ejakulation gebraucht wird) verwenden.
Awareness of the biological and the psychological considerations in sexual performance is crucial in the exploration of treatments that promote sexual enhancement. Biological factors include, but are not limited to, genetic makeup, physical health, and nutrition. Psychosocial factors involve upbringing, belief systems, self-efficacy, relationships, personality, and experiences. Improving and enhancing sexual function pharmacologically include approved and off-label medications and are based partly on research and partly on anecdotal reports. There is a growing body of literature describing pharmacological interventions, but in many cases their utility is hard to establish due to placebo responses, side effect profiles, and negative impact of comorbidities. Nevertheless, this chapter brings a collection of prescription medications for which the evidence for sexual enhancement exists.
Die Zeiten als Oxytozin ausschließlich als Geburts- und Stillhormon galt, sind schon lange vorbei. Es ist zum Kuschel-, Bindungs- und Vertrauenshormon avanciert. Prägt es doch die Qualität zwischenmenschlicher Beziehungen in vielerlei Hinsicht – und nicht nur positiv.
Objective:
To study sexual function, quality of life, and depression in men, whose female partners are undergoing double-blind placebo-controlled randomized treatment for hypoactive sexual desire disorder (HSDD).
Design:
Open prospective cohort study of 22 weeks.
Setting:
Academic medical center.
Patient(s):
Male partners of 30 premenopausal and postmenopausal women with HSDD.
Intervention(s):
Baseline, 3-month, and 5-month assessment (for 8 weeks each) of male response to female partner's use of oxytocin nasal spray (32 IE) and placebo within 50 minutes before sexual intercourse.
Main outcome measure(s):
Primary outcome parameters were Sexual Life Quality Questionnaire-Male, Sexual Activity Record, Partner Performance Questionnaire, and Hamilton Depression Scale.
Result(s):
Male Sexual Life Quality questionnaire improved significantly from -7.4 ± 9.9 at baseline to 8.2 ± 12 with female partners' treatment with oxytocin nasal spray and to 10.8 ± 13.8 with placebo. Frequency of intercourse improved slightly but not significantly from 6.3 ± 3.9 at baseline to 7.3 ± 4 with female oxytocin therapy, but not with placebo. Male desire and arousal remained stable throughout the study period. Evaluation of female partners' performance by men improved significantly from 8.9 ± 2.8 at baseline to 10.6 ± 2.2 with oxytocin and to 11.2 ± 2.6 with placebo.
Conclusion(s):
Female treatment with either oxytocin or placebo for HSDD significantly improves male sexual quality of life and evaluation of female partner's sexual performance with no difference between oxytocin and placebo on any outcome parameters. A nonsignificant improvement was seen in the frequency of intercourse, male arousal, desire, satisfaction, and Hamilton depression scale.
Clinical trial registration number:
NCT02229721.
Orgasm is a sensation of intense pleasure creating an altered consciousness state accompanied by pelvic striated circumvaginal musculature and uterine contractions that induces a state of well-being and contentment. Women’s orgasms can be prompted by erotic stimulation of a variety of genital and nongenital sites. Some women, however, do not reach orgasm despite different partners and different instruments used. These women are the focus of this chapter. While the etiology of FOD remains uncertain, literature has shown multiple risk factors related to FOD classified as: psychological, physiological, sociodemographic, hereditary, and comorbid medical conditions. Multiple psychological conditions can interfere with a woman’s ability to reach orgasm. Such conditions include, but are not limited to, anxiety, depression, attention deficit disorder, body image, sexual abuse, and negative religious views on sex. It is important to rule out insufficient and/or inadequate stimulation before assigning an FOD diagnosis. In addition, comorbidities like vascular disease, diabetes, multiple sclerosis, spinal cord injury, and other pelvic conditions can all exacerbate symptoms of FOD. Lastly, medications such as selective serotonin reuptake inhibitors (SSRIs) and antipsychotics can negatively impact orgasmic potential. With regard to treatment, cognitive and behavioral techniques have been used in cases where the orgasm problems are acquired or manifest themselves only during partnered sex. A number of studies have also shown that androgen and nonhormonal treatments can have beneficial effects in the setting of FOD. Due to the high level of comorbidity with other sexual disorders, most women with FOD will present with a complex combination of problems, requiring a comprehensive assessment that takes into consideration the known correlates of FOD. The diagnosis of FOD should be based on the clinician’s judgment that the woman’s orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.
Orgasm is the third phase of the sexual response cycle. Orgasm also describes the cerebral process of pleasure that is most often associated with ejaculation. Oxytocin and prolactin rise during ejaculation and orgasm, though the hormonal control of orgasm has not been completely elucidated. The most common cause of orgasmic dysfunction is iatrogenic, due to selective serotonin reuptake inhibitors, although anorgasmia associated with delayed ejaculation is also described. Treatment of orgasmic dysfunction is evolving, as there are no FDA-approved medications currently available. Further research is necessary in all aspects of the science of orgasm, especially the treatment of orgasmic dysfunction.
Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically. We also highlighted specific settings where drugs could be introduced to medical practice. Electronic databases were searched from 1966 to February 2016, including PubMed MEDLINE, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google Scholar using key words; delayed ejaculation, retarded ejaculation, inhibited ejaculation, drugs, treatment, or pharmacology. To achieve the maximum sensitivity of the search strategy and to identify all studies, we combined "delayed ejaculation" as Medical Subject Headings (MeSH) terms or keywords with each of "testosterone" or "cabergoline" or "bupropion" or "amantadine" or "cyproheptadine" or "midodrine" or "imipramine" or "ephedrine" or "pseudoephedrine" or "yohimbine" or "buspirone" or "oxytocin" or "bethanechol" as MeSH terms or keywords. There are a number of drugs to treat patients with DE including: Testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. Review of literature showed that evidence level 1 (Double blind randomized clinical trial) studies were performed with testosterone, oxytocin, buspirone or bethanechol treatment. It is concluded that successful drug treatment of DE is still in its infancy. The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care for these patients. Various drugs are available to address such problem, however their evidence of efficacy is still limited and their choice needs to be individualized to each specific case.
Die Zeiten als Oxytozin ausschließlich als Geburts- und Stillhormon galt, sind schon lange vorbei. Es ist zum Kuschel-, Bindungs- und Vertrauenshormon avanciert. Prägt es doch die Qualität zwischenmenschlicher Beziehungen in vielerlei Hinsicht — und nicht nur positiv.
Parkinson's disease is a common neurodegenerative disease diagnosed by well established clinical motor symptoms. However, the disease also encompasses many nonmotor issues that can impact a myriad of processes such as cardiovascular status, gastrointestinal function, autonomic function, mood and sleep. These issues can be more debilitating and impactful on health status in part because of a lack of effective treatments. The pathophysiology of the disease process is under active investigation with postulated mechanisms involving both the central nervous system and the periphery. More in depth examination of the many nonmotor symptoms may aid in the discovery of the overarching pathological origin and progression of Parkinson's disease. Examining the disease process from the perspective of nonmotor symptoms may also provide additional target pathways and potential drug development options not considered previously.
Background: Sexual dysfunction is a well-documented side effect of selective serotonin reuptake inhibitors (SSRIs). Commonly reported side effects include erectile impotence, anorgasmia, ejaculatory delay, pain, loss of sensation, and decreased pleasure. Early reports of the reversal of sexual dysfunction after using sildenafil in male and female patients receiving various types and dosages of SSRIs are promising and prompted this study. Our aim was to evaluate the effects of oral sildenafil on reported secondary sexual dysfunction in patients concurrently treated with SSRIs.
Method: Fourteen male patients who developed sexual dysfunction while receiving SSRIs were screened using the Arizona Sexual Experience (ASEX) scale. An electrocardiogram was obtained at the beginning and at the end of the study. Each patient was prescribed sildenafil tablets to be taken twice a week, 25-100 mg, prior to sexual activity and told to record the findings in a running diary which he was to keep during his treatment period. The patients were seen weekly and evaluated by clinical interview and ASEX scale. Patients were treated for a total of 8 weeks.
Results: All but 1 of the 14 patients experienced an improvement of sexual dysfunction, with 9 patients at the first dose of 25 mg and 4 at higher doses (3 at 50 mg and 1 at 75 mg). One patient required 100 mg to obtain minimal response.
Discussion: Sildenafil was shown to be helpful in the treatment of SSRI-induced sexual dysfunction. Three patients continued to experience ongoing positive effects after discontinuation of sildenafil; the other 10 patients relapsed.
Social adaptation requires specific cognitive and emotional competences. Individuals with high-functioning autism or with Asperger syndrome cannot understand or engage in social situations despite preserved intellectual abilities. Recently, it has been suggested that oxytocin, a hormone known to promote mother-infant bonds, may be implicated in the social deficit of autism. We investigated the behavioral effects of oxytocin in 13 subjects with autism. In a simulated ball game where participants interacted with fictitious partners, we found that after oxytocin inhalation, patients exhibited stronger interactions with the most socially cooperative partner and reported enhanced feelings of trust and preference. Also, during free viewing of pictures of faces, oxytocin selectively increased patients' gazing time on the socially informative region of the face, namely the eyes. Thus, under oxytocin, patients respond more strongly to others and exhibit more appropriate social behavior and affect, suggesting a therapeutic potential of oxytocin through its action on a core dimension of autism.
The purpose of this study was to determine whether plasma oxytocin (OT) levels change during human sexual responses and, if so, to demonstrate the temporal pattern of change. Plasma OT levels were measured by RIA before, during, and after private self-stimulation to orgasm in normal men (n = 9) and women (n = 13). Blood samples were collected continuously through indwelling venous catheters. The subjects pressed a signal to indicate the start and finish of orgasm/ejaculation. Objective assessment of sexual arousal and orgasm was obtained by measuring blood-pulse amplitude and electromyographic activity, recorded continuously throughout testing from an anal device containing a photoplethysmograph and electromyograph electrodes connected to a polygraph located in an adjacent room. These measures allowed collection of data from men and women of changes in blood flow and muscle activity in the lower pelvic/pubic area. Plasma OT levels increased during sexual arousal in both women and men and were significantly higher during orgasm/ejaculation than during prior baseline testing. We suggest that the temporal pattern of secretion could be related to smooth muscle contractions of the reproductive system during orgasm.
The Autism Spectrum Quotient (AQ) has been developed to measure the degree to which an adult with normal intelligence has autistic traits. In this paper it is evaluated for its potential as a screening questionnaire in clinical practice on one hundred consecutive referrals to a diagnostic clinic for adults suspected of having Asperger Syndrome or high functioning autism (AS/HFA). The results indicate that it has good discriminative validity and good screening properties at a threshold score of 26. The implications of these results are discussed.
BACKGROUND: Sexual dysfunction is a well-documented side effect of selective serotonin reuptake inhibitors (SSRIs). Commonly reported side effects include erectile impotence, anorgasmia, ejaculatory delay, pain, loss of sensation, and decreased pleasure. Early reports of the reversal of sexual dysfunction after using sildenafil in male and female patients receiving various types and dosages of SSRIs are promising and prompted this study. Our aim was to evaluate the effects of oral sildenafil on reported secondary sexual dysfunction in patients concurrently treated with SSRIs. METHOD: Fourteen male patients who developed sexual dysfunction while receiving SSRIs were screened using the Arizona Sexual Experience (ASEX) scale. An electrocardiogram was obtained at the beginning and at the end of the study. Each patient was prescribed sildenafil tablets to be taken twice a week, 25-100 mg, prior to sexual activity and told to record the findings in a running diary which he was to keep during his treatment period. The patients were seen weekly and evaluated by clinical interview and ASEX scale. Patients were treated for a total of 8 weeks. RESULTS: All but 1 of the 14 patients experienced an improvement of sexual dysfunction, with 9 patients at the first dose of 25 mg and 4 at higher doses (3 at 50 mg and 1 at 75 mg). One patient required 100 mg to obtain minimal response. DISCUSSION: Sildenafil was shown to be helpful in the treatment of SSRI-induced sexual dysfunction. Three patients continued to experience ongoing positive effects after discontinuation of sildenafil; the other 10 patients relapsed.
Background:
Oxytocin and its receptor have been found throughout the gastrointestinal (GI) tract, where it affects gut function. Clinically, we have noticed an improvement of bowel habits during lactation in constipated women. The aim of this study was to examine whether oxytocin has an effect on bowel symptoms and psychological well being in women with refractory constipation.
Methods:
Fifty-nine women with refractory constipation were included in a double blind, multicentre study. After a 2-week run-in period, they were randomly allocated to nasal inhalation of either placebo or oxytocin treatment twice daily for 13 weeks, followed by a 2 weeks, posttreatment period. The patients completed a questionnaire every day concerning bowel habits, abdominal pain and discomfort, and Gastrointestinal Symptoms Rating Scale (GSRS) and Psychological General Well-being (PGWB) twice during the study; namely, during the baseline period and at the end of the treatment period.
Results:
Both oxytocin and placebo led to improvement of the constipation according to the GSRS and led to improvement in the sensation of incomplete evacuation and anorectal obstruction, without significant differences between the groups. Abdominal pain and discomfort responded weakly to oxytocin, with no effect of the placebo. In a subgroup of patients with IBS and concomitant depression, a weak improvement in depressed mood was observed after oxytocin administartion.
Conclusion:
Nasal administration of oxytocin had no significant advantage over placebo concerning an effect on constipation. However, it seems to have a positive effect on abdominal pain and discomfort and depressed mood. These findings should be further explored.
Oxytocin receptor (OTR) expressed in the rat penis and mediated the contractility of the corpus cavernosum smooth muscle both in vitro and in vivo, and OTR could maintain penile detumescence; however, the expression of OTR in diabetic rat penis remains unknown. In the present study, we investigated the expression of OTR in diabetic rat penis. The experimental rats were randomly divided into control group and STZ-diabetic rats group. The expressions of mRNA and protein were examined by real-time quantitative PCR, Western blotting and immunohistochemistry respectively. Erectile function was evaluated by measuring intracavernous pressure following electrostimulation of the cavernous nerves. mRNA and protein expression of OTR significantly increased in diabetic rats group compared with the control group. Erectile function of diabetic rats group significantly decreased compared with the control group. Our data showed that the expression of OTR significantly increased in diabetic rats group and OTR may involve in the development of diabetic erectile dysfunction.
Oxytocin has numerous prosocial and antipsychotic-like effects in animals. Prosocial effects of acute intranasal oxytocin administration have also been reported in human subjects. We conducted a randomized, placebo-controlled trial testing the effects of twice daily intranasal oxytocin treatment for 14 days on psychotic symptoms and social cognition in patients with schizophrenia. PANSS scores declined significantly and several social cognition measures improved significantly or nearly significantly in oxytocin (N=11) but not placebo (N=9) recipients. Our results suggest that, in addition to reducing classic psychotic symptoms, oxytocin may diminish certain social cognition deficits that are not improved by current antipsychotic medications.
There has been unprecedented interest in the prosocial effects of the neuropeptide oxytocin in humans over the last decade. A range of studies has demonstrated correlations between basal oxytocin levels and the strength of social and bonding behaviors both in healthy individuals and in those suffering from psychiatric disorders. Mounting evidence suggests associations between polymorphisms in the oxytocin receptor gene and prosocial behaviors and there may also be important epigenetic effects. Many studies have now reported a plethora of prosocial effects of intranasal application of oxytocin, including the domains of trust, generosity, socially reinforced learning, and emotional empathy. The main focus of this review will be to summarize human preclinical work and particularly the rapidly growing number of clinical studies which have identified important links between oxytocin and a wide range of psychiatric disorders, and have now started to directly assess its therapeutic potential.
Oxytocin (100 ng) injected unilaterally into the ventral subiculum of the hippocampus induces penile erection episodes, which started 30 min after treatment and were abolished by the prior injection of d(CH(2))(5)Tyr(Me)(2)-Orn(8)-vasotocin (2 μg), an oxytocin receptor antagonist, into the ventral subiculum. Oxytocin-induced penile erection occurred 15 min after the increase of the concentration of extracellular dopamine in the dialysate obtained from either the nucleus accumbens or the prelimbic medial prefrontal cortex, which was also abolished by d(CH(2))(5)Tyr(Me)(2)-Orn(8)-vasotocin. An increase in extracellular glutamic acid concentration was also observed in the same dialysate obtained from the ventral tegmental area, but not from the prelimbic medial prefrontal cortex or the nucleus accumbens in which dopamine concentration was measured, 15 min after the injection of oxytocin into the ventral subiculum. This effect was also abolished by the prior injection of d(CH(2))(5)Tyr(Me)(2)-Orn(8)-vasotocin into the ventral subiculum. These results confirm previous findings showing that ventral subiculum oxytocin-induced penile erection is mediated by an increase of glutamic acid neurotransmission in the ventral tegmental area. This in turn increases mesolimbic and mesocortical dopaminergic activity, releasing dopamine in the nucleus accumbens and in the prelimbic medial prefrontal cortex. These results are in line with previous studies supporting the hypothesis that the ventral subiculum participates in a complex neural circuit controlling not only penile erection and copulation, but also sexual motivation, arousal and rewarding.
Oxytocin is a potent inducer of penile erection when injected into the central nervous system. In male rats, the most sensitive brain area for the pro-erectile effect of oxytocin is the paraventricular nucleus of the hypothalamus. This nucleus and surrounding regions contain the cell bodies of all oxytocinergic neurons projecting to extra-hypothalamic brain areas and the spinal cord. This review shows that oxytocin induces penile erection also when injected in some of these areas (e.g., ventral tegmental area, ventral subiculum of the hippocampus, posteromedial cortical nucleus of the amygdala and thoraco-lumbar spinal cord). Microinjection studies combined with intra-cerebral microdialysis and double immuno-fluorescence studies suggest that oxytocin in these areas activates directly or indirectly (mainly through glutamic acid) mesolimbic dopaminergic neurons. Dopamine released in the nucleus accumbens in turn activates neural pathways leading to the activation of incerto-hypothalamic dopaminergic neurons in the paraventricular nucleus. This activates not only oxytocinergic neurons projecting to the spinal cord and mediating penile erection, but also those projecting to the above extra-hypothalamic areas, modulating directly or indirectly (through glutamic acid) the activity of mesolimbic dopaminergic neurons controlling motivation and reward. Together these neural pathways may constitute a complex hypothetical circuit, which plays a role not only in the consummatory phase of sexual activity (erectile function and copulation), but also in the motivational and rewarding aspects of the anticipatory phase of sexual behaviour.
Both human and animal studies suggest oxytocin may have antipsychotic properties. Therefore, we conducted a clinical trial to directly test this notion.
Nineteen schizophrenia patients with residual symptoms despite being on a stable dose of at least one antipsychotic were enrolled in a randomized, double-blind, crossover study. They received 3 weeks of daily intranasal oxytocin (titrated to 40 IU twice a day) and placebo adjunctive to their antipsychotics. Order of intranasal treatment was randomly assigned and there was a 1-week washout between treatments.
Analysis of the 15 subjects who completed all the study visits revealed that oxytocin significantly reduced scores on the Positive and Negative Symptom Scale (p < .001) and Clinical Global Impression-Improvement Scale (p < .001) compared with placebo at the 3-week end point. No benefit was seen at the early time points. Oxytocin was well tolerated and produced no adverse effects based upon patient reports or laboratory analysis.
The results support the hypothesis that oxytocin has antipsychotic properties and is well tolerated. Higher doses and longer duration of treatment may produce larger benefits and should be evaluated in future studies.
Sexual desire is controlled by brain systems involved in sexual excitation and inhibition. Hypoactive sexual desire disorder (HSDD) may result from hypofunctional excitation, hyperfunctional inhibition, or some mix of the two.
This study aimed to identify neurochemical and neuroanatomical systems involved in sexual excitation and inhibition, their role during normal, and hypoactive sexual expressions.
A comprehensive review of the human and animal literature is made, and a theory surrounding the ways that HSDD can be manifested and treated is presented.
Drug effects and neural systems derived largely from rat studies that are involved in the stimulation of sexual desire (excitatory system) vs. the stimulation of sexual reward, sedation, and satiety (inhibitory system).
Brain dopamine systems (incertohypothalamic and mesolimbic) that link the hypothalamus and limbic system appear to form the core of the excitatory system. This system also includes melanocortins, oxytocin, and norepinephrine. Brain opioid, endocannabinoid, and serotonin systems are activated during periods of sexual inhibition, and blunt the ability of excitatory systems to be activated.
Drugs that stimulate the activation of hypothalamic dopamine or that blunt endocannabinoid or serotonin release and/or postsynaptic binding may be effective in stimulating sexual desire in animals and humans. The characterization of how those drugs work will help generate a rational approach to drug development in the treatment of HSDD.
A well-mapped set of brain regions is dedicated to social cognition. It is responsive to social cues, engaged in moral decision-making and makes predictions about the likely behaviour of other people. Recent studies of affiliation, using animal models, have revealed that specific neurotransmitters and hormones influence the neural circuits of 'the social brain'. There is converging evidence that the interface between the neuropeptides oxytocin and vasopressin and dopaminergic reward circuits is of particular importance. In the context of recent research, we discuss emerging evidence for the impact of these neuropeptides on the regulation of the social brain. We also examine the putative role of allelic variation in candidate genes on individual differences in social cognitive processing and associated social behaviour.
Oxytocin (80 ng) injected into the caudal mesencephalic ventral tegmental area (VTA) of male rats induces penile erection. Such an effect occurs together with an increase in nitric oxide (NO) production, as measured by the augmented concentration of NO(2)(-) and NO(3)(-) found in the dialysate obtained from this brain area by means of intracerebral microdialysis. Both effects are abolished by d(CH(2))(5)Tyr(Me)(2)-Orn(8)-vasotocin (1 microg), an oxytocin receptor antagonist, by S-methyl-l-thiocitrulline acetate (20 microg), a neuronal NO synthase inhibitor, or by omega-conotoxin GVIA (50 ng), a N-type Ca(2+) channel blocker, all injected into the VTA 15 min before oxytocin. In contrast, 1H-[1,2,4]oxadiazole[4,3-a]quinoxalin-1-one (40 microg), a guanylate cyclase inhibitor, given into the VTA 15 min before oxytocin, abolishes penile erection, but not the increase in NO production, while haemoglobin (40 microg), a NO scavenger, injected immediately before oxytocin reduces the increase in NO production, but not penile erection. 8-Bromo-cyclic guanosine monophosphate (0.5-10 microg) microinjected into the VTA induces penile erection with an inverted U-shaped dose-response curve; the maximal effective dose being 3 microg. Immunohistochemistry reveals that in the caudal VTA oxytocin-containing axons/fibres (originating from the paraventricular nucleus of the hypothalamus) contact cell bodies of mesolimbic dopaminergic (tyrosine hydroxylase-positive) neurons containing both NO synthase and guanylate cyclase. These results suggest that oxytocin injected into the VTA induces penile erection by activating NO synthase in the cell bodies of mesolimbic dopaminergic neurons. NO in turn activates guanylate cyclase present in these neurons, thereby increasing cyclic GMP concentration.
Der Effekt von Tabletten von synthetischem Oxytocin, (Syntocinon®, Sandoz) wurde in einer doppelt-blinden Versuchsserie im Vergleich zu Placebo untersucht.
3 Gruppen von insgesamt 29 ambulanten Patienten wurden für mindestens 7 Wochen behandelt. 9 Patienten nahmen täglich 300 IU, 10 Patienten 600 IU und die restlichen 10 Patienten erhielten Placebo.
Die besten Behandlungsresultate zeigten sich bei der Behandlung mit 300 IU pro Tag. Der Unterschied zwischen dieser Gruppe und der Placebogruppe war statistisch signifikant, sowohl für die Parameter sexuellen Interesses und sexueller Fähigkeit (P < 0.05 oder P < 0.10). Tägliche Einnahme von 600 IU zeigte keinen wesentlichen therapeutischen Effekt.
In beiden Dosierungen wurde Oxytocin gut vertragen. Nebenwirkungen wurden nicht beobachtet.
Introduction. This is a case report on male anorgasmia that was successfully treated with oxytocin. Oxytocin is increased during arousal and peaks during orgasm. More recently, a study on humans published in Nature has shown its value in social bonding, increasing trust, and enhancing the sense of well-being.
Aim. To test the effectiveness of administering oxytocin in a case of treatment-resistant anorgasmia.
Methods. The patient underwent a biopsychosocial evaluation by a psychiatrist trained in sexual medicine and sex therapy for male orgasmic disorder, acquired type. Medical conditions, effect of substances, and psychological issues were ruled out. The patient was properly consented to using oxytocin as an off-label trial. Oxytocin was administered using a nasal spray intracoitally because of its ultra-short half-life.
Results. Oxytocin was effective in restoring ejaculation.
Conclusions. A case of treatment-resistant male anorgasmia was successfully treated with intracoital administration of intranasal oxytocin. Ishak WW, Berman DS, and Peters A. Male anorgasmia treated with oxytocin. J Sex Med 2008;5:1022–1024.
The role of the neuropeptide oxytocin (OT) ranges from the modulation of neuroendocrine physiological effects to the establishment of complex social and bonding behaviours. Experimental studies in animals, as well as case reports in humans, suggest that OT affects different aspects of sexual behaviour and has predominantly facilitating properties for sexual appetence and performance. Using a previously established experimental paradigm of sexual arousal and masturbation-induced orgasm, this study investigated the acute effects of intranasal OT application (24I.U.) on endocrine parameters and measures of sexual appetence and function in healthy men (n=10). In a double-blind, placebo-controlled, balanced cross-over design, sexual arousal, and orgasm were induced by an erotic film and masturbation. In addition to the continuous recording of endocrine (OT, cortisol, prolactin, epinephrine, norepinephrine) and cardiovascular data (heart rate), parameters of appetitive, consummatory, and refractory sexual behaviour were assessed using the acute sexual experience scale (ASES). OT plasma levels were significantly elevated after intranasal OT throughout the whole experiment (>60 min). In addition, OT treatment induced significantly higher increases in epinephrine plasma levels during sexual activity without affecting cortisol levels, prolactin levels or heart rate. OT treatment did not alter appetitive, consummatory, and refractory sexual behaviour according to the ASES. However, when subjects were asked about their subjective perception of whether OT or placebo had been applied, eight out of 10 subjects in the OT group answered correctly, thus pointing to an altered perception of arousal. In conclusion, intranasally administered OT leads to a marked increase in OT plasma levels together with increased secretion of catecholamines when subjects are engaged in sexual activity in a laboratory setting. As the effects of OT on sexual behaviour were equivocal, future studies should examine possible facilitating effects further by including males, females, and couples in a field setting, taking into account that OT exerts the most prominent behavioural effects in pair bond formations.
SESS: 7 OUTPUT: Fri Feb 24 17:26:44 2012 SUM: 879BF931 /v2503 Prosocial effects of oxytocin and clinical evidence for its therapeutic potential
- Km Kendrick
- W Maier
- R Hurlemann
JOBNAME: No Job Name PAGE: 2 SESS: 7 OUTPUT: Fri Feb 24 17:26:44 2012 SUM: 879BF931
/v2503/blackwell/journals/JSM_v0_i0/jsm_2703
References
1 Striepens N, Kendrick KM, Maier W, Hurlemann R. Prosocial effects of oxytocin and clinical evidence for its therapeutic
potential. Front Neuroendocrinol 2011;32:426-50.
Expression of oxytocin receptor in diabetic rat penis Oxytocin selectively facilitates recognition of positive sex and relationship words
- M Li
- T Wang
- S Guo
- K Rao
- J Liu
- Z Ye
Li M, Wang T, Guo S, Rao K, Liu J, Ye Z. Expression of
oxytocin receptor in diabetic rat penis. Andrologia 2011;••:
••-••.
19 Unkelbach C, Guastella AJ, Forgas JP. Oxytocin selectively
facilitates recognition of positive sex and relationship words.
Psychol Sci 2008;19:1092-4.