Article

Sexual frequency and immunoglobulin A (IgA)

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Abstract

112 college students reported the frequency of their sexual encounters and were divided into four categories: none, infrequent (less than once a week), frequent (one to two times per week), and very frequent (three or more times per week). Participants also described their overall sexual satisfaction. Saliva samples were collected and assayed for salivary immunoglobulin A (IgA). Individuals in the frequent group showed significantly higher levels of IgA than the other three groups, which were comparable. Data on length of relationship and sexual satisfaction were not related to the group differences.

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... Sexual activity is also good for the heart and can regulate stress levels [18]. Further, levels of immunoglobulin have been shown to increase by 30% among those who engage in sex once or twice a week compared to individuals who had no, or infrequent sex [19]. However, further research is necessary to examine how sexual activity can positively impact an individual's wellbeing. ...
... However, further research is necessary to examine how sexual activity can positively impact an individual's wellbeing. The cohort engaging in sex in that study [19] were those based in a relationship, and it was difficult to establish whether this included masturbation. Regardless, the role sex technology could play in supporting wellbeing as an adjunct intervention for varying healthcare issues would have to be evidenced prior to sextech being promoted in this context. ...
Article
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Sextech involves technology aimed at enhancing sexual experience and human sexuality. Part of this technology includes digisexuality which concerns sexual and emotional engagement with a sex robot. Research investigating both the positive and negative roles sex that robots may play in emotional and physical well-being remains limited. The present study therefore examined the motivation for men having intimate relationships with lifelike sex robots and revealed an in-depth understanding of the role that sex robots play in that motivation. Existing content was gathered through online platforms including documentaries and video interviews to gain an in-depth understanding of the aspects that lead individuals to develop sexual relationships with sex robots. A summative content analysis and Foucauldian discourse was conducted via an inductive and exploratory analysis based on the reports of eight men on their emotional and sexual relationship with sex robots. As a result, four major discourses emerged from the data that encapsulated differing drives of human-robotic sexual relationships. These were 1) the male power fantasy 2) powerlessness 3) cognitive dissonance and 4) power dynamics. It was found that all elements were co-related and interconnected whereby power-over and power-to constructs were identified throughout the discourse. The rationalizations attributed to engaging in robot sex are discussed using a critical discursive stance.
... Poor physical health and sexuality affect each other in a bidirectional way [33,73]. Sexual activity is seen to have positive impact on the autonomic nervous system, cardiovascular system, cognitive faculty, and immunity [78][79][80][81]. Sexually active people, in one study, have been shown to have high salivary IgA antibody levels [78]. ...
... Sexual activity is seen to have positive impact on the autonomic nervous system, cardiovascular system, cognitive faculty, and immunity [78][79][80][81]. Sexually active people, in one study, have been shown to have high salivary IgA antibody levels [78]. Regarding the mechanism of sexual activity in improving mental health, studies postulate a role of hypothalamo-pituitary-adrenal (HPA) axis, endorphins, endogenous sex hormones, oxytocin and prolactin [82]. ...
Chapter
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The Coronavirus disease 2019 (COVID-19) pandemic has been a global unprecedented health threat. Besides the myriad of effects on public health, the psychosocial implications of the outbreak have been far-fetched. Though the increased prevalence of psychiatric disorders, reduced access to care and social vulnerabilities have been highlighted in literature, the immense impact on sexuality and psychosexual health tends to be silent. The World Health Organization (WHO) defines sexual health as "a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity." Sexual practices and intimacy have been influenced by more ways than one, namely fear of infection, ambiguity about viral spread, misinformation, physical distancing, travel restrictions, intimate partner violence and deprivation of 'social touch'. The frontline workers, socioeconomically impoverished groups, age and sexual minorities are especially affected. Sexual and reproductive rights are compromised due to reduced help-seeking, panic and stigma related to the outbreak. Psychological resilience helps one navigate through stressful situations and assumes a special importance during the ongoing crisis. This chapter reviews the multi-faceted intersections between sexual health and resilience, highlights the possible roles of pandemic-related uncertainty and advocates for certain guidelines to promote and preserve healthy expressions of sexuality for coping during COVID-19.
... Individuals who have higher levels of worklife balance will likely have higher levels of ego-centered sexual satisfaction, and in turn, are more likely to report higher levels of health. Considering that sexual activity is associated with improved immune functioning (Charnetski & Brennan, 2004;Haake et al., 2004), cardiovascular strength (de Araújo, 2009;Palmeri et al., 2007), and in some cases longevity (Chen et al., 2007;Palmore, 1982;Seldin et al., 2002), as well as decreased rates of disease and mental health issues (Davison et al., 2009;Dimitropoulou et al., 2009;Ganong & Larson, 2011;McCall-Hosenfeld et al., 2008), it was not surprising that sexual satisfaction leads to increased health. Sexual activity is related to health because of when individuals engage in sexual activities, they are getting a form of exercise, and the hormones released after orgasm benefit the body and mind (Charnetski & Brennan, 2004;Davison et al., 2009;Palmeri et al., 2007). ...
... Considering that sexual activity is associated with improved immune functioning (Charnetski & Brennan, 2004;Haake et al., 2004), cardiovascular strength (de Araújo, 2009;Palmeri et al., 2007), and in some cases longevity (Chen et al., 2007;Palmore, 1982;Seldin et al., 2002), as well as decreased rates of disease and mental health issues (Davison et al., 2009;Dimitropoulou et al., 2009;Ganong & Larson, 2011;McCall-Hosenfeld et al., 2008), it was not surprising that sexual satisfaction leads to increased health. Sexual activity is related to health because of when individuals engage in sexual activities, they are getting a form of exercise, and the hormones released after orgasm benefit the body and mind (Charnetski & Brennan, 2004;Davison et al., 2009;Palmeri et al., 2007). As such, given that sexual activity is associated with positive health outcomes, satisfaction with said sexual life would also be a predictor because the two are linked. ...
Thesis
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Previous research has shown that there is a significant positive relationship between work-life balance and workplace wellbeing. However, the factors that impact this relationship have been historically understudied. One factor that has been left out of the research is sexual satisfaction. While research has been produced on sexual satisfaction's impact on overall wellbeing, its' impact on workplace wellbeing has not been studied. This research aimed to test the theoretical relationship between work-life balance, sexual satisfaction, and workplace wellbeing. Specifically, this study researches if sexual satisfaction mediates the relationship between work-life balance and workplace wellbeing. After surveying 150 participants, this research concluded that sexual satisfaction does not mediate the relationship between work-life balance and workplace wellbeing. However, sexual satisfaction does mediate the relationship between work-life balance and health. Additionally, the findings extended the literature through the examination of linkages between work-life balance, sexual satisfaction and workplace outcomes that had never been examined. The results and implications of these findings are further discussed.
... Despite being relatively small, this trend warrants scientific investigation and explanation, considering that sexual activity serves various important functions on both individual and interpersonal levels. For instance, sex reduces stress (Ein-Dor & Hirschberger, 2012), helps falling asleep (Oesterling et al., 2023), boosts the immune system (Charnetski & Brennan, 2004), and enhances the emotional connection argue that sexual pleasure is linked to individuals' ability to shield hedonic activities from intrusive thoughts, which encompass thoughts related to long-term goals or values that disrupt a hedonic activity (e.g., thoughts about duties during leisure time). Recent research indicates that individuals vary in their capacity to shield hedonic activities, and these differences in trait hedonic capacity are positively associated with affective well-being, life satisfaction, and mental health (Bernecker & Becker, 2021). ...
Article
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Although pleasure is a primary motivator for sexual activity, research into the mechanisms facilitating pleasurable sexual experiences is limited. The present research adopts a self-regulatory perspective on sexual pleasure, investigating individuals’ capacity to shield hedonic activities from distracting thoughts (trait hedonic capacity) as a correlate of sexual pleasure and sexualized drug use. Study 1 (N = 247) demonstrates that young adults with higher trait hedonic capacity experience more sexual pleasure and are less prone to cognitive distraction during partnered sexual activities. Pre-registered Study 2 replicates these findings while accounting for demand effects (N = 182, n = 86). Expanding on these findings, pre-registered Study 3 (N = 903) shows that young adults with lower trait hedonic capacity are more inclined to use alcohol as a means of coping with cognitive distraction during sexual activity. Exploratory moderation analyses suggest that this is particularly true for women and individuals with higher levels of stress. In summary, low trait hedonic capacity is associated with lower sexual pleasure and a tendency to use alcohol with the motivation to cope with distracting thoughts during partnered sexual activity.
... Sexual wellbeing is essential for maintaining overall physical and mental health through a variety of biological and psychological processes (1)(2)(3). Regular sexual activity reduces stress, regularizes sleep cycle, and regulates our mental wellbeing as a whole. On the contrary, the persistent depression and anxiety can affect sexual health (SH), which in turn lowers our quality of life (4). ...
Article
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Background Sexual dysfunction (SD) and its effect on our life is an important but less studied topic especially during post-COVID era. This study examines the extent of SD and other mental health predictors and their effect on quality of life. Methods A cross-sectional survey of sexually active adults was conducted in an Indian metro-city. Along with sociodemographic data, sexual dysfunction, depression, anxiety, stress, and quality of life were assessed by Arizona Sexual Experience Scale (ASEX), Depression Anxiety and Stress Scale (DASS), and WHOQOL-BREF, respectively. Structural equations modeling was used to understand their relationship. Results Out of the total 1,376 respondents, 80.52% were male, 65.98% were married, and 48.54% were graduates. The mean age of the participants was 34.42 (±9.34) years. Of the participants, 27.18% had sexual dysfunction. Majority of the respondents did not have depression (59.30%), anxiety (52.33%), or stress (44.48%). Mild and moderate levels were the commonest findings among those who had depression, anxiety, or stress. Among the respondents, 27.18% had sexual dysfunction as per the ASEX instrument. Increase in age and female gender were associated with sexual dysfunction overall and also all its components. Presence of depression adversely affected ease of achieving orgasm and satisfaction from orgasm and was associated with sexual dysfunction overall. The respondents had a mean score of 73.57 (±13.50) as per the WHO-QOL. Depression and stress emerged as statistically significant factors for poor quality of life, while sexual dysfunction was not associated statistically. Conclusion More than one-fourth of the study population reported sexual dysfunction during the first wave of the pandemic in India. The study findings highlight the role of poor mental health issues in this regard. In fact, issues like depression and stress were associated with poor quality of life as well. The current findings unequivocally warrant specific interventions to improve mental health of the respondents.
... Sexual wellbeing is essential for maintaining overall physical and mental health through a variety of biological and psychological processes (1)(2)(3). Regular sexual activity reduces stress, regularizes sleep cycle, and regulates our mental wellbeing as a whole. On the contrary, the persistent depression and anxiety can affect sexual health (SH), which in turn lowers our quality of life (4). ...
Article
Full-text available
Background: Sexual dysfunction(SD) and its effect on our life is an important but less studied topic especially during post-Covid era. This study examines the extent of SD and other mental health predictors and their effect on quality of life. Methods: A cross-sectional survey of sexually active adults was conducted in an Indian metro-city. Along with sociodemographic data, sexual dysfunction, depression, anxiety, stress and quality of Life were assessed by Arizona Sexual Experience Scale (ASEX), Depression Anxiety and Stress Scale (DASS) and WHOQOL-BREF respectively. Structural Equations Modeling was used to understand their relationship. Results: Out of the total 1376 respondents 80.52% were male, 65.98% were married, 48.54% were graduates. The mean age of the participants was 34.42 (± 9.34) years. 27.18% had sexual dysfunction. Majority of the respondents did not have depression (59.30%), anxiety (52.33%) or stress (44.48%). Mild and moderate levels were the commonest findings among those who had depression, anxiety or stress. Among the respondents 27.18% had sexual dysfunction as per the ASEX instrument. Increase in age and female gender were associated with sexual dysfunction overall, and also all its components. Presence of depression adversely affected ease of achieving orgasm and satisfaction from orgasm, and was associated with sexual dysfunction overall. The respondents had a mean score of 73.57 (±13.50) as per the WHO-QOL. Depression and stress emerged as statistically significant factors for poor quality of life, while sexual dysfunction was not associated statistically. Conclusion: More than one-fourth of the study population reported sexual dysfunction during the first wave of the pandemic in India. The study findings highlight the role of poor mental health issues in this regard. In fact, issues like depression and stress were associated with poor quality of life as well. The current findings unequivocally warrant specific interventions to improve mental health of the respondents.
... Partnered sexual activity is a risk factor for lowered immunity in women with depressive symptoms, but a possible resilience factor for men with depressive symptoms (Lorenz & van Anders, 2014). Students who had sexual intercourse once or twice a week had IgA levels 30 percent higher than those who were abstinent (Charnetski & Brennan, 2004). IgA is an antibody that serves as a first-line defense against most invading pathogens. ...
Article
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Objective Sexual activity is a fundamental human function with short-term and long-term emotional, social, and physical benefits. Yet within healthcare, sexuality has been marginalized and many HCPs are unaware of its beneficial implications for immediate and long-term health. Methods To challenge this assumption we combined the data that already had been collected by the authors with an extensive search of articles on the various health benefits of sexual activity. The results of this process are displayed according to short-term, intermediate-term, and long-term benefits with some explanation about potential causal relationships. Results For the time being, it cannot yet be proved that “good sex promotes good health” since good health also favors good sex. Conclusions Despite lacking such convincing evidence, the article concludes with recommendations for the relevant professions. The balance of research supports that sexuality anyhow deserves greater attention among HCPs and that sexuality research needs better integration within health research.
... Sexual frequency also factors into better health, including improved immune functioning (Lorenz et al., 2018) and cardiovascular health (Ebrahim et al., 2002). Charnetski and Brennan (2004) found in their research among heterosexual college students that those having frequent (once or twice per week) versus having no, infrequent (< once per week), or very frequent (≥ 3 times per week) sex (any kind of genital contact with a partner) was associated with higher salivary IgA, a marker for overall health of the immune system health and the first line defense against pathogens and infections, regardless of relationship duration or sexual satisfaction. Research has found that men are 34% less likely to have prostate cancer later in life if they ejaculated 21 times per month compared to 4-7 times per month over the course of their lifetime (Rider et al., 2015). ...
Article
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The primary objective of this cross-sectional study was to examine the associations of self-reported health, happiness, marital happiness, frequency of sexual activity, and number of partners from a multinational survey of individuals who are consensually non-monogamous (CNM) or open to being CNM, completed in 2012 with 4062 respondents. We compared data from this survey with the 2010–2014 US General Social Surveys (GSS). This study explored these variables and their predictors by gender (including 612 non-binary-gendered CNM individuals), marital status, number of partners, sexual frequency, age, education, and income and were broken down by behavioral sexual orientation, marital status, and other relevant categories. Respondents in our CNM sample generally reported being as healthy (sometimes healthier; e.g., all respondents M–W Z = 7.66, p < .001, η2 = 0.007), happy (frequently happier; e.g., multiple-partnered Z = 15.43, p < .001, η2 = 0.069), happy in their marriages (in some cases happier; e.g., multiple-partnered females Z = 2.61, p = .009, η2 = 0.067), and reported having more frequent sexual activity (e.g., all Z = 29.54, p < .001, η2 = 0.094) with more partners (e.g., all Z = 60.75, p < .001, η2 = 0.393) compared to corresponding individuals within the GSS. This study contributes to knowledge about commonalities and differences between the general population and those who are CNM regarding health, happiness, and happiness in marriage, including differences in optimal number of sexual partners and sexual frequency.
... Endorphin levels are associated with higher natural killer cell activity. 40 The evidence shows that sexual activity might help prevent infection by bolstering immune function 41,42 and protect against cardiovascular disease by lowering the heart rate and blood pressure. 43 A decreased frequency of sex often indicates a deterioration of physical health 44 and may also be a predictor of depression and marital disharmony. ...
Article
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Introduction There are many Western reports on factors influencing coital frequency among men. However, no articles could be found about the factors influencing sexual activity among Chinese men. Aim The aim of this study was to identify the factors that influence the coital frequency of Chinese men. Main Outcome Measures The main outcome measures included self-reported monthly coital frequency, age, occupation, education level, andrology-related scales and dietary habits. Methods Data for 1,407 men aged 18–79 years were collected in the Health Management Center of the Third Xiangya Hospital of Central South University from January 2019 to May 2019. The respondents completed the questionnaires independently or with the help of an interviewer (who read or explained the questionnaires to them) to analyse the factors that influence coital frequency. Results In the previous 6 months, the sample had a mean monthly coital frequency (±SD) of 4.34 ± 3.18. Univariate logistic regression results indicated that the number of children (P = 0.004), IIEF-5 scores (P <0.001), EHSs (P <0.001) and frequency of milk consumption (P = 0.001) were associated with more frequent sexual activity. These statistical associations did not change after further adjustment for age, occupation, and reproductive history. We observed that the frequency of sexual activity showed an increasing trend with a greater number of children, higher IIEF-5 scores, higher EHSs and greater frequency of milk consumption (test for trend, P<0.05). Both univariate and multivariate analysis results indicated that the frequency of sexual activity decreased with increasing age (test for trend, P<0.001). Conclusion The coital frequency of Chinese men is associated with erectile function, anthropometric parameters, age, occupation, and dietary habits. Xiang Y, Peng J, Yang J, et al. What Influences Coital Frequency Among Chinese Men?: A Cross-Sectional Study. Sex Med 2021;9:100363.
... In a study on 112 college students, those who had sex more than once or twice per week had significantly higher levels of SIgA than less sexually active ones. 45 Interestingly, the presence of maintained sexual activity with a partner, but not by masturbation, can also influence immunity, reflected by SIgA levels, during a high-score depressive episode. 46 While there are clear indications that sexual activity and a satisfying sexual life improve overall physical health and quality of life, during a pandemic, this can be overlooked. ...
Article
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Introduction A novel coronavirus (COVID-19) reached pandemic levels by March 11th, 2020, with a destructive impact across socioeconomic domains and all facets of global health, but little is known of its impact on sexual health. Objective To review current knowledge on sexual health-related containment measures during pandemics, specifically COVID-19, and focus on 2 main areas: intimacy and relational dynamics and clinical effects on sexual health. Methods We carried out a literature search encompassing sexual health and pandemic issues using Entrez-PubMed and Google Scholar. We reviewed the implications of the COVID-19 pandemic on sexual health regarding transmission and safe sex practices, pregnancy, dating and intimacy amid the pandemic, benefits of sex, and impact on sexual dysfunctions. Results Coronavirus transmission occurs via inhalation and touching infected surfaces. Currently, there is no evidence it is sexually transmitted, but there are sexual behaviors that pose a higher risk of infectivity due to asymptomatic carriers. Nonmonogamy plays a key role in transmission hubs. New dating possibilities and intimacy issues are highlighted. Sexual activity has a positive impact on the immune response, psychological health, and cognitive function and could mitigate psychosocial stressors. COVID-19 pandemic affects indirectly the sexual function with implications on overall health. Conclusion Increased awareness of health-care providers on sexual health implications related to the COVID-19 pandemic is needed. Telemedicine has an imperative role in allowing continued support at times of lockdown and preventing worsening of the sexual, mental, and physical health after the pandemic. This is a broad overview addressing sexual issues related to the COVID-19 pandemic. As this is an unprecedented global situation, little is known on sexuality related to pandemics. Original research is needed on the topic to increase the understanding of the impact the current pandemic may have on sexual health and function. Pennanen-Iire C, Prereira-Lourenço M, Padoa A, et al. Sexual Health Implications of COVID-19 Pandemic. Sex Med Rev 2021;9:3–14.
... If you are finding that sex helps you to manage stress better, you might appreciate some of the health benefits of regular sex, perhaps particularly relevant at the moment. Research suggests a link between orgasms from penile-vaginal intercourse and reduced blood pressure 12 , as well as between sexual activity and pain control 13 , improved immune function 14 and improved cognitive capacity in older adults 15 . Pleasurable sexual touch is also associated with improved genital health. ...
Article
The COVID-19 pandemic and the resulting social changes that were required to slow the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) have resulted in lockdowns across many countries and led to substantial numbers of people being quarantined. For single people, their opportunities to meet a partner were completely lost. For couples who lived apart, this meant that they were not able to see their partner for many months. However, by contrast, for cohabiting couples, lockdown meant that they were forced to spend 24 h a day with each other, and perhaps their children or housemates, for months at a time. As lockdowns have loosened around the world, the possibility of a second wave arises, and lockdowns are being reinstated in many regions. The prospect of potential long-term lockdowns means that adjusting to this new normal in relationships is an important consideration. In this Viewpoint, three specialists in sexology and psychology discuss the effects of lockdown on intimacy and consider how it can be considered an opportunity as well as an obstacle for making love in the time of corona.
... Once a week proxies the average frequency of sex activity in American adults, 33 and has been previously associated with health benefits. 34 Number of sexual partner last year was derived for men and women, respectively. We summarized the total number of sex partners (same or opposite sex) in the past year for each participant who reported having (performing or receiving) any kind of sex. ...
Article
Introduction Physical activity is likely to be associated with sexual activity. However, to date, there is no literature on the relationship between overweight/obesity and sexual activity outcomes. Aim Thus, the present study assessed the associations among physical activity, sedentary behavior, and weight status with sexual activity and number of previous sexual partners in a representative sample of U.S. adults. Methods Data on leisure time physical activity, total sitting time, weight status, sexual behavior outcomes, and other characteristics were extracted from the National Health and Nutrition Study cycle 2007 to 2016. Logistic regression models were used to evaluate associations among body mass index, leisure time physical activity, and total sitting time with past-year sexual activity and number of sexual partners. Main Outcome Measure Self reported frequency of past-year sexual activity and number of sex partners in the past year. Results In a sample of 7,049 men (mean age: 38.3 ± 0.3 years) and 7,005 women (mean age: 38.7 ± 0.2 years) being overweight was associated with higher odds of frequent sexual activity (OR = 1.5; 95% CI = 1.2−1.7) among men, but lower odds among women (OR = 0.8; 95% CI = 0.6−0.9). Sufficient physical activity was associated with higher odds of frequent sexual activity among both men (OR = 1.3; 95% CI = 1.1−1.5) and women (OR = 1.2; 95% CI = 1.0−1.4). In those living alone, being obese was associated with lower odds of having at least 1 sexual partner for men (OR = 0.7; 95% CI = 0.5−0.9) and women (OR = 0.6; 95% CI = 0.4−0.8). Being sufficiently physically active was associated with higher odds of having at least 1 sexual partner only in men (OR = 1.6; 95% CI = 1.2−2.2). Clinical Implications Healthcare professionals need to be made aware of these results, as they could be used to plan tailored interventions. Strengths & Limitations Strengths include the large, representative sample of U.S. adults and objective measures of anthropometry. Limitations include the cross-sectional design of the study and that all variables on sexual history were self-reported. Conclusion The present study identifies novel modifiable behavioral and biological antecedents of sexuality outcomes.
... One or two times per week can increase an individual's antibody concentration by 30% and strengthen the immune system (immunoglobulin A, IgA). Charnetski & Brennan (2004) and sexual activity stimulates the brain to release sexual reward-related neurochemical substances called opioid and oxytocin (Pfaus et al., 2012). However, patients with breast cancer may still have sex during treatment, but should pay attention to avoiding the problem of vaginal infection. ...
Article
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As the number of breast cancer survivors increases, these patients with sexual problems also increase. For breast cancer survivors, sexual problems are a common and painful experience. Although breast cancer survivors often encounter sexual problems, Taiwanese women are culturally conservative and patients rarely discuss sex problems with clinicians. In this study, we used qualitative methods to better understand the changes in sexual life and related care strategies for breast cancer survivors. Twenty interviews were conducted on clinical patients enrolled in hospitals that received breast cancer treatment. The data were analysed by performing a constant comparative analysis. Three themes emerged: the causes of changes in sexual life, internal response strategies and external response strategies. Ten subthemes were identified. Changes in sexual life in patients with breast cancer in this study included changes related to body image, influence of friends and family, age, genital problems, and illegal love of a partner. Breast cancer survivors can tolerate and regulate sexual life changes by adopting internal and external response strategies. Medical staff must be sensitive and must understand strategies for dealing with sexual life changes that may occur during cancer adjustment and how these strategies can help women’s well-being in the rest of their lives.
... Research further suggests that social support from high-quality relationships may be the protective mechanism against mortality (Holt-Lunstad et al., 2010). Similarly, frequency of sexual intimacy for individuals in relationships has been linked to greater mental and physical health outcomes, such as more general happiness and greater life satisfaction (Muise et al., 2016), greater heart variability (Costa & Brody, 2012), lower daily somatic symptoms (Stadler et al., 2012), reduced daily diurnal cortisol (Ditzen et al., 2008), and a more robust immune response (Charnetski & Brennan, 2004). However, to date, no studies have examined biomarkers of long-term health status such as telomere length. ...
Article
High-quality relationships have been shown to be beneficial for physical and mental health. This study examined overall relationship satisfaction and perceived stress as well as daily reports of partner support, partner conflict, and physical intimacy obtained over the course of one week in a sample of 129 high and low stress mothers. Telomere length was examined in whole blood, as well as the two cell subpopulations: peripheral blood mononuclear cells (PBMCs) and granulocytes. Telomerase activity was measured in PBMCs. Analyses revealed no statistically significant associations of telomere length with current relationship satisfaction, daily support or conflict, or perceived stress. In contrast, women who reported any sexual intimacy during the course of the week had significantly longer telomeres measured in whole blood and PBMCs, but not in granulocytes. These relationships held covarying for age, body mass index, perceived stress, the relationship indices, and caregiver status. Sexual intimacy was not significantly related to PBMC telomerase activity. These data provide preliminary data that sexual intimacy is associated with longer telomere length. Future studies investigating these associations are warranted.
... Although there is considerable research examining the nonsexual aspects of women's same-sex relationships, less is known about the sexual aspects of the relationship in general, and about sexual satisfaction specifically (Christopher & Sprecher, 2000;Cohen & Byers, 2014;Peplau, Fingerhut, & Beals, 2004). Sexual satisfaction is important because it is closely linked to overall relationship satisfaction and stability, psychological well-being, physical health, and quality of life, although most of this research was conducted with mixed-sex (male-female) couples (Apt, Hurlbert, Pierce, & White, 1996;Charnetski & Brennan, 2004;Christopher & Sprecher, 2000;Davison, Bell, LaChina, Holden, & Davis, 2009;Ebrahim et al., 2002;Karney & Bradbury 1995;Laumann et al., 2006). Most sexual-minority women (SMW) who are in a romantic relationship report that their sex life is satisfying (Cohen & Byers, 2014;Matthews, Tartaro, & Hughes, 2003;Peplau, Cochran, & Mays, 1997;Roberts, Sorenson, Patsdaughter, & Grindel, 2000). ...
Article
We examined the validity of the interpersonal exchange model of sexual satisfaction for sexual-minority women (SMW) with a range of sexual identities (lesbian, bisexual, queer, unlabeled, questioning). Participants, 898 (192 who were dating, 439 who were cohabitating) SMW in a romantic relationship of at least 3 months, completed an online survey that included the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire. The results provide support for the validity of the model for SMW in that all the model components (relationship satisfaction, balance of sexual rewards and costs, balance of relative sexual rewards and costs, equality of rewards, equality of costs) were significantly associated with sexual satisfaction. All of the components, except equality of sexual costs, contributed uniquely to the prediction of sexual satisfaction. Neither relationship stage (dating vs. cohabiting) nor sexual identity (lesbian vs. other sexual-minority identity) moderated these associations. Women daters reported a significantly higher level of sexual rewards, sexual costs, and sexual satisfaction than did women cohabiters. The interpersonal exchange model may be used by clinicians as a framework for exploring with a couple, experiences of low sexual satisfaction. The results also add to an emerging positive picture of the sexual relationships of SMW at both stages; this information can be used to counter negative stereotypes. Online supplemental files are available at http://journals.sagepub.com/doi/suppl/10.1177/0361684316679655.
... Mean frequency of intercourse events reported on sexual event diaries was 6.67 times/cycle (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The effect of menstrual cycle phase on frequency of sexual events was nonsignificant [F(1,3) ¼ 0.08, P¼ .96], ...
Article
Objective: To examine differences in inflammation markers in sexually active versus abstinent women and observe changes in inflammation markers across the menstrual cycle. Cycle-related immune fluctuations may have evolved to reduce interference with conception. If so, reproductively active (i.e., sexually active) women should show the most variability in cytokine expression. Design: Participants provided serum samples at menses and ovulation (from which cytokines were assayed) and saliva samples at menses and during follicular, ovulation, and luteal phases (from which C-reactive protein [CRP] was assayed). Participants self-reported intercourse frequency during the study. Setting: Academic research laboratory. Patient(s): Thirty-two healthy, naturally cycling premenopausal women (sexually active, n = 15; abstinent, n = 17). Intervention(s): Observational study. Main outcome measure(s): Levels of proinflammatory cytokines (interleukin-6 [IL-6], interferon γ [IFN-γ], tumor necrosis factor-α [TNF-α]), an anti-inflammatory cytokine (interleukin-4 [IL-4]), and a marker of total inflammation (CRP). Result(s): Sexually active women had higher levels of all of the immune markers measured, including both pro- and anti-inflammatory cytokines, than abstinent women. Relative to sexually active women, abstinent women had less change across the menstrual cycle in levels of CRP. Among sexually active women, higher intercourse frequency predicted greater midcycle decreases in CRP, IL-6, and IFN-γ and midcycle increases in IL-4. Conclusion(s): Sexual activity may stimulate a complex interaction between pro- and anti-inflammatory cytokines that subsequently drives midcycle declines in inflammation.
... Replicating the findings of several other studies (Brown et al., 2008;Charnetski and Brennan, 2004;Lorenz and van Anders, 2014), we found that higher levels of sexual activity was associated with lower SIgA in healthy women. Novel to this study, we found that T was associated with lower IgA among highly sexually active women. ...
Article
Although testosterone (T) has been characterized as universally immunosuppressive across species and sexes, recent ecoimmunology research suggests that T's immunomodulatory effects (enhancing/suppressing) depend on the organism's reproductive context. Very little is known about the immune effects of T in healthy females, and even less about how reproductive effort modulates the immune effects of T in humans. We investigated how the interaction between endogenous T and sexual activity predicted menstrual cycle-related changes in several measures of immunity: inflammation (indexed by interleukin-6, IL-6), adaptive immunity (indexed by immunoglobulin A, IgA), and functional immunity (indexed by bactericidal assay). Thirty-two healthy women (sexually abstinent, N=17; sexually active with one male partner, N= 15) provided saliva samples at four points in the menstrual cycle: menses, follicular, ovulation, and luteal phases. Among sexually abstinent women, T was positively associated with IL-6 across the cycle; for sexually active women, however, T was positively associated with IL-6 in the luteal phase only, and negatively associated with IL-6 at ovulation. High T predicted higher IgA among women who reported infrequent intercourse, but lower IgA among women who reported very frequent intercourse. Finally, across groups, T was positively associated with greater bacterial killing at menses, but negatively associated in the luteal phase. Overall, rather than being universally immunosuppressive, T appeared to signal immunomodulation relevant to reproduction (e.g., lowering inflammation at ovulation, potentially preventing immune interference with conception). Our findings support the hypothesis that the immunomodulatory effects of endogenous T in healthy females depend on sexual and reproductive context.
... While this study found no association between sexual activity status and cycle phase on IgA levels, frequency of sexual activity within sexually active participants was not considered. Finally, in a sample of male and female college students, there was a curvilinear pattern between IgA and sexual frequency, with individuals reporting sexual activity 1-2x/week showing significantly greater IgA than any other group (abstinent, <1x/week, >2x/week) [32]. However, these analyses treated both men and women in the same group, despite evidence of sex/gender differences in humoral immunity [33] and self-reported sexual frequency [34]. ...
Article
Several studies have documented shifts in humoral immune parameters (e.g., immunoglobulins) across the menstrual cycle in healthy women. It is thought that these shifts may reflect dynamic balancing between reproduction and pathogen defense, as certain aspects of humoral immunity may disrupt conception and may be temporarily downregulated at ovulation. If so, one could expect maximal cycle-related shifts of humoral immunity in individuals invested in reproduction - that is, women who are currently sexually active - and less pronounced shifts in women who are not reproductively active (i.e., abstinent). We investigated the interaction of sexual activity, menstrual cycle phase, and humoral immunity in a sample of 32 healthy premenopausal women (15 sexually active, 17 abstinent). Participants provided saliva samples during their menses, follicular phase, ovulation (as indicated by urine test for LH surge), and luteal phase, from which IgA was assayed. Participants also provided blood samples at menses and ovulation, from which IgG was assayed. Sexually active participants provided records of their frequency of sexual activity as well as condom use. At ovulation, sexually active women had higher IgG than abstinent women (d=0.77), with women reporting regular condom use showing larger effects (d=0.63) than women reporting no condom use (d=0.11). Frequency of sexual activity predicted changes in IgA (Cohen's f(2)=0.25), with women reporting high frequency of sexual activity showing a decrease in IgA at ovulation, while women reporting low frequency or no sexual activity showing an increase in IgA at ovulation. Taken together, these findings support the hypothesis that shifts in humoral immunity across the menstrual cycle are associated with reproductive effort, and could contribute to the mechanisms by which women's physiology navigates tradeoffs between reproduction and immunity.
... Sexual activity: (1) Increases longevity: Men with increased orgasmic frequency (i.e., had sex at least two times per week) had a 50% lower risk of mortality at a 10-year follow-up (Davey Smith et al, 1997); (2) Lowers the risk of chronic disease (e.g., heart disease and cancer): Among men, frequency of sex was associated with a lower risk of fatal coronary heart disease (Ebrahim et al, 2002). Furthermore, a national survey of US men found high ejaculation frequency (i.e., ≥21 ejaculations per month) was associated with decreased risk of total prostate cancer (Leitzmann et al, 2004); (3) Increases immunity: Increased levels of immunoglobulin A, an essential antibody used by the immune system to protect against viral infections, were found in college students reporting having sex at least three times per week (Charnetski and Brennan, 2004); (4) Associated with reduced stress: Participants who had vaginal sex in the last 2 weeks had lower blood pressure and stress response to stress-inducing tasks (Brody, 2006). Among medical residents, stress negatively affected desire, sexual arousal , and sexual satisfaction (Sangi-Haghpeykar et al, 2009); and (5) Increases physical fitness: Sexual intimacy was associated with physical fitness level among Fifty Plus Fitness Association members (Bortz and Wallace, 1999); frequency of sexual activity was higher among men enrolled in an intensive physical fitness program (White et al, 1990). ...
Chapter
Sexual behavior augments human experience, allowing people to express affection, develop intimate bonds and interpersonal relationships, and experience pleasure. Sexual behavior can also have unwanted consequences, such as sexually transmitted infections or unintended pregnancy. Researchers often assess sexual behavior to learn more about how it enhances the human experience and to understand conditions under which sexual behavior leads to unwanted consequences. Such assessments can be challenging because sexual behavior typically occurs in private, at the dyadic level, and it is often a stigmatized and culturally sensitive subject. Researcher often rely on self-reports, which are vulnerable to cognitive (e.g., memory) and social (e.g., self-presentation) biases. Research has investigated how best to assess sexual behavior to optimize accurate and reliable self-reports, which are critical to improving sexual functioning, reducing sexually transmitted infections, and informing public policy decisions. In this chapter, we discuss the importance of measuring sexual behaviors, review assessment modes and measures, and present challenges to sexual assessment. Although we focus primarily on retrospective methods of assessment, we also present contemporaneous assessments methods. Finally, we offer recommendations for improving sexual behavior assessment in future research.
... In humans it has been shown that lack of control in the work place inhibits S-IgA and increases incidence of upper respiratory infections (Schaubroeck et al., 2001). Furthermore, if we accept the notion that this group of cats were frustrated, representing low arousal of the appetitive/reward system, our findings are in accordance with those showing that pleasure/happiness (high arousal of the appetitive/reward system) increase secretion of S-IgA, e.g. during sexual activity (Charnetski and Brennan, 2004). ...
Article
We tested the hypothesis that during their first week in an animal shelter, cats exhibit groups of behaviours that are connected to mucosal immune and adrenal responses. The behaviour of 34 cats was observed from admission to day 5 and immunoglobulin A (S-IgA) and cortisol were quantified from faeces. A multidimensional model constructed by Principal Component Analysis indicated the presence of three distinct behavioural dimensions. Behaviours forming dimension 1 were hiding, flat postures, freeze, startle, crawl and retreat from humans. These were significantly contrasted (R -0.6 to -0.4) to dimension 3 behaviours which included normal patterns of feeding, grooming, sleeping and locomotion, sitting at the front of the cage while calmly observing activities, sleeping or resting while lying on their side, rubbing on cage items and friendly behaviour towards humans. Dimension 2 behaviours included persistent meowing, scanning, pacing and pushing, together with bouts of destructive behaviour, attempts to escape and redirected aggression. Dimension 2 was not significantly contrasted to dimension 3 (R< -0.4 except for sleep = 0.6) or dimension 1 (R ≤-0.2). S-IgA values were greater (P <0.001) for cats clustered in dimension 3 (mean 7.1 ±0.5 loge µg/g), compared to dimensions 1 and 2 which were not significantly different (1: 5.6 ±0.6; 2: 5.6 ±0.7 loge µg/g). Cortisol values were similar for the three dimensions. Despite the difficulty in generalising the results to the shelter cat population due to small sample size, our findings suggest that behaviour is a good indicator of mucosal immune function in shelter cats. This may be of clinical significance for the management of upper respiratory disease in animal shelters.
... In humans it has been shown that lack of control in the work place inhibits S-IgA and increases incidence of upper respiratory infections (Schaubroeck et al., 2001). Furthermore, if we accept the notion that this group of cats were frustrated, representing low arousal of the appetitive/reward system, our findings are in accordance with those showing that pleasure/happiness (high arousal of the appetitive/reward system) increase secretion of S-IgA, e.g. during sexual activity (Charnetski and Brennan, 2004). ...
Article
We tested the hypothesis that during their first week in an animal shelter, cats exhibit groups of behaviours that are connected to mucosal immune and adrenal responses. The behaviour of 34 cats was observed from admission to day 5 and immunoglobulin A (S-IgA) and cortisol were quantified from faeces. A multidimensional model constructed by Principal Component Analysis indicated the presence of three distinct behavioural dimensions. Behaviours forming dimension 1 were hiding, flat postures, freeze, startle, crawl and retreat from humans. These were significantly contrasted (R -0.6 to -0.4) to dimension 3 behaviours which included normal patterns of feeding, grooming, sleeping and locomotion, sitting at the front of the cage while calmly observing activities, sleeping or resting while lying on their side, rubbing on cage items and friendly behaviour towards humans. Dimension 2 behaviours included persistent meowing, scanning, pacing and pushing, together with bouts of destructive behaviour, attempts to escape and redirected aggression. Dimension 2 was not significantly contrasted to dimension 3 (R< -0.4 except for sleep = 0.6) or dimension 1 (R ≤-0.2). S-IgA values were greater (P <0.001) for cats clustered in dimension 3 (mean 7.1 ±0.5 loge μg/g), compared to dimensions 1 and 2 which were not significantly different (1: 5.6 ±0.6; 2: 5.6 ±0.7 loge μg/g). Cortisol values were similar for the three dimensions. Despite the difficulty in generalising the results to the shelter cat population due to small sample size, our findings suggest that behaviour is a good indicator of mucosal immune function in shelter cats. This may be of clinical significance for the management of upper respiratory disease in animal shelters.
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Zusammenfassung Sexualität kann das Krebsrisiko durch sexuell übertragbare Infektionen wie HPV (humane Papillomviren), HIV (humanes Immundefizienzvirus) oder Hepatitisviren, aber auch Lebensstilfaktoren beeinflussen. Präventive Maßnahmen, wie beispielsweise HPV-Impfungen und ein verantwortungsbewusstes Sexualverhalten, senken das Krebsrisiko. Eine Krebsdiagnose und die damit verbundenen Therapien können zu sexuellen Funktionsstörungen führen. Über 60 % der krebskranken Frauen und 40 % der Männer leiden unter sexuellen Funktionsstörungen. Eine offene Kommunikation und eine interdisziplinäre Behandlung sind entscheidend, um die Patient:innen umfassend zu unterstützen und sexuelle Funktionsstörungen gezielt zu behandeln.
Chapter
Female Arousal and Orgasm: Anatomy, Physiology, Behaviour and Evolution is the first comprehensive and accessible work on all aspects of human female sexual desire, arousal and orgasm. The book attempts to answer basic questions about the female orgasm and questions contradictory information on the topic. The book starts with a summary of important early research on human sex before providing detailed descriptions of female sexual anatomy, histology and neuromuscular biology. It concludes with a discussion of the high heritability of female orgasmicity and evidence for and against female orgasm providing an evolutionary advantage. The author has attempted to gather as much information on the subject as possible, including medical images, anonymized survey data and previously unreported trends. The groundbreaking book gives a scientific perspective on sexual arousal in women, and helps to uncover information gaps about this fascinating yet complex phenomenon.
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Background :Post-Coital Dysphoria is a condition characterized by an array of inexplicable negative feelings such as - guilt, disgust, frustration and sadness that individuals might experience after engaging in satisfying sexual intercourse. Aim: The aim of the present study was to get an in-depth understanding of post-coital dysphoria and it's most common predictors amongst the Indian Youth. Methods: For the purpose of the current study, telephonic interview was carried out with a total of 20 individuals ( female=16, male = 4) between the age 18-26 years. Main Outcome Measures: Interpretative phenomenological analysis (IPA) was utilized to analyze the predictors of post-coital dysphoria amongst the participants of the study. Results : Of all participants in the current study (n=21), a total of 11 participants reported experiencing more than one negative emotion after sex for no apparent reason. The most common themes that emerged across the narrative of all participants were : Ambivalence, sexual abuse (childhood sexual abuse/adult sexual abuse) , self esteem, uncertainty surrounding relationship, unmet sexual expectations and stigma associated with engaging in pre-marital sexual intercourse. Strengths & limitations : This is the rst study ever to be conducted on an Indian population . It's qualitative nature allows a more in-depth understanding about it's manifestation and the personal experiences of individuals who report experiencing it's related symptoms. The nature of the sample and the unequal representation of men and women may limit the generalizability of the study.
Chapter
Sexual activity has not only a wide range of emotional and social but also physical consequences.
Article
OBJECTIVES: To examine changes over time in the reported frequency of occurrence of sex and associations between sexual frequency and selected variables. DESIGN: Repeat, cross sectional, population based National Surveys of Sexual Attitudes and Lifestyles (Natsal-1, Natsal-2, and Natsal-3). SETTING:British general population. PARTICIPANTS:18 876 men and women aged 16-59 and resident in Britain were interviewed in Natsal-1, completed in 1991; 11 161 aged 16-44 years in Natsal-2, completed in 2001, and 15 162 aged 16-74 years in Natsal-3, completed in 2012. Comparisons of actual and preferred sexual frequency in men and women aged 16-44 (the age range common to all surveys) between the three surveys. Factors associated with sexual frequency of at least once a week were examined using Natsal-3 data. MAIN OUTCOME MEASURES: Sexual activity in the past month; frequency of sex in the past month; preferred frequency of sex. RESULTS: Median number of occasions of sex in the past month was four in Natsal-1 and Natsal-2 and three in Natsal-3 among women; and three in Natsal-1, Natsal-2, and Natsal-3 among men. The proportion reporting no sex in the past month fell between Natsal-1 and Natsal-2 (from 28.5% to 23.0% in women and from 30.9% to 26.0% in men) but increased significantly in Natsal-3 (to 29.3% in women and 29.2% in men). The proportion reporting sex 10 times or more in the past month increased between Natsal-1 and Natsal-2, from 18.4% to 20.6% in women and from 19.9% to 20.2% in men, but fell in Natsal-3, to 13.2% in woman and 14.4% in men. Participants aged 25 and over, and those married or cohabiting, experienced the steepest declines in sexual frequency (P values for interaction <0.05). Alongside the declines in sexual frequency, there was an increase in the proportion reporting that they would prefer sex more often. Age adjusted odds ratios showed that men and women in better physical and mental health had sex more frequently, as did those who were fully employed and those with higher earnings. CONCLUSIONS: Frequency of sex has declined recently in Britain, more markedly among those in early middle age and those who are married or cohabiting. The findings and their implications need to be explained in the context of technological, demographic, and social change in Britain and warrant further investigation.
Article
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Objectives To examine changes over time in the reported frequency of occurrence of sex and associations between sexual frequency and selected variables. Design Repeat, cross sectional, population based National Surveys of Sexual Attitudes and Lifestyles (Natsal-1, Natsal-2, and Natsal-3). Setting British general population. Participants 18 876 men and women aged 16-59 and resident in Britain were interviewed in Natsal-1, completed in 1991; 11 161 aged 16-44 years in Natsal-2, completed in 2001, and 15 162 aged 16-74 years in Natsal-3, completed in 2012. Comparisons of actual and preferred sexual frequency in men and women aged 16-44 (the age range common to all surveys) between the three surveys. Factors associated with sexual frequency of at least once a week were examined using Natsal-3 data. Main outcome measures Sexual activity in the past month; frequency of sex in the past month; preferred frequency of sex. Results Median number of occasions of sex in the past month was four in Natsal-1 and Natsal-2 and three in Natsal-3 among women; and three in Natsal-1, Natsal-2, and Natsal-3 among men. The proportion reporting no sex in the past month fell between Natsal-1 and Natsal-2 (from 28.5% to 23.0% in women and from 30.9% to 26.0% in men) but increased significantly in Natsal-3 (to 29.3% in women and 29.2% in men). The proportion reporting sex 10 times or more in the past month increased between Natsal-1 and Natsal-2, from 18.4% to 20.6% in women and from 19.9% to 20.2% in men, but fell in Natsal-3, to 13.2% in woman and 14.4% in men. Participants aged 25 and over, and those married or cohabiting, experienced the steepest declines in sexual frequency (P values for interaction <0.05). Alongside the declines in sexual frequency, there was an increase in the proportion reporting that they would prefer sex more often. Age adjusted odds ratios showed that men and women in better physical and mental health had sex more frequently, as did those who were fully employed and those with higher earnings. Conclusions Frequency of sex has declined recently in Britain, more markedly among those in early middle age and those who are married or cohabiting. The findings and their implications need to be explained in the context of technological, demographic, and social change in Britain and warrant further investigation.
Article
Even with the well‐recognized benefits of exercise, levels of physical activity are on the decline, while weight gain levels are increasing. The purpose of this evidence‐based literature review was to investigate the relationship between physical fitness, sexual functioning and overall health. There is too little information about these relationships to the detriment of educational programming efforts designed to help protect the public against noncommunicable diseases and their associated individual, family, organization, and societal costs. The literature review revealed that even modest increases in physical activity were positively associated with enhanced sexual functioning. Sexual functioning was also strongly linked to overall health, supporting the usefulness of including sensitively‐presented information about the benefits of exercise and being physically fit as it relates to sexual functioning in adult health education curricula. Gender and age differences, physical self‐concept, and well‐being also emerged as important factors when considering the links between physical fitness, sexual functioning and overall health. Recommendations for research included (a) controlling for possible social desirability effects and (b) designing new research that follows the association between physical activity, sexual functioning and overall health longitudinally in more international settings beyond the U.S. and western Europe.
Article
Past research has found menstrual-cycle-related changes in functional immune response; we examined if sexual activity also changed markers of immune defense. We followed 32 naturally cycling women (15 sexually active with a partner ≥ 1 time/week, 17 sexually abstinent for the last four months) over one menstrual cycle. Participants provided serum and saliva samples at menses and ovulation, and additional saliva samples at midfollicular and midluteal phases. At each phase, participants also self-reported symptoms associated with colds, flu, pain, menstrual discomfort, and premenstrual syndrome. We tested saliva and serum for ability to kill Escherichia coli or Candida albicans, and serum for complement protein activity. For serum-mediated pathogen killing, among sexually active women only, there was a significant midcycle decrease in killing of E. coli. For saliva-mediated pathogen killing, among abstinent women only, there was a significant midcycle decrease in killing of E. coli, and midcycle increase in killing of C. albicans. Sexually active women had significantly lower complement activity than abstinent women overall. Finally, both groups reported lower physical symptoms at midcycle and higher symptoms at menses. There may be important differences in immune function between healthy women who are sexually active versus abstinent. Further replication is warranted.
Chapter
Sexual intimacy is a central feature in marital relationships, but the frequency of sexual intercourse peaks during the early years of marriage and declines steadily during the later years of marriage. There are a variety of individual and relational factors that can affect the frequency of sexual relations between romantic partners, such as habituation, age, physical health, psychological well-being, and relationship quality. Declines in sexual frequency can have consequences for the strength of romantic relationships and is predictive of relationship dissatisfaction and dissolution. Promoting open communication, encouraging a communal orientation toward sex, and breaking the cycle of anxiety and avoidance can help strengthen sexual relations for long-term married and cohabiting couples.
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Background There is a growing population of geriatric men experiencing sexual health concerns. These issues may stem from surgical interventions of the prostate gland, age-related changes affecting erectile dysfunction, or other concerns. Objectives To illuminate the male sexual dysfunctions lessened via pelvic floor muscle rehabilitation and proper education to assist clinicians in achieving positive patient outcomes. Methods The literature was reviewed from 1996 to 2015 using PubMed. Results Effective conservative care strategies exist for appropriate patients via pelvic floor muscle therapy, manual therapy, education regarding cardiovascular health, and triage to psychological and sexual counseling. Conclusion Efficacy is present for this population, but some conditions are more effectively treated conservatively than others.
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The utility of monogamy (in practice) as a strategy for preventing sexually transmitted infections (STIs) was investigated. By reviewing recent literature surrounding monogamous relationships and sexual behaviors, the authors determined that monogamy might not prevent against STIs as expected. First, the authors elucidate the ways in which public health officials and the general public define and interpret monogamy and discuss how this contributes to monogamy as an ineffectual STI prevention strategy. Second, the authors provide evidence that individuals' compliance with monogamy is likely to be low, similar to rates of compliance with other medical advice. Lastly, the authors draw upon recent research findings suggesting that when people label themselves as monogamous, they are less likely to engage in safer sex behaviors than people who have an explicit agreement with their partner to be non-monogamous. Future research and clinical directions to promote sexual health and destigmatize sexual behaviors are considered. Copyright © 2015. Published by Elsevier Inc.
Sexual behavior is an important aspect of adolescent development with implications for well-being. These chapters highlight important perspectives on studying sexual health from a normative, developmental perspective, such as viewing a range of sexual behaviors as life events; considering potentially positive physical health, mental health, social health, and identity outcomes; examining both intraindividual and interindividual differences in outcomes; recognizing the romantic relationship context of sexual behavior; and understanding how sexual media may impact sexual health outcomes. We suggest new directions for studying sexual health outcomes, such as studying behaviors beyond vaginal sex and condom use, new methodologies such as latent class analysis, sophisticated longitudinal designs, and collection and analysis of dyadic data. We recommend research on populations underrepresented in sexual health research such as late adolescents who do not attend traditional universities and adolescents from ethnic/racial minorities. Finally, we consider future directions for sexuality education and prevention efforts. © 2014 Wiley Periodicals, Inc.
Article
IntroductionDepression can suppress immune function, leading to lower resistance against infection and longer healing times in depressed individuals. Sexuality may also influence immune function, with evidence that sexual activity is associated with lowered immune function in women and mixed results in men. Immune mediators like immunoglobulin A (IgA) are immediately relevant to sexual health, since they are the first line of defense against pathogens at mucous membranes like the vagina. AimThis study aims to determine if and how depression, sexual activity, and their interaction impact salivary IgA (SIgA) in men and women. Methods In Study 1, a community-based sample of 84 women and 88 men provided saliva samples and completed questionnaires on their demographic background, level of depression, and frequency of partnered and solitary sexual activity. Study 2, conducted separately in an undergraduate student sample of 54 women and 52 men, had similar methods. Main Outcome MeasuresThe main outcome measures were scores on the General Well-Being Schedule depression subscale, reported frequency of sexual activity, and SIgA levels as measured by enzyme immunoassay. ResultsAcross studies, higher levels of partnered sexual activity were associated with lower SIgA for women with high depression scores, but not for women with low depression scores. In contrast, higher levels of partnered sexual activity were associated with higherSIgA for men with high depression scores, but not for men with low depression scores. Conclusion Our results show that partnered sexual activity is a risk factor for lowered immunity in women with depressive symptoms but a possible resilience factor for men with depressive symptoms. This suggests a role for sexual activity in determining the impact of depression on physical health parameters. Lorenz T and van Anders S. Interactions of sexual activity, gender, and depression with immunity. J Sex Med 2014;11:966-979.
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Recently, scientific and popular press articles have begun to represent sex as a health-promoting activity. A number of scientific studies have identified possible health benefits of sexual activity, including increased lifespan and decreased risk of certain types of cancers. These scientific findings have been widely reported on in the popular press. This "sex for health" discourse claims that sexual activity leads to quantifiable physical and mental health benefits in areas not directly related to sexuality. Analyzing this discourse provides an opportunity to better understand both broader health promotion discourses and current norms and anxieties about sexuality. In this article, I place this "sex for health" discourse within the context of broader health promotion discourses and within the context of a number of historical and contemporary discourses connecting health and sexuality. I argue that although the "sex for health" discourse may serve to de-stigmatize sexual activity for some, it may also increase pressure on others to be sexually active and may further pathologize sexual "dysfunction." In addition, these representations often serve to further privilege a normative form of sexual behavior - coitus in the context of a monogamous heterosexual partnership - at the expense of non-normative sexual desires, identities, and practices.
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It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses. After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer. The rates of both respiratory infection (P less than 0.005) and clinical colds (P less than 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings. Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.
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To examine a hypothesized link between daily stressful events and secretory immunoglobulin A (sIgA) antibody, 96 adults from the community completed daily event questionnaires and gave daily saliva samples for up to 12 weeks. They also ingested a capsule of a novel protein to challenge their secretory immune systems. The questionnaire yielded measures of negative and positive experiences, of their content, and of negative and positive affect. On a within-subjects, day-to-day basis, reporting more desirable events was related to more sIgA antibody, and reporting more undesirable events was related to less. Desirable events also had lagged (1 and 2 days), positive effects on sIgA levels. Undesirable work events and desirable leisure and household events were more strongly related to sIgA than events in other categories. Positive affect related directly to sIgA, and negative mood related inversely to same-day sIgA.
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During the course of evolution invertebrates and vertebrates have maintained common signaling molecules, such as neuropeptides. For example, complete hormonal-enzymatic systems for the biosynthesis of opioid peptides have been found in both the CNS and immune systems of these animals. These signaling molecules have been found in the blood circulation and act as immunomodulators. In vertebrates, release of the signaling molecules occurs during stress (cognitive or pathogens), which triggers the hypothalamo-hypophysial-adrenal axis. Similarly, these neuropeptides are used as messengers to initiate and stimulate the innate immune response in invertebrates. Thus, the crosstalk between nervous and immune systems has an ancient evolutionary origin and the messengers used have been conserved during the course of evolution reflecting their vital importance.
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The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most Isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.
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In a prospective study of 15 spouses of women with advanced breast carcinoma, lymphocyte stimulation responses to phytohemagglutinin, concanavalin A, and pokeweed mitogen were significantly suppressed during the first two months following the death of a spouse compared with prebereavement levels. A highly significant suppression was seen as early as one month after bereavement. No differences were found in total lymphocyte or B- or T-cell numbers. An intermediate level of mitogen responsivity was found during the four- to 14-month period after bereavement. Suppressed immunity following the death of a spouse may be related to the increased morbidity and mortality associated with bereavement. (JAMA 1983;250:374-377)
Article
The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27779 cancer cases. Unmarried persons with cancer had decreased overall survival (relative hazard, 1.23; 95% confidence limits, 1.19 to 1.28). We identified three complementary explanations for the poorer survival of the unmarried persons. First, unmarried persons were more likely to be diagnosed at a regional or distant stage (odds ratio, 1.19; 95% confidence limits, 1.12 to 1.25). After adjustment for stage, unmarried persons were more likely to be untreated for cancer (odds ratio, 1.43; 95% confidence limits, 1.31 to 1.55). Finally, after adjustment for stage and treatment, unmarried persons still had poorer survival. Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment.(JAMA 1987;258:3125-3130)
Article
The brain and immune system form a bidirectional communication network in which the immune system operates as a sense organ to provide the brain with information about infection and injury, thereby allowing the brain to coordinate a defense. Activated immune cells release proteins called cytokines, which signal the brain by both blood and neural routes. Information that reaches the brain across this sensory channel produces large changes in neural activity, behavior, mood, and cognitive functioning. Appreciation of the functioning of this network may illuminate poorly understood aspects of stress, depression, and intraindividual variability in behavior, mood, and cognition.
Article
IntroductionDepression can suppress immune function, leading to lower resistance against infection and longer healing times in depressed individuals. Sexuality may also influence immune function, with evidence that sexual activity is associated with lowered immune function in women and mixed results in men. Immune mediators like immunoglobulin A (IgA) are immediately relevant to sexual health, since they are the first line of defense against pathogens at mucous membranes like the vagina. AimThis study aims to determine if and how depression, sexual activity, and their interaction impact salivary IgA (SIgA) in men and women. Methods In Study 1, a community-based sample of 84 women and 88 men provided saliva samples and completed questionnaires on their demographic background, level of depression, and frequency of partnered and solitary sexual activity. Study 2, conducted separately in an undergraduate student sample of 54 women and 52 men, had similar methods. Main Outcome MeasuresThe main outcome measures were scores on the General Well-Being Schedule depression subscale, reported frequency of sexual activity, and SIgA levels as measured by enzyme immunoassay. ResultsAcross studies, higher levels of partnered sexual activity were associated with lower SIgA for women with high depression scores, but not for women with low depression scores. In contrast, higher levels of partnered sexual activity were associated with higherSIgA for men with high depression scores, but not for men with low depression scores. Conclusion Our results show that partnered sexual activity is a risk factor for lowered immunity in women with depressive symptoms but a possible resilience factor for men with depressive symptoms. This suggests a role for sexual activity in determining the impact of depression on physical health parameters. Lorenz T and van Anders S. Interactions of sexual activity, gender, and depression with immunity. J Sex Med 2014;11:966-979.
Article
Ninety newlywed couples (mean age = 25), selected on the basis of extremely stringent mental and physical health criteria, were admitted to a hospital research unit for 24 hours to provide a detailed assessment of conflict-resolution behaviors and changes in autonomic, endocrine, and immune function. Among these newlyweds, negative or hostile behaviors during marital conflict (coded from videotaped interactions) were associated with increased levels of epinephrine, norepinephrine, growth hormone, and ACTH as well as greater immunological change over the subsequent 24 hours. Wives demonstrated greater and more persistent physiological changes related to marital conflict than husbands. To assess the generalizability of these physiological changes, a similar laboratory paradigm was used with 31 older couples (mean age = 67) who had been married an average of 42 years. Consistent with the data from newlyweds, both endocrinological and immunological data showed significant relationships to negative behavior during marital conflict in these older couples. These findings suggest that abrasive marital interactions have important endocrinological and immunological correlates.
Article
This study investigated the effect of daily relaxation on concentrations of serum immunoglobulins A, G, and M and secretion rates of salivary immunoglobulin A (S-IgA). Twenty-four volunteers were randomly assigned to practice a relaxation technique daily for 3 weeks and 16 to a waiting list control condition. Blood and saliva samples were collected before and after a supervised 20-min relaxation session at the beginning and end of the 3-week practice period. S-IgA secretion rate increased significantly (pbefore to after relaxation samples was higher (p=.014) in subjects who had practiced relaxation once a day for 3 weeks than in waiting list control subjects practicing for the first time. Serum IgA (ppp
Article
This study measured depressive symptoms in 98 men of whom 49 had and 49 had not had a recent experience of family death or serious family illness. The relationships of depression and occurrence of the stressful event to immune function was explored. Persons with higher scores on depression in both groups showed less responsiveness of their lymphocytes to phytohemagglutinin and to allogeneic cells. Data indicate that not all persons react the same way to stressful events and that those with high and low depressive features can be differentiated by their immune responses.
Article
Site-specific cancer incidence rates were computed by sex, age, and marital status for whites and blacks separately for ages 35-64 years with the use of population-based incidence data from the Third National Cancer Survey (1969-71) and with demographic data from the 1970 U.S. Census. Although rates were presented for all cancer sites combined and for 44 specific sites or rubrics, discussion focused on the 17 most common cancers. Within age, race, and sex groups, patterns of cancer incidence by marital status were compared by means of standardized incidence ratios, and the consistency of marital status patterns across age groups was assessed statistically. Among the most notable findings were: excess cancer rates across most sites and age groups in single black males, consistently high rates for cancer of the lung and bronchus in divorced white males and in single black females, low rates for the hormone-dependent reproductive tumors (prostate gland, breast, uterine corpus, and ovary) in separated white males and females, and high rates for cervical cancer among separated white women. Marital status patterns, where found, frequently differed between whites and blacks and between males and females.
Article
The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.
Article
This study investigated the effect of daily relaxation on concentrations of serum immunoglobulins A, G, and M and secretion rates of salivary immunoglobulin A (S-IgA). Twenty-four volunteers were randomly assigned to practice a relaxation technique daily for 3 weeks and 16 to a waiting list control condition. Blood and saliva samples were collected before and after a supervised 20-min relaxation session at the beginning and end of the 3-week practice period. S-IgA secretion rate increased significantly (p less than .001) after 20 min of relaxation. A longer-term practice effect also occurred in that the increase in secretion rate in "before to after" relaxation samples was higher (p = .014) in subjects who had practiced relaxation once a day for 3 weeks than in waiting list control subjects practicing for the first time. Serum IgA (p less than .001), IgG (p less than .001), and igM (p less than .05) increased significantly over the 3-week practice period. Relaxation may be a self-regulating strategy affecting both humoral and cellular divisions of the immune system.
Article
The field of psychoimmunology has rapidly expanded in recent years and various parameters of the immune system have been examined in relation to psychological factors. The secretory immune system is one of the more interesting aspects of the entire immune system because it protects mucosal membranes from invading organisms. Stress-produced changes in secretory immunoglobulin A (s-IgA) as measured by radial immunodiffusion assays have been reported in several studies. We present three reasons why total s-IgA protein, the measure derived from radial immunodiffusion assays, may not be a reasonable measure of immune system functioning, and we suggest an alternative method for examining secretory IgA that focuses on s-IgA antibody response to a novel antigen.
Article
Forty-six college students provided saliva samples just after taking an examination, one hour and 45 minutes later, and several days later, at a period of rest. As compared with baseline levels, the power stress of an examination was associated with an increase in salivary immunoglobulin A (S-IgA), a measure of B-cell immune function, and with an increase in norepinephrine (NE) concentrations in the saliva. The increase in NE was greater for those for whom n power was greater than n affiliation rather than for those for whom the reverse was true. Greater increases in, and levels of, NE at the examination and after were associated with greater subsequent drops in S-IgA, which reached below baseline levels for those for whom n power was stronger. The examination stimulated adrenergic activity, which in the long run depressed immune function for those with a strong power motive who had been most aroused adrenergically by the examination.
Article
Exposure of the mucus membranes of the intenstinal or repiratory tracts to various viral antigens elicits immunological reactivity both at the local as well as in the systemic sites. The reactivity generated involves antibody as well as cell-mediated immune responses. Recent investigations have revealed that the outcome of the initial cell-virus interaction in the mucose leads to protection as seen in infections with certain viruses while in others it may play a role in the pathogenesis of disease. The information on the mechanism of and the factors influencing protection or pathogenesis in viral diseases acquired vis gastrointenstinal or repiratory tract will be reviewed in this chapter.
Article
Salivary immunoglobulin A (IgA) concentration increased significantly after subjects viewed a humorous videotape and did not change significantly after they viewed a didactic videotape. Scores on a questionnaire measuring the perceived use of humor as a coping skill were positively related to initial IgA concentration and inversely related to changes in IgA concentration after subjects' viewing of the humorous videotape, which implies a ceiling effect. Enhancement of the immune system may be one link between anecdotal claims of relationships between an individual's being in a positive emotional state and healing.
Article
When an unknown amount of antigen is allowed to diffuse radially from a well in a uniformly thin layer of antibody-containing agar for a sufficient time to allow all antigen to combine, the final area reached by the precipitate is directly proportional to the amount of antigen employed, and inversely proportional to the concentration of antibody. It is also shown that the temperature at which the plates are incubated has no perceptible influence upon the results. By standardizing the technical conditions of the experiment it is possible to use this principle for the immunochemical determination of antigens. In the experimental albumin-antialbumin system here described, the lower limit of the method was found to correspond to 0·0025 μg of antigen, and to an antigen concentrations of 1·25 μg per ml. The standard deviation of the antigen determinations was less than 2 per cent of the mean.
Article
The neuropeptides beta-endorphin and met-enkephalin are potent analgesics and have a broad spectrum of biologic activities including the recently described alterations of lymphocyte proliferation and antibody production. The current study demonstrates that beta-endorphin and met-enkephalin stimulate human mononuclear cell chemotaxis, as measured by the in vitro leading front assay for migration. The response to both beta-endorphin and met-enkephalin was bimodal, with peak activities occurring at 10(-12) M and 10(-8) M. The distance migrated in response to optimal concentrations of beta-endorphin or met-enkephalin was approximately 80% of that obtained with 10(-8) M formyl-methionyl-leucyl-phenylalanine (f-MLP) and was blocked by prior incubation with 10(-8) M naloxone. Removal of glass adherent cells resulted in a loss of the response to beta-endorphin. Quantitation of the number of cells responding to beta-endorphin showed that only about 50% as many cells responded to beta-endorphin as compared with f-MLP. Human neutrophils showed some migration in response to beta-endorphin and met-enkephalin, although the average optimal migration was less than 30% of that observed with 10(-8) M f-MLP. Studies of the in vivo infusion of beta-endorphin into the cerebral ventricle of the rat resulted in the immigration of macrophage-like cells and are consistent with the in vitro evidence for a chemotactic effect of beta-endorphin.
Article
In a prospective study of 15 spouses of women with advanced breast carcinoma, lymphocyte stimulation responses to phytohemagglutinin, concanavalin A, and pokeweed mitogen were significantly suppressed during the first two months following the death of a spouse compared with prebereavement levels. A highly significant suppression was seen as early as one month after bereavement. No differences were found in total lymphocyte or B- or T-cell numbers. An intermediate level of mitogen responsivity was found during the four- to 14-month period after bereavement. Suppressed immunity following the death of a spouse may be related to the increased morbidity and mortality associated with bereavement.
Article
This study investigated the effects of music and an auditory stimulus on immunoglobulin A (IgA). Groups of college students (N = 66) were exposed to one of four conditions: a 30-min, tone/click presentation; 30 min. of silence; 30 min, of a Muzak tape referred to as "Environmental Music"; and a 30-min. radio broadcast comparable in musical style. Saliva samples collected before and after each 30-min. treatment were assayed for IgA. Analysis indicated significant increases in IgA for the Muzak condition (n = 20) but not for any of the other conditions. Possible mechanisms of action and implications for immunocompetence are discussed.
Article
Data were collected on 10 newswriters in a newspaper's newsroom. These included self-reported stress ratings and saliva samples for secretary immunoglobulin A (IgA) analysis. The stress ratings and saliva samples were taken initially and after three 30-min. periods. The first time period was a baseline measure and involved the workers engaging in their usual tasks. At Time 2 music was presented for 30 min. while workers engaged in their normal activities. At Time 3 workers resumed their normal duties. Findings showed an increase in IgA that was not statistically significant, a reduction in stress during the music period that was statistically significant, and a statistically significant negative correlation between stress and IgA.
Article
The construct of explanatory style has been related to numerous aspects of human psychology, including health. Our research has focused on the effects of various psychological variables on the immune system, in particular Immunoglobulin A (IgA). We had participants fill out the Attributional Style Questionnaire (ASQ), the predominant measure of explanatory style, and assayed saliva samples for secretory IgA. No relationship was observed between overall ASQ score and IgA, or composite optimism score and IgA. However, we observed significant negative correlations between both the composite pessimism score and IgA, as well as the hopelessness score and IgA. Pessimistic explanatory style may therefore be related to immune system deficits and poor health.
Article
Because of interest in the link between oral and general health, clinicians are increasingly using salivary analyses to diagnose systemic disease and to monitor general health. The reason for this interest lies in the ability of new diagnostic tools, such as sensitive enzyme-linked immunosorbent assays, as well as other technologies, to distinguish a range of salivary components that are biomarkers for changes in the body's health. The noninvasive nature of salivary testing has made it an attractive and effective alternative to blood and urine testing, and home testing kits have made it possible for people to monitor their own health using this diagnostic medium. This paper explores what saliva can reveal about general health, drawing examples from recent research on salivary biomarkers of systemic illness and highlighting the current use, and potential clinical and research applications, of diagnostics based on oral fluids.
Suppres-sion of lymphocyte stimulation following bereavement Secretory IgA as a mea-sure of immunocompetence
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The faith factor: proof of the healing power of prayer The effect of an examination on salivary norepinephrine and immunoglobulin levels
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The effect of petting a dog on immunoglobulin A (IgA) Paper presented at the annual meeting of the Eastern Psychological Association Feeling good is good for you: how pleasure can boost your immune system and lengthen your life
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CHARNETSKI, C. J., &BRENNAN, F. X. (2001a) The effect of petting a dog on immunoglobulin A (IgA). Paper presented at the annual meeting of the Eastern Psychological Association, Washington, DC. CHARNETSKI, C. J., & BRENNAN, F. X. (2001b) Feeling good is good for you: how pleasure can boost your immune system and lengthen your life. Emmaus, PA: Rodale Press. CHARNETSKI, C. J., BRENNAN, F. X., &HARRISON, J. F. (1998) Effect of music and auditory stim-uli on Immunoglobulin A (IgA). Perceptual and Motor Skills, 87, 1163 -1170.
Local immune responses Molecules of emotion Effects of positive and negative emotions on salivary IgA
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Local immune responses Molecules of emotion
OGRA, P. L. (1985) Local immune responses. British Medical Bulletin, 41, 28. PERT, C. B. (1997) Molecules of emotion. New York: Scribner.
Feeling good is good for you: how pleasure can boost your immune system and lengthen your life
  • C J Charnetski
  • F X Brennan
CHARNETSKI, C. J., & BRENNAN, F. X. (2001b) Feeling good is good for you: how pleasure can boost your immune system and lengthen your life. Emmaus, PA: Rodale Press.
The faith factor: proof of the healing power of prayer
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MATTHEWS, D. A. (1999) The faith factor: proof of the healing power of prayer. New York: Penguin Press.
(1997) Molecules of emotion
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OGRA, P. L. (1985) Local immune responses. British Medical Bulletin, 41, 28. PERT, C. B. (1997) Molecules of emotion. New York: Scribner.