Search Results (295)

Background: Sexual dysfunction (SD) affects up to two-thirds of individuals with early-onset Parkinson’s disease (PD), yet it remains underexplored in developing countries where stigma, depression, and treatment side effects may worsen its burden. This study investigated the magnitude and correlation of SD in early-onset PD. Methods: A cross-sectional study included 74 individuals with PD onset at ≤55 years of age. SD was assessed using the Medical Outcomes Study Sexual Functioning Scale, alongside interviews on sexual experiences after initiating PD medication. Prevalence was estimated descriptively, and Spearman’s correlation identified correlates of SD. Results: Half of participants reported SD, including lack of sexual interest (52.7%), difficulty relaxing or enjoying sex (52.7%), and impaired arousal (50%). Among men, 48% experienced erectile problems, while 44% of women reported difficulty achieving orgasm. After starting anti-Parkinson’s medication, 16% noted markedly reduced sexual desire, whereas nearly 10% reported increased desire. In men, SD correlated with levodopa dose (r = 0.411, p < 0.01). In women, SD correlated with stigma (r = 0.389, p < 0.05), depression (r = 0.529, p < 0.01), and anxiety (r = 0.629, p < 0.01). Conclusions: One in two individuals with early-onset PD experiences SD, independent of gender. Findings highlight the need for routine sexual health assessment and careful monitoring of treatment side effects. Interventions targeting stigma, depression, and anxiety are critical to improve sexual well-being in this population. Full article

Internal Boxing (neijiaquan 內家拳) is an advanced form of the Daoist gymnastic exercise of daoyin (導引). However, how it achieves a paradigmatic shift from qi/blood regulation to deep-level transmutation of sexual energy still requires further exploration. Therefore, it is of great significance to look into how Internal Boxing inheres and integrates various techniques of “desire transmutation” (zhuanyu 轉欲) from internal alchemy (neidan 內丹), thereby transcending traditional daoyin, bringing about a significant systematic reconfiguration in the model of body cultivation practices in Daoist medicine. The traditional daoyin (i.e., “guiding and stretching”) practice emphasizes the regulation of qi/blood, but it remains limited in accounting for and producing the self-conscious transmutation of sexual energy. In contrast, Internal alchemy provides a different system of theory and techniques, which is centered on the concept of “transmutation of desires”, converting human desires into high-level life energy through a process of interaction between one’s internal spirit (xinshen 心神) and internal breathing (neixi 內息). This study thus examines the ways in which Internal Boxing integrates and reconfigures these techniques within its bodily training regimen. In the core of all these styles is the goal to refine the primordial essence (yuanjing 元精) by transitioning the method to induce the flow of vital energy from breathing to somatic movements. As a result, this study shows that the innovations of Internal Boxing reconfigure the qi/blood regulation model in the traditional daoyin practice, causing a systematic reconfiguration in the transmutation of sexual energy and, further, bridging the gap between daoyin and internal alchemy in both theory and practice. Furthermore, such innovations also develop a holistic view of the human body as marked by an emphasis on the “unity of pre-heaven (xiantian 先天) and post-heaven (houtian 後天) states”, which expands in both depth and breadth the theories of body cultivation practices in Daoist medicine. Full article

Understanding the genetic diversity and structure of regional cacao and its close relatives is essential for strengthening conservation strategies and enhancing the resilience of Amazonian agroforestry systems. This study evaluated the genetic diversity, population structure, and varietal relationships of 48 sexually derived regional accessions of Theobroma cacao, T. grandiflorum, and T. bicolor with desirable morpho-agronomic traits, together with eight universal T. cacao reference clones, all cultivated in farmer-managed agroforests of the northwestern Colombian Amazon, using a panel of 15 SSR markers. The loci exhibited substantial allelic richness (mean Na = 8.53) and consistently high expected heterozygosity (Hexp = 0.74), with numerous private alleles indicating species- and lineage-specific divergence. Bayesian clustering, ΔK inference, and minimum spanning networks identified four genetically coherent subpopulations corresponding to the three species and a distinct lineage within T. cacao, strongly aligned with the discriminant analysis of principal components (DAPC) results. Analysis of Molecular Variance (AMOVA) revealed that most genetic variation occurred among subpopulations (56.68%), while pairwise FST (Wright’s fixation index) values confirmed strong interspecific differentiation and significant divergence within T. cacao. No isolation-by-distance pattern was detected. These findings demonstrate that regional Theobroma germplasm maintained in smallholder agroforests constitutes a valuable reservoir of genetic diversity that complements universal reference clones. By documenting species-level divergence and lineage-specific variation, this study supports the integration of farmer-managed genetic resources into conservation planning and highlights their importance for the long-term resilience of Amazonian cacao-based agroforestry landscapes. Full article

Background and Objectives: Autologous hematopoietic stem cell transplantation (AHSCT) offers life-saving treatment for hematologic malignancies but can result in persistent sexual dysfunction and relationship challenges. Attachment theory provides a valuable framework for understanding how enduring relational patterns influence sexual well-being. This study aimed to assess sexual function and attachment styles in AHSCT survivors and examine correlations between attachment and sexual health outcomes. Materials and Methods: A multicenter, cross-sectional study was conducted from December 2019 to March 2022 in five public hospitals in Athens, Greece. Participants were 127 adult survivors who had undergone AHSCT between 6 months and 5 years before enrollment. Sexual function was evaluated with the International Index of Erectile Function (IIEF) for men and the Female Sexual Function Index (FSFI) for women. Attachment style was measured using the Experience in Close Relationships Scale–Short Form (ECRSHORT-FORMSCALE). Results: Men demonstrated high erectile function (IIEF total: 54.10 ± 20.1), whereas women reported moderate sexual dysfunction (FSFI total: 22.51 ± 8.95). Both genders showed average attachment levels, with anxiety scoring lowest and discomfort with closeness highest. Between-group comparisons revealed no significant difference in anxiety (p = 0.95), a near-significant difference in avoidance (p = 0.056), and a significant difference in discomfort with closeness (p < 0.0001), with women scoring higher. In men, no significant correlations emerged between attachment and sexual function. In women, higher attachment anxiety correlated negatively with all FSFI domains except pain, avoidance correlated positively with lubrication, and discomfort with closeness correlated negatively with desire and pain. Conclusions: Findings reveal gender-specific patterns in attachment and their influence on sexual function of AHSCT survivors, highlighting the need for attachment-informed interventions to support intimacy, relationship satisfaction, and overall quality of life in survivorship care. Full article

Objective: This study aimed to investigate aspects of sexual response in cisgender women by querying what participants deem to be important physiological and subjective components of sexual arousal. It was also explored whether education about the role of genital blood flow influenced participant responses. Methods: Standard sexuality-based questionnaires were administered assessing function, desire, flexibility, satisfaction, and history, prior to administering a short semi-structured interview. Experiences of sexual arousal were explored in the interview in an open-ended fashion. A brief educational video condition was shared with half of the participants at random. We explored whether being presented additional information about genital function changed the way women describe their physiological response. Those in the control group completed the interview questions once. Those in the educational condition group completed the interview, watched the brief educational video and then repeated the interview questions. Following the interview, all participants completed a brief follow-up questionnaire assessing preferred arousal terminology. Results: The sample size included 30 cisgender women with a mean age of 21.10 (4.38), with 70% in a committed relationship. Additionally, there were no group difference found with those who reported a history of sexual trauma/abuse vs. no trauma/abuse in regard to sexual function, satisfaction, distress and flexibility. The physical arousal sensations described most often in the interview included lubrication (n = 27), blood flow (n = 23), and pulsating (n = 9), whereas, in the ranked term analysis, the three most highly ranked genital sensations were wetness, throbbing and tingling. For non-genital sensations, those most often reported in the interviews included nipples/breast changes (n = 17), skin sensitivity (n = 13), and changes in body temperature (n = 12), whereas them most highly ranked non-genital sensations were heart rate increase, hardness of nipples/breast changes, and skin sensitivity. There were no group differences in the reporting of full-body or genital sensations and the frequency of use of terminology related to blood flow. The two most important themes emerging from the qualitative analysis included the distinct themes of subjective and physiological arousal. The majority of participants placed an emphasis on subjective arousal, deeming it the most important part of their sexual response, with physiological arousal largely deemed important only when subjective arousal was also present. Conclusions: The same themes were present in both groups, indicating that the brief educational video was unlikely to have influenced the way women described their physiological arousal. Participants in both groups placed a dominant emphasis on sensations related to genital blood flow and the importance of subjective arousal. Full article

The current systematic review modified the Enduring Vulnerability Stress Adaptation model of relationship functioning and the Attachment System Activation model of individual functioning to incorporate various aspects of orgasmic functioning within the broader context of sexual health and sexual satisfaction. This provided conceptual frameworks for integrating the findings on a wide range of correlates of orgasms, sexual satisfaction, and other components of sexual health into comprehensive models of individual and interpersonal functioning to guide future research. A systematic search of the ProQuest, PubMed, and Web of Science databases (through September, 2025) for records linking sexual satisfaction with at least one other component of sexual health or at least one correlate (distress, well-being, physical health, relationship satisfaction, attachment avoidance, or attachment anxiety) yielded 3369 unique records, resulting in a final set of 228 records, representing 281 independent (sub)samples and a final combined sample of 248,021 participants. A total of 1201 effects were extracted, yielding 44 meta-analytic effects (using random effects modeling). Path analyses of meta-analytic correlation matrices revealed that dimensions of sexual health (i.e., sexual satisfaction, orgasms, sexual desire, lack of sexual pain, vaginal lubrication) demonstrated unique links to greater health, interpersonal functioning, and individual functioning (i.e., higher psychological well-being, physical health, and relationship satisfaction; lower psychological distress, attachment anxiety, and attachment avoidance). Meta-regression moderation analyses revealed that the effect linking orgasms to higher sexual satisfaction was especially pronounced for women and for individuals in clinical (sub)samples. In addition, the link between orgasms and lower distress was especially pronounced for older individuals. The findings were limited by the cross-sectional nature of the vast majority of the findings (96%), leaving the directions of causality unclear. Taken together, these results highlight the central role that sexual health might play in individual and relationship health, supporting the proposed conceptual models and highlighting directions for future research. Full article

This perspective advances a psychoanalytic—embodiment account of the “libido of generativity” (LoG)—future-oriented reorganization of erotic desire that links embodied arousal with caregiving, legacy, and shared projects. We define LoG along four axes (direction of investment: dyad↔triad; temporal horizon: immediacy↔future; outcome modalities: procreative, creative–sublimative, community-forming; affective regulation: shame/guilt↔pride/gratitude). Integrating interoception, body ownership/agency, and self-compassion with reproductive mentalizing, we specify three proximal levers—embodiment, affect regulation, and representation—through which sexual mindfulness can recalibrate bodily salience, blunt shame-based self-objectification, and expand triadic representations (self–partner–child/symbolic offspring). We then translate these mechanisms into a brief, practice-ready relationship guidance (RG) curriculum (6–8 sessions) combining somatic mindfulness, compassion micro-practices, reproductive-mentalizing dialogs, communication skills, and generative rituals. We articulate falsifiable propositions (e.g., mindfulness → ↑couple satisfaction via ↓body-image self-consciousness and ↑reproductive mentalizing) and a sex/gender-attentive reporting plan (SAGER). Primary outcomes include sexual functioning/satisfaction and couple satisfaction/communication; secondary mechanistic endpoints index interoceptive accuracy/awareness (including heartbeat-evoked potentials), self-compassion, and reproductive mentalizing. By aligning contemplative practices with couple-skills training and equity-focused implementation, the LoG framework offers a testable bridge from psychoanalytic theory and embodiment science to measurable improvements in sexual health and couple well-being. Full article

Background and Objectives: Sexual function often fluctuates during pregnancy, yet the contributions of body image-related quality of life (BI-QoL)—operationalized via body image instruments such as the Body Exposure during Sexual Activities Questionnaire (BESAQ) and pregnancy-specific body image scales—and relationship satisfaction remain inconsistently quantified. This systematic review aimed to synthesize evidence on the associations between BI-QoL, relationship satisfaction, and female sexual function in pregnant women. Methods: Following PRISMA 2020, PubMed/MEDLINE, Scopus, and Web of Science were searched up to 23 August 2025. Eligible studies enrolled pregnant women and reported quantitative data on BI-QoL and/or relationship satisfaction alongside sexual outcomes. Risk-of-bias used design-appropriate tools; findings were narratively synthesized due to heterogeneity. Results: Thirteen studies met criteria (predominantly cross-sectional; sample sizes 107–472; one RCT; several couples/longitudinal cohorts). Female Sexual Function Index (FSFI) means clustered in the mid-20s; in a randomized trial, the intervention arm improved FSFI by +1.76 points (22.95 → 24.71; p = 0.002). Overall female sexual dysfunction reached 54.7% in the largest cross-sectional sample. Higher body exposure anxiety was associated with ~4.24-fold greater odds of dysfunction across trimesters. Marital satisfaction explained ≈36% of FSFI variance in multivariable models. Pregnancy context factors related to BI-QoL included planned pregnancy (β = −0.273) and third trimester (β = −0.280) indicating better BI-QoL, while more children predicted worse BI-QoL (β = +0.317). In one cohort, BI during sexual activity worsened postpartum versus pregnancy (p = 0.01). Conclusions: Across diverse settings, poorer BI-QoL and lower relationship satisfaction were consistently linked to reduced sexual function during pregnancy, with desire/arousal most affected. Routine screening and couple-sensitive counseling should be considered as promising, yet still under-tested, strategies that warrant further evaluation in intervention studies. Full article

Background and Objectives: Pelvic floor disorders are highly prevalent among women globally and can severely compromise daily functioning and well-being. Emerging energy-based modalities have reshaped conservative management strategies, by allowing individualized therapeutic approaches. The aim of this study was to evaluate the utility of customized energy-based applications, via an innovative multimodal EVA/DAFNE device that incorporates multimodal energy-based synergistic technologies for the treatment of pelvic floor dysfunction. Materials and Methods: Patients with PFDs (pelvic organ prolapse, all types of urinary incontinence, bladder voiding dysfunction, and dyspareunia) who selected conservative treatments were prospectively enrolled. Baseline and after-treatment quality of life was assessed using the following validated tools: Urinary Distress Inventory-6 (UDI-6), Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Female Sexual Function Index-6 (FSFI-6), Marinoff Scale, 0-100 VAS, and Vaginal Health Index. Overall improvement was measured through the Patient Global Impression of Improvement (PGI-I). Three to five sessions of treatment tailored according to the patient’s symptoms and clinical findings were delivered. Data were analyzed using standard statistical methods. Results: Twenty-six women with PFD who desired energy-based conservative treatment were recruited. Mean age was 48.6 ± 16.7 years. Indications for treatment were dyspareunia (n = 10; 38.5%), stress urinary incontinence (n = 9; 34.6%), mild pelvic organ prolapse (n = 6; 23.1%), genitourinary syndrome of menopause (n = 5; 19.2%), voiding dysfunction (n = 4; 15.4%), and overactive bladder syndrome (n = 2; 7.7%). Mean number of treatments was four. Baseline and after-treatment quality-of-life scores differed significantly. According to PGI-I scores 88.5% of patients considered themselves improved. Conclusions: Our study provides pilot estimates as to the safety and efficacy of a multimodal integrated treatment protocol for the treatment of PFD. Integrating multimodal energy-based conservative therapy into tailored treatment protocols can prove efficient and useful. Full article

This article examines the development of Islamic education in Islamic primary schools in the Netherlands from 1988 to 2025. Since the early 1970s, the Muslim population in the Netherlands has grown significantly—initially due to labor migrants from Turkey and Morocco, and later as a result of asylum seekers from countries such as Somalia, Iraq, and Syria. The desire to practice and pass on their faith led to the establishment of mosques, educational centers, boarding schools, and eventually Islamic primary schools. In 1987, some of the founders of Islamic primary schools aspired to establish institutions similar to Madrasas, focusing heavily on Islamic instruction such as Qur’an recitation and Hadith studies. However, these ambitions could not be realized due to funding requirements. Others were inspired by the Imam Hatip schools in Turkey, which offer religious subjects such as Qur’an, Hadith, and Sira (the life of the Prophet Muhammad) alongside the national curriculum. Ultimately, a Dutch model of Islamic education emerged—partly influenced by the Imam Hatip concept, yet possessing a distinct identity. This study investigates how Islamic education has evolved in practice through semi-structured interviews, school observations, document analysis, and a national survey of religion teachers. The findings indicate that the desire to provide Islamic religious education was the primary motive behind the founding of the first Islamic primary school in 1988. Since then, this objective has remained central to school boards and parents alike. Religious education has progressed from fragmented teaching materials rooted in Arabic and Turkish contexts to coherent, Dutch-language curricula. By 2025, the teaching materials of Worden wie je bent (“Becoming Who You Are”) and the Amana have become dominant. Instruction encompasses not only religious knowledge and Qur’an recitation but also social-emotional development, citizenship, and sexuality education within an Islamic framework. Full article

Background: Erectile dysfunction (ED) is one of the manifestations of long COVID-19 and in most cases has an endothelial and neurogenic nature. Many experimental and clinical investigations have revealed the high efficacy of transcutaneous electrical nerve stimulation (TENS) of the pudendal nerve and low-level laser therapy (LLLT) in the treatment of ED. Purpose: To compare LLLT and TENS, and investigate the dynamics of their efficacy when combined in the treatment of patients with post-COVID-19 ED using the International Index of Erectile Function-15 (IIEF-15). Materials and Methods: This interventional, randomized controlled trial enrolled 82 patients with ED following COVID-19. All patients had their first ED diagnosis after COVID-19 within one month of the onset of respiratory symptoms. The duration of patients’ ED was not less than six months, but less than one year. Patients were divided into four groups, one of which received sham LLLT and TENS (n = 20). The remaining patients underwent effective treatment using LLLT (n = 21), TENS (n = 21), and combined LLLT and TENS (n = 20). To study the effectiveness of the treatment, IIEF-15 and an assessment of tactile sensation in the genital area before and after the treatment, as well as 3 months after the end of the treatment, were used. Results: Both LLLT and TENS had a significant effect in improving erectile function, of 38% (p ≤ 0.01) and 27% (p ≤ 0.01), respectively. The improvement in erectile function after LLLT was higher than after TENS by 8.2% (p ≤ 0.05), but the combination of these methods exceeds the result of using LLLT alone by 20% (p ≤ 0.01). The reduction in hypoesthesia after LLLT did not exceed 17.4% (p ≤ 0.05). However, after TENS, the reduction in hypoesthesia reached 48.7% (p ≤ 0.01), and with a combination of the two methods, it reached 60.9% (p ≤ 0.01). Treatment outcomes in LLLT, TENS, and LLLT + TENS groups were stable for 3 months. Conclusions: According to IIEF-15 dynamics, LLLT and TENS are both very beneficial in treatment of post-COVID-19 ED, with LLLT showing a moderately better outcome than TENS. LLLT and TENS were found to have significant positive therapeutic effects on orgasm, sexual desire, and sexual satisfaction, among other aspects of sexual function. Nevertheless, the combination of LLLT and TENS proved to be much more successful in enhancing all IIEF domains, expanding the therapeutic effect spectrum, and improving the TENS effect following LLLT application. Only after TENS did genital hypoesthesia reliably regress, and the effect was amplified when TENS and LLLT were combined. Full article

This paper reexamines the contested categories of sex addiction and Compulsive Sexual Behavior Disorder (CSBD) through a feminist-critical synthesis of 63 peer-reviewed articles published between 2000 and 2024. Rather than treating these diagnoses as neutral clinical entities, the review situates them within broader systems of normative regulation, emphasizing how psychiatric discourse, cultural anxieties, and digital infrastructures converge to define sexual deviance. The analysis is organized around the following three themes: (1) clinical ambivalence, where blurred thresholds of disorder mirror the opaque judgments of algorithmic moderation; (2) moral panic, which persists less as episodic reaction than as a durable strategy of governance embedded in media and platform logics; and (3) the pathologization of margins, whereby diagnostic and digital regimes disproportionately target queer, racialized, and gender-nonconforming sexualities. The paper introduces the concept of digital moral regulation to describe how platform architectures extend older traditions of moral governance, embedding cultural judgments into technical systems of visibility and suppression. By reframing CSBD as part of this regulatory formation, the review underscores that debates over compulsive sexuality are not solely matters of diagnostic precision, but of power: who defines harm, whose desires are legitimized, and how infrastructures translate cultural unease into regimes of control. Full article

This research explores gender differences in long- and short-term relationships and sexual satisfaction among older adults. Socioemotional Selectivity Theory posits that as people age, they prioritize immediate emotional satisfaction due to perceptions of limited time. This shift influences older adults’ romantic relationships, increasing the likelihood of seeking meaningful connections and reducing the prevalence of negative emotions. With healthy relationships linked to physical, psychological, and financial benefits, research is needed to further understand older adult romantic relationships. Older adults (n = 155) from the Seniors Together in Aging Research (STAR) completed a survey assessing relationship preferences and current and predicted sexual satisfaction. T-tests were used to determine gender differences. Several gender differences were noted. Men reported greater levels of sexual satisfaction and predicted more positive future sex as compared to women. Men placed greater importance on long-term relationships. There was no gender difference in short-term relationship importance. Women may have shorter-term relationship desires to avoid taking on caregiving. This aligns with previous research indicating that when seeking new relationships, women are cautious about the potential of providing care to a partner. Greater sexual satisfaction reported by men aligns with previous research noting that men tend to be more sexually satisfied throughout the lifespan. Full article

Background/Objectives: The aim of this study was to investigate the experiences of Swedish patients with inflammatory bowel disease (IBD) regarding intimacy and sexuality-related issues, and to explore both patients’ and healthcare professionals’ perspectives on discussing these topics. Methods: This cross-sectional cohort study used two internet-based questionnaires: one targeting patients and the other healthcare professionals. The patient survey examined the impact of IBD and its treatment on relationships and sexuality, as well as expectations on healthcare support. The survey of healthcare professionals focused on experiences of discussing sexuality-related topics with IBD patients. Responses were analyzed using both quantitative and content analysis. Results: A total of 556 IBD patients and 118 healthcare professionals responded. Among patients, 78% reported difficulties related to relationships and sexuality, with physical symptoms like pain, fecal urgency, and bloating, and psychological problems such as fear of leakage and reduced sexual desire. Over half wished for these issues to be addressed in routine care, yet 84% had never initiated such discussions themselves. Among healthcare professionals, 23% never addressed issues of relationship and sexuality with patients, and another 50% did so only occasionally. Only 15% had access to qualified sexologists for referrals, and just 8% offered sexual rehabilitation after pelvic surgery. Conclusions: Sexual health is frequently compromised in IBD patients, especially in women, but remains insufficiently addressed in clinical practice. Both patients and healthcare professionals expressed a need for more open discussions about relationships and sexuality. Improving care requires routine screening, multidisciplinary support, and the development of guidelines for managing sexual dysfunction in IBD. Full article

The present research assessed university student stakeholders’ perceptions of positive outcomes (i.e., appropriateness and benefits of conferencing) and negative outcomes (i.e., endangerment and revictimization of the complainant) associated with restorative justice-based direct conferencing in sexual misconduct cases. Stakeholders received random assignment to a 2 (allegation severity: more vs. less) × 2 (evidence strength: lower vs. higher) between-participant experimental design. More severe allegations and higher evidence strength were associated with lower ratings of appropriateness; allegation severity and evidence strength interacted to affect ratings of benefits; and more severe allegations, but not stronger evidence, were associated with higher ratings of endangerment and revictimization. Belief in the alleged perpetrator’s guilt explained the relationship between evidence strength and ratings of appropriateness, and desire to punish the alleged perpetrator explained the relationship between allegation severity and ratings of appropriateness. Researchers and Title IX coordinators should evaluate and respond to stakeholder sentiment toward direct conferencing. Full article