Sexual initiation

Grammer, K. Kruck, K. 1996. Female control and female choice. In When women want sex perspectives on female sexual initiation and aggression. (Ed. by B. Anderson C. Struckmann-Johnson) New York Guilford Press. 

Although nitrite use was initially described among homosexual men who used nitrites in the context of sexual activity, more recently their use has expanded to include heterosexuals. Currently, in addition to being used as sexual enhancers, nitrites are frequently used in combination with amphetamines and ecstasy to accompany high energy dance and music among young... 

Abused drugs generally produce pleasant effects that are desired by the user. However, while most individuals will experience these pleasant effects, not everyone abuses these drugs, and not everyone who abuses them becomes dependent on them. Why some persons abuse drugs while most people do not is a complex area of research. It appears that genetic, environmental, and cultural factors may all interact to predispose some individuals to substance abuse and subsequent dependence. The initial hedonic experiences secondary to use of drugs appear to be primarily due to their ability to activate the primary reward circuits in the brain. These same reward circuits operate under normal circumstances to reinforce certain activities that promote survival, such as food, social affiliation, or sexual activity. 

The initial dose of SSRI is similar to that used in depression. Patients should be titrated as tolerated to response. Many patients will require maximum recommended daily doses. Patients with comorbid panic disorder should be started on lower doses (Table 37-4). When discontinuing SSRIs, the dose should be tapered slowly to avoid withdrawal symptoms, with the possible exception of fluoxetine. Relapse rates may be as high as 50%, and patients should be monitored closely for several weeks.58 Side effects of SSRIs in SAD patients are similar to those seen in depression and most commonly include nausea, sexual dysfunction, somnolence, and sweating. 

Amenorrhea traditionally is described as either primary or secondary in nature. Primary amenorrhea is the absence of menses by age 16 in the presence of normal secondary sexual development or the absence of menses by age 14 in the absence of normal secondary sexual development. Secondary amenorrhea is the absence of menses for three cycles or 6 months in a previously menstruating woman. However, in clinical practice, there is a significant amount of overlap. The initial evaluation of amenorrhea is often the same regardless of age of onset, except in unusual clinical situations.1... 

Psychogenic dysfunction occurs if a patient does not respond to psychic arousal. It occurs in up to 30% of all cases of ED. Common causes include performance anxiety, strained relationships, lack of sexual arousability, and overt psychiatric disorders such as depression and schizophrenia.5 It is postulated that the anxious or nervous man will have excessive stimulation of the sympathetic system, leading to smooth muscle contraction of arterioles and vascular spaces within erectile tissue.6 O Many patients may initially have organic dysfunction, but develop a psychogenic component as they try to cope with their inability to achieve an erection. It has been estimated that up to 80% of ED cases have an organic cause, with many having a psychogenic component as well.1... 

Androgens are important for general sexual function and libido, but testosterone supplementation is only effective in patients with documented low serum testosterone levels. In patients with hypogonadism, testosterone replacement is the initial treatment of choice, as it corrects decreased libido, fatigue, muscle loss, sleep disturbances, and depressed mood. Improvements in ED may occur, but they should not be expected to occur in all patients.23 The initial trial should be for 3 months. At that time, re-evaluation and the addition of another ED therapy is warranted. Routes of administration include oral, intramuscular, topical patches or gel, and a buccal tablet. 

Generally, when treating a sexually transmitted infection (STI), the index patient should be provided with a sufficient quantity of medication for the partner to be treated, increasing the probability that the initial infection will be cured in both patients. 

The vascular wall is a target for sexual hormones. In the particular case of estrogens, specific receptors have been found in both endothelium and vascular smooth muscle cells (VSMC) (Venkov et al. 1996 Karas et al. 1994). The trophic effects of estrogens on the endothelium have been advocated as crucial against initiation and promotion of atherosclerosis. Thus, cellular and animal models,... 

Unlike control females, chemically naive females do not prefer the volatile components of male odors compared to female odors. When these females are allowed contact with the odors, however, they demonstrate robust preferences for the male odors. Critically, initially naive females that receive contact experience with male soiled bedding as adults display sexual odor preferences when subsequently... 

In 1995 (LC) and 1996 (JH, CL JW), students carried out projects as part of their Field Course training that, although not initiated for the purpose, allowed a unique analysis to be carried out when retrospectively linked to the public knowledge over sexual liaisons. This analysis was of the characteristics of people who, in this brief and competitive situation, did and did not copulate (or nearly copulate). 

An initial widespread scepticism over fluctuating asymmetry has had to be re-appraised in the light of many demonstrations (e.g. for insects, birds, and humans) that symmetry is associated with various facets of sexual behaviour. Almost universally, for a whole range of animals, it has been found that males who are more symmetrical are faster,... 

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