Understanding the Prevalence of Sexual Dysfunctions in Women: an Evolutionary Perspective

Apostolou, Menelaos

doi:10.1007/s40750-015-0029-1

Cited by 16 publications

(4 citation statements)

References 79 publications

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“…Instead, most human research on evolutionary reproductive senescence has focused on the grandmother hypothesis, with some lesser consideration given to age-related changes in male reproductive function (e.g., Bribiescas, 2016). Among the few exceptions, Apostolou (2015Apostolou ( , 2016 seeks to account for sexual dysfunctions such as erectile dysfunction and hypoactive female sexual desire from an evolutionary perspective. His account of male sexual dysfunction recognizes age-related patterns, but still leaves out why other aspects of sexuality exhibit age-related decreases.…”

Section: Discussionmentioning

confidence: 99%

Age-related patterns in sexual behaviors and attitudes among single U.S. Adults: An evolutionary approach.

Gray

Garcia

Gesselman

2019

Evolutionary Behavioral Sciences

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While a large body of research has sought to understand human longevity and caregiving (e.g., the grandmother hypothesis) from an evolutionary life history perspective, this same view has rarely been brought to bear on age-related changes in human sexuality. Moreover, much of the existing research on age-related patterns in human sexual behaviors and attitudes features samples of predominantly partnered individuals. Here, we test hypotheses concerning age-and sex-related differences in measures of sexuality among 1,522 single adults 21 years of age and older from throughout the United States. Consistent with expectations, we document age-related decreases in sexual behavior, ideal frequency of sexual behavior, perceived changes in sexual desire, and openness to an array of sexual behaviors (e.g., having sex with multiple partners), although sexual satisfaction increased with age in women but not men. Also consistent with expectations, men reported more frequent sexual behavior, ideal frequency of sexual behavior, greater perceived change in sexual motivation, and more openness to various sexual behaviors (e.g., a one-night stand) compared to women. Conversely, women reported higher sexual satisfaction and were more open to getting married than men. Interaction effects were also observed, including between age and sex on sexual satisfaction, with older women reporting relatively higher sexual satisfaction than older men. We place these findings in the wider body of research on human sexuality, contrasting this evolutionary life history approach with prevailing descriptive or biomedical foci on age-related sexual dysfunction.

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Section: Discussionmentioning

confidence: 99%

Age-related patterns in sexual behaviors and attitudes among single U.S. Adults: An evolutionary approach.

Gray

Garcia

Gesselman

2019

Evolutionary Behavioral Sciences

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“…This predicts that sexual dysfunctions would be rare, a prediction which is not consistent with empirical evidence. A recently published paper employed anthropological evidence in order to reconstruct the ancestral human condition, and then to applied three evolutionary models in order to account for the high prevalence of sexual dysfunctions in women (Apostolou 2015). The purpose of the current paper is to use the same rationale in order to understand the high prevalence of sexual dysfunction in men.…”

Section: Introductionmentioning

confidence: 99%

Sexual Dysfunctions in Men: An Evolutionary Perspective

Apostolou

2015

Evolutionary Psychological Science

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Successful sexual intercourse is a prerequisite for successful reproduction, a fact that translates into strong evolutionary pressures being exercised on mechanisms that regulate sexual functioning to work optimally. In effect, selection forces would remove from the gene pool any alleles that predispose for sexual dysfunctions, limiting their prevalence to very low levels. But this did not happen with epidemiological studies indicating that sexual dysfunctions are common, with approximately one in three men facing such a difficulty. This raises the question why evolutionary forces have allowed such variation in sexual functioning given its importance in reproduction. The present paper attempts to address this question by applying three evolutionary models on anthropological and historical evidence that depicts the ancestral human condition. It is argued that the high prevalence of sexual dysfunctions in men is predominantly explained by the mismatch between ancestral and modern environments, with selection forces not having sufficient time to optimize sexual functioning mechanisms to the demands of modern conditions. The proposed evolutionary framework is employed to derive predictions which are examined against the available evidence on sexual dysfunctions.

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“…Sexual dysfunction occurs when women suffer clinically significant personal distress resulting from their poor sexual experiences, and occurs in 33% to 43% of women after cancer diagnosis 5,6 . Female sexual dysfunction is classified into three major categories: sexual desire/arousal disorders, orgasmic disorders, and genito-pelvic pain/ penetration disorders 7-12 …”

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confidence: 99%

“…5,6 Female sexual dysfunction is classified into three major categories: sexual desire/ arousal disorders, orgasmic disorders, and genito-pelvic pain/ penetration disorders. [7][8][9][10][11][12] Sexual dysfunction after a cancer diagnosis is mainly treatment related and can be impacted by more than one component of a woman's cancer therapy. 10,[13][14][15] Cytotoxic chemotherapy side effects such as alopecia and fatigue commonly lead to poor self-esteem and, in many women, decreased desire for sexual engagement.…”

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confidence: 99%

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

et al. 2022

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Importance: Cancer and its treatment negatively affect female sexual health and function. The prevalence of female sexual dysfunction after cancer is between 33% and 43%. Numerous studies have addressed treatment options for sexual dysfunction in women with cancer, but it still remains a challenge to select the most efficacious option for patients.Objective: To compile and appraise recent evidence of any interventions for managing sexual dysfunction in female cancer survivors.Evidence Review: A literature search of the electronic databases MEDLINE, EMBASE, PsycINFO, and Cochrane Central Register of Controlled Trials (January 2011 to February 2021) was conducted using general search terms of ''women'', ''cancer'', ''intervention'', ''sexual dysfunction''. We included randomized controlled trials (RCTs) and uncontrolled before-after studies that evaluated the efficacy of intervention for female sexual dysfunction in women with history of cancer. Methodological quality of studies was assessed using Risk of Bias (RoB) 2.0 for RCTs and National Institutes of Health (NIH) assessment tools for uncontrolled before-after studies.Findings: Thirty-six studies were included for qualitative synthesis (14 RCTs (n ¼ 1284), 17 uncontrolled trials (n ¼ 589), and 5 cohort studies (n ¼ 497). Only four studies were at low risk of bias. Topical interventions (vaginal gels or creams) were able to alleviate vaginal dryness and dyspareunia, with intravaginal dehydroepiandrosterone (DHEA) (6.5 mg) gel showing evidence of improved sexual function. Evidence for estriol-lactobacilli vaginal tablets was unreliable due to a small-scale study. Psychoeducational therapy (internet-based cognitive behavioral therapy [CBT]) studies typically were at high risk of bias, but all displayed significant improvements of sexual function. Both laser therapy (fractional CO 2 and erbium) and multimodal approach studies were at concerning risk of bias, although suggesting beneficial effects on sexual function.Conclusions and Relevance: The most reliable evidence for improvement was from a study of DHEA vaginal gel, but in general, gels or creams were useful in reducing dyspareunia. Pharmacological, psychoeducational, laser therapy, and multimodal approaches demonstrated potential in managing cancer-related sexual issues, but most were small in size (10-70 participants), with moderate to high risk of bias. Therefore, large-scale, double-blind, RCTs with long-period follow-up, and at low risk of bias are needed to show efficacy for these interventions.

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Understanding the Prevalence of Sexual Dysfunctions in Women: an Evolutionary Perspective

Cited by 16 publications

References 79 publications

Age-related patterns in sexual behaviors and attitudes among single U.S. Adults: An evolutionary approach.

Age-related patterns in sexual behaviors and attitudes among single U.S. Adults: An evolutionary approach.

Sexual Dysfunctions in Men: An Evolutionary Perspective

Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review

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