Benjamin Maoz

THE PERCEPTION OF MENOPAUSEIN FIVE ETHNIC GROUPS IN ISRAEL

Abstract. An investigation was made into the menopausal symptoms and attitudes of 1, 148 Israeli women of five different ethnic origins. The results show that, while some of the somatic menopausal symptoms are independent of ethnic origin, psychic and psychosomatic symptoms are more closely associated with this variable. Similarly, attitudes to the climacteric vary across cultural origins, especially with regard to husband‐wife relationships. This study underlines the necessity of a multi‐factorial, biological, sociological, psychological and anthropological approach to problems of menopause.

Factors Influencing Sexual Activity After Prostatectomy: A Prospective Study

Between 16 and 30 per cent of all prostatectomy patients become impotent after an operation for benign prostatic hyperplasia. Since the surgical technique does not seem to be the factor responsible for such a serious problem, more accentuated by the fact that this operation is becoming increasingly frequent with the increase in life expectancy, an assessment of 15 patients before and after prostatectomy is presented. With a statistical analysis of a structured interview (including a mini-Minnesota Multiphasic Personality Inventory test before and after the operation) 3 main differentiating factors emerged between the potent and the impotent group: 1) the level of anxiety exhibited by the patient, 2) whether the patients received an explanation about the surgery and its outcome prior to the operation and 3) the patients general satisfaction with life.

The Correlation of Increased Serum Prolactin Levels with Decreased Sexual Desire and Activity in Elderly Men

Serum prolactin levels and sexual function were evaluated in 28 men from 60 to 64 years of age and in 44 men from 65 to 70 years of age. All subjects were married, physically healthy, and had no psychopathology or marital problem. About a third of the men aged 60 to 70 years suffered from impotence. No obvious correlation between elevated levels of serum prolactin and impotence was obtained. Subjects aged 65 to 70 who had decreased libido exhibited a significant elevation of serum prolactin levels, while subjects of the same age group who had reserved (normal) libido appeared to have low serum prolactin levels. Nine of ten men aged 60 to 70 years with serum prolactin levels above 40 ng/ml reported decreased libido. Potent men of both age groups (60–70 years) with high prolactin levels showed a tendency to have a decrease in frequency of sexual intercourse. Thus, it seems that mild hyperprolactinemia in aging men may be associated with decreased sexual desire and frequency of sexual activity.

Hyperprolactinemia: A Possible Cause of Sexual Impotence in Male Patients Undergoing Chronic Hemodialysis

Hyperprolactinemia is known to cause impotence in patients with normal renal function and elevated serum prolactin levels (SPLs) have also been reported in uremia. This study was undertaken to examine a possible role of elevated SPLs in the impotence of male patients undergoing chronic hemodialysis (CHD). SPLs in 16 male patients undergoing CHD were evaluated using a homologous double-antibody radioimmunoassay with prolactin isohormones isolated from human amniotic fluid. Patients were divided in 2 groups: 6 patients were sexually impotent and 10 sexually potent. Patients with emotional disturbances or marital conflicts known to cause impotence were excluded from the study. The SPLs of the impotent patients were found to be significantly elevated in comparison to the levels of the potent patients (136.7 +/- 28.2 vs. 37.3 +/- 2.7 ng/ml, p less than 0.001). Furthermore, in 2 patients who were successfully treated with bromocriptine to suppress hyperprolactinemia, recovery of sexual potency was noted. Thus, sexual impotence in male CHD patients seems to be associated with marked hyperprolactinemia. It is suggested that elevated SPLs may be an important cause of impotence among CHD patients.

Ethnicity and adaptation to climacterium

SummaryAn investigation was made into the menopausal symptoms and attitudes of 1,148 Israeli women of five different ethnic origins.The results show that, while some of the somatic menopausal symptoms are independent of ethnic origin, psychic and psychosomatic symptoms are more closely associated with this variable.Similarly, the general health of menopausal women also varies with cultural origin. This variation is shown to correlate with the psychic and psychosomatic symptomatology of the climacterium.This study underlines the necessity of a multi-factorial, biological, sociological, psychological and anthropological approach to problems of menopause.

Sulpiride-induced hyperprolactinemia and impotence in male psychiatric outpatients

The relationship between erectile dysfunction and sulpiride stimulatory effect on prolactin secretion was studied in 13 married male psychiatric outpatients. The patients population was comprised of 2 groups: patients with anxiety disorders resistant to minor tranquilizers who were treated with sulpiride up to 200 mg/day, and schizophrenic patients treated with sulpiride 600 mg/day. All the patients were maintained on maximal dose for a period of 3 weeks. Sexual function and blood prolactin levels were monitored once weekly. The patients who developed impotence were maintained on higher doses of sulpiride and exhibited higher prolactin levels in comparison to the potent patients. Restoration of potency was observed after reduction or discontinuation of sulpiride treatment. It is concluded that sulpiride induced impotence is associated with hyperprolactinemia.

CHAPTER 7 – Love, War, and the Life Cycle of the Family

… there was a war; this war, the last war, any war, it does not matter which war … It is strange that their first Latin declension and conjugation should be of love and war.”

Psychosomatic Thinking as Reflected in Practice and Teaching of Primary Health Care-Introducing the Salutogenic Approach

The symposium which was opened by an introductory paper by B. Maoz was dedicated to the late Aaron Antonovsky. Antonovsky was an outstanding sociologist of health in Israel with an international reputation. He developed the concept of salutogenesis, which means: Why do many people stay healthy? What are the inner and outer resources for this healthy coping? This question stands in contradiction to the question which is usually asked by physicians, namely why do people become sick?

Community psychiatry in border settlements in Israel

SummaryAn analysis of our work during two years in a community mental health clinic serving a small town and an agricultural area near the northern border of Israel was presented. The clinic was staffed by a team of psychiatrists, psychologists and social workers who came to the area for one and a half days every week from a university psychiatric hospital in the center of the country. Only the nurse was a resident of the clinic was an attempt to provide a border population with expert psychiatric services which had previously been lacking, while maintaining a close connection with the central psychiatric hospital. All this was done on a relatively low budget. In spite of the difficult working conditions, an ambulatory team, travelling to the place and serving a wide area which was often under emergency conditions, was able to do effective work. A total number of 485 patients was seen during the two years, only 60 of whom were hospitalised, and very few were referred for private psychotherapy.The success of the clinics operation can be explained by appropriate initial classification of referrals, concentration on short term therapy, close cooperation between the team members and effective interaction with the relevant agencies in the community. The clinic handled patients from two population groups (the town of Kiryat Shmona and the villages of the area), which differed considerably from demographic, social and therapeutic points of view.