J.J. van der Werff ten Bosch

Erection Problems in Medical Practice: Differential Diagnosis with Relatively Simple Method

Functional sexual potency can be assumed when penile erection occurs during visual erotic stimulation, and to a lesser degree with normal nocturnal penile tumescence. Erection, increase in circumference as well as rigidity, can be measured with a simple device consisting of a calibrated felt band with a sliding collar fastened to 1 end. Subjects were 58 consecutive patients, mainly from a urology outpatient department, with erection problems and 67 healthy control men. Changes in penile circumference were measured during viewing of an erotic videotape and during sleep. Functional sexual potency, at least partially, was presumed to exist in 41 patients (71%), many of whom had a somatic pathological condition that might easily have been believed to be the cause of the erectile dysfunction. During the latter half of the study nocturnal penile tumescence also was measured. This group included 7 patients who did not respond to the visual stimuli, 5 of whom had normal nocturnal penile tumescence. We conclude that the erection meter, in conjunction with an erotic video test and nocturnal penile tumescence measurements, is a useful and simple device in the differential diagnosis of erectile difficulties in men. This is true especially when elaborate sleep laboratory facilities and neurophysiological equipment are not available.

Ontogeny of sex differences in open-field ambulation in the rat

The effects of age and gonads were studied in rats subjected to open-field tests, during which ambulation behavior was recorded. Subjects were three groups of male and female rats: sham-operation on day 1 and day 21; gonadectomy on day 1 and sham-operation on day 21; and sham-operation on day 1 and gonadectomy on day 21. Half of each group were tested in a circular open field (3 min/day, 3 consecutive days) on days 28-30; the others were tested on days 47-49. Representatives of both batches were tested again in a square open field on days 76-78. There was a sex difference in ambulation at 77 days, but not at earlier ages. In animals gonadectomized on day 1 or day 21 the sex difference in adulthood failed to occur, because castration caused the males to ambulate as much as sham-operated and ovariectomized females. On the basis of our results and reports in the literature it is suggested that testicular secretions around puberty have an organizing effect on ambulation behavior. The intact adult male rat ambulates less than the adult female and this difference persists after castration in adulthood. Castration well before puberty prevents the development of the adult sex difference.

Mounting behavior of female guinea pigs after prenatal and adult administration of the propionates of testosterone, dihydrotestosterone, and androstanediol

Abstract Female guinea pigs were exposed prenatally (Day 28–58) to the propionates of testosterone (TP), dihydrotestosterone (DHTP), or androstanediol (ADP). Only TP females failed to display lordosis in adulthood after estrogen and progesterone treatment. When given TP in adulthood, females in all groups mounted, but TP and DHTP females showed augmented intromission frequencies and higher percentages of correctly oriented mounts relative to controls. Moreover, TP females responded more quickly to TP injections in adulthood and had higher over-all mounting frequencies than other groups, while DHTP females displayed mounting frequencies intermediate to controls and TP females. ADP females were not different from controls for any measure of mounting behavior. No female in any group mounted when given DHTP in adulthood, even after 7 wk of daily injections. Since male guinea pigs do mount in response to DHTP given in adulthood, the results raise the possibility that mechanisms determining sensitivity to specific steroids may not be mediated exclusively by steroids during critical periods of embryological differentiation.

Sexuality and psychophysiological functioning in women with diabetes mellitus.

Subjective and objective psychophysiological responses to erotic visual stimulation were recorded for 24 women with diabetes mellitus type I and 10 control women. There were no significant differences in subjective responses (general sexual arousal and genital arousal) between the two groups. The objective response, a rise in the temperature of the labium minus, varied with the height of the initial temperature. Since this temperature was significantly higher in diabetic women, the subsequent rise during erotic visual stimulation was less in diabetic women than in controls. When samples from the two groups were matched for initial temperature, the difference in the increase in labial temperature was no longer statistically different. In both groups of women there was a significant correlation between the degree of subjective arousal and the rise in labial temperature when women with a high temperature (greater than 37 degrees C) at the start of the visual erotic stimulation were not included. The absence of a statistically significant effect of diabetes mellitus on the parameters studied may be due to a lack of serious neuropathy and angiopathy in the present sample of diabetic women. Future psychophysiological studies should include women with serious neuropathy with or without diabetes mellitus.

The role of the preputial glands in sexual attractivity of the female rat

This study shows that olfactory cues contribute to attractivity of the female rat but that the preputial glands are a minor source of such olfactory stimuli. In the experiments described, a residential plus-maze was used. The amount of time resident male rats spent in the vicinity of an estrous female rat was used as a measure of female attractivity. In the first experiment it was shown that male rats were attracted to anaesthetized estrous female rats but that these females were less attractive than unanaesthetized estrous females. In the second experiment it was shown that after removal of the preputial glands females were still attractive for male rats. The results of the third experiment demonstrated that estrous preputialectomized female rats remained attractive for male rats when they were anesthetized. When the resident male rats could make a choice between an estrous preputialectomized female and an estrous control female there was a tendency for the latter to be preferred. It can be concluded that olfactory cues enhance the attractivity of an estrous female rat, but that it is not the only sensory modality used by the female to attract a (distant) male. The preputial glands are of minor importance as a source of olfactory signals.

Psychosexual functioning in women with complete testicular feminization: Is androgen replacement therapy preferable to estrogen?

Effects of oral testosterone undecanoate (Andriol) on blood hormone levels, moods, sociosexual functioning and self-image of the body were studied in four gonadectomized patients with complete testicular feminization. In a double-blind cross-over experiment, patients were treated with oral testosterone undecanoate (120 mg/day) or placebo for four weeks. Peripheral blood was taken for hormone assays at the end of each four-week period. Psychosexual functioning was reported once weekly, mood scales twice weekly. In three patients testosterone treatment resulted in adult male blood levels of testosterone and estradiol. One patient did not show increased steroid levels, possibly because of hyperthyroxinaemia. No systematic effects were found on coitus, masturbation, sexual thoughts, scores on desire for bodily contact, and on attention for physical appearance. In one patient there was a marked and sustained rise in the positive moods and a fall in negative moods during androgen treatment. These results do not demonstrate that androgen therapy is preferable to estrogen in gonadectomized women with complete testicular feminization with regard to psychosexual functioning.

Anterior hypothalamic lesions and pubertal development in female rhesus monkeys

Electrolytic lesions were made in the anterior hypothalamus of 8 prepubertal female rhesus monkeys, aged 1.1-1.7 years. Six unoperated females served as controls. No effects were found of the lesions upon age and body weight at menarche or at first ovulation, as estimated by blood levels of progesterone and laparoscopic observations. From these findings it appears that the neural control of puberty in the female rhesus may not be exerted through the anterior hypothalamus, in contrast with the rat and ferret. Further, an attempt was made to identify biometric correlates of hormonal changes during puberty. Firstly, the well known dip in growth rate, about 0.4 years before menarche, was observed. Secondly, there was a marked spurt in growth of the nipples starting at 0.2 years before menarche. The close temporal association between accelerated nipple growth and menarche suggests that both of these developmental characteristics result from changes in (presumably ovarian) steroid hormone secretion.

Behavioral aspects of puberty in group-living stumptail monkeys (Macaca arctoides)

Behavioral changes before and around the time of puberty were studied in a longitudinal manner in male and female stumptail monkeys. Around the time of testicular descent (mean age: 3.3 years) males started to become more aggressive towards adult males. Within two years following testicular descent males rose in rank with the support of others and reached stable (sub)top positions in the dominance hierarchy. In the female rank-stabilization took place gradually between one year before and two years after first ovulation (mean age: 3.7 years). Copulatory activity began about two (in females) to two-and-a-half years (in males) before reproductive capacity was attained. Female copulatory activity began to rise about six months before first ovulation, when they started to copulate with adult males. In males copulatory frequency rose sharply between six and twelve months prior to testicular descent. Until a few months after testicular descent males could copulate openly in the group without interruption; from about 1 year following testicular descent virtually all copulations had to take place surreptitiously to avoid interruption by higher ranking adult males. It is postulated that this decreasing tolerance of adults may contribute to the process of peripheralization and migration of young adult males which occur in free ranging macaque groups.

Routine psychophysiological screening of 384 men with erectile dysfunction

Psychophysiological screening was carried out on 384 consecutive patients with erectile dysfunction of psychogenic or psychogenic-organic origin. Visual sexual stimulation with penile vibration caused a satisfactory erection in roughly 50% of patients. Nonresponders subsequently produced a good penile response with intracavernous injection of vasoactive substance. Orgasm-ejaculation can occur in the absence of a full erection. In such cases subsequent intracavernous injection brought about a (near) full erection. A first intracavernous injection was most effective when combined with visual and vibrotactile stimulation. The magnitude of the response to such stimulation is useful to enable the doctor to prescribe the lowest dose of a vasoactive substance, thus minimizing the risk of priapism. Preferably, drug treatment of men with erectile dysfunction should be combined with sexual counseling or therapy.

An automated device for measuring locomotor activity in rats

An automated plus maze is described that is capable of recording the locomotor activity of 12 rats simultaneously. The system is built around an 8008 microprocessor chip from INTEL. The base of the system is formed by 12 plus mazes in which the activity of the animals under test can be monitored.