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Papers by Stephen Holzapfel

Research paper thumbnail of No 279-Directive clinique de consensus sur la santé sexuelle de la femme

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2017

Research paper thumbnail of Physical and Mental Aspects of Maintaining Sexual Health in Older Women

Mood and Sexuality Changes Associated with Menopause Most women make the transition through menop... more Mood and Sexuality Changes Associated with Menopause Most women make the transition through menopause with few long-term negative effects on their sexuality. Two-thirds of women in relationships are still sexually active in their 60s, with a gradual decline to about 25% of couples in their 80s. While many are comfortable with these changes, some are distressed by the loss of physical intimacy. The absence of a partner due to death, divorce or partner illness curtails women’s sexual lives more often than do their own medical issues. Aging men face increasing erectile dysfunction, with one in seven men experiencing complete impotence by age 70.1 Given that North American women marry men who are on average four years older than themselves, and that men die six years sooner, most women face up to a decade of widowhood. Laumann et al. conducted a survey to determine the sexual function of average American women ages 18–59, and found a high prevalence of sexual dysfunction.2 Of the women ...

Research paper thumbnail of Maternal serum screening

Research paper thumbnail of Treating sexual disorders in family practice

Research paper thumbnail of Introduction to core competencies for BESTCO certified sex therapists

The Canadian Journal of Human Sexuality

Since 2000 or so, the core competencies movement in psychotherapy has led to the identification o... more Since 2000 or so, the core competencies movement in psychotherapy has led to the identification of requirements for therapy and therapists across theoretical orientations and clinical domains. One ...

Research paper thumbnail of No. 279-Female Sexual Health Consensus Clinical Guidelines

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2017

To establish national guidelines for the assessment of women's sexual health concerns and the... more To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women. Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e .g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e .g ., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international m...

Research paper thumbnail of Sexual medicine

Research paper thumbnail of Viagra and broken hearts

Canadian family physician Médecin de famille canadien

Research paper thumbnail of Sexual medicine in family practice. Part 1: How to help

Canadian family physician Médecin de famille canadien

Family physicians are in a unique position to help patients with sexual problems. They know their... more Family physicians are in a unique position to help patients with sexual problems. They know their patients over a long time and often have both partners as patients. Most problems require minimal intervention, usually by providing information. Family physicians are sometimes the only professionals who are trusted enough to be told of abusive or incestuous situations.

Research paper thumbnail of Core competencies for BESTCO certified sex therapists

The Canadian Journal of Human Sexuality

In 2015, the leadership of the Board of Examiners in Sex Therapy and Counselling of Ontario (BEST... more In 2015, the leadership of the Board of Examiners in Sex Therapy and Counselling of Ontario (BESTCO) struck a committee to establish the first set of core competencies for the field of sex therapy....

Research paper thumbnail of Treating sexual disorders in family practice

Research paper thumbnail of Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey

The Journal of Sexual Medicine

Research paper thumbnail of Aging and sexuality

Canadian family physician Médecin de famille canadien, 1994

Sexual expression among the elderly is a predictor of general health. Considering aging patients&... more Sexual expression among the elderly is a predictor of general health. Considering aging patients' sexual function can affect medical care and improve the quality of their lives.

Research paper thumbnail of Directive clinique de consensus sur la santé sexuelle de la femme

Journal of Obstetrics and Gynaecology Canada, 2012

Research paper thumbnail of Female sexual health consensus clinical guidelines

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2012

To establish national guidelines for the assessment of women's sexual health concerns and the... more To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual heath care for women. Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e.g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e.g., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medic...

Research paper thumbnail of Stress, social support, and emotional distress in a community sample of pregnant women

Journal of Psychosomatic Obstetrics and Gynaecology, Sep 1, 2004

Research paper thumbnail of Written patient information about triple-marker screening: A randomized, controlled trial

Obstetrics & Gynecology, 1997

Research paper thumbnail of Psychological outcomes following maternal serum screening: a cohort study

Canadian Medical Association Journal

Maternal serum screening is used to assist in the prenatal detection of congenital anomalies. Its... more Maternal serum screening is used to assist in the prenatal detection of congenital anomalies. Its use is controversial, and one concern that has been expressed is its psychological effects on women. The authors examined whether this test leads to an increase in anxiety and depression among women who have a false-positive result as compared with those who have a true-negative result or do not undergo testing. A prospective cohort study with baseline assessment at 15 to 18 weeks' gestation and follow-up at 24 weeks' gestation was conducted. Pregnant women at 8 geographically diverse sites across Ontario were recruited. The main outcome measures were the state portion of the State--Trait Anxiety Inventory and the Center for Epidemiologic Studies Depression Scale. Of the 2418 potential subjects 2020 (83.5%) were enrolled and eligible; 1741 (86.2%) completed the follow-up. A total of 1177 women (67.6%) underwent maternal serum screening. No overall adverse psychological effects a...

Research paper thumbnail of Maternal serum screening

Research paper thumbnail of Adverse effects of screening for gestational diabetes: a prospective cohort study in Toronto, Canada

Journal of medical screening, 1997

To investigate the adverse effects associated with a false positive 50 g glucose challenge test f... more To investigate the adverse effects associated with a false positive 50 g glucose challenge test for gestational diabetes mellitus (GDM). Consecutive women attending a prenatal registration clinic at a large community hospital in suburban Toronto, Canada. Prospective cohort study of women between 12 and 24 weeks' gestation with no previous history of diabetes mellitus or GDM. Main outcome measures included anxiety (Spielberger's State-Trait Anxiety Inventory), depression (Centers for Epidemiologic Studies Depression Scale), perceived maternal health, and concern about health of the newborn. Among 2564 eligible subjects, there were 897 subjects with complete data at enrollment and at 32 weeks' gestation, including 88 who had false positive glucose challenge test results. At 32 weeks, only 20% (95% confidence limits 11%, 28%) of women with false positive glucose challenge test results rated their health as excellent, compared with 38% (35%, 42%) of those having negative res...

Research paper thumbnail of No 279-Directive clinique de consensus sur la santé sexuelle de la femme

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2017

Research paper thumbnail of Physical and Mental Aspects of Maintaining Sexual Health in Older Women

Mood and Sexuality Changes Associated with Menopause Most women make the transition through menop... more Mood and Sexuality Changes Associated with Menopause Most women make the transition through menopause with few long-term negative effects on their sexuality. Two-thirds of women in relationships are still sexually active in their 60s, with a gradual decline to about 25% of couples in their 80s. While many are comfortable with these changes, some are distressed by the loss of physical intimacy. The absence of a partner due to death, divorce or partner illness curtails women’s sexual lives more often than do their own medical issues. Aging men face increasing erectile dysfunction, with one in seven men experiencing complete impotence by age 70.1 Given that North American women marry men who are on average four years older than themselves, and that men die six years sooner, most women face up to a decade of widowhood. Laumann et al. conducted a survey to determine the sexual function of average American women ages 18–59, and found a high prevalence of sexual dysfunction.2 Of the women ...

Research paper thumbnail of Maternal serum screening

Research paper thumbnail of Treating sexual disorders in family practice

Research paper thumbnail of Introduction to core competencies for BESTCO certified sex therapists

The Canadian Journal of Human Sexuality

Since 2000 or so, the core competencies movement in psychotherapy has led to the identification o... more Since 2000 or so, the core competencies movement in psychotherapy has led to the identification of requirements for therapy and therapists across theoretical orientations and clinical domains. One ...

Research paper thumbnail of No. 279-Female Sexual Health Consensus Clinical Guidelines

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2017

To establish national guidelines for the assessment of women's sexual health concerns and the... more To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual health care for women. Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e .g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e .g ., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international m...

Research paper thumbnail of Sexual medicine

Research paper thumbnail of Viagra and broken hearts

Canadian family physician Médecin de famille canadien

Research paper thumbnail of Sexual medicine in family practice. Part 1: How to help

Canadian family physician Médecin de famille canadien

Family physicians are in a unique position to help patients with sexual problems. They know their... more Family physicians are in a unique position to help patients with sexual problems. They know their patients over a long time and often have both partners as patients. Most problems require minimal intervention, usually by providing information. Family physicians are sometimes the only professionals who are trusted enough to be told of abusive or incestuous situations.

Research paper thumbnail of Core competencies for BESTCO certified sex therapists

The Canadian Journal of Human Sexuality

In 2015, the leadership of the Board of Examiners in Sex Therapy and Counselling of Ontario (BEST... more In 2015, the leadership of the Board of Examiners in Sex Therapy and Counselling of Ontario (BESTCO) struck a committee to establish the first set of core competencies for the field of sex therapy....

Research paper thumbnail of Treating sexual disorders in family practice

Research paper thumbnail of Prevalence and Predictors of Sexual Problems Among Midlife Canadian Adults: Results from a National Survey

The Journal of Sexual Medicine

Research paper thumbnail of Aging and sexuality

Canadian family physician Médecin de famille canadien, 1994

Sexual expression among the elderly is a predictor of general health. Considering aging patients&... more Sexual expression among the elderly is a predictor of general health. Considering aging patients' sexual function can affect medical care and improve the quality of their lives.

Research paper thumbnail of Directive clinique de consensus sur la santé sexuelle de la femme

Journal of Obstetrics and Gynaecology Canada, 2012

Research paper thumbnail of Female sexual health consensus clinical guidelines

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2012

To establish national guidelines for the assessment of women's sexual health concerns and the... more To establish national guidelines for the assessment of women's sexual health concerns and the provision of sexual heath care for women. Published literature was retrieved through searches of PubMed, CINAHL, and the Cochrane Library from May to October 2010, using appropriate controlled vocabulary (e.g., sexuality, "sexual dysfunction," "physiological," dyspareunia) and key words (e.g., sexual dysfunction, sex therapy, anorgasmia). Results were restricted, where possible, to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medic...

Research paper thumbnail of Stress, social support, and emotional distress in a community sample of pregnant women

Journal of Psychosomatic Obstetrics and Gynaecology, Sep 1, 2004

Research paper thumbnail of Written patient information about triple-marker screening: A randomized, controlled trial

Obstetrics & Gynecology, 1997

Research paper thumbnail of Psychological outcomes following maternal serum screening: a cohort study

Canadian Medical Association Journal

Maternal serum screening is used to assist in the prenatal detection of congenital anomalies. Its... more Maternal serum screening is used to assist in the prenatal detection of congenital anomalies. Its use is controversial, and one concern that has been expressed is its psychological effects on women. The authors examined whether this test leads to an increase in anxiety and depression among women who have a false-positive result as compared with those who have a true-negative result or do not undergo testing. A prospective cohort study with baseline assessment at 15 to 18 weeks' gestation and follow-up at 24 weeks' gestation was conducted. Pregnant women at 8 geographically diverse sites across Ontario were recruited. The main outcome measures were the state portion of the State--Trait Anxiety Inventory and the Center for Epidemiologic Studies Depression Scale. Of the 2418 potential subjects 2020 (83.5%) were enrolled and eligible; 1741 (86.2%) completed the follow-up. A total of 1177 women (67.6%) underwent maternal serum screening. No overall adverse psychological effects a...

Research paper thumbnail of Maternal serum screening

Research paper thumbnail of Adverse effects of screening for gestational diabetes: a prospective cohort study in Toronto, Canada

Journal of medical screening, 1997

To investigate the adverse effects associated with a false positive 50 g glucose challenge test f... more To investigate the adverse effects associated with a false positive 50 g glucose challenge test for gestational diabetes mellitus (GDM). Consecutive women attending a prenatal registration clinic at a large community hospital in suburban Toronto, Canada. Prospective cohort study of women between 12 and 24 weeks' gestation with no previous history of diabetes mellitus or GDM. Main outcome measures included anxiety (Spielberger's State-Trait Anxiety Inventory), depression (Centers for Epidemiologic Studies Depression Scale), perceived maternal health, and concern about health of the newborn. Among 2564 eligible subjects, there were 897 subjects with complete data at enrollment and at 32 weeks' gestation, including 88 who had false positive glucose challenge test results. At 32 weeks, only 20% (95% confidence limits 11%, 28%) of women with false positive glucose challenge test results rated their health as excellent, compared with 38% (35%, 42%) of those having negative res...