Common Sexual Dysfunction Research Articles

Attention Deficit Hyperactivity Disorder and Sexual Functioning - is there a connection?

Understanding how ADHD affects sexual functioning is key to providing comprehensive care. This review looks into the current research on sexual health in people with ADHD, focusing on how common sexual dysfunction is, how ADHD symptoms might impact sexual behavior, and what role medications play. By summarizing the existing studies, this review aims to highlight what we don’t know yet and suggest future research to improve treatment and patient outcomes. The review covers literature related to sexual functioning in ADHD, particularly looking at connections to hypersexuality, paraphilias, and various sexual behaviors. A thorough search of electronic databases, including PubMed, PsycINFO, and Google Scholar, was conducted using relevant keywords such as 'ADHD,' 'hypersexuality,' 'paraphilias,' 'sexuality,' 'sexual behavior,' and 'sexual violence.' The study duration was 6 months. Common features of ADHD, such as impulsivity, poor impulse control, and difficulties with self-regulation, may contribute to risky sexual behaviors, compulsive sexual behavior, or the development of paraphilic interests. It's important for doctors dealing with ADHD in children to discuss sexual health as the patient nears adolescence and offer guidance on safe sex. Treatment should combine medication with therapy. Since impulsivity seems to play a big role in risky sexual behavior, making contraceptives readily available could be important for sexual health. Longitudinal studies are necessary to better understand the temporal relationships and progression of sexual behaviors and ADHD symptoms over time. Given the potential impact of ADHD on sexual behavior and functioning, healthcare providers should consider screening for ADHD in patients presenting with issues related to hypersexuality, paraphilias, or other sexual concerns.

Correlates of Sexual Dysfunction in Male Patients with Alcohol Dependence Syndrome: A Cross-Sectional Study

Introduction: Sexual dysfunction and alcohol dependence syndrome are complex issues that significantly impact the overall well-being and quality of life of affected individuals. Sexual dysfunction, encompassing various issues such as erectile dysfunction, reduced libido, and orgasmic disorders, is a prevalent concern affecting a substantial proportion of the male population worldwide. Aim: To estimate prevalence of sexual dysfunction in patients admitted for Alcohol dependence and to identify various Clinical and Socio demographic correlates for sexual dysfunction in this population. Materials and Methods: The study involved fifty-eight male participants who had sought deaddiction treatment at the Psychiatry Outpatient Department of Tertiary Care Centre, Maduranthakam for alcohol dependence syndrome, diagnosed according to the ICD‑10. Information on sociodemographic, alcohol-related, and sexual dysfunction-related variables was gathered. Sexual dysfunction was assessed for the past year, ignoring temporary and situational complaints. The relationship between sexual dysfunction and various study variables was explored using relevant statistical tools. Results: Out of the total sample size evaluated using SAD-Q score, 71% are moderately dependent and 29 % are severely dependent. Sexual Dysfunction was present for 64% of patients in the study. For the 58 patients in the study, the most common sexual dysfunction reported was an absence of sexual desire in 19 patients, followed by erectile dysfunction which was present in 18 patients. The ability to reach orgasm was difficult for 6 patients. Satisfaction from orgasm was absent for 4 patients. Conclusion: This research seeks to advance our understanding of sexual dysfunction in male patients with alcohol dependence syndrome by unravelling the intricate web of factors influencing their sexual health.

Research progress on the therapeutic application of extracellular vesicles in erectile dysfunction.

Erectile dysfunction (ED) is one of the most common male sexual dysfunctions and is related to many pathogenic factors. However, first-line treatment, represented by phosphodiesterase 5 inhibitors, is unable to maintain long-term efficacy. Extracellular vesicles (EVs) have recently attracted the attention of researchers in the fields of cardiovascular disease, neurologic disease, and regenerative medicine and may become a treatment for ED. This article reviews recent applications of EVs in the treatment of ED from the aspects of the source, the therapeutic mechanism, and the strategies to enhance therapeutic efficacy. These research advances lay the foundation for further research and provide references for in-depth understanding of the therapeutic mechanism and possible clinical application of EVs in ED.

Comparison of Current International Guidelines on Premature Ejaculation: 2024 Update.

Premature ejaculation (PE) is a common male sexual dysfunction that can cause significant distress in the patient and partner. This study aimed to compare the current international guidelines on PE to highlight their similarities and differences. We examined the latest guidelines from the European Association of Urology (EAU), American Urological Association/Sexual Medicine Society of North America (AUA/SMSNA), and International Society of Sexual Medicine (ISSM) by comparing definitions, classifications, epidemiology, pathophysiology, and recommendations on diagnosis and therapy. The quality of guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) Global Rating Scale (GRS). We found significant variations in the definitions of PE and recommendations on management of patients. The EAU guidelines were the most recent, the AUA/SMSNA guidelines lacked detail in some areas, and the ISSM guidelines were the most complete but also the least updated. The search for a unified definition and the development of standardized diagnostic and therapeutic pathways remain concrete issues to improve the management of patients with PE worldwide.

The Analysis Study of Efficacy, Effectiveness, and Clinical Risk of Tramadol as Treatment of Premature Ejaculation : A Comprehensive Systematic Review

Background: Premature ejaculation is a common sexual dysfunction affecting 20%-30% of men. Understanding the effectiveness and potential dangers of tramadol in treating premature ejaculation can help develop efficient treatment protocols. Methods: In accordance with the PRISMA 2020 principles, this systematic review focused specifically on comprehensive English literature published from 2013 to 2024. Result: The study examined over 2000 papers from respectable sources such as Science Direct, SagePub, and PubMed. Following the decision to subject eight publications to further scrutiny, a comprehensive examination of the complete body of literature was conducted. Conclusion: Tramadol, an analgesic derived from opioids, effectively suppresses premature ejaculation (PE) and enhances sexual satisfaction during sexual intercourse. Nevertheless, the efficacy and safety of its use in treating PE are still a subject of discussion due to a lack of solid empirical evidence. Additional investigation is required to ascertain the effectiveness of the medication and its possible adverse effects.

LncRNA MALAT1 facilitates BM-MSCs differentiation into endothelial cells and ameliorates erectile dysfunction via the miR-206/CDC42/PAK1/paxillin signalling axis

BackgroundErectile dysfunction (ED) is a common male sexual dysfunction, with an increasing incidence, and the current treatment is often ineffective.MethodsVascular endothelial growth factor (VEGFA) was used to treat bone marrow-derived mesenchymal stem cells (BM-MSCs), and their cell migration rates were determined by Transwell assays. The expression of the von Willebrand Factor (vWF)VE-cadherin, and endothelial nitric oxide synthase(eNOS) endothelial markers was determined by qRT‒PCR and Western blot analyses. The MALAT1-induced differentiation of BM-MCs to ECs via the CDC42/PAK1/paxillin pathway was explored by transfecting VEGFA-induced BM-MSC with si-MALAT1 and overexpressing CDC42 and PAK1. The binding capacity between CDC42, PAK1, and paxillin in VEGFA-treated and non-VEGFA-treated BM-MSCs was examined by protein immunoprecipitation. MiR-206 was overexpressed in VEGFA-induced BM-MSC, and the binding sites of MALAT1, miR-206, and CDC42 were identified using a luciferase assay. Sixty male Sprague‒Dawley rats were divided into six groups (n = 10/group). DMED modelling was demonstrated by APO experiments and was assessed by measuring blood glucose levels. Erectile function was assessed by measuring the intracavernosa pressure (ICP) and mean arterial pressure (MAP). Penile erectile tissue was analysed by qRT‒PCR, Western blot analysis, and immunohistochemical staining.ResultsMALAT1 under VEGFA treatment conditions regulates the differentiation of BM-MSCs into ECs by modulating the CDC42/PAK1/paxillin axis. In vitro experiments demonstrated that interference with CDC42 and MALAT1 expression inhibited the differentiation of BM-MSCs to ECs. CDC42 binds to PAK1, and PAK1 binds to paxillin. In addition, CDC42 in the VEGFA group had a greater ability to bind to PAK1, whereas PAK1 in the VEGFA group had a greater ability to bind to paxillin. Overexpression of miR-206 in VEGFA-induced BM-MSCs demonstrated that MALAT1 competes with the CDC42 3’-UTR for binding to miR-206, which in turn is involved in the differentiation of BM-MSCs to ECs. Compared to the DMED model group, the ICP/MAP ratio was significantly greater in the three BM-MSCs treatment groups.ConclusionsMALAT1 facilitates BM-MSC differentiation into ECs by regulating the miR-206/CDC42/PAK1/paxillin axis to improve ED. The present findings revealed the vital role of MALAT1 in the repair of BM-MSCs for erectile function and provided new mechanistic insights into the BM-MSC-mediated repair of DMED.

(078) ASSESSMENT OF RESIDENT EDUCATION IN THE DIAGNOSIS AND TREATMENT OF COMMON CONDITIONS OF FEMALE SEXUAL DYSFUNCTION

Abstract Introduction Female sexual dysfunction (FSD) affects 30-50% of women. Despite the fact that doctors from all specialties are likely to encounter patients with sexual health difficulties, just half of U.S. medical schools currently offer formal teaching in sexuality. Due to insufficient training in the female pelvic physical exam and minimal training on sexual health, FSD has been substantially underdiagnosed and undertreated. Objective The aim of our study was to assess the knowledge and confidence of residents on how to conduct a comprehensive vulvar examination, as well as to assess the comfortability with diagnosing and managing conditions of FSD. Methods This cross-sectional analytical survey study used Qualtrics to administer the survey. The target audience included urology residents, obstetrics and gynecology residents, dermatology residents, internal medicine residents, family medicine residents, and emergency medicine residents. The survey link and a brief description of the project were emailed to all residency program directors in these specialties who had valid email addresses provided in the FREIDA American Medical Association Residency Database. Program directors were requested to share the link to the anonymous online survey with their current resident cohorts. Results In total, n=141 residents completed the survey (n=19 OBGYN, n=18 urology, n=5 dermatology, n=37 family medicine, n=27 internal medicine, n=35 emergency medicine). Less than half of all respondents indicated they had received prior formal training in physical examination of the clitoris (23%), vulvar vestibule (45%), and pelvic floor (36%). Regarding FSD, the following percentage of respondents indicated they had received prior training in these conditions: 78% genito-pelvic pain/penetration disorder, 36% hypoactive sexual desire disorder, 24% female orgasmic disorder, 33% female sexual arousal disorder. The majority of respondents reported feeling uncomfortable with the diagnosis and management of these conditions. Conclusions Residents are uncomfortable with diagnosing and managing common female sexual dysfunctions, owing to a lack of training in both vulvar examination and these conditions of FSD. This educational shortcoming persists across several specialties. Awareness of this knowledge and comfortability gap is critical for implementing the appropriate changes to resident education. Improving residents’ ability to diagnose and treat FSD is important for preparing the next generation of physicians to appropriately attend to the needs of female patients. Disclosure No.

The sexual functions of male patients suffering from affective disorders.

This study aimed to outline the picture of the sexual functions of male patients with affective disorders as an important part of their lives. The sample consisted of 57 male patients diagnosed with mood disorders in remission. They were interviewed for demographic and clinical data, asked to fill in number of self-descriptive questionnaires' Sexual Function of Man (SFM/K), the Montgomery-Åsberg Depression Scale (MADRS) and Young Mania Scale (YMRS), and the Alcohol Use Disorders Identification Test (AUDIT). Lower levels of sexual functioning were experienced by patients who had suffered from affective disorder for a longer time, and who had a diagnosis of recurrent depressive disorder (F33), in comparison with patients with bipolar disorder (F31). The most common sexual dysfunction was premature ejaculation, while the rarest was erectile dysfunction. An occurrence of any sexual disorder at least once in the past was reported by 66% of all patients. Participants did not have problems with alcohol usage. A worse quality of sexual functioning was associated with a longer history of affective disorder. Sexual dysfunction can be affected by even the most minor depressive and manic-depressive components. The tools used excluded non-heterosexual patients. Further research based on bigger samples is required.

Breaking the Taboo: Unveiling the Prevalence and Predictors of Female Sexual Dysfunction in Tunisia

Introduction Female sexuality is a complex and multifactorial domain that can be influenced by a variety of psychological, biological, relational, and sociocultural factors. However, sexual dysfunctions in women remain a taboo subject in many cultures and are often underestimated, underdiagnosed, and undertreated. In Tunisia, few studies have been conducted to assess the prevalence of sexual dysfunctions in women and their predictive factors.Objectivesto determine the prevalence of sexual dysfunctions in a group of Tunisian women and to identify the predictive factors of these dysfunctions.Methods This is a cross-sectional, descriptive, and analytical study, over a period of three months, from September to December 2022, conducted online via a pre-established questionnaire to collect various sociodemographic data, personal history, psychoactive substance consumption, weight, and height. We used the Female Sexual Function Index (FSFI) scale to evaluate sexual functioning in participants. We recruited sexually active Tunisian women over 18 years of age who agreed to anonymously respond to the questionnaire. The form was disseminated on social networks, in groups that focus on women, with a rate of three publications per week.ResultsWe collected data from 90 women with a mean age of 35 ± 12.84 years.More than half of our population (60%, n=54) had at least one sexual dysfunction.The most common sexual dysfunctions reported were arousal disorders (31.3%), followed by desire disorders (26.8%) orgasm disorders (12.4%).We found that several factors were significantly associated with sexual dysfunctions : Women over 45 years of âge (p<10-3), who are divorced (p=0,02), have a low socioeconomic status (p=0,04), and report having experienced traumatic romantic/sexual expériences (p<10-3) were found to have a higher prevalence of sexual dysfunctions. According to our results, cannabis consumption had a negative impact on lubrication (p<10-3) and orgasm (p=0.003) among our study respondents. Personal psychiatric history also had a negative influence on arousal (p=0.02) and sexual satisfaction (p=0.01).ConclusionsBy identifying sexual dysfunctions early and treating them effectively, we can improve the quality of life of those affected and avoid serious consequences on their physical and mental health. It is therefore crucial to promote a proactive approach to sexual health and encourage healthcare professionals to approach sexuality openly and comprehensively.Disclosure of InterestNone Declared

Men’s views on causes and consequences of erectile dysfunction or premature ejaculation in a primary care population: a qualitative study

Objective To explore men’s views on the causes and consequences of two common sexual dysfunctions – erectile dysfunction and premature ejaculation – and how this affects physical and mental health as well as social life and intimate or close relations. Design A qualitative design with semi-structured interviews using open-ended questions was employed. Individual interviews were conducted, audio recorded and transcribed, and a qualitative content analysis of the text was performed. Setting Informants were recruited from an outpatient primary care clinic in Sweden that offers consultation about sexual health to primarily younger men, age 20 years and above. Subjects A total of 18 participants were included in the study, ten with erectile dysfunction and eight with premature ejaculation or both. Main outcome measures Using the content analysis, different views and strategies of erectile dysfunction and premature ejaculation were presented to illustrate a range of perceptions. Results The main theme emerged as ‘Striving to understand and deal with the problem’, which was divided into four categories: ‘Reasons for seeking healthcare’, ‘Own perceptions/images about the problem and its cause’, ‘Experienced consequences on sex life’ and ‘Relationship qualities’. Participants experienced their problems in relation to a partner. Feelings of shame and fear of not being fit for desired sexual practices were common. They thought that underlying physical illness or previous sexual activities could have caused their problems. Decreased sexual desire and low self-esteem were seen as consequences, and participants wished for both medical treatment and counselling as support. Conclusion Sexual dysfunction impairs general health and relationships with partners. While counselling is the basic treatment, those who are offered pharmaceutical treatment need follow-up concerning effectiveness and potential concerns.

Does erectile dysfunction predict cardiovascular risk? A cross-sectional study of clinical characteristics in patients with erectile dysfunction combined with coronary heart disease.

Erectile Dysfunction (ED) is a common sexual dysfunction in men who are unable to consistently obtain and maintain sufficient penile erection to accomplish a satisfactory sexual life. ED is currently considered to be a predictor of cardiovascular disease (CVD), but few studies have observed the association between ED and clinical features of coronary heart disease (CHD). An investigation of the association between ED and clinical characteristics of CHD was carried out using a cross-sectional study design. This cross-sectional single-center study was conducted in the Department of Cardiology and included 248 patients. Associations between patients' general information, underlying disease information, coronary heart disease information, and ED severity were statistically and analytically analyzed using SPSS 26.0 software. Patients with comparable clinical characteristics were grouped together using K-means clustering. Finally, ordered logistic regression analysis was performed for general and underlying disease information. In the comparison of general data, age, education, and weekly exercise were associated with the distribution of ED severity. In the comparison of underlying disease information, the number of underlying diseases, hypertension, diabetes, hyperlipidemia, anxiety state, and depressive state were associated with the distribution of ED severity. In the comparison of CHD information, the degree of ED severity was associated with CHD subtypes, lesion sites, number of stenoses, degree of stenosis, and interventional interventions. The time from ED to CHD onset was associated with the subtypes of CHD and the number of stenoses. We clustered the main characteristics of low-risk and high-risk patients and ordered logistic regression analysis found that BMI, smoking, alcoholism, number of underlying diseases, diabetes, anxiety state, and depression state were all risk factors for CHD severity (P < 0.05); the higher the value of the above factors, the more severe the degree of CHD. Age was a protective factor for CHD severity; the younger the patient, the lower the likelihood of myocardial infarction. ED severity and the time from ED to CHD onset may be predictive of coronary heart disease severity. Reducing smoking and alcohol consumption, maintaining a healthy body weight, and regular physical activity are important in preventing CVD in ED patients.

(072) Effect of Diafragmatic Breathing Exercises on Individual with Premature Ejaculation

Abstract Introduction Premature ejaculation (PE) is defined as an intravaginal ejaculation latency time (IELT) of less than 60 seconds and the most common sexual dysfunction among men. There is no published study researching the effect of diafragmatic breathing exercises (DBE) on PE and also no optimal training protocol has been identified. Objective Investigate the effect of DBE on PE and to create a new treatment protocol. Methods Sixty two men with PE aged between 20–45 years were included in the study and randomly divided into Group I or Group II (n=1:1). Both groups underwent the treatment protocol includes behavioral therapy (BT) and pelvic floor rehabilitation (PFR) in 4 steps: 1) awareness of the pelvic floor muscles (PFM), 2) PFM specific contraction, 3) using the BT for learning the timing of pre-orgasmic sensation and maintenance of PFM contraction during sensation of the pre-orgasm, 4) PFM strengthening exercises. PFM strengthening exercises were given 3 days/week, 2 times/day for 8 weeks. Group I also underwent DBE that were given as 3 s inspiration-7 s expiration, at least 10 times/session for each day, 2 sessions/day, for 8 weeks. For awareness and specific contraction of PFM, patient was asked to contract his PFM with the cue to stop to urine while performing a digital rectal examination in supine. In order to learn the timing of pre-orgasmic sensation, masturbation exercises were given to the patient with start-stop tecnique. During the cycle of the pre-orgasmic sensation contraction of PFM was requested. After 4 or 5 cycles the patient can let himself reach ejaculation. Result of this training discussed with the patient once a month by phone-call. PFM strengthening exercises comprised sustained for slow (10 s submax. contraction-10 s relaxation x15 times) and fast twitch muscle fibers (1 s contraction-10 s relaxation x10 times). Outcome measurements were made by a blinded assessor at pre-treatment and at the end of the 8 week (post-treatment). Stop watch was used to calculate IELT, Ultrasound was used to measure PFM strength (US-S) and PFM endurance (US-E) and Elite-HRV device was used to measure autonomic nervous system parameters (Root mean square of successive differences (RMSSD), proportion of NN50 (PNN50), Low frequency power (LF-Power), High frequency power (HF-power), Low frequency/high frequency ratio (LF/HF-ratio)). Results Twenty nine (mean age=31.4±6.5) in Group I and 30 (mean age=31.3±7.6) in Group II (total 59) completed the study. There was no significant difference between the groups in terms of demographic characteristics and pre-treatment IELT. Both groups showed significant improvement in all measurement parameters (all p&amp;lt;0.001), except LF/HF at post-treatment. When the differences between pre-treatment and posttreatment were compared, IELT (p=0.016), RMSDD (p&amp;lt;0.001), PNN50 (p=0.001), LF Power (p=0.001), HF Power (p=0.006), US-S (p&amp;lt;0.001), US-E (p&amp;lt;0.001) were significant in favor of Group I. Conclusions BT and PFR combined protocol, showed increase in IELT, PFM strentgh and endurance and improvements at autonomic nervous system parameters. Adding DBE to this protocol showed better improvements in all parameters. Disclosure No.

(137) Telemedicine for Sexual Health Issues: A Descriptive Cross-Sectional Study

Abstract Introduction Telemedicine has revolutionized healthcare by enabling remote consultations. In the realm of sexual health, it offers a discreet and convenient platform for couples to seek expert advice, receive counseling, and access personalized treatments from the comfort and privacy of their own homes. Objective The objective of this study is to examine the predominant sexual health issues in telemedicine consultations and analyze the socio-demographic profiles of the subjects accessing the service. Methods The study received ethical clearance from the Institutional Review Committee of the Medical College. A sexual wellness clinic was established within the psychiatry department, operating on specific days. Patients visiting the clinic were provided with a WhatsApp number for teleconsultation. This number was also shared on various social media platforms to reach a wider audience. During the study period, 88 individuals sought telemedicine consultation, of whom 51 presented with one or more sexual health issues and were included in the study after providing informed verbal consent. The subjects' sociodemographic profiles and relevant clinical data were recorded. Diagnosis of sexual dysfunction followed the DSM5 criteria, while other sexual health issues were categorized separately. Data were analyzed using descriptive statistics. Results Among 51 subjects 48 were male while 3 were female. Fourty six subjects had some sexual dysfunction while 5 subjects presented with other sexual health issues. Majority of the patients were young. Among sexual dysfunction, premature ejaculation was the most common sexual dysfunction while among sexual health issues, dhat syndrome was the most common one. Conclusions In regions with limited access to sexual health services, telemedicine offers a promising alternative, providing accessible and private consultations. This study emphasizes its significance in addressing sexual health concerns and advocates for further integration into mainstream healthcare. Disclosure No.

(259) Comparison of Dapoxetine vs Paroxetine vs Clomipramine for Premature Ejaculation Patients

Abstract Introduction Premature ejaculation (PE) is a common male sexual dysfunction. The International Society for Sexual Medicine (ISSM) defines PE as the inability to delay ejaculation during all or nearly all vaginal penetrations with latency time before or within 1 minute of penetration for lifelong PE and within 3 minutes for acquired PE and negative personal consequences such as distress, bother, frustration. The introduction of Selective Serotonin reuptake inhibitors (SSRIs) and Tricyclic antidepressants (TCA) revolutionized the treatment of PE. However not many studies have compared the efficacy and safety of these drugs in a single study. Objective To compare the clinical efficacy and safety of Dapoxetine, Paroxetine, and Clomipramine for the oral pharmacotherapy of PE. Methods Men presenting with self-reported PE were evaluated with full medical/sexual history, comorbidities, focused physical examination, assessment for Erectile function, any investigations suggested by these findings. IELT was determined by stopwatch method for every intercourse attempt. IELT were recorded before and after using the above medications in each group. ISSM definition of PE formed basis of diagnosis. All patients were married potent men in a stable relationship for at least 6 months and possible sexual intercourse equal or greater than one per week. None of the patients had received other treatment for PE for at least 4 weeks before the start of the study. All subjects gave their written informed consent before entering the study. Standardized assessment measures such as validated questionnaires &amp; Patient Reported Outcomes (PRO) used as adjunct for assessment. Results 48 Patients with PE were recruited in this study. Patients were randomly assigned to receive 60 mg Dapoxetine ‘on-demand’(group 1, n = 24), or 20 mg Paroxetine daily (group 2, n = 12) or 50 mg Clomipramine (group 3, n = 12) orally daily during a 12-week period for each agent. After 12 weeks of treatment with Dapoxetine, Paroxetine and Clomipramine, the IELT was increased from the pretreatment mean of 35 seconds to 184 seconds, from 32 seconds to 178 seconds and from 34 seconds to 169 seconds, respectively (P = 0.01 in group 1 and 2,P = 0.02 in group 3). Baseline and 12-week mean intercourse satisfaction domain values of the IIEF were 10, 11, 10 and 14, 15, 13 in groups 1, 2, and 3 respectively. The mean number of coitus per week pretreatment and at 12-week treatment were 1.4, 1.3 and 1.3/week which rose to 2.4, 2.3 and 2.2 for Dapoxetine, Paroxetine and Clomipramine, respectively. The most common adverse effects of each drug were nausea, diarrhea, headache and perspiration. Conclusions Oral SSRIs &amp; TCA are safe and effective treatments for PE. Dapoxetine, although approved, does Not appear to be widely used; cost could be an issue. Its use can result in better QoL for the patient and their sexual partner. Paroxetine has the advantage of improving IELT with well-tolerated side effects. It has good efficacy in the treatment of PE. Higher dose of Clomipramine results in a longer IELT without higher risk of adverse events. Larger studies with different dosages and treatment regimens are required to yield more credible outcomes. Disclosure No.

Effect of cranial electrotherapy stimulation (CES) in treatment of premature ejaculation: a randomized clinical trial

BackgroundPremature ejaculation is one of the most common male sexual dysfunction, affecting approximately 30% of men. The aim of this study is to evaluate the efficacy and at the same time the safety of the cranial electrotherapy stimulation (CES) device in treatment of premature ejaculation disorder.MethodsBased on a randomized clinical trial, two groups were included in the study, so that the first group was treated with sertraline along with an ATANG (AT-9 model) CES, and the second group with sertraline and inactive the CES device (as the placebo group). The state of premature ejaculation after treatment (using the Premature Ejaculation Diagnostic Tool (PEDT) questionnaire) was evaluated and compared for both groups.ResultsIn the intervention and placebo groups, the average score of the PEDT questionnaire before the intervention did not differ significantly between the two groups (p-value equal to 0.93). However, the average score of the PEDT questionnaire after the intervention for CES group and placebo group was 10.28 ± 1.93 and 13.23 ± 3.05, respectively, which demonstrated a significant decrease in the intervention group (p-value equal to 0.01).ConclusionThe use of CES device as a complementary treatment along with routine drug treatment (sertraline) is associated with a significant improvement in the condition of premature ejaculation of patients.Trial registrationName of the registry: IRCT Iranian Registry of Clinical Trials.Trial registration number: IRCT20210621051657N1.Date of registration: December 11, 2022.URL of trial registry record: https://en.irct.ir/trial/57201.

The Integration of Psychological Intervention in the Multimodal Treatment of Patients with Prostate Cancer and Erectile Dysfunction

Male sexual dysfunction refers to a lack of attraction and a lack of normal sexual performance. The most common sexual dysfunction in men is erectile dysfunction. Erectile dysfunction is the inability to achieve an erection or to sustain satisfactory sexual intercourse. Sexual dysfunction is associated with oncological treatment, having a significant impact on the quality of life. Sexuality is a frantic sense of awakening to life, it is excitement and a lot of energy, it gives the feeling of invincibility, it is the opposite of death. For many cancer patients, getting an erection is a negative problematic experience, combined with feelings of hopelessness, depression, accompanied by loss of self-esteem. Taking into account the medical aspect, the present paper highlights the interpersonal psychological aspect with reference to the cognitive-behavioural model. The present analysis describes the problem of sexual dysfunction and illustrates a panorama of therapeutic models to plan an effective intervention. This study aims to perform a review of the evidence on the role of cognitive-behavioural psychotherapy in addressing erectile dysfunction problems in prostate cancer patients. An extensive bibliographic search of online database and relevant manuscripts was followed.

(258) Trends in Prevalence, Incidence and Pharmacological Prescriptions for Premature and Delayed Ejaculation – A Claims Database Analysis

Abstract Introduction Premature (PE) and delayed (DE) ejaculation are common male sexual dysfunction disorders. Despite a community-reported prevalence of approximately 30% for PE and 5% for DE, the clinical prevalence, incidence, and rates of pharmacological prescriptions for both disorders remain under-investigated in the literature. Objective Our objective is to assess the trends in prevalence, incidence, and pharmacological treatment of PE and DE using a large claims database. Methods The TriNetX Research database, a large insurance claims database, was queried to identify all adult (≥18 years) males that were evaluated from January 2012 through December 2022. The number of men diagnosed with PE (ICD-10 F52.4) and DE (F52.32 and N53.11) was compared to the total number of men evaluated using six-month intervals (January-June, July-December) to calculate percent prevalence and incidence. A chi-squared test of linear trends was performed for prevalence and incidence. Rates of prescribed treatments were calculated comparing the number of men receiving the treatment to the total number of men with the assessed disorder using six-month intervals for PE and one-year intervals for DE. Results A total of 17,647 adult males with a diagnosis of PE and 6,304 adult males with a diagnosis of DE were identified from January 2012 to December 2022. The prevalence and incidence for both disorders are found in Figure 1. The chi-square test for trends showed a significant increasing trend in the prevalence of PE (χ2 = 303.44, p-value = &amp;lt;0.0001) and DE (χ2 = 314.14, p-value = &amp;lt;0.0001) and incidence of PE (χ2 = 6.40, p-value = 0.0114) and DE (χ2 = 187.43, p-value = &amp;lt;0.0001). In the final period, 63.5% males with PE and 33.4% males with DE received at least one medication of the investigated therapies. The most common medications prescribed to men with PE were phosphodiesterase-5 inhibitors (25.7%), paroxetine (17.4%), topical anesthetics (13.4%), and sertraline (12.2%). The most common medications prescribed to men with DE were testosterone (11.7%), bupropion (12.2%), and cabergoline (10.0%). The prescription rates of all of the investigated medications for PE and DE are shown in Figures 2 and 3, respectively. Conclusions In this large US claims database analysis, premature and delayed ejaculation are overall diagnosed at low but increasing rates. Furthermore, the rates of pharmacological prescriptions for PE remains relatively low, despite pharmacotherapy being recommended as first-line options under the current guidelines. Additional research is necessary to investigate the long-term efficacy of individual medications for both PE and DE. Disclosure No.

Study of Sexual Dysfunctions in Male Patients with Alcohol Dependence Syndrome

Background: Virtually all aspects of the human sexual response are affected by alcohol. Chronic and persistent alcohol use has been seen to impair erectile, orgasmic and ejaculatory capacities, which leads to marked distress and interpersonal difficulty. Aims and Objectives: To study the prevalence and types of sexual dysfunction and to study the impact of the severity of alcohol dependence on sexual dysfunctions in male patients with alcohol dependence syndrome. Methodology: A cross-sectional study was done at the outpatient Department of Psychiatry of a tertiary teaching hospital. Socio-demographic details of the patient and alcohol-related clinical variables were collected using the study proforma. The severity of alcohol dependence was assessed using the Alcohol Dependence Scale (ADS). To assess the presence of sexual dysfunction, the Arizona Sexual Experience Scale (ASEX) was used and the type of sexual dysfunction was decided by the Sexual Dysfunction Checklist (SDC) based on ICD 10, and the data was analysed. Results: 170 male patients with alcohol dependence, with a mean age of 35.84 years, participated in the study. The prevalence of sexual dysfunction was 67.06%. Loss or lack of sexual desire was the most common sexual dysfunction, followed by failure of genital response (erectile dysfunction), frequency dissatisfaction and premature ejaculation. The majority of the sample studied had one or more sexual dysfunctions. The ADS score positively correlated with the ASEX score, and this correlation was statistically significant. Conclusion: Alcohol use was found to be associated with sexual dysfunctions, and lack of sexual desire was the most common sexual dysfunction.

How Sex Works (and When it’s in Working)

Sexuality is a fundamental aspect of human life, including a range of physical, impassioned, and intellectual aspects. This abstract explores the elaborate mechanical details of how sex affects everything, removing the complexities that delimit human desire. Key elements include desire, ideas, and intercourse answers, all influenced by a myriad of organic, mental, and public factors. This item tests the key processes complicated in sexual functioning in the way that hormones, intellect, and reproductive organs interact. Intercourse dysfunction is a widespread issue that can improve the functioning of these processes. Common sexual dysfunctions, including sterility, rash ejaculation, and depressed sexuality have been discussed in depth. Furthermore, we investigate the intellectual facets of sexual troubles such that depiction anxiety, corpse figure concerns, and past blows can considerably impact an individual’s intercourse experience. The abstract still highlights the significance of communication and consent in athletic intercourse friendships, emphasizing that intercourse welfare is not determined only by tangible determinants. Key determinants for maintaining a fulfilling and effective sexual life were investigated, including open ideas, emotional relationships, and shared respect. In conclusion, this abstract offers observations of the multifaceted character of human lust, exemplifying how it works, and when it is in optimal disrepair. Understanding the miscellaneous factors that influence intercourse functioning and discussing average sexual dysfunctions, things, and couples can help navigate the complicated nature of their sexual lives, promoting more athletic and fulfilling relationships

Identifying and Assessing Sexual Dysfunction: Strategies for Counselors

Sexual health is a key component of wellness. It includes functioning, satisfaction, social interaction, and access to care. Due to the high prevalence of sexual dysfunction, many mental health clients are likely experiencing sexual dysfunction. However, sexual dysfunction is often not reported by clients, and mental health professionals are usually not trained to identify or assess it. Given that counselors are agents of wellness and that sexual health is considered integrally connected to overall wellness, it is important that counselors understand the most common sexual dysfunctions and assessment techniques. This article offers conceptualizations and strategies to assist mental health professionals in identifying and assessing sexual health problems.