Male Sexual Function Research Articles

Levels of prolactin and testosterone and associated sexual dysfunction and breast abnormalities in men with schizophrenia treated with antipsychotic medications

Sexual dysfunction is one of the most bothersome adverse drug effects seen in men and women taking antipsychotic medications and negatively impacts medication adherence. Antipsychotic medications are associated with hyperprolactinemia, which is known to contribute to sexual and hormonal side effects in men. However, testosterone also plays a key factor in male sexual function and may be affected by abnormal prolactin levels through gonadotropin-releasing hormone inhibition. This study was a pilot study undertaken to assess the prevalence of elevations in prolactin levels, related reductions in testosterone levels, associated symptoms of sexual dysfunction and breast abnormalities in male participants, and related distress to these symptoms in men taking prolactin-elevating antipsychotic medications. The study was conducted as a cross-sectional study. Our results showed a notably high prevalence of sexual side effects in this population, with gynecomastia occurring in 50% and penile-related symptoms in 73%. Additionally, we found elevated prolactin levels in 68% and low testosterone levels in 55% of our participants. This study was limited in its power due to a small sample size of 22 men and the lack of a control group. Still, even in our relatively small sample, we see a trend of hyperprolactinemia being associated with low testosterone and a significant correlation of low testosterone levels with penile-related symptoms. This suggests that testosterone plays a major role in the sexual side effects reported by men taking antipsychotics, although larger studies are needed to further categorize this relationship.

Male and Female Sexual Function and Dysfunction; Andrology.

No AccessJournal of UrologyUrological Survey1 Nov 2021Male and Female Sexual Function and Dysfunction; Andrology Allen D. SeftelMD Allen D. SeftelAllen D. Seftel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002173AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue 5November 2021Page: 1311-1313 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen D. Seftel More articles by this author Expand All Advertisement PDF downloadLoading ...

A Preliminary Study of Short-Term Sexual Function and Satisfaction Among Men Post-Myocardial Infarction.

Sexuality is an important component of holistic quality of life, and myocardial infarction (MI) negatively influences many aspects of sexuality, including sexual function. However, there is limited literature that examines sexuality beyond the most basic physical components. This pilot study aimed to describe the relationships between the physical, psychologic, and social domains of holistic sexuality at an early timepoint post-MI. Adult men post-MI were mailed self-report surveys at 2 weeks post discharge. Physical domains of sexuality were measured with the arousal, orgasm, erection, lubrication, and pain subscales of the Male Sexual Function Index (MSFI). The social domain utilized the sexual satisfaction subscale of the MSFI. The psychologic domain included the desire subscale of the MSFI and sexual fear (Multidimensional Sexuality Questionnaire). Spearman correlations were estimated to examine associations among the different measurement subscales. Twenty-four men post-MI were analyzed. Average scores on the MSFI were 9.2 (SD 7.7). Desire and satisfaction were the highest scoring subscales among men when compared with other subscales (i.e. erection, lubrication). There was minimal evidence supporting a relationship between sexual fear and function. Additional research is also needed with larger samples, and among women post-MI.

Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study.

IntroductionMale sexual dysfunction is a common problem, and there are many self‐report questionnaires for measuring sexual function among men; however, the Brief Male Sexual Function Inventory (BSFI) is a tool that has 5 subscales, which is more complete than others. a validated self‐report questionnaire, in the local language with modest expressions is required for men.AimTo determine the validity and reliability of the Persian version of the BSFI among men.MethodsThis cross-sectional study was conducted on 200 males. The sampling process was performed in several stages from health centers. After the accomplishment of the standard process of back-translating the questionnaire from English to Persian, its face, content, and construct validity were evaluated. The collected data were analyzed using confirmatory factor analysis, multivariate analysis of variance, and Pearson correlation coefficient. To determine the reliability of the instrument, the test-retest method was used with 2 weeks interval and the Cronbach's alpha coefficient method was applied to check the internal homogeneity.Main Outcome MeasuresReliability (internal consistency and test-retest) and validity were assessedResultsAccording to the research findings, confirmatory factor analysis had an acceptable fit. By modifying the measurement model and fitting the final model, the fitting indices were obtained as the following: Chi-square statistic = 21.63, NPAR = 36, P = .001 > 0.05; Tucker-Lewis index = 0.956; comparative fit indices = 0.976; Normed Fit Index = 0.952; and root mean square error of approximation = 0.068. These values indicated that the obtained model had a good fit for the data. Moreover, Cronbach's alpha and intra-cluster correlation coefficients of the whole questionnaire were calculated at 0.893 and 0.893, respectively (confidence interval between 0.811–0.950), showing the internal consistency of the items in the whole questionnaire and domain.ConclusionThe BSFI questionnaire showed a 5-factor structure similar to the original structure and the 11-item Persian version of the questionnaire of male sexual function can be considered a valid and reliable tool to assess the level of male sexual function. Rezaei N, Sharifi N, Fathnezhad-Kazemi A, et al. Evaluation of Psychometric Properties of the Persian Version of Brief Male Sexual Function Inventory: A Cross-Sectional Study. Sex Med 2021;9:100409.

Male and Female Sexual Function and Dysfunction; Andrology.

No AccessJournal of UrologyUrological Survey1 Oct 2021Male and Female Sexual Function and Dysfunction; Andrology Allen D. SeftelMD Allen D. SeftelAllen D. Seftel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002130AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue 4October 2021Page: 1047-1049 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen D. Seftel More articles by this author Expand All Advertisement Loading ...

Effect of depression and anxiety on sexual functioning in couples trying to conceive with and without an infertility diagnosis

Objective This study examined the effects of anxiety and depression on sexual functioning in couples trying to conceive, and tested the moderating role of infertility diagnosis on this association. Design An online questionnaire was completed by 1453 individuals in a heterosexual relationship for more than one year. The final sample had 107 couples who were actively attempting a pregnancy (63 had an infertility diagnosis; 44 were presumably fertile). Data was analyzed with the Actor-Partner Interdependence Model (APIM). Main Outcome Measures Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS), and male and female sexual functioning were assessed through the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI), respectively. Results Actor effects were found between depression and sexual functioning in both men (β= −.28, p= .003) and women (β= −.43, p < .001), with no significant partner effects. The moderation analysis showed that the relationship between depression and sexual functioning is stronger in infertile men than in presumably fertile men (β= −.29; p= .002). Conclusion Psychological interventions with couples trying to conceive should address the role of depression in sexual functioning, particularly in infertile men.

Sacral Neuromodulation for Lower Urinary Tract Symptoms: Effect of Therapy on Saudi Patient Sexual Function.

BackgroundSacral neuromodulation (SNM) is FDA-approved therapy for lower urinary tract and bowel dysfunction. It is newly introduced therapy in Saudi Arabia.AimTo evaluate the effect of SNM therapy in both male and female Saudi patient's sexual function.MethodsA prospective cohort study was conducted for all patients who underwent SNM implantation from January 2016 till January 2020 at a single center in Jeddah, Saudi Arabia. Sexual function was assessed before and after treatment using International Index of Erectile Function (IIEF-5) for men and the Female Sexual Function Index (FSFI) for women.Main Outcome measuresSexual function score changes from the baseline was reported. Correlation analysis was studied between IIEF-5 to assess erectile dysfunction and FSFI assessing desire, arousal, orgasm, pain and sexual satisfaction and other collected data including patient's age, functional diagnosis and post void residual (PVR).ResultsThe study included 13 total patients (8 female, 5 male) with mean age 47y (33-60). Diagnosis included non-obstructive urine retention (5), refractory overactive bladder (3), combined retention + over active bladder (OAB) (1), pelvic pain syndrome (3) and impotence in 1 patient. All male patients showed significant improvement in their IIEF-5 score from mean pre op 7.8 ±5.7 to post op sore of 19.8±2.3 with significant p value p=0.003.Female patients showed significant improvement in their FSFI total score from baseline of 18.313±7.4 to post-operative mean FSFI score 26.7±1.8 with p value = 0.013. Domains od FSFI which showed significant improvement were desire, arousal, orgasm and sexual satisfaction with p value =0.002, p=00.1,0.012, and p=0.015. Age, functional diagnosis and PVR did not show significant correlation with IIEF-5 and FSFI score.ConclusionOur results suggest that SNM might improve male and female sexual dysfunction regardless of patient's age and diagnosis. Banakhar MA, Younos A. Sacral neuromodulation for lower urinary tract symptoms: effect of therapy on Saudi patient sexual function. Sex Med 2021;9:100388.

Hypogonadism and Sexual functioning in males with and without Diabetes Type II

The aim of this study was to investigate the relationships between hypogonadism and sexual functioning in males with and without type II diabetes based on the moderating roles of marital status, the level of education, and age. Specifically, the predictive role of hypogonadism on the explanation of sexual functioning was investigated. The participants included 229 males with and without type II diabetes. A demographic questionnaire, the International Index of Erectile Function (IIEF), and (2) the Testosterone Level Test (TLT) were used in this study. Patients with type II diabetes had significantly lower testosterone levels, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction than individuals in the control group. The erectile function, orgasmic function, sexual desire, intercourse satisfaction, and the overall sexual satisfaction had significant positive relationships to the total testosterone level in this sample. The total testosterone level explained 39% of the overall sexual function variation in the present study. Patients with type II diabetes have higher hypogonadism and a lower sexual functioning than healthy individuals, and there is a significant linear relationship between the total testosterone level and sexual functioning in males.

Male and Female Sexual Function and Dysfunction; Andrology.

Male and Female Sexual Function and Dysfunction; Andrology.

Can Nutrition Help in the Treatment of Infertility?

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse or six months for women aged 35 years or older. The physical, emotional, psychological, and financial statuses of infertile couples are tremendously affected especially after undergoing diagnostic and/or curative treatments. Human fertility is influenced by multiple factors including female or male, and modifiable or non-modifiable factors. There is growing evidence that nutri-tion may play an important role in adjusting fertility-related outcomes in both men and women. The objective of our study was to summarize the latest data on nutritional factors (specific food groups, nutrients, and nutritional supplements) that have an impact on female or male sexual and reproductive function. PubMed and Google Scholar platforms were used to collect appropriate articles for the review using several combinations of keywords (infertility, diet, dietary supplements, antioxidants, and beverages). Adherence to a healthy dietary pattern favoring fish, poultry, whole grains, fruits, vegetables, and healthy fats, was related to better fertility in both genders. Despite the multifactorial etiology of sexual infertility, nutrition may affect the sexual/reproductive function in both women and men.

Theoretical Substantiation of the Use of Sildenafil in the Treatment of Chronic Prostatitis

Every year, the number of patients with chronic prostatitis (CP) in the world is increasing and improving the effectiveness of treatment of this pathology is becoming a priority topic in modern urology. One of the complications of CP is sexual dysfunction, primarily premature ejaculation, as well as erectile dysfunction (ED). Treatment of CP and its sexual complications is an individual and complex complication. It is undeniable that sildenafil citrate plays an important role in the treatment of ED as a complication of CP. The hypothetical mechanism of the effectiveness of PDE-5 in CP is mediated by the relaxation of the smooth muscles of the ducts of the software, the effect of increasing the drainage of the components that are formed due to reflux in the interstitial tissue. The above phenomenon can suppress inflammation and cause a reduction in prostatic symptoms. Increased activity of NO-synthetase and PDE-5 in the tissues of PO promotes the formation of muscle relaxant effects, drainage of the acinus, reduced activity of the autonomic nervous system and activation of vascular circulation in the PVC and structures of the lower urinary tract. Current scientific evidence indicates that PDE-5 inhibitors can improve lower urinary tract symptoms by relaxing bladder smooth muscle fibers and PO, by signaling NO / cGMPc, or by improving RhoA / Rho kinase. Some results suggest that in addition to the effects of reducing the hyperactivity of the autonomic nervous system, dilation of cavernous vessels and antiproliferative effect, PDE-5 have a direct anti-inflammatory effect, increasing the level of cGMP. The accumulation of the latter can inhibit inflammation and can be a potential mechanism for preventing the development of diseases in which inflammation plays a central role. Given that inflammation is a major factor in the progression of CP, sildenafil citrate is able to restore PO function because they act as potent anti-inflammatory drugs. Thus, PDE-5 inhibitors can not only mediate smooth muscle relaxation, but can also directly reduce inflammation in the software by increasing cGMP levels. Based on theoretical data on the positive effect of sildenafil on the erectile component and symptoms of the lower urinary tract in persons with CP with complications such as ED, it can be considered that the inclusion of sildenafil citrate in sequential standard therapy for CP reduces indicators of erectile function. The appointment of sildenafil citrate in patients with complications of CP in the form of ED improves the quality of erections in patients, and also has a positive effect on various other indicators of male sexual function (enhances orgasm, increases the duration of sexual intercourse).

Hypoprolactinemia and hyperprolactinemia in male schizophrenia patients treated with aripiprazole and risperidone and their relationships with testosterone levels.

AimSeveral reports have shown that risperidone increases prolactin concentrations, while aripiprazole decreases prolactin concentrations. The frequency of abnormal prolactin concentrations in patients with schizophrenia receiving these drugs is still unknown. Furthermore, although hyperprolactinemia leads to sexual dysfunction, the relationship between hyperprolactinemia and testosterone, which may be directly related to male sexual function, is not well understood.MethodsThe subjects were 94 male schizophrenia outpatients receiving risperidone or paliperidone (risperidone group) and 83 male schizophrenia outpatients receiving aripiprazole. We measured the serum prolactin and total and free testosterone concentrations. We compared the prolactin and testosterone levels in patients receiving risperidone or paliperidone and patients receiving aripiprazole.ResultsThe average serum prolactin concentration was 27.5 ± 13.1 ng/mL for the risperidone group and 3.9 ± 3.5 ng/mL for the aripiprazole group, and the concentrations were significantly different (P < .001). Hypoprolactinemia was observed in 75% of the aripiprazole group and hyperprolactinemia in 65% of the risperidone group. A positive correlation between prolactin levels and the risperidone daily dose was found, whereas a negative correlation between prolactin levels and the aripiprazole daily dose was observed. In the risperidone group, total testosterone concentrations were correlated with age, while free testosterone concentrations were inversely correlated with age and prolactin levels.ConclusionWe found very common hyperprolactinemia and hypoprolactinemia in the risperidone or paliperidone group and aripiprazole group, respectively. Testosterone concentrations were associated with elevated prolactin levels in patients receiving risperidone or paliperidone. Further studies are needed to determine the clinical relevance of abnormal prolactin concentrations in male and female patients with schizophrenia.

Sexual function and depressive symptoms in men with hypoprolactinaemia secondary to overtreatment of prolactin excess: A pilot study

BackgroundLow prolactin levels have been found to impair libido and arousal, as well as to reduce wellbeing in young women. ObjectiveThe aim of this study was to investigate whether drug-induced hypoprolactinaemia affects male sexual function and depressive symptoms. MethodsThe study population consisted of three groups of young and middle-aged men. Two groups were treated with dopamine agonists because of previous hyperprolactinaemia but differed in current prolactin levels, which were <3ng/ml (n=12; group 1) or within the reference range (3–20ng/ml) (n=20; group 2). The control group (group 3) included 24 dopamine agonist-naïve normoprolactinaemic men. During the study, doses of dopaminergic agents in group 1 were reduced by 25–50% compared to doses before the start of the study. Circulating levels of prolactin, testosterone, free calculated testosterone, dehydroepiandrosterone-sulphate, oestradiol and gonadotropins were measured upon enrolment in the study and six months later. Moreover, at the beginning and the end of the study, all men enrolled completed questionnaires assessing sexual functioning (IIEF-15) and depressive symptoms (BDI-II). ResultsGroup 1 differed from groups 2 and 3 in domain scores for sexual desire and erectile function, and in the overall BDI-II score. It was also characterised by lower levels of total testosterone and calculated free testosterone. Reduction of drug doses normalised sexual desire and erectile function, reduced BDI-II scores and increased prolactin as well as total and free calculated testosterone. Groups 2 and 3 did not differ from each other in sexual functioning, depressive symptoms or hormone levels. ConclusionsThe results obtained indicate that men with dopamine agonist-induced hypoprolactinaemia are characterised by impaired sexual functioning and reduced wellbeing. These disturbances are a consequence of subnormal prolactin levels and do not seem to reflect adverse effects of dopamine agonists.

Impact of Bariatric Surgery on Male Sexual Health: a Prospective Study.

Obesity is a worldwide prevalent problem which negatively affects most of the human body systems. Male sexual dysfunction is a frequent problem in obese individuals. Nowadays, bariatric surgery is the most successful way for the management of morbid obesity. Recent research has concluded that it has a significant improving effect on sexual function. This study aimed to assess the long-term effect of bariatric surgery on male sexual function. Sixty-six male patients indicated for bariatric surgery were enrolled in this prospective study. Only forty-eight of them completed the study. Patients were invited to fill the International Index of Erectile Function (IIEF) questionnaire twice, preoperatively (T1) and 12 months postoperatively (T2). Simultaneously, patients' serum testosterone levels were assayed. At T2, the patients showed highly significant increase in the IIEF scores and the serum testosterone levels (p<0.001). Only weight and BMI were significant predictors of the IIEF scores. The same factors as well as the patients' age were predictors of the serum testosterone levels. Bariatric surgery improves male sexual health. It is associated with significant increase in IIEF score and serum testosterone levels.

The impact of cannabis use on male sexual function: A 10-year, single-center experience.

Despite increasing consumption rates in much of the world, the impact of cannabis use on various components of male sexual function remains poorly established. The purpose of this study was to further evaluate the relationship between cannabis use and reproductive and sexual function using a large patient cohort from a single academic andrology clinic. This is a historical cohort study from a single academic center andrology clinic. Patients from 2008-2017 were included. Intake questionnaires provided baseline demographic information, as well as data regarding substance use and various sexual function parameters. Subjects were categorized as cannabis users or non-users. Cannabis users and non-users were compared using descriptive statistics and Chi-squared tests, and regression analyses were performed to test for association. A total of 7809 males were included in the study; 993 (12.7%) were cannabis users and 6816 (87.3%) were non-users. Cannabis users had a higher mean Sexual Health Inventory for Men (SHIM) score (21.9±4.4 vs. 21.2±4.8, p<0.001) and mean serum total testosterone (13.4±12.0 nmol/L vs. 12.6±11.8 nmol/L, p=0.04) than non-users, although they also had a higher rate of positive Androgen Deficiency in the Aging Male (ADAM) scores (52% vs. 46%, p<0.001). Cannabis users also reported higher sexual frequency compared to non-users (8.8 events/month vs. 7.8 events/month, p<0.05). On multivariate analysis, cannabis use was not associated with SHIM score or serum testosterone concentration. Cannabis use was associated with positive ADAM scores. Cannabis use was not associated with clinically significant deleterious effects on male sexual parameters in this cohort.

Male and Female Sexual Function and Dysfunction; Andrology.

No AccessJournal of UrologyUrological Survey1 Sep 2021Male and Female Sexual Function and Dysfunction; Andrology Allen D. SeftelMD Allen D. SeftelAllen D. Seftel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001910AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue 3September 2021Page: 752-755 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Allen D. Seftel More articles by this author Expand All Advertisement PDF DownloadLoading ...

Probing penile hemodynamics by using photoplethysmography as objective indicators for male erection quality and sexual function

Erectile dysfunction (ED) is mostly due to the lack of blood flow into the penis. In the past 20 years, near-infrared spectroscopy (NIRS) was used in measuring the concentrations and temporal dynamics of different hemoglobin types. However, the dynamics of the light absorption (photoplethysmography; PPG) have not been applied to survey penile hemodynamics and erection quality. This paper compared the use of photoplethysmography (PPG) to study vascular ED with standard penile Doppler ultrasonography. Men diagnosed with vascular ED for at least 6 months and nominated for penile ultrasonography were included. PPG signals were collected during the ultrasound examination. All beat-to-beat PPG waveforms were aligned with the peak and averaged to one representative template waveform for feature analysis, including amplitude differences (APD) index, reflection time index (RTI), augmentation index (AI), and perfusion index (PI). An inverse correlation was found between end-erection amplitude and both erection hardness score (EHS) and resistive index (RI). APD index and EHS as well as the international index of erectile function-5 (IIEF) and RI were positively correlated. RTI and AI were inversely correlated to IIEF and RI. PI was positively correlated to RI. PPG may therefore be useful as a noninvasive, convenient, technique for sexual function evaluation.

Prevalence of Erectile Dysfunction in Males Post COVID-19 Infection

Many men have reported erectile dysfunction as a consequence of COVID-19 infection. The underlying causes, whether related to hormonal changes or endothelial dysfunction, are not yet fully understood. This study aims to investigate the impact of COVID-19 on male sexual function and fertility, specifically focusing on erectile dysfunction. A cohort of 50 males who had no prior history of erectile dysfunction before contracting COVID-19 was assessed. The study analyzes the progression of these conditions over a 90-day period postrecovery from COVID-19, with a particular emphasis on age-related factors. All males were confirmed infected COVID-19. Comprehensive medical histories were obtained from all participants, and physical examinations were conducted. International Index of Erectile Function (IIEF-5) questionnaire was employed to assess the erectile dysfunction. Assessments were performed at three separate intervals, 30, 60, and 90 days after their recovery from COVID-19. Participants consistently reported varying degrees of erectile dysfunction, which appeared to improve over time. Notably, the participants who reported erectile dysfunction tended to be older than those who did not, and this age-based distinction was highly significant (p = 0.004). In conclusion, this study highlights the impact of COVID-19 infection on male sexual function, with age and the time post-recovery emerging as significant factors contributing to these effects.

A novel mutation in FK506 binding protein-like (FKBPL) causes male infertility

AimTo perform a mutation analysis of FK506 binding protein-like (FKBPL) in patients with azoospermia.MethodsDNA samples were isolated from the peripheral blood of 30 azoospermic male patients with normal 46 XY karyotype and 10 healthy controls. Multiplex polymerase chain reaction assays were used to evaluate Y microdeletions, and the patients without deletions were further analyzed. Sanger sequencing was used for mutation analysis.ResultsA heterozygous adenine to guanine substitution was observed at position c.28 (c.28A>G) (one patient), guanine to adenine substitution at c.90 (c.90G>A) (three patients), and a novel insertion mutation of TCTCATAAGTCT at c. 229_240dup (two patients), all in FKBPL exon 2. Furthermore, four different benign variants were observed in the same gene.ConclusionOur study supports the literature on the etiologic effects of changes on autosomal chromosomes and highlights the importance of molecular analysis of all known and unknown genes that could be involved in male sexual development and function.

Male and Female Sexual Function and Dysfunction; Andrology.

Male and Female Sexual Function and Dysfunction; Andrology.