Male Sexual Function Research Articles

Relationship Status Rather than Sociosexuality or Sexual Orientation Predicts Male Sexual Functioning.

Male sexual functioning is a prerequisite for conception and consequently for reproduction and is thus a crucial mechanism from an evolutionary and social perspective. Previous studies reported better sexual functioning in coupled compared to single individuals. However, it is not clear whether sexual functioning increases or decreases with a short-term casual sexual strategy, which is another possibility, along with a long-term strategy. Furthermore, sexual orientation may represent yet another mating strategy that may influence sexual functioning. Here, we aimed to test the possible associations between male sexual functioning and sexual strategies, as measured through sociosexuality, relationship status, and sexual orientation. We hypothesize that due to its relationship with the evolved motivation of mate acquisition and mate retention, both stable relationships and sociosexuality would be positively associated with male sexual functioning. We did not expect significant differences in sexual functioning among men with different sexual orientations. We sampled 427 healthy men of different sexual orientations (203 heterosexuals, 77 bisexuals, and 147 gay men) who completed the Male Sexual Function Index (MSFI) and its subscales of desire, arousal, erection, orgasm, and satisfaction; the Sociosexual Orientation Inventory-Revised; and sociodemographic questions. A multivariate general linear model showed that, compared to single individuals, partnered individuals reported greater MSFI-arousal, MSFI-erection, MSFI-orgasm, and MSFI-satisfaction. Sociosexuality and sexual orientation only weakly predicted MSFI domains. Male sexual functioning thus seems to be moderately associated with a long-term mating strategy and can thus serve for relationship maintenance rather than for acquiring new partners.

Constitutive Androstane Receptor Regulates Germ Cell Homeostasis, Sperm Quality, and Male Fertility via Akt-Foxo1 Pathway.

Male sexual function can be disrupted by exposure to exogenous compounds that cause testicular physiological alterations. The constitutive androstane receptor (Car) is a receptor for both endobiotics and xenobiotics involved in detoxification. However, its role in male fertility, particularly in regard to the reprotoxic effects of environmental pollutants, remains unclear. This study aims to investigate the role of the Car signaling pathway in male fertility. In vivo, in vitro, and pharmacological approaches are utilized in wild-type and Car-deficient mouse models. The results indicate that Car inhibition impaired male fertility due to altered sperm quality, specifically histone retention, which is correlated with an increased percentage of dying offspring in utero. The data highlighted interactions among Car, Akt, Foxo1, and histone acetylation. This study demonstrates that Car is crucial in germ cell homeostasis and male fertility. Further research on the Car signaling pathway is necessary to reveal unidentified causes of altered fertility and understand the harmful impact of environmental molecules on male fertility and offspring health.

Clomiphene Citrate Treatment as an Alternative Therapeutic Approach for Male Hypogonadism: Mechanisms and Clinical Implications.

Male hypogonadism, which is characterized by low testosterone levels, has a significant impact on male sexual function, overall health, and fertility. Testosterone replacement therapy (TRT) is the conventional treatment for this condition, but it has potential adverse effects and is not suitable for men seeking to conceive. Testosterone plays an essential role in male sexual function, metabolism, mood, and overall well-being. Clomiphene citrate, a drug originally developed for female infertility, has recently gained attention as an off-label treatment for male hypogonadism. By blocking the negative feedback of estrogen on the hypothalamus and pituitary glands, clomiphene stimulates gonadotropin secretion, leading to increased endogenous testosterone production, which, in turn, improves sperm parameters and fertility and alleviates the symptoms of hypogonadism. Regarding the safety profile of clomiphene compared with TRT, clomiphene appears to confer a lower risk than TRT, which is associated with adverse effects such as polycythemia. Furthermore, combination therapy with clomiphene and anastrozole or human chorionic gonadotropin has been investigated as a potential approach to enhancing the effectiveness of treatments for improving hypogonadism symptoms. In conclusion, clomiphene citrate may offer a promising alternative to TRT for men with hypogonadism, particularly those desiring fertility preservations. However, its long-term efficacy and safety remain inadequately understood. Future research should focus on exploring the benefits of combination therapies and personalized treatment strategies based on individual patient characteristics.

Poweromin X Ten, a polyherbal formulation improves male sexual function: In vivo and network pharmacology study.

Poweromin X Ten (PXT) is a polyherbal formulation, traditionally used to enhance male sexual function. However, the safety and benefits of PXT have not been scientifically evaluated. Therefore, the present study investigated the toxicity and aphrodisiac potential of PXT in male rats and explored its principal mechanisms of action. Male Wistar rats were orally administered PXT (50 or 100 mg/kg) for 28 days, and sexual activity parameters, including latency and frequency of mounting and intromissions, were studied. The reproductive toxicity and spermatogenic potential were also examined. Furthermore, dopamine and serotonin levels in brain regions associated with sexual activity were assessed. Network analysis was used to identify the key bioactive compounds and their core targets involved in their beneficial actions. Treatment with PXT improved sexual activity in male rats, as evidenced by reduced mounting and intromission latency and a significant increase in mount frequency. Moreover, PXT exhibited spermatogenic potential and did not induce reproductive toxicity. Notably, treatment with 50 mg/kg PXT elevated dopamine levels in median preoptic area and hypothalamus. Pathway analysis indicated that PXT primarily modulated the PI3K-Akt, calcium, and MAPK signalling pathways to enhance male sexual function. Network analysis identified macelignan, β-estradiol, testosterone, and paniculatine as key bioactive components of PXT, which likely act through core targets, such as androgen receptor (AR), Mitogen-activated protein kinase 3 (MAPK3), epidermal growth factor receptor (EGFR), estrogen receptor 1 (ESR1), and vascular endothelial growth factor (VEGF) to facilitate the improvement of male sexual function. Study results suggest that PXT is a safer alternative with aphrodisiac and spermatogenic potential. These effects are partly attributed to the enhanced dopamine levels in the brain. Furthermore, this study provides insights into the specific signalling pathways and bioactive compounds that underlie the improvements in male sexual function associated with PXT.

The interplay between male fertility, mental health and sexual function.

The interplay between male fertility, mental health and sexual function.

Short and Long-Term Effects of COVID-19 on Male Sexual Function

Background: Reviewing the literature, a vast number of studies are available about the pulmonary effects of coronavirus disease 2019 (COVID-19). However, the effects of COVID-19 infection on sexual function, especially the long-term effects, have been rarely reported. Here, we report the short and long-term effects of COVID-19 infection on male sexual function. Methods: Using the International Index of Erectile Function (IIEF) questionnaire, the sexual function of 96 COVID-19 patients was evaluated at months 0, 1, 3, and 6 following hospitalization. Results: The findings showed that the sexual function indicators decline during the first month of infection, then start to improve and reach the baseline by the 6th month of infection. Additionally, the analysis of the demographic data revealed that higher age and lower education levels are associated with lower levels of sexual function indicators. Conclusions: Infection with COVID-19 may result in sexual dysfunction, which gradually improves over six months.

Pseudoephedrine for ejaculatory dysfunction after retroperitoneal lymph node dissection in testicular cancer.

To assess the impact of ejaculatory dysfunction (EjD; failure of emission or retrograde ejaculation) on health-related quality of life (HRQoL) after retroperitoneal lymph node dissection (RPLND) for testicular cancer and explore the efficacy of pseudoephedrine hydrochloride as treatment. In a single arm, phase II trial, patients at ≥6 months after RPLND were invited to complete patient-reported outcome measures (European Organisation for Research and Treatment of Cancer [EORTC] quality of life questionnaire [QLQ]-30-item core, EORTC QLQ-testicular cancer-26, and Brief Male Sexual Function Inventory) evaluating HRQoL and sexual function in follow-up (ACTRN12622000537752/12622000542796). If EjD was reported, post-ejaculatory urine ± semen analysis was undertaken. In eligible patients, pseudoephedrine hydrochloride 60 mg was administered orally every 6 h for six doses. The primary endpoint was sperm count >39 million sperm/ejaculate (>5th centile) following treatment. The trial was powered to detect a clinically relevant 36% achieving sperm count of >39 million sperm/ejaculate. Secondary endpoints included semen volume >1.5 mL, total motile sperm count, safety, and HRQoL impacts. Of the 58 patients enrolled, the median (interquartile range [IQR]) age was 35 (29-41) years, with a median (IQR) of 37 (18-60) months from RPLND. EjD was reported in 33 (57%), including 27/52 (52%) receiving follow-up at our centre. There were no differences in global HRQoL; however, role functioning (P = 0.045), sexual problems (P < 0.005), and sexual enjoyment (P = 0.005) was poorer if EjD was present. In all, 24/33 (73%) patients with EjD consented to pseudoephedrine treatment. Of 22 evaluable patients, four (18%) achieved a sperm count of >39 million/ejaculate (P = 0.20), and four (18%) had a semen volume of >1.5 mL (P = 0.20). There was a mean increase of 105 million sperm/ejaculate (P = 0.051) and 1.47 mL increase in semen volume (P = 0.01). No safety concerns arose. Ejaculatory dysfunction is common after RPLND but did not impact global HRQoL in our cohort. Pseudoephedrine improved EjD for some; however, its efficacy was lower than expected. Pseudoephedrine may be considered on an individualised basis.

Perceptions of prostate cancer patients undergoing definitive radiotherapy on the impact of prostate cancer and radiation therapy on male sexuality.

Male sexual function is an important aspect of the life of prostate cancer patients and plays a significant role in the long-term quality of life of prostate cancer survivors. However, there is a paucity of published literature on the perceived impact of prostate cancer and its treatment on the sexual function of patients in Ghana and West Africa in general. The purpose of this study was to explore the perceptions of prostate cancer patients on the effects of the disease and radiation therapy on male sexual function. The study also examined the changes in sexuality experienced by men with prostate cancer. This research was a descriptive longitudinal study conducted at the third largest hospital in Africa. The study included Ghanaian prostate cancer patients of all ages who were treated with definitive radiotherapy at the study site between October 2021 and May 2022. Quantitative data were collected and analysed using the Statistical Package for Social Sciences version 26.0 and Microsoft Excel 2019. Descriptive statistics were used to determine frequencies and percentages of the demographic characteristics. The mean age of the participants was 65.7 years (SD 6.7) ranging from 50 to 81 years. Patients had different ideas about the potential adverse effects of prostate cancer (86%) and radiotherapy (70%) on male sexual function. A decrease in sexual desire (54%) was the commonest perceived effect of prostate cancer on male sexual function followed by premature ejaculation (49%) and a decrease in sexual activity (48%). On the other hand, erectile dysfunction (49%) was the commonest perceived effect of radiotherapy for prostate cancer on male sexual function followed by a decrease in sexual desire (38%) and premature ejaculation (37%). Health professionals were the major source of information regarding the perceptions of the patients on the effects of both prostate cancer (46%) and radiation therapy (43%) on male sexual function. There should be enhancement of awareness measures to educate Ghanaian cancer patients on the side effects and implications of treatment on their sexuality. Comprehensive sexual health assessment should be incorporated in the routine care of patients with cancers that have the potential to impact the sexual function of patients.

Evaluation of Sexual Function of Transgender Individuals.

The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.

The effect of calcium oxalate stones and uric acid stones on male sexual function.

This study compared the effects of calcium oxalate stones and uric acid stones on male sexual function. We enrolled 100 patients with ureteral stones. According to the composition of the stones, they were divided into the calcium oxalate stone group and the uric acid stone group. All patients underwent ureteroscopic holmium laser lithotripsy. General data such as age, body mass index, course of disease, stone diameter, and degree of renal hydronephrosis were compared. Sperm parameters, including sperm density, sperm viability, and sperm deformity rate, as well as International Index of Erectile Function-5 questionnaire (IIEF-5) scores, and Quality of Life (QOL) scores, were measured and compared before and 6weeks after the surgery. There were no statistically significant differences in general data and sperm parameters between the two groups before the surgery (P > 0.05). However, there were significantly lower IIEF scores but significantly higher QOL scores in the uric acid stone group. In the calcium oxalate stone group, there were no statistically significant differences in sperm parameters, IIEF score, and QOL score before and after the surgery (P > 0.05). In the uric acid stone group, there were no statistically significant differences in sperm parameters before and after surgery (P > 0.05), whereas there were significantly higher IIEF scores but significantly lower QOL scores after the surgery (P < 0.05). The prevalence of erectile dysfunction (ED) in the uric acid stone group was 38.18% (21/55), which was significantly higher compared to 20.00% (9/45) in the calcium oxalate stone group (P < 0.05). The multivariate binary logistic regression analysis showed that the independent risk factor related to ED was uric acid stones (odds ratio: 2.637, 95% confidence interval 1.040-6.689, P = 0.041). No statistically significant differences were found in sperm parameters between patients with and without ED. Compared with the calcium oxalate stone group, patients with uric acid stones had a higher prevalence of ED and poorer sexual performance.

The Impact of Vaginoplasty on Female and Male Sexual Function and Satisfaction.

An important factor which underlines the clinical significance of vaginal laxity presence is the association of the latter with the female sexual function. Male sexuality can also be affected by vaginal laxity. We aimed to investigate the effect of vaginoplasty on a cohort of women, who underwent the respective procedure under the indication of vaginal laxity/impaired sexual function. At the same time, it is very important to evaluate the sexual satisfaction of partners after vaginal tightening. Fifty women who underwent vaginoplasty and their male partners (n=50) were included in the study. State-Trait Anxiety Inventory (STAI) and Female Sexual Function Index (FSFI) were performed to female patients three months before and after the treatment. Also, male partners were asked for their sexual functions by International Index of Erectile Function-5 (IIEF-5) three months before and after the treatment. A 5-question questionnaire inquiring about pleasure status was administered to the male partners using a four-point Likert scale. Post-treatment STAI THE STATE and STAI THE TRAIT scores of the female patients were statistically significantly lower than their pre-treatment scores (52.5 vs 32, p<0.001; 56 vs 44, p<0.001, respectively). The post-treatment FSFI score of the female patients was significantly higher than their pre-treatment score (19.2 vs 29.7, p<0.001). Our results demonstrated significant improvement in the sexual function of males and females and additionally, a significant decrease in the indices of the temporary anxiety levels and the inherent predisposition for anxiety disorders after vaginoplasty.

P-015 Impaired spermatogenesis in colitis: the role of interferon-γ mediated ferroptosis in sertoli cells by colitic CD4+ T cells

Abstract Study question Does colitis have an impact on spermatogenesis and what could be the potential mechanism? Summary answer Colitis causes sertoli cell ferroptosis and disrupts spermatogenesis in mice due to the migration of colitic CD4+ T cells that produce interferon-γ. What is known already In recent years, there has been a significant increase in rheumatic and inflammatory diseases. Epidemiological data reveals that dysregulated immune conditions can directly or indirectly impact male fertility and sexual function in patients of reproductive age. Inflammatory bowel disease (IBD), which encompasses Crohn’s disease and ulcerative colitis, is a chronic, recurring gastrointestinal inflammatory disorder characterized by bloody stools and weight loss. A study from a Swedish national cohort showed that IBD patients had diminished sperm fertility and increased sperm DNA fragmentation compared to healthy individuals. However, the precise mechanisms underlying male fertility problems in IBD remain unclear. Study design, size, duration In this study, C57BL/6 mice were kept under specific pathogen-free conditions. A murine colitis model that simulates human colitis histological features and symptoms was created using Dextran Sulfate Sodium (DSS). To establish the model, 2-2.5% DSS was added to the mice’s drinking water from days 0 to 7, followed by a three-day recovery period. Participants/materials, setting, methods Testis, epididymis and colon sections were stained with hematoxylin and eosin for histological analysis. The localization and phenotype of infiltrated lymphocytes in epididymis and testis were studied by immunostaining and flow cytometry. Sperm functions including motility, viability, and DNA integrity were assessed by standard assays. Iron, malondialdehyde, and reactive oxygen species (ROS) levels were analysed by commercial kit. Main results and the role of chance Colitis was found to impair male fertility in DSS-induced colitic mice, causing testis and epididymis tissue damage along with inflammatory cell infiltration. Colitis altered the immune cell phenotypes in the testis and epididymis. The proportion and absolute cell count of CD4+ T cells and CD19+ B cells increased after colon inflammation. Testicular sertoli cells in colitic mice exhibited ferroptosis, characterized by increased levels of iron deposition, malondialdehyde, and ROS. We assessed sperm parameters from the cauda epididymis of mice. Compared to the control group, there were significant reduction in sperm concentration, motility, viability and DNA integrity in the group with murine colitis induction. Consistently, we observed lower numbers of active pups from the fathers of the colitis group compared to control mice. CD4+ T cells with interferon-γ producing capabilities accumulated in the testes of colitis mice. Leukocyte flow cytometric analysis and parabiotic mouse model further demonstrated that colitis promoted pathogenic CD4+ T cells migration to the testis through circulation. The treatment of anti-CD4 antibody, anti-interferon-γ antibody or ferroptosis inhibitor can attenuate the colitis-associated testis pathologies. Limitations, reasons for caution Our study was conducted exclusively in mice. The pathogenic effect and the corresponding mechanism of colitis on male fertility in humans still needs to be confirmed. Wider implications of the findings Our team identified the mechanism linking dysregulated gut immune cell activity to testicular dysfunction. By identifying specific molecules on colitic immune cells, which allow their infiltration into the testis, may pave the way for a new therapeutic approach potentially improving the prognosis of colitis and related fertility impairments. Trial registration number not applicable

P-372 Reproductive ability in survivors of childhood, adolescent, and young adult testicular tumors

Abstract Study question There is little comprehensive fertility evaluation in testicular tumors. Summary answer Our study provides evidence that sexual dysfunction and infertility represent the major persisting side effects with testicular tumor patients. What is known already Testicular cancer, although accounting for 1% of all cancers, is the most common cancer in men of reproductive potential with a peak incidence in men between the ages of 15-35, with more than 95% of the patients being cured.There are many researches on semen quality in testicular cancer. Study design, size, duration We performed a retrospective study by collecting 126 records of testicular cancer patients who attempted sperm banking in the Human Sperm Bank, West China Second University Hospital, Sichuan University between 2011 and 2022. Participants/materials, setting, methods Semen samples were collected by masturbation after 2–7 days of sexual abstinence. While a few of the patients had a longer period of sexual abstinence than one week, due to emergency treatment (data not shown). All samples were allowed to liquefy at 37 °C for 60 min and were then assessed according to World Health Organization protocols (WHO, 1999, 2010). Main results and the role of chance Semen quality and hormone levels before chemotherapy/radiotherapy In our study, we compare semen samples before and after orchiectomy, no differences in semen analysis were observed between pre-and post-orchiectomy groups. Semen quality after cancer treatment: type of treatment Total sperm number worsened significantly at T3(T6, 6 months after the end of treatment), T6 compared to baseline (T0, before beginning cancer treatment) and returned to near-baseline values at T24 in Carboplatin 2 cycles and EP/BEP 2-4 cycles groups. Moreover, Serum LH and FSH was increased at T3, T6 compared at T0. Sexual Functioning The BFSI (Brief Male Sexual Function Inventory) is a validated self-report measure of sexual functioning. We compared BSFI scores before and after orchiectomy, no differences were observed in sexual drive, sexual erection, sexual ejaculation, DEE (drive, erection, ejaculation) problems and sexual satisfaction between pre-and post-orchiectomy groups. Chemotherapy/radiation group significantly fewer sexual satisfaction problems compared with untreatment/surgery group. Fertility outcome Fertility data were available for 88 patients. 65 (73.9%) had no children, for various reasons (young age, financial reasons, marital status), 6 (6.8%) already had at least one child prior to their cancer diagnosis. Seventeen patients (19.3%) wanted children, but only 11 of these succeeded in achieving fatherhood, through natural fertility (8 patients) or ART (3 patients). Limitations, reasons for caution Small sample size, and the follow-up was not long enough. Wider implications of the findings We analyzed semen parameters, hormone levels, sexual functioning, fertility outcome for testicular cancer patient, both before diagnosis and after treatment, with the aim to provide practical recommendations. Trial registration number not applicable’

P-488 The importance of identifying and addressing sexual functioning in couples with unexplained infertility

Abstract Study question How is the sexual functioning of newly diagnosed unexplained infertile couples and which factors are associated? Summary answer At least 25% of couples are at risk of sexual dysfunction. Sexual functioning is associated with age, infertility duration, sperm quality, personal and relational wellbeing. What is known already A large proportion of unexplained infertile couples have the ability to conceive naturally over time. Sexual functioning is important for natural conception rates, but infertility is associated with reduced sexual functioning. Surprisingly, sexual functioning and its risk-factors are still understudied in unexplained infertility. Knowing the risk factors for reduced sexual functioning would enable fertility specialists to timely diagnose, prevent or treat sexual dysfunction, and in this way improve natural conception rates. The current literature is mainly based on individual-level data, neglecting the fact that observations, such as sexual functioning, arising from couples are not independent. Study design, size, duration Cross-sectional digital survey data and medical chart factors, which also served as the baseline assessment of a randomized controlled trial (Pleasure&amp;Pregnancy, trial registration number NTR5709), were subjected to a dyadic analysis followed by linear regression. A total of 700 heterosexual couples recently diagnosed with unexplained infertility in secondary or tertiary fertility clinics were addressed between 2016 and 2021. Participants/materials, setting, methods Heterosexual couples (female age 18-38 year) with unexplained infertility and who were able to have coitus were eligible. Sexual functioning was assessed with the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF). Determinants included demographic, lifestyle and diagnostic and wellbeing factors as assessed with the Hospital Anxiety and Depression Scale (HADS) and the Revised Dyadic Adjustment Scale (R-DAS). B represents the impact on sexual functioning when a factor changes 1 unit. Main results and the role of chance A total of 581 (83%) women and 478 (68%) men filled out questionnaires. Survey data and medical chart factors were available for 451 couples. About one in four women (24.3%) and one in fourteen men (7.3%) were at risk of respectively female sexual dysfunction and erectile dysfunction after fertility work-up. Couples had a mean coital frequency of 7 times per month (SD 2.7). Higher female and male sexual desire (B: 0.04, p&amp;lt;0.01 and B: 0.02, p&amp;lt;0.02) and satisfaction (B: 0.03, p&amp;lt;0.01 and B: 0.06, p&amp;lt;0.01), but not orgasm were significantly associated with increased coital frequency. Own age (B: -0.64), anxiety (B: -9.47), depression (B: -7.61) and relationship distress (B: -8.97), and partners’ relationship distress (B: -5.08) and total motility sperm count (B: -4.88) were associated with lower female sexual functioning. Own age (B: -0.17), anxiety (B: -5.03), depression (B: -3.65), relationship distress (B: -5.77), and partners’ age (B: -0.46) and relationship distress (B: -3.14) and couples’ duration of infertility (B: -0.24) were associated with lower male sexual functioning. Limitations, reasons for caution The study is prone to selection bias given the inclusion of couples seeking medical help, consenting to a RCT and were having coitus. Not all previous identified determinants of sexual functioning were studied due to factors as missing data, low case numbers or not being assessed in the Pleasure&amp;Pregnancy RCT. Wider implications of the findings Clinicians advising couples with unexplained infertility to continue natural conception, need to be aware that at least 25% of couples are at risk of sexual dysfunction. Clinicians should consider risk factors of reduced sexual functioning, take a sexual anamnesis and advice sexual counselling and treatment if indicated. Trial registration number Baseline assessment of RCT (Pleasure&amp;Pregnancy) with trial registration number NTR5709

Effects of dioxin exposure on reproductive and thyroid hormone levels and male sexual function in airbase military workers in Vietnam.

Dioxins are endocrine disruptors that may disturb male sexual and reproductive function. Studies on human populations are limited, and their results are controversial. This study evaluated the impact of dioxin exposure on reproductive and thyroid hormone levels and sexual function in men. A total of 140 men working in four military airbases (three bases were formerly contaminated with dioxin by the herbicide spraying campaign in the Vietnam War) were recruited to measure the serum dioxin levels. Four reproductive hormones (testosterone, follicle-stimulating hormone, luteinizing hormone (LH), and prolactin) and three thyroid hormones (free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone) were measured. Male sexual function endpoints including sexual drive, erection, ejaculation, problems, and overall satisfaction were assessed by the Brief Male Sexual Function Inventory. The percentage of subjects with low testosterone and LH levels was 19.6% and 16.7%, respectively. Dioxins, especially 2,3,7,8-tetrachlorodibenzo-P-dioxin and toxic equivalent concentrations of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans, were inversely associated with testosterone and prolactin levels, but positively associated with FT3 and FT4, and showed adverse relationships with sexual function, such as sexual drive, problems, and overall satisfaction. Our results suggested that exposure to dioxin disrupts the homeostasis of reproductive and thyroid hormones leading to adverse effects on male sexual function.

Hypovitaminosis-D and sexual dysfunction

Sex has a significant impact on a person's quality of life. Numerous elements, including endocrine, vascular, psychological, and neurological ones, have an impact on sexual function. Male and female sexual dysfunction is a prevalent issue in both sexes. About 30% of males and 40% of women are reported to have sexual dysfunction. The main factors influencing sexual responsiveness are neurological and endocrine activity. An increased risk of obstetric and gynecologic issues, including endometriosis, polycystic ovaries, infertility, gestational diabetes, preeclampsia, and ovarian and breast cancer, is also linked to vitamin-D insufficiency. Data from several studies conducted worldwide indicate that vitamin D is vital for both male and female sexual function.

Association between life's essential 8 and male biochemical androgen deficiency: evidence from NHANES 2013-2016.

To evaluate the association of Life's Essential 8 (LE8) and its subscales with male biochemical androgen deficiency (MBAD) and total testosterone based on the data from the national health and nutrition examination survey (NHANES) database. Data of males aged 20 years or older from NHANES of 2013-2016 were extracted. LE8 score was calculated based on American Heart Association definitions. Total testosterone (TT) values were measured in NHANES using precise isotope dilution liquid chromatography. MBAD was defined as serum TT of <300 ng/dL. Univariate and multivariable analyses were conducted. Propensity score matching (PSM) and weighted regression after matching were added as sensitivity analyses. The generalized additive model, smooth curve fitting, and the recursive algorithm were used to determine the potential inflection points. Piecewise regression models with log-likelihood ratio test were used to quantify nonlinear effects. A total of 3094 participants who were males and aged 20 years or above were included. Out of them, 805 males were diagnosed with MBAD. After adjusting the confounders in the multivariable model, LE8 was independently associated with MBAD (OR 0.96, P < 0.001) and TT (β 2.7, P < 0.001). The association remained robust even after PSM. The non-linear relationship of LE8 behaviors score with MBAD and TT was revealed. LE8 was an independent protective factor of MBAD and a feasible approach to promote male endocrine sexual function.

Urinary and sexual function after robotic and laparoscopic rectal cancer surgery: a systematic review and meta-analysis.

The purpose of the study was to compare the protective effects of robotic rectal cancer surgery (RRCS) and laparoscopic rectal cancer surgery (LRCS) on urinary and sexual function of patients. We conducted a systematic search in the PubMed, Web of Science, Cochrane Library, and Embase for studies comparing the impact of RRCS and LRCS on urinary function and sexual function. The International Prostate Symptom Score (IPSS), the five-item version of the International Index of Erectile Function (IIEF-5) and the Female Sexual Function Index(FSFI) were used to evaluate the urinary function and sexual function of patients. A total of 13 studies comprising 1964 patients were included in this meta-analysis, including 3 randomized controlled trials, 5 retrospective cohort studies, 3 prospective cohort studies, and 2 propensity score-matched studies. Nine hundred and fifty-nine patients underwent RRCS and 1005 patients underwent LRCS. Statistical analysis of the IPSS scores indicated urinary function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12months postoperatively [mean difference (MD), -1.06, 95% CI -1.85 to -0.28; and MD, -0.96, 95% CI -1.60 to -0.32; and MD, -1.09, 95% CI -1.72 to -0.46]. Statistical analysis of the IIEF-5 scores indicated male sexual function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12months postoperatively (MD, 1.76, 95% CI 0.80 to 2.72; and MD, 1.83, 95% CI 0.34 to 3.33; and MD, 1.05, 95% CI 0.09 to 2.01). Statistical analysis of the FSFI scores indicated female sexual function was significantly better in the RRCS group than in the LRCS group at 6 and 12months postoperatively (MD, 2.86; 95% CI 1.38 to 4.35; and MD, 4.19; 95% CI 1.85 to 6.54). RRCS is more favorable than LRCS in preserving the urinary and sexual function of patients with rectal cancer.

The influence of correction of carbohydrate metabolism and body weight on endogenous testosterone production in men with type 2 diabetes mellitus, obesity and hypogonadism

Male hypogonadism and type 2 diabetes mellitus (T2DM) are often combined and aggravate each other. Considering the pathogenetic relationship with the components of the metabolic syndrome (hyperglycemia, insulin resistance, obesity) and the potential reversibility of testosterone deficiency, as well as the wariness of doctors and patients regarding testosterone replacement therapy, it is interesting to study the effect of various methods for correcting carbohydrate metabolism and obesity on endogenous testosterone production. When analyzing the effect of lifestyle correction, drug therapy for T2DM and obesity, as well as metabolic surgery on testosterone production, encouraging results were obtained with regard to methods that provide, first of all, significant reduction in body weight (medications from the group of glucagon-like peptide-1 receptor agonists and bariatric surgery). As for other classes of new antidiabetic drugs, it is likely that all of them may have direct or indirect beneficial effects on male sexual function, mainly by reducing glucotoxicity and inflammation. However, this hypothesis requires studies on large samples of patients. In addition, there is still no convincing data on the significance of correction of carbohydrate metabolism, regardless of weight loss, in relation to endogenous testosterone production, and there is also no data on the degree of improvement in glycemic control required for a clinically significant increase in serum testosterone levels.

The impact of male genital self-image on depression, anxiety and sexual functions

Aim This study aims to examine the relationship between male genital self-perception and sexual functioning and depression anxieties. Method The study included male patients who were referred to the andrology outpatient clinic between March 2022 and June 2022. Demographic data of the patients were recorded. Cigarette and alcohol consumption was also noted. The Male Genital Self Image Scale (MGSIS) questionnaire was used for the Genital Self Image(GSI) assessment, which consists of 7 questions. The International Index of Erectile Function (IIEF), composed of 15 questions, was used to evaluate sexual function. STAI-I, STAI-II, and BECK scales were used for depression and anxiety. The penis size of the patients was measured in a flask and stretched condition, and the midpenile circumference was recorded. Patients were compared with respect to GSI, depression, anxiety, and sexual functioning. Results A total of 75 patients were included in the study. The mean age of the patients was 46.69 ± 11.32 (26–72), and the mean BMI was 27.82 ± 3.79 (22.46–40.40) kg/m2. A slightly positive correlation was found between the patients’ flask penis size and MGSIS-total scores (r = 0.260, p = .024) and IIEF-SF scores (r = 0.240, p = .038). There was a moderately positive correlation between the stretched penis size and IIEF-OS (r = 0.403, p < .001) and IIEF-SF (r = 0.354, p = .002). While the MGSIS-total score and the STAI-I and STAI-II scores had a moderate negative correlation, there was an advanced negative correlation between the MGSIS-total score and the BECK score. Conclusion Disruption of men’s genital self-perception is moderately related to their susceptibility to depression and anxiety. This situation affects the person’s sexual performance and causes orgasm problems to increase.