Sexual Function In Men Research Articles

Investigation of Sexual Function in Men with Spinal Cord Injury in a Rehabilitation Hospital in Turkey

Sexual function is one of the most important functions for males with spinal cord (SC) injuries, and there are wide ranges and conflicting results about sexual dysfunction and the frequency of education of these patients. The aim of our retrospective study is to evaluate sexual function and to determine the level of sexual education provided by medical professionals in males with SC injury. Eighty-one inpatient males with SC injury were included in the study. "International Index of Erectile Function" and "International Spinal Cord Injury Male Sexual Function Basic Data Set" were used to evaluate sexual function. The median age of the patients was 31 years old (range 20-63), and the median disease duration was 190 days (range 30-5475). Of 81 patients, 55.6% had C1-T10, 33.3% had T11-L2, and 11.1% had L3 and lower injury. Of the patients, 90.1% were never informed about the impact of SC injury on sexual function. The rates of normal psychogenic and reflex erection were 16 and 18.5%, respectively. Erectile dysfunction was severe in 66.7% and moderate in 16% of patients. Only 4.9% of patients had normal ejaculation and 7.4% had normal orgasmic function. Sexual desire was very high or high in 49.4% and moderate in 32.1%. Overall, sexual satisfaction was high or moderate in only 6.2% of patients. Sexual education rates of male SC injured persons are very low. Although most of the patients have normal sexual desire, erection, ejaculation, orgasmic function, and sexual satisfaction are severely damaged.

Obesity Surgery Improves Hypogonadism and Sexual Function in Men without Effects in Sperm Quality.

(1) Background: Obesity is associated with hypogonadism, sexual dysfunction, and impaired fertility in men. However, its effects on semen parameters or sexual function remain debatable. (2) Methods: This paper involves a longitudinal study in men submitted for obesity surgery at a university tertiary hospital. Patients were studied at baseline and at 6, 12, and 18 months after obesity surgery. At each visit, anthropometry measures were collected and hormonal and semen parameters were studied. Sexual function was evaluated with the International Index of Erectile Function (IIEF). (3) Results: A total of 12 patients were included. The average body mass index of patients decreased from 42.37 ± 4.44 to 29.6 ± 3.77 kg/m2 at 18 months after surgery (p < 0.05). Hormonal parameters improved after obesity surgery. The proportion of sperm cells with normal morphology tended to decrease from baseline and became most significant at 18 months (5.83 ± 4.50 vs. 2.82 ± 2.08). No significant changes were found in the remaining semen parameters. Erectile function improved significantly at six months after surgery. (4) Conclusions: The authors believe that, in general, the effects of obesity surgery on fertility may be limited or even deleterious (at least in the short and midterm follow-up).

High Versus Low Ligation of the Inferior Mesenteric Artery in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis.

Background and Objectives: This study aimed to compare the effects of high ligation (HL) versus low ligation (LL) in colorectal cancer surgery. Materials and Methods: We performed a comprehensive search using multiple databases (trial registries and ClinicalTrials.gov), other sources of grey literature, and conference proceedings, with no restrictions on the language or publication status, up until 10 March 2021. We included all parallel-group randomized controlled trials (RCTs) and considered cluster RCTs for inclusion. The risk of bias domains were “low risk,” “high risk,” or “unclear risk.” We performed statistical analyses using a random-effects model and interpreted the results according to the Cochrane Handbook for Systematic Reviews of Interventions. We used the GRADE guidelines to rate the certainty of evidence (CoE) of the randomized controlled trials. Results: We found 12 studies (24 articles) from our search. We were very uncertain about the effects of HL on overall mortality, disease recurrence, cancer-specific mortality, postoperative mortality, and anastomotic leakage (very low CoE). There may be little to no difference between HL and LL in postoperative complications (low CoE). For short-term follow-up (within 6 months), HL may reduce defecatory function (constipation; low CoE). While HL and LL may have similar effects on sexual function in men, HL may reduce female sexual function compared with LL (low CoE). For long-term follow-up (beyond 6 months), HL may reduce defecatory function (constipation; low CoE). There were discrepancies in the effects regarding urinary dysfunction according to which questionnaire was used in the studies. HL may reduce male and female sexual function (low CoE). Conclusions: We are very uncertain about the effects of HL on survival outcomes, and there is no difference in the incidence of postoperative complications between HL and LL. More rigorous RCTs are necessary to evaluate the effect of HL and LL on functional outcomes.

Efficacy of pelvic floor muscle training on the sexual function of men after radical prostatectomy: an overview of systematic reviews

This study aimed to evaluate the evidence in the literature on the efficacy of pelvic floor muscle training on the sexual function (SF) of men after prostatectomy by an overview of systematic reviews (SR) of randomized clinical trials. The search for studies was conducted in five databases without any language restriction: EMBASE, PUBMED, Science Direct, PEDro, and Cochrane Library. The main results were extracted from the SR by two reviewers, and meta-analysis was performed from the primary studies for the outcomes SF scores and erectile dysfunction. 4 reviews were included in the qualitative synthesis, which involved 8 clinical trials and 891 participants. The reviews had moderate to good methodological quality, but a high overlap of clinical studies was founded. Meta-analysis showed that pelvic floor muscle training improves sexual function scores not in 3 months (p=0.51) but in 6 months (p=0.02) and it did not show efficacy on erectile dysfunction after three (p=0.58) and 12 months (p=0.32). Studies with moderate to good methodological quality demonstrate that pelvic floor muscle training only improve sexual function score in 6 months, but not had efficacy in erectile dysfunction in men after prostatectomy.

Hypoactive Libido: Neurohumoral Characteristics, Regions of the Brain Regulating Sexual Desire, and Its Reactions to Erotic Stimuli

The article indicates that sexual desire is considered to result from a complex balance between inhibitory and stimulating factors (neurotransmitters, hormones), which influence functioning of the brain. For example, dopamine, oxytocin, estrogens, noradrenalin, melanocortin, norepinephrine and testosterone produce excitory influence, while serotonin, endocannabinoiids, prolactin (PRL) and opioids produce inhibitory influence. The article contains data of researches, which informed about peculiarities in reactions of the brain in people with hypoactive sexual desire to erotic stimuli as well as sex differences of the above reactions to these stimuli. Also, key regions in the brain that regulate sexual desire (the prefrontal cortex, locus coeruleus, medial preoptic area, paraventricular nucleus, and reward- and attention-processing centers of the ventral tegmental area and the nucleus accumbens) are listed. Information about hormonal regulation of sexual desire in men is given. The article informs about studies that are not consistent with the established view about an inhibitory influence of hyperprolactinaemia (HP) on sexual functions in men (G. Corona et al., 2007, 2014), whose authors, on the contrary, note that analysis of the relation between PRL level and sexual disorders revealed a strong correlation between lower PRL levels and reduced pleasure from orgasm. They also revealed that a low PRL level was associated with erectile dysfunction (ED) and early ejaculation. This phenomenon may be explained by the fact that the low PRL level was associated with bad health. G. Corona et al. (2007, 2014) insist that severe HP may be associated with ED only because of HP, which in its turn is caused by hypogonadal state. Moreover, and what is especially important for the problem in question, severe HP was associated with hypoactive sexual desire (HSD), an increased level of thyrotropin and hypogonadism. A relationship between severe HP and HSD was confirmed after correction of testosterone and thyrotropic hormone levels and use of psychotropic agents. The cited authors conclude that in compliance with their findings severe, rather than mild, HP is an important determinant of HSD. Nevertheless they believe that PRL can produce more positive than negative effects in initiating and maintaining sexual behavior. Our article also discusses hormonal regulation of sexual desire in women. Though before it was supposed that adrenal androgens played a pivotal role for appearance of sexual desire in them, later an opinion formed that it was not so and the focus was shifted to ovarian corticosteroids, including estradiol and testosterone. It is noted that though ovarian corticosteroids can produce some effect on sexual desire in women, their exact role in the appearance of HSD disorder in females remains unclear.

P-509 Evolution of quality of life, sexual function and marital agreement in long term infertile couples: a 10-year prospective cohort study

Abstract Study question Comparing the sexual function, marital adjustment, and quality of life of long-term infertile and parenting couples after a history of ART Summary answer Long time infertility alters the sexual function in women but does not impact negatively the quality of life and the marital adjustment of the couples What is known already The short-term impact of the diagnosis of infertility and its treatments on heterosexual couples has been investigated. But very little literature exists regarding the evolution of the quality of life, marital agreement, and the sexual function of long-term infertile couples. After ART, parenthood is considered to impact the quality of life and thus the conjugal life of the couples in a short time. But there are very few studies comparing the quality of life of couples who underwent ART in regard to the success or not of their parenthood project in the long term. Study design, size, duration This is a prospective, cohort-type analytical study where each patient is their own control over time. Patients were recruited at the Fertility Treatment Unit of our department, over a 10-year period (2009-2018). An interview was held with each partner at the 1st consultation and 10 years later. The recruitment phase took place from January 1st, 2009, and May 31, 2009. Participants/materials, setting, methods We included all heterosexual married couples with women under 40 and men under 45. The evaluation of the quality of life was standardized by the Medical Outcomes Study Short Form 36 (SF-36) and the Fertility Quality Of Life (FertiQol). The female sexual function was evaluated with the Female Sexual Function Index (FSFI). The male sexual function was evaluated through the International Index of Erectile Function (IIEF). The marital adjustment Test (MAT) evaluated the conjugal life. Main results and the role of chance We included 100 couples (100 women and 100 men) of whom only 44 were still together after 10 years:18 were still childless, 8 had adopted, and 18 had live births. The divorce rate in our study population was 56%. There were no significant differences in the socio-demographic features of the parenting and childless couples. Men's sexual function was not different between fathers and childless men. Childless women's sexual function was impaired compared with mothers either regarding the global function (p = 0.003) or all its components (Desire (p = 0,025), excitation (p = 0,001), lubrification (p = 0,007), orgasm (p = 0,017), pain (p = 0,008), and satisfaction (p = 0,006)). There is no difference in terms of marital adjustment (p = 0.479) and in terms of quality of life when applying the SF36. In the 18 long-term infertile women, the core FertiQol emotional scores and the FertiQol treatment tolerance scores were lower than in men (respectively, p = 0.02 and 0.003). Limitations, reasons for caution The small size of the sample of our study is the main limitation of the study. It is mainly related to the high rate of divorce in this specific population and the long period of the study. Wider implications of the findings Health care professionals need to emphasize the information of the couples of the potential effects of long-term infertility on the couple's marital life, the sexual life, and the quality of life, especially among women. They also need to help the patients seek the help and counseling they need. Trial registration number not applicable

Does Infertility Stress Impair Sexual Function in Infertile Women and Men? A Cross-Sectional Study in Iran.

BackgroundThe issue of infertility is a worldwide challenge, estimated to affect around 50 million couples. This study aimed to evaluate the relationship between infertility stress and sexual function in men and women with infertility.MethodsIn this cross-sectional study, 300 men and women with infertility were recruited. A demographic questionnaire, the Fertility Problem Inventory, the Female Sexual Function Scale (FSFI), and the International Index of Erectile Function (IIEF) were used to collect data. Independent t-test, Chi-square, and linear and logistic regressions were used to assess the data.ResultsThe total score of sexual function in women and men was 22.18 ± 7.86 and 57.7 ± 17.8, respectively. Infertility duration and the ability to pay for the costs of infertility treatment had a significant relationship with sexual function in women. A significant association was found between communication concerns and sexual function scores in men with infertility. Infertile women had more sexual concerns, while infertile men had more communication concerns.ConclusionThis study showed that women with infertility had more infertility stress than men with infertility. Women with higher infertility duration and the inability to pay for the infertility treatment costs impaired sexual function. Women with infertility had more sexual concerns, while Men with infertility had more communication concerns. Policymakers need to consider strategies such as counseling for men and women with infertility to help them cope with their problems, especially their psychological problems. The lack of random enrollment of participants and lack of control group were the limitations of this study.

Repetitive Negative Thinking and Sexual Functioning in Portuguese Men and Women: A Cross-Sectional Study

Objective: Repetitive negative thinking (RNT) is a transdiagnostic process involved in the development and maintenance of emotional disorders that negatively affect sexual functioning. However, empirical evidence for the role of RNT on sexual functioning is still lacking. The current study aimed to investigate the role of RNT on sexual functioning in men and women by examining differences in RNT between men and women and between individuals with and without subclinical sexual difficulties. It also aimed to investigate the predictive role of RNT on sexual function indices in men and women. Methods: A total of 424 participants (270 women) completed online a sociodemographic questionnaire and Portuguese versions of the Persistent and Intrusive Negative Thoughts Scale, the Female Sexual Functioning Index, and the International Index of Erectile Function. Results: The main findings showed that women scored significantly higher than men on the RNT. Similarly, individuals with subclinical sexual difficulties scored significantly higher on the RNT compared with individuals without sexual difficulties. RNT was a statistically significant and negative predictor of sexual functioning in women and men. The role of RNT on sexual functioning in women and men was found, with men and women with subclinical sexual difficulties more likely to express persistent and intrusive negative thoughts compared with men and women without sexual difficulties. Conclusions: In summary, RNT appears to be a negative predictor of sexual functioning in both women and men, suggesting that individuals with more intrusive and negative persistent thoughts also have more difficulty in their sexual response.

Preserving Sexual Function in Men With LUTS Secondary to Large Prostates

Changes in sexual function and the development of lower urinary tract symptoms (LUTS) are individually well identified and studied patterns in elderly men that affect quality of life. Therefore, clarifying the relationship between these 2 conditions has received more attention and numerous epidemiological studies have indicated a strong association. In 2003, the Multinational Survey of the Aging Male (MSAM-7) analyzed over 14,000 surveys by men between the ages of 50–80, showing a strong relationship between sexual dysfunction and severity of LUTS independent of other comorbidities.

Ameliorative effect of methanolic extract of Tribulus terrestris L. on nicotine and lead-induced degeneration of sperm quality in male rats

Ethnopharmacological relevanceThe use of herbal and medicinal plants to treat male infertility is well known in history. Tribulus terrestris L. (TT) belongs to the Zygophyllaceae family and it is used in folk medicine to vitalize and also improve both physical performance and sexual function in men in addition to the protective effect of the gross saponins of TT against ischemic stroke and its clinical anti-inflammatory property.Aim of the study: This study aimed to investigate the effects of methanol extract of T. terrestris on nicotine hydrogen tartrate and lead-induced degeneration of sperm quality in male rats and to identify the volatile bioactive non-polar compounds thought to be responsible for its activity using gas chromatography-mass spectrometry (GC-MS). Materials and methodsThe effect of T. terrestris on nicotine hydrogen tartrate and lead-induced infertility was evaluated in male rats. Fifty-four mature male albino rats weighing 220–250 g body weight were used. The rats were randomly divided into 9 equal groups (n = 6). Infertility was induced by administering nicotine hydrogen tartrate (0.50 mg/kg) through peritoneal injection (i.p.) or lead acetate (1.5 g/L) orally with drinking water for sixty days. Two doses (50 and 100 mg/kg body weight of the animal) of T. terrestris were also used. At the end of the experimental period, the rats were anesthetized and sacrificed. Blood samples were collected. Hormonal analyses were carried out on the serum. The testicle, epididymis, and accessory sex organs (seminal vesical and prostates) were removed for histopathological analysis. Gas chromatography-mass spectrometry (GC-MS) analysis of the methanol extract was also carried out to identify major volatile compounds in T. terrestris methanol extract. ResultsNicotine and lead toxicity caused a significant (p < 0.05) decrease in the number of sperm, motility, and an increase in the sperm abnormalities such as the reduction in weight and size of sexual organs (testis, epididymis, and accessory sex glands), reduction of diameter and length of seminiferous tubules. The administration of T. terrestris methanol extract, however, improved the semen quantity and quality, sexual organ weights, and fertility of male rats and, thus, ameliorated the adverse effects of nicotine and lead. Ten major compounds were found from the GC-MS analysis of the extract of T. terrestris methanol extract. ConclusionFindings showed that T. terrestris plant methanolic extracts ameliorated nicotine hydrogen tartrate and lead-induced degeneration of sperm quality in male rats. The GC-MS analysis of the T. terrestris plant methanolic extracts revealed the presence of several important bioactive compounds which were thought to be responsible for the ameliorative effect. Further isolation and evaluation of the individual components would provide relevant lead to finding new drugs.

Erectile function outcomes following surgical treatment of ischemic priapism

IntroductionIschemic Priapism is defined as an abnormally prolonged state of erection, exceeding 6 h, often and irreducible, occurring without any sexual stimulation. Ischemic priapism has a fatal consequence on the sexual function of men if it's not promptly managed. This pathology can cause erectile dysfunction and this can alter the quality of life of patients. ObjectiveThe aim of our study was to determine the factors influencing erectile function after treatment of ischemic priapism. Patients and methodsThis is a ten-year retrospective, descriptive and analytic study of 40 patients who consulted the urology department at the university hospital center for treatment of ischemic priapism (2010–2019). ResultsWe included 40 patients in our study. The mean age was 35.2 [18–62]. Duration of priapism varied from 20 to 360 h (mean 76.6). The most common etiology of priapism was sickle cell disease in 65% of cases. The mean preoperative IIEF-5 score was 23 [21–26]. All patients underwent corporal aspiration with an injection of ephedrine, but detumescence was observed in only 10% of cases. Thirty-six patients had a distal shunt with detumescence in approximately 70% of cases. Eleven patients underwent a distal shunt but seven patients had definitive fibrosis. After the episode of priapism, only eight patients retained normal erectile function. The mean postoperative IIEF-5 score was 14 [ 7−26]. We noted an improvement in erectile function in 8 patients treated with tadalafil. In multivariate analysis, we have demonstrated that a treatment delay exceeding 48 h, fibrosis and the necessity of a distal shunt significantly affects postoperative erectile function (p = 0.001; p = 0.002; p = 0.002 respectively). ConclusionAccording to our study, delayed management exceeding 48 h, fibrosis and the necessity of a surgical distal shunt are three independent factors affecting erectile function after treatment of ischemic priapism.

Sexual function and sexual quality of life in men with genital warts: a cross-sectional study

BackgroundHuman papillomavirus is the most common sexually transmitted infection, usually passing from one person to another after the first sexual activity. Infection with this virus and the occurrence of genital warts (GWs) could have several effects on patients’ health. This study was performed to evaluate the sexual function and sexual quality of life (SQOL) in men with GWs.MethodsThis cross-sectional study was conducted from September 2019 to March 2020 with a sample size of 105 men with GWs in the dermatology clinic of Shahid Faghihi Hospital in Shiraz University of Medical Sciences, Iran. Data were collected using a demographic questionnaire, the International Index of Erectile Function (IIEF), and the Sexual Quality of Life-Men (SQOL-M) questionnaires and analyzed by descriptive and inferential tests with SPSS software version 22.ResultsThe mean score for overall sexual function in men was 48.50 ± 8.89. About 35.2% of men had overall sexual dysfunction (SD). The highest disorder rate was related to the erection domain (85.7%), and the lowest was related to the desire domain (5.7%). In the erection domain, most men (54.3%) experienced mild to moderate erectile dysfunction. The mean score for SQOL-M was 38.36 ± 14.47, and 56.2% of them had a good SQOL.ConclusionsGWs affected men’s erection more than the other sexual function domains. SD in men with GWs has a significant impact on their SQOL and ED was associated with impaired SQOL. Therefore, it is recommended to pay more attention to SD screening alongside SQOL assessment of men with GW.

Effect of Stem Cell Infusion Therapy on Sexual Function in Men and Women with Type 2 Diabetes and Metabolic Syndrome: Results from the ACESO & CERES Clinical Trials

ABSTRACT Introduction Despite growing interest in restorative therapies for sexual function, there exists a paucity of human research into potential therapeutic applications of stem cell therapy (SCT). Mesenchymal Stem Cells (MSCs) and its effects on sexual function have not yet been explored in patients with Type 2 Diabetes Mellitus (DM) and Metabolic Syndrome (MetS) Objective To determine the effect of stem cell infusion therapy on sexual function in men and women with DM or MetS. Methods We used International Index of Erectile Function (IIEF-15) collected from men and Sexual Quality of Life Questionnaire-Female (SQOL-F) collected from women enrolled in the ACESO (NCT02886884) and CERES (NCT03059355) pilot/phase I clinical trials. Participants were enrolled in the trials based on diagnosis of DM or MetS, respectively, and endothelial dysfunction - defined as Brachial Artery Flow Mediated Vasodilation (FMD) &amp;lt;7%. Intervention in both trials was peripheral intravenous infusion of allogeneic MSCs. Follow-up was for 1 year. Questionnaires were collected at baseline and at 1-, 3-, 6-, and 12-months post-infusion. Participants received 20 or 100 million MSCs from either bone marrow (n=21) or umbilical cord (n=6). We performed subgroup analyses evaluating dose, source, and study diseases. Descriptive and analytic statistics were used to analyze the data. Results Data was pooled from 20 men and 7 women from the two trials. Overall, 14 received 100 million MSCs and 13 received 20 million MSCs. Median age was 61 [IQR=55-73] years. Incidence of hypertension, coronary artery disease, smoking and alcohol use were similar among each trial. Erectile dysfunction (ED) was defined by an IIEF-Erectile Function (IIEF-EF) sub-domain score ≤24 at baseline (n=16). Among men with ED, median IIEF-EF score at baseline was 5 [IQR=2-17], 6 [IQR=3-17] at 1 month, 3 [IQR=2-8] at 3 months, 4 [IQR=3-13] at 6 months, and 5.5 [IQR=2-16] at the end of 12 months (p=0.8127). Subgroup analyses revealed no changes in erectile function in either treatment dose. Similar patterns were found in other IIEF sub-domains, except median sexual desire score which increased among all men from 1-3 months post-infusion, then subsided from 6-12 months (p=0.4723). SQOL-f is a validated self-assessment questionnaire rated on a six-point scale in which higher scores reflect better female sexual quality of life. Median SQOL score among all women at baseline was 30 [IQR=19-50], 25 [IQR=23-36] at 1 month, 34 [IQR=19-46] at 3 months, 29 [IQR=21-32] at 6 months, and 34 [IQR=26-49] at the end of 12 months (p=0.8866). Main limitations of this study include the small sample size, sexual function was not a primary endpoint, and the absence of a placebo comparison arm. Conclusions Neither ED or SQOL appears to have improved following peripheral infusion of MSCs in patients with DM and MetS, but nevertheless appears to be safe with no decline in sexual function over 1 year. The optimal route, source, and dose of SCT to enact a meaningful change in sexual function in different patient populations has yet to be determined and deserves further research in future larger randomized clinical trials. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Longeveron LLC

Comparing the Effects of Melatonin and Zolpidem on Mental Health and Sexual Function in Men With Opioid Addiction: Evidence From a Randomized Clinical Trial.

BackgroundMental health problems and impaired sexual function are widely reported among those suffering from drug abuse, particularly among those under methadone maintenance therapy (MMT).AimsThe current study aimed to, firstly, investigate the effect of melatonin and zolpidem on mental health and sexual function of those with drug abuse under MMT, and, secondly, to compare the effects of melatonin and zolpidem on the studied outcomes.MethodsThe current randomized, single-blind, placebo-controlled clinical trial was conducted on 98 participants who were randomly assigned into three groups of melatonin (n = 34), zolpidem (n = 32), and placebo (n = 32). All participants received the intervention once a day for 30 days, without changes in nutrition. Mental health and sexual function were measured before and 30 days after the intervention.ResultsThe mean age of participants in the groups of melatonin, zolpidem, and placebo was 35.8 ± 9.6 years (22–58 years of old), 35.9 ± 9.3 years (21–58), and 37.2 ± 7.8 years (26–53), respectively. Sexual function mean score was significantly increased from 38 to 41 in the melatonin group, while it deceased in zolpidem (from 39.1 to 38) and placebo (39.25–38.59) groups. Also, mental health mean scores improved statistically significantly in the melatonin group (from 60.65 to 43.56; p = 0.002), and descriptively in the zolpidem group (57.88–51.18; p = 0.129). Concerning both outcomes, the observed improvement was considerably higher in the melatonin group. The highest improvement was observed in dimensions of overall satisfaction and depression in the melatonin group (1.18 and −8.4, respectively).ConclusionMelatonin could significantly improve both mental health and some domains of sexual function of those with drug abuse under MMT, while zolpidem did not show a significant effect.Trial Registration Numberhttps://www.irct.ir/trial/53047, identifier: IRCT20201214049718N1.

Associations Between Pornography Consumption, Sexual Flexibility, and Sexual Functioning Among Austrian Adults

To date, only a few studies have examined the associations between pornography consumption and sexual functioning. The Acquisition, Activation, Application Model (3AM) indicates that the frequency of pornography consumption and the perceived realism of pornography may influence whether sexual scripts are acquired from viewed pornography. Having sexual scripts that are alternative to their preferred sexual behaviors may help people switch to alternative sexual behavior when sexual problems arise. The current study analyzed whether frequent pornography consumption was associated with greater sexual flexibility and greater sexual functioning. Additionally, the perceived realism of pornography consumption was tested as a moderator of those associations. At an Austrian medical university, an online cross-sectional questionnaire study was conducted among 644 medical students (54% women and 46% men; Mage = 24.1 years, SD = 3.8). The participants were asked about their pornography consumption, partnered sexual activity, sexual flexibility, perceived realism of pornography, and sexual functioning. Manifest path analyses revealed direct and indirect associations between frequent pornography consumption and greater sexual functioning through greater sexual flexibility in women but not in men. Perceived realism did not moderate those associations. In conclusion, our study was in line with previous studies that found no significant associations between men’s pornography consumption and sexual functioning in men. However, some women may expand their sexual scripts and learn new sexual behaviors from pornography consumption, which may help with their sexual functioning.

Função sexual, sintomatologia depressiva e qualidade de vida de pessoas submetidas à terapia hemodialítica

Objective to analyze the correlation between sexual function, depressive symptomatology and quality of life of people on hemodialysis treatment. Method a cross-sectional study developed with 54 participants. Data collection occurred between the months of March and May 2020. The data were analyzed with the Mann-Whitney and Spearman Correlation tests, with a 95% confidence interval. Results the correlation between sexual function and depressive symptomatology was only clinically relevant for women (ρ= -0.724). Regarding quality of life, it was observed that the overall sexual function of men is negatively correlated with the pain dimension (ρ= -0.349) and with the social function (ρ= -0.347). For women, overall sexual function is positively correlated with physical function (ρ= 0.501), general health (ρ= 0.737), mental component (ρ= 0.497), sleep (ρ= 0.753), quality of social interaction (ρ= 0.621), and patient satisfaction (ρ= 0.457). Conclusion and implications for the practice increased sexual function was strongly correlated with reduced depressive symptoms and increased quality of life, implying the need to strengthen sexual approaches through protocols that provide referral flows to specialized trans-disciplinary teams.

Clinical and Laboratory Assessment of Androgenic Status and Principles of Hormone Therapy in Sexological and Andrological Patients

The article considers the main clinical manifestations and diagnostic approaches to sexual and andrological disorders in men, the principles of hormone therapy in sexopathology and andrology. Treatment and diagnosis of any form of sexual disorder involves an individual approach, phasing, complexity, taking into account the fact that sexual function and its disorders are always a traumatic factor that deepens and self-fixes as it progresses. The formation and state of sexual function are influenced by ethical and moral attitudes, as well as personal characteristics of the patient. Creating a trusting relationship between the patient and the doctor, tact, attention of the doctor, his compliance with the rules of deontology – the necessary conditions for successful treatment. Given that sexual function in men has several levels of regulation, in which the leading role is played by a higher (cortical) level, when prescribing treatment it is necessary to assess the level and extent of damage, determine the role of damaged levels of regulation in the genesis of sexual dysfunction. ways to eliminate disorders of sexual function and determine the role of sexual partners in the development of sexual disorders. Based on modern ideas about the stages and components of the copulatory cycle, in the treatment of sexological and andrological patients it is recommended to adhere the principles that fully affect all its parts. In sexual dysfunction, drug therapy is more often used, which includes the appointment of hormonal, sedative, vegetotropic, vasoactive and stimulant drugs. Advances in modern pharmacology have made it possible to synthesize and isolate from tissues steroid and protein hormones used in the treatment of disorders of the reproductive system, thus allowing real care to sexological and andrological patients.

Quality of Life, Sexual Functioning and Chronic Disease: A Comparative Study with Portuguese Women without Chronic Disease, and Women with Diabetes Type 1 and 2, and Arterial Hypertension

Aims: Previous research has focused on the impact of chronic diseases on men's sexual functioning and quality of life; however, little is known about the association between chronic disease and women’s sexual functioning and quality of life. Current study aimed at exploring the differences in quality of life and sexual functioning between women without chronic disease, and women with type 1 diabetes, with type 2 diabetes, and with arterial hypertension. Methods: A web-survey was completed by 313 Portuguese women (167 without chronic disease, 48 with type 1 diabetes, 48 with type 2 diabetes, and 50 with arterial hypertension). Results: Women without chronic disease scored significantly higher than women with chronic disease in quality of life and sexual functioning, adjusting for age. Conclusions: Quality of life and sexual functioning in women with chronic diseases is impaired.

Study of the Efficiency of Using Type 5 Phosphodiesterase Inhibitors in the Therapy of Ereсtile Dysfunction in Patients with Metabolic Syndrome

Metabolic syndrome is a symptom complex that combines abdominal obesity, insulin resistance, hyperglycemia, dyslipidemia and arterial hypertension. One of the complications of metabolic syndrome is sexual dysfunction in men. The objective: is to evaluate the efficacy and tolerability of udenafil 200 mg in the treatment of erectile dysfunction in patients with metabolic syndrome. Materials and methods. The clinical efficacy of the IV generation PDE-5 inhibitor medicine udenafil in 76 patients with erectile dysfunction of mixed origin and with metabolic syndrome in dynamics was studied. The average age was 51,6±8,2 years. The observation period was 12 weeks, but the control of metabolic syndrome parameters (anthropometry, review, biochemical blood tests) and the assessment of erectile function were carried out for 6 months. Results. After 12 weeks, patients achieved positive results in weight loss, BMI and waist circumference, although not significantly. It is necessary to note the positive changes in the indicators of the cardiovascular system. The downward trend was demonstrated by such indicators as heart. Diet therapy and taking statins have improved the indicators of fat metabolism. Correction of metabolic disorders in patients was accompanied by an increase in total and free testosterone. However, there was no statistically significant difference in the degree of increase in the concentration of androgens. Correction of metabolic disorders in patients was accompanied by an increase in total and free testosterone. During treatment, almost all integrative indices of IIEF increased. Specifically, the index «erectile function» improved 2,26 times (p&lt;0,01), «satisfaction with intercourse» 2,59 times (p&lt;0,001), «orgasm» 2,0 times (p&lt;0,01), «libido» – 2,9 times (p&lt;0,001), «general satisfaction» 2,3 times (p&lt;0,01). According to various indicators, the sexual function of men with metabolic syndrome and erectile dysfunction improved 2–2,9 times. Changes in cavernous blood flow on Doppler ultrasonography showed an increase in peak systolic blood flow rate by 1,5 times, which is associated with the udenafil half-life. Our data indicate that the use of the medicine udenafil is perspective in men with erectile dysfunction and metabolic syndrome and in those who do not have stable family-sexual relations to ensure spontaneity of sexual relations. Conclusions. Udenafil can be considered as a first-line medecine in the treatment of erectile dysfunction in patients with metabolic syndrome.

Hypothalamic-pituitary-gonadal axis and sexual functioning in metformin-treated men after discontinuation of testosterone replacement therapy: A pilot study.

Metformin was found to reduce elevated gonadotropin levels. The aim of the present study was to determine whether metformin modulates the impact of discontinuation of testosterone therapy on hypothalamic-pituitary-gonadal axis activity and sexual function in men with low testosterone levels. The study included 28men with late-onset hypogonadism (defined according to the criteria of the European Male Aging Study group) receiving testosterone undecanoate (120mg in three equal doses), 12 of whom had been treated with oral metformin (1.7-3g daily). Both testosterone and metformin had been administered for at least six months before enrolment. In all patients, testosterone replacement required to be discontinued. The control group included 16 testosterone- and metformin-treated men with late-onset hypogonadism who during the entire study period continued their treatment. Glucose homeostasis markers, as well as plasma levels of insulin, gonadotropins, testosterone, calculated bioavailable testosterone, dehydroepiandrosterone-sulphate, oestradiol, thyrotropin, free thyroxine, prolactin, insulin-growth factor-1 and cortisol were measured at the beginning of the study and four months later. Moreover, at the beginning and the end of the study, all enrolled patients completed a questionnaire assessing their sexual functioning (IIEF-15). Discontinuation of testosterone therapy resulted in a decrease in total testosterone and bioavailable testosterone (by 42% and 45% in metformin-treated patients, and by 52% and 54% in metformin-naïve patients), as well as impaired all aspects of male sexual function. Changes in bioavailable testosterone, as well as in erectile function, orgasmic function and sexual desire were less pronounced if subjects received metformin. Only in metformin-naïve men, follow-up FSH and LH levels were higher than at baseline (by 75% and 62%). Moreover, discontinuation of testosterone therapy in metformin-naïve men increased glycated haemoglobin, as well as worsened insulin sensitivity. There were no differences between baseline and follow-up levels of the remaining hormones. In metformin-naïve subjects, the increase in gonadotropin levels correlated with the changes in testosterone levels and insulin sensitivity. No effect on glucose homeostasis markers, hormone levels and sexual functioning was observed in the control group. The obtained results suggest that metformin treatment mitigates the unfavourable effect of discontinuation of testosterone treatment on hypothalamic-pituitary-testicular axis activity and sexual function in men with late-onset hypogonadism.