Men's Sexual Health Research Articles

Gaps in the management of diabetes in Asia: A need for improved awareness and strategies in men's sexual health.

Sexual dysfunction, which is defined as 'difficulty during any stage of the sexual encounter that prevents or impairs the individual or couple from enjoying sexual activity', is globally prevalent in males with prediabetes and diabetes. It is an early harbinger of cardiovascular diseases and has a profound impact on one's physical, mental, and social health. Among patients with either prediabetes or diabetes, the most common male sexual dysfunctions are hypogonadism, erectile dysfunction, and premature ejaculation. In Asia, although sexual health is an important factor of men's health, it is rarely discussed freely in real-life practice. Addressing sexual health in Asian males has always been challenging with multiple barriers at the levels of patients and health care providers. Therefore, the assessment and management of sexual dysfunction in routine clinical practice should involve a holistic approach with effective patient-provider communication. In this review, we discuss the epidemiology, pathophysiology, and the management of hypogonadism, erectile dysfunction, and premature ejaculation among males with either prediabetes or diabetes (type 1 and type 2), as well as the evidence gaps across Asia.

Effects of COVID-19 on sexual health in men with suspected infertility using semen analysis and serum hormone profile: A single-center experience

Effects of COVID-19 on sexual health in men with suspected infertility using semen analysis and serum hormone profile: A single-center experience

Global online interest in finasteride sexual side effects.

Prior literature has suggested that finasteride may negatively impact men's sexual health. In 2011, the Food and Drug Administration(FDA) provided a warning on finasteride drug labels to incorporate sexual side effects such as reduced libido and erectile dysfunction. We aimed to evaluate global online interest in finasteride sexual side effects, their penetrance and variation, and how they compared overtime. We also aimed to evaluate the influence of the FDA label warnings on web-based searches for finasteride side effects. We utilized Google search engine from January 2004 to December 2020 to include separate trends from web searches of "Propecia," "Propecia side effects," "finasteride", "finasteride side effects", and "post-finasteride syndrome" compared amongst the United States, United Kingdom, and Australia. We performed join-point regression analysis. We compared the annual relative search volume (ARSV) and annual percentage change (APC) to evaluate for loss or gain of interest in the respective key terms. We determined thatthe average ARSV for "finasteride" was 14.8% in 2004 and increased significantly to 57.3% in 2020 (APC: +9.25%, 95% CI 8 to 10.5, p < 0.001). Likewise, there was significant increased interest in "finasteride side effects" (APC: +20.7, p < 0.001) and "post-finasteride syndrome" (APC: +29.2; p < 0.001) in the United States overtime. Finally, when we compared trends before and after the FDA warnings, the average ASRV of "finasteride", "finasteride side effects", and "post-finasteride syndrome" all increased significantly (p = 0.001, p = 0.014, p < 0.001), respectively. Thus, it is evident that there is a global web-based interest in finasteride and its sexual health side effects, particularly after the FDA warning in 2011. There is boosted public awareness, and thus providers should have more detailed and careful conversations with patients prior to starting a 5α-reductase inhibitor such as finasteride.

Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19: A randomized placebo-controlled trial

ObjectiveAccording to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19. MethodsIn this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group. ResultsTreatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05). ConclusionDaily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.

LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men's mental and sexual health: A three-arm randomized controlled trial.

Effective Skills to Empower Effective Men (ESTEEM) represents the first intervention to address the psychological pathways through which minority stress undermines young sexual minority men's (SMM's) mental and sexual health using transdiagnostic cognitive-behavioral therapy. This study compared the efficacy of ESTEEM against two existing interventions. Participants were young HIV-negative SMM (N = 254; ages = 18-35; 67.2% racial/ethnic minority) experiencing a depression, anxiety, and/or stress-/trauma-related disorder and past-90-day HIV transmission risk behavior. After completing HIV testing and counseling, participants were randomized to receive 10-session ESTEEM (n = 100); 10-session community-based LGBQ-affirmative counseling (n = 102); or only HIV testing and counseling (n = 52). For the primary outcome of any HIV transmission risk behavior at 8 months, ESTEEM was not significantly associated with greater reduction compared to HIV testing and counseling (risk ratio [RR] = 0.89, p = .52). Supportive analyses of the frequency of HIV transmission risk behavior at 8 months showed a nonsignificant difference between ESTEEM compared to HIV testing and counseling (RR = 0.69) and LGBQ-affirmative counseling (RR = 0.62). For secondary outcomes (e.g., depression, anxiety, substance use, suicidality, number of mental health diagnoses) at 8 months, ESTEEM had a larger effect size than the two comparison conditions, but these comparisons did not reach statistical significance when adjusting for the false discovery rate. Observed effect sizes for condition comparisons were smaller than the effect sizes used to power the study. In exploratory analyses, ESTEEM showed promise for reducing comorbidity. Because the control conditions were associated with stronger effects than anticipated, and given the heterogeneous nature of transdiagnostic outcomes, the study possessed insufficient power to statistically detect the consistently small-to-moderate benefit of ESTEEM compared to the two control conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A multi-faceted intervention to improve screening of erectile dysfunction for men with diabetes mellitus in public health clinics: A pilot study.

Erectile dysfunction (ED) is common in men with diabetes and is associated with coronary artery disease and psychological distress. However, discussion of ED in primary care consultations is uncommon. Interventions, such as audit and feedback, mandate of management, and workshop on men's sexual health, have been proposed to improve ED screening in public health clinics. This study aimed to pilot test a multi-faceted intervention to increase ED screening among men with diabetes and to improve knowledge and confidence in ED screening among primary healthcare providers (PHPs). We conducted an interrupted time-series quasi-experimental study with PHPs at public health clinics in Perak, Malaysia from February 2019 to February 2020. Doctors, nurses, and assistant medical officers involved in diabetes care were recruited. The intervention was conducted between July and September 2019 and comprised two phases: audit and feedback, and mandate from management (phase 1), and an interactive face-to-face workshop (phase 2). The primary outcome measure was monthly ED screening rate, and the data were retrieved from health records and the clinical diabetes registry. The PHPs completed a questionnaire on ED knowledge and confidence in ED screening before and after the workshop. The total number of attendances by patients with diabetes was 50,325 during the study period, of which 21,413 were by men. A total of 30 PHPs participated in the training workshop: 7 (23.3%) doctors, 12 (40%) medical assistants, and 11 (36.7%) nurses. The mean duration of employment at a health clinic was 7 ± 5 years. The majority of the participants were male (56.7%), Malay (80%), married (76.7%), and had no experience with working in a urology department (76.7%). There was a significant improvement in the mean knowledge score (39.0 ± 11.4 vs. 63.6 ± 6.2, p<0.001) and median confidence level in ED screening from 2 (IQR 2-3) to 4 (IQR 4-4) after the workshop (p<0.001). After phase 1, the rate of ED screening increased from a baseline of between 10.3% (February 2019) and 12.7% (June 2019) before intervention to between 15% (July 2019) and 18.9% (September 2019) and was maintained between 18% (October 2019) and 17.9% (December 2019) after phase 2. Subsequently, the ED screening rate declined from 14.6% (January 2020) to 10.9% (February 2020). This study found that audit and feedback with mandate from management increased ED screening and detection rate. The workshop improved the participants' knowledge and confidence in ED screening but did not further increased ED screening. The improved practice was sustained for 6 months after the intervention, while the detection rate of ED persisted. We propose regular audit and feedback with mandate from management to sustain the practice of ED screening in men with diabetes.

Socio-demographic factors, sexual attitudes, sexual self-efficacy, and sexual satisfaction on sexual health-seeking behaviors: A structural equation model

ABSTRACT Introduction While the World Health Organization (WHO) actively promotes sexual health, the research on sexual health-seeking behaviors are extremely limited. Individuals are entitled to attain sexually satisfying relationship without coercion or force and is driven by free-will and respect. The information-driven promotion of sexual health worldwide has been instrumental to keep individuals responsible for their own sexual health. However, the general population of men are hesitant to seek sexual health care until end stage of sexual issues due to masculinity embarrassment, and stigma. Furthermore, the effects of individuals’ sociodemographic factors such as age, educational level, and sexual orientation, sexual attitudes, sexual self-efficacy, and sexual health-seeking behaviors are poorly understood. Objective This study aimed to investigate the influence of socio-demographic factors such as age, educational level, and sexual orientation, sexual attitudes including permissiveness, birth control, communion, and instrumentality, sexual self-efficacy, and sexual satisfaction on sexual health-seeking behaviors among Filipino men. Methods The study subjects included Filipino men 18 years old and above, able to write and read English, and able to use internet connected devices including smartphones, tablets, or personal computers. After IRB approval, a cross-sectional correlational study was conducted. Using Survey Monkey® platform, the data was collected from Filipino men who qualified based on the inclusion criteria. Structural equation modelling (SEM) technique was used for data analysis. Results A total of N= 464 Filipino men completed the survey. The result shows that sociodemographic factors such as age (β= .13, p=&amp;lt;0.05) and educational level (β= .12, p=&amp;lt;0.05), significantly influenced active and decision-making sexual health-seeking behavior. While, educational level (β= .14, p=&amp;lt;0.05) and heterosexuality (β= -.17, p=&amp;lt;0.05) significantly influenced intellectual sexual health seeking behavior. Furthermore, the sexual attitude communion (β= -.13, p=&amp;lt;0.05) and self-efficacy (β= .12, p=&amp;lt;0.05) demonstrates significant effect on interactional sexual health seeking behavior. The data analysis also presents that heterosexuality and sexual attitude communion are significant negative predictors of interactional sexual health-seeking behaviors among Filipino men. However, sexual satisfaction and sexual attitudes including permissiveness, birth control, and instrumentality failed to demonstrate effects on any of the sexual health-seeking behaviors. See Figure 1 for the SEM. Conclusions This research study presents a landmark model for sexual health-seeking behaviors. It is important to consider the individuals socio-demographic factors including age, educational level, and sexual orientation in determining the sexual health-seeking behaviors, as men in general are hesitant to seek sexual health care, therefore, clinicians including primary care physicians and advanced practice nurses such as nurse practitioners and clinical nurse specialists are at the best position to initiate discussions concerning men's sexual health. Furthermore, it is recommended to assess sexual attitude communion and sexual self-efficacy in the primary care settings. The negative effects of heterosexuality and sexual attitude communion needs further investigation. Future research on application of De Guzman sexual health-seeking behavior model is needed.

Association of Poly-tobacco Use with Erectile Dysfunction: Findings from the Population Assessment of Tobacco and Health (PATH) Study

ABSTRACT Introduction The tobacco use landscape has shifted over time to include two or more tobacco products (i.e. "poly-tobacco" use). Tobacco smoking remains independently associated with erectile dysfunction (ED); however, data on the patterns of multiple tobacco products use on men's sexual health, including ED, are limited. Objective We sought to systematically evaluate the effects of poly-tobacco use on ED using nationally representative data. Methods Data from the Population Assessment of Tobacco and Health (PATH) survey wave 4 (December 2016- January 2018) was examined. Those who responded, “sometimes or never” to the question “Ability to get and keep an erection adequate for satisfactory intercourse?” were classified as having ED. Tobacco users were classified as mono-, poly- and non- users based on the past 30-day tobacco products use. Multivariate logistic regression models were used to identify association of tobacco use with ED among a restricted sample that included only men aged 20-65 who did not report any prior cardiovascular diagnosis. We adjusted for several covariates including sociodemographic characteristics, diabetes, body mass index, mental health status, and physical exercise. Results Included in the study were adult males, aged 20-65 years or older, who responded to the question assessing ED between December 2016 to January 2018 (N=8,651). Among the study population, 19.5% participants were mono-tobacco users and 16.1% were poly-tobacco users. The proportion of ED for the sample population was 8.2%; prevalence among mono-tobacco users was 1.7% and poly-tobacco users was 1.4%. Compared to non-users, current poly-tobacco users were more likely (adjusted OR (aOR)= 1.43; 95% CI=0.99, 2.07;p&amp;lt;0.05) to report having ED. Conclusions With the shift in the landscape of tobacco products that is associated with increasing prevalence of poly-tobacco products use, adult men and clinicians should be aware of its potential impact. Future studies should evaluate the longitudinal effect of multiple tobacco and tobacco use trajectories on the development of ED among adult men. Disclosure No

International Continence Society (ICS) report on the terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction.

The terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction has not been defined and organized into a clinically based consensus terminology report. The aim of this terminology report is to provide a definitional document within this context that will assist clinical practice and research. This report combines the input of the members of sexual health in men with LUT and PF Dysfunction working group of the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give coding to definitions. An extensive process of 18 rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). The Committee retained evidence-based definitions, identified gaps, and updated or discarded outdated definitions. Expert opinions were used when evidence was insufficient or absent. A terminology report for sexual health in men with LUT and PF dysfunction, encompassing 198 (178 NEW) separate definitions, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different speciality groups involved. Conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 years) review is anticipated to keep the document updated. A consensus-based terminology report for sexual health in men with LUT and PF dysfunction has been produced to aid clinical practice and research. The definitions that have been adopted are those that are most strongly supported by the literature at this time or are considered clinical principles or consensus of experts' opinions.

Sexual Function in Men Living With a Fontan Circulation.

Introduction: It is unknown if the Fontan circulation has an impact on sexual health in men. This study assessed self-reported sexual health and fertility in men with a Fontan circulation.Aims: In this prospective, cross-sectional study, Australian men ≥18 years enrolled in the Fontan Registry of Australia and New Zealand were invited to complete the International Index of Erectile Function (IIEF), alongside questions assessing fertility. These data were compared to historical, age-matched controls.Results: Of 227 eligible men, 54 completed the survey; of those 37 were sexually active and included in the final analysis. Mean age was 28 ± 3 years, age at Fontan was 5 ± 3 years. Fontan type was extra-cardiac conduit in 15 (41%), lateral tunnel in 12 (32%), and atriopulmonary connection (APC) in 10 (27%). Ventricular function was normal in 24 (83%), and all were New York Heart Association Class I (23 patients, 79%) and II (six patients, 21%). Nine participants (24%) had erectile dysfunction (IIEF-EF score ≤25). The severity was mild (IIEF 22–24) in six (16%), mild–moderate (IIEF 17–21) in two (5%), and moderate (IIEF 11–16) in one (3%). Baseline characteristics and current medication usage were similar in those with and without erectile dysfunction. Compared with historical control values, erectile function was not significantly impaired in the Fontan population (p =0.76). Men with a Fontan circulation had decreased levels of sexual desire and overall satisfaction (p < 0.001). There was no correlation between the presence of erectile dysfunction and any assessed parameter. Eleven (30%) of the cohort reported a pregnancy with a prior partner.Conclusion: In our cohort, overall erectile function was comparable between men with a Fontan circulation and historical controls, however sexual desire and overall satisfaction were reduced. There was no correlation between study parameters and the presence of erectile dysfunction. The proportion of the cohort who had a prior pregnancy was congruent with population data.

8.L. Skills building seminar: How to operationalise ‘masculinities’ in gender-transformative reproductive healthcare?

Abstract Reproductive health care has been described as feminised and, in a neoliberal fashion, focussing on the individual patient rather than on their various relations within health care infrastructures, wider community and close social ties. In this context, there seems to be an implicit assumption of what a man actually is; namely partnered, cisgendered and heterosexual who are, generally speaking, not considered reproductive. As a consequence, men's sexual and reproductive health and rights are often marginalised and not meaningfully included in (co-)managing their own and their community's health outcomes. Furthermore, gender-transformative health scholars warn from possible pitfalls including simply ‘bolstering' gender onto existing policies, and continuing to look at men's and women's health as monolithic practices that are cordoned off from wider structures of intersectional inequalities. Within this area of research, the sociological concept of masculinities argues that gender is inherently relational, that means gender identity is not an inherent feature to ‘a' body but emerges and changes in response to its specific environment. It recognizes power imbalances within a hegemonic order and between genders. Looking across, beyond and between simple variables is therefore an essential skill to develop gender-transformative health care. Skills for gender-inclusive public health scholars must lie in developing a community-driven, feminist-inspired, rights-based approach, avoiding to fall back onto familiar assumptions as to how men do health, and demonstrating a radical openness towards new types of co-constituted masculinities. Specifically, this workshop operationalises masculinities in health care, building skills on four levels: conceptual framing of research; study and method design; data analysis and theory building; responding to broader societal discourses. The workshop will take the following structure: (1) Icebreaker (7 min): Participants present their own definition of masculinities; we reflect on assumptions and emerging questions; (2) Capacity Building (23 min): Chairpersons hold a presentation on a) social implications of a focus on masculinities within public health research; b) How men are marginalized in reproductive public health and why this affects everyone; c) and real-world implications of how gender-blind health research and care; Collaborative learning (15-20 min): Participants critically reflect on short excerpts in public health discourses on what men (supposedly) do and are (e.g. policy documents of UN and ICPD) and why certain depictions might be problematic for all and why; (4) Reflections, implications (10 min): We reflect on learnings, and on what we can do in terms of public health research methods, policy and practice; (5) Post-workshop: Participants are granted access to a shared folder with further readings and can continue to formulate policy and practice through a dedicated online space. Key messages We highlight masculinities as avenue towards gender-transformative reproductive health care, building skills for public health researchers and practitioners. We open up a collaborative platform and galvanise the political impetus towards gender-transformative best practices across health care.

P–041 Reproductive concerns and sexual health in men with newly diagnosed testicular cancer prior to orchiectomy: preliminary results from an on-going study

Abstract Study question What is the prevalence of reproductive concerns among patients with newly diagnosed testicular cancer (TC), and how do they rate their sexual health (SH). Summary answer Of 20 patients, 75% (n = 15) were moderate to highly concerned about decreased reproductive functioning. Twenty-four percent exhibited overall low SH. What is known already Currently, only little is known about reproductive concerns among TC patients. Furthermore, these concerns have not been investigated in a TC population prior to orchiectomy. One study among post-surgery TC patients two years after diagnosis, reported that 28% had high degree of reproductive concern. The literature indicates that TC patients’ sexual health is negatively affected due to altered body image and sexual dysfunction. However, studies regarding sexual health have primarily been performed on long term survivors of TC. Thus, little is known about SH in this population prior to treatment. Study design, size, duration The present cross-sectional study included patients from the fertility clinic in Horsens, Denmark. Patients were approached at their pre-scheduled appointment for cryopreservation of semen prior to orchiectomy. Enrolment started March, 2019 and is still on-going. Preliminary data is included from 21 enrolled patients. Participants/materials, setting, methods Patients newly diagnosed with TC, who were referred to the fertility clinic for semen cryopreservation prior to orchiectomy and other treatment modalities were invited. The patients responded to a questionnaire package of which reproductive concerns were assessed with seven questions with Likert scale response options ranging from 0 (not concerned) to 5 (highly concerned). SH was assessed with the validated 22-item questionnaire European Organization for Research and Treatment of Cancer Sexual health questionnaire (EORTC-SHQ). Main results and the role of chance A total of 37 patients met the inclusion criteria and of these 21 were enrolled in the study. Due to technical issues, only 20 out of 21 patients completed the full questionnaire package. Patients were asked about concerns regarding the ability to father children. Nine patients (45%) were moderately concerned, and six patients (30%) were highly concerned. When asked about their concerns of not being able to father children without fertility treatment, the answers were mostly unaffected with eight patients (40%) being moderately concerned, and seven patients (35%) highly concerned. Four patients (20%) were highly concerned that decreased semen quality would affect future or present relationships. Patients were also asked if they felt sufficiently informed regarding the chance of fathering children without help from a fertility clinic following cancer treatment. Three patients (15%) reported that they were insufficiently informed, while four patients (20%) responded only to a little extend. Five patients (23,8%) scored ≤ 50 on the EORTC SHQ indicating that they had low SH. Eleven patients (52,3%) felt less masculine due to their disease. Furthermore, one patient (4,8%) scored ≤ 50 on the symptomatic scale, indicating that he had symptomatic sexual problems as fatigue and sexual pain. Limitations, reasons for caution The relatively low participant number is a limitation, making the results less generalizable. Furthermore, there is a risk of selection bias due to the moderate inclusion rate. Also, the questionnaire examining fertility related concerns were non validated, and focused mainly on the fertility-related aspects of reproductive concerns. Wider implications of the findings: A considerable number of patients with newly diagnosed TC show substantial reproductive concerns as well as lowered sexual health. These worries could possibly be alleviated by more sufficient information from the health professionals already in the beginning of the treatment phase, reducing further emotional distress during the remaining treatment period. Trial registration number ClinicalTrials.gov ID:NCT03880994

Sexual history taking in primary care

Sexual history can be neglected in a routine nursing or medical assessment. Sarah Kipps gives tips to assist in making a sexual history taking session as comfortable as possible for both health professional and patient Practitioners in primary care are in a unique position to improve the sexual health of men and women. They can do this by introducing the topic of sexual health into their everyday consultations and thereby normalising the subject as part of routine health for the patient. There is evidence that health professionals find sexual history taking to be one of the more challenging aspects of a consultation. There are a number of different reasons for this: feeling not equipped to ask questions of such a sensitive nature; fear of opening a ‘can of worms’ which cannot be dealt with; and the general social embarrassment and difficulties experienced talking about sex in general. This article will give health professionals some tips and guides to assist in making a sexual history taking session as comfortable as possible for both health professional and patient.

Paradigm Shift in Clinical Practice of Sexual Health in Men During COVID-19 Pandemic

Sexual health-care seeking behavior and practices have been affected during COVID-19 pandemic. The impact of COVID-19 on this subspecialty is far reaching. This study aimed to assess the impact of COVID-19 on health-care seeking practice pertaining to sexual health in men in our tertiary care center and review the relevant literature regarding impact of COVID-19 on sexual health seeking practice and challenges faced. Outpatient data was analyzed from January 2019 to April 2021. Patients awaiting surgical procedures due to COVID were documented. A narrative synthesis of literature based on systematic search using the keywords sexual health, sexual health seeking, sexual health practice, andrology, and COVID with operators “AND” and “OR” was carried out in three search engines PubMed, Scopus, and Embase. The study outcomes were obtained by comparing data of outpatient attendance and compiling the reviewed literature. The mean attendance fell significantly from 95.11±11.17 to 17.25±13.70 persons (P &lt;.0001) per outpatient clinic, March 2020 being the reference point. Teleconsultation has taken over physical consultation. In 98/949 cases, teleconsult could not be provided despite registration. Over 25 patients were waiting for surgical procedures pertaining to andrology due to shut down of elective services. Similar trends have been reported from other countries. Number of patients seeking consultation for sexual health problems has dramatically decreased during COVID-19 era. Establishment of data safe teleconsultation facility and its widespread advertisement is needed to encourage patients to seek consult.

Pornography and its impact on the sexual health of men

Increased internet access has been accompanied by increased numbers of adolescent and adult men viewing online pornography, and there is growing concern about how this may affect their sexual development, sexual function, mental health and intimate relationships. This paper briefly reviews men's relationship with porn and the possible impact on sexual function.

A pilot cultural adaptation of LGB-affirmative CBT for young Chinese sexual minority men's mental and sexual health.

Young men who have sex with men (YMSM) represent one of the most at-risk groups for HIV infection and experience sexual minority stress especially in high-stigma settings, which affects their psychological health and increases likelihood of HIV-risk behaviors. The HIV epidemic in China is increasing rapidly among YMSM. However, no evidence-based intervention has specifically targeted Chinese YMSM's minority stress to improve their mental and sexual health. Adaptation of evidence-based interventions to promote the mental and sexual health of YMSM is one promising way to achieve the global target of HIV epidemic control. The current adaptation study followed the Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing model. YMSM (n = 41) and key stakeholders (n = 16) in China provided feedback into the selected intervention, a cognitive-behavioral therapy called Effective Skills to Empower Effective Men, originally developed with efficacy in the United States. An open pilot (n = 8) was also then conducted. Qualitative and quantitative data collected from each adaptation phase were analyzed to form the adapted intervention: "Yi Si Tang ()." Adaptations addressed a cultural context prioritizing family needs, limited support from the health system, as well as YMSM delivery preferences. YMSM and key stakeholders deemed the intervention acceptable and preliminarily feasible for the Chinese context. The pre-post comparison of mental and sexual health outcomes indicated improvement in mental health and sexual health of Chinese YMSM. Outcomes of the small initial pilot suggest future promise for this first-of-its-kind intervention for Chinese YMSM. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Impact of Anti-hypertensive Therapy in the Sexual Health of Men and Women: An Analysis From the SPRINT Trial.

Pharmacologic anti-hypertensive (HT) treatment reduces cardiovascular risk. However, many patients are nonadherent due to perceived or real concern about sexual-related side effects. In a subset of the SPRINT (a randomized trial of intensive vs. standard blood-pressure control) trial, we sought to investigate the impact of anti-HT treatment on sexual activities of men and women over time, and whether this impact varied with a more or less intensive anti-HT therapy. Random-effects models for panel/longitudinal data. Among the 1,268 men and 613 women included in this substudy, 862 (68%) men and 178 (29%) women declared to be engaged in sexual activity of any kind. Compared with women and men not engaged in sexual activity, those engaged were younger (64 vs. 69 years for women and 65 vs. 75 years for men). Women had an overall low satisfaction with their sexual life but their sexual health was not affected by anti-HT therapy over time nor modified by an intensive treatment. Men's erections were slightly deteriorated over time (-0.1 to -0.2 points on a scale of 1 (worse) to 5 (best); P < 0.05), but were not aggravated by intensive anti-HT therapy (P > 0.05 for all). Self-declared women's sexual health was not affected by an intensive anti-HT therapy. Men reported a slight deterioration in the quality of their erections, irrespective of standard or intensive therapy. These findings may help reassuring patients about the sexual safety of intensive anti-HT therapy, therefore, potentially improving adherence to intensive therapy strategy.

Sexual Health in Men Living with a Fontan Circulation

Sexual Health in Men Living with a Fontan Circulation

Men's health in the modern era of cystic fibrosis

Cystic fibrosis (CF) has a profound impact on men's sexual and reproductive health (SRH) [1]. Over 97% of men with CF are infertile due to obstructive azoospermia from congenital bilateral absence of the vas deferens (CBAVD) [1]. Hypogonadism may result in decreased muscle mass, low bone mineral density (BMD), and potentially poorer quality of life [2]. Men's SRH experiences and care utilization have not been investigated in the modern era of CF, but prior research has shown major gaps in counseling and care [3,4].

Sexual Health in the Elderly Population.

Among the growing elderly population, sexual health remains an important concern for individuals and couples. An understanding of the expected changes with aging and taking care of aging men and women is important for treating sexual dysfunction. Sexual health issues related to aging can be both linked between men and women and independent. The aim of this study is to determine the most important considerations that contribute to sexual satisfaction in men and women in this population. Many factors contribute to the overall sexual health of men and women. Hypogonadism and erectile dysfunction both warrant thorough evaluation and consideration of treatment to improve sexual satisfaction. Underlying cardiovascular issues may be present in men presenting with these concerns. In addition to hormone replacement and traditional therapy for erectile dysfunction, therapeutic stem cell injection has shown some promise. Menopause, vaginal dryness, and dyspareunia play important roles in sexual satisfaction in women. Vaginal moisturizers, topical estrogen, and MonaLisa Touch laser therapy all may aid in improving these symptoms and ultimately sex lives. Studies have also demonstrated some benefit in populations with arousal disorders, which can be present in the elderly. Male patients often describe issues related to erectile dysfunction and hypogonadism, and issues with sexual drive. The pathophysiology is linked between these conditions and treatment of one component can provide symptom relief on a larger scale. A combination of testosterone therapy, lifestyle modifications, and therapy for erectile dysfunction relates to sexual satisfaction in men. In women, an understanding of the physiological process of menopause and offering therapy when indicated can improve the quality of sexual health and provide satisfaction to both patient and partner. While aging can diminish drive and desire, proper counseling and treatment may significantly benefit some patients. A multimodal approach involving the physician, patient, and partner will optimize care and may improve the quality of life in the elderly. This review outlines some normal changes due to aging and identifies some current treatment options for a population in which sexual health can be often ignored or dismissed. By understanding the available tools, a more comprehensive approach can be taken to achieve satisfaction in couples and individuals alike.