Sexual Problems In Men Research Articles

Are Specific Sexual Activities During Partnered Sex and Masturbation Related to Sexual Problems in Men?

Objectives: To evaluate whether the presence of sexual problems in men (i.e., erectile dysfunction, premature ejaculation, or delayed ejaculation) is associated with differential sexual behavior during masturbation and partnered sex. Methods: Cisgender participants (n = 2,807) completed an internet-based, cross-sectional questionnaire about sexual interest, behavior, and functioning. Results: Men with premature ejaculation were less likely to engage in foreplay-type behaviors, whereas men with erectile dysfunction or delayed ejaculation were more likely to include self-stimulation and/or other stimulation strategies during partnered sex. Conclusions: Different behavioral patterns among dysfunctional men represent potential strategies for modulating sexual arousal levels.

Sexual Dysfunction associated with Alcohol Abuse Among Male Adults: A Literature Review

This literature review delves into the significant issue of sexual dysfunction resulting from alcohol abuse among adult males in South Africa. There is a dearth of studies on sexual dysfunction caused by chronic alcohol use. With alcohol consumption being a widespread and culturally ingrained behavior in the region, this study examines the existing body of research to elucidate the complex relationship between alcohol abuse and sexual problems in men. Articles were searched from scientific search engines such as CINAHL Plus (EBSCO), PubMed, Medline, APA Psych and INFO as well as manual searches through Google and Google Scholar search engines. Both quantitative and qualitative studies that showed the sexual dysfunction associated with alcohol abuse among male adults were included. A total of 95 articles were screened, and 8 full-text articles were ultimately included in the review. The review reveals a strong association between alcohol abuse and various forms of sexual dysfunction, including erectile dysfunction, diminished sexual desire, and performance anxiety. The detrimental effects of alcohol on the male sexual functioning are multifaceted, involving physiological, psychological, and socio-cultural factors. This literature review offers a thorough examination of the significant concern of sexual dysfunction arising from alcohol abuse in adult males. It underscores the necessity of acknowledging and addressing the intricate relationship between alcohol use and sexual health to formulate effective prevention and treatment strategies. The study advocates for additional research on the same topic, emphasizing the need to inform healthcare professionals, policymakers, and researchers. The ultimate objective is to enhance the sexual health and overall well-being of men through evidence-based insights and targeted interventions.

Comorbidities Among Sexual Problems in Men: Results From an Internet Convenience Sample.

IntroductionMen suffering from one sexual problem sometimes report having another sexual problem, but few studies have determined concordance rates among dysfunctions in non-clinical samples.AimThis study determined comorbidities among sexual dysfunctions based on an internet convenience sample of 4432 men from Hungary, the USA, and other world regions that visit social media fora.MethodParticipants completed an online 55-item questionnaire that included questions assessing erectile dysfunction (ED), premature ejaculation (PE), delayed ejaculation (DE), and lack of sexual interest (LSI).Main Outcome MeasuresConcordance rates and odds ratios among sexual dysfunctions.ResultsApproximately 8% of men suffered from two or more sexual problems; men with a severe sexual problem were significantly more likely to suffer from a second sexual problem; concordance between PE and erectile dysfunction ranged from 23–29%, with subtypes of lifelong vs acquired PE showing patterns similar to one another; and most men with delayed ejaculation reported minimal problems with LSI, although LSI was generally key to understanding all other dysfunctions.ConclusionThe percentage of men with one sexual problem having a second sexual problem was substantial, ranging from 23–40%. These findings will help clinicians better understand the intertwined nature of sexual problems and assist them in developing management protocols that address concomitant inadequacies in sexual response. Rowland DL, Oosterhouse LB, Kneusel JA, et al. Comorbidities Among Sexual Problems in Men: Results From an Internet Convenience Sample. Sex Med 2021;9:100416.

Is Cycling Practice Related to Men's Pelvic Floor Dysfunctions? A Hypothesis-Generating Observational Study.

Background: There is a lack of consensus with regards to the consequences of cycling practice on urogenital and sexual problems in men. The aim of the study was to analyse the relationship between intensity of cycling practice and urinary tract symptoms, erectile dysfunction, and urinary incontinence. Methods: Observational hypothesis-generating design. Cyclists, men, between 25 and 70 years who had been cycling for more than one year were included. During the statistical analysis, a multiple linear regression model, partial correlation and Spearman’s correlation were carried out. Results: Fifty-eight men participated in the study. Results showed that there is a correlation between years of cycling and prostate symptoms (p = 0.041), and between age and erectile dysfunction (p = 0.001). The multiple linear regression model and the partial correlation analysis showed a correlation between the years of cycling and prostate symptoms (p = 0.007 and p = 0.018). Conclusions: The results have shown that there is a slight correlation between the years of cycling and the presence of lower urinary tract symptoms, independently of the man’s age. Therefore, the results display that high-intensity cycling practice might impact negatively in some men’s pelvic floor functions. Further research is needed to analyse the impact of cycling on urogenital problems in this population group.

ASSOCIATION BETWEEN ERECTILE DYSFUNCTION AND SEVERITY OF CORONARY ARTERY DISEASE

Background: Erectile dysfunction (ED) is the most common sexual problem in men and defined as inability to attain or maintain a penile erection sufficient for successful vaginal intercourse. Erectile dysfunction is considered a primarily vascular disease in the majority of the cases. Numerous risk factors that contribute to the development and onset of ED are principal for the development of coronary artery disease (CAD). Objective: Documentation of the relation between erectile dysfunction and severity of coronary artery disease in patients presented with acute coronary syndrome focusing on the relation between onset of erectile dysfunction and onset of acute coronary ischemia. Patients and methods: This study included Egyptian patients admitted with acute coronary syndrome (ACS) with history of erectile dysfunction (ED), and underwent coronary angiography. They were subdivided into 3 groups: Group1 (control group G1, n= 30) which have a normal coronary angiography or non-atherosclerotic coronary artery disease, group 2 (G2, n= 36) which have a single coronary artery disease, group 3 (G3, n= 34) which have more than one coronary artery disease. Comparative study was done between three groups according to risk factors, comorbidities and severity of atherosclerotic coronary artery lesions according Gensini score, degree of erectile dysfunction which was assessed by international index of erectile function (IIEF) and penile artery duplex. Results: The total number of patients admitted with acute coronary syndrome (ACS) and diagnosed as erectile dysfunction patients according international index of erectile function (IIEF) was 36. The total number was 6 (20.0%) in the control group, 10 (27.8%) in the second group, 20 (58.8%) in the third group with a significant difference between groups. Comparison between results of penile artery duplex in our study groups was classified according to response to papaverine injection into either no erection, tumescence and rigidity not sufficient for intercourse, tumescence and rigidity sufficient for intercourse or full erection. There was no significant difference between groups. Conclusion: The recognition of ED was a warning sign of silent vascular disease. It has led to the concept that a man with ED and no cardiac symptoms is a cardiac (or vascular) patient until proven otherwise.

ASSOCIATION BETWEEN ERECTILE DYSFUNCTION AND SEVERITY OF CORONARY ARTERY DISEASE

Background: Erectile dysfunction (ED) is the most common sexual problem in men and defined as inability to attain or maintain a penile erection sufficient for successful vaginal intercourse. Erectile dysfunction is considered a primarily vascular disease in the majority of the cases. Numerous risk factors that contribute to the development and onset of ED are principal for the development of coronary artery disease (CAD). Objective: Documentation of the relation between erectile dysfunction and severity of coronary artery disease in patients presented with acute coronary syndrome focusing on the relation between onset of erectile dysfunction and onset of acute coronary ischemia. Patients and methods: This study included Egyptian patients admitted with acute coronary syndrome (ACS) with history of erectile dysfunction (ED), and underwent coronary angiography. They were subdivided into 3 groups: Group1 (control group G1, n= 30) which have a normal coronary angiography or non-atherosclerotic coronary artery disease, group 2 (G2, n= 36) which have a single coronary artery disease, group 3 (G3, n= 34) which have more than one coronary artery disease. Comparative study was done between three groups according to risk factors, comorbidities and severity of atherosclerotic coronary artery lesions according Gensini score, degree of erectile dysfunction which was assessed by international index of erectile function (IIEF) and penile artery duplex. Results: The total number of patients admitted with acute coronary syndrome (ACS) and diagnosed as erectile dysfunction patients according international index of erectile function (IIEF) was 36. The total number was 6 (20.0%) in the control group, 10 (27.8%) in the second group, 20 (58.8%) in the third group with a significant difference between groups. Comparison between results of penile artery duplex in our study groups was classified according to response to papaverine injection into either no erection, tumescence and rigidity not sufficient for intercourse, tumescence and rigidity sufficient for intercourse or full erection. There was no significant difference between groups. Conclusion: The recognition of ED was a warning sign of silent vascular disease. It has led to the concept that a man with ED and no cardiac symptoms is a cardiac (or vascular) patient until proven otherwise.

Analysis of Sexual Problems in Men With Psoriasis

Psoriasis may have a negative impact on many aspects of patient life. The aim of the study was to evaluate the influence of psoriasis on erectile dysfunction and other sexual problems in men with psoriasis. A total of 76 men aged between 20 and 66 years (mean 43.9 ± 13.2 years) were enrolled. Psoriasis severity assessed according to the Psoriasis Area and Severity Index (PASI) ranged from 2.0 to 49.8 points (mean 15.1 ± 10.3 points). All patients were asked to complete the International Index of Erectile Function, the Beck Depression Inventory (BDI), and the Dermatology Life Quality Index. A detailed medical history regarding sexual problems was also collected. Erectile dysfunction was found in 43.8% of patients. The severity of erectile dysfunction negatively correlated with the age of patients (ρ = –0.42; p < 0.01) and depressive symptoms assessed by BDI (ρ = –0.39, p < 0.01). The majority of patients (77.6%) declared that the skin condition at least occasionally negatively influenced their sexual life. Patients with more severe psoriasis more often avoided sexual intercourse (p < 0.01) and felt ashamed in front of their sexual partners (p = 0.04). The vast majority of men (96.1%) felt unattractive during psoriasis exacerbation and felt embarrassed if skin lesions were present on uncovered body regions. More than half avoided social activities and sexual intercourse due to psoriasis. Moreover, 44.7% experienced rejection during their life because of psoriasis. Psoriasis negatively influences mostly emotional aspects of sexual life. Psychological disturbances, severity of the disease, smoking, metabolic syndrome, and other concomitant diseases might influence the presence and progression of erectile dysfunction in psoriatic patients. Dermatologists should be aware of these problems to put more attention on this aspect of psoriasis.

Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors.

5-Alpha reductase inhibitors (5-ARIs) are widely used in the treatment of benign prostatic hyperplasia (BPH) and androgenic alopecia (AGA). To examine all available data on the effects of 5-ARIs on sexual functioning in AGA treatment and to assess whether 5-ARIs increase the risk of sexual dysfunction. A literature review of publications at PubMed related to the subject was used. We assessed erectile dysfunction, ejaculation impairment, and decreased libido. 5-ARIs may cause side effects such as erectile dysfunction, ejaculation problems, and decreased libido in patients. Their long-term impact and precise mechanism have not been clarified. Data from studies on 5-ARIs are important for drug selection and patient counseling. More training and awareness is needed for clinicians and patients to recover many patients from sexual adverse effects. 5-ARIs used in the treatment of AGA have well-defined side effects, which can negatively affect sexual life. It is unknown and unpredictable which men using these drugs may be subject to these side effects and when these effects may appear. Studies have been insufficient to provide a clear answer to this question. Coskuner ER, Ozkan B, Culha MG. Sexual Problems of Men With Androgenic Alopecia Treated With 5-Alpha Reductase Inhibitors. Sex Med Rev 2019;7:277-282.

Management of antipsychotic-induced hyperprolactinaemia

SummaryHyperprolactinaemia is a common endocrine disorder that can be associated with significant morbidity. Antipsychotic medications are frequently linked to hyperprolactinaemia. This disorder usually presents as menstrual problems in women and sexual problems in men, which affect the patients' quality of life and adherence to antipsychotic treatment. In the past, treatment for hyperprolactinaemia was recommended only for symptomatic patients. However, it has become clear that persistent asymptomatic hyperprolactinaemia can be associated with long-term physical morbidities such as osteoporosis and possibly breast cancer. Hence, it is imperative that hyperprolactinaemia is managed even if asymptomatic when initially detected. This article discusses the various management options, such as reducing the dose of antipsychotic medication, switching to a prolactin-sparing antipsychotic and adding aripiprazole to the treatment regimen.Learning Objectives• Understand the physiology of the prolactin hormone• Be able to judge when to intervene if a patient on an antipsychotic medication presents with hyperprolactinaemia• Learn about the different treatment options

Individual Psychosexual Counseling Is One of the Educational Necessities for Cardiac Rehabilitation of Patients in Iran

Cardiovascular diseases (CVDs) are debilitating conditions with long-term physical and psycho-logical consequences (1). After a cardiac event or procedure, the patient encounters several problems, two of the most important of which are psychosexual dysfunction and difficulty in resuming sexual activity (2-4). The World Health Organization (WHO) defines sexual health as a state of physical, emotional, psychological, and social well-being related to sexual interaction and sexuality (2). Resuming sexual activity is a common concern among patients, such that in nearly half of patients resuming sexual activity is associated with fear (5). In the developed countries, despite cultural constraints and shame, numerous cardiac patients frequently request information on how to resume sexual activity (2). However, the evidence suggests that information on sexual issues is not easily available to patients, which can lead to misper-ceptions among patients on how to resume sexual activity (2, 6). According to the available evidence, 37-76% of cardiac patients experience changes in their sexual activity, only in 42% of whom these issues are raised with the treating physician (7, 8). However, in the developing countries, only 11% of patients receive information about sexual life after a cardiac event (7) and Iran is no exception in this regard. Barriers to sexual activity include lack of need for patients by health professionals, lack of experience of care providers, time constraints, linguistic and cultural barriers, as well as fear and shame (6). After cardiac event or procedures, doubt about resuming sexual activity, fear of sudden death during sexual intercourse, inadequate knowledge about when and how to resume sexual activity, as well as sexual anxiety and depression are the main obstacles cardiac patients face (9, 10). Based on the repeated recommendations of professionals and researchers on this issue, psychosexual counseling and rehabilitation is one of the educational needs of this group of patients (2, 3, 6, 8, 11), and the focus of sexual counseling strategies should be on assuaging patients' anxiety and the healthy resumption of sexual activity (3). Counseling and psychosexual education can be presented to patients in the form of verbal (face to face counseling), written (books and pamphlets), and visual (photos and videos) information (2, 6). The content of sexual education and psych-osexual counseling with a focus on psychosocial homework, including cognitive behavioral therapy and social support, can be effective in reducing patient anxiety and problems (6). In addition, in relation to delivery format of psychosexual counseling to cardiac patients, various approaches were proposed and it seems that culture plays an important role in choosing the appropriate format. Based on pair, group, or one-on-one teaching methods and seminars despite being used in different parts of the world (2, 6), it seems that one-on-one approach is more appropriate for the Iranian culture. Our experience in Kermanshah center of cardiac rehabilitation showed that patients do not welcome pair and group meetings and they generally refuse to participate in meetings and ask their questions. However, creating a private and safe environment with a same-sex counselor can facilitate participation of patients. Given that the sexual problems of men and women, and consequently, their needs are different (4), content of interventions should be defined according to the needs of each sex. Therefore, we recommend providing one-on-one psychosexual counseling, as one of the educational requirements of patients, in cardiac rehabilitation centers of Iran.

Sexual problems in male vs. female non-Hodgkin lymphoma survivors: prevalence, correlates, and associations with health-related quality of life.

The objective of this study was to examine the prevalence and factors associated with sexual problems and their relationship to health-related quality of life (HRQOL) in male and female non-Hodgkin lymphoma (NHL) survivors. In this cross-sectional study, 738 NHL survivors (425 men and 313 women; mean time since diagnosis, 6.2years) in South Korea completed the six-item instrument of adult sexual behavior used by the National Health and Social Life Survey in the United States. HRQOL was measured by two subscales of the EORTC QLQ-C30. Sexual problems were reported by a greater proportion of women (range, 31.9 to 64.4%) than men (range, 23.3 to 49.1%). Among four items common to both sexes, three (lacking interest in sex, unable to achieve orgasm, sex not pleasurable) were significantly more prevalent in women. Significant factors associated with multiple sexual problems in men were older age and being unemployed; in women, they were marital status and comorbidity. Lastly, more significant associations between sexual problems and HRQOL were observed in men than in women. Male and female NHL survivors differ in the prevalence of sexual problems and the factors associated with them as well as their associations with HRQOL. These findings can be used to develop sex-specific interventions to improve sexual function in this population.

Lifestyle Factors and Premature Ejaculation: Are Physical Exercise, Alcohol Consumption, and Body Mass Index Associated With Premature Ejaculation and Comorbid Erectile Problems?

IntroductionPremature ejaculation (PE) is a common sexual problem in men, but its etiology remains uncertain. Lifestyle factors have long been hypothesized to be associated with sexual problems in general and have been proposed as risk factors for PE. AimTo explore associations among physical exercise, alcohol use, body mass index, PE, and erectile dysfunction. MethodsA population-based sample of Finnish men and a sample of Finnish men diagnosed with PE were surveyed for statistical comparisons. Participants using selective serotonin reuptake inhibitors or other medications known to affect symptoms of PE were excluded from analyses. Main Outcome MeasuresSelf-report questionnaires: Multiple Indicators of Premature Ejaculation, International Index of Erectile Function–5, Alcohol Use Disorders Identification Test, and Godin Leisure-Time Exercise Questionnaire. ResultsThe clinical sample reported lower levels of physical exercise (mean = 27.53, SD = 21.01, n = 69) than the population-based sample (mean = 34.68, SD = 22.82, n = 863, t930 = 2.52, P = .012), and the effect size was large (d = 0.85). There was a small negative correlation between levels of physical exercise and symptoms of PE (r = −0.09, P < .01, n = 863) in the population-based sample. The association between physical exercise and PE remained significant after controlling for effects of age, erectile dysfunction, alcohol use, and body mass index. ConclusionIf future studies show that the direction of causality of this association is such that physical activity alleviates PE symptoms, then including physical activity in PE treatment interventions could be a promising addition to treatment regimes.

Premature ejaculation in Spanish men

The vast majority of men experience premature ejaculation at some point in their sexual life. It is the most common sexual problem in men, affecting between 25–40% of them. This disease has both organic and psychological causes so it is important to search an organic disorder in order to dismiss the organic causes. The following case is about a 56-year-old male, married and retired. He went to the USMC in Huelva relating a premature ejaculation problem from approximately two years ago. He relates feeling a great discomfort due to the inability to maintain a satisfactory sexual relationship with his partner. The patient was diverted from the Department of Urology at the Juan Ramon Jimenez hospital, so we dismissed an organic or physical disorder. He refers an intervention of a herniated disc, which made him staying in bed during a long season, as a precipitating event. After that appears a first episode of premature ejaculation, what produced him a great discomfort, presenting anticipatory anxiety symptoms to the sexual experience from then. These anticipatory anxiety symptoms were characterized by negative thoughts about the own sexual performance and the capability to satisfy the partner. After this first episode more episodes of the same type occurred, increasing the described anxiety and worsening his sexual performance. During the treatment, the basilar compression technique was practiced in addition a restructuration of the negative thoughts of the patient regarding to his sexual performance was made. Lastly, we worked together with his partner strengthening the relationship and the communication between them.

Men with Sexual Problems and Their Partners: Findings from the International Survey of Relationships.

Epidemiologic studies of sexual function problems in men have focused on the individual male and related sociodemographic characteristics, individual risk factors and lifestyle concomitants, or medical comorbidities. Insufficient attention has been given to the role of sexual and relationship satisfaction and, more particularly, to the perspective of the couple as causes or correlates of sexual problems in men or women. Previously, we reported results of the first large, multi-national study of sexual satisfaction and relationship happiness in 1,009 midlife and older couples in five countries (Brazil, Germany, Japan, Spain, U.S.). For the present study, we examined, within each problem, the association of four major sexual problems in men (loss of sexual desire, erectile problems, premature ejaculation, delayed/absent orgasm) and multiple problems, with male and female partners' assessments of physical intimacy, sexual satisfaction, and relationship happiness, as well as associations with well-known health and psychosocial correlates of sexual problems in men. Sexual problem rates of men in our survey were generally similar to rates observed in past surveys in the general population, and similar risk factors (age, relationship duration, overall health) were associated with lack of desire, anorgasmia, or erection difficulties in our sample. As in previous surveys, there were few correlates of premature ejaculation. As predicted, men with one or more sexual problems reported decreased relationship happiness as well as decreased sexual satisfaction compared to men without sexual problems. Moreover, female partners of men with sexual problems had reduced relationship happiness and sexual satisfaction, although these latter outcomes were less affected in the women than the men. The association of men's sexual problems with men's and women's satisfaction and relationship happiness were modest, as these couples in long-term, committed relationships were notable for their relatively high levels of physical affection and relationship happiness.

A Swiss Longitudinal Study of the Prevalence of, and Overlap Between, Sexual Problems in Men and Women Aged 20 to 50 Years Old

The aim of this study was to obtain data on the development and course of sexual problems and their interrelationships by investigating a representative sample of men and women over a period of 30 years. A representative sample of 299 women selected from the complete electoral register and 292 men selected from screening lists for military service in Zurich, Switzerland, answered questions about their sexuality as part of a series of seven interviews between ages 20 (1979) and 50 (2008). Of the initial sample of 591 participants, 43% (57% of them male) were lost to follow-up. Interviews were conducted using the Structured Psychopathological Interview and Rating of the Social Consequences of Psychological Disturbances for Epidemiology (SPIKE), a semistructured interview. Sexual problems were identified on the basis of the study participants’ self-appraisal. One-year prevalence rates, lifetime risks, and overlap of functional, emotional, and sexual desire problems in men and women were evaluated. The findings confirmed higher lifetime risks in women than in men for any sexual problem (females 67.0%; males 46.0%) and for functional (39.3%; 22.1%), emotional (35.7%; 15.9%), and sexual desire problems (51.6%; 33.3%). While in general men's sexual problems increased with age, no such association was observed in women. The overlap of all three problems (functional, emotional, and sexual desire) was reported by 16.9% of women but only 5.0% of men. Although there are commonalities, the type but also the development and, in particular, the overlap of sexual problems in women and men are markedly different.

Sexual healing in patients with prostate cancer on hormone therapy.

Since prostate cancer becomes more common with age, at least one-third of men have sexual problems at diagnosis. All localized treatments for prostate cancer greatly increase the prevalence of sexual dysfunction, which include loss of desire, erectile dysfunction, and changes in orgasm. Even men on active surveillance have a higher rate of problems than matched peers without prostate cancer. However, men given androgen deprivation therapy (ADT) have the worst rates of sexual dysfunction. Even after 3 to 4 months of ADT, men's desire for sex is decreased and irreversible damage may occur to the erectile tissue in the penis. Erections do not recover in about one-half of men, even if ADT is discontinued. Although intermittent ADT allows some recovery of sexual function, serum testosterone requires 9 to 12 months off ADT to recover. Again, one-half of men have permanent erectile dysfunction. If ADT causes atrophy of the erectile tissue, blood leaks out of the venous system during erection. This syndrome is difficult to treat except with surgery to implant a penile prosthesis. Despite the high rate of sexual problems in men on ADT, a small group stays sexually active and is able to have reliable erections. To improve men's sexual satisfaction on ADT, it may be important to educate them about getting extra mental and physical sexual stimulation, as well as using penile rehabilitation during hormone therapy. Information on reaching orgasm and coping with problems such as dry orgasm, pain with orgasm, and urinary incontinence during sex also should be provided.

Unusual Masturbatory Practice as an Etiological Factor in the Diagnosis and Treatment of Sexual Dysfunction in Young Men

Masturbation is a common sexual activity among people of all ages throughout life. It has been traditionally prohibited and judged as immoral and sinful by several religions. Although it is no longer perceived as a negative behavior, masturbation is often omitted in the diagnostic inquiry of patients with sexual problems. The aims of this study are to increase the awareness of clinicians to the importance of including questions regarding masturbatory habits in the process of sexual history taking, to analyze cases of male sexual dysfunction (SD) associated with unusual masturbatory practices, and to propose a practical tool for clinicians to diagnose and manage such problems. A clinical study of four cases that include a range of unusual masturbatory practices by young males who applied for sex therapy is described. An intervention plan involving specific questions in case history taking was devised. It was based on detailed understanding of each patient's masturbatory practice and its manifestation in his SD. Effects of identifying and altering masturbatory practices on sexual function. The four men described unusual and awkward masturbatory practices, each of which was associated with different kinds of SD. The unlearning of the masturbatory practices contributed notably to improvement of their sexual function. The four cases in this study indicate that the detailed questioning of masturbatory habits is crucial for a thorough assessment and adequate treatment of sexual problems in men. We propose specific questions on masturbatory behavior as well as a diagnostic and therapeutic flowchart for physicians and sex therapists to address those problems.

A review of analytical methods for the determination of four new phosphodiesterase type 5 inhibitors in biological samples and pharmaceutical preparations

The introduction of oral phosphodiesterase type 5 inhibitor therapy in 1998 revolutionized the treatment of erectile dysfunction. Erectile dysfunction is the most common sexual problem in men. It often has a profound effect on intimate relationships and quality of life. The analysis of pharmaceuticals is an important part of the drug development process as well as for routine analysis and quality control of commercial formulations. Whereas the determination of sildenafil citrate, vardenafil and tadalafil are well documented by a variety of methods, there are few publications about the determination of udenafil, lodenafil carbonate, mirodenafil and avanafil. The paper presents a brief review of the action mechanism, adverse effects, pharmacokinetics and the most recent analytical methods that can determine drug concentration in biological matrices and pharmaceutical formulations of these four drugs.

Standard Operating Procedures for Taking a Sexual History

While there is evidence of increased professional and public awareness of sexual problems, both male and female sexual dysfunctions remain underdiagnosed and undertreated by health care professionals around the world. Health care professionals (HCPs) are typically reluctant, disinterested, or unskilled in sexual problem management and regrettably are often disinclined to inquire about sexual issues. HCPs in all countries receive variable, nonstandardized, or inadequate training in sexual history taking and its treatment. This article presents a standard operating procedure (SOP) for taking a sexual history from men or women with sexual problems or performance concerns. Review of relevant evidence-based literature identified through a PubMed search, integrated with expert opinion. Guidelines for taking a sexual history are presented along with the relevant domains, opening and follow-up questions. The SOP presented in this article offers HCPs a brief, structured, and uniform method for obtaining a sexual history from men or women seeking health care services. Sexual history taking should be based on three basic principles, which serve as the foundation for managing sexual problems in men and women. These include the following: (i) a patient-centered approach; (ii) evidenced-based diagnostic and treatment recommendations; and (iii) use of a unified management approach for men and women. Sexual history taking should always be conducted in a culturally sensitive manner, taking account of the individual's background and lifestyle, status of the partner relationship, and the clinician's comfort and experience with the topic. Sexual inquiry should be incorporated into all new patient encounters, when possible, if only to ask one or two broad questions such as the following: "Are you sexually active? Do you have any sexual concerns or problems you would like to discuss?" Sexual history taking is a cornerstone of sexual medicine clinical practice. All patients should be provided an opportunity for frank and open discussion of sexual issues or concerns, conducted in an atmosphere of sensitivity and respect.

Quality of life in erectile dysfunction patients and their partners responding to tadalafil versus sildenafil citrate

Background Erectile dysfunction (ED) is considered the most common sexual problem in men, with a direct impact on the life of the patient and their partners. Quality of life (QOL) has become a useful variable to assess the overall impact of diseases and medical treatments from the patient’s point of view. Aim The aim of this study was to estimate the QOL in ED patients responding to tadalafil versus sildenafil citrate as well as that of their partners and also to find out the type of treatment associated with the best QOL among these patients. Methods The present study was carried out over a period of 2 months and involved 60 diagnosed ED patients and their partners who were divided into two groups. Group A comprised 30 male patients who responded to tadalafil (20 mg) on demand therapy as well as their partners. Group B comprised 30 male patients who responded to sildenafil citrate (50 mg) on demand therapy as well as their partners. All patients included in the study were subjected to a thorough medical history taking, physical and genital examination, and QOL assessment using the WHO QOL BREF questionnaire before administration of tadalafil or sildenafil as a treatment for their condition; they were then reassessed after 2 months. Results The present study showed that ED has a negative impact on all domains of QOL. Conclusions Treatment with tadalafil or sildenafil improves QOL for both the patients and their partners in different domains of QOL.