Sexual Side Effects Research Articles

Interplay between depression and sexuality

Disorders of sexual function are afrequent comorbidity of depression and have complex interactions on psychological, sexual and relationship qualities. To determine the prevalence of sexual functional disorders in depressed patients, the effects of antidepressant drugs and development of treatment recommendations. Evaluation of the current literature and discussion of fundamental studies. Depression and sexual dysfunction frequently affect each other in complex ways which makes it important to address interpersonal relationship dynamics and to include these in the therapy. The use of serotonergic antidepressants can greatly increase the risk for sexual dysfunction by up to 27times. In addition to (couples) therapeutic interventions, reducing the dose or switching medications to, e.g., bupropion or using additive medications can also be treatment options. Despite the shame associated with the topic, it is crucial for therapists to address sexual topics early and openly. Relationship dynamics should be considered during therapy. If antidepressant medications are used it is recommended to provide a more detailed clarification for patients about their potential sexual side effects and their limited treatment options before starting the medication.

Fluoxetine Mitigates Human Sperm Quality by Disrupting the Antioxidant Defense System and Altering the Expression of Apoptosis-Related Genes: An In Vitro Study.

Fluoxetine is used in the management of depression, anxiety and other mood disorders by increasing serotonin levels in the brain and can cause sexual side effects by changing the homeostasis of sex hormones and increasing oxidative stress. Since many men who take fluoxetine are of reproductive age and sperm are exposed to fluoxetine for a considerable time, this study aimed to examine the in vitro effects of fluoxetine on human sperm biochemical markers and sperm parameters. Semen samples from 30 fertile men were divided into three groups: a positive control group, a negative control group and a fluoxetine-treated group. We investigated sperm parameters, mitochondrial membrane potential (MMP), acrosome reaction, DNA fragmentation, chromatin integrity, and the expression of CASPASE8, CASPASE9, BAX, and BCL2 genes and proteins. Data were analyzed using repeated measures analysis. The results showed that the average percentage of motility, viability, MMP, acrosome and chromatin integrity, total antioxidant capacity (TAC) level, and BCL2 gene and protein expression in the fluoxetine group were significantly reduced compared to the positive and negative control groups. While the average percentage of non-progressive motility, sperm DNA fragmentation, malondialdehyde (MDA) level, reactive oxygen species (ROS), gene and proteins expression of CASPASE8, CASPASE9 and BAX increased significantly. This study suggests that fluoxetine may impair sperm quality by increasing the expression of apoptotic genes, proteins, and oxidative stress. Therefore, careful management of fluoxetine in treating depression is crucial, especially in men of reproductive age, due to its potential sexual side effects. HIGHLIGHTS: • Fluoxetine reduces the quality of human sperm by inducing oxidative stress. • Fluoxetine lowers the total antioxidant capacity in human sperm by increasing ROS. • Fluoxetine increases the expression of apoptosis genes in human sperm.

Predictors of Sexual Dysfunction, Associated Distress, and Sexual Satisfaction Among Male and Female Patients Living with Anxiety Disorders in Denmark

ABSTRACT Although previous studies have established links between anxiety disorders, sexual dysfunctions, and sexual satisfaction, there is relatively little research on the specific factors associated with living with an anxiety disorder that might contribute to these sexual health disparities. This study assessed the associations between anxiety, cognitive distractions, biased expectancies, and 1) sexual dysfunction (DSM-5 diagnostic criteria) 2) associated distress, and 3) sexual satisfaction while considering the role of pharmacological treatment-related sexual side effects and comorbid depressive symptoms. A large clinical population (N = 207) of people with anxiety diagnoses seeking treatment at 11 outpatient anxiety clinics in Denmark participated. Higher cognitive distraction levels were linked with a greater risk of sexual dysfunction, more sexual dysfunction-associated distress, and lower sexual satisfaction. Higher sexuality and anxiety biased expectancies were associated with an increased risk of sexual dysfunctions and associated distress and decreased sexual satisfaction. Higher anxiety symptom severity was only associated with lower sexual satisfaction among female respondents. Higher anxiety sensitivity was linked to a higher risk of sexual dysfunction, associated distress, and lower sexual satisfaction among female participants only.

Sexual dysfunction after Rezum therapy for benign prostatic hyperplasia: A scoping review for the current insights and findings

AbstractBenign prostatic hyperplasia (BPH) is a common condition among aging men, often leading to lower urinary tract symptoms (LUTS) of varying severity. Both medical and surgical treatments for BPH can negatively impact sexual function, affecting patients' overall quality of life. This has highlighted the need for minimally invasive interventions that minimize sexual side effects. Rezum, a water vapor therapy, has gained popularity in managing BPH and LUTS due to its proposed potential to preserve sexual function. This scoping review examines the impact of Rezum therapy on sexual function in patients treated for BPH. The review was conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews. A comprehensive search was performed using the PubMed and Scopus databases up to August 2024. Articles were included if they involved patients treated with Rezum for BPH and reported the effect of Rezum on sexual function using validated scoring tools. A total of 15 studies encompassing 2,425 patients, met the inclusion criteria. Erectile function was assessed in all studies using the International Index of Erectile Function (IIEF) scores. Of these, seven studies reported no significant changes in erectile function scores, six demonstrated improvements, and two reported a significant decline. Ejaculatory function was evaluated using the Male Sexual Health Questionnaire (MSHQ). The MSHQ‐Bother score was reported in seven studies, with three indicating improvement and none reporting deterioration. The MSHQ‐Function score was reported in eight studies, with only one study reporting a decline, while the remaining studies found no significant changes. In conclusion, Rezum therapy for managing BPH shows favorable outcomes for sexual function or, at the very least, does not negatively impact it. These findings can guide patient counseling, especially for those seeking to preserve ejaculation. Further research is needed to compare Rezum with other treatment options regarding sexual function.

Topical dutasteride for androgenic alopecia: current state and prospects.

Androgenic alopecia has a high incidence, affecting 80% of men and 50% of women in their lifetimes. Although not a life-threatening disease, it can be a deep psychological burden to patients and still lacks an effective and safe treatment. Dutasteride is a5-alpha-reductase inhibitor approved to treat benign prostatic hyperplasia that is also commonly prescribed off-label to treat androgenic alopecia. However, oral dutasteride may cause several severe sexual and neurological sideeffects. Therefore, an effective, localized dutasteride treatment that can reduce the effects of systemic uptake is of great interest. Here, we review available therapies to treat androgenic alopecia focusing on topicalformulations developed thus far-including minoxidil, finasteride, and cosmetics-and on dutasteride-loaded nanocarriers targeting hair follicles.

Clinical Correlates of Antipsychotic Plasma Levels with Long-Acting Paliperidone: Corrélats cliniques des concentrations plasmiques de palipéridone à libération prolongée.

The majority of patients with schizophrenia experience dramatic improvement in psychotic symptoms when treated with antipsychotic medication. Maintenance treatment can prevent relapses but problems with medication adherence limit effectiveness. Long-acting injectable antipsychotics (LAIs) provide an opportunity to establish adherence but challenges remain in ensuring that the dose selected is therapeutic. Therapeutic drug monitoring has not been established as valuable for LAIs in the maintenance treatment of schizophrenia. This exploratory study was undertaken to describe plasma paliperidone levels in outpatients treated with the LAI paliperidone palmitate and to determine whether paliperidone levels are associated with subjective experience on medication and side effects. Twenty-one outpatients with schizophrenia receiving treatment with LAI paliperidone consented to participation in this study. Blood samples were obtained for measurement of paliperidone and prolactin levels at the first visit. A second paliperidone level was obtained at the time of the next injection for 18 of the participants. Clinical rating scales were administered at the first visit to assess illness severity, attitudes regarding medication, subjective well-being and side effects. Paliperidone levels were highly correlated at the two time points (ρ = .85; P < .001). Mean paliperidone level at the first visit was 34.9 ng/ml and ranged from 5.1 to 73.9 ng/ml. Higher paliperidone levels were correlated with higher prolactin levels (ρ = 0.59, P < .01) and lower sexual desire (ρ = -.58, P < .01). We demonstrated that paliperidone levels can be measured reliably in patients receiving LAI paliperidone. Higher plasma levels were associated with higher prolactin levels and reduced sexual desire but not with measures of subjective experience on medications or other side effects. Measurement of paliperidone levels in patients treated with paliperidone palmitate may have the potential to minimize the dose of medication prescribed and, in turn, the severity of sexual side effects.

Prevalence of Sexual Side Effects in Female Psychiatric Patients Taking Psychotropic Medications: A Cross-Sectional Study

Prevalence of Sexual Side Effects in Female Psychiatric Patients Taking Psychotropic Medications: A Cross-Sectional Study

Effect of Atomoxetine on Mouse Isolated Vas Deferens Contractility

Objective: Atomoxetine (ATX), a selective noradrenaline re-uptake inhibitor, is a preferred drug with sufficient efficacy and favorable safety profile for the treatment of attention-deficit hyperactivity disorder. Ejaculatory dysfunctions have been reported in the patients receiving ATX as sexual side effect, of which underlying mechanisms are largely unknown. The present study aimed to investigate the effect of ATX on mouse isolated vas deferens (VD) contractility as a potential mechanism of ATX-induced ejaculatory dysfunction. Material and Methods: Isolated organ bath studies were performed on prostatic parts of VD obtained from adult male Balb/c mice. The effect of ATX (10-6, 10-5, 3x10-5 and 10-4 M) on KCl (80 mM), phenylephrine (PhE, 3x10-4 M), adenosine 5’-triphosphate (ATP, 10-2 M) and electrical field stimulation (EFS; 100 V, 64 Hz)-induced contractions of VD strips were evaluated in concentration dependent manner. Results: ATX at 10-6 and 10-5 did not alter the contractile responses (p&gt;0.05), however, higher concentrations of ATX (3x10-5 or 10-4 M) significantly inhibited the KCl, PhE, ATP and EFS-induced contractions of VD strips (p&lt;0.05). Conclusion: The present study demonstrated for the first time that ATX decreased the contractile responses of mouse isolated VD concentration-dependently. Our results suggest that ejaculatory dysfunction might be related to the inhibitory effect on ATX on VD.

A Proposed Algorithm for the Pharmacological Treatment of Generalized Anxiety Disorder in the Older Patient.

This is a new algorithm from the Psychopharmacology Algorithm Project at the Harvard South Shore Program, focused on generalized anxiety disorder (GAD) in older adults. Pertinent articles were identified and reviewed. Selective serotonin reuptake inhibitors (SSRIs) are considered to be first-line medications, with a preference for sertraline or escitalopram. If avoiding sexual side effects is a priority, buspirone is an option for the relatively healthy older adult. If response is inadequate, the second recommended trial is with a different SSRI or one of the serotonin-norepinephrine update inhibitors (SNRIs), venlafaxine or duloxetine. For a third medication trial, additional alternatives added to the previous options now include pregabalin/gabapentin, lavender oil, and agomelatine. If there is an unsatisfactory response to the third option chosen, quetiapine may be considered. We recommend caution with the following for acute treatment in this population: benzodiazepines and hydroxyzine. Other agents given low priority but having some supportive evidence were vilazodone, vortioxetine, mirtazapine, and cannabidiol. Acknowledging that the median age of onset of GAD is in early adulthood, many patients with GAD will have been started on benzodiazepines (or other medications that require caution in the elderly) for GAD at a younger age. These medications may be continued with regular observation to see if the potential harms are starting to exceed the benefits and a switch to other recommended agents may be justified.

Sexual dysfunctions (SD) and selective serotonin reuptake inhibitors (SSRIs): from preclinical studies to intervention strategies

In the light of existing literature, we reviewed the causes, management and potential therapeutic benefits of SSRI (Selective serotonin reuptake inhibitor) agents regarding sexual functions. (SSRIs) are the most commonly used medications for the treatment of depression, based on their effectiveness and safety profile. Sexual dysfunctions (SD) caused by SSRIs are one of the most important reasons for discontinuation of treatment in both genders. Knowing the intervention strategies in patients who develop SD is pivotal for the proper management of sexual side effects and the treatment adherence of patients. The effects of SSRIs on sexual functions can also be used to treat certain disorders. SSRIs have a high success rate in the treatment of premature ejaculation and their off-label use for this purpose is widely recognized.

Comparison of combination therapy with tamsulosin and dutasteride or finasteride in patients with benign prostatic hyperplasia: a randomized clinical trial

BackgroundBased on our observations at the largest outpatient urology clinic in Iran, patients for whom finasteride is prescribed as a secondary drug to tamsulosin tend to experience earlier and more severe sexual side effects without any difference in the amelioration of symptoms. This study aimed to compare the time lag, efficacy, and side effects of combination therapy with varying doses of dutasteride or finasteride added to tamsulosin for benign prostatic hyperplasia (BPH) treatment.MethodsIn this study 165 were randomized into 5 groups (each N = 33); receiving tamsulosin 0.4mg plus either of A: finasteride 3mg, B: placebo, C: dutasteride 0.25mg, D: finasteride 5mg or E: dutasteride 0.5mg. During the 6-month period of the study, International Prostate Symptom Score (IPSS), post-void residual urine (PVR), International Index of Erectile Function (IIEF-5), prostate volume (PV), prostate specific antigen (PSA) and maximum urinary flow rate (Qmax) were evaluated at baseline and at the 1st, 3rd and 6th month. The differences between each time point and baseline were then compared between groups.ResultsAt 3-month follow-up, group E exhibited a higher decrease in PSA but a greater increase in Qmax compared to group A (p = 0.047 and 0.006, respectively). Group C showed higher Qmax increase compared to group A at 3 and 6 months (p = 0.003 and 0.014) and concurrently a more pronounced PV decrease at 1 and 3 months (p = 0.047 and 0.003, respectively). Group D had a significantly more decrease in their IIEF-5 compared to group A at one-month visit (p = 0.006).ConclusionsIn summary, at the sixth-month follow-up, dutasteride demonstrated superiority over finasteride solely in enhancing Qmax. Therefore, dutasteride may be marginally more beneficial as a secondary component of combination therapy in BPH.Trial registration IRCT, IRCT20120516009772N2. Registered 18 January 2021 Retrospectively registered, https://irct.behdasht.gov.ir/search/result?query=IRCT20120516009772N2.

Sexual dysfunction following retinoid treatment: a systematic review.

Despite product monograph warnings of post-retinoid sexual dysfunction (PRSD) for isotretinoin and recent policy decisions regarding the safety of isotretinoin, this study demonstrates that there remains conflicting and low-quality evidence on this topic and it is not possible to ascertain causation between retinoids and PRSD. Dermatologists and patients should be aware of the conflicting data regarding sexual dysfunction associated with systemic retinoid therapy. Routine screening for sexual side-effects during systemic retinoid treatment may be reasonable, as patients are less likely to self-disclose sexual health concerns.

Sexuality after breast cancer treatment: A physician’s survey of current clinical practice

BackgroundSide effects of breast cancer treatment (BCT) impact patients’ general and sexual wellbeing. Sexuality related complaints are reported by 70% of breast cancer survivors mainly due to the genitourinary syndrome of menopause (GSM). In clinical care, sexual side effects are often un(der)detected because physicians as well as patients experience barriers to discuss sexuality-related issues. Materials and methodsWe composed an online survey ourselves using known definitions about sexuality and menopause and known factors for not discussing sexuality. We used multiple-choice questions with a Likert scale to optimize interpretation of the statements. 64 practitioners completed the survey. With this online survey, we examined physicians’ knowledge of −and attitude towards- sexual wellbeing and detection and treatment of GSM in breast cancer survivors (BCS). ResultsVaginal dryness and dyspareunia were the symptoms most associated with menopause (n = 63/64 (98 %) and n = 56/64 (87 %)) and sexuality (n = 63/64 (98 %) and n = 61/64 (95 %)). These 2 complaints were also the most discussed symptoms of menopause (vaginal dryness n = 51/64 (80 %) and dyspareunia n = 45/64 (70 %)). The main reason to not discuss these issues were absence of reporting GSM (n = 40/64 (62 %)) and absence of a direct cause to discuss GSM (n = 35/64 (55 %). 64 % (n = 41/64) of practitioners don’t feel sufficiently educated to discuss and treat GSM. They proposed vaginal estrogens to treat GSM as first or second line respectively in 12 % (n = 8/64) and 46 % (n = 30/64) of symptomatic BCS. DiscussionAlthough sexuality related complaints are common in BCS, 64% of all participating physicians feel they are not adequately trained to handle them. More attention towards training of physicians is needed to discuss GSM related complaints also when they are not spontaneously reported by a patient and with clear guidance towards the medical treatment of GSM in BCS.

Disease-Modifying Symptomatic Treatment (DMST): The Potential Role of Vortioxetine in the Treatment of Depression in Patients with Multiple Sclerosis.

In multiple sclerosis (MS), alongside the physical symptoms, individuals often grapple with anxiety and depressive symptoms as prevalent comorbidity. Mood disturbances, frequently undertreated in clinical practice, significantly impact the quality of life of individuals with MS, exacerbating disability and hindering overall well-being. Furthermore, traditional antidepressant therapies are often associated with adverse events, such as sexual side effect, weight gain, which could limit their use in these patients. Vortioxetine is one of the most innovative antidepressant drugs in the current pharmacopeia. Its pharmacological profile includes serotonin reuptake inhibition, antagonism for hydroxytryptamine (HT) receptors 5-HT3, 5-HT1D and 5-HT7, partial agonism for 5-HT1B, and agonism for 5-HT1A. It has been shown to have a beneficial effect on depression-related cognitive dysfunction, as well as on anxiety, depression, anhedonia and emotional blunting. Recently a potential anti-inflammatory action was also described. Limited clinical studies have specifically explored the efficacy of vortioxetine in treating depressive symptoms in MS. However, extrapolating from existing research in major depressive disorder, it is plausible that vortioxetine's multimodal mechanism could provide a favorable therapeutic approach. This position paper, which summarizes the output of annual clinical meeting held by the DMSTs in MS Italian Study Group, is focused on the possible role that vortioxetine could play as symptomatic treatment (ST) of depressed patients with MS, hypothesizing a direct impact on the clinical course of the disease.

Gynecologic cancer survivor preferences for provider communication regarding sexual health after treatment: a qualitative study.

Survivorship from gynecologic cancers is becoming increasingly prevalent. There are significant sexual side effects that influence quality of life that would be reduced with proper intervention; however, existing literature highlights the lack of understanding of the sexual health needs within this population. Furthermore, multiple studies show that one contributing factor to sexual well-being in survivorship is provider-patient communication. The aim of this study is to explore experiences of sexual distress and survivor experiences of sexual health communication. Adult participants who had been out of active treatment for 3months were recruited to participate in focus groups. Six focus groups (n = 32) were conducted with survivors of gynecologic cancers via Zoom. Research team members analyzed content using thematic analysis. Two broad themes were identified: Experiences of provider communication and Preferences for provider communication, with subthemes nested under both. Subthemes from the Experiences theme included absent/lacking communication, negative experiences, emotional reaction to lack of communication, and feeling like sexuality was not valued. Subthemes from the Preferences theme included more conversation and open communication about sexuality, more resources/referrals, and more provider training on sexuality. Survivor experiences of subjective sexual health are often dependent on the type and quality of information they receive from their healthcare team during treatment. Unfortunately, the majority of participants endorsed negative or absent communication related to their sexual health needs, leading to additional distress.

Sexual side effects of antipsychotic drugs in schizophrenia: Protocol for a systematic review with single-arm, pairwise and network meta-analysis of randomized controlled trials and non-randomized studies

Introduction Sexual dysfunctions are common yet underreported side effects of antipsychotics for schizophrenia, affecting 30-80% of treated individuals. These side effects can severely impact social interactions and treatment adherence for individuals with schizophrenia, but comprehensive comparative evidence assessing the risk profiles of different antipsychotics is lacking. This study aims to address this gap using network meta-analysis that integrates data from both randomized-controlled trials (RCTs) and non-randomized studies (NRS). Protocol This systematic review will include both RCTs and NRS focusing on participants with schizophrenia or schizophrenia-like psychoses, without restrictions on symptoms, gender, ethnicity, age, or setting. For interventions, all second-generation antipsychotics will be included. The primary outcome will be the occurrence of at least one sexual adverse event of any kind. Secondary outcomes will be the occurrence of any sexual adverse event evaluated in men and women separately, and any adverse event related to the three phases of sexual response cycle separately: desire (e.g. libido, sexual thoughts), arousal (e.g. erection, lubrication) and orgasm (e.g. ejaculation, anorgasmia), and any adverse effect related to breast dysfunction and menstruation irregularities. Study selection and data extraction will be performed independently by two reviewers. The Cochrane Risk of Bias tool 1 and ROBINS-I will be employed to evaluate the risk of bias for RCTs and NRS, respectively. Single-arm meta-analysis of proportions will synthesize the average frequency of sexual adverse events in treated participants. Pairwise and network meta-analysis of RCTs and NRS will be used to evaluate comparative tolerability. Subgroup and sensitivity analyses will explore possible heterogeneity in results and validate the findings’ robustness. The quality of the evidence will be evaluated using GRADE. Discussion This study will provide vital insights into the sexual side effects of antipsychotics by combining evidence from clinical trials and real-world practice, facilitating better decision-making in choosing the optimal antipsychotic for individuals.

(098) IMPACT OF PRE-TREATMENT COUNSELLING ON DECISIONAL REGRET OF PROSTATE CANCER SURVIVORS: CROSS-SECTIONAL ANALYSIS OF PATIENT REPORTED EXPERIENCE FOLLOWING DIAGNOSIS OR TREATMENT

Abstract Introduction Prostate cancer (PCa) impacts patient lives beyond oncological concerns alone. PCa survivorship includes the mental, physical, sexual, emotional, and financial effects patients endure from time of diagnosis, through treatment, and beyond. For some, this includes decision regret (DR). We aim to determine survivor experiences and understanding from a functional perspective throughout survivorship. Objective Our objective was to describe the local experiences and perspectives of PCa survivors regarding their functional outcomes at both the pre and post treatment level. Additionally, we sought to investigate the relationship between patients’ understanding of sexual and urinary side effects of treatment as well as modality of care delivery (ie virtual or in person) and development of treatment DR. Methods This is a cross-sectional survey of survivors. Our survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Topics included erectile dysfunction (ED), penile shortening, urinary incontinence, and patient understanding throughout their care. Survey items included binary and Likert scale questions regarding patient understanding and treatment impact, as well as an open answered question asking how survivorship care may be improved. Responses were used identify predictors of DR. Results 514 patients received our survey with a response rate of 23.7% (n = 122). The average age of diagnosis and treatment were 65.2 and 65.9 respectively. Most common treatments included 63.9% radical prostatectomy (RP), 54.1% radiotherapy (RT), and 36.1% androgen deprivation therapy (ADT). 71.9% reported sexual health to be very or somewhat important, but 27.9% reported no pre-treatment discussion of potential ED. 14.9% reported lacking understanding of treatment impact on erections. 76.9% reported no counselling on penile shortening and 95.0% reported no counselling on climacturia, prior to treatment. 27.3% reported no pre-treatment discussion of urinary incontinence and 11.5% reported lacking understanding of treatment impact on urination. Predictors of DR included treatment with RP, and low pre-treatment understanding of potential ED and urinary incontinence. Common open answer responses included desire for more information regarding support groups, treatment side effects, and management of such. Conclusions PCa survivors are at high risk of DR. Virtual care does not seem to impact DR. However, the degree of pre-treatment understanding of treatment options and their functional impact does. Survivors are motivated to learn about their condition, requesting more information on treatments, side effects, and local support groups. Apart from PCa diagnosis and management, it is equally as important to discuss functional aspects. Disclosure No.

(097) IMPACT OF PROSTATE CANCER ON SEXUAL QUALITY OF LIFE FOR FEMALE PARTNERS OF PATIENTS

Abstract Introduction Prostate cancer diagnosis and treatment can have a significant impact on sexual quality of life for patients and their partners. We developed and validated a new instrument, the Sexual Concerns In Partners of Patients with Prostate cancer (SCIPPP-F), to measure sexual quality of life among female partners of patients with prostate cancer. Objective To examine scores on the SCIPPP-F questionnaire in 200 female partners from across the U.S. and factors associated with worse scores. Methods The SCIPPP-F survey includes 19 questions in 7 domains: 1) distress/satisfaction, 2) loss of connection as a couple, 3) active communication, 4) discomfort with communication, 5) frustration with sexual counseling, 6) expansion of sexual repertoire, and 7) non-penetrative sexual activity. All questions have 5 response choices (not at all, a little bit, somewhat, quite a bit, very much). Descriptive statistics were used to examine the distribution of survey responses, and the Mann–Whitney U test was used to compare median scores between subgroups of partners based on demographics and relationship characteristics. Results Results of the survey are shown in the table. More than half of partners (53%) felt their sex life is quite a bit or very much worse since the prostate cancer diagnosis and/or treatment, and 35% were not at all satisfied with their current sex life. Loss of intimacy was a common complaint. Additionally, approximately 1/3 of partners were at least somewhat uncomfortable talking to their partner about sexual problems and frustrated/angry about the lack of information they received about sexual health from clinicians, with 51 partners (26%) reporting that they were not at all prepared for sexual side effects. Notably, the majority of partners were at least somewhat comfortable trying new ways to achieve intercourse and at least somewhat satisfied with hugging, kissing, and other intimate activities rather than intercourse. There were no significant differences in median overall SCIPPP-F scores based on partners’ marital status, relationship length (&amp;gt;30 vs &amp;lt; =30 years), or menopausal status; however, there was a trend toward lower (better) SCIPPP-F scores among non-white partners (p = 0.07). Conclusions These results identify multiple actionable gaps in sexual quality of life for female partners of patients with prostate cancer, including a need for more comprehensive sexual counseling prior to treatment and interventions to improve sexual quality of life, such as individual/couples counseling and/or sex therapy. Funding acknowledgement: Department of Defense. Disclosure No.

Care for sexual health in oncology survey: Discussions about sexual health with people with cancer in the context of the obligation to provide informed consent

PurposeThe purpose of this paper is to describe the impacts of cancer treatment on sexual health in a sample of people who had been treated for mixed types of cancer; to describe discussions they had with professionals about sexual health that occurred during cancer care; and to consider the extent to which these discussions were sufficient to enable participants to give informed consent for the sexual side effect of cancer treatment. MethodA cross-sectional, online survey using a convenience sample of people with cancer was recruited via UK cancer charities. Eligibility criteria included having received treatment and follow-up care for any type of cancer in the UK during the previous 10 years. Univariate analysis was conducted using SPSS. Results136 people with cancer participated in this survey. The majority of participants reported having experienced a worsening of their sexual lives, which bothered them. Whilst 33.6% of the sample (n = 125) reported having discussed sexual health during their cancer care, only 5.4% reported that a healthcare professional initiated a pre-treatment discussion about the sexual side effects of cancer treatment. ConclusionsThese results suggest that the proportion of participants who were provided with sufficient information to give informed consent for the sexual side effects of cancer treatment was very low. This indicates that healthcare professionals may require specific advice on how to include this topic during the informed consent process.

A Study of Prevalence of Sexual Dysfunction in Patients Receiving Psychotropic Drugs

Background: Sexual dysfunction is the most common side effect associated with psychotropic drugs. It is a threat to patient’s quality of life and a major reason for non –compliance. Psychotropic agents can impair the sexual response in different ways due to their neurobiological mode of action. Prevalence rates of sexual side effects are extraordinarily difficult to estimate due to a variety of factors, such as the effect of the disorder being treated, co morbid disorders and baseline sexual dysfunction. Objectives: To study the association between sexual dysfunction and psychotropic drugs in patients using various psychotropic drugs like antidepressants, anti-psychotics, anti-cravings and anxiolytics. Methods: A cross sectional study was done among 200 patients. A self-designed semi structured questionnaire consisting of socio demographic details, relevant psychiatric history and Psychotropic – Related Sexual dysfunction questionnaire (PR Sex DQ – SALSEX) was used. The obtained data was entered in MS excel and analysed using SPSS software Results: Among 200 patients ,62.5% of males and 38.5% of females felt that their psychiatric medications were causing sexual side effects. Out of them 41.7% of men and 30.03 % of women. Conclusion: The most relevant groups for impairment are antidepressants and antipsychotics due to the serotonin agonistic and anti – dopaminergic properties as well as the prolactin increasing characteristics. The treatment of psychiatric disorders should follow a comprehensive treatment plan that anticipates a likely sexual dysfunction at the initiation of treatment.