Disfunciones sexuales en las mujeres con endometriosis: estudio de prevalencia / Sexual dysfunctions in women with endometriosis: prevalence study

Antecedentes: En las mujeres con endometriosis, son frecuentes las disfunciones sexuales, particularmente el dolor/dispareunia. Objetivo: Evaluar y caracterizar la prevalencia de disfunciones sexuales en las mujeres con endometriosis en Armenia (Quindío), Colombia. Método: Estudio de corte transversal, en 137 mujeres mayores de 18 años con diagnóstico de endometriosis confirmada histológicamente, atendidas en tres clínicas de alta complejidad entre 2017 y 2022. Se utilizó como instrumento el Índice de Función Sexual Femenina (IFSF). Resultados: La edad promedio de las participantes fue de 34,68 ± 7,32 años. La prevalencia de disfunciones sexuales fue del 75,91%, caracterizando en primer lugar el dolor/dispareunia (75,91%), seguido de disminución del deseo sexual (56,93%) y en tercer lugar problemas de lubricación (54,01%). El promedio en la puntuación del IFSF fue de 20,82 ± 7,22 y la proporción de mujeres con puntuación ≥ 26,55 fue del 24,08%. La mediana en el número de disfunciones sexuales fue 3 (rango: 1 y 6). Conclusiones: En las mujeres con endometriosis se evidencia una alta prevalencia de disfunciones sexuales, equivalente a tres cuartas partes de las afectadas. Al momento de atender una mujer con este padecimiento se requiere evaluar sus efectos en la función sexual para poder implementar intervenciones terapéuticas oportunas.

Background: Sexual dysfunctions, particularly pain/dyspareunia, are common in women with endometriosis. Objective: To evaluate and characterize the prevalence of sexual dysfunctions in women with endometriosis in Armenia (Quindío), Colombia. Method: Cross-sectional study in 137 sexually active women older than 18 years with a diagnosis of histologically confirmed endometriosis, attended in three highly complex clinics between 2017 and 2022. The Female Sexual Function Index (FSFI) was used as an instrument. Results: The average age of the participants was 34.68 ± 7.32 years. The prevalence of sexual dysfunctions reported 75.91%, characterizing pain/dyspareunia in the first place (75.91%), followed by decreased sexual desire (56.93%) and thirdly problems of lubrication (54.01%). The average score of the FSFI was 20.82 ± 7.22; the proportion of women with a score ≥ 26.55 was 24.08%. The median in the number of sexual dysfunctions reached 3 (range: 1 and 6). Conclusions: In women with endometriosis there is evidence of a high prevalence of sexual dysfunctions, equivalent to three-quarters of the affected women. When caring for a woman with this condition, it is necessary to evaluate its effects on sexual function in order to implement timely and effective therapeutic interventions.

ZHAO Hongli's Experience in Diagnosing and Treating Male Infertility with Six Meridians / 浙江中医药大学学报

[Objective]To summarize the academic experience of Director ZHAO Hongli in the treatment of male infertility with six meridians syndrome differentiation.[Methods]By summarizing the clinical cases of male infertility treated by Director ZHAO and combining his interpretation of the six meridians syndrome differentiation,this paper summarizes Director ZHAO's experience in treating this disease with six meridians syndrome differentiation,fully elaborates the characteristics of the disease and the diagnosis and treatment ideas,and verifies and analyzes it with a typical medical case.[Results]Director ZHAO believes that male infertility has many clinical symptoms and can be treated with six meridians syndrome differentiation.The first step in syndrome differentiation is to distinguish between deficiency and excess.Those who belong to the excess category are based on the disease of the six Fu organs and Yang meridians,which are mostly three Yang disease patterns.Those who belong to the deficiency category are based on the disease of the five Zang organs and Yin meridians,which are mostly three Yin disease patterns.Director ZHAO carefully observes the pathogenesis and also establishes cold-heat complex type of male infertility,using Banxia Xiexin Decoction to communicate Yin and Yang.In terms of drug application,attention should be paid to patients'innate physique,combining Chinese and western medicine according to the characteristics of laboratory tests,advocating food therapy at the same time as medication,and paying attention to psychological counseling.In the case presented,the patient experienced erectile dysfunction after marriage,symptoms differentiation was of Yangming Channel syndrome.Treatment involved modified Gegen Qinlian Decoction to clear the Yangming heat,combined with Simiao Powder to clear damp-heat in lower-Jiao.After more than three months of comprehensive treatment based on the evolving symptoms,the patient's wife was successfully conceived.[Conclusion]Director ZHAO deeply verses in the classics,applies the six meridians syndrome differentiation to the treatment of male infertility innovatively,emphasizing individualized treatment based on syndrome differentiation,receiving remarkable efficacy,which offers a new perspective for both the clinical application of classical prescriptions and the treatment of male infertility.

Chronic Pain and Erectile Dysfunction: Mechanism, Treatment, and Future Perspective

@#Erectile dysfunction is a problem with multiple causes and is challenging to diagnose. Chronic pain has been associated with erectile dysfunction in some studies. Chronic pain can be a potential direct or indirect cause of sexual dysfunction. A decreased sexual desire due to restricted sexual activity in chronic pain can result in erectile dysfunction. Erectile dysfunction has been linked to migraines, chronic pain, and psychological factors. Multiple neurotransmitters may contribute to the pathophysiology of erectile dysfunction. Depression and anxiety, as well as painkillers like pregabalin and opioids, can be indirect causes of erectile dysfunction. Numerous factors affect the occurrence of erectile dysfunction; therefore, erectile dysfunction must be treated holistically.

The use of phosphodiesterase inhibitors in the treatment of female sexual dysfunction: scoping review

Abstract Objective The purpose of this study was to analyze the available evidence regarding the efficacy of iPDE5 in the treatment of female sexual dysfunction (FSD). Methods A comprehensive literature search was conducted in March 2023 through the main scientific databases. Results A total of 53 articles were identified, out of which, 6 met the predefined inclusion criteria. All of these were randomized controlled trials. Among the included studies, 4 demonstrated the effectiveness of sildenafil in improving sexual response and addressing FSD, while 2 studies failed to establish its efficacy in this context. Conclusion Overall, the efficacy of sildenafil in the treatment of FSD remains controversial and inconclusive based on the available evidence. Further research is necessary to clarify the therapeutic potential of iPDE5 in addressing FSD and to better understand the factors that influence treatment outcomes.

Prevalencia y caracterización de las disfunciones sexuales en mujeres en transición a la menopausia / Prevalence and characterization of sexual dysfunctions in women in transition to menopause

Objetivo: Caracterizar las disfunciones sexuales y estimar la prevalencia en un grupo de mujeres en transición a la menopausia, así como evaluar la frecuencia de la sintomatología climatérica. Método: Estudio de corte transversal, entre 2017 y 2020, que incluyó 411 mujeres en transición a la menopausia, residentes en el Quindío, con pareja estable y actividad sexual en las últimas 6 semanas. Se utilizó como instrumento el FSFI-6 (6-Item Female Sexual Function Index). Resultados: La edad promedio fue de 46,53 ± 2,87 años. La prevalencia de disfunciones sexuales fue del 38,92%, caracterizadas por dificultades con el deseo sexual (38,92%), seguido de dolor/dispareunia (35,52%). El promedio general en la puntuación del FSFI-6, en la totalidad de la población participante, fue de 22,29 ± 0,84 puntos; en la población afectada (< 19 puntos) fue de 15,78 ± 3,94. En los dominios, la puntuación más baja estuvo en el deseo (3,14 ± 0,56). La mediana de disfunciones sexuales por mujer fue de tres (23,84%). Conclusiones: más de un tercio de las mujeres del Quindío en transición a la menopausia presentan disfunciones sexuales; el trastorno más común fue el bajo deseo. Se deben hacer esfuerzos para aumentar la conciencia en los asuntos de salud sexual.

Objective: To characterize sexual dysfunctions and estimate the prevalence in a group of women in transition to menopause, as well as to evaluate the frequency of climacteric symptoms. Method: Cross-sectional study, between 2017 and 2020, included 411 women in transition to menopause, residents of Quindío, with a stable partner and sexual activity in the last 6 weeks. The FSFI-6 (6-Item Female Sexual Function Index) was used as an instrument. Results: The mean age was 46.53 ± 2.87 years. The prevalence of sexual dysfunctions was 38.92%, characterized by difficulties with sexual desire (38.92%), followed by pain/dyspareunia (35.52%). The general average, in the FSFI-6 score, in the entire participating population, was 22.29 ± 0.84 points; while in the affected population (< 19 points), it was 15.78 ± 3.94. In the domains, the lowest score was in desire (3.14 ± 0.56). The median number of sexual dysfunctions per woman was three (present in 23.84%). Conclusions: This study showed that more than one third of the women in Quindío, in transition to menopause, had sexual dysfunctions; the most common type of disorder was low desire. Efforts should be made to increase awareness about sexual health issues.

Calidad de vida laboral y riesgo de disfunción sexual en enfermeras

Las experiencias y relaciones personales insatisfactorias en el ámbito laboral se asocian a resultados negativos en el aspecto sexual. La disfunción sexual femenina (DSF) es la alteración de cualquiera de las fases del orgasmo. La calidad de vida laboral (CVL) es la percepción del trabajador entre las exigencias del trabajo y las técnicas de afrontamiento. Objetivo: Determinar la asociación entre la calidad de vida laboral y el riesgo de disfunción sexual femenina en enfermeras de un hospital público del Callao, Perú. Método: Estudio observacional, transversal y analítico realizado en enfermeras del Hospital Nacional Daniel Alcides Carrión (HNDAC) de la provincia Constitucional del Callao, Perú. El riesgo de DSF fue medido con la prueba de Rosen. La CVL fue medida con el cuestionario de CVP-35. El análisis estadístico se realizó con el programa STATA versión 15. Se consideró significativo un valor de p<0,05 con un IC de 95%. Resultados: El estudio contó con la participación de 168 enfermeras que respondieron de forma completa. Las dimensiones de CVL asociadas a DSF fueron apoyo directo (p=0,01), motivación intrínseca (p=0,003), la pregunta sobre desconexión de trabajo (p=0,007), el ingreso mensual (p=0,003), el estado civil (p=0,001) y consumo de alcohol (p=0,014). No hubo asociación en el análisis multivariado. Conclusión: En el presente estudio no existió una asociación entre las dimensiones de la calidad de vida laboral y el riesgo de disfunción sexual femenina ajustado por confusores.

Unsatisfactory personal experiences and relationships in the work environment are associated with negative sexual outcomes. Female sexual dysfunction (FSD) is the disturbance of any of the phases of orgasm. Quality of work life (QWL) is the worker's perception between work demands and coping techniques. Objective: To determine the association between quality of work life and the risk of female sexual dysfunction in nurses of a public hospital in Callao, Peru. Methods: Observational, cross-sectional, analytical study conducted in nurses of the Hospital Nacional Daniel Alcides Carrión (HNDAC) of the Constitutional province of Callao, Peru. The risk of FSD was measured with the Rosen test. CVL was measured with the CVP35 questionnaire. Statistical analysis was performed with the STATA version 15 program. A value of p<0.05 with a 95% CI was considered significant. Results: The study involved 168 nurses who responded completely. The dimensions of CVL associated with DSF were direct support (p=0.01), intrinsic motivation (p=0.003), the question on work disconnection (p=0.007), monthly income (p=0.003), marital status (p=0.001) and alcohol consumption (p=0.014). There was no association in the multivariate analysis. Conclusion: In the present study there was no association between dimensions of quality of work life and confounder-adjusted risk of female sexual dysfunction.

Associação da educação sexual, cinesioterapia e terapia manual no tratamento de mulheres anorgásmicas: um estudo de caso / Association of sex education, kinesiotherapy and manual therapy in the treatment of anorgasmic women: a case study

O orgasmo é o ápice da excitação sexual e, quando comumente não experienciado, denomina-se anorgasmia, segunda queixa sexual mais frequente entre mulheres. A fisioterapia é um recurso que visa beneficiar a qualidade de vida das mulheres anorgásmicas por meio da prevenção, reparação de função e tratamento de quadros álgicos. O estudo teve como objetivo avaliar os efeitos da associação das técnicas de cinesioterapia aplicada à musculatura do assoalho pélvico, massagem perineal e conscientização acerca da sexualidade das participantes. Os métodos utilizados foram educação sexual, massagem perineal e cinesioterapia associada ao uso da sonda uroginecológica New PelviFit Trainer, como biofeedback visual, para promover conscientização e estimar os efeitos sobre a condição da musculatura do assoalho pélvico de mulheres com relato de anorgasmia. O resultado obtido com o protocolo da associação das técnicas terapêuticas em mulheres com disfunção orgásmica apresentou melhora da função sexual feminina, aumento da força e do estado de relaxamento da musculatura do assoalho pélvico, avaliados pelo questionário Índice de Função Sexual Feminina, quantificados por meio da escala de Oxford modificada e da escala de avaliação de flexibilidade vaginal, respectivamente. Como conclusão, a aplicação das técnicas fisioterapêuticas aliadas ao tratamento humanizado, com enfoque na conscientização das mulheres, autopercepção corporal e manutenção da função sexual, promoveu melhora da disfunção sexual orgásmica. Apesar de necessário maior embasamento científico relativo ao tema, a presente abordagem para o tratamento em questão apresentou-se promissora e pertinente à base de dados. (AU)

Orgasm is the peak of sexual excitement, when not commonly experienced, it is called anorgasmia, second most frequent sexual complaint among women. Physiotherapy is a resource that aims to improve the quality of life of anorgasmics women through prevention, function repair and pain management. The purpose of the study was to evaluate the effects of kinesiotherapy techniques applied on the pelvic floor muscles, associated with perineal massage and the participants' sexual awareness. The methods used were sexual education, perineal massage, kinesiotherapy associated with the use of the New PelviFit Trainer urogynecological probe, as a visual feedback, to promove awearness and estimate its effects on the pelvic floor muscles condition in women reporting anorgasmia. The result obtained with the protocol of association of therapeutic techniques in women with orgasmic dysfunction showed improvement in the female sexual function, assessed by the Female Sexual Function Index questionnaire, increased strength and pelvic floor muscles relaxation, quantified using the Modified Oxford scale and the vaginal flexibility assessment scale, respectively. As a conclusion, the application of physiotherapeutic techniques combined with humanized treatment, with a focus on awareness of women, body self-perception and maintenance of sexual function, promoted improvement of orgasmic sexual dysfunction. Despite the need for a greater scientific basis on the subject, the present approach to the treatment in question was promising and relevant to the database. (AU)

Female sexual dysfunction in chronic obstructive pulmonary disease

Background: Sexual life of women with chronic obstructive pulmonary disease (COPD) can be affected by breathing difficulties, a decrease in functional status, depressive mood and fatigue. Objetive: To evaluate the sexual dysfunction in female COPD patients and the possible explanatory mechanisms or correlations between these conditions. Methods: The study included 70 female patients with COPD aged between 36-65 and 70 age-matched controls. All the subjects completed questionnaires for the Female Sexual Functional Index (FSFI), BECK depression inventory and, spirometry. Results: Statistically significant sexual dysfunction was noted in COPD patients compared to the non-COPD group (p0.005). In linear regression analysis determining depression, no statistically significant factor was found among age, number of comorbidities, and FEV1/ forced vital capacity (FVC) % predicted (p>0.05). In multivariable analysis, only fatigue during intercourse was found to be a statistically significant factor in predicting sexual dysfunction among factors like age, presence of comorbidities, duration of the disease, smoking status, FEV1%, m MRCpoints, 6-minutes walk test, BECK depression scores (p=0.008). Conclusion: Sexual dysfunction is reported in many COPD females and seems to be related not to spirometric measures or exercise capacity but to fatigue. Depression is also a common comorbidity, of which both disorders are often neglected.

Antecedentes: La vida sexual en mujeres con enfermedad pulmonar obstructiva crónica (EPOC) es afectada por dificultades respiratorias, disminución del estado funcional, estado de ánimo depresivo y fatiga. Objetive: Evaluar la disfunción sexual en mujeres con EPOC y posibles mecanismos explicativos de esas dos condiciones Métodos: Participaron 70 pacientes mujeres con EPOC, rango edad 36-65 años y 70 controles emparejados por edad. Todos los sujetos respondieron un cuestionario para el índice funcional sexual femenino e inventario de depresión de BECK, mas una espirometría. Resultados: Se observó disfunción sexual significativa en las pacientes con EPOC comparado con el grupo sin EPOC. Las puntuaciones del inventario de depresión BECK fueron significativamente inferiores a las del grupo control. No hubo correlación entre las puntuaciones del FSFI y la depresión BECK con las características de las "mujeres" (r=-0.055). No se encontraron diferencias significativas en edad, FEV1% y antecedentes de exacerbación del año anterior según la gravedad de la depresión. En la regresión lineal para determinar la depresión, no hubo ningún factor estadísticamente significativo entre edad, número de comorbilidades y FEV1/FVC% predicho. En el multivariado, sólo la fatiga durante el coito resultó ser un factor significativo para predecir la disfunción sexual entre factores como edad, presencia de comorbilidades, duración de la enfermedad, hábito tabáquico, FEV1%, m MRCpoints, prueba de la marcha de 6 minutos y puntuaciones de depresión de BECK. Conclusiones: La disfunción sexual parece no estar relacionada con las medidas espirométricas o la capacidad de ejercicio, pero si con la fatiga. La depresión es una comorbilidad frecuente, de la que a menudo se descuidan ambos trastornos.

Sexual dysfunction in Brazilian patients with multiple sclerosis / Disfunção sexual em pacientes brasileiros com esclerose múltipla

Abstract Background People with multiple sclerosis (PwMS) show an increased risk of sexual dysfunction (SD), both in women and men. Objective The aim of the present study was to apply the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and evaluate our results by comparing them with those in in the literature, as well as to assess the ease of applying the scale and the engagement of the patients in discussing the topic of sexuality. Methods We developed and applied a web-based Google form questionnaire that the respondents completed online, which included the MSISQ-19, for the assessment of sexual function. Baseline characteristics were reported as proportions and mean ± standard deviation (SD) or median ± interquartile range (IQR) as appropriate according to data distribution. Categorical variables were stratified by sex and compared with chisquared tests. Statistical analyses were performed using STATA v. 16 (StataCorp., College Station, TX, USA). Results Of the 621 respondents, 541 were included in the analysis. Among the patients with MS, a total of 347 (64.14%) exhibited SD. When stratified by gender, the frequencies of SD were not significantly different. Conclusion There is a high incidence of sexual dysfunction among PwMS and we need to identify the reasons for this and implement strategies to treat and counsel our patients. The MSISQ-19 can be used to help clinicians to assess sexual functioning in a quick and easy way and give patients the possibility to address this topic and receive appropriate help and support.

Resumo Antecedentes Pacientes com esclerose múltipla apresentam altas taxas de disfunção sexual em diversos estudos. Objetivo Avaliar a aplicação e resultados da ferramenta para avaliação de disfunção sexual em pacientes com Esclerose Multipla, Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), bem como comparar os resultados encontrados com a literatura já existente e ter a percepção do engajamento dos pacientes sobre o tema. Métodos Realizado através de questionário on-line na plataforma Google Forms, composto por questões sobre perfil demográfico e relacionadas à doença e o questionário MSISQ-19. Os dados demográficos e sobre a doença foram descritos como proporções e média ± desvio padrão (DP) ou mediana ± intervalo interquartil (IIQ). As variáveis categóricas foram estratificadas por sexo e comparadas com testes de qui-quadrado. As análises estatísticas foram realizadas no programa STATA v. 16 (StataCorp., College Station, TX, EUA). Resultados Um total de 621 pacientes responderam ao questionário, sendo inclusos na análise 541 respostas, após a aplicação dos critérios de elegibilidade. Um total de 347 (64,14%) pacientes apresentaram disfunção sexual, sem diferença entre os gêneros. Conclusão Disfunção sexual apresenta alta prevalência no grupo estudado, sendo necessário identificar as causas e implementar estratégias de tratamento. O MSISQ-19 é uma ferramenta fácil e rápida de ser aplicada, podendo ser utilizada para facilitar a comunicação com os pacientes sobre o tema, possibilitando assim o tratamento das disfunções sexuais nessa população.

Comparison of sexual functions in women with and without type 1 diabetes

SUMMARY OBJECTIVE: This study aimed to investigate female sexual function in patients with type 1 diabetes by comparing female sexual function index scores between women with and without type 1 diabetes. METHODS: A total of 62 women with type 1 diabetes and 69 age-matched women without diabetes but with similar backgrounds were enrolled in the patient and control groups, respectively. All participants were sexually active and had no systemic diseases other than diabetes in the patient group. RESULTS: The frequency of female sexual dysfunction was significantly higher, and the mean female sexual function index score was significantly lower in women with diabetes compared to the control group (p=0.01). There was a significant relationship between sexual dysfunction and duration of diabetes, glycosylated hemoglobin test, and body mass index (p<0.05). CONCLUSION: This study demonstrates that female sexual dysfunction is more common among women with type 1 diabetes than among women without type 1 diabetes. Patients with type 1 diabetes should be evaluated in terms of sexual health. Health professionals should give more attention to and provide guidance regarding sexual function in women with type 1 diabetes.

EVALUATION OF FEMALE SEXUAL DYSFUNCTION IN THE DIABETIC WOMEN IN A TERTIARY CARE MEDICAL COLLEGE AND HOSPITAL IN EASTERN INDIA

Background: In women, the evidences regarding the association between diabetes and sexual dysfunction are less conclusive as compared to males. Diabetes-induced vascular and nerve dysfunctions may impair the sexual response by producing structural and functional changes in the female genitalia. The present study is significant in this regard that it has been conducted among individuals hailing from urban, suburban and rural areas of the state of West Bengal making questionnaires in vernacular languages to reach maximum number of individuals possible. The data obtained was analysed statistically to derive conclusions. In this cross- Methods: sectional 100 female patients with type 2 diabetes mellitus attending the diabetes clinic in Endocrine OPD of Medical College and Hospital Kolkata were screened and included as the study population. Sexual dysfunctions in women was measured here using the standard questionnaire and the FSFI score <24 was taken as the criteria for accepting the presence of sexual dysfunction. The FSD score was compared against parameters like age, duration of diabetes, Body mass index (BMI), blood sugar (glycemic status) fasting and post-prandial , diabetes-related complications and addiction and prevalence was calculated. Prevalence of se Results : xual dysfunction in the study population is 51% showing association between diabetes and female sexual dysfunction.The prevalence of FSD was found to be maximum (75%) in the age group 41- 50years. Strong association of FSD with age is found as p-value is 0.002. the prevalence of FSD was maximum (92.31%) in the participants whose Duration of diabetes more than equal to 11 years. Very Strong association of FSD with Duration of diabetes is found as p-value < 0.001. The prevalence of FSD was found to be maximum (94.74%) in the group (19% of the study population) who are on insulin. Extremely strong association of FSD with insulin usage is found as p-value is 0.000. The prevalence of FSD was found to be maximum (71.43%) in the group (42% of the study population) who do not have controlled ppbg (>180 mg/dl). Quite strong association of FSD with ppbg control is found as p-value is 0.001. The prevalence of FSD was found to be maximum (72.5%) in the participants who were overweight.11% of the population is obese and in them prevalence of FSD is 63.64. Very strong association of FSD with BMI of the participant is found as p-value is 0.000.Major association of FSD was seen absent with addiction, OHA intake, micro and macrovascular compications in the patients. Of all the six domains evaluated to reach FSFI score, majority of the patients had decreased desire. Prevalence Conclusion: of sexual dysfunction in the study population is 51%. Longer duration of diabetes, inadequate diabetes control, insulin intake, obesity (higher BMI) and higher age of the participant has a role to play in the development of FSD as per this study. The ability to diagnose and treat FSD in unsuspecting diabetics will result in long term improvement in quality of life

Transsphenoidal surgery for prolactinomas in male patients: a retrospective study / 亚洲男科学杂志(英文版)

Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone <2.3 ng ml-1 was an independent predictor of improvement in erectile dysfunction. In conclusion, our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma. The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.

Current status and new progress of drug therapy for premature ejaculation / 现代泌尿外科杂志

Premature ejaculation (PE) is the most common male sexual dysfunction with a high incidence, which seriously affects the relationship between a husband and wife and family harmony. Drug therapy is a first-line treatment for PE patients with premature ejaculation, and has achieved good efficacy, but the clinically available drugs are single and the abandonment rate is high. Coupled with the ineffective treatment of some patients, new drug research and development is imminent. This paper systematically reviews the current status of drug treatment for premature ejaculation, focusing on the research and development of new drugs and research progress in order to provide a reference for clinicians.

TCM understanding and treatment strategy of hypertension complicated with sexual dysfunction / 中国中药杂志

Hypertension and its target organ damage have become a major public health problem. Sexual dysfunction is a new problem in the treatment of modern hypertension. Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction. In addition, three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction. In traditional Chinese medicine(TCM), hypertension belongs to "vertigo" "headache" "head wind", etc. In the past, the understanding of the TCM pathogenesis of hypertension was mainly from the perspectives of "liver wind" and "Yang hyperactivity". However, based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice, it has been identified that kidney deficiency was the key pathogenesis. Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM, especially the deficiency of kidney Yin. Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure, improve sexual dysfunction, reverse risk factors, and protect target organs. This article systematically discussed the TCM understanding, modern pathophysiological mechanism, and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds) in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.

Post-stroke sexual dysfunction / 国际脑血管病杂志

Sexual function is a basic component of adult life quality. Studies have shown that both men and women can experience sexual dysfunction after stroke. The prevalence of post-stroke sexual dysfunction is likely to be higher than expected. This article reviews the epidemiology, influencing factors, evaluation and intervention of post-stroke sexual dysfunction.

The risk factors of low anterior resection syndrome and its influence on psychological status and quality of life in rectal cancer patients / 中华普通外科杂志

Objective:To investigate the effects of low anterior resection syndrome (LARS) on psychological and physical function and quality of life in patients with rectal cancer.Methods:From May 2014 to May 2019, 200 patients were included. LARS scale score was adopted, and the clinical and pathological data were collected. Univariate analysis and multivariate Logistic regression analysis were performed. the European Organization for Research and Treatment of Cancer Quality of Life core questionnaire and psychological distress management screening tool survey were conducted to evaluate the quality of life and psychological state. The incidence of postoperative sexual dysfunction in male patients was analyzed.Results:The incidence of LARS was 43.0%. Multivariate analysis showed that body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance ≤5 cm from anal margin, and preoperative radiotherapy were independent risk factors for LARS ( OR=2.123, 15.109, 7.302, 12.682, all P<0.05).The overall health level and the scores of physical function and emotional function in the functional dimension of patients in the severe LARS group were significantly lower than those in the no/mild LARS group ( t=5.788, 8.831, 8.745, all P<0.05). The scores of fatigue and diarrhea were significantly higher than those in the no/mild LARS group ( t=26.280, 49.476, all P<0.05). The psychological distress thermometer score and the scores of communication , emotional and physical problems in the severe LARS group were significantly higher than those in the no/mild LARS group ( t=4.246, 6.563, 5.913, 4.408, all P<0.05). Conclusion:LARS is a common complication after Dixon procedure for rectal cancer. Body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance from anal margin ≤5 cm, and preoperative radiotherapy are independent risk factors for LARS.

More attention should be paid to rare male sexual dysfunction / 中华泌尿外科杂志

The World Health Organization defines sexual health as a state of physical, emotional, mental and social health related to sex, which is not just the absence of disease, dysfunction, etc. In clinical practice, in addition to common male sexual dysfunction such as erectile dysfunction and premature ejaculation, rare forms of male sexual dysfunction may also be encountered. Perhaps due to our lack of understanding of this type of disease, it is easy to overlook or miss diagnosis in clinical practice. Based on the latest literature reports and our clinical experience in diagnosis and treatment, this article elaborates on its definition, clinical symptoms, diagnosis and treatment, and possible pathogenesis. It is hoped that clinician can pay attention to and accurately diagnose rare male sexual dysfunction.

Incidence rate and protection strategy of sexual dysfunction after minimally invasive surgery for benign prostatic hyperplasia / 现代泌尿外科杂志

In recent years, minimally invasive surgery has been rapidly developed and has become the first choice for the treatment of moderate to severe benign prostatic hyperplasia (BPH). Although it can significantly improve the lower urinary tract symptoms, reduce complications, and enhance security, postoperative sexual dysfunction(SD) is still common, which affects the patients’ quality of life. In this paper, we discuss the incidence rate of SD after BPH surgery, the protection strategy of sexual function, and how to choose reasonable treatment from the perspective of sexual function protection.

Sexual dysfunction in women with type 2 diabetes mellitus: A single-centre cross-sectional study from Bangladesh

ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.

Evaluation of sexual function and depression in female patients with fibromyalgia

SUMMARY OBJECTIVE: Fibromyalgia is one of the most important problems, especially for women. Studies point to disorders in the sexual functions of fibromyalgia patients that reduce their quality of life. The aim of this study was to investigate sexual dysfunction and its relationship with disease severity and depression in women with fibromyalgia. METHODS: This study included 98 female patients diagnosed with fibromyalgia and 54 healthy women. The Female Sexual Function Index was used to assess sexual dysfunction. Fibromyalgia disease severity was measured with the Fibromyalgia Impact Questionnaire. Hamilton Depression Scale was filled in to evaluate the depression status of the patients. RESULTS: According to the female sexual function index data, female sexual dysfunction was found in 78 (79.6%) patients with fibromyalgia and only in 12 (22.2%) controls. When the female sexual function index scores of fibromyalgia patients with and without depression were compared, patients with additional depression had lower female sexual function index scores, and this difference was statistically significant (p=0.002). In the correlation analysis, the female sexual function index score showed a significant negative correlation with the hamilton depression scale (rho=-0.235, p=0.020) and fibromyalgia impact questionnaire (rho=-0.215, p=0.033) scores. CONCLUSION: This study highlights the high prevalence of sexual dysfunction in female fibromyalgia patients and the significant correlation between sexual dysfunction and both disease severity and depression.