The role of androgen in male sexual arousal / 中华男科学杂志

Sexual arousal is an important factor for the success of sexual behavior, and regulated by the central nervous system, its underlying mechanism is very complicated. Androgen is the most important endocrine hormone in men, which is deeply involved in the whole process of male sexual response, but how it regulates male sexual arousal has not been fully clarified and remains one of the hotspots in current andrological research. Therefore, this paper presents an overview of the advances in the studies of the related role and mechanism of androgen in male sexual arousal. In the central nervous system, androgen regulates the release of dopamine neurotransmitters by binding androgen receptors or metabolizing neurosteroids, thus activating the brain reward system. Besides, androgen regulates the neuronal plasticity and spinous process formation in the neural circuit of sexual arousal to ensure successful activation and conduction of the neural circuit. However, the specific regulating mechanism of sexual arousal remains to be further explored.

Prevalencia y factores asociados al deseo sexual hipoactivo en hombres del Quindío / Prevalence and Factors Associated with Hypoactive Sexual Desire in Quindío Men

Introducción El deseo sexual hipoactivo describe el bajo interés hacia la actividad sexual en general, caracterizando la escasa o nula motivación para tener relaciones eróticas, con disminución o ausencia de pensamientos o fantasías sexuales. Objetivo Evaluar la prevalencia y factores asociados, al deseo sexual hipoactivo en hombres del Quindío, así como estimar las demás disfunciones sexuales. Métodos Estudio observacional. La población estuvo constituida por 171 hombres que asistieron a consulta externa en una clínica universitaria de la ciudad de Armenia, Colombia, en el 2019. Se excluyeron los hombres menores de 18 años, residentes fuera del Quindío, situación psicopatológica o social que dificultara la comprensión del instrumento y los que no consintieron participar en el estudio. Se aplicó como instrumento el "Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ)". Se evaluaron las características socio-demográficas, estilos de vida, salud sexual y reproductiva, antecedentes y comportamiento sexual. Se hizo análisis descriptivo. Resultados La edad promedio fue de 41,79 ± 11,46 años (rango 18­81). La prevalencia de disfunciones sexuales en el grupo estudiado fue de 21,63%. La puntuación del MGH-SFQ fue de 14,61 ± 4,23 puntos (variación: 7,26 - 19,26). Se presentaron dificultades con el interés sexual (15,78%), excitación sexual (6,43%), orgasmo (8,77%), erección (21,63%) y satisfacción sexual global (12,28%). La mediana de disfunciones sexuales por hombre fue de 2, que se hizo presente en el 27,48% %. El análisis multivariado (regresión logística) mostró que los factores asociados al deseo sexual hipoactivo fueron testosterona baja (OR: 5,59; IC95% 1,82­18,37), ansiedad / depresión (OR: 5,53; IC95% 1,72­18,43), convivencia en pareja mayor a 10 años (OR: 5,19; IC95%: 2,71­11,71), ansiedad de desempeño (OR: 4,62; IC95% 1,95­10,56), incremento de la edad (OR: 3,42; IC95%: 1,26­9,36), cansancio / estrés (OR: 2,58; IC95%: 1,08­3,28), trastornos del sueño (OR: 1,89; IC95%: 1,35­2,58), conflictos de pareja (OR: 1,53; IC95%: 1,02­2,37) y antecedente de disfunciones sexuales (OR: 1,47; IC95%: 0,99­2,22); mientras que, el uso de juguetes sexuales (OR: 0,78; IC95%: 0,72­0,96; p = 0,021), consumo de vitamina D (2000 UI / diarias) (OR: 0,64; IC95%: 0,42­0,96) o de Inhibidores de fosfodiesterasa-5 (OR: 0,78; IC95%: 0,63­0,93) constituyeron factores protectores. Conclusiones En el presente estudio, el 21,63% de los hombres presentaron disfunciones sexuales. Los trastornos de la erección (21,63%) y el interés sexual (15,78%), fueron los más afectados. La testosterona baja, ansiedad / depresión y convivencia en pareja mayor a 10 años, encabezan los principales factores asociados al deseo sexual hipoactivo. El hacer actividades juntos (OR: 0,44; IC95%: 0,34­0,68), el respeto a ser personas diferentes (OR: 0,53; IC95%: 0,41­0,71), mantener la armonía en la pareja (OR: 0,61; IC95%: 0,47­0,79) y la expresión de sentimientos a la pareja (OR: 0,68; IC95%: 0,46­0,95) constituyen una línea de protección para mejorar las estrategias de prevención de los trastornos sexuales en esa población

Introduction Hypoactive sexual desire describes the low interest in sexual activity in general, characterizing the little or no motivation to have erotic relationships, with a decrease or absence of sexual thoughts or fantasies. Objective To determine the sexual dysfunctions and to evaluate the prevalence and associated factors, to the hypoactive sexual desire in men of Quindío. Methods Observational study. The population consisted of 171 men who attended an outpatient clinic at a university clinic in the city of Armenia, Colombia, in 2019. Men under 18 years of age, residents outside of Quindío, psychopathological or social situation that made understanding difficult, were excluded of the instrument and those who did not consent to participate in the study. The "Massachusetts General Hospital-Sexual Functioning Questionnaire (MGH-SFQ)" was applied as an instrument. Socio-demographic characteristics, lifestyles, sexual and reproductive health, background and sexual behavior were evaluated. Descriptive analysis was done. Results The average age was 41.79 ± 11.46 years (variation: - 81). The prevalence of sexual dysfunctions in the study group was 21.63%. The MGH-SFQ score was 14.61 ± 4.23 points (range between 7.26 - 19.26). There were difficulties with sexual interest (15.78%), sexual arousal (6.43%), orgasm (8.77%), erection (21.63%) and overall sexual satisfaction (12.28%). The median sexual dysfunction per man was 2, which was present in 27.48%%. The multivariate analysis (logistic regression) showed that the factors associated with hypoactive sexual desire were low testosterone (OR: 5.59; 95% CI 1.82­18.37), anxiety / depression (OR: 5.53 ; 95% CI 1.72­18.43), cohabitation in a couple older than 10 years (OR: 5.19; 95% CI: 2.71­11.71), performance anxiety (OR: 4.62; 95% CI 1.95­10.56), increase in age (OR: 3.42; 95% CI: 1.26­9.36), fatigue / stress (OR: 2.58; 95% CI: 1.08­3, 28), sleep disorders (OR: 1.89; 95% CI: 1.35­2.58), couple conflicts (OR: 1.53; 95% CI: 1.02­2.37) and a history of sexual dysfunctions (OR: 1.47; 95% CI: 0.99­2.22); while, the use of sex toys (OR: 0.78; 95% CI: 0.72­0.96; p = 0.021), vitamin D consumption (2000 IU / daily) (OR: 0.64; 95% CI: 0.42­0.96) or of phosphodiesterase-5 inhibitors (OR: 0.78; 95% CI: 0.63­0.93) constituted protective factors. Conclusions In the present study, 21.63% of men had sexual dysfunction. Disorders of erection (21.63%) and sexual interest (15.78%) were the most affected. Low testosterone, anxiety / depression and coexistence in a couple older than 10 years, lead the main factors associated with hypoactive sexual desire. Low testosterone, anxiety / depression and coexistence in couples older than 10 years, are the main factors associated with hypoactive sexual desire. Doing activities together (OR: 0.44, 95% CI: 0.34­0.68), respect for being different people (OR: 0.53, 95% CI: 0.41­0.71), maintaining harmony in the couple (OR: 0.61; 95% CI: 0.47­0.79) and the expression of feelings toward the couple (OR: 0.68; 95% CI: 0.46­0.95) constitute a protection line to improve prevention strategies for sexual disorders in this population.

Disfunções sexuais nos três trimestres gestacionais / Sexual dysfunction in three gestational trimesters

Introdução: Dificuldades sexuais são bastante frequentes durante a gestação, pelas mudanças hormonais e emocionais deste período.Objetivo: Avaliar a prevalência de disfunções sexuais nos três trimestres gestacionais. Métodos: Pesquisa observacional com 140 mulheres de 7 unidades básicas de saúde de um município do interior do RS. Foram aplicadosuma ficha de avaliação e o Female Sexual Function Index. Foi realizada a estatística descritiva para representação dos grupos e o teste de normalidade de Kolmogorov-Smirnov para os testes de hipóteses com nível de significância de 5%. Resultados: Houve alta prevalência de disfunção sexual, com diferença entre o primeiro e o segundo trimestres (p 0,018), e entre o primeiro e o terceiro trimestres (p 0,014). Conclusão: Houve alta prevalência de disfunção sexual (33,04%), sendo os domínios mais afetados a satisfação (100%), lubrificação (94,69%), orgasmo (94,59%) e excitação (91,89%). Identificou-se aumento das disfunções sexuais com a evolução da gestação.

Introduction: Sexual difficulties are quite frequent during gestation, due to the hormonal and emotional changes of this period. Objective: To evaluate the prevalence of sexual dysfunction in the three gestational trimesters. Methods: Observational research with 140 women from 7 basic health units of a municipality in the interior of RS. An evaluation form and the Female Sexual Function Index were applied. Descriptive statistics were performed for group representation and the Kolmogorov-Smirnov normality test was used for hypothesis tests with a significance level of 5%. Results: There was a high prevalence of sexual dysfunction, with a difference between the first and second quarters (p 0.018), and between the first and third quarters (p 0.014). Conclusion: There was a high prevalence of sexual dysfunction (33.04%), with satisfaction (100%), lubrication (94.69%), orgasm (94.59%) and excitation (91.89%) being the most affected domains. It was identified an increase of the sexual dysfunctions with the evolution of the gestation.