Efficacy of Yougui pill combined with Buzhong Yiqi decoction in alleviating the sexual dysfunction in female rats through modulation of the gut microbiota.

CONTEXT: Yougui pill combined with Buzhong Yiqi decoction (YPBYD) is used to relieve sexual dysfunction in clinical practice. OBJECTIVE: To investigate changes in microbial composition caused by sexual dysfunction and identify dominant bacteria related to YPBYD treatment. MATERIALS AND METHODS: Female Sprague-Dawley rats were randomly divided into four groups (n = 6): one group underwent Sham operation (Sham group), while three groups underwent ovariectomy (one model and two treatment groups). The ovariectomized (OVX) rats received oestradiol benzoate (250 µg/kg/week) or YPBYD (3.6 mL/d) via oral gavage for 4 weeks. Vaginal smear assay was performed; the serum levels of cyclic adenosine monophosphate (cAMP) and oestradiol (E2) were measured, followed by collection of stool samples for 16S rRNA sequencing. RESULTS: After YPBYD treatment, the levels of E2 and cAMP in OVX rats significantly increased (E2: from 20.45 ± 1.60 ng/L to 24.38 ± 1.70 ng/L; cAMP: from 261.41 ± 9.21 pg/mL to 373.75 ± 17.37 pg/mL). OVX treatment decreased diversity of gut microbiota and YPBYD treatment restored gut microbiota composition. Compared with Sham group, the abundance of Romboutsia significantly increased, while those of Proteobacteria and Staphylococcus markedly decreased in OVX group (all p < 0.05); meanwhile, the abundance of these microbes showed an opposite trend after YPBYD treatment. These microbiotas were involved in tyrosine and tryptophan biosynthesis and fatty acid metabolism. DISCUSSION AND CONCLUSIONS: These findings are the first to indicate YPBYD can alleviate female sexual dysfunction by modulating gut microbiota in OVX rats, which will help enhance the understanding on potential mechanism of YPBYD against sexual dysfunction.

Treatment Outcomes of Vaginal Infections on Sexual Function.

Vaginal infections are the most common gynecological diseases and one of the causes of sexual dysfunction. In more than 50% of patients, sexual dysfunction is twice as common. Evaluation of the treatment outcome of vaginal infections can be effective in identifying factors related to the sexual function. This is a descriptive-observational study that included patients referred to Imam Sajjad Shahriar Hospital during 2017-2018. Patients that met the inclusion criteria (with vaginal infections of Candida, Gardnerella and mixed infections - Candida and Gardnerella - Mixed group) completed the Female Sexual Function Index (FSFI) questionnaire before and one month after treatment. Data were analyzed by SPSS 16, paired t-test, ANOVA, and multiple regression. P-value <0.05 was considered significant. After the treatment of vaginitis, there was a significant increase in all aspects of the FSFI questionnaire. The mean and standard deviation of sexual function of women before and after treatment were 18.26 ± 4.36 and 26.27 ± 4.97 in the Candida group, 20.06 ± 4.94 and 25.87 ± 5.32 in the Gardnerella group, and 19.69 ± 4.25 and 27.05 ± 5.12 in the Mixed group. Prior to treatment in the Mixed and Gardnerella group, the most important sexual dysfunction was related to the dyspareunia component, while in the Candida group, the most important sexual dysfunction was related to the desire component. After treatment, the components of dyspareunia in the Mixed and Gardnerella group and the orgasmic component in the Candida group showed the greatest improvement. The regression test showed that the effect of age, body mass index and duration of sex on sexual function was significant (P <0.05). Duration of the disease had the greatest impact on sexual dysfunction, and after treatment of the disease, sexual function improved significantly. Proper diagnosis and treatment are effective in improving women's sexual function. The results of this study can be promoted to midwives and gynecologists.

Microbiota potential for the treatment of sexual dysfunction.

Inability to have a satisfactory sexual intercourse is a serious problem affecting many people. Despite enormous efforts for developing effective treatments for pathologic conditions associated with sexual malfunction, still a lot of patients do not respond well to such treatments. Microbiota has been shown to affect obesity, diabetes, hypertension, stress/anxiety and sex hormonal disturbances. Nevertheless, no research has concentrated on the link between microbiota and human sexuality or sexual dysfunction. We propose another line of enquiry into sexual dysfunction by hypothesizing a relationship between microbiota and factors affecting human sexuality. Hence, it can be assumed that microbiota manipulation may improve sexual behavior and reduce sexual dysfunction. We also discuss the evidence to back up this hypothesis, and present some predictions.

Antibiotic treatment can delay ejaculation in patients with premature ejaculation and chronic bacterial prostatitis.

INTRODUCTION: Premature ejaculation (PE) is regarded as the most common male sexual disorder. Previous studies reported that prostatic inflammation was highly prevalent in PE. However, the effect of antibiotic treatment of cases with PE and chronic prostatitis has not been extensively investigated. AIM: To examine the effect of antibiotic treatment in delaying ejaculation in patients with PE and chronic prostatitis. METHODS: A total of 145 consecutive men attending of secondary premature ejaculation (SPE) were included in this study. Sequential microbiologic specimens were obtained from urine and prostatic fluid. Antibiotics were given for 1 month according to the results of their culture and sensitivity test. All patients were instructed to follow up with our clinic monthly for at least 4 months. At the end of the 4-month follow-up, another prostatic secretion analysis was performed. RESULTS: Based on expressed prostatic secretion culture and white blood cell (WBC) count, 94 (64.8%) were having chronic bacterial prostatitis. The remaining 51 (35.2%) patients had negative WBC count. Of the 94 patients with SPE and chronic bacterial prostatitis, 20 patients were left untreated and considered as a control group. All 74 patients with PE and chronic prostatitis continued the 1-month treatment duration. Following 1-month antibiotic treatment, all 74 patients with initially positive cultures had sterile final cultures (P < 0.05). Sixty-two (83.9%) patients showed increases in their ejaculatory latency time and reported good control of their ejaculation and were considered treatment responsive. None of the control group patients experienced any improvement either in their prostatic infection condition or in their ejaculation time. The follow-up of treatment-responsive patients (N = 62) revealed no recurrence of PE with negative prostatic culture. CONCLUSIONS: Successful eradication of causative organisms in patients with PE and chronic prostatitis may lead to marked improvement in intravaginal ejaculatory latency time and ejaculatory control.

Chronic prostatitis in premature ejaculation: a cohort study in 153 men.

INTRODUCTION: Premature ejaculation is a common male sexual dysfunction, affecting 30-40% of sexually active men in an age-dependent manner. Chronic prostatitis has been suggested as an important organic cause of premature ejaculation. AIM: The aim of this study was to confirm previous data reported on the incidence of chronic prostatitis in a large cohort of patients with primary and secondary premature ejaculation. METHODS: A total of 153 consecutive heterosexual men aged 29-51 years with premature ejaculation and another 100 male healthy subjects were included in this study. Sequential microbiologic specimens were obtained according to the standardized Meares and Stamey protocol. Nonbacterial prostatitis was defined by the evidence of prostatic inflammation but negative cultures of urine and prostatic fluids in men with various genitourinary symptoms. RESULTS: There was no significant difference between patients and control subjects regarding age, education, or intercourse frequency. Prostatic inflammation was found in 64% and chronic bacterial prostatitis in 52% of the patients with premature ejaculation, respectively, showing statistical significance compared with control subjects (P < 0.05). CONCLUSIONS: Results in our study showed a high prevalence of chronic prostatitis in patients with premature ejaculation. Examination of the prostate, physically and microbiologically, should be considered during assessment of patients with premature ejaculation.

Prevalence of chronic prostatitis in men with premature ejaculation.

OBJECTIVES: To investigate the prevalence of chronic prostatitis in men with premature ejaculation. The etiology of premature ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management. METHODS: We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with premature ejaculation and 30 controls by bacteriologic localization studies. The incidence of premature ejaculation in the subjects with chronic prostatitis was also evaluated. RESULTS: Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with premature ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P <0.05). CONCLUSIONS: Considering the role of the prostate gland in the mechanism of ejaculation, we suggest a role for chronic prostate inflammation in the pathogenesis of some cases of premature ejaculation. Since chronic prostatitis has been found with a high frequency in men with premature ejaculation, we stress the importance of a careful examination of the prostate before any pharmacologic or psychosexual therapy for premature ejaculation.