Sexual Medicine最新文献

{"title":"Causal association between statin use and erectile dysfunction: a 2-sample Mendelian randomization study.","authors":"Wu Wensong, Fang Dengpan, Xu Jianxin, Wang Yiwei, Chen Fangmin","doi":"10.1093/sexmed/qfag048","DOIUrl":"10.1093/sexmed/qfag048","url":null,"abstract":"<p><strong>Background: </strong>The impact of statins on erectile dysfunction (ED) remains a subject of intense clinical debate. Previous observational studies have yielded inconsistent results and are often limited by confounding factors and reverse causation.</p><p><strong>Methods: </strong>To investigate the causal relationship between statin use and ED risk through a 2-sample Mendelian randomization (MR) analysis of genome-wide association study summary data from the UK Biobank and FinnGen. Genetic variants for general statins and specific types (atorvastatin, simvastatin, and rosuvastatin) were utilized as instrumental variables. The primary effect was estimated using the inverse variance weighted (IVW) method. Sensitivity analyses, including MR-Egger, weighted median, and MR-PRESSO, and leave-one-out analyses, were conducted to ensure the robustness of the findings, alongside the MR Steiger directionality test to validate causal orientation.</p><p><strong>Results: </strong>IVW analysis demonstrated that general statin use is associated with a higher risk of ED (OR = 1.064; 95% CI, 1.011-1.119; <i>P</i> = .018). Subgroup analysis revealed that lipophilic statins significantly increased ED risk: atorvastatin (OR = 27.892; 95% CI, 1.912-40.977; <i>P</i> = .015) and simvastatin (OR = 4.948; 95% CI, 1.598-15.319; <i>P</i> = .006). In contrast, no causal relationship was found for hydrophilic rosuvastatin (<i>P</i> = .428). Sensitivity analyses confirmed the absence of horizontal pleiotropy and heterogeneity. The MR Steiger directionality test confirmed that the causal direction from statin use to ED was robust. Additionally, the leave-one-out analysis demonstrated that the overall results were not driven by any single SNP.</p><p><strong>Conclusion: </strong>Statin use, particularly atorvastatin and simvastatin, causally increases the risk of ED, whereas rosuvastatin appears to have a neutral effect.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag048"},"PeriodicalIF":2.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tampon test measurement properties in women with provoked vestibulodynia: baseline data from a pragmatic randomized clinical trial.","authors":"Slawomir Wojniusz, Kristine Grimen Danielsen, Mette Bøymo Kaarbø, Anne Lise Ording Helgesen","doi":"10.1093/sexmed/qfag051","DOIUrl":"10.1093/sexmed/qfag051","url":null,"abstract":"<p><strong>Introduction: </strong>Provoked vestibulodynia (PVD) is a common cause of dyspareunia in young women. Because intercourse-related pain cannot be assessed consistently in all affected women, the tampon test (TT) is often used as a standardized proxy for insertional pain. This study aimed to evaluate within-person variability, measurement precision, and convergent validity of the TT, and to describe baseline sociodemographic and clinical characteristics of women enrolled in a pragmatic randomized clinical trial of PVD.</p><p><strong>Methods: </strong>Women aged 18-35 years with diagnosed PVD completed baseline questionnaires and 3 standardized TT assessments over 1 week. TT pain was rated on a 0-10 numerical rating scale (NRS). Baseline characteristics were described for the total sample and stratified by PVD onset type. Systematic change across TT repetitions, minimal detectable change at the 95% confidence level (MDC95), and correlations between TT pain and recalled pain during last intercourse were examined.</p><p><strong>Results: </strong>Eighty-six participants completed baseline assessment. Median age was 26.5 years, median symptom duration was 6.0 years, and 40% had primary PVD. Participants showed substantial symptom burden, including impaired sexual function, elevated psychological distress, and reduced health-related quality of life. Women with primary PVD reported higher TT pain than women with secondary PVD, whereas most other baseline characteristics were similar. Mean TT pain decreased slightly across repetitions from 5.1 to 4.6, although approximately 30% of participants showed fluctuations of ≥2 NRS points. Measurement precision improved when repeated TT scores were averaged: MDC95 decreased from 3.8 for a single TT to 2.7 for the mean of two tests and 2.2 for the mean of three tests. TT pain correlated moderately with pain during last intercourse (r = 0.46-0.49).</p><p><strong>Discussion: </strong>Women enrolled in this pragmatic PVD trial showed substantial symptom burden and clinical heterogeneity. Repeated TT assessments improved measurement precision and may therefore be preferable when insertional pain is used as an outcome in longitudinal PVD studies, particularly when evaluating within-person change or individual treatment response. TT pain showed partial convergent validity with recalled intercourse pain, but the 2 measures should not be considered interchangeable.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag051"},"PeriodicalIF":2.4,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude of adolescent sexual activity and its associated factors among selected secondary school student in Addis Ketema Sub-city, Addis Ababa, Ethiopia.","authors":"Elias H Babeta, Hussen M Asfaw, Getahun T Dibaba","doi":"10.1093/sexmed/qfag044","DOIUrl":"10.1093/sexmed/qfag044","url":null,"abstract":"<p><strong>Introduction: </strong>Early sexual debut poses significant risks to adolescent health. This study investigated the prevalence and factors associated with adolescent sexual activity among secondary school students in Addis Ketema, Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>A quantitative cross-sectional study was conducted using self-administered questionnaires from November to December 2021. Data were analyzed using frequency distributions and logistic regression. The primary outcomes were the prevalence of adolescent sexual activity and the adjusted odds ratios (AOR) for its significant associated factors.</p><p><strong>Results: </strong>The prevalence of adolescent sexual activity was 17.3%, with a majority being male (77%). The most common reason for initiation was self-desire (36.1%). Significant predictors were having a boyfriend/girlfriend (AOR = 4.58), alcohol consumption (AOR = 5.42), school type (AOR = 3.15), and watching pornography (AOR = 21.25).</p><p><strong>Discussion: </strong>A considerable prevalence of adolescent sexual activity exists in this setting, driven by identifiable relational, behavioral, and environmental factors. Key strengths include direct measurement of a sensitive public health issue. Limitations comprise potential social desirability bias in self-reported data, limited qualitative depth, and possible underreporting due to parental consent requirements for minors. Targeted interventions should address modifiable risk factors, particularly pornography consumption and substance use, to reduce early sexual activity.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag044"},"PeriodicalIF":2.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of sexual function after obstetric anal sphincter injury: a 12-year follow-up cohort study.","authors":"David Baud, Maud de Rham, Karine Lepigeon, Chahin Achtari, Baptiste Tarasi","doi":"10.1093/sexmed/qfag047","DOIUrl":"10.1093/sexmed/qfag047","url":null,"abstract":"<p><strong>Introduction: </strong>Obstetric anal sphincter injuries (OASIS) may lead to pelvic floor complications, including sexual dysfunction. While short- and medium-term studies have reported increased dyspareunia and decreased sexual pleasure, desire, lubrication, and orgasm ability following OASIS, evidence on long-term sexual function remains limited.</p><p><strong>Aims: </strong>This longitudinal follow-up cohort study aimed to assess sexual function 12 years after vaginal delivery in women with and without OASIS, and to evaluate its evolution over time.</p><p><strong>Methods: </strong>The questionnaire used in our previous study, including patients' sociodemographic characteristics and the Female Sexual Function Index (FSFI), was mailed to the same cohort of women previously included in a case-control study. The FSFI is a validated questionnaire assessing female sexual function across 6 domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. Mean FSFI total scores, domain scores, and individual item scores were compared between women with and without OASIS. Changes in sexual function were also evaluated in comparison with the results obtained 6 years after the index delivery.</p><p><strong>Results: </strong>Completed questionnaires were returned by 52 women in the OASIS group and 141 women in the control group, with an overall participation rate of 79.8%. Mean FSFI total scores and domain scores were similar between women with and without OASIS. However, lubrication during sexual activity for less than half of the time (19.6% vs 8.5%, <i>P</i> = .033) and pain during vaginal penetration for about half of the time or more (13.7% vs 5.0%, <i>P</i> = .041) were reported more frequently in women with OASIS. In contrast to findings at 6 years, difficulty reaching orgasm was no longer significantly different between groups (10.0% vs 5.0%, <i>P</i> = .212). No significant changes were detected over time in individual FSFI items, domain scores, or total score.</p><p><strong>Conclusion: </strong>Overall sexual function does not appear to differ between women with and without OASIS 12 years after vaginal delivery. However, women with OASIS continue to report more frequent pain during vaginal penetration and reduced lubrication during sexual activity in the long term.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag047"},"PeriodicalIF":2.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burdens of human papillomavirus-associated cervical cancer attributable to sexually acquired human papillomavirus infections among individuals aged 10-54 years from 1990 to 2021: findings from the Global Burden of Disease study 2021.","authors":"Pengkhun Nov, Duanyu Wang, Minghao Tan, Vicheth Virak, Xiaofang Zhou, Kun Liu, Youwen Zhu, Shishan Zhou, Hong Zhu","doi":"10.1093/sexmed/qfag045","DOIUrl":"10.1093/sexmed/qfag045","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) infections that cause cervical cancer (CC) are transmitted through sexual contact. Certain sexual behaviors influence the risk of HPV acquisition and transmission.</p><p><strong>Aim: </strong>This study aimed to evaluate the global burden, temporal trends, and future projections of CC attributable to sexually acquired HPV infections among individuals aged 10-54 years to optimize prevention strategies.</p><p><strong>Methods: </strong>Data were extracted from the Global Burden of Disease (GBD) Study 2021. We analyzed deaths and disability-adjusted life years (DALYs) associated with CC linked to sexual transmission of HPV in the 10-54 age-group, stratified by age, Sociodemographic Index, and GBD region. The estimated annual percentage change was utilized to analyze trends from 1990 to 2021. Furthermore, Autoregressive Integrated Moving Average (ARIMA) models were applied to predict the disease burden trajectory through 2050.</p><p><strong>Outcomes: </strong>The primary outcomes assessed were the absolute counts and age-standardized rates (ASRs) of CC-related deaths and DALYs attributed to sexual transmission of HPV.</p><p><strong>Results: </strong>In 2021, there were 117 060 (95% uncertainty interval [UI], 106 690-128 467) CC deaths and 5 572 161 (95% UI, 5 057 538-6 116 191) DALYs globally among individuals aged 10-54 due to sexually acquired HPV infections. While the absolute numbers of deaths and DALYs increased by 23.9% and 23.1%, respectively compared to 1990, the age-standardized death and DALY rates significantly declined to 2.31 and 110.12 per 100 000. India and China bore the highest absolute burden, whereas Southern sub-Saharan Africa exhibited the highest standardized rates. Conversely, the Middle East and North Africa region reported the lowest burden. ARIMA models predict an increasing global burden in this demographic between 2021 and 2050.</p><p><strong>Clinical implications: </strong>Targeted public health policies and increased HPV vaccination coverage are urgently required, particularly in high-burden, low- and middle-income regions, to counteract the projected rise in CC cases associated with sexual transmission of HPV.</p><p><strong>Strengths and limitations: </strong>This study provides valuable insights into the HPV-associated burden of CC over 3 decades; however, it is limited by the GBD's reliance on a standardized risk factor definition that may not capture all local behavioral nuances, potential underreporting in historical data due to undeveloped registry systems, reliance on modeling for data-scarce regions, and incomplete global data on HPV vaccine coverage.</p><p><strong>Conclusion: </strong>While ASRs of CC associated with sexually acquired HPV are declining, the absolute burden remains substantial and geographically disparate, highlighting the need for sustained global intervention.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag045"},"PeriodicalIF":2.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between obstructive sleep apnea and sex hormones in U.S. adult males: a population-based study.","authors":"Yuan Ji, Pengbo Hua, Haoyue Gao, Qiming Liang, Jingqing Wu, Liwei Peng, Jingqi Wang","doi":"10.1093/sexmed/qfag042","DOIUrl":"10.1093/sexmed/qfag042","url":null,"abstract":"<p><strong>Background: </strong>The relationship between obstructive sleep apnea (OSA) and comprehensive sex hormone profiles, including free testosterone, in men remains unclear.</p><p><strong>Aim: </strong>This study aimed to explore the independent association between OSA risk and a panel of sex hormone indices after adjusting for obesity.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 2218 adult males from the National Health and Nutrition Examination Survey 2015-2016. OSA was assessed using an adjusted multivariable apnea prediction index and categorized into tertiles. Sex hormones were measured via isotope dilution liquid chromatography-tandem mass spectrometry and immunoassays. Associations were examined using weighted multivariable linear and logistic regression, adjusted for demographics, and clinical factors. Restricted cubic spline and mediation analyses were performed to assess nonlinearity and the mediating role of sex hormone-binding globulin.</p><p><strong>Outcomes: </strong>Primary outcomes were total testosterone, sex hormone-binding globulin, and free androgen index; secondary outcomes included estradiol, total testosterone/estradiol ratio, and testosterone deficiency prevalence.</p><p><strong>Results: </strong>In fully adjusted models, higher OSA risk was significantly associated with lower ln(total testosterone) (<i>β</i> = -0.23, 95% CI, -0.40 to -0.06) and ln(sex hormone-binding globulin) (<i>β</i> = -0.49, 95% CI, -0.66 to -0.31). No significant association was found with free testosterone or estradiol. Testosterone deficiency prevalence was markedly higher in the high-risk OSA group (43.83%) versus the low-risk group (12.70%), with a borderline significant association for the continuous OSA score (OR = 3.85, <i>P</i> = .04). Sex hormone-binding globulin mediated a substantial proportion of the OSA-total testosterone relationship (<i>P</i> < .001).</p><p><strong>Clinical implications: </strong>Routine screening for sex hormone-binding globulin in obese OSA patients may help prevent misdiagnosis of hypogonadism and guide targeted intervention.</p><p><strong>Strengths and limitations: </strong>Strengths include a nationally representative sample and comprehensive hormone profiling; limitations include the cross-sectional design and subjective OSA assessment.</p><p><strong>Conclusion: </strong>OSA risk is associated with a hormonal profile of low total testosterone and sex hormone-binding globulin but preserved free testosterone, a relationship strongly moderated by body mass index.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag042"},"PeriodicalIF":2.4,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual function and its associations with anxiety, depression, functionality, and quality of life in women with lipedema.","authors":"Hatice Betigül Meral, Sena Tolu, Bengisu Meral Ketenci, Zeynep Noyan, Aylin Rezvani","doi":"10.1093/sexmed/qfag041","DOIUrl":"10.1093/sexmed/qfag041","url":null,"abstract":"<p><strong>Background: </strong>Lipedema is a chronic adipose tissue disorder primarily affecting women, characterized by abnormal fat accumulation, pain, and reduced mobility. Its impact on sexual function remains underexplored. This study aimed to evaluate sexual function in women with lipedema and examine its associations with anxiety, depression, lower extremity function, and quality of life.</p><p><strong>Methods: </strong>In this cross-sectional study, 100 sexually active women were recruited: 50 with lipedema and 50 age- and Body Mass Index-matched healthy controls. Sexual function was assessed with the Female Sexual Function Index (FSFI); anxiety and depression with the Hospital Anxiety and Depression Scale (HADS-A and HADS-D); quality of life with the EuroQOL 5-Dimensional 5-Level (EQ-5D-5L) instrument; lower extremity function with the Lower Extremity Functional Scale (LEFS); and pain intensity with the Visual Analog Scale (VAS). Multiple linear regression analysis was conducted to identify the factors associated with the total FSFI score.</p><p><strong>Results: </strong>Women with lipedema had significantly lower total FSFI scores compared to controls (21.58 ± 3.99 vs. 25.86 ± 3.21, <i>P</i> < .001), with 76% having FSFI scores below the cut-off (≤ 26.55) compared to 36% of controls. All FSFI domain scores were significantly lower in the lipedema group (all <i>P</i> < .05). In the lipedema group, there was a significant correlation between total FSFI scores and age (<i>P</i> = .002), pain intensity (VAS; <i>P</i> = .022), depression (HADS-D; <i>P</i> = .010), quality of life (EQ-5D-5L index; <i>P</i> = .027), and lower extremity function (LEFS; <i>P</i> < .001). Multiple linear regression analysis identified depression (HADS-D; <i>P</i> = .047), perceived health status (EQ-5D-5L VAS; <i>P</i> = .033), and lower extremity function (LEFS; <i>P</i> = .011) as independent variables that had a significant relationship with the total FSFI score.</p><p><strong>Discussion: </strong>Lower sexual function is common among women with lipedema and is associated with anxiety and depressive symptoms, lower extremity function, and pain intensity. These findings highlight the importance of incorporating sexual function assessment into the routine evaluation of patients with lipedema and support the need for comprehensive multidisciplinary treatment approaches addressing physical, psychological, and sexual health aspects of care.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag041"},"PeriodicalIF":2.4,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis and prediction of sexual well-being variables in men with and without lifelong premature ejaculation in a non-western context.","authors":"Azamjon Makhmudov, Azamjon Tulaboev, David L Rowland, Sarvar Aliev, Jamshid Rikhsiboyev","doi":"10.1093/sexmed/qfag039","DOIUrl":"10.1093/sexmed/qfag039","url":null,"abstract":"<p><strong>Background: </strong>Premature ejaculation (PE) is often viewed as couples' problem, with research increasingly emphasizing the importance of evaluating the man's PE in the context of partner variables as a meaningful outcome in PE management.</p><p><strong>Aim: </strong>To describe and compare differences in self and perceived partner sexual well-being in men with lifelong PE (LPE) and men without PE, and further, to understand the role of various PE symptoms (ejaculatory control, ejaculatory latency [EL], consistency of symptomology) on sexual well-being specifically within the LPE group.</p><p><strong>Methods: </strong>One thousand two hundred sixty-five men visiting a urology clinic in Uzbekistan responded to validated items asking about the intensity of PE symptoms, their sex-related distress/bother, and the perceived dissatisfaction of their partner. Regression modeling was used to identify salient predictors of sexual well-being related to both the man himself and his partner.</p><p><strong>Outcomes: </strong>Predictors of sexual well-being in both the overall sample (LPE and non-PE men) and in just the LPE group.</p><p><strong>Results: </strong>Although both LPE (n = 187) and non-PE (n = 990) men from this clinical sample showed negative effects of urologic symptomology on their well-being, PE men's well-being was diminished even further (<i>P</i> < .001, all measures). The strongest predictors of diminished well-being in the overall clinical sample were, in order of effect size, consistency of the PE problem, lack of ejaculatory control, and short ELs (<i>R</i> ² = .416-.197). The strongest predictor of diminished well-being within the LPE group was consistency of the PE problem, with EL playing a lesser or non-significant role (<i>R</i> ² = .167-.006).</p><p><strong>Clinical translation: </strong>In addition to managing PE symptoms, clinicians should help patients and their partners explore ways to address the effects of PE symptomology on their sexual well-being.</p><p><strong>Strengths and limitations: </strong>The well-validated items, multifactorial definition of groups, multiple sexual-well-being outcome variables, and well-powered analyses represented study strengths. The lack of the partner's own assessment of sexual dissatisfaction and the lack of contextual factors such as relationship satisfaction, sexual interest, and partner sexual functioning prevented a more comprehensive view regarding patient and partner well-being.</p><p><strong>Conclusion: </strong>Men with PE report greater negative effects on sexual well-being than men with other urological problems, with consistency of the PE problem standing out as the strongest factor associated with diminished sexual well-being and poor ejaculatory control and short ELs playing a lesser role. Findings highlight the importance of treatment that addresses the psychosexual well-being of both the man and his partner.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag039"},"PeriodicalIF":2.4,"publicationDate":"2026-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between visceral adiposity index and arteriogenic erectile dysfunction: a multicenter cross-sectional study.","authors":"Yangyang Mei, Hu Zhao, Nuo Ji, Yu Liu, Guoyang Zhang, Yiming Chen, Renfang Xu, Wei Zhang, Hao Lu, Dong Xue, Qianfeng Zhuang, Xingliang Feng","doi":"10.1093/sexmed/qfag015","DOIUrl":"10.1093/sexmed/qfag015","url":null,"abstract":"<p><strong>Background: </strong>Arteriogenic erectile dysfunction (AED) is a common form of erectile dysfunction (ED) associated with vascular dysfunction. Visceral adiposity, reflected by the Visceral Adiposity Index (VAI), is a known risk factor for metabolic disorders, but its role in AED remains unclear.</p><p><strong>Aim: </strong>This study aimed to explore the association between VAI and AED and investigate whether total testosterone (TT) mediates this relationship.</p><p><strong>Methods: </strong>A total of 216 men, including 111 patients with AED and 105 controls, were enrolled from 3 hospitals. AED was diagnosed using a stepwise approach, including abnormal nocturnal penile tumescence and rigidity testing (NPTR) and confirmatory penile color Doppler duplex ultrasonography (CDDU). Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of VAI for identifying AED. Multivariate logistic regression was used to identify independent risk factors for AED. A multiple mediation analysis was performed to evaluate the indirect effect of TT in the VAI-erectile function relationship using the PROCESS macro in SPSS.</p><p><strong>Outcomes: </strong>VAI was calculated using a formula: VAI (men) = [waist circumference (WC)/(39.68 + (1.88 × body mass index (BMI))] × (triglycerides (TG)/1.03) × (1.31/high-density lipoprotein cholesterol (HDL-C)). Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5).</p><p><strong>Results: </strong>The AED group had significantly higher VAI values than controls (1.92 [0.72-3.11] vs 1.37 [0.79-1.95], <i>P</i> < .001). Multivariate logistic regression analysis identified VAI as an independent predictor of AED (OR = 2.548, 95% CI, 1.892-4.017, <i>P</i> < .001). ROC analysis demonstrated that VAI had good diagnostic performance for identifying AED, with an area under the curve (AUC) of 0.704 (95% CI, 0.635-0.774, <i>P</i> < .001). Mediation analysis showed that TT partially mediated the relationship between VAI and erectile function, explaining approximately 23% of the total effect.</p><p><strong>Clinical implications: </strong>These findings highlight the importance of visceral adiposity and TT levels in the pathophysiology of AED, providing insights for potential therapeutic interventions.</p><p><strong>Strengths and limitations: </strong>This multicenter study used standardized NPTR followed by penile CDDU to objectively define AED. VAI provided an integrated measure of visceral adiposity beyond BMI or WC. Limitations include the cross-sectional design (precluding causal inference), possible residual confounding, and a relatively limited sample size.</p><p><strong>Conclusion: </strong>This study suggests that VAI is independently associated with AED and that testosterone reduction partially mediates this relationship.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag015"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gender paradox of infertility: a comparative study of marital adjustment and sexual dysfunction in Bangladesh.","authors":"Mohammad Shamsul Ahsan, Leuza Mubassara, Farzana Deeba, Nusrat Mahmud, Samina Akter, Md Al-Amin Khan, Ahsan Aziz Sarkar, Andrea Sansone","doi":"10.1093/sexmed/qfag040","DOIUrl":"10.1093/sexmed/qfag040","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility significantly impacts self-image, sexuality, and interpersonal dynamics. While sexual dysfunction is a known consequence of infertility, its prevalence and impact on marital adjustment, specifically within the socio-cultural context of Bangladesh remain under-explored. The aim of this study was to determine the prevalence of sexual dysfunction among infertile men and women and to examine its association with marital adjustment.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at two tertiary hospitals in Bangladesh and data were collected from September 2024 to June 2025. A total of 658 participants (320 men and 338 women) were recruited via systematic random sampling. Sexual function was evaluated using the International Index of Erectile Function (IIEF-EF), the Premature Ejaculation Diagnostic Tool (PEDT), and the 6-item Female Sexual Function Index (FSFI-6). Marital adjustment was assessed using the Revised Dyadic Adjustment Scale (RDAS).</p><p><strong>Results: </strong>The overall prevalence of sexual dysfunction in this cohort was 25.4% (<i>n</i> = 167/658). Men were disproportionately affected compared to women. Among men (<i>n</i> = 320), 37.5% (<i>n</i> = 120) had at least one form of male sexual dysfunction, defined as erectile dysfunction (ED) and/or overt premature ejaculation (PE). Specifically, ED was identified in 33.7% (<i>n</i> = 108) of male participants, categorized as mild (24.1%), mild-to-moderate (8.1%), and moderate (1.6%). Overt PE (PEDT >11) was present in 13.1% (<i>n</i> = 42), including 9.3% (<i>n</i> = 30) with comorbid ED and PE, while 12 men had overt PE without ED. Probable PE (PEDT 9-10) was identified in 5.6% (<i>n</i> = 18) but was not included in the composite definition of male sexual dysfunction. Among women (<i>n</i> = 338), the prevalence of female sexual dysfunction was significantly lower at 13.9% (<i>n</i> = 47). Sexual dysfunction was inversely correlated with marital adjustment scores across both genders (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>A substantial \"gender paradox\" exists in infertility-related sexual health in Bangladesh, where men exhibit a significantly higher prevalence of sexual dysfunction than women. These findings highlight the necessity of integrating sexual medicine and psychological counseling into routine infertility management to improve both reproductive outcomes and marital quality. Strengths include the use of validated psychometric instruments and a relatively large, clinic-based sample. Limitations include cross-sectional design and reliance on self-report measures, which may limit generalizability and causal interpretation.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 4","pages":"qfag040"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}