Sexual Medicine最新文献

{"title":"Sexual difficulties in men who have sex with men living with HIV: their mental health and health-related quality of life.","authors":"Yuyuan Xu, Xiaoli Lin, Xiaoxuan Wu, Hongjie Chen, Xuwen Xu, Yuanhui Jiang, Suling Chen, Bing Li, Huiqun Zhong, Shaohang Cai","doi":"10.1093/sexmed/qfae060","DOIUrl":"10.1093/sexmed/qfae060","url":null,"abstract":"<p><strong>Background: </strong>Health-related quality of life (HRQoL) is gaining significance for people living with human immunodeficiency virus (HIV), with sexual difficulties being a crucial yet frequently neglected component of HRQoL, especially in HIV-positive men who have sex with men (MSM).</p><p><strong>Aim: </strong>The study sought to assess the levels of sexual difficulties and explore the associations between sexual difficulties, mental health, and HRQoL in HIV-positive MSM.</p><p><strong>Methods: </strong>A cohort of 475 HIV-positive MSM was studied from January 2017 to December 2021. Sociodemographic, clinical, and lifestyle data were collected. Participants were divided based on Arizona Sexual Experience Scale (ASEX) scores into 2 groups: those with sexual difficulties and a control group without difficulties.</p><p><strong>Outcomes: </strong>Psychological symptoms were evaluated by the Symptom Checklist-90 (SCL-90), HRQoL was accessed via 36-item Short Form Health Survey, and sexual function was assessed using the ASEX. We also employed path analysis to unveil latent mechanisms, alongside multivariate analysis to identify independent factors, and aimed to elucidate the interplay among sexual function, HRQoL, and mental health in HIV-positive MSM.</p><p><strong>Results: </strong>A total of 391 HIV-positive MSM were enrolled in the control group and 84 in the sexual difficulties group. The control group had significantly higher physical HRQoL (<i>P =</i> .004) and mental HRQoL (<i>P =</i> .045). In addition, SCL-90 scores were higher in the sexual difficulties group (<i>P =</i> .001). Multivariate analyses that indicated regular exercise (odds ratio, 0.553; <i>P =</i> .024) and alcohol consumption (odds ratio, 1.780; <i>P =</i> .033) were independent factors associated with sexual difficulties. The proportion of alcohol consumption in the sexual difficulties group was significantly higher (<i>P =</i> .003). ASEX scores increased gradually with increasing frequency of alcohol consumption (<i>P =</i> .031). Results from structural equation model showed a negative association between HRQoL and ASEX scores (β = -0.13, <i>P</i> < .001) and SCL-90 scores (β = -0.40, <i>P</i> < .001).</p><p><strong>Clinical implications: </strong>HIV-positive MSM experiencing sexual difficulties exhibited lower HRQoL and worse mental health, with independent associations identified for regular exercise and alcohol consumption in relation to sexual difficulties.</p><p><strong>Strengths and limitations: </strong>Our research has pioneered in demonstrating that HRQoL mediates the relationship between sexual difficulties and psychological symptoms among HIV-positive MSM undergoing highly active antiretroviral therapy. We found the protective factor associated with sexual difficulties was regular exercise while the risk factor was alcohol consumption. However, the data were collected only from China, and it is still unclear how HRQoL changes after intervention","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae060"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294971","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":"No bidirectional association between serum 25-hydroxyvitamin D and erectile dysfunction: Mendelian randomization and genetic association studies.","authors":"Xiang Liu, Longhua Luo, Cong Peng, Zixin Wang, Jiaming Zhou, Xiang Sun","doi":"10.1093/sexmed/qfae061","DOIUrl":"10.1093/sexmed/qfae061","url":null,"abstract":"<p><strong>Background: </strong>The causal relationship between the level of serum 25-hydroxyvitamin D [25(OH)D] and the risk of erectile dysfunction (ED) is still unclear.</p><p><strong>Aim: </strong>We tried to determine the causal relationship between the level of serum 25(OH)D and ED risk.</p><p><strong>Methods: </strong>In this study, we used genome-wide association study data from the UK Biobank to analyse the relationship between serum 25(OH)D (as the exposure) and ED (as the outcome). Linkage disequilibrium score regression (LDSC) was used to assess the genetic correlation between 2 traits. The CAUSE (Causal Analysis using Summary Effect estimates) method and Mendelian randomization (MR) were employed to evaluate the bidirectional causal relationship. The MRlap method was utilized to assess the impact of sample overlap on the results. To assess potential heterogeneity and horizontal pleiotropy, we utilized methods such as MR-Egger, MR-PRESSO (Mendelian Randomization Pleiotropy Residual Sum and Outlier), weighted median, and others.</p><p><strong>Outcomes: </strong>The primary outcome was defined as self or physician-reported ED, or using oral ED medication, or a history of surgery related to ED.</p><p><strong>Results: </strong>The LDSC analysis did not reveal a significant genetic correlation between serum 25(OH)D and ED (r_g = 0.2787, <i>P =</i> .3536). Additionally, the CAUSE (<i>P</i> value testing that the causal model is a better fit >.05) and MR analyses (odds ratio, 0.8951; 95% confidence interval, 0.7480-1.0710; <i>P =</i> .2260) did not support a causal relationship between 25(OH)D and ED, and our study did not detect any heterogeneity and pleiotropy.</p><p><strong>Clinical implications: </strong>This study provides evidence on whether vitamin D needs to be ingested to prevent or treat ED.</p><p><strong>Strengths and limitations: </strong>We used LDSC and MR to avoid bias. However, the population in this study was limited to European ancestry.</p><p><strong>Conclusion: </strong>No causal relationship was found between 25(OH)D and ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae061"},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294955","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":"Peripheral pathway gene variants in lifelong premature ejaculation: CYP19A1, CYP1A1, and CYP1A2 enzymes polymorphisms in Chinese Han men.","authors":"Fei Wang, Defan Luo, Jianxiang Chen, Cuiqing Pan, Zhongyao Wang, Housheng Fu, Jiangbing Xu, Meng Yang, Cun Zhou, Rui Li, Shaowei Mo, Liying Zhuang, Weifu Wang","doi":"10.1093/sexmed/qfae056","DOIUrl":"https://doi.org/10.1093/sexmed/qfae056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recent genetic association studies focusing on central pathways have been performed to investigate the correlation between susceptibility alleles and the risk of lifelong premature ejaculation (LPE). However, there remains a dearth of documented genes associated with peripheral pathways.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;In this study we aimed to investigate the relationship between single nucleotide polymorphisms (SNPs) associated with the peripheral genes &lt;i&gt;CYP19A1&lt;/i&gt;, &lt;i&gt;CYP1A1&lt;/i&gt;, and &lt;i&gt;CYP1A2&lt;/i&gt; and the risk of LPE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From August 2017 to August 2020, a total of 511 participants (139 LPE patients and 372 controls) were recruited. Trained medical professionals diagnosed LPE according to the standard definition set by the International Society for Sexual Medicine. Nine candidate SNPs were chosen and genotyped using the MassARRAY system. Allele and genotype frequencies of the SNPs among patients and controls were compared using the χ&lt;sup&gt;2&lt;/sup&gt; test. Logistic regression analysis, adjusted for age, was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) using PLINK version 1.9. Haploview software was employed to analyze linkage disequilibrium and haplotype distribution. The interaction among candidate SNPs concerning LPE risk was evaluated using multifactor dimensionality reduction. The relationship between selected polymorphisms and specific features was assessed using analysis of variance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome: &lt;/strong&gt;Heterozygous SNPs located in the &lt;i&gt;CYP19A1&lt;/i&gt; (rs4646, rs17601876), &lt;i&gt;CYP1A1&lt;/i&gt; (rs1048943), and &lt;i&gt;CYP1A2&lt;/i&gt; (rs762551, rs2470890) genes showed significant correlations with the risk of LPE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings of this study confirmed that heterozygous SNPs in the &lt;i&gt;CYP19A1&lt;/i&gt; (rs4646 AC vs CC: OR, 1.84; CI, 1.10-3.09; rs17601876 AG vs GG: OR, 1.80; CI, 1.06-3.05) and &lt;i&gt;CYP1A1&lt;/i&gt; genes (rs1048943 CT vs TT: OR, 1.71; CI, 1.02-2.87), respectively, can significantly increase the LPE risk. Participant scores for the Premature Ejaculation Diagnostic Tool (&lt;i&gt;P&lt;/i&gt; =.002) and International Index of Erectile Function-5 (&lt;i&gt;P&lt;/i&gt; =.020) differed significantly by genotype for the different genotypes of &lt;i&gt;CYP1A1&lt;/i&gt;-rs1048943. Haplotype analysis revealed strong linkage disequilibrium under &lt;i&gt;CYP1A2&lt;/i&gt;_rs762551-rs2470890 (D' = 1.00).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The findings of this and other investigations of genetic determinants and potential pathogenic mechanisms of LPE may advance diagnostic and therapeutic opportunities in LPE patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;In this study of LPE in men with CYP gene variants we addressed a current research gap. However, data on risk factors such as smoking and drinking were incomplete in both the case and control groups. In future studies we will expand the sample size and enhance data on risk factors for more precise assessment","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae056"},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294968","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":"Letter to the Editor on \"Causal associations between prostate diseases, renal diseases, renal function, and erectile dysfunction risk: a 2-sample Mendelian randomization study\".","authors":"Youqian Zhang, Li Li, Qiong Wen","doi":"10.1093/sexmed/qfae058","DOIUrl":"10.1093/sexmed/qfae058","url":null,"abstract":"","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae058"},"PeriodicalIF":2.6,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294954","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":"Response to Letter to the Editor on \"Causal associations between prostate diseases, renal diseases, renal function, and erectile dysfunction risk: a 2-sample Mendelian randomization study\".","authors":"Diliyaer Dilixiati, Kaisaierjiang Kadier, Jian-De Lu, Shiping Xie, Baihetiya Azhati, Reyihan Xilifu, Mulati Rexiati","doi":"10.1093/sexmed/qfae059","DOIUrl":"https://doi.org/10.1093/sexmed/qfae059","url":null,"abstract":"","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae059"},"PeriodicalIF":2.6,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294970","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 health in patients with malignant hematological disease: a Danish cross-sectional study.","authors":"Kristina Holmegaard Nørskov, Ida Schjoedt, Anders Tolver, Mary Jarden","doi":"10.1093/sexmed/qfae053","DOIUrl":"https://doi.org/10.1093/sexmed/qfae053","url":null,"abstract":"<p><strong>Background: </strong>Patients who undergo treatment for hematologic malignancies may experience a decline in sexual health, alterations in sexual functioning, and reproductive capacity during survivorship.</p><p><strong>Aim: </strong>This study investigated the prevalence of sexual dysfunction and factors influencing sexual activity and functioning in patients with hematologic malignancies, to identify potential targets for interventions in clinical practice.</p><p><strong>Methods: </strong>This nationwide cross-sectional study included adult patients diagnosed with a hematologic malignant disease in Denmark in the period from January 20, 2013, to August 20, 2022. Eligible participants received electronic questionnaires through their officially assigned digital mailbox.</p><p><strong>Outcomes: </strong>Outcomes included the Female Sexual Function Index, International Index of Erectile Function, Female Sexual Distress Scale-Revised, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Sexual Health, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.</p><p><strong>Results: </strong>A total of 362 patients, on average 5.7 ± 3.4 years postdiagnosis, completed the questionnaires. Of these, 52.5% women and 73.2% men reported sexual dysfunction, with more women (40.9%) than men (34.1%) being sexually inactive. Across gender, this was significantly more prevalent in patients >65 years of age and in those with a low quality of life. In addition, for women a significant association with fatigue and sleep difficulties was observed. In total, 40.3% reported sexual-related personal distress, with the highest proportion among patients 40 to 65 years of age. Most patients (98.7%) with sexual dysfunction had not discussed sexual issues with their healthcare professional.</p><p><strong>Clinical implications: </strong>It is hoped that knowledge from this study will help healthcare professionals in clinical practice and encourage them to proactively address and discuss sexual health issues with their patients, irrespective of age.</p><p><strong>Strengths and limitations: </strong>Sexually inactive participants may reduce the overall score of sexual function in the scoring of both the Female Sexual Function Index and International Index of Erectile Function. We therefore analyzed sexual function in a subgroup analysis in only those being sexually active to emphasize that level of dysfunction persists in sexually active participants.</p><p><strong>Conclusion: </strong>Patients report a high prevalence of sexual dysfunction, sexual distress, and gender-specific sexual symptoms following diagnosis and treatment of a malignant hematologic disease, impacting their quality of life.Sexual Health in Patients With Hematologic Malignancies; NCT05222282; https://clinicaltrials.gov/study/NCT05222282.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae053"},"PeriodicalIF":2.6,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294972","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":"Prompt matters: evaluation of large language model chatbot responses related to Peyronie's disease.","authors":"Christopher J Warren, Victoria S Edmonds, Nicolette G Payne, Sandeep Voletti, Sarah Y Wu, JennaKay Colquitt, Hossein Sadeghi-Nejad, Nahid Punjani","doi":"10.1093/sexmed/qfae055","DOIUrl":"https://doi.org/10.1093/sexmed/qfae055","url":null,"abstract":"<p><strong>Introduction: </strong>Despite direct access to clinicians through the electronic health record, patients are increasingly turning to the internet for information related to their health, especially with sensitive urologic conditions such as Peyronie's disease (PD). Large language model (LLM) chatbots are a form of artificial intelligence that rely on user prompts to mimic conversation, and they have shown remarkable capabilities. The conversational nature of these chatbots has the potential to answer patient questions related to PD; however, the accuracy, comprehensiveness, and readability of these LLMs related to PD remain unknown.</p><p><strong>Aims: </strong>To assess the quality and readability of information generated from 4 LLMs with searches related to PD; to see if users could improve responses; and to assess the accuracy, completeness, and readability of responses to artificial preoperative patient questions sent through the electronic health record prior to undergoing PD surgery.</p><p><strong>Methods: </strong>The National Institutes of Health's frequently asked questions related to PD were entered into 4 LLMs, unprompted and prompted. The responses were evaluated for overall quality by the previously validated DISCERN questionnaire. Accuracy and completeness of LLM responses to 11 presurgical patient messages were evaluated with previously accepted Likert scales. All evaluations were performed by 3 independent reviewers in October 2023, and all reviews were repeated in April 2024. Descriptive statistics and analysis were performed.</p><p><strong>Results: </strong>Without prompting, the quality of information was moderate across all LLMs but improved to high quality with prompting. LLMs were accurate and complete, with an average score of 5.5 of 6.0 (SD, 0.8) and 2.8 of 3.0 (SD, 0.4), respectively. The average Flesch-Kincaid reading level was grade 12.9 (SD, 2.1). Chatbots were unable to communicate at a grade 8 reading level when prompted, and their citations were appropriate only 42.5% of the time.</p><p><strong>Conclusion: </strong>LLMs may become a valuable tool for patient education for PD, but they currently rely on clinical context and appropriate prompting by humans to be useful. Unfortunately, their prerequisite reading level remains higher than that of the average patient, and their citations cannot be trusted. However, given their increasing uptake and accessibility, patients and physicians should be educated on how to interact with these LLMs to elicit the most appropriate responses. In the future, LLMs may reduce burnout by helping physicians respond to patient messages.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae055"},"PeriodicalIF":2.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294969","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":"Age-related differences in the prevalence of premature ejaculation: taking a second and more detailed look.","authors":"David L Rowland, Zsuzsanna Kӧvi, Krisztina Hevesi","doi":"10.1093/sexmed/qfae057","DOIUrl":"10.1093/sexmed/qfae057","url":null,"abstract":"<p><strong>Background: </strong>Research indicates an inconsistent relationship between age and the prevalence of premature ejaculation (PE), with studies reporting an increase, decrease, or no change with age.</p><p><strong>Aim: </strong>To reexamine the possible relationship between age and PE prevalence, implementing methodological improvements that enhance the likelihood of detecting real effects.</p><p><strong>Methods: </strong>From a sample of 2772 men, we analyzed a subset of 418 classified as having probable or definite PE based on the Premature Ejaculation Diagnostic Tool. We not only analyzed men with lifelong PE (LPE; n = 316) and acquired PE (APE; n = 102) separately but assessed prevalence differences across age groups using an omnibus measure to establish PE status and specific PE diagnostic criteria, individually and in multifactorial combination.</p><p><strong>Outcome: </strong>Prevalence of PE in younger vs older men.</p><p><strong>Results: </strong>LPE, but not APE, showed age-related differences in prevalence, with LPE being lower in the higher age group. This pattern was most discernible when a multifactorial approach was used to establish PE status.</p><p><strong>Clinical translation: </strong>Older men may be less distressed about their dysfunction or may benefit from diminishing ejaculatory function with age.</p><p><strong>Strengths and limitations: </strong>This cross-sectional study used an improved methodology to detect age-related differences in PE prevalence. Future studies would benefit from a larger sample size that enables a breakdown of prevalence using a greater number of age categories.</p><p><strong>Conclusion: </strong>According to an improved methodology, men with LPE showed a decline in prevalence with aging. A methodology aimed at exploring this relationship should-at the very least-not only distinguish between LPE and APE subtypes but also consider using a multifactorial method of determining PE status that includes a measure of bother/distress.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae057"},"PeriodicalIF":2.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120517","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":"Investigation of the psychometric properties of the Toronto Alexithymia Scale in men with and without compulsive sexual behavior.","authors":"Patrícia do Espírito Santo Gonçalves, Marco de Tubino Scanavino","doi":"10.1093/sexmed/qfae050","DOIUrl":"10.1093/sexmed/qfae050","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previous studies have provided initial evidence supporting the association between compulsive sexual behavior (CSB) and alexithymia, but these studies did not investigate the psychometric property of a measure of alexithymia in individuals with CSB, which is necessary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study investigated the factor analysis, reliability, and construct validity of the Toronto Alexithymia Scale (TAS) in men with CSB and control individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study included 418 participants (304 individuals with CSB and 114 control individuals) who underwent a semi-structured psychiatric interview and completed the following instruments: the Sexual Compulsivity Scale, Hypersexual Disorder Screening Inventory, Beck Anxiety Inventory, Beck Depression Inventory, TAS, and Barratt Impulsiveness Scale. The eligible participants were men 18 years of age or older who were literate and residing in Brazil. Individuals who met the diagnostic criteria for Goodman's criteria for sex addiction were subsequently assessed for the excessive sexual drive (International Classification of Diseases-Tenth Revision F52.7) criteria. Those who met this second criteria were considered individuals with CSB. Participants who did not reach this point were considered control individuals. We conducted factor analysis, reliability analysis (internal consistency and temporal stability), and discriminant and construct validity analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The outcomes included the TAS total score and scores on TAS factors 1, 2, 3, and 4.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The extracted factors explained 44% of the variance in the TAS. Factor 1 explained 21%, but 3 items (items 2, 9, and 21) did not load onto this factor. The Cronbach's alpha was 0.83, and the reproducibility (intraclass correlation coefficient) was 0.70. The TAS can differentiate between individuals with CSB and control individuals. The different forms of validity were demonstrated through correlations between factors 1 to 4 and the total score, as well as with impulsivity, hypersexuality, sexual compulsivity, and depression. Surprisingly, anxiety was only weakly correlated with factors 1 and 2. Moreover, the TAS-4 score was not correlated with impulsivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The TAS can be used in clinical practice to identify men with difficulties in recognizing subjective experiences, and proper interventions can subsequently be provided to these patients to increase their treatment efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Various dimensions of alexithymia covary with other key psychopathological symptoms of CSB. This study examined a convenience sample. The results cannot be generalized to the broader population. Factors 3 and 4 presented low internal consistency (0.50).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In general, TAS presented good psychometric properties in a sample mai","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae050"},"PeriodicalIF":2.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120518","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":"Ohnut vs waitlist control for the self-management of endometriosis-associated deep dyspareunia: a pilot randomized controlled trial.","authors":"Kate Wahl, Natasha L Orr, Gurkiran Parmar, Sandy X J Zhang, Rebecca G K MacLeod, Heather Noga, Arianne Albert, Ryan Flannigan, Lori A Brotto, Paul J Yong","doi":"10.1093/sexmed/qfae049","DOIUrl":"10.1093/sexmed/qfae049","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Deep dyspareunia affects 50% of people with endometriosis. The Ohnut is a set of interlocking rings that fit over the penis/insertive object. One or more rings can be used to limit insertion depth and reduce deep dyspareunia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;We conducted a pilot, parallel, open-label randomized controlled trial (RCT) to investigate the feasibility of the study design and the acceptability and preliminary efficacy of the Ohnut.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Participants were recruited from a tertiary center for endometriosis. Eligibility criteria were surgically confirmed endometriosis, age 19-49 years, monogamous sexual relationship with a partner willing to participate in the study, and no comorbid superficial dyspareunia, anxiety, or depression. Couples were randomized into an intervention group or a waitlist control group using a 1:1 allocation ratio. All couples had sex as normal during weeks 1 to 4 (baseline period), and couples in the intervention group used the Ohnut with sex during weeks 5 to 10 (intervention period) while controls had sex as normal. Patient participants used daily diaries to record sexual activity and deep dyspareunia score (0-10) for the 10-week study. Intervention group participants completed an acceptability questionnaire at the end of the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcomes were feasibility of the study and acceptability of the Ohnut. We also assessed differences in deep dyspareunia scores in the participants who used the Ohnut compared to the control participants who did not.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We recruited approximately 5 couples per month of active recruitment. Of 864 potentially eligible participants, we successfully contacted 44.7% (n = 386), of whom 8.0% (n = 31) consented, 64.8% (n = 250) were ineligible, and 27.2% (n = 105) declined. Thirty-one couples were randomly assigned to the intervention or control group, and 17 couples completed the study. Intervention group couples used the Ohnut for an average of 72.4% (32.7%) of sexual encounters during the intervention period. The mean acceptability index score for the Ohnut was 0.83 (0.078) among patients and 0.83 (0.049) among partners (index between 0 and 1). After controlling for baseline deep dyspareunia, there was a significant difference in the intervention period mean deep dyspareunia scores between the control and intervention group (4.69 (2.44) vs 2.46 (1.82), &lt;i&gt;P&lt;/i&gt; = .012).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;We identified preliminary evidence for the acceptability and efficacy of the Ohnut among both patients and partners, suggesting that the Ohnut may be a useful stand-alone or adjuvant management tool for endometriosis-associated deep dyspareunia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Strengths of this study were the \"real-world\" use of the Ohnut and data collection from both patients and partners. Limitations of the study design included the s","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 4","pages":"qfae049"},"PeriodicalIF":2.6,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111926","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}