Sexual Medicine最新文献

{"title":"PPP1R14A in male erectile dysfunction: key role in smooth muscle cells.","authors":"Yongdong Pan, Ruihang Zhang, Yubo Gu, Lujie Song","doi":"10.1093/sexmed/qfag021","DOIUrl":"10.1093/sexmed/qfag021","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a prevalent male health condition impairing quality of life. Existing therapies have limited efficacy, so novel pharmacological targets and clear molecular mechanisms of ED are needed.</p><p><strong>Aim: </strong>This study aims to integrate single-cell RNA sequencing (scRNA-seq) and genome-wide association studies (GWAS) analysis to uncover potential therapeutic targets for ED and clarify its molecular mechanisms.</p><p><strong>Methods: </strong>The study synthesized data from ED GWAS, scRNA-seq, protein quantitative trait loci, and expression quantitative trait loci datasets. Two-sample Mendelian randomization (MR) analysis, with instrumental variable weighted as the main method, was used to assess protein-ED causal relationships. Molecular docking screened candidate compounds, and murine penis experiments validated differential expression.</p><p><strong>Outcomes: </strong>Reveal the key molecular targets and regulatory mechanisms of ED pathogenesis, screen potential targeted drugs, and provide theoretical and experimental basis for the precise treatment of ED.</p><p><strong>Results: </strong>After scRNA-seq preprocessing, 2579 differentially expressed genes across five cell types were identified. MR analysis found 113 plasma proteins significantly associated with ED. Among overlapping genes, 4 eQTLs were ED-related, with PPP1R14A showing the strongest association (OR = 1.27; 95% CI, 1.10-1.45; P_IVW = 0.0007). PPP1R14A was predominantly expressed in smooth muscle cells (SMCs) and upregulated in ED patients. Pathway enrichment analysis revealed that PPP1R14A and its co-expressed genes are primarily involved in vascular smooth muscle contraction, actin phosphorylation, and calcium homeostasis. Progesterone and ampicillin were identified as potential binding candidates. Diabetic and elderly mice (with lower intracavernous pressure) had significantly higher PPP1R14A expression in cavernous tissue.</p><p><strong>Clinical translation: </strong>PPP1R14A can serve as a new candidate target for targeted therapy of ED. Potential binding compounds such as progesterone and ampicillin provide directions for subsequent drug development and lay the foundation for precise treatment of ED (especially diabetes-related and senile ED).</p><p><strong>Strengths and limitations: </strong>The advantage lies in the systematic analysis of the ED mechanism through multi-omics integration (scRNA-seq + MR + proteomics), clarifying cell-specific expression and causal relationships; the limitations are the limited sample size, the lack of direct in vivo and in vitro functional verification experiments, the need for further clinical verification of the safety and efficacy of drug candidates, and the failure to cover all ED subtypes and ethnic diversity.</p><p><strong>Conclusion: </strong>PPP1R14A plays a key role in the pathogenesis of ED. It affects the erectile process by regulating the function of SMCs. This stu","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 3","pages":"qfag021"},"PeriodicalIF":2.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780241","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":"Prevalence of erectile dysfunction among healthy and sexually active Malaysian men aged 18 to 39 years.","authors":"Arvinder-Singh Hs, Rukman Awang Hamat, Josephine P Durai, Harpreet Kaur, Nuh I Razlan, Sivaneswaran Lechmiannandan, Christopher C K Ho, Philip R Devesahayam","doi":"10.1093/sexmed/qfag009","DOIUrl":"10.1093/sexmed/qfag009","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance, and in Malaysia, ED among the young is poorly understood.</p><p><strong>Aim: </strong>To identify the prevalence of ED in healthy Malaysian men aged 18 to 39 years and factors affecting the presence of ED.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among healthy Malaysian men aged 18 to 39 years, using a standardized questionnaire. The link to the questionnaire was distributed via social media and communication applications. After consent, basic demography and ED was measured via the validated International Index of Erectile Function-15 (IIEF-15) questionnaire. Participants answered the questions in Malay or English. A sample size of 344 participants was needed for the study. Data was analysed using SPSS version 26.0 (IBM).</p><p><strong>Outcomes: </strong>To identify the prevalence of ED among young Malaysian men and its associated factors.</p><p><strong>Results: </strong>A total of 390 men completed the survey, and data from 361 were included in the final analysis. The mean age was 32.89 years (SD, 4.73), 66.5% were Malay, 49.6% were from the M40 group (middle 40% of wage earners in Malaysia), 52.4% were professionals in their fields, 31.3% were from Selangor, 67.6% lived in urban settings, 60.9% were married, 83.9% were heterosexually orientated, and the mean number of children among married men was 1.52 (SD, 1.24). The prevalence of ED was 32.7% (95% CI, 27.8%-37.9%) of the total participants, with 3.9% (95% CI, 2.2%-6.6%) experiencing severe ED. A multivariate regression analysis showed the following as being associated with ED: B40 status (below 40% of wage earners in Malaysia; adjusted odds ratio [AOR], 9.72; 95% CI, 2.43-38.94; <i>P</i> = .001), a homosexual/bisexual orientation (AOR, 11.66; 95% CI, 1.28-105.89; <i>P</i> = .03), and a decreased sexual desire (AOR, 9.02; 95% CI, 2.91-27.95; <i>P</i> < .001).</p><p><strong>Clinical implications: </strong>Because ED was prevalent in younger Malaysians and linked to metabolic diseases, perhaps the screening of non-communicable diseases, including mental health, should also target younger Malaysians.</p><p><strong>Strengths and limitations: </strong>This study was among the very few in Malaysia that examined ED in the young age group. However, factors such as smoking and psychosocial causes were not taken into account, as there may have been a potential reporting bias. We also included all sexual orientations into the study (i.e., IIEF-15 might have not been suitable for homosexuals - however, analysis removing the homosexual orientated group yielded similar results in the multivariate regression).</p><p><strong>Conclusion: </strong>The prevalence of ED in young healthy Malaysian men was about 1 in 3. Given the psychosocial factors involved, perhaps an insightful look toward mental healt","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 3","pages":"qfag009"},"PeriodicalIF":2.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691649","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":"Clinical features and risk factors analysis of diabetes mellitus complicated with Peyronie's disease.","authors":"Yuanyuan Li, Xuewen Diao, Zulong Wang","doi":"10.1093/sexmed/qfag012","DOIUrl":"10.1093/sexmed/qfag012","url":null,"abstract":"<p><strong>Background: </strong>The association between Diabetes Mellitus (DM) and Peyronie's disease (PD), as well as the impact of DM on PD phenotypes, remains not fully elucidated.</p><p><strong>Aim: </strong>To investigate the association between PD and DM and to assess the impact of DM on the clinical phenotype of PD.</p><p><strong>Methods: </strong>This case-control study retrospectively enrolled 136 PD patients from Department of Andrology, The First Affiliated Hospital of Henan University of Chinese Medicine (December 2019 to May 2025) as the case group. Two control groups were established concurrently: andrology patients without PD and healthy examinees. To control for confounding bias, propensity score matching (PSM) was used to balance baseline characteristics. Logistic regression analysis was employed to determine the independent association between DM and PD. Furthermore, clinical characteristics were compared between PD patients with and without DM.</p><p><strong>Outcomes: </strong>This study evaluate the correlation between DM and PD, as well as the clinical manifestations of their comorbidity.</p><p><strong>Results: </strong>① The prevalence of DM and the proportion of related risk factors were significantly higher in the case group (<i>P</i> < .05). ② After PSM, logistic regression confirmed an independent association between DM and PD (Model 1: OR = 2.815, 95% CI: 1.376-5.989; Model 2: OR = 3.436, 95% CI: 1.823-6.709). ③ Compared to the non-DM subgroup, PD patients in the DM subgroup had a greater number of plaques, higher plaque elasticity, and a larger curvature angle, but reported lower pain scores (all <i>P</i> < .05).</p><p><strong>Clinical implications: </strong>This finding suggests that clinicians should be vigilant for occult yet structurally severe PD in diabetic patients and consider implementing multidisciplinary management strategies.</p><p><strong>Strengths and limitations: </strong>The strengths of this study lie in its relatively large sample size of PD patients within the field of andrological rare diseases, the dual-control design, and the robust PSM analysis conducted. Limitations include its retrospective, single-center design and the potential for residual confounding factors.</p><p><strong>Conclusion: </strong>DM is independently associated with PD and is linked to a distinct clinical phenotype characterized by more severe fibrosis (more plaques, greater curvature) but diminished pain perception.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 3","pages":"qfag012"},"PeriodicalIF":2.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623702","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":"Safety profile and signal detection of tadalafil: a real-world analysis based on the Food and Drug adverse event reporting system.","authors":"Jie Li, Kecheng Li, Shihuang Yang, Yaxing Chen, Peixuan Ren, Guohe Deng, Lixing Lei, Qilong Ma, Haodong Yang, Longsheng Deng","doi":"10.1093/sexmed/qfag014","DOIUrl":"10.1093/sexmed/qfag014","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Tadalafil, a phosphodiesterase type 5 inhibitor, is widely used for erectile dysfunction and benign prostatic hyperplasia. Although generally well tolerated, concerns have emerged regarding uncommon but potentially clinically relevant adverse event (AE) reports and safety signals, particularly involving ocular, auditory, and cardiovascular systems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To characterize the post-marketing safety profile of tadalafil and identify potential safety signals using a real-world pharmacovigilance database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;All AE reports with tadalafil as the primary suspected drug were retrieved from the FDA Adverse Event Reporting System (FAERS) from Q1 2004 to Q1 2024. After data deduplication and Medical Dictionary for Regulatory Activities (MedDRA, version 26.0) recoding, descriptive analyses were conducted to summarize demographic characteristics and AE distributions. Disproportionality analyses-including reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and empirical Bayes geometric mean-were applied to detect safety signals at system organ class (SOC) and preferred term (PT) levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Primary outcomes included frequencies of reported AEs and identification of statistically significant signals across multiple signal-detection algorithms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 85 927 reports, 9304 identified tadalafil as the primary suspect drug. Reported AEs involving tadalafil spanned 23 SOCs. Using 4 signal detection algorithms, 135 PTs were found to show statistically significant disproportionality. In addition, several potential safety signals not listed in the current drug labeling-such as retinal hemorrhage, elevated intraocular pressure, and ejaculatory dysfunction-were detected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;The identified signals highlight the importance of clinical vigilance, particularly in patients with potential vascular or sensory risk factors, and these findings contribute to raising clinical awareness and will guide future pharmacological epidemiological studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This study provides the most comprehensive real-world safety evaluation of tadalafil using FAERS up to 2024, employing 4 complementary algorithms to improve signal robustness. However, intrinsic limitations of spontaneous reporting-such as under-reporting, reporting bias, incomplete information, and inability to infer causality-necessitate cautious interpretation. Confounding by comorbidities and co-medications cannot be fully excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This systematic pharmacovigilance analysis characterizes the post-marketing safety signal spectrum of tadalafil and identifies several potential safety signals that warrant further investigation, and these findings are informative and may serve as a reference for future controlled studies and p","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag014"},"PeriodicalIF":2.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575240","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":"Sarcopenia-related traits and erectile dysfunction: a bi-directional Mendelian randomization study.","authors":"Xu Jianxin, Wu Wensong, Fang Dengpan, Wang Yiwei, Chen Fangmin","doi":"10.1093/sexmed/qfag010","DOIUrl":"10.1093/sexmed/qfag010","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) and sarcopenia share many risk factors, but the causal direction of their association remains unclear.</p><p><strong>Aim: </strong>To investigate the potential causal relationship between sarcopenia-related traits and ED using genetic data.</p><p><strong>Methods: </strong>We conducted a bi-directional 2-sample Mendelian randomization (MR) analysis to evaluate the potential causal relationship between sarcopenia-related traits (hand grip strength, appendicular lean mass, and walking pace) and ED. We selected the inverse variance weighted (IVW) method as the main method to assess the causal effect, and we use Cochrane's Q tests derived from the IVW and MR-Egger method to evaluate the heterogeneity. To investigate horizontal pleiotropy, the study employed MR-Egger and MR-PRESSO methods. Leave-one-out analysis was conducted to assess the influence of individual genetic loci on the outcomes.</p><p><strong>Outcomes: </strong>Specific sarcopenia-related functional traits might increase the risk of ED, while reverse causality was not observed.</p><p><strong>Results: </strong>When considering sarcopenia-related characteristics as exposure factors, we found a positive causal relationship between appendicular lean mass and ED (OR = 1.097, CI = 1.009-1.194, <i>P</i> = .029) and a negative causal relationship between walking pace and ED (OR = 0.325, CI = 0.172-0.613, <i>P</i> = .00052). Hand grip strength showed no causal relationship with ED. Reverse MR results indicated that ED as an exposure factor did not have a causal relationship with sarcopenia-related characteristics. The MR-Egger intercept indicated no evidence of horizontal pleiotropy (<i>P</i> > .05). Cochran's Q test showed no significant heterogeneity (<i>P</i> > .05). Leave-one-out analysis revealed that excluding any single SNP did not significantly change the overall error lines, confirming the reliability of our conclusions.</p><p><strong>Clinical implications: </strong>Interventions aimed at improving overall physical function and fitness, particularly addressing a slow walking pace, may help reduce the risk of ED.</p><p><strong>Strengths and limitations: </strong>Key strengths include the MR design minimizing confounding and reverse causation, and comprehensive sensitivity analyses. The main limitation is that our study only contains samples of European descent.</p><p><strong>Conclusion: </strong>Specific sarcopenia-related functional traits, particularly a slower walking pace, may play a causal role in ED. These findings highlight the importance of overall physical function and fitness in ED risk, although further studies are needed to clarify the specific role of muscle mass.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag010"},"PeriodicalIF":2.4,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575178","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":"From sedation to stimulation: anecdotal case reports of enhanced sexual arousal in men and women taking diphenhydramine hydrochloride.","authors":"Melitzsa Pascale Regis, James G Pfaus","doi":"10.1093/sexmed/qfag011","DOIUrl":"10.1093/sexmed/qfag011","url":null,"abstract":"<p><strong>Introduction: </strong>Unexpected enhancement of sexual arousal, desire, and orgasm following diphenhydramine (DPH) ingestion has emerged in anecdotal reports across online platforms.</p><p><strong>Aims: </strong>To examine whether there are common effects of DPH on the sexual responses of women and men who respond to DPH with excitation rather than sedation.</p><p><strong>Methods: </strong>Qualitative case data were gathered from surveys of men and women on a DPH Reddit site to examine the consistency, intensity, and subjective nature of DPH effects on sexual arousal, desire, and orgasm.</p><p><strong>Results: </strong>Participants described enhanced sexual arousal, orgasm, increased stimulation sensitivity, and profound emotional release from DPH. Some found the effects stronger than those of prescription medications for sexual arousal disorders.</p><p><strong>Conclusion: </strong>These observations suggest a paradoxical pharmacological action of DPH, potentially involving dopaminergic and/or histaminergic pathways. While DPH itself is not a recognized therapeutic agent for the treatment of sexual dysfunctions, these unexpected effects may point toward a novel neurochemical mechanism of sexual excitation in some individuals that warrants further investigation.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag011"},"PeriodicalIF":2.4,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514754","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":"Using artificial intelligence to predict sexual health outcomes in endometriosis: a decision tree model algorithm.","authors":"Alexandre Vallée, Anis Feki, Jean-Marc Ayoubi","doi":"10.1093/sexmed/qfag013","DOIUrl":"10.1093/sexmed/qfag013","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometriosis profoundly impairs sexual function through complex interactions between pain, hormonal disturbances, psychological distress, and sociodemographic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To develop and validate a decision tree-based model identifying key predictors of sexual dysfunction in women with endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional online survey among 1586 women with endometriosis recruited through social media in France between November 2023 and January 2024. Participants completed sociodemographic and clinical questionnaires and the Female Sexual Function Index (FSFI), with sexual dysfunction defined as FSFI &lt; 26.55. The predictors included pain characteristics, menstrual symptoms, digestive symptoms, infertility, BMI, lifestyle factors, and treatment history. A classification and regression tree model was trained on 70% of the sample and validated on the remaining 30%. Model performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Subgroups at high or low risk of sexual dysfunction were identified through terminal nodes (rules) of the decision tree.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcome was classification into sexual dysfunction versus normal sexual function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 1586 respondents, 1358 (86%) met the criteria for sexual dysfunction. The decision tree demonstrated strong discrimination in the training dataset (AUC = 0.96; sensitivity = 98%; specificity = 82%) and acceptable performance in the validation dataset (AUC = 0.79; sensitivity = 72%; specificity = 77%). Chronic pelvic pain, dyspareunia, worsening pain over time, heavy menstrual bleeding, infertility, BMI, digestive symptoms, education level, and treatment history were identified as major determinants. Several terminal nodes showed a 100% probability of sexual dysfunction, most notably women with severe menstrual cramps, heavy menstrual bleeding, no treatment, normal weight or obesity, infertility, or pronounced digestive symptoms. Conversely, women with no dyspareunia, no urinary or bowel pain, high education, and overweight exhibited a 0% probability of dysfunction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;AI-driven decision trees can support early identification of high-risk profiles and guide individualized management strategies to improve sexual health in women with endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Strengths include a large sample, comprehensive symptom profiling, and transparent model interpretability. Limitations include reliance on self-reported diagnosis, potential selection bias inherent to online recruitment, lack of geographic and clinical verification data, and the cross-sectional nature of the analysis, preventing causal inference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A decision tree-based model accurately identified key predictors of sexu","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag013"},"PeriodicalIF":2.4,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514689","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":"Correction to: Difficulties in emotion regulation, repetitive negative thinking, and sexual and psychological distress: a two-wave longitudinal mediation study using a transdiagnostic approach.","authors":"","doi":"10.1093/sexmed/qfag016","DOIUrl":"10.1093/sexmed/qfag016","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/sexmed/qfaf052.].</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag016"},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514695","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":"Selective serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor use and sexual dysfunction: a pharmacovigilance analysis.","authors":"Mengting Shen, Luyao He, Pei Chen, Lei Zhang, Duan Zeng, Yan Li, Huafang Li","doi":"10.1093/sexmed/qfag008","DOIUrl":"10.1093/sexmed/qfag008","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) remain commonly used owing to their proven antidepressant efficacy, however, they are also associated with a considerable risk of sexual adverse effects.</p><p><strong>Aim: </strong>To examine the relationship between individual SSRIs/SNRIs and distinct sexual dysfunction symptoms.</p><p><strong>Methods: </strong>Using the Food and Drug Administration's Adverse Event Reporting System (FAERS) database, we performed a pharmacovigilance analysis of adverse drug events. Disproportionality signals were detected using reporting odds ratios (RORs) and information components (ICs), with Bayesian shrinkage transformation applied to mitigate random variability.</p><p><strong>Outcomes: </strong>The primary outcome indicators are RORs and ICs, which were employed to evaluate the association between SSRIs and SNRIs and the development of sexual dysfunction.</p><p><strong>Results: </strong>Comparative analysis of antidepressant-related adverse events in the FAERS database showed that while sexual dysfunction was associated with all studied SSRIs/SNRIs (sertraline, citalopram/escitalopram, paroxetine, fluoxetine, venlafaxine, and duloxetine), symptom profiles varied markedly. Sertraline presented the most diverse array of sexual dysfunction manifestations, contrasting with duloxetine's relatively restricted adverse effect profile.</p><p><strong>Clinical implications: </strong>This study provides valuable real-world evidence to assist clinicians in optimizing antidepressant selection, proactively identifying high-risk populations for sexual dysfunction, and improving patient compliance and quality of life during antidepressant treatment.</p><p><strong>Strengths and limitations: </strong>The use of FAERS offers large-scale real-world data on antidepressant-related sexual dysfunction to enhance generalizability. But the limitation is FAERS' passive surveillance nature, which may involve underreporting or insufficient clinical context, restricting causal inference.</p><p><strong>Conclusion: </strong>While previous studies have not fully elucidated antidepressant-related sexual dysfunction, our findings delineate distinct sexual adverse effect profiles between SSRIs and SNRIs, contributing valuable evidence for personalized treatment approaches.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfag008"},"PeriodicalIF":2.4,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514701","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":"Addressing complicated vesicovaginal fistula post-intercourse in MRKH: the critical imperative for comprehensive sex education and awareness.","authors":"Gautam Shubhankar, Ankur Mittal, Vikas Kumar Panwar, Deelip Kumar Singh","doi":"10.1093/sexmed/qfae076","DOIUrl":"10.1093/sexmed/qfae076","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a rare congenital disorder, affects approximately 1 in 4500 to 5000 females, leading to the underdevelopment or absence of the uterus and upper vaginal segment. While the physical manifestations of MRKH are substantial, the associated psychological and social repercussions, exacerbated by societal norms, can be profound. Inadequate sex education further compounds the challenges faced by these women, particularly in postmarital contexts. This report highlights an unprecedented case of a young woman with MRKH type II who developed a complicated vesicovaginal fistula (VVF) following vaginal intercourse, underscoring the urgent need for enhanced sex education and awareness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This study aims to document and analyze a unique case of post-coital VVF in a patient with MRKH syndrome, illustrating the consequences of inadequate sex education. The broader objective is to advocate for comprehensive sexual and reproductive health education, particularly in regions with limited access, to prevent such complications and improve the quality of life for affected individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A detailed case study of a young woman in her early twenties with MRKH type II is presented. The patient experienced continuous urine leakage per vaginum following intercourse, which was preceded by dyspareunia and bleeding. A clinical examination revealed a large, complicated VVF involving the bladder neck and posterior bladder wall, coupled with a left ectopic kidney as confirmed by ultrasound. The patient received broadspectrum antibiotics, wound care, and extensive psychosocial counseling, with an emphasis on sex education for her and her family. A multidisciplinary approach was employed, planning delayed VVF repair and vaginoplasty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patient's wound gradually healed with conservative management, and her psychosocial outlook improved significantly following counseling and education. The family's understanding of MRKH and its implications was enhanced, reducing stigma and promoting a supportive environment. Surgical planning for reconstructive procedures was successfully initiated, with the patient showing positive engagement in her care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case highlights the critical importance of comprehensive sex education for individuals with MRKH syndrome, particularly in underserved regions. The development of a complex VVF post-intercourse is a stark reminder of the preventable complications arising from inadequate knowledge and awareness. Enhanced educational initiatives are imperative to equip patients and families with the understanding needed to mitigate risks, reduce stigma, and improve the overall wellbeing of those affected by MRKH. This case underscores the need for an integrated approach combining education, psychological support, and medical care to optimize outcomes for patien","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfae076"},"PeriodicalIF":2.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469085","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}