Sexual medicine reviews最新文献

{"title":"Gut microbiota in sexual function: exploring new avenues.","authors":"Lu Zhu, Bing Song, Rongqiu Zhang, Chao Wang, Xiaojin He, Yunxia Cao, Guanjian Li","doi":"10.1093/sxmrev/qeaf039","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf039","url":null,"abstract":"<p><strong>Introduction: </strong>The gut microbiota, which is recognized for its crucial role in regulating numerous physiological processes, harbors a relationship with sexual function that has remained relatively understudied.</p><p><strong>Objectives: </strong>This narrative review aims to integrate the existing evidence regarding the association between the gut microbiota and sexual function. Additionally, it endeavors to discuss the research challenges and delineate the future directions within this burgeoning field.</p><p><strong>Methods: </strong>A comprehensive analysis was carried out on both pre-clinical and clinical studies. The scope of the analysis encompassed: (1) the associations between the composition of the gut microbiota and various forms of sexual dysfunctions, (2) the risk factors for sexual dysfunction that are associated with alterations in the microbiota, and (3) the potential interventions that target the regulation of the gut microbiota.</p><p><strong>Results: </strong>In the context of erectile dysfunction and hypoactive sexual desire disorder, several investigations have identified specific changes in the gut microbiota. Additionally, risk factors for sexual dysfunction, such as mental health disorders, obesity, diabetes, hypertension, and thyroid dysfunction, are also influenced by the gut microbiota. Promising intervention strategies include dietary modification, supplementation with probiotics or prebiotics, fecal microbiota transplantation, and bioengineering approaches.</p><p><strong>Conclusion: </strong>The current body of evidence has established a link between gut microbial dysbiosis and the pathophysiology of various sexual health issues. Despite the fact that our understanding and assessment of the impact of gut microbes on the sexual function of the host are still in their infancy, continued advancements may unveil novel potential targets for the management of sexual health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual and reproductive health in neurological disorders: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).","authors":"Stacy Elliott, Veronika Birkhäuser, Frederique Courtois, Murat Gül, Emad Ibrahim, Carlotte Kiekens, Peter Wayne New, Mst Clin Epi, Dana A Ohl, Mikkel Fode","doi":"10.1093/sxmrev/qeaf030","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf030","url":null,"abstract":"<p><strong>Introduction: </strong>Neurological disorders impact both the central and peripheral nervous systems, often leading to sexual dysfunction (SD). These conditions affect not only genital function but also sensory and motor abilities, pain perception, bladder and bowel control, mood, and hormonal balance. Despite the significance of sexual health for overall quality of life, SD in individuals with neurological conditions remains an under addressed issue.</p><p><strong>Objectives: </strong>This review aims to provide an overview of SD in individuals with neurological disorders, examining underlying neurophysiological mechanisms, the impact of various neurological conditions, and available treatment strategies. The goal is to offer clinically relevant recommendations to healthcare professionals managing SD in these patients.</p><p><strong>Methods: </strong>A panel of experts reviewed and synthesized the literature on SD in neurological disorders, with an emphasis on randomized controlled trials and high-quality evidence. The review covers central and peripheral neural control of sexual function, SD associated with specific neurological disorders, and diagnostic and treatment approaches.</p><p><strong>Results: </strong>Sexual dysfunction in neurological disorders varies by condition. For example, erectile dysfunction (ED) and anejaculation are common in spinal cord injury, while Parkinson's disease may be associated with hypersexuality and orgasmic disorders. Brain injuries such as traumatic brain injury, stroke, and neurodegenerative diseases can reduce libido and satisfaction, and multiple sclerosis is associated with ED and reduced genital arousal. Pharmacological and nonpharmacological interventions, including phosphodiesterase-5 inhibitors, vibratory stimulation, hormonal therapy, pelvic floor therapy, and assistive devices, demonstrate variable efficacy depending on the neurological condition. A multidisciplinary approach, including medical, psychological, and rehabilitative interventions, is crucial for optimizing sexual health in these patients.</p><p><strong>Conclusion: </strong>Sexual dysfunction is a prevalent consequence of neurological disorders. Proper assessment, should include a sexual history and neurological examination with specific attention to genital sensation and reflex testing. Effective management requires a holistic, multidisciplinary approach. Addressing sexual health should be a core component of neurological rehabilitation to enhance patients' quality of life.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral biomarkers in compulsive sexual behavior disorder: a systematic review.","authors":"Bianca de O Ferreira, Bruno J Teixeira, Leda L Talib, Marco D T Scanavino","doi":"10.1093/sxmrev/qeaf046","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf046","url":null,"abstract":"<p><strong>Background: </strong>Compulsive sexual behavior disorder (CSBD) is defined by a persistent inability to regulate sexual impulses, leading to significant distress and impairment. Although it is recognized as a disorder in the International Classification of Diseases-11, the underlying neurobiological mechanisms are not yet fully understood.</p><p><strong>Aim: </strong>The aim of this systematic review is to summarize recent findings on peripheral biomarkers in individuals with CSBD and to provide a comprehensive overview of the current state of the field.</p><p><strong>Methods: </strong>We searched articles published in the last 10 years in PubMed, Scopus, and Web of Science following The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Eligible studies included adult participants formally diagnosed with CSBD, hypersexual disorder, or sexual addiction, and that assessed peripheral biomarkers. Exclusion criteria comprised studies focused on neurological comorbidities, neuroimaging alone, or animal models. A total of 10 articles met the inclusion criteria.</p><p><strong>Outcomes: </strong>The primary outcomes were associations between peripheral biomarkers and clinical or psychological variables in CSBD, including hormone levels, epigenetic patterns, and immune markers.</p><p><strong>Results: </strong>The reviewed studies investigated neuroendocrine, epigenetic, and immunological biomarkers in individuals with CSBD. Altered DNA methylation was identified in stress-related genes (e.g., CRH, CRHR1, FKBP5, NR3C1), often associated with HPA axis dysregulation and non-suppression in the dexamethasone suppression test (DST). Specific microRNAs (e.g., MIR4456, MIR708) showed differential methylation and expression patterns. Neuroendocrine findings included elevated post-DST cortisol and ACTH levels, increased plasma oxytocin and LH levels, and associations between salivary testosterone and CSBD symptoms in men. Immunological alterations included increased TNF-α and decreased IL-6.</p><p><strong>Clinical implications: </strong>These preliminary findings suggest biological alterations related to stress, hormonal regulation, and inflammation in CSBD, but clinical application remains limited.</p><p><strong>Strengths and limitations: </strong>This is the first systematic review focused on peripheral biomarkers in CSBD. However, limited sample diversity, cohort overlap, and lack of replication restrict generalizability.</p><p><strong>Conclusion: </strong>Evidence supports a multifactorial biological profile in CSBD. Future longitudinal, multimodal studies in diverse populations are essential to clarify the diagnostic and clinical relevance of these biomarkers.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current methods for assessing erogenous sensation: implications for sensory outcomes in genital gender-affirming surgery.","authors":"Myan Bhoopalam, Bashar A Hassan, Aurora J Grutman, Aaron Bao, Nina Rossa Haddad, Sami Tuffaha, A Lee Dellon, Fan Liang","doi":"10.1093/sxmrev/qeaf034","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf034","url":null,"abstract":"<p><strong>Introduction: </strong>Preserving erogenous sensation is essential for postoperative sexual function and patient satisfaction following gender-affirming surgery. However, the biological basis of erogenous sensation and its assessment methods are not well understood.</p><p><strong>Objective: </strong>This review summarizes the current mechanistic understanding of erogenous sensation and identifies existing knowledge gaps for future research.</p><p><strong>Methods: </strong>Three databases were queried from their inception to December 2022 for full-text English articles investigating erogenous sensation. Two independent reviewers screened the studies, and key results were extracted. The findings were compiled to discuss erogenous sensation, organized into neurophysiologic mechanisms, assessment modalities, and the sensibility of different erogenous territories.</p><p><strong>Results: </strong>Of the 143 included studies, 46 (32%) articles investigated the physiology of erogenous sensation. Of those, 13 (28%) studies focused on the brain regions involved in processing erogenous sensations. Most studies (92 [64%]) assessed erogenous sensation following a procedure. Among this group, 53 (58%) studies relied only on subjective patient-reported outcomes (ie, survey, visual analog scale, etc.). Only 22 (24%) studies used objective assessment modalities such as vibrotactile detection thresholds and vaginal photoplethysmography.</p><p><strong>Conclusion: </strong>Significant gaps remain in the understanding and assessment of erogenous sensation. Current research is limited by methodological inconsistencies and a lack of standardized, objective measurement tools. Future efforts should prioritize developing validated assessment methods and conducting longitudinal studies to enhance sensory outcome evaluation in gender-affirming surgery.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How has the biopsychosocial model fared in sexual medicine and sex therapy?","authors":"Michael A Perelman, Annamaria Giraldi, Sharon Parish, Daniela Wittmann, William Fisher, Sharon L Bober, Alexander Pastuszak, James Pfaus","doi":"10.1093/sxmrev/qeaf029","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf029","url":null,"abstract":"<p><strong>Introduction: </strong>The purported predominance of the biopsychosocial model is reviewed, including its underlying factors that determine the etiology and treatment of sexual disorders. We recommend that sexual health professionals embrace a broader recognition of all facets of the model. Periodic re-examination is necessary to optimize its strengths and minimize misapplication.</p><p><strong>Objectives: </strong>Improving the application of the full scope of the biopsychosocial model will help ensure that it remains robust and inclusive. Awareness of its limitations should prompt clinicians to expand their knowledge through continuing education.</p><p><strong>Methods: </strong>Co-authors reviewed database searches, including PubMed, Google Scholar, and ClinicalTrials.gov. Publications, sexual society presentations, and guidelines were also considered, along with expert opinions. Authored by an intentionally recruited, diverse group of experts representing different disciplines, geographic regions, genders, and perspectives, our manuscript deserves substantial consideration. However, this work does not employ the rigorous methodology used by professional societies in producing guidelines.</p><p><strong>Results: </strong>The biopsychosocial model is widely used; however, too many sex therapists and sexual medicine experts claim to adopt the model while merely paying it lip service. Clinicians support multidisciplinary approaches, yet siloed thinking persists. Collegial respect is increasing, but perspectives remain divided. While sex therapists recognize psychosocial nuances, many are unaware of biomedical advances in diagnosis and treatment that impact sexuality. Conversely, many physicians lack sufficient awareness of the cognitive, emotional, behavioral, and cultural factors contributing to sexual disorders. Physicians who prefer broader assessments often find that time constraints in clinical practice hinder multilayered engagement.</p><p><strong>Conclusion: </strong>The biopsychosocial model must encompass all predisposing, precipitating, and maintaining biological, medical/surgical, cognitive, behavioral, emotional, social, and cultural factors involved in the etiology and management of sexual disorders. Etiology is best understood at a granular level that acknowledges multiple proportional contributing factors. We recommend that clinicians across disciplines increase their awareness of all relevant etiologic and treatment factors while continuing to use the accessible term \"biopsychosocial.\"</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Common misconceptions\" are not limiting testosterone therapy.","authors":"Scott Selinger","doi":"10.1093/sxmrev/qeaf040","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf040","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basic science and translational research: recommendations from the Fifth International Consultation for Sexual Medicine (ICSM 2024).","authors":"Noel N Kim, Hunter Wessells, Michael E DiSanto, Monica G Ferrini, Guiting Lin, James G Pfaus, Fernanda Priviero, Paul J Yong, Carol A Podlasek","doi":"10.1093/sxmrev/qeaf032","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf032","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Sexual function is a critical issue for human health and impacts the quality of life of patients and their partners. In this ICSM report, basic science and translational perspectives have been examined from the past decade of literature since the last ICSM report, and have been integrated to produce a state of the art summary of the physiology and molecular biology of sexual function/dysfunction and development of novel nanotechnology-based vehicles and treatments to aid regeneration and clinical translation in men and women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Examine, critically assess, and curate the most important and impactful basic and translational research findings on male and female sexual dysfunction since 2015.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Literature reviews were performed by a multidisciplinary committee of sexual medicine experts between June 2023 through May 2024. Findings were presented at the ICSM meeting in Madrid (June 2024), and comments from the consultation were incorporated to develop this consensus report.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Erectile dysfunction (ED), which accompanies prostatectomy, diabetes, aging, and vascular disease in men, develops through both common and distinct mechanisms that involve neural injury, penile remodeling (smooth muscle (SM) apoptosis and increased collagen/fibrosis), dysregulated SM contractility, increased oxidative stress, immune response, and genomic instability. In women, disorders of genital pain, arousal, sexual desire, and orgasm involve multiple, overlapping neurological and endocrine mechanisms. Research on ED has been more extensive and the underlying molecular mechanisms have been better characterized than female sexual dysfunction. Future research directions should focus on pathways that underlie penile tissue remodeling and fibrosis associated with cavernous nerve injury in prostatectomy and diabetes, since this leads to irreversible ED. Particular emphasis should be placed on therapeutic targets to improve/enhance nerve regeneration, neuroprotection, \"on demand\" sexual function, SM contractility/relaxation, oxidative stress, immune response, and hormone function. In women, despite the existence of approved and off-label treatments for disorders of sexual desire and orgasm, the greater influence of psychosocial factors for these aspects of sexual function demands a multidisciplinary approach, along with predictive animal models. Genome-wide association studies have great potential in advancing the field but require replication and functional validation of findings from bioinformatic analyses. Progress in nanotechnology and regenerative therapies offers an exciting frontier in the targeted delivery of ameliorative/restorative treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Research in sexual medicine has expanded through accelerated rates of discovery and increased breadth and diversity. However, much work remains in translating preclinical f","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the link between muscle quality and erectile dysfunction: assessing the impact of mass and strength.","authors":"Michelle Duan, Beatriz Hernandez, Shane Kronstedt, John Donato, Gal Saffati, Niki Parikh, Mohit Khera, Gabrielle Lyon","doi":"10.1093/sxmrev/qeaf033","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf033","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual dysfunction is a prevalent issue affecting quality of life. Skeletal muscle mass and strength are emerging biomarkers for overall health. Considered in tandem, sexual function and muscle mass have significant implications for well-being.</p><p><strong>Objectives: </strong>We aim to explore the relationship between skeletal muscle parameters and sexual function via mechanisms and discuss the role of testosterone.</p><p><strong>Methods: </strong>PubMed literature searches were conducted using MeSH: \"Muscle, Skeletal,\" \"Sexual Dysfunctions, Physiological,\" and \"Sexual Dysfunctions, Psychological.\" Keywords included \"sarcopenia,\" \"muscle mass,\" \"muscle strength,\" \"hand strength,\" \"resistance training,\" \"skeletal muscle,\" \"weight lifting,\" \"sexual function,\" \"sexual dysfunction,\" \"erectile function,\" \"erectile dysfunction,\" and \"male sexual function.\"</p><p><strong>Results: </strong>This yielded 355 results and 32 were included. Skeletal muscle mass and strength contribute independently to healthy sexual function through metabolic and endothelial mechanisms, particularly in aging adults and men with comorbidities like sarcopenia, diabetes, and obesity. Cross-sectional studies using muscle volume, hand-grip strength (HGS), and bioelectrical impedance assessment show correlations between muscle parameters and erectile function, sexual desire, and overall sexual satisfaction. In older men, HGS correlates with decreased erectile dysfunction risk (OR: 0.86 per 5 kg, 95% CI 0.78-0.96). Despite the established influence of testosterone on muscle and endothelial health, an independent correlation between HGS and International Index of Erectile Function-5 (IIEF-5) score persists after adjustment for serum testosterone (β = .169, P = .037) showing the strength of this relationship independent of testosterone.</p><p><strong>Conclusion: </strong>There is a positive correlation between erectile function and muscle health. Maintaining skeletal muscle with nutrition and physical activity improves erectile and overall health outcomes. Therapies that target sexual function and muscle health simultaneously (eg, testosterone and L-carnitine) may further benefit sexual function. Future studies are warranted to strengthen and elucidate this relationship and to follow the longitudinal outcomes of these therapies on sexual health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of social media on female genital self-image.","authors":"Ghada Farouk Mohammed","doi":"10.1093/sxmrev/qeaf031","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf031","url":null,"abstract":"<p><strong>Introduction: </strong>By offering a historical analysis that moves from the early modern period to the present, this essay examines the various factors that have shaped female genital self-image (FGSI) and sexual attitudes. Four main categories are identified as being particularly influential.</p><p><strong>Objectives: </strong>The review aims to improve doctors' understanding of the impact of social media on FGSI thereby promoting a comprehensive and holistic approach.</p><p><strong>Methods: </strong>A comprehensive search technique was used to obtain research papers from the following databases: PubMed (MEDLINE), Scopus, and Web of Science. Google Scholar was also manually searched. The search results were imported into Rayyan reference management and assessed using the established inclusion criteria. The quality of the articles was assessed using the appropriate JBI checklist (ie, according to the study design), and the JBI grades of recommendation were used to grade the evidence.</p><p><strong>Results: </strong>First, the review considers anatomical texts to determine how cultural beliefs about the female capacity for sexual enjoyment influenced perceptions of the female genitals as early as the 17th century. Next, the review engages with medical discourses-ranging from the scientific to the social-to establish 19th-century attitudes toward the connection between female genital anatomy and psychological state. Third, the review explores the application of psychoanalytic theory to uncover the internalization of societal norms in the construction of a similarly negative genital self-image in the early- to mid-20th century. Fourth, the review provides insights from the sexual liberation movement, with a particular focus on the importance of communication in the enhancement of female self-image.</p><p><strong>Conclusions: </strong>In conclusion, there is an association between increased time spent on social media platforms and heightened FGSI, alongside its interacting effect on multiple areas of self-perception and functioning in women.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual function and dysfunction in the LGBTQIA+ community-including before and after gender-affirming surgery: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).","authors":"Maurice M Garcia, Maria Manuela Peixoto, Heather L Armstrong, Erika Kelley, Gail Knudson, Natnita Mattawanon, Christopher W Wheldon","doi":"10.1093/sxmrev/qeaf024","DOIUrl":"10.1093/sxmrev/qeaf024","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based clinical practice guidelines focused on sexual (dys)function for the LGBTQIA+ (ie, lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual) community, including before and after gender-affirming surgery, are still scarce.</p><p><strong>Objectives: </strong>To provide an overview and recommendations for sexual (dys)function among individuals with diverse sexual orientations, transgender and gender-diverse individuals, and intersex individuals/individuals with differences of sexual development (DSD).</p><p><strong>Methods: </strong>A committee of experts conducted a comprehensive review of the literature, focusing on scientific publications since the last consultation, for the fifth International Consultation on Sexual Medicine.</p><p><strong>Results: </strong>Researches that considered populations with diverse sexual orientations were reviewed and largely focused on sexual satisfaction/pleasure, sexual functioning, and sexual difficulties. Additional topics included relationship and psychological dimensions, sexual functioning during receptive anal sex, chemsex, minority stress, asexuality, and sexuality in older adulthood. The main challenges are related to small sample sizes and mostly cross-sectional study designs that limit the generalization of findings. Research focused on sexual (dys)function among transgender and gender-diverse individuals tends to focus on a medical perspective of sexual function and is often based on cisgender models or methodology. Research has also focused attention on the relationship between medical interventions for gender-affirming care (eg, hormone therapy, surgery) and has often included cross-sectional designs or short-term follow-up. Current research also highlights the unique facets of sexual (dys)function that appear important to gender-diverse individuals, such as relational and body image factors. Fewer articles focused on individuals with intersex traits/DSD, and these included a diverse approach to the samples studied and methodology used. Much of this research focused on the impact of medical interventions (eg, hormone therapy, surgery) on sexual satisfaction and function. Across populations, there were limited validated measures of sexual (dys)function.</p><p><strong>Conclusion: </strong>Overall, the main challenges in the field are related to methodological gaps, as acknowledged in this review, and a summary of the literature is provided. Diversity, equity, and inclusion, as well as ethical considerations, are addressed, and clinical recommendations for supporting the sexual well-being of individuals with diverse sexual orientations, transgender and gender-diverse individuals, and intersex individuals/individuals with DSD are presented.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"283-300"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}