Sexual medicine reviews最新文献

{"title":"Sexuality in female patients on hemodialysis: a scoping review.","authors":"Solange Imhof, Fabiana Baggio Nerbass, Rafaela Gonzaga Dos Santos, Heitor S Ribeiro, Luana Gabriele Nilson","doi":"10.1093/sxmrev/qeaf059","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf059","url":null,"abstract":"<p><strong>Background: </strong>Kidney failure significantly affects sexuality, particularly female sexual function.</p><p><strong>Aim: </strong>This study aims to map current knowledge regarding the sexuality of women undergoing hemodialysis (HD).</p><p><strong>Methods: </strong>A scoping review was conducted following Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Databases searched included MEDLINE, Web of Science, and gray literature sources up to August 2023. The guiding question was: \"What is the available evidence on sexuality in women on hemodialysis?\" Studies containing the terms \"sexuality,\" \"women,\" and \"hemodialysis\" were included, without language or publication date restrictions.</p><p><strong>Results: </strong>From 1048 initially identified articles, 23 met inclusion criteria. An additional 15 gray literature studies were included, totaling 38 studies involving 2165 women on HD. Sexual dysfunction was highly prevalent, with a pooled estimate of 87%. Most studies (61.5%) used the Female Sexual Function Index to assess dysfunction. Women on HD presented higher rates of dysfunction compared to other stages of chronic kidney disease. Sexual dysfunction was often associated with poor quality of life, depression, and anxiety. Only four studies used qualitative methods, addressing topics such as gender roles, social constructs of sexuality, the impact of treatment on sexual health, and access to professional support.</p><p><strong>Conclusion: </strong>Women on HD face high rates of sexual dysfunction, closely linked to mental health and quality of life. Qualitative research on their lived experiences remains scarce and deserves further attention.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239634","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":"Review of the vestibular glands: functional anatomy, clinical significance, and role in sexual function.","authors":"Sara Perelmuter, Olivia Giovannetti, Diane Tomalty","doi":"10.1093/sxmrev/qeaf027","DOIUrl":"10.1093/sxmrev/qeaf027","url":null,"abstract":"<p><strong>Introduction: </strong>Glandular tissues, including the vestibular glands, play an important role in the female genital system. Despite this acknowledgement, the detailed structure and function of the major and minor vestibular glands has yet to be comprehensively reviewed.</p><p><strong>Objectives: </strong>Through a review of current evidence, this paper aims to consolidate current understanding of the functional anatomy, physiological significance, and suggested role in sexual function of the vestibular glands, and identify knowledge gaps to inform future research.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using various databases. Keywords included \"vestibular glands\", \"Bartholin's glands\", and \"minor vestibular glands\". Original research on the anatomy, embryology, function, and pathophysiology of the vestibular glands were included for review.</p><p><strong>Results: </strong>Limited literature focused on the embryonic development of the vestibular glands, though there is a prevailing hypothesis that they originate from the urogenital sinus. The major vestibular glands are described as oval-shaped glands and located at the posterior vaginal introitus, with ducts opening into the vulvar vestibule, though supporting anatomical data is lacking. Microscopic analyses indicate these glands produce mucin and contain neuroendocrine cells. However, data on blood supply and innervation were scarce. There is also a conspicuous lack of delineation between the major and minor vestibular glands both anatomically and functionally. Some studies linked the glands to sexual function, suggesting a role in lubrication and orgasm, though supporting evidence is limited.</p><p><strong>Conclusions: </strong>The vestibular glands are presumed to play a role in female sexual function, though their detailed physiology remains poorly understood. While these glands are believed to aid in lubrication, significant gaps exist in understanding concerning their embryology and anatomy (eg, blood supply, innervation) remain to be addressed. Future research should prioritize detailed functional anatomical and physiological studies to better understand these glands, which may in turn help inform clinical knowledge of related disorders.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"687-697"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249586","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":"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":"483-512"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","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":"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":"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":"612-622"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","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":"Letter to the Editor on \"Exploring the potential of DeepSeek-R1 in sexual and reproductive\".","authors":"Wenting Tong, Hui Zhang, Jinping Chen","doi":"10.1093/sxmrev/qeaf042","DOIUrl":"10.1093/sxmrev/qeaf042","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"766-768"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769073","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":"Unveiling research landscapes in erectile dysfunction: a bibliometric analysis comparing basic scientific research and clinical studies.","authors":"Zhongjie Zheng, Yi Lu, Yan Chen, Qianxi Chen, Eric Chung, Hui Jiang, Kai Hong, Hongjun Li, Haocheng Lin","doi":"10.1093/sxmrev/qeaf048","DOIUrl":"10.1093/sxmrev/qeaf048","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) is a highly prevalent male sexual disorders, affecting million of men worldwide. Given the volume of literature in ED, bibliometric analyses will provide an important resource to highlight landmark articles.</p><p><strong>Objectives: </strong>To evaluate the publication trends and impacts between basic scientific research and clinical studies through bibliometric analysis of ED literature between 1998 and 2023.</p><p><strong>Methods: </strong>We searched for articles in the Web of Science database from 1 January 1998 to 31 December 2023 using MeSH terms specific to ED. Relevant articles were divided into basic scientific research and clinical studies. A bibliometric analysis was performed by using \"Citespace\" and \"VOSviewer\" software.</p><p><strong>Results: </strong>A total of 6450 studies were identified, with 4808 in clinical studies and 1642 basic scientific research. The USA has the highest publication rate with 1851 articles, followed by China (853) and Italy (635). The University of California, San Francisco ranked first in basic scientific research with 68 research papers, while the University of Florence led the clinical research with 133 papers. The Journal of Sexual Medicine and the Journal of Urology were found to have the highest academic influence. Clinical research papers receive more citations than basic scientific ones. Notably, vardenafil emerged as the most frequently used keyword in ED research over the past decade, ranking first in both basic scientific and clinical studies.</p><p><strong>Conclusion: </strong>Bibliometric analyses can provide an in-depth analysis in distinguishing ED literature. There is a need to foster multi-center international collaborations and new emphasis on novel technology and recent scientific advances.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"632-642"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862482","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 hormonal regulation of men's sexual desire, arousal, and penile erection: recommendations from the fifth international consultation on sexual medicine (ICSM 2024).","authors":"Giulia Rastrelli, Leen Antonio, Serge Carrier, Andrea Isidori, Mario Maggi","doi":"10.1093/sxmrev/qeaf025","DOIUrl":"10.1093/sxmrev/qeaf025","url":null,"abstract":"<p><strong>Introduction: </strong>The sexual response, including sexual desire and arousal/penile erection in men, is affected by several hormones and neurotransmitters.</p><p><strong>Objectives: </strong>To give resources to understand the usefulness to assess different hormones when considering a man with hypoactive sexual desire or erectile dysfunction and to provide evidence-based recommendations for clinical practice. A level of evidence grading system was used to provide strong, moderate, or conditional recommendations.</p><p><strong>Methods: </strong>An extensive revision of the scientific literature was performed by the subcommittee of the International Consultation of Sexual Medicine. The results were first extensively discussed by the sub-committee members and presented publicly for further discussion with other experts. The roles of hypothalamic (kisspeptin, α-melanocyte-stimulating hormone), pituitary (prolactin, oxytocin [OT], and growth hormone), thyroid, adrenal (dehydroepiandrosterone, glucocorticoids, and mineralocorticoids) and sex hormones were considered.</p><p><strong>Results: </strong>Testosterone has a primary role in controlling and coordinating male sexual desire and arousal, acting at multiple levels. Accordingly, meta-analysis indicates that testosterone therapy for hypogonadal individuals can improve low desire and erectile dysfunction. Hyperprolactinemia is associated with low desire which can be successfully corrected by appropriate treatments. OT, α-melanocyte-stimulating hormone, and kisspeptin are important in eliciting sexual arousal; however, the use of these peptides or their analogs, for stimulating sexual arousal is still under investigation. Evaluation and treatment of other endocrine disorders are suggested only in selected cases.</p><p><strong>Conclusions: </strong>Endocrine abnormalities are common in patients with sexual dysfunction. The identification of some of these is mandatory (ie, testosterone, prolactin), whereas, for others, it is known that their disorders may cause sexual dysfunction without, however, being frequently recognized in subjects consulting for sexual dysfunction (ie, thyroid and growth hormones). Others may be important, but the clinical use is limited by issues with their measurement (ie, estradiol, dihydrotestosterone), whereas for some hormones or neuropeptides, the clinical usefulness for diagnostic and/or therapeutic purposes should still be established.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"433-455"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302770","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":"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":"751-763"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","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":"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":"663-673"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","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":"Update on late-onset hypogonadism: current concepts, controversies, clinical diagnosis, pathogenesis, and treatment approaches.","authors":"Xiaopeng Tang, Yanghua Xu, Ningjing Ou, Yuxin Tang, Hao Chen","doi":"10.1093/sxmrev/qeaf043","DOIUrl":"10.1093/sxmrev/qeaf043","url":null,"abstract":"<p><strong>Introduction: </strong>Since its proposal in 2002, late-onset hypogonadism (LOH) has been a subject of considerable controversy. Although its status as a pathophysiological entity is undisputed, the underlying mechanisms remain contentious and are not fully understood.</p><p><strong>Objectives: </strong>To evaluate current therapies for LOH, such as testosterone replacement therapy (TRT) and weight loss interventions, and to explore innovative anti-aging strategies aimed at counteracting age-related factors contributing to LOH.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted to explore the ongoing controversies and challenges in the clinical diagnosis of LOH. Additionally, the efficacy and limitations of current therapeutic approaches, including novel anti-aging strategies and combination therapies were critically examined.</p><p><strong>Results: </strong>Current therapies address specific aspects of LOH, such as TRT for low testosterone levels and weight loss interventions for obesity, which is the strongest risk factor. However, these therapies have shortcomings, including potential health hazards associated with TRT and disputed efficacy of weight loss interventions. Recent discoveries have led to the development of innovative anti-aging strategies, which show promise in overcoming the limitations of existing methods. Several clinical trials have substantiated the efficacy of these novel approaches, particularly when used in combination therapies.</p><p><strong>Conclusions: </strong>While further clinical trials are necessary, novel anti-aging strategies hold promise for enhancing the efficacy of existing LOH treatments and overcoming their limitations. These innovative approaches could potentially offer more effective solutions for managing LOH.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"652-662"},"PeriodicalIF":3.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769075","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}