Sexual medicine reviews最新文献

{"title":"The role of kidney transplantation in the management of erectile dysfunction: a review of hormonal changes and psychosocial impacts in male patients.","authors":"Muhammad Adil Malik","doi":"10.1093/sxmrev/qeaf079","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf079","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney transplantation is a life-saving intervention for patients with end-stage renal disease (ESRD), significantly improving longevity and quality of life compared to dialysis. However, despite these benefits, a considerable proportion of male recipients (20%-50%) continue to experience erectile dysfunction (ED), highlighting an ongoing concern in post-transplant health management.</p><p><strong>Objectives: </strong>The aim of this review is to examine the role of kidney transplantation in addressing erectile dysfunction, with a particular focus on the interplay between hormonal changes, specifically testosterone and thyroid hormones and psychosocial factors such as anxiety, depression, and overall quality of life, by analyzing the multifactorial etiology of ED, including neurovascular, hormonal, and psychological dimensions.</p><p><strong>Methods: </strong>A comprehensive analysis of existing literature was conducted, focusing on studies that examine ED prevalence, underlying mechanisms, and treatment approaches in kidney transplant recipients. Articles were selected based on their relevance to hormonal, psychological, and metabolic factors contributing to post-transplant sexual dysfunction.</p><p><strong>Results: </strong>Findings indicate that persistent hormonal imbalances, including altered testosterone and thyroid hormone levels, significantly contribute to ED post-transplant. Additionally, psychosocial factors such as anxiety, depression, and reduced quality of life exacerbate the condition. Current therapeutic approaches emphasize a multidisciplinary framework that integrates hormonal regulation, psychological support, and metabolic management to address ED effectively.</p><p><strong>Conclusion: </strong>Addressing ED in kidney transplant recipients requires a comprehensive approach that considers both physiological and psychological factors. Future research may focus on refining treatment protocols by incorporating hormonal therapies, mental health interventions, and lifestyle modifications to optimize sexual health outcomes and overall well-being in this vulnerable population.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514849","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":"On-demand testosterone for the treatment of female sexual dysfunction: a systematic review.","authors":"Leyi B Yin, Rui M Bernardino, Keiran Pace, Sara Mansouri, Sanchit Kaushal, Jessica G Cockburn, Neil E Fleshner","doi":"10.1093/sxmrev/qeag014","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag014","url":null,"abstract":"<p><strong>Introduction: </strong>Female sexual dysfunction is common, distressing, and notoriously difficult to treat. In the last two decades, short-course (\"on-demand\") testosterone (T) regimens-delivered sublingually, intranasally, inhaled, topically, or intramuscularly-have been explored as rapid-acting prn enhancers of female libido. The objective of this study is to quantify efficacy, safety, and pharmacokinetics (PK) of short-term T therapy (prn) in women with sexual dysfunction.</p><p><strong>Methods: </strong>PRISMA 2020 guidelines for systematic reviews were followed. Twelve RCTs and five PK studies (n = 940) were identified via Embase/MEDLINE/Web of Science (inception-March 2025). Outcomes included desire/arousal scores, satisfying sexual events (SSE), pharmacokinetics, and adverse events. Risk of bias was assessed using the Cochrane risk-of-bias tool.</p><p><strong>Results: </strong>Although absolute serum T excursions differ widely across formulations, most achieve supra-physiological free-T peaks within 15 min and return to baseline within 2-6 h. There is mixed evidence that this window coincides with maximal central arousal effects. However, when combined with phosphodiesterase-5 or 5-HT1A agonists, there tends to be improved genital vasocongestion and sexual satisfaction. Adverse events were mild but tended to be common.</p><p><strong>Conclusions: </strong>Short-term T therapy combined with phosphodiesterase-5 inhibitors or 5-HT1A agonists may be benefit select subgroups of women with sexual dysfunction with a favorable short-term safety, however, sample sizes remain small and further research is required.Registration: This study was registered in PROSPERO: CRD42024615106.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494625","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":"A systematic review of associations-exploring whether prostate size is related to sexual function outcomes following water vapor thermal therapy.","authors":"Philip Westbrook, Ahmer Farooq, Golnaz Venkatraman, Isabelle Searcy, Kevin Kerian, Tyson Rogers, Kevin T McVary","doi":"10.1093/sxmrev/qeag007","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag007","url":null,"abstract":"<p><strong>Introduction: </strong>Rezūm water vapor thermal therapy (WVTT) is a safe and effective treatment for lower urinary tract symptoms/benign prostatic hyperplasia (BPH) in patients with prostate sizes between 30 and 80 cm3 and preserves sexual function. However, its effect on sexual function in patients with large prostate volumes (≥80 cm3) is unknown.</p><p><strong>Objectives: </strong>This systematic review aims to assess the association of prostate size with sexual function outcomes in lower urinary tract symptoms/benign prostatic hyperplasia patients after treatment with WVTT.</p><p><strong>Methods: </strong>Medline and Embase were searched (2013-2024) to identify articles reporting sexual function outcomes for both average (≤80 cm3) and large gland (>80 cm3) patients within the same study at baseline and ≥12 months. Adverse events impacting sexual function, postoperative benign prostatic hyperplasia medication usage, and baseline/≥12-month data for sexual function outcomes were extracted in DistillerSR. Outcomes were summarized for each subgroup (average gland, large gland). ROBINS-I was used to assess risk of bias, and the Grading of Recommendations, Assessment, Development and Evaluation system was used to assess certainty of evidence.</p><p><strong>Results: </strong>Of 394 articles, 4 were included. Corresponding to three distinct studies reporting sexual function outcomes at baseline and ≥12 months post-WVTT (306 average and 85 large gland patients at baseline). Scales included International Index of Erectile Function (IIEF)-15, IIEF-5 (Sexual Health Inventory for Men-SHIM), IIEF-Ejaculatory Function (EF) Domain, Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD) Bother, and MSHQ-EjD Function. At follow-up, all three studies reported no clinically significant associations between sexual function outcomes and prostate size for large gland and average gland patients.</p><p><strong>Conclusions: </strong>Despite limited studies reporting sexual function outcomes in both average and large gland patients, this systematic review showed there was no clinically meaningful association between prostate size and erectile or ejaculatory function at ≥12 months after WVTT.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776852","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":"Comparative outcomes of single-incision versus dual-incision techniques in simultaneous penile prosthesis and artificial urinary sphincter implantation.","authors":"Adnan El-Achkar, Nilson Marquardt Filho, Craig Cronin, Joseph Cheaib, Alexandre Yamada Fujimura Junior, Tuan Thanh Nguyen, Xuan Thai Ngo, Arthur L Burnett","doi":"10.1093/sxmrev/qeag006","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag006","url":null,"abstract":"<p><strong>Introduction: </strong>While outcomes of simultaneous penile prosthesis (PP) and artificial urinary sphincter (AUS) implantation are well documented, comparative data on single-incision versus dual-incision techniques remain limited.</p><p><strong>Objectives: </strong>This narrative review aims to synthesize the available evidence comparing clinical outcomes and complication rates between these two surgical approaches in patients undergoing simultaneous dual implantation.</p><p><strong>Methods: </strong>A structured literature review of MEDLINE (OVID), PubMed, and the Cochrane Library was performed from database inception through October 2024 to identify studies reporting outcomes and complications following simultaneous PP and AUS implantation. Patients were grouped according to surgical approach: single incision (penoscrotal or perineal) versus dual incision. The reported outcomes included device infection, revision rates, urethral erosion, and mechanical failure. Quantitative outcome ranges and pooled proportions were summarized descriptively.</p><p><strong>Results: </strong>Ten studies comprising 269 patients were included. Of these, 167 underwent dual implantation via a single incision, and 102 via dual incisions. The mean age ranged from 58 to 68 years across cohorts, with a median follow-up ranging from 12 to 72 months. Social continence (defined as ≤1 pad per day) in the single-incision group ranged from 72% to 96%, compared with approximately 90% in the dual-incision group. Functional penile prosthesis rates were consistently above 96% in both groups. The single-incision group demonstrated lower reported rates of revision (16.5% vs 30.5%) and mechanical failure (2.8% vs 13.1%) compared with the dual-incision group; however, outcome ranges overlapped substantially across studies. Rates of device infection (4.1% vs 5.1%) and urethral erosion (10.0% vs 7.0%) were similar between surgical approaches.</p><p><strong>Conclusions: </strong>Simultaneous PP and AUS implantation via a single incision demonstrates clinical outcomes comparable to the dual-incision technique, with similar rates of infection, urethral erosion, mechanical failure, and revisions. These findings support the feasibility of either approach for simultaneous implantation.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776911","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":"Management of Penile Mondor's disease: insights from a scoping review.","authors":"Alessio Papaveri, Angelo Cafarelli, Federico Falsetti, Luca Spinozzi, Davide Ciavarella, Enrico Sicignano, Valentina Maurizi, Michele Marchioni, Luigi Schips, Daniele Castellani, Vineet Gauhar, Carlo Giulioni","doi":"10.1093/sxmrev/qeaf080","DOIUrl":"10.1093/sxmrev/qeaf080","url":null,"abstract":"<p><strong>Introduction: </strong>Penile Mondor's disease (PMD) is a rare, benign thrombophlebitis of the superficial dorsal vein of the penis. Despite its distinctive clinical features, PMD remains under-recognized, and its optimal management is not well defined.</p><p><strong>Objectives: </strong>This scoping review aimed to evaluate the current evidence on medical treatment and clinical outcomes of therapy in PMD.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, and Scopus was performed on July 25, 2025, using predefined keywords. Eligible studies included English-language peer-reviewed articles involving adult patients with PMD that reported clinical or radiological treatment outcomes. Case reports, reviews, conference abstracts, and non-English publications were excluded. Screening was performed independently by two reviewers, with disagreements resolved by a third.</p><p><strong>Results: </strong>Five studies met inclusion criteria. Most cases of PMD were self-limited, resolving spontaneously within 4-8 weeks without sequelae. Conservative management (including sexual abstinence, non-steroidal anti-inflammatory drugs, and topical heparinoids) was effective in most patients. The role of anticoagulant therapy remains controversial and may be considered only in cases with proven thrombophilia or recurrent disease. Surgical interventions, such as thrombectomy or superficial vein resection, were rarely required and reserved for refractory cases. Importantly, PMD did not result in chronic erectile dysfunction. Transient erectile impairment during the acute phase was attributed to pain, vascular inflammation, and psychological distress, with full recovery observed after resolution.</p><p><strong>Conclusion: </strong>Current evidence supports conservative therapy as the mainstay of PMD management. Pharmacological interventions may provide symptomatic relief, while surgical treatment should be limited to refractory cases. Larger prospective studies are needed to establish standardized protocols and clarify the role of thrombophilia screening.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934741","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":"Judith and Holofernes: alcohol's role in male sexual health in the light of the systems sexology.","authors":"Dimitri Yannas, Andrea Sansone, Angelo Cignarelli, Daniele Santi, Giorgia Spaggiari, Francesco Giorgino, Tommaso B Jannini, Alberto Siracusano, Emmanuele A Jannini","doi":"10.1093/sxmrev/qeag008","DOIUrl":"10.1093/sxmrev/qeag008","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol has been a central part of human culture for millennia and is closely linked to sexual behavior, a relationship portrayed in both negative and positive terms, from impaired performance to enhanced desire. Its influence on male sexual function is complex, shaped by biological, psychological, and social factors, as well as patterns and levels of consumption.</p><p><strong>Objectives: </strong>This review aims to summarize current evidence on the effects of acute and chronic alcohol consumption on male sexual function, highlighting mechanisms, patterns of use, and clinical implications.</p><p><strong>Methods: </strong>A PubMed search using MeSH terms and keywords related to alcohol and male sexual dysfunction (SD) yielded 599 articles. Relevant studies were selected for inclusion in this non-systematic narrative review, integrating findings from epidemiological, experimental, and clinical research.</p><p><strong>Results: </strong>Alcohol exerts complex pathophysiological and psychological effects-ranging from cardiovascular, hormonal, and neurological alterations to cognitive, emotional, and behavioral changes-that together shape its multifaceted impact on male sexual function. Social and cultural factors may further modulate this relationship. Light-to-moderate intake can have neutral or modestly protective effects on erectile function and may facilitate sexual activity. In contrast, heavy or binge consumption is consistently associated with erectile dysfunction, may contribute to ejaculatory disorders, and is linked to a reduced overall sexual quality of life. Chronic alcohol abuse, as seen in Alcohol Use Disorders (AUD), exacerbates sexual impairment through physiological toxicity, psychosocial stressors, and psychiatric comorbidities, while SD can, in turn, promote maladaptive drinking behaviors, creating a bidirectional relationship.</p><p><strong>Conclusion: </strong>Alcohol's impact on male sexual function is dose- and context-dependent. While moderate intake appears benign, excessive consumption leads to significant SD that might, in turn, contribute to AUD. The systems sexology framework provides a holistic lens to understand how 4 interrelated domains (mind, body, experience, and society) interact in shaping alcohol-sex relationship, informing prevention and therapeutic strategies.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318351","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":"Priapism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).","authors":"Ates Kadioglu, Mustafa Kadihasanoglu, Asif Muneer, Nelson E Bennett, Murat Dursun, Lawrance Hakim, William Akakpo, Ryan P Terlecki, Arthur L Burnett","doi":"10.1093/sxmrev/qeaf072","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf072","url":null,"abstract":"<p><strong>Introduction: </strong>Male genital emergencies involving the penis are uncommon and necessitate immediate medical attention as well as surgery. The term \"priapism\" refers to a persistent erection caused by malfunctioning mechanisms that control rigidity, flaccidity, and penile tumescence. Identification of the underlying hemodynamics is necessary for a prompt and accurate diagnosis of priapism.</p><p><strong>Objectives: </strong>To discuss the epidemiology, pathophysiology, and classification of priapism, as well as to give healthcare professionals up-to-date clinical evidence on the management of the priapism.</p><p><strong>Methods: </strong>The members of the Fifth International Consultation for Sexual Medicine (ICSM) Committee 22 have conducted a review of the peer-reviewed scientific literature to present an objective, comprehensive analysis regarding the diagnosis and management of priapism. This report reviews the literature from 2010 to 2025 on priapism and concentrates on guidelines that have been written in the last ten years. Every relevant article was examined critically and discussed.</p><p><strong>Results: </strong>This manuscript provides evidence-based diagnostic and treatment recommendations for ischemic, non-ischemic, recurrent ischemic priapism, and priapism in patients with sickle cell disease. The role of imaging, laboratory testing, early urologists' involvement when a patient presents to the emergency room, the discussion of conservative therapies, improved data for patient counseling regarding the risks of erectile dysfunction and surgical complications, specific recommendations regarding intra-cavernosal phenylephrine with or without irrigation, the inclusion of novel surgical techniques, and early penile prosthesis placement are all covered in this recommendation.</p><p><strong>Conclusion: </strong>Every patient with priapism should have an emergency evaluation to determine whether they have acute ischemic or non-ischemic priapism, and those who have experienced an acute ischemic event should receive early intervention when necessary. Treatment for NIP must be based on the goals of the patient, the resources at hand, and the experience of the clinician; it is not an emergency.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901078","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":"GLP-1 receptor agonists and sexual function in women and men: a narrative review of emerging evidence and the need for further research.","authors":"Zaher Merhi","doi":"10.1093/sxmrev/qeag015","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag015","url":null,"abstract":"<p><strong>Introduction: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) may influence reward-related and sexual behaviors.</p><p><strong>Objective: </strong>To synthesize evidence from preclinical and clinical studies evaluating the impact of GLP-1 RAs on libido and sexual function in both women and men.</p><p><strong>Methods: </strong>A structured synthesis of published studies examining GLP-1 RAs in relation to sexual behaviors, libido, and sexual parameters was performed using PubMed.</p><p><strong>Results: </strong>In animal models, the GLP-1 RA exendin-4 administration suppressed sexual interaction behaviors in a brain region-specific manner, particularly within the laterodorsal tegmental area, posterior ventral tegmental area, and nucleus accumbens shell, while activation of the nucleus of the solitary tract reduced pre-sexual, sexual, and post-sexual behaviors accompanied by elevated corticosterone and altered monoamine turnover. These findings suggest diminishing sexual motivation and performance in rodents through neuroendocrine and stress-related mechanisms. In humans, evidence remains mixed. Pharmacovigilance analyses from the FDA Adverse Event Reporting System revealed reports of erectile dysfunction, decreased libido, and orgasmic dysfunction among GLP-1 RA users, but disproportionality analyses indicated insignificant associations. A social media-based netnographic analysis of user posts found self-reported reductions in substance use and compulsive behaviors, with variable effects on libido-ranging from enhancement attributed to weight loss and improved body image to decreased desire in others. A randomized, double-blind crossover trial in healthy lean men demonstrated that dulaglutide had no effect on sexual desire, hypothalamic-pituitary-gonadal axis hormones, or semen parameters, suggesting no direct impairment of male sexual or reproductive function. However, recent clinical case reports have identified possible female sexual side effects.</p><p><strong>Conclusion: </strong>Collectively, preclinical evidence supports inhibitory effects of GLP-1 receptor activation on sexual motivation, whereas human findings are limited and reveal heterogeneous outcomes possibly influenced by gender, metabolic status, GLP-1 RA drug type, and psychosocial factors. Further mechanistic and controlled clinical studies are warranted since there seems to be a divergence between preclinical and clinical data.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500028","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":"A scoping review of the biopsychosocial factors influencing sexual desire in menopause.","authors":"Kate B Metcalfe, Cindy M Meston","doi":"10.1093/sxmrev/qeag009","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag009","url":null,"abstract":"<p><strong>Introduction: </strong>Declining sexual desire is one of the most common and distressing symptoms of menopause and has significant implications on sexual satisfaction and overall well-being. Though declining ovarian function and sex hormone levels characteristic of menopause may contribute to low desire, some menopausal women report stable or even increased desire since the onset of menopause, suggesting that biological, psychological, and social factors are also relevant.</p><p><strong>Objectives: </strong>This scoping review synthesized existing research examining these biopsychosocial factors associated with desire in menopause.</p><p><strong>Methods: </strong>Following best practices for scoping reviews, comprehensive searches were conducted in PubMed and PsycINFO in July 2025, for articles examining sexual desire in menopause. Quantitative studies were included if they examined peri- or postmenopausal women, measured sexual desire as a distinct construct, and examined desire in relation to a biological, psychological, or social construct. A total of 818 articles were reviewed, with 31 meeting inclusion criteria. Data were extracted and thematically synthesized across the three biopsychosocial domains.</p><p><strong>Results: </strong>Biological factors most relevant to sexual desire include other domains of sexual dysfunction, as well as genitourinary syndrome of menopause, particularly pain with intercourse and vaginal dryness. Other symptoms of menopause, namely sleep disruptions and poor general health are also associated with declines in desire. Psychological factors, especially anxiety and depression, strongly predicted decreased desire. Although less researched, poor body image and negative attitudes about sex appear to impact desire. Social factors such as relationship dissatisfaction and relationship length tend to correlate with declines in desire.</p><p><strong>Conclusions: </strong>Sexual desire in menopause reflects a complex interplay of biological, hormonal, and social influences that extend beyond declining ovarian function and hormones. A biopsychosocial framework is essential for advancing research and holistic care to support menopausal women with low desire.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575469","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 dysfunctions in male patients with infertility: recommendations from the Fifth International Consultation for Sexual Medicine (ICSM 2024).","authors":"David Shin, Andrea Sansone, Pramod Krishnappa, Abdulaziz Baazeem, Helen L Bernie, Mohammad Shamsul Ahsan, Nannan Thirumavalavan, Wayne J G Hellstrom, Rupin Shah","doi":"10.1093/sxmrev/qeaf073","DOIUrl":"10.1093/sxmrev/qeaf073","url":null,"abstract":"<p><strong>Introduction: </strong>The issue of sexual dysfunction in infertile couples is often neglected and underreported. As sexual dysfunction can both contribute to and result from infertility, clinicians should be equipped to identify and address these issues as part of comprehensive fertility care.</p><p><strong>Objectives: </strong>To develop evidence- and consensus-based recommendations for the clinical management of male sexual dysfunction (MSD) in the context of infertility.</p><p><strong>Methods: </strong>Initial recommendations were formulated based on expert opinion and exploratory analysis of various types of MSD associated with infertility. A focused literature review was conducted for each topic, followed by iterative rounds of expert discussion to refine recommendations. Final consensus was achieved at the 5th International Consultation on Sexual Medicine meeting, and recommendations were rated using GRADE criteria.</p><p><strong>Results: </strong>MSD and infertility often coexist, necessitating a detailed sexual history and physical examination during the initial infertility evaluation. Erectile dysfunction may be effectively managed with counseling, phosphodiesterase-5 inhibitors, or intracavernosal injections (eg, alprostadil, papaverine, phentolamine), which do not impair fertility outcomes. For low libido or unconsummated marriages, a multidisciplinary approach tailored to the couple's priorities-sexual function or fertility-is recommended. Ejaculatory disorders may be treated with counseling, penile vibratory stimulation, electro-ejaculation, medications, or assisted reproduction, depending upon the underlying cause. Selective serotonin reuptake inhibitors, used for premature ejaculation, may adversely affect sperm parameters and should be prescribed cautiously. Men with hypogonadism seeking fertility should avoid exogenous testosterone; alternatives such as selective estrogen receptor modulators, aromatase inhibitors, or gonadotropins may be considered. Lifestyle optimization, management of comorbidities, and use of fertility-safe lubricants can improve sexual and reproductive outcomes for couples trying to conceive.</p><p><strong>Conclusion: </strong>MSD and infertility are often interrelated. Incorporating routine sexual health assessments into fertility evaluations enables clinicians to diagnose and treat MSD effectively, thereby improving both sexual function and reproductive success.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935038","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}