Sexual medicine reviews最新文献

{"title":"Erectile dysfunction in patients with Peyronie's disease treated with different grafts: a systematic review.","authors":"Marco Tozzi, Andrea Gobbo, Giuseppe Fallara, Massimiliano Depalma, Alberto Quistini, Francesco Chierigo, Letizia Maria Ippolita Jannello, Wai Gin Lee, Omid Sedigh, Karl H Pang, Fabio Castiglione, Onur Omer Cakir, Stefano Luzzago, Francesco Alessandro Mistretta, Roberto Bianchi, Martina Maggi, Nicolo' Maria Buffi, Rocco Damiano, Gennaro Musi, Matteo Ferro, Carlo Bettocchi, Andrea Salonia, David Ralph","doi":"10.1093/sxmrev/qeaf053","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf053","url":null,"abstract":"<p><strong>Introduction: </strong>Peyronie's disease causes penile curvature and painful erections, potentially impairing quality of life; surgical grafts are employed to correct curvature and restore penetrative sexual function.</p><p><strong>Objectives: </strong>This study aimed to summarize the evidence on perioperative and functional outcomes of surgical grafting procedures for Peyronie's disease.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA guidelines. Databases including PubMed, EMBASE, Scopus, Google Scholar, and the Cochrane Library were searched up to April 1, 2023. Eligible studies included retrospective or prospective reports on patients aged 18 years or older treated with various graft materials, including vein, dermal, buccal mucosa, small intestinal submucosa, human cadaveric, and bovine pericardium. Quality was assessed using the JBI Critical Appraisal Checklist. Due to data heterogeneity and a lack of comparative studies, no quantitative synthesis was performed. The systematic review was registered on PROSPERO-CRD42024508997. The review focused on perioperative outcomes, erectile function changes, and complication rates associated with different graft materials.</p><p><strong>Results: </strong>Out of 521 articles identified from 1933 to 2023, 71 studies involving 2692 patients met the inclusion criteria. Six studies were prospective, and the remainder were retrospective. Quality assessment revealed a high or severely high risk of bias across all included studies. Erectile function worsened in 0%-70% of patients, with complication rates ranging from 0% to 50%. No comparative studies among graft types were identified.</p><p><strong>Conclusion: </strong>Various graft materials offer reliable perioperative and functional outcomes for Peyronie's disease; however, further comparative studies are essential.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087310","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}

{"title":"Blue balls: a brief history.","authors":"Diederik F Janssen","doi":"10.1093/sxmrev/qeaf015","DOIUrl":"10.1093/sxmrev/qeaf015","url":null,"abstract":"<p><strong>Introduction: </strong>Blue balls is a mundane complaint that generates substantive popular lore but has little coverage in the sexual medicine literature.</p><p><strong>Objectives: </strong>To draft a first medical history of relevant nosology and etiology.</p><p><strong>Methods: </strong>The Latin, French, German, Dutch, Italian, and English literature was mined.</p><p><strong>Results: </strong>As expected from a period of not only widespread scaremongering concerning masturbation and \"semen loss\" but also \"overly rigid continence,\" scrotal pain reminiscent of blue balls was well covered between the 1820s and 1920s, under variably inclusive nosologic headings: \"hernia seminalis,\" \"orchioncus,\" \"simple spermatocele,\" \"epididymis distensa,\" \"irritable testis,\" \"testicular epilepsy,\" \"testicular neuralgia,\" \"spermatic colic,\" \"stone-ache,\" \"epididymitis sympathica,\" \"epididymitis erotica,\" \"epididymitis antiperistaltica,\" \"paradidymitis erotica acuta,\" and \"epididymo-deferential colic.\" Even an analogical \"ovaralgia erotica\" was hypothesized. Observations had the radical potential of supporting poena naturalis (natural punishment) arguments against \"too strict\" continence and even pro masturbation. This historical push toward concepts of normal and habitual sexuality was fortified by equally tendentious concepts of \"constitutional\" or \"temperamental\" predisposition in some men. Yet the clear potential of the diagnosis to moderate strong prevailing sentiments against masturbation remained poorly realized until well into the early 20th century.</p><p><strong>Conclusion: </strong>Discomfort of the blue balls variety widely animated clinical sexual discourse from the early 18th century onward. It specifically informed interlocking, gendered ideas about sexual entitlement expressed in normative frames for sexual habits, eroto-sexual constitution, and behavioral health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"423-430"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064385","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 satisfaction in people and couples belonging to sexual orientation and gender diversities: a bibliometric analysis.","authors":"Pablo Mangas, Juan Carlos Sierra","doi":"10.1093/sxmrev/qeaf019","DOIUrl":"10.1093/sxmrev/qeaf019","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual satisfaction is a key component of individual and relational well-being and is defined as the subjective perception of enjoyment and fulfillment in sexual life. For individuals and couples belonging to sexual orientation and gender diversities (SOGDs), this satisfaction may be influenced by unique factors related to the experience of their sexual orientation and gender identity. However, the scientific literature exploring sexual satisfaction in these groups remains scarce. The present work analyzes the growth and characteristics of scientific production in this field of study.</p><p><strong>Objectives: </strong>Mapping scientific articles indexed in Scopus and Web of Science on the scientific production of sexual satisfaction in SOGD individuals and couples and identifying the production growth, sources, authors, countries and affiliations, relevant terms, and collaborative networks.</p><p><strong>Methods: </strong>A bibliometric analysis of 333 articles published in scientific journals was performed. The selected studies included terms related to the SOGD population and sexual satisfaction in the title, abstract and keywords. The articles covered the period 1976-2023 and were analyzed in terms of temporal production; authors, countries and institutions; relevant terms; trend topics; co-occurrence; and collaborations, using R-bibliometrix and VOSviewer.</p><p><strong>Results: </strong>The analysis revealed a progressive growth in scientific production, especially in the last decade. The main journals that published on the subject include The Journal of Sexual Medicine, Archives of Sexual Behavior, and The Journal of Sex Research. The studies were mainly concentrated in North American and European countries. Recurring terms such as HIV and relationship satisfaction were identified, while some SOGD collectives remained underrepresented. Additionally, limited intellectual collaboration networks were observed.</p><p><strong>Conclusions: </strong>This analysis highlights the need to expand research on sexual satisfaction in SOGD populations to include underrepresented regions and groups. A more inclusive and collaborative approach is recommended, addressing experiences of sexual satisfaction from affirmative and multicultural perspectives.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"362-372"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754525","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":"Understanding the erectile dysfunction-cardiovascular disease connection: clinical and pathophysiological insights.","authors":"Jinshun An, Boyu Xiang, Jingxuan Peng, Dongjie Li","doi":"10.1093/sxmrev/qeaf014","DOIUrl":"10.1093/sxmrev/qeaf014","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) and cardiovascular disease (CVD) share common pathophysiological mechanisms and molecular pathways, with ED serving as an independent risk factor and prognostic marker for CVD.</p><p><strong>Objectives: </strong>This review aims to explore the relationship between ED and CVD, analyze their shared pathophysiological mechanisms, and discuss the implications of these findings for clinical practice.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using PubMed, MEDLINE, and Web of Science databases, with keywords including \"erectile dysfunction,\" \"cardiovascular disease,\" \"endothelial dysfunction,\" \"inflammation,\" \"oxidative stress,\" \"NO/cGMP/PKG signaling pathway,\" \"RhoA/ROCK pathway,\" and \"testosterone deficiency.\"</p><p><strong>Results: </strong>The study found a positive correlation between ED and the incidence rate and severity of CVD, with shared mechanisms such as endothelial dysfunction, oxidative stress, and systemic inflammation. Mendelian randomization studies provided evidence of a causal relationship between genetically predicted CVD and ED risk, although reverse causality remains less clear. Early detection of ED may help prevent and manage CVD, with ED serving as a sentinel marker for asymptomatic coronary artery disease. The review also highlighted the potential of combining treatments like phosphodiesterase type 5 inhibitors with rho-associated protein kinase inhibitors or glucagon-like peptide-1 receptor agonists with testosterone therapy to optimize both cardiovascular and sexual outcomes.</p><p><strong>Conclusions: </strong>Understanding the association between ED and CVD is crucial for improving patients' quality of life and cardiovascular prognosis. Future research should focus on elucidating the mechanistic pathways underlying ED and CVD, validating causal relationships through long-term, multimodal studies, and developing standardized risk algorithms for early intervention. For clinical practice, proactive ED screening in high-risk populations and interdisciplinary collaboration between cardiologists and urologists are essential to prevent CVD progression and enhance patient quality of life.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"406-422"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736216","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":"Evaluation of erectile function in laboratory animals: an overview.","authors":"Jianxiong Ma, Yuhe Si, Yihao Chen, Jiahua Qian, Chenxi Wang, Qiang He","doi":"10.1093/sxmrev/qeaf017","DOIUrl":"10.1093/sxmrev/qeaf017","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) is a common male sexual disorder that diminishes quality of life significantly. Despite extensive research, little is known about the complex physiological mechanisms of ED, in part owing to disparities between animal and human physiology. Comprehensive and objective assessment methods for animal models are crucial to bridge this translational gap.</p><p><strong>Objectives: </strong>Various experimental approaches for evaluating erectile function in rodent models are explored.</p><p><strong>Methods: </strong>A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on the evaluation of erectile function in experimental animals. Studies without erectile assessment methods or insufficient data, editorials, letters, commentaries, and non-English articles were excluded.</p><p><strong>Results: </strong>The ICP-to-mean arterial pressure ratio remains a valuable indicator for evaluating erectile function. Furthermore, laser speckle blood perfusion imaging technology offers an approach for assessing changes in cavernous blood flow, whereas infrared thermal imaging technology enables real-time temperature monitoring during erectile responses. Microscopic ultrasound and magnetic resonance imaging allow high-resolution observation of hemodynamic and histological changes in the rat model penis, real-time assessment of blood flow, and detailed anatomical information. Human-rat homologous marker detection using blood tests has high clinical relevance and translational potential. In addition, wearable adaptive penile rigidity monitoring (WARM) dynamically monitors erectile function by accurately and continuously detecting changes in the girth of the rat penis in a non-invasive manner. Utilizing ex vivo models of cavernous tissue, such as the cavernous artery and smooth muscle, can provide valuable insights into the mechanisms underlying ED and the pharmacological effects and efficacy of drugs.</p><p><strong>Conclusion: </strong>This comprehensive review covers diverse approaches, including new technologies, for assessing erectile function in rodent models, including new technologies. By addressing the limitations of the existing methodologies and providing a framework for accurate and reliable evaluations, this review provides a basis for further research on the pathophysiology of ED and potential therapeutic interventions.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"394-405"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754457","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":"Understanding the functional significance of the labia minora: a scoping review on sexual physiology.","authors":"Sara Perelmuter, Sarah Ponce, Meghana Chapalamadugu, Katelyn Maliszewski, Gabrielle Smotrich, Rachel Rubin","doi":"10.1093/sxmrev/qeaf018","DOIUrl":"10.1093/sxmrev/qeaf018","url":null,"abstract":"<p><strong>Background: </strong>The labia minora, an essential yet understudied component of female genital anatomy, has been hypothesized to play a role in the female sexual function. Despite its potential importance, empirical evidence linking the labia minora's anatomical characteristics to sexual function remains limited.</p><p><strong>Aim: </strong>Through critically assessing the current literature on the labia minora, this scoping review aims to consolidate existing research on the labia minora's anatomy, vascularization, innervation, and its role in female sexual function.</p><p><strong>Methods: </strong>Scoping review methods according to (PRISMA-ScR) were followed. A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, and Scopus, from database inception to March 31, 2024. Studies were screened for original research on anatomy, vascularization, innervation, and sexual function of the labia minora, and data were extracted from those meeting the inclusion criteria. The quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and the JBI Critical Appraisal Tool.</p><p><strong>Results: </strong>Of the 480 studies identified, a total of 27 studies met the inclusion criteria, with the majority (56%) rated as \"good\" quality evidence. The labia minora was consistently found to have rich vascularization and a high density of nerve endings, suggesting a role in sexual arousal and engorgement. However, significant variations in labial morphology were noted, and the impact of these variations on sexual function remains unclear. Additionally, the role of hormonal influences, particularly androgens, on labial anatomy and function is poorly understood.Conclusion: The labia minora likely plays a critical role in female sexual function, yet many aspects of its anatomy and function are not well understood. Future research should prioritize detailed studies of its vascular and neural structures and the effects of hormonal changes to improve clinical outcomes and therapeutic interventions for vulvar-related conditions.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"347-361"},"PeriodicalIF":3.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736217","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":"Infection, inflammation, and sexual function in male and female patients-recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).","authors":"Fernando Facio, Elena Colonnello, Laith Alzweri, Estela Citrin, Alexandra Dubinskaya, Megan Falsetta, Adriano Fregonesi, Susan Kellogg-Spadt, Leonardo Seligra Lopes, Emmanuele A Jannini","doi":"10.1093/sxmrev/qeaf021","DOIUrl":"10.1093/sxmrev/qeaf021","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.</p><p><strong>Objectives: </strong>We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.</p><p><strong>Results: </strong>Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.</p><p><strong>Conclusions: </strong>This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"301-317"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014039","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":"Testosterone deficiency and treatments: common misconceptions and practical guidance for patient care.","authors":"Mohit Khera, James M Hotaling, Martin Miner","doi":"10.1093/sxmrev/qeaf011","DOIUrl":"10.1093/sxmrev/qeaf011","url":null,"abstract":"<p><strong>Introduction: </strong>Misconceptions about testosterone therapy are prevalent and there is an unmet need for a review of current literature that can be leveraged by physicians to deliver safe and effective care for men with hypogonadism.</p><p><strong>Objectives: </strong>This review aims to address common misconceptions about testosterone therapy using current literature and synthesize practical guidance for clinicians with patients who are starting testosterone therapy.</p><p><strong>Methods: </strong>A literature search of PubMed, Embase, CINAHL was carried out to identify associations between testosterone therapy and prostate cancer, cardiovascular risk, and hepatic toxicity; definitions of hypogonadism; and practical guidance for clinician with patients starting testosterone therapy.</p><p><strong>Results: </strong>There is no evidence to support the misconception that testosterone therapy leads to or promotes progression of prostate cancer, no evidence that testosterone therapy increases cardiovascular risk, no evidence that newer oral testosterone therapy formulations (eg, testosterone undecanoate) are associated with hepatic toxicity, and no consistent definition of hypogonadism among regulatory agencies and expert bodies. Clinicians should diagnose hypogonadism using testosterone concentrations and/or symptoms of testosterone deficiency, help patients select a testosterone therapy formulation that best fits their needs and preferences (including considerations for dose adjustment), ensure appropriate laboratory monitoring before and during treatment, and assess how patients are feeling during treatment.</p><p><strong>Conclusions: </strong>Testosterone therapy is not associated with increased prostate cancer or increased cardiovascular risk, newer oral testosterone therapy formulations are not associated with hepatic toxicity, and a strict definition of hypogonadism is difficult because patient individualization is required. Each patient in real-world clinical practices has unique baseline characteristics and will likely respond differently to testosterone therapy. As the primary goal of testosterone therapy is to provide relief from symptoms of hypogonadism, physicians should work with their male patients to create a comprehensive treatment plan that suits the patient's specific needs and preferences.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"373-380"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754527","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 recent data on disorders of ejaculation and orgasm in men: recommendations from the Fifth International Consultation on Sexual Medicine.","authors":"Alan W Shindel, Ege Can Serefoglu, Stanley Althof, Mohamed Arafa, Gajanan Bhat, Eelke Snoeren, Yan Zhang, Amr El-Meliegy","doi":"10.1093/sxmrev/qeaf016","DOIUrl":"10.1093/sxmrev/qeaf016","url":null,"abstract":"<p><strong>Introduction: </strong>Disorders of ejaculation and orgasm (DEO) in men are poorly understood and can pose a substantial burden to men and their sexual partners.</p><p><strong>Objectives: </strong>Under the aegis of the International Consultation on Sexual Medicine, a multinational, multidisciplinary panel of experts was convened to review the world literature and generate a consensus on management of DEO in men. This document represents a summary of the panel's report on physiology of ejaculation and orgasm, mental health conditions, and specific DEO that are not related to the timing of climax (ie, premature and delayed ejaculation).</p><p><strong>Methods: </strong>Narrative review of existing literature and consensus recommendations from the expert panel.</p><p><strong>Results: </strong>The processes of ejaculation and orgasm are complex and include neuronal and hormonal factors as well as psychological and interpersonal dynamics. Care of the patient presenting with a potential DEO centers on sensitive history taking and selective testing. Declines in semen volume may occur naturally with age and can be seen in the context of medical or surgical therapies. Pain with ejaculation/orgasm has a myriad of potential etiologies and may be part of a complex chronic pelvic pain syndrome; assessment for related diagnoses that may be contributory is warranted. Hematospermia can be distressing but is often benign; management when indicated is geared toward detecting potentially reversible etiologies. Climacturia is a troublesome condition of urine loss common after prostate surgeries; Behavioral and physical therapy and surgical intervention may be of value in these cases. Management strategies for anhedonic orgasm and post-orgasmic illness syndrome are not well established. Dhat is a complex syndrome oftentimes centered around pathological fear of semen loss that is best managed with a sensitive and culturally appropriate focus.</p><p><strong>Conclusions: </strong>An understanding of the processes of ejaculation and what is known about DEO can aid clinicians and researchers in providing optimal care.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"318-337"},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796303","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}