Sexual medicine reviews最新文献

{"title":"Internet-based cognitive behavioral therapy, web-based counseling, and online/digital psychoeducation for male sexual dysfunction: a systematic review.","authors":"Arya Srisadono, Muhammad Adamas, Cennikon Pakpahan, Camil C Branco","doi":"10.1093/sxmrev/qeag020","DOIUrl":"10.1093/sxmrev/qeag020","url":null,"abstract":"<p><strong>Introduction: </strong>Male sexual dysfunctionhas a substantial impact on psychological well-being and intimate partner relationships. The expanding availability of digital health services has enabled online interventions, such as internet-based cognitive behavioral therapy (ICBT), digital psychoeducation, and web-based counseling, to emerge as alternatives to conventional therapies.</p><p><strong>Objective: </strong>To evaluate the effectiveness, feasibility, and acceptability of digital and online interventions for male sexual dysfunction, and to synthesize evidence from randomized, non-randomized, and observational studies on clinical outcomes and patterns of digital engagement.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted across several databases using predefined keywords. Eligible studies included randomized controlled trials, experimental studies, and analytical observational studies published between 2007 and 2024. Extracted data comprised country, participant characteristics, type and duration of intervention, control conditions, outcome measures, and main findings. The primary outcome was improvement in erectile/sexual function using certain parameters, while secondary outcomes included relationship satisfaction, anxiety, and depression.</p><p><strong>Results: </strong>Of 2482 records identified, and 21 met the inclusion criteria. Overall, web-based ICBT and psychoeducational interventions improved erectile function and sexual satisfaction compared with control conditions. Most interventions lasted 6-12 weeks and incorporated therapist feedback or automated systems. Remission rates for erectile dysfunction ranged from 20% to 30%; however, participant adherence was low (<60%). Several studies also reported reductions in performance anxiety and improvements in sexual confidence, with no serious adverse effects.</p><p><strong>Conclusion: </strong>Online interventions are promising approaches for managing male sexual dysfunction. Nevertheless, low adherence rates and heterogeneity in intervention formats remain major challenges. The findings also suggest heterogeneous benefits of digital interventions, alongside improved accessibility, reduced stigma, and increased engagement in help-seeking among men with sexual dysfunction. Future research should prioritize strategies to enhance adherence, integrate mobile health technologies, and assess long-term outcomes through large-scale clinical trials.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610047","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":"Therapeutic applications of phosphodiesterase inhibitors in male reproductive health: narrative review.","authors":"Yashas Kiran Ninjoor, Vanishree Vasave Madhvacharya, Sandhya Kumari, M R Nagaraja, Jagadish P C, Dagur Singh Hanuman, Eerappa Rajakumara, Suranga P Kodithuwakku, Satish Kumar Adiga, Kshitish K Acharya, Guruprasad Kalthur","doi":"10.1093/sxmrev/qeag023","DOIUrl":"10.1093/sxmrev/qeag023","url":null,"abstract":"<p><strong>Introduction: </strong>Phosphodiesterases (PDEs) are a family of enzymes that regulate intracellular levels of cyclic nucleotides, such as cyclic adenosine monophosphate and cyclic guanosine monophosphate. PDEs are considered key modulators of cellular signaling processes, including those governing male reproductive health. Owing to the pivotal role played by PDEs in male reproductive health, pharmacologic inhibition of PDEs has gained substantial attention in improving male reproductive health. However, despite the potential therapeutic application of PDE inhibitors (PDEis) in this field, a comprehensive understanding remains limited of the PDE subtype-specific actions in male reproductive tissues, the potential off-target effects, and the long-term safety of PDE inhibition, emphasizing a critical gap in current knowledge. A systematic evaluation of existing evidence on the role of PDEs, as well as the therapeutic application of PDEis and their safety, is necessary for a better understating in the context of male reproductive and sexual health.</p><p><strong>Objectives: </strong>This narrative review aims to critically synthesize and highlight the current evidence on the function of PDEs in male reproductive organs and evaluate the clinical applications of PDEis as therapeutic agents in male reproductive health and sexual medicine.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed and Scopus to identify the expression and function of PDEs in male reproductive organs and the use of PDEis for the treatment of erectile dysfunction and reproductive cancer and for the improvement of male fertility.</p><p><strong>Results: </strong>PDEs of different families are expressed in a tissue-specific manner in the testis, epididymis, prostate gland, seminal vesicle, and penis, indicating their significant role in male reproductive health. Inhibitors of PDEs, even though popularly known for their therapeutic role in treating erectile dysfunction, have exhibited a promising role in the treatment of prostate cancer, testicular cancer, testicular function enhancement, and sperm motility improvement.</p><p><strong>Conclusions: </strong>PDEis have a promising role in improving male reproductive and sexual health. However, the lack of studies addressing their long-term health effects and safety limits their routine therapeutic applications for improving male reproductive health. Future systematic clinical trials and mechanistic studies can certainly illuminate the possible role of PDEis in improving male reproductive health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843116","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":"Psychiatric disorders, psychopharmacology and sexual dysfunction from the fifth international consultation on sexual medicine (ICSM 2024).","authors":"Christian J Nelson, Anita H Clayton, Michal Lew-Starowicz, Richard Balon, Wafaa Eltantawy, Flavia Glina, Paraskevi-Sofia Kirana","doi":"10.1093/sxmrev/qeag017","DOIUrl":"10.1093/sxmrev/qeag017","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization estimates that one in eight people around the world is living with a psychiatric disorder. An under-recognized consequence of psychiatric disorders is the detrimental impact they may have on sexuality. Psychotropic medications to treat psychiatric disorders can also have a significant, negative effect on sexual functioning.</p><p><strong>Objective: </strong>This review is a consensus International Consultation on Sexual Medicine (ICSM) report developed to outline and describe these impacts.</p><p><strong>Methods: </strong>The committee members first discussed the structure of the manuscript. Literature searches were conducted for each section, seeking key words related to sexual dysfunction and each specific psychiatric condition and for psychiatric medications and classes of drugs. A modified Delfi approach was used when making decisions on content and recommendations. The content and recommendations were presented at ICSM where experts across the field of sexual medicine provided feedback. These comments were reviewed by the co-chairs of the 24 committees for discussion and feedback.</p><p><strong>Results: </strong>In relation to psychiatric disorders and sexual dysfunction, there are two primary themes evident in the literature, (1) there are significant methodological weaknesses, and (2) the prevalence of sexual dysfunction across all psychiatric disorders is generally high and elevated compared to controls (when available). Additionally, sexual dysfunction associated with psychotropic medications is a frequent treatment-emergent side effect, for antidepressants ranging from 25% to 80% and for antipsychotics ranging from 16% to 60% depending on the underlying mechanism of action of a particular medication. Sexual dysfunction is also associated with many of the co-morbid conditions related to a psychiatric diagnosis.</p><p><strong>Conclusion: </strong>The committee outlined three recommendations which highlight the importance of assessing for sexual dysfunction in those who report psychiatric disorders, evaluating sexual dysfunction across treatment while treating these disorders with psychotropic medication, and recognizing that the causes of sexual dysfunction are often multi-factorial.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623904","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 sexual health becomes marginalized in long-term care: a scoping review of multi-level barriers.","authors":"Aysu Yıldız Karaahmet, Shahla Shafaati Laleh","doi":"10.1093/sxmrev/qeag022","DOIUrl":"10.1093/sxmrev/qeag022","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual health is a fundamental component of quality of life across the life course; however, it remains largely neglected in institutional care settings for older adults. In nursing homes and long-term care facilities, sexual health is frequently constrained by a range of individual, institutional, sociocultural, and ethical factors, which are often examined in isolation within the existing literature.</p><p><strong>Objectives: </strong>This scoping review aimed to map the barriers affecting the sexual health of older adults living in nursing homes and long-term care facilities and to examine how these barriers interact across multiple levels, contributing to complex and reinforcing mechanisms within institutional care contexts.</p><p><strong>Methods: </strong>A scoping review methodology was employed in accordance with the Joanna Briggs Institute framework and reported following the PRISMA-ScR guidelines. Systematic searches were conducted in MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, ASSIA, and relevant grey literature sources. Qualitative, quantitative, and mixed-methods studies addressing barriers to sexual health among older adults in institutional care settings were included. Data were charted and synthesized thematically.</p><p><strong>Results: </strong>Nineteen studies met the inclusion criteria. Four interrelated themes were identified: (1) individual-level barriers, (2) institutional and environmental barriers, (3) sociocultural barriers, and (4) ethical and legal barriers. The findings indicate that these barriers do not operate independently; rather, individual vulnerabilities are often amplified through institutional regulations and ethical uncertainties, while sociocultural norms and family expectations further legitimize restrictive practices. This interaction contributes to the systematic marginalization of sexual health within long-term care environments.</p><p><strong>Conclusions: </strong>The review highlights that barriers to sexual health among older adults in institutional care are shaped by interacting and mutually reinforcing processes, rather than isolated factors. Addressing sexual health in nursing homes therefore requires approaches that move beyond single-level interventions and consider the relational and systemic nature of these barriers. Future research should focus on empirically testing these mechanisms and developing multi-level, person-centred interventions to support sexual health in long-term care settings.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723944","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":"Cognitive behavioral therapy-based interventions for problematic pornography use: a scoping review.","authors":"Graziele Zwielewski, Valter Machado, Andreia A Fiamoncini, Ana Luísa Quinta-Gomes, Roberto M Cruz","doi":"10.1093/sxmrev/qeag027","DOIUrl":"10.1093/sxmrev/qeag027","url":null,"abstract":"<p><strong>Introduction: </strong>Problematic pornography use (PPU) has attracted increasing interest due to its reported associations with psychological distress, sexual difficulties, and relationship concerns in a subset of users. Several psychotherapeutic interventions have been proposed. Still, there is no widely accepted, evidence-based, standardized protocol for its treatment.</p><p><strong>Objective: </strong>This scoping review aimed to identify and synthesize intervention protocols based on cognitive behavioral therapy (CBT) for the treatment of PPU, published between 2019 and 2024.</p><p><strong>Methods: </strong>A systematic search was conducted in the PubMed, Scopus, and PsycINFO databases, using predefined terms such as \"cognitive behavioral therapy,\" \"pornography,\" \"PPU,\" and \"problematic pornography use.\" Empirical studies presenting CBT-based protocols for PPU, published in English, Portuguese, or Spanish between 2019 and 2024, were included. Two independent reviewers conducted double-blind screening of the studies, with discrepancies resolved by consensus. Extracted data included participant characteristics, study design, intervention components, session structure, and outcomes.</p><p><strong>Results: </strong>The initial search identified 437 studies. After removing duplicates and full-text screening, 11 studies met the inclusion criteria. Interventions varied in therapeutic approach, including CBT alone, ACT, mindfulness-based practices, and hybrid protocols, integrating CBT techniques with ACT-based or mindfulness-based strategies. Delivery modalities included in-person (n = 5), online (n = 5), and mixed (n = 1). Most protocols addressed emotional regulation, cognitive restructuring, craving management, and relapse prevention. Although all studies reported reductions in the frequency of PPU and associated symptoms, interventions that combined CBT with other techniques tended to report larger effect sizes. No studies reported complete abstinence, and there were high dropout rates in self-guided interventions.</p><p><strong>Conclusions: </strong>Despite promising findings, current CBT-based protocols for treating PPU lack standardization and methodological rigor. The field would benefit from consensus on diagnostic criteria, therapeutic goals, outcome measures, and additional randomized clinical trials that integrate mental health and sexual health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780591","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 interplay between testosterone and depression: bridging research, clinical applications, and health: a narrative review.","authors":"Megan C Abadom, Emmanuel Nyong, Beatriz S Hernandez, Gal Saffati, Niki Parikh, Mohit Khera","doi":"10.1093/sxmrev/qeag024","DOIUrl":"10.1093/sxmrev/qeag024","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past decade, the global burden of depression has increased and remains higher in women than in men. Emerging evidence suggests that low testosterone is linked to depressive symptoms in both sexes, raising important questions about its causal role and potential as a therapeutic target.</p><p><strong>Objective: </strong>To provide a narrative review of the literature on the relationship between testosterone and depression across both sexes, examine underlying neurobiological mechanisms, and assess the efficacy and risks of testosterone replacement therapy (TRT) as a treatment for depressive symptoms.</p><p><strong>Methods: </strong>We conducted a narrative review of PubMed, Medline, and Google Scholar for articles published between 1980 and 2024. Eligible sources included primary research articles, systematic reviews, meta-analyses, and narrative reviews that examined the relationship between testosterone levels, depression, and the effects of TRT on mood regulation. Search terms include low testosterone, hypogonadism, depression, mood disorders, androgen deficiency, TRT, neurotransmitters, and mental health.</p><p><strong>Results: </strong>Low testosterone is associated with depressive symptoms, particularly in hypogonadal men. Testosterone modulates serotonergic, dopaminergic, and GABAergic systems and acts on brain regions involved in mood regulation, including the prefrontal cortex, amygdala, and hippocampus. TRT improves mood, energy, and libido in hypogonadal men, though evidence in eugonadal men and women is mixed. Ethnic and genetic factors, such as androgen receptor Cytosine, Adenine, Guanine (CAG) repeat length, may influence susceptibility and treatment response. Risks of TRT include erythrocytosis, prostate-specific antigen elevation, cardiovascular events, and metabolic changes.</p><p><strong>Conclusion: </strong>Testosterone may play a significant role in mood regulation, and its deficiency may contribute to depressive symptoms. TRT is a promising treatment option for select patients, though it must be personalized and closely monitored to balance therapeutic benefits with potential risks.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843096","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":"Pelvic floor modalities for the management of female sexual dysfunction: a narrative review.","authors":"Zubeila Aihemaiti, Diliyaer Dilixiati, Alapati Waili, Atila Abulizi, Chunlin Wang, Bingzhang Qiao, Gulixian Shata, Reziya Dilixiati, Abudureheman Zebibula","doi":"10.1093/sxmrev/qeag025","DOIUrl":"10.1093/sxmrev/qeag025","url":null,"abstract":"<p><strong>Objectives: </strong>Female Sexual Dysfunction (FSD) affects 40%-45% of women globally, with multifactorial causes including pelvic floor dysfunction and hormonal changes. While hormone therapy and psychobehavioral interventions have demonstrated efficacy, they are often limited by side effects, contraindications, variable adherence, and a lack of standardized protocols. Physical therapy (PT) approaches have emerged as promising non-invasive alternatives or adjuncts, targeting underlying neuromuscular, vascular, and structural mechanisms of FSD. This review focuses on PT approaches, evaluating their mechanisms and clinical outcomes to guide evidence-based practice.</p><p><strong>Methods: </strong>The review followed the PICO framework: Population (women with FSD), Interventions (PT modalities), Comparators (sham/control/alternative treatments), and Outcomes (sexual function scores, pelvic floor muscle parameters, safety). A systematic search was performed in PubMed, Embase, and Web of Science up to April 13, 2025. The search strategy combined relevant MeSH terms and keywords using Boolean operators across three conceptual blocks: including \"Sexual Dysfunction, Physiological\"[Mesh], \"Hypoactive Sexual Desire Disorder\", \"Orgasmic Disorder\" etc., AND \"transcutaneous electrical nerve stimulation\", \"pelvic floor muscle training\", \"gradual dilation,\" etc., AND \"Women\"[Mesh], \"Female,\" \"female patient\" etc. The full search strategy and screening flowchart is available in Supplementary Material. Inclusion criteria: Randomized controlled trials (RCTs), cohort studies, pilot studies, and case reports were included if they involved women with FSD who received PT interventions and reported outcomes related to sexual function. Exclusion criteria: non-PT interventions, non-FSD populations, and non-English publications. Study selection involved two independent reviewers screening titles/abstracts and full texts. Data on study design, population, intervention, outcomes, and key findings were extracted into standardized tables.</p><p><strong>Results: </strong>Forty-nine clinical studies with 2742 participants were included. Electromagnetic therapy, electrical stimulation, Radiofrequency therapy, pelvic floor muscle training, multimodal pelvic floor physical therapy, vibratory stimulation, dilator therapy, and acupuncture all demonstrated potential efficacy in improving FSD-related symptoms, including sexual function, vaginal laxity, pain, and orgasmic function.</p><p><strong>Conclusions: </strong>Numerous physical therapy modalities have demonstrated potential efficacy in improving FSD-related symptoms, although evidence quality varies across interventions. Future large-scale RCTs with standardized protocols are needed to confirm long-term benefits and establish optimal treatment algorithms.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821202","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":"Definitions, classification, and epidemiology of sexual dysfunction: a consensus statement from the Fifth International Consultation on Sexual Medicine 2024.","authors":"Landon Trost, David Rowland, Cindy Meston, Sheryl Kingsberg, Peer Briken, Martin Gross, Tammary Esho, Ron Lewis, Annamaria Giraldi","doi":"10.1093/sxmrev/qeag028","DOIUrl":"10.1093/sxmrev/qeag028","url":null,"abstract":"<p><strong>Introduction: </strong>The creation and maintenance of accurate definitions for sexual dysfunction and sexual health of women and men represents a foundational principle of academic medicine and facilitates both clinical practice and research endeavors.</p><p><strong>Aims: </strong>To create and refine definitions relating to sexual health for women and men using an evidence-based and consensus approach. Additionally, to provide a high-level summary of key prevalence data relating to specific sexual dysfunctions.</p><p><strong>Methods: </strong>An international and multidisciplinary consensus meeting was held in 2024 of sexual medicine specialists throughout the world. Prior to the meeting, committee members relevant to this topic performed extensive background research into various sexual dysfunctions/disorders. Following the meeting, a final consensus document was created and is herein presented. Each section details prior definitions, the 2024 International Consultation on Sexual Medicine definition, and prevalence data relating to each specific definition.</p><p><strong>Main outcome measures: </strong>Evidence- and consensus-based definitions were created, including detailed discussions as to word modification and selection. Additionally, summarized prevalence data were presented.</p><p><strong>Results: </strong>A total of seven female definitions were presented, including hypoactive sexual desire disorder, female genital arousal disorder, female cognitive arousal disorder, female orgasmic disorder, female orgasm illness syndrome, sexual pain-penetration disorder, and persistent genital arousal disorder in women. For men, a total of 17 definitions were presented, including anejaculation, anhedonic/hypohedonic orgasm, anorgasmia, compulsive sexual behavior disorder, decreased libido, delayed ejaculation, dysejaculation, erectile dysfunction, genital dysmorphophobia, hard flaccid syndrome, hypoactive sexual desire disorder, micropenis, Peyronie's disease, post-orgasmic illness syndrome, premature ejaculation, restless genital syndrome, and retrograde ejaculation.</p><p><strong>Conclusions: </strong>Multiple definitions relating to women and men were created or revised using an evidence-based and consensus framework. Clinicians and researchers are encouraged to utilize these definitions to better standardize clinical care and future research studies.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975678","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 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":"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":3.0,"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":"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":3.0,"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}