Journal of Sexual Medicine最新文献

{"title":"Testosterone replacement therapy for low libido in idiopathic hypogonadism: an unmet regulatory need.","authors":"Skyler Howell, Mohit Khera","doi":"10.1093/jsxmed/qdag275","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag275","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet needs in the treatment of erectile dysfunction and a place for topical treatments in the therapeutic landscape.","authors":"Gerald B Brock, Faysal A Yafi, Wayne J G Hellstrom, Christian Nelson, David Ralph, Stanton Honig, Geoff Hackett, Rachel Rubin, Amy Pearlman, Sam Ward, Eric Chung, Hossein Sadeghi-Nejad, Noah Stern","doi":"10.1093/jsxmed/qdag251","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag251","url":null,"abstract":"<p><strong>Background: </strong>Systemic therapy with phosphodiesterase type 5 inhibitors (PDE5is) is the standard of care for erectile dysfunction (ED), but these treatments are not effective in all men, and others may prefer non-systemic treatment options.</p><p><strong>Aim: </strong>The goal of this Delphi consensus initiative was to address unmet needs in the treatment of men with ED and the best use of a US Food and Drug Administration (FDA) cleared topical therapy, MED3000 (Eroxon®), that is available without a prescription.</p><p><strong>Methods: </strong>The iterative Delphi process involved the creation of an initial slate of 38 statements and brief summaries of related evidence (if available), followed by the review from 2 co-chairs and 3 rounds of consensus development by an independent panel.</p><p><strong>Outcomes: </strong>The Delphi process reduced the initial set of 38 statements to 31 for which there was ≥80% support (in some cases after revision of the initial statement and revoting) from the panel in the final round of voting.</p><p><strong>Results: </strong>Statements for which consensus was achieved were consistent with current guidelines in recognizing the need for topical ED therapy. They also provided practical expert advice on the best use of this topical therapy. Statements regarding MED3000 (Eroxon®) for which consensus was not achieved identified important clinical considerations that would benefit from further analysis of existing clinical trial results for MED3000 and collection of new real-world data.</p><p><strong>Clinical implications: </strong>This initiative identified multiple unmet needs that may be addressed by a well-tolerated and efficacious topical treatment. It also provided a critical assessment from experienced healthcare professionals of the evidence supporting the use of an over-the-counter topical therapy for ED.</p><p><strong>Strengths and limitations: </strong>The main strength of this Delphi initiative was an expert assessment of unmet needs in ED and the place in therapy for topical medications. The main limitation was that available data for topical treatment leaves some questions unanswered, most notably efficacy in different subpopulations of men with ED.</p><p><strong>Conclusions: </strong>Overall, the statements supported in this Delphi initiative may provide a framework for more detailed recommendations that could be incorporated into treatment guidelines. In addition, the statements for which unanimous support could not be achieved help to identify evidence gaps that are targets for future research.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes following testicular prosthesis implantation: a systematic review and meta-analysis.","authors":"Navid Roessler, Malte W Vetterlein, Tim A Ludwig, Roland Dahlem, Margit Fisch, Florian Janisch","doi":"10.1093/jsxmed/qdag261","DOIUrl":"10.1093/jsxmed/qdag261","url":null,"abstract":"<p><strong>Introduction: </strong>Testicular prosthesis (TP) implantation is widely used to restore scrotal appearance or as a part of gender-affirming surgery. This systematic review and meta-analysis aimed to synthesize contemporary evidence on outcomes following TP implantation and identify gaps in outcome reporting.</p><p><strong>Methods: </strong>In this prospectively registered review (CRD420261332293), MEDLINE, Web of Science, and Google Scholar were searched in March 2026 for studies reporting outcomes following TP implantation in cisgender and transgender populations. Primary outcomes were overall patient satisfaction and decision regret. Secondary outcomes included patient-reported prosthesis characteristics and reintervention rates. Pooled proportions were calculated using random-effects models, and risk of bias was assessed using the Risk of Bias in Non-randomized Studies-of Interventions tool.</p><p><strong>Results: </strong>Of 5579 records screened, 22 studies including 2320 patients were eligible. Overall satisfaction was reported in 11 studies (n = 817), with a pooled proportion of 84% (95% confidence interval [CI], 77%-88%). Decision regret was reported in 8 studies (n = 584), with a pooled proportion of 10% (95% CI, 7%-13%). Most patients perceived prosthesis characteristics as appropriate, including shape (83%, 95% CI, 73%-89%, n = 531), weight (86%, 95% CI, 75%-92%, n = 652), size (76%, 95% CI, 70%-82%, n = 777), and position (75%, 95% CI, 66%-83%, n = 788). However, only 58% reported appropriate prosthesis consistency (95% CI, 40%-74%, n = 626), with firmness frequently perceived as suboptimal. Reintervention rates and major complications appeared uncommon but were inconsistently reported. Evidence was limited by heterogeneous outcome definitions, incomplete follow-up, and lack of standardized patient reported outcomes.</p><p><strong>Discussion: </strong>Testicular prosthesis implantation results in high patient satisfaction and low decision regret. However, inconsistent reporting and lack of validated outcome measures highlight the need for standardized patient reported outcome measures and harmonized surgical outcome reporting to support evidence-based counseling and clinical decision-making.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Sexocorporel-based sexual counseling on sexual health literacy and sexual quality of life among married deaf women of reproductive age: a randomized controlled trial.","authors":"Atefeh Arefi Fard, Soheila Rabeipoor, Rafat Bakht, Samira Barjasteh","doi":"10.1093/jsxmed/qdag252","DOIUrl":"10.1093/jsxmed/qdag252","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Deaf women frequently experience barriers in accessing sexual and reproductive health information and communication-sensitive counseling services. Limited access to culturally appropriate sexual education may negatively affect sexual health literacy and sexual quality of life. Sexocorporel is a body-oriented sexual counseling approach integrating bodily awareness, emotional regulation, and relational communication; however, evidence regarding its effectiveness among deaf women remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the effectiveness of Sexocorporel-based sexual counseling on sexual health literacy and sexual quality of life among married deaf women of reproductive age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This parallel-group randomized controlled trial was conducted among 100 married women with congenital or prelingual deafness registered with the Welfare Organization of Hamadan Province, between December 2025 and April 2026. Participants were randomly assigned to either the intervention group (n = 50) or control group (n = 50) using block randomization with allocation concealment. The intervention group received 4 weekly sessions of Sexocorporel-based sexual counseling with sign-language support, whereas controls received routine services only. Sexual health literacy and sexual quality of life were assessed at baseline and 1 month after the intervention using the Sexual Health Literacy for Adults Questionnaire and the Sexual Quality of Life Questionnaire-Female, respectively. Data were analyzed using t-tests and analysis of covariance (ANCOVA). The trial was registered in the Iranian Registry of Clinical Trials (IRCT) (registration number: IRCT20251119068046N1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcome was sexual health literacy. The secondary outcome was sexual quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline characteristics were comparable between groups (P &gt; .05). After adjustment for baseline values, the intervention group demonstrated significantly higher sexual health literacy scores across all domains and significantly better sexual quality of life compared with the control group (all P &lt; .001). ANCOVA analyses demonstrated moderate-to-large intervention effect sizes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Communication-adapted and body-oriented counseling interventions may improve access to effective sexual healthcare services for deaf women and help to reduce disparities in sexual health education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Strengths include the randomized controlled design, allocation concealment, blinded statistical analysis, and adaptation of the intervention to the communication needs of deaf women. Limitations include reliance on self-report measures, short-term follow-up, and recruitment from a single geographical setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Sexocorporel-based sexual counseling may represent an effective and communicati","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile prosthesis implantation in younger men: outcomes from a tertiary center.","authors":"Shiv Sarna, Abdullah Al-Mitwalli, Thomas Reid, Fiona Holden, Chi-Ying Li, Wai Gin Lee, Andrew Christopher, David Ralph, Pippa Sangster","doi":"10.1093/jsxmed/qdag227","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag227","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor on \"Beyond the bladder: incontinence-specific, physical, and psychological contributors to sexual function in women with urinary incontinence\".","authors":"Nancy Yang, Alison J Huang","doi":"10.1093/jsxmed/qdag256","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag256","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The International Index of Erectile Function-6 as a tool for detecting subclinical erectile dysfunction: insights from latent variable modeling and item response theory.","authors":"Daniele Mollaioli, Andrea Sansone, Elena Colonnello, Tommaso B Jannini, Giacomo Ciocca, Erika Limoncin, Emmanuele A Jannini","doi":"10.1093/jsxmed/qdag260","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag260","url":null,"abstract":"<p><strong>Background: </strong>In the diagnosis of erectile dysfunction (ED), the 5 + 1 erectile function domain of the International Index of Erectile Function (IIEF-6) is the reference screening tool, but its conventional sum-score scoring may mask subtle functional impairments in high-functioning men because of ceiling effects.</p><p><strong>Aim: </strong>To operationalize the detection of subclinical erectile dysfunction (SED) using latent variable modeling applied to the IIEF-6 and to validate SED as a distinct phenotype independent of ejaculatory and psychological confounders.</p><p><strong>Methods: </strong>This cross-sectional analysis used the well-established database of the SEXCOVID study, including 1114 sexually active Italian men aged 18-65 years. Erectile function was assessed with the IIEF-6. Ordinal Structural Equation Modeling and Item Response Theory were applied to generate latent erectile function scores, which were linearly calibrated to standard clinical cutoffs. Anxiety, depressive symptoms, and premature ejaculation (PE) were assessed using validated questionnaires.</p><p><strong>Outcomes: </strong>Primary outcomes were score distribution properties, diagnostic reclassification rates, item discrimination parameters, and associations with psychological and ejaculatory measures.</p><p><strong>Results: </strong>Raw IIEF-6 scores showed pronounced ceiling effects, whereas latent modeling restored variance and approximate normality. Latent scoring increased correlations between erectile function and anxiety and depression by 20.1% and 27.9%, respectively. Overall, 17.7% of subjects were diagnostically reclassified. Notably, 144 men (12.9%) classified as \"No ED\" by sum scores were reclassified as \"Mild ED,\" defining the SED phenotype. High-discrimination items related to erection firmness and maintenance primarily drove reclassification. SED subjects did not differ from healthy controls in PE risk but showed mildly higher anxiety and depression levels.</p><p><strong>Clinical implications: </strong>Latent scoring of the IIEF-6 identifies clinically relevant erectile instability that is not captured by conventional sum scores, enabling earlier preventive assessment.</p><p><strong>Strengths and limitations: </strong>Strengths include advanced psychometric modeling and a large community sample; limitations include the cross-sectional design and self-reported measures.</p><p><strong>Conclusion: </strong>Latent variable modeling enhances the diagnostic sensitivity of the IIEF-6 and provides empirical support for SED as a distinct, measurable clinical entity.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual orientation differences in female sexual dysfunction in a large cohort of nurses in older adulthood.","authors":"Tabor Hoatson, Julia C Bond, Colleen A Reynolds, Julia L Marcus, Brittany M Charlton","doi":"10.1093/jsxmed/qdag266","DOIUrl":"10.1093/jsxmed/qdag266","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major depressive disorder with preserved sexual interest represents a distinct subtype: results from resting-state fMRI.","authors":"Zhuying Jiang, Minlie Pan, Jie Sun, Yuhong Zheng, Jinhui Wang, Jinghua Wang, Shao-Wei Xue","doi":"10.1093/jsxmed/qdag259","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag259","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual-interest symptoms are common in major depressive disorder (MDD), yet their neurodynamic correlates remain unclear. This study examined whether 17-item Hamilton Depression Rating Scale (HAMD-17) Item-14 sexual-interest symptom status in MDD is associated with variation in resting-state brain co-fluctuation dynamics.</p><p><strong>Methods: </strong>Resting-state functional magnetic resonance imaging (fMRI) data were obtained from MDD patients with HAMD-17 Item-14 sexual-interest symptoms (SI+, n = 111), MDD patients without such symptoms (SI-, n = 110), and healthy controls (HC, n = 203). Edge-time series (ETS) were computed as the element-wise products of z-scored blood-oxygen-level-dependent signals between pairs of brain regions. The co-fluctuation strength of each ETS was quantified at each frame using the root sum square (RSS), and frames were categorized into high (top 5%), intermediate (normal 90%), and low (bottom 5%) amplitude states to characterize global co-fluctuation amplitude, temporal persistence, and transition dynamics. Principal component analysis (PCA) was further applied to high-amplitude frames to examine default mode network (DMN)-related co-fluctuation patterns.</p><p><strong>Results: </strong>The clearest subgroup differences were observed in intermediate-amplitude co-fluctuation and trough-to-trough duration. Relative to SI-, SI+ showed higher intermediate-amplitude RSS, shorter duration, and less persistent transition dynamics, suggesting heightened but more temporally unstable resting-state coordination. During high-amplitude events, PCA identified an antagonistic mode between the somatomotor/ventral attention networks and the DMN, with DMN-related differences most evident between SI+ and HC.</p><p><strong>Conclusions: </strong>17-item Hamilton Depression Rating Scale Item-14 sexual-interest symptom status in MDD was associated with altered resting-state co-fluctuation dynamics, with DMN-related differences most evident relative to healthy controls. These findings suggest that this routinely assessed symptom marker may help identify clinically relevant heterogeneity within MDD and may support greater clinical attention to symptom dimensions potentially relevant to treatment adherence and patient-reported outcomes. However, the findings should be interpreted as non-specific resting-state correlates of an Item-14-defined clinical profile, rather than as direct neural indices of sexual interest or as a basis for mechanistic or treatment guidance. Further studies using detailed sexual-function assessments and longitudinal or multimodal designs are needed to clarify the specificity and clinical relevance of these associations.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who should monitor antidepressant therapy for premature ejaculation? A risk-stratified shared-care approach.","authors":"Onder Canguven","doi":"10.1093/jsxmed/qdag264","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag264","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 9","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}