{"title":"Effect of imipramine on ejaculatory dysfunction in a rat hypogastric nerve injury model.","authors":"Kunihisa Nezu, Shinichi Yamashita, Juntaro Koyama, Takuro Goto, Yu Suzuki, Takuma Sato, Yoshihide Kawasaki, Naoki Kawamorita, Akihiro Ito","doi":"10.1093/jsxmed/qdaf092","DOIUrl":"10.1093/jsxmed/qdaf092","url":null,"abstract":"<p><strong>Background: </strong>Peripheral sympathetic nerve injury, resulting from surgery around the abdominal aorta, including retroperitoneal lymph node dissection for testicular cancer, often causes ejaculatory dysfunction (EjD). EjD reduces sexual activity and male fertility. Imipramine (IMI) has been empirically used for EjD. However, research using animal models and clinical studies on EjD is limited.</p><p><strong>Aim: </strong>We investigated the effects of IMI in a rat model of EjD following hypogastric nerve (HGN) injury using apomorphine (APO)-induced ejaculations and lumbar splanchnic nerve (LSN) electrostimulation.</p><p><strong>Methods: </strong>Thirty-six male Sprague-Dawley rats were divided into six groups: Sham, Sham-IMI, Crush-Vehicle, Crush-IMI, Cut-Vehicle, and Cut-IMI. In the Crush group, the bilateral HGNs were crushed, and in the Cut group, the bilateral HGNs were excised. IMI (1 mg/kg) or Vehicle was administered intraperitoneally 7-30 days after HGN injury.</p><p><strong>Outcomes: </strong>Ejaculatory function was assessed weekly using the weight of solid semen ejaculated from the urethral meatus after subcutaneous administration of 0.5 mg/kg APO. Changes in seminal vesicle pressure (SVP) were assessed using APO-induced ejaculation (ΔSVPA) and LSN electrostimulation (ΔSVPE) 30 days after HGN injury. Dunnett's test was used to determine significant differences between groups.</p><p><strong>Results: </strong>In the Crush-IMI group, the mean solid semen weights significantly increased 21 and 28 days after HGN injury compared with those in the Crush-Vehicle group (P = .011 and P = .036, respectively). However, in the Cut-IMI group, no increase in solid semen weight was observed. The ΔSVPA in the Crush-IMI group was higher than that in the Crush-Vehicle group; however, the difference was not statistically significant. Furthermore, ΔSVPE in the Crush-IMI group was significantly higher than that in the Crush-Vehicle group (P = .024). Additionally, the mean seminal vesicle weights in the Crush-IMI group were lower than those in the Crush-Vehicle group at 30 days after HGN injury (P = .014).</p><p><strong>Clinical implications: </strong>IMI improves SV function, suggested that IMI might be useful in patients with EjD.</p><p><strong>Strengths and limitations: </strong>This study shows that IMI has an effect on EjD by improving SV function in a rat model. Limitations include a lack of the mechanisms or the effect of IMI at different doses on EjD.</p><p><strong>Conclusion: </strong>This model allowed for the comprehensive assessment of EjD in rats, and IMI attenuated EjD after HGN injury. It aids in the clarification of the mechanism and development of treatments for nerve injury-related EjD.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1006-1013"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055215","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 mediating role of sexual dysfunction knowledge in the association between sexual function and depression: a large-scale national cross-sectional study in reproductive-aged population.","authors":"Lewen Ruan, Yuyang Zhang, Yuying Sheng, Baoyan Wu, Hui Yu, Zhenyu Huang, Hui Jiang, Xiansheng Zhang, Dongdong Tang","doi":"10.1093/jsxmed/qdaf070","DOIUrl":"10.1093/jsxmed/qdaf070","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction (SD) and depression are prevalent issues that significantly affect both physical and mental health.</p><p><strong>Aim: </strong>This study aimed to explore the association between sexual function (SF) and depression in reproductive-aged population and further examine the mediating role of knowledge regarding the effect of sexual dysfunction on fertility (KSDF).</p><p><strong>Methods: </strong>This study enrolled a total of 10 761 participants aged 20-40 from 31 regions, including 5259 males and 5502 females, with a median age of 29.0 years. Basic demographic data were collected initially, followed by clinical data acquisition.</p><p><strong>Outcomes: </strong>The International Index of Erectile Function 5 (IIEF5), the Premature Ejaculation Diagnostic Tool (PEDT), the Female Sexual Function Index-19 (FSFI-19), the Patient Health Questionnaire-9, and the Disease Knowledge Questionnaire.</p><p><strong>Results: </strong>The study revealed a significant bidirectional association between SF and depression among the population. Specifically, poorer SF was correlated with higher severity of depressive (IIEF5 [β = -0.155, P < .001], PEDT [β = 0.311, P < .001], and FSFI-19 [β = -0.059, P < .001]). Conversely, higher severity of depressive was associated with poorer SF (IIEF5 [β = -0.202, P < .001], PEDT [β = 0.249, P < .001], and FSFI-19 [β = -0.191, P < 0.001]). Furthermore, in males, the KSDF mediated the bidirectional associations between SF and depression. Specifically, the mediating proportions were as follows: KSDF mediated 3.00% of the association between IIEF5 and depression, and 2.20% of the association between PEDT and depression; similarly, for the association between depression and SF, KSDF mediated 2.50% of the association between depression and IIEF5 and 2.20% between depression and PEDT. However, no such mediation was observed in females.</p><p><strong>Clinical implications: </strong>This provides new insights for the clinical management of these issues in the male reproductive-aged population.</p><p><strong>Strengths and limitations: </strong>These findings suggest that enhancing this knowledge could interrupt bidirectional association between impaired SF and depression in this demographic, potentially alleviating both conditions without requiring additional interventions. However, cross-sectional study design does not allow us to draw corresponding causal conclusions.</p><p><strong>Conclusion: </strong>The current study further demonstrated a significant bidirectional association between SF and depression among the reproductive-aged population, and importantly, the KSDF was found to mediate this association in males.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1053-1061"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052497","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}
Sri Contractor, Suvitha Viswanathan, Olivia Negris, Monica Myers, Jennifer Romanello
{"title":"The representation of female sexual medicine and genital anatomy in a United States Medical Licensing Exam step 1 resource.","authors":"Sri Contractor, Suvitha Viswanathan, Olivia Negris, Monica Myers, Jennifer Romanello","doi":"10.1093/jsxmed/qdaf089","DOIUrl":"10.1093/jsxmed/qdaf089","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1069-1070"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995108","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}
C Emi Bretschneider, Caroline Smerdon, Brian Bieber, Nathan Goodrich, James Griffith, H Henry Lai, James A Hokanson, Anna C Kirby, Abigail Smith, Magaly Guerrero, Sreya Gutta, Kathryn E Flynn, Karen John, Catherine S Bradley
{"title":"Sexual function in women with bothersome lower urinary tract symptoms: findings from the symptoms of lower urinary tract dysfunction research network (LURN) cohort study.","authors":"C Emi Bretschneider, Caroline Smerdon, Brian Bieber, Nathan Goodrich, James Griffith, H Henry Lai, James A Hokanson, Anna C Kirby, Abigail Smith, Magaly Guerrero, Sreya Gutta, Kathryn E Flynn, Karen John, Catherine S Bradley","doi":"10.1093/jsxmed/qdaf063","DOIUrl":"10.1093/jsxmed/qdaf063","url":null,"abstract":"<p><strong>Background: </strong>Bothersome lower urinary tract symptoms (LUTS) can negatively affect the quality of life in women, including sexual function.</p><p><strong>Aim: </strong>The primary aim of the study was to explore the association between LUTS severity and sexual functioning among women with LUTS.</p><p><strong>Methods: </strong>Female participants enrolled in the Symptoms of the first Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN-I) observational cohort study with a frequency rating of at least \"sometimes\" and a bother rating of at least \"somewhat\" on at least one LUTS Tool question. LUTS and sexual function were quantified by patient questionnaires at baseline, 3 months, and 12 months after study enrollment. LUTS were assessed via the LUTS Tool, while sexual function was assessed using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, International Urogynecological Association-Revised (PISQ-IR). Longitudinal analyses were restricted to females with completed baseline and 12-month (or 3-month, if missing) questionnaires. Associations between baseline sexual function, clinical characteristics, and LUTS were analyzed using linear regression.</p><p><strong>Outcomes: </strong>The primary outcomes were bothersome LUTS, defined by the LUTS Tool, and sexual function, defined by the PISQ-IR.</p><p><strong>Results: </strong>Female participants (n = 528) were identified. At baseline, 245 participants were not sexually active (NSA), while 283 were sexually active (SA). Baseline characteristics of the cohort are described in Table 1; compared with NSA, SA was younger (49 vs 63 years) and more likely to be married/civil union (67% vs 43%). Less severe LUTS (10 points lower) was associated with higher (better) PISQ-IR summary and subscale scores (condition-specific, condition-impact, global quality, and arousal/orgasm subscales) for SA participants. For NSA participants, less severe LUTS was associated with higher condition-specific and condition-impact subscale scores. A subset of participants (n = 406) had follow-up data at 12 months. Longitudinally, LUTS Tool scores improved on average from baseline to 12 months by seven points, while PISQ-IR scores generally remained stable.</p><p><strong>Clinical implications: </strong>As LUTS improves, overall sexual function in SA and NSA women remains stable.</p><p><strong>Strengths and limitations: </strong>Strengths of the study include the use of a validated sexual function questionnaire, PISQ-IR, which captures sexual function in women who are not SA. Limitations of the study include the fact that participants presented to tertiary academic centers for care, which may limit the study's generalizability.</p><p><strong>Conclusion: </strong>In a large cohort of women with prospectively collected data on LUTS and sexual function, sexual function largely remained stable over time even as LUTS bother improved.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1035-1042"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039890","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":"Association between clitoral doppler flow and pelvic floor muscle tone in women without sexual dysfunction.","authors":"Luis C Franco, Laura E Dussan","doi":"10.1093/jsxmed/qdaf098","DOIUrl":"10.1093/jsxmed/qdaf098","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"991-992"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040403","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}
Firoozeh Raisi, Robabeh Soleimani, Azin Ahmadzadeh, Seyedeh Nasibeh Sadati, Arghavan Fakhrian, Mir Mohammad Jalali
{"title":"Efficacy and safety of pharmacological treatments in patients with premature ejaculation: an umbrella review of meta-analyses of randomized controlled trials.","authors":"Firoozeh Raisi, Robabeh Soleimani, Azin Ahmadzadeh, Seyedeh Nasibeh Sadati, Arghavan Fakhrian, Mir Mohammad Jalali","doi":"10.1093/jsxmed/qdaf094","DOIUrl":"10.1093/jsxmed/qdaf094","url":null,"abstract":"<p><strong>Introduction: </strong>Premature ejaculation (PE) is a common male sexual dysfunction characterized by short ejaculatory latency with minimal stimulation, an inability to delay or control ejaculation, and distress or dissatisfaction due to the condition. Pharmacological therapy is central to PE management, with dapoxetine as the only approved selective serotonin reuptake inhibitor (SSRI). Off-label options, including long-acting selective serotonin reuptake inhibitors (SSRIs) (eg, paroxetine), topical anesthetics, phosphodiesterase type 5 inhibitors (eg, sildenafil), and tramadol, have also been explored. Despite numerous systematic reviews on its treatment, challenges remain due to methodological heterogeneity, variability in outcome measures, and inconsistencies in trial quality, making it difficult to draw reliable conclusions.</p><p><strong>Objectives: </strong>This umbrella review of systematic reviews and meta-analyses (SR-MAs) of randomized controlled trials (RCTs) examined the efficacy of pharmacological treatments in prolonging intravaginal ejaculatory latency time (IELT) and their safety by analyzing associated adverse events in adults with PE.</p><p><strong>Methods: </strong>A comprehensive search of SR-MAs ranging from 1990 to 2024 was performed. Two reviewers independently screened articles, extracted data, and assessed quality of previous SR-MAs using the A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) tool and the risk of bias of RCTs using Cochrane's risk-of-bias tool for randomized trials. The primary outcome of interest was IELT. Effect sizes from primary studies of all SR-MAs were extracted, and after removing overlapping RCTs, a re-meta-analysis was conducted. We appraised evidence certainty using the Grading of recommendations, Assessment, Development, and Evaluations scoring system (GRADE).</p><p><strong>Results: </strong>This review included 44 SR-MAs covering 65 RCTs. Only two SR-MAs rated as moderate to high quality in the AMSTAR-2 assessment. Additionally, only six out of 65 RCTs had a low risk of bias. The median follow-up for included RCTs was 7.9 months. These treatments significantly improved IELT compared to placebo, with paroxetine achieving the largest mean difference (5.64 min; 95% confidence interval [CI]: 3.50 to 9.07). However, all pharmacological treatments were associated with adverse events, with paroxetine having the lowest risk (RR: 1.5; 95% CI: 0.3 to 7.3), while risk ratios were higher for other treatments, including 4.1 for topical anesthetics, 2.4 for tramadol, and 1.8 for dapoxetine. Only topical anesthetics and paroxetine demonstrated a moderate to high rating in the GRADE assessment.</p><p><strong>Conclusion: </strong>Topical anesthetics, tramadol, and SSRIs significantly increase IELT. However, substantial heterogeneity among meta-analyses may limit the robustness of these findings. Future RCTs should include extended follow-up periods to better assess the long-term","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1014-1023"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043623","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":"Hypoandrogenic state inhibits erectile function in rats via miR-200a-3p.","authors":"Yuan Wang, Jun Jiang, Rui Jiang","doi":"10.1093/jsxmed/qdaf081","DOIUrl":"10.1093/jsxmed/qdaf081","url":null,"abstract":"<p><strong>Background: </strong>Androgen deficiency is an important cause of erectile dysfunction (ED), and miRNAs are small-molecule RNAs with multiple biological functions. However, whether androgen deficiency affects erectile function by regulating miRNAs is unknown.</p><p><strong>Aim: </strong>The aim of the study was to investigate the differential expression of key miRNAs in the penile corpus cavernosum of castrated rats and the relationship between these miRNAs and erectile function.</p><p><strong>Methods: </strong>The expression of key miRNAs in the penile corpus cavernosum of sham-operated, castration-operated, and post-castration testosterone replacement-treated rats was detected via high-throughput sequencing. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were performed to identify significantly up-regulated and down-regulated miRNAs in the penile corpus cavernosum of castrated rats, functional assays and prediction and validation of target genes were performed for key miRNAs, and the relationships between the expression of key microRNAs and maximum intracavernous pressure/mean arterial pressure ratio (ICPmax/MAP) were examined.</p><p><strong>Outcomes: </strong>Significant up-regulation of miR-200a-3p in the penile corpus cavernosum of castrated rats leads to ED by activating the RhoA/Rho-kinase signaling pathway and inhibiting p-eNOS/eNOS.</p><p><strong>Results: </strong>Among these miRNAs, the expression of miR-200a-3p was significantly greater in the penile corpus cavernosum of the cast group (50.67 ± 6.91) than in that of the sham group (1.00 ± 0.09) and the cast+T group (2.07 ± 0.35) (P < 0.05). Dlc1 and p-eNOS/eNOS in the penile corpus cavernosum of the cast group were significantly lower than those of the sham and cast+T groups (P < 0.05). The over-expression of miR-200a-3p significantly inhibited the expression of Dlc1 and decreased p-eNOS/eNOS and ICPmax/MAP (P < 0.05). Inhibition of miR-200a-3p significantly up-regulated the expression of Dlc1 and elevated the ICPmax/MAP (P < 0.05).</p><p><strong>Clinical implications: </strong>Inhibition of miR-200a-3p expression and function in the penile corpus cavernosum may be a potential treatment for ED due to androgen deficiency.</p><p><strong>Strengths and limitations: </strong>This study revealed that miR-200a-3p can lead to ED by affecting the RhoA/Rho-kinase and eNOS/NO signaling pathways. However, the specific mechanism of miR-200a-3prole in ED needs to be further investigated.</p><p><strong>Conclusion: </strong>Significant up-regulation of miR-200a-3p in the penile corpus cavernosum of castrated rats inhibited Dlc1 expression, which activated the RhoA/Rho-kinase signaling pathway in smooth muscle cells and inhibited p-eNOS/eNOS in endothelial cells to suppress erectile function. Inhibiting endogenous miR-200a-3p in the penile corpus cavernosum of castrated rats may improve erectile function.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"993-1005"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045008","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}
Sarah Ponce, Emily Markarian, Sara Perelmuter, Anna Patterson, Rachel S Rubin, Tanaz Ferzandi
{"title":"Pelvic and vulvovaginal pain in medical students: insight into patient experience and gaps in medical education.","authors":"Sarah Ponce, Emily Markarian, Sara Perelmuter, Anna Patterson, Rachel S Rubin, Tanaz Ferzandi","doi":"10.1093/jsxmed/qdaf079","DOIUrl":"10.1093/jsxmed/qdaf079","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1077-1078"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057432","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":"Mean platelet volume as a neurobiological marker in lifelong premature ejaculation: insights into platelet activation and subtype stratification.","authors":"Guodong Liu, Yuyang Zhang, Xu Wu, Hui Gao, Hui Jiang, Xiansheng Zhang","doi":"10.1093/jsxmed/qdaf084","DOIUrl":"10.1093/jsxmed/qdaf084","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1071-1073"},"PeriodicalIF":3.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052081","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}