Journal of Sexual Medicine最新文献

{"title":"Correction to: The relationship between sexual health literacy and sexual function of women with diabetes mellitus: a cross-sectional study.","authors":"","doi":"10.1093/jsxmed/qdaf069","DOIUrl":"10.1093/jsxmed/qdaf069","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"988"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702081","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":"Complications of the Penuma penile implant for genital enhancement.","authors":"David W Barham, Jeffrey Lee, Hares Ghaziyar, Joel Gelman","doi":"10.1093/jsxmed/qdaf055","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf055","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"975-977"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020498","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 of blood biomarkers for neural injury with recent, frequent exposure to partnered sexual strangulation in young adult women.","authors":"Megan E Huibregtse, Isabella L Alexander, Tsung-Chieh Fu, Lillian M Klemsz, Molly Rosenberg, J Dennis Fortenberry, Debby Herbenick, Keisuke Kawata","doi":"10.1093/jsxmed/qdaf036","DOIUrl":"10.1093/jsxmed/qdaf036","url":null,"abstract":"<p><strong>Background: </strong>\"Choking\" or partnered strangulation is an emerging and popular sexual behavior that is more often experienced by young women, yet the neurobiological consequences of partnered sexual strangulation remain unclear.</p><p><strong>Aim: </strong>The aim of the present study was to assess differences in 5 brain-injury blood biomarkers in young adult women who frequently engaged in sexual strangulation.</p><p><strong>Methods: </strong>Young adult women were recruited from a large Midwestern university and assigned to groups based on sexual strangulation experience: (1) at least 4 instances of being strangled by a partner during sexual activities in the past 30 days or (2) no prior experience being strangled by a sexual partner. Choking/strangulation history during partnered sexual activities was assessed using a self-report questionnaire. Blood samples were collected via venipuncture. Data from 32 female participants (median 21.5 years old [IQR 20-24]) were available for analysis: 15 with a history of recent, frequent partnered strangulation exposure and 17 without any history of partnered sexual strangulation.</p><p><strong>Outcomes: </strong>Serum levels of 5 blood biomarkers for brain injury were measured using sandwich enzyme-linked immunosorbent assay (S100B) and single-molecule array digital immunoassay (neurofilament light, tau, ubiquitin C-terminal hydrolase L1, and glial fibrillary acidic protein).</p><p><strong>Results: </strong>Group differences for the 5 biomarkers were examined using 1-way multivariate analysis of covariance, adjusting for age and alcohol use. We observed a significant multivariate effect of group, Pillai's trace = 0.485, F(5, 24) = 4.235, P = .007, η2 = 0.47. Univariate results indicated that female college students who were recently, frequently strangled during partnered sexual activities exhibited elevated S100B levels compared to their peers who had never engaged in this partnered sexual behavior, F(1,28) = 11.165, P = .002, η2 = 0.29.</p><p><strong>Clinical implications: </strong>Engaging in this partnered sexual behavior may elicit neuroinflammation, with unknown long-term consequences for brain health.</p><p><strong>Strengths and limitations: </strong>Strengths include the recruitment of a novel population, as this investigation was the first of its kind to examine neurobiological correlates of repetitive exposure to partnered sexual strangulation. Another strength is the panel of 5 blood biomarkers that were assessed, providing information from multiple cell types and pathophysiological processes. Limitations were the relatively small sample size and the cross-sectional design, which prevents causal inference.</p><p><strong>Conclusion: </strong>Young adult women with a history of recent, frequent experience being strangled by a sexual partner exhibited higher serum S100B, an astrocyte-enriched protein, compared to their biomarkers, meriting future work to determine a causal mechanism","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"961-970"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12069890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588068","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":"Burnout and career satisfaction among urologists specializing in sexual health.","authors":"Sarah Schrup, Meg Hanley, Emily May, James M Jones, Matthew Ziegelmann, Martin S Gross","doi":"10.1093/jsxmed/qdaf074","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf074","url":null,"abstract":"<p><strong>Background: </strong>While the rate of physician burnout has been characterized as relatively high among urologists compared to other specialties, a specific examination of burnout and predictors of burnout among urologists specializing in sexual medicine has not been conducted.</p><p><strong>Aim: </strong>The aim of this study was to collect demographic characteristics of urologists specializing in sexual medicine, assess the occurrence of and risk factors for burnout, and characterize satisfaction with career, compensation and work-life balance.</p><p><strong>Methods: </strong>We surveyed 96 urologists specializing in sexual medicine to characterize demographic and practice characteristics and assess their satisfaction with career aspects and levels of burnout. Univariable and multivariable modeling with stepwise variable selection was utilized to identify predictive variables of burnout.</p><p><strong>Outcomes: </strong>The Copenhagen Burnout Inventory was used to assess personal burnout, work-related burnout, patient-related burnout, and overall burnout.</p><p><strong>Results: </strong>Twenty-four percent (n = 23) of participants reported burnout with 35.4% (n = 34) reporting personal burnout, 38.5% (n = 37) reporting work-related burnout, and 24.0% (n = 23) reporting patient-related burnout. Younger age (P = 0.051), Black/African American or multiracial race compared to white race (P < 0.0001), Latino or Hispanic background (P = 0.034), female sex (P = 0.059), being unmarried (P = 0.047), and increased educational debt (0.030) were identified as predictive of overall burnout in adjusted analysis. Dissatisfaction with work-life balance was significantly related to an increase in all categories of burnout (P < 0.01).</p><p><strong>Clinical implications: </strong>These findings may guide practice patterns and initiatives to support groups identified at increased risk of burnout, as well as function as a benchmark for future studies of burnout in the sexual medicine urology community.</p><p><strong>Strengths and limitations: </strong>While this is the first study of burnout specifically among sexual medicine urologists and findings are consistent with the overall urology community, the small sample size may lead to a biased sample.</p><p><strong>Conclusion: </strong>Several demographic and personal characteristics were identified to be predictive of burnout among the sexual medicine urology community, indicating opportunities for additional support.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"869-876"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057149","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":"Assessing comfort levels with female sexual dysfunction among medical residents: a nationwide cross-sectional survey study and its implications for medical education.","authors":"Mariah Milazzo, Abigail Kohut-Jackson, Olivia Negris, J Conrado, Valencia Henry, Sarah Ponce, Rainey Horwitz, Jiayue Chen, Lorna Kwan, Rachel S Rubin, Lindsey Burnett, Maria Uloko","doi":"10.1093/jsxmed/qdaf071","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf071","url":null,"abstract":"<p><strong>Background: </strong>Female sexual dysfunction (FSD) affects 30%-50% of women but is substantially underdiagnosed and undertreated due in large part to the fact that just half of US medical schools offer formal sexual health teaching with an overwhelming skew toward male sexual health.</p><p><strong>Aim: </strong>The aim of this study is to assess the knowledge and confidence of residents in conducting a comprehensive pelvic examination and their comfortability diagnosing and managing conditions of FSD.</p><p><strong>Methods: </strong>In June 2023, the authors used Qualtrics to administer this cross-sectional survey. The target audience included resident physicians in Urology, Obstetrics and Gynecology, Dermatology, Internal Medicine, Family Medicine, and Emergency Medicine. The authors emailed a survey link and brief description of the project to all residency program directors in these specialties with valid email addresses in the FREIDA American Medical Association Residency Database. Program directors shared the link to the anonymous online survey with their current resident cohorts.</p><p><strong>Results: </strong>In total, n = 128 residents completed the survey. Less than half of all respondents indicated they had received prior formal training in physical exam of the clitoris (23%), vulvar vestibule (45%), and pelvic floor (35%). Regarding FSD, the following percentage of respondents indicated they had received training in these conditions: 78% genito-pelvic pain/penetration disorder, 38% hypoactive sexual desire disorder, 23% female orgasmic disorder, and 30% female sexual arousal disorder. The majority of respondents reported feeling uncomfortable with diagnosis and management of these conditions.</p><p><strong>Clinical implications: </strong>Improving residents' ability to diagnose and treat FSD is essential for preparing the next generation of physicians to appropriately attend to the needs of female patients.</p><p><strong>Strengths and limitations: </strong>One limitation of this study is the low survey response rate despite outreach to all relevant US residency programs. Additionally, our study did not account for the potential impact of different educational backgrounds on respondents' comfort levels with FSD, which could be addressed in subsequent research. A major strength of this study is being the first study to survey residents across specialties about their knowledge of FSD.</p><p><strong>Conclusion: </strong>Residents across several specialties are uncomfortable with diagnosing and managing common FSDs owing to a lack of training in both pelvic examination and conditions of FSD.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"694-700"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027423","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":"Antimicrobial resistance and biofilm formation of penile prosthesis isolates: insights from in-vitro analysis.","authors":"Bradley J Roth, Prajit Khooblall, Navid Leelani, Mangesh Suryavanshi, Andrew Shumaker, Glenn Werneburg, Aaron Miller, Petar Bajic","doi":"10.1093/jsxmed/qdaf001","DOIUrl":"10.1093/jsxmed/qdaf001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Inflatable penile prostheses (IPPs) have been shown to harbor biofilms in the presence and absence of infection despite exposure to various antimicrobials. Microbes persisting on IPPs following antibiotic exposure have not been adequately studied to assess biofilm formation capacity and antibiotic resistance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;In this study, we aimed to assess these properties of microbes obtained from explanted infected and non-infected IPPS using an in vitro model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;35 bacterial isolates were grown and tested against various single-agent or multiple agent antibiotic regimens including: bacitracin, cefaclor, cefazolin, gentamicin, levofloxacin, trimethoprim-sulfamethoxazole, tobramycin, vancomycin, piperacillin/tazobactam, gentamicin + piperacillin/tazobactam, gentamicin + cefazolin, and gentamicin + vancomycin. Zones of inhibition were averaged for each sample site and species. Statistics were analyzed with Holm's corrected, one-sample t-tests against a null hypothesis of 0. Isolates were also allowed to form biofilms in a 96-well polyvinyl plate and absorbance was tested at 570 nm using a microplate reader.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Resistance was determined via clinical guidelines or previously established literature, and the mean and standard deviation of biofilm absorbance values were calculated and normalized to the optical density600 of the bacterial inoculum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Every species tested was able to form robust biofilms with the exception of Staphylococcus warneri. As expected, most bacteria were resistant to common perioperative antimicrobial prophylaxis. Gentamicin dual therapy demonstrated somewhat greater efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This study examines a broad range of antimicrobials against clinically obtained bacterial isolates. However, not all species and antibiotics tested had standardized breakpoints, requiring the use of surrogate values from the literature. The microbes included in this study and their resistance genes are expectedly biased towards those that survived antibiotic exposure, and thus reflect the types of microbes which might \"survive\" in vivo exposure following revisional surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical translation: &lt;/strong&gt;Despite exposure to antimicrobials, bacteria isolated during penile prosthesis revision for both infected and non-infected cases exhibit biofilm forming capacity and extensive antibiotic resistance patterns in vitro. These microbes merit further investigation to understand when simple colonization vs re-infection might occur.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although increasing evidence supports the concept that all IPPs harbor biofilms, even in the absence of infection, a deeper understanding of the characteristics of bacteria that survive revisional surgery is warranted. This study demonstrated extensive biofilm forming capabilities, and resistance patt","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"898-908"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588065","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":"Intracavernosal injection of aviptadil and phentolamine for refractory erectile dysfunction.","authors":"Abdullah Al-Mitwalli, Fiona Holden, Angelo Di Giovanni, Andrea Gobbo, Mohammad Shah, Giovanni Chiriaco, Pippa Sangster, David Ralph, Wai Gin Lee","doi":"10.1093/jsxmed/qdaf067","DOIUrl":"10.1093/jsxmed/qdaf067","url":null,"abstract":"<p><strong>Background: </strong>Intracavernosal injection (ICI), most commonly with alprostadil, is recommended for Phosphodiesterase 5 Inhibitors (PDE5i) nonresponders in erectile dysfunction (ED) treatment; however, its use can cause pain (12%) and priapism (1%).</p><p><strong>Aim: </strong>We aimed to evaluate the efficacy of another ICI, Invicorp, and a combination of aviptadil with phentolamine mesylate (AvP), in contemporary practice.</p><p><strong>Methods: </strong>We conducted a retrospective single-center analysis on patients referred for AvP because they developed intolerable Pain following Alprostadil ICI (group PA) or had Failed maximal dose (40 μg) of Alprostadil (group F). Self-administration was taught in a nurse-led clinic, followed by a 6-week telephone follow-up. Efficacy was evaluated at 3 months and was defined as resumption of penetrative sexual activity.</p><p><strong>Results: </strong>Of these, 308 men were included in this study with a mean follow-up period of 13.3 months. All these patients had a trial of alprostadil ICI, 96% had failed PDE5i, 66% had trailed a vacuum erection device, and 36% had failed intraurethral alprostadil. Overall, 182 men (59%) found AvP ICI effective. Indications were 177 in the PA group and 131 in the FA group. Efficacy of AvP in the PA group was 76% and this compares to 36% in the FA group (P < .0001). The most common adverse event was facial flushing in 69 patients (22.5%). Ischemic priapism was reported in only one patient (0.3%).</p><p><strong>Clinical implications: </strong>AvP represents an effective and well-accepted second-line option for men who have experienced failure with most nonsurgical treatments for ED.</p><p><strong>Strengths and limitations: </strong>This is the largest and only study to outline the use of AvP ICI with clear distinguishing of efficacy rates for both patients who have failed conventional maximum dose alprostadil ICIs and those who developed pain from it. Limitations of this study include its retrospective design and lack of validated instruments to objectively assess erectile function.</p><p><strong>Conclusion: </strong>Almost 60% of the participants with refractory ED were successfully managed through the administration of AvP.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"726-730"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796360","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":"Experience with gender affirming hormones and puberty blockers (gonadotropin releasing hormone agonist): a qualitative analysis of sexual function.","authors":"Jamie L Finegan, Maja Marinkovic, Kyle Okamuro, Ron S Newfield, Jennifer T Anger","doi":"10.1093/jsxmed/qdaf061","DOIUrl":"10.1093/jsxmed/qdaf061","url":null,"abstract":"<p><strong>Background: </strong>Gender-affirming medical therapy (GAMT), including puberty blockers (PB) and gender-affirming hormone therapy (GAHT), is part of the transition for many transgender and nonbinary (TGNB) individuals; however, there have been few studies investigating sexual function and desire during GAMT, and no reports on individuals who received PB.</p><p><strong>Aim: </strong>We aimed to qualitatively evaluate the sexual experience of TGNB individuals during GAMT and identify significant and consistent themes that arose from our analysis.</p><p><strong>Methods: </strong>We performed an Institutional Review Board-approved two-institutional study. Our study group (n = 63) included individuals who had received or were receiving puberty blockers (GnRHa) and/or GAHT (estrogen or testosterone) at the time of enrollment.</p><p><strong>Outcomes: </strong>The enrolled subjects were interviewed using an open-ended topic-based guide, and qualitative analysis was performed by hand coding the interview transcripts using Constructivist Grounded Theory qualitative methods until thematic saturation was reached.</p><p><strong>Results: </strong>A total of 63 TGNB subjects (33 transgender women, 20 transgender men, 10 non-binary, or another gender identity), aged 18-25 years, were interviewed about the effect of GAMT on their sexual function and desire. Our analysis uncovered several themes that were consistent among subjects from different subgroups. Half the participants reported feeling no regrets regarding GAMT therapy, and the other half reported that they wished they had started GAMT sooner. Two notable themes were identified: many subjects reported \"less dysphoria\" as a positive change in sexual desire, and others reported more enjoyable sexual experiences since being on GAMT. The subgroup of subjects with a history of GnRHa use did not differ in their experiences and responses from the subgroup on GAHT alone, which indicated no negative effect of GnRHa on sexual function.</p><p><strong>Clinical implications: </strong>Our results illuminate the need for providers to discuss the potential impacts of GAMT on sexual function and desire with transgender and nonbinary patients.</p><p><strong>Strengths & limitations: </strong>An important strength of this study is the open-ended interview design. This design allowed subjects to speak freely and openly about their experience. One limitation is a relatively small sample size, particularly of the puberty blocker (GnRHa) subgroup. A more robust sample is needed to further investigate the effect of GAMT on sexual function and desire in TGNB individuals, specifically those receiving GnRHa.</p><p><strong>Conclusion: </strong>Themes were similar for all subjects; however, the most prominent theme among our subjects was that the positive changes in sexual function and desire outweighed any negative changes.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"945-950"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797096","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, preferences, and gender identity: health, cognition, and life history strategies.","authors":"Jaroslav Flegr, Jaroslava Varella Valentova","doi":"10.1093/jsxmed/qdaf076","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf076","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"978-979"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991163","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":"From hyper- to hypo-: ADHD medications & sexual dysfunction.","authors":"Elijah W Hale, Tyler J Igoe, Oscar R Bernat, Tyler D Cohan, Katherine P Thompson","doi":"10.1093/jsxmed/qdaf054","DOIUrl":"10.1093/jsxmed/qdaf054","url":null,"abstract":"<p><strong>Background: </strong>Although attention-deficit/hyperactivity disorder's (ADHD's) impact on academic and social outcomes is well documented, its influence on sexual health, especially in adolescents, remains poorly understood and adolescents with ADHD are at higher risk for high-risk sexual behaviors (HRSBs) and sexual dysfunction, which prior research has indicated may be somewhat influenced by medication.</p><p><strong>Aim: </strong>To define the relationship between ADHD treatment and sexual dysfunction in adolescents, focusing on the effects of stimulant versus non-stimulant medications and gender differences.</p><p><strong>Methods: </strong>Using de-identified electronic medical records from the TriNetX platform, this retrospective cohort study analyzed over 600 000 adolescents with ADHD. Patients were divided into male and female cohorts and further classified by stimulant, non-stimulant, or no medication use. Propensity score matching was applied to control for demographic factors. Sexual outcomes were identified using ICD-10 codes, including HRSBs, erectile dysfunction in males, and dyspareunia in females.</p><p><strong>Outcomes: </strong>The primary outcomes of interest were HRSB with both opposite- and same-sex partners, paraphilia disorder, increased libido, hyper/compulsive sexual behavior, ejaculatory dysfunction, erectile dysfunction, contraception use, and dyspareunia.</p><p><strong>Results: </strong>Stimulant medications were linked to increased libido and hypersexual behaviors, especially in males, who also reported higher rates of erectile dysfunction. Females on stimulants exhibited higher rates of contraceptive use and slightly elevated libido. Non-stimulant medications showed fewer sexual side effects.</p><p><strong>Clinical implications: </strong>The findings underscore the need for clinicians to carefully consider the sexual side effects of ADHD medications, particularly stimulants, when developing treatment plans for adolescents, and gender differences in sexual dysfunction and high-risk sexual behaviors suggest that tailored interventions are necessary to address the unique needs of male and female patients.</p><p><strong>Strengths and limitations: </strong>The limitations of this paper include its retrospective nature and the fact that the data collected were self-reported. Additionally, the lack of diversity in the patient population is a limitation.</p><p><strong>Conclusions: </strong>Stimulant medications may exacerbate certain sexual dysfunctions, particularly in males, while non-stimulant treatments have milder effects; gender-specific differences suggest distinct sexual health impacts for males and females and clinicians should consider the potential sexual side effects of ADHD medications, particularly in adolescents, and further research is needed to explore the long-term effects of ADHD treatments on sexual health.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"701-710"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796270","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}