Journal of Sexual Medicine最新文献

{"title":"Obesity and sexual desire: a systematic review and meta-analysis.","authors":"Małgorzata Biernikiewicz, Agnieszka Rusiecka, Dariusz Kałka","doi":"10.1093/jsxmed/qdaf057","DOIUrl":"10.1093/jsxmed/qdaf057","url":null,"abstract":"<p><strong>Background: </strong>Impaired sexual functioning is one of the consequences of obesity with hormonal disorders involving testosterone.</p><p><strong>Aim: </strong>To explore the link between obesity and sexual desire, to assess how changes in body weight affect sexual desire, and to examine the role of testosterone in these changes in obese and overweight men.</p><p><strong>Methods: </strong>The systematic review was conducted in PubMed. Studies involving obese/overweight men that reported different libido levels or changes after weight loss interventions were included. Meta-analysis and meta-regression were performed.</p><p><strong>Results: </strong>The search identified 2259 studies, of which 28 met the eligibility criteria. Most studies focused on weight-loss interventions (n = 21, 77%), with 13 studies investigating the effect of bariatric surgeries. Testosterone levels were reported in 14 studies. The studies encompassed a total population of 18 653 people, including 10 356 obese and overweight men. Of the 28 identified studies, 15 indicated a potential association between BMI, waist circumference, and sexual desire. Effect size meta-analysis (calculated using data from four studies presenting results before and after bariatric surgery) suggests that an increase in the International Index of Erectile Function sexual desire domain was very strongly associated with changes in a patients' weight resulting from bariatric surgery (d = 1.22, 95% CI 0.41-2.03, P = 0.003). The meta-analysis of four studies, presenting results before and after diet intervention, showed a strong impact of weight loss on an increase of the Sexual Desire Inventory (SDI), (d = 1.16, 95% CI 0.44-1.88, P = 0.002) The meta-regression revealed a significant association between the level of sexual desire on the SDI and the magnitude of BMI changes before and after dieting interventions (R2 = 77.97%; P = 0.002). The meta-analysis of plasma total testosterone levels from studies that present results before and after selected diets showed a strong impact of diet on the increase in testosterone levels after interventions (d = 1.39 95% CI 0.86-1.92; P < 0.001). There was a significant impact of the level of plasma total testosterone on the variance of sexual desire in the SDI questionnaire (R2 = 5.33%; P < 0.001).</p><p><strong>Limitations of evidence: </strong>A lack of studies that focus on sexual desire in obesity, the heterogeneity of the included population, the variability in the used questionnaires and reported statistics.</p><p><strong>Conclusions: </strong>A potential association between sexual desire and body weight exists. Weight loss interventions, including dietary changes and bariatric surgery, significantly increased both sexual desire and plasma total testosterone levels. Additionally, variations in plasma total testosterone levels had a significant effect on the variability of sexual desire in obese men.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"677-693"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755708","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":"Simultaneous perineal urethroplasty and penile prosthesis explantation for urethral stricture and fractured malleable penile prosthesis through a single perineal incision: a case report and literature review.","authors":"Nazim Furkan Gunay, Fatih Yanaral, Omer Sarilar","doi":"10.1093/jsxmed/qdaf049","DOIUrl":"10.1093/jsxmed/qdaf049","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"973-974"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665344","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":"Letter to the Editor on \"The importance of gender medicine in understanding sexual dysfunction in female patients with multiple sclerosis\".","authors":"Rocco Salvatore Calabrò","doi":"10.1093/jsxmed/qdaf065","DOIUrl":"10.1093/jsxmed/qdaf065","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"984-985"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755705","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":"Novel technique of horizontal plication with corporoplasty for Peyronie's disease: the rare Christmas tree deformity.","authors":"Ramzy T Burns, Juliet K Hardesty, Helen L Bernie","doi":"10.1093/jsxmed/qdaf060","DOIUrl":"10.1093/jsxmed/qdaf060","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"673-674"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774572","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 relationship between perceived stress and erectile function in patients with psychogenic erectile dysfunction: the mediating role of fatigue.","authors":"Zhi Cao, Tianle Zhu, Peng Yang, Yukuai Ma, Yunlong Ge, Pan Gao, Hui Jiang, Xiansheng Zhang","doi":"10.1093/jsxmed/qdaf045","DOIUrl":"10.1093/jsxmed/qdaf045","url":null,"abstract":"<p><strong>Background: </strong>Psychological stress is closely linked to psychogenic erectile dysfunction (pED). In our recent clinical work, many pED patients report high levels of stress and fatigue, leading us to hypothesize these factors may play a contributory role in the development of pED.</p><p><strong>Aim: </strong>This research aims to elucidate how fatigue may mediate the connection between perceived stress and erectile function in individuals with pED.</p><p><strong>Methods: </strong>We assessed 125 patients diagnosed with pED. Erectile dysfunction severity was measured using the International Index of Erectile Function-5 (IIEF-5) and the Nocturnal Penile Tumescence and Rigidity (NPTR) tests. Perceived stress and fatigue were evaluated with the Perceived Stress Scale-14 and the Multidimensional Fatigue Inventory-20. Data were descriptively analyzed, and correlations among the 3 variables were examined. The mediating effect was assessed using the bootstrap method within the SPSS PROCESS macro.</p><p><strong>Outcomes: </strong>The outcomes include the relationship between perceived stress and erectile function and the mediating role of fatigue in patients with pED.</p><p><strong>Results: </strong>Our findings revealed a substantial negative correlation between perceived stress and erectile function (β = -0.604, P < .001). Fatigue emerged as a mediator in this relationship (β = -0.214, P < .05). The significance of the indirect effect of perceived stress via fatigue was confirmed through non-parametric bootstrapping (95% CI = -0.426 to -0.153), with fatigue contributing 26.46% to the total effect.</p><p><strong>Clinical implications: </strong>These findings have provided new ideas for interventions in the clinical management of pED, particularly for improving erectile function by simultaneously managing fatigue and stress.</p><p><strong>Strengths and limitations: </strong>This study explores the broader context of pED and provides a new perspective on the etiology of pED. The main drawback of this study is its lack of generalizability, as it was conducted within a monocultural and specific social context.</p><p><strong>Conclusion: </strong>Our findings of this study suggest that targeting both fatigue and perceived stress may be effective strategies for improving erectile function in patients with pED, providing valuable insights for research and clinical practice.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"719-725"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665345","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":"Gender dysphoria/incongruence, sexual dysphoria, or sex-gender discordance: which term is more accurate?","authors":"Zeki Bayraktar","doi":"10.1093/jsxmed/qdaf047","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf047","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"666-667"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031143","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":"Improved psychosexual wellbeing with administration of combined Sildenafil plus Melatonin compared than either drug alone in management of women with polycystic ovarian syndrome: a 3-month randomized clinical study.","authors":"Zahra AsadiKalameh, Sadaf Abbasi, Seyed-Abdolvahab Taghavi, Fatemeh Bazarganipour","doi":"10.1093/jsxmed/qdaf028","DOIUrl":"10.1093/jsxmed/qdaf028","url":null,"abstract":"<p><strong>Background: </strong>Given the significant impact of depression, sexual function, and health-related quality of life (HRQOL) in women with Polycystic Ovarian Syndrome (PCOS), it is crucial to identify scientifically supported interventions that enhance these outcomes and thereby promote HRQOL.</p><p><strong>Aim: </strong>The present study aimed to assess the effect of adjutant administration of Sildenafil plus Melatonin on psycho-sexual status in PCOS women undergoing Metformin in an Iranian population.</p><p><strong>Methods: </strong>This study was a randomized clinical trial. 216 Eligible women were assigned to four groups including Sildenafil plus Metformin, Melatonin plus Metformin, Melatonin plus Sildenafil and Metformin, and Metformin alone. The duration of intervention was 3 months.</p><p><strong>Outcomes: </strong>The Female Sexual Function Index, Hospital Anxiety and Depression Scale and modified PCOS health-related QOL questionnaire were used to evaluate sexual function, severity of depression and HRQOL, respectively.</p><p><strong>Results: </strong>Based on the results of the present study, statistically significant improvement was found in menstrual cyclicity, sexual function (desire and arousal), HRQOL concerning menstrual and emotional aspects and severity of depression between the groups before and after the intervention in Sildenafil plus Melatonin compared to other groups after 3 months (P < 0.05).</p><p><strong>Clinical implications: </strong>The present research determined administration of Sildenafil plus Melatonin enhances menstrual cyclicity status, mental well-being, sexual function, and HRQOL in women with PCOS who undergoing Metformin treatment.</p><p><strong>Strengths & limitations: </strong>The current research possesses several strengths, notably its adherence to the rigorous standards of a randomized controlled trial with well-defined initial inclusion criteria. In addition, this questionnaire is based on the previously ratified tools used. A robust sample size was maintained, enhancing the statistical power of the analysis. However, all the sample participants were sourced from a university referral clinic. Additionally, due to cultural norms, every participant in this study was married. Lastly, the absence of a post-intervention follow-up period is a notable gap; such a period could help determine the duration of the clinical effects or assess if ongoing treatment with Sildenafil plus Melatonin is necessary to sustain these effects.</p><p><strong>Conclusions: </strong>Findings from this initial randomized controlled trial indicate that a 12-week administration of Sildenafil plus Melatonin could enhance menstrual cyclicity status, reduce depression severity, and sexual function as well as HRQOL in women with PCOS who undergoing Metformin.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"813-824"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658979","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":"Global survey on penile implant surgeons' preferences and intra-operative decision making.","authors":"Sarah M Norton, Josephine Walshaw, Eleanor Simmons, Dasha Pospyelova, Daniel Wignall, Ian Eardley, Mamoun Elmamoun, Patrick C Gordon","doi":"10.1093/jsxmed/qdaf039","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf039","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 5","pages":"980-981"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014497","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 attitudes of transgender and gender-diverse adolescents and their parents regarding fertility, parenthood, and fertility preservation before the start of puberty suppression or gender-affirming hormone therapy.","authors":"Tessa H R Stolk, Norah M van Mello, Lidewij S Boogers, Andreas Meißner, Judith A F Huirne, Alessandra D Fisher, Silvia Ciancia, Daniel Klink, Martine Cools, Sabine E Hannema, Emmy van den Boogaard","doi":"10.1093/jsxmed/qdaf029","DOIUrl":"10.1093/jsxmed/qdaf029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gender-affirming treatment for transgender and gender-diverse (TGD) adolescents can consist of puberty suppression (PS) and gender-affirming hormone treatment (GAHT), which may affect fertility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aims to evaluate the attitudes and decision-making regarding parenthood and fertility preservation from TGD adolescents and their parents and analyze the fertility preservation use and outcome before the start of treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Adolescents under 18 starting PS or GAHT between November 2021 and March 2024 were enrolled in a multicenter prospective cohort study \"ENIGI adolescents,\" conducted at Amsterdam University Medical Centre, Ghent University Hospital, and Florence University Hospital. Adolescents and parents were asked to complete the \"Transgender Youth Fertility Attitudes Questionnaire\" and the \"Decision Conflict Scale.\" Information about fertility preservation use and outcomes was extracted from electronic patient files.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Attitudes from TGD adolescents and their parents regarding desire for children, fertility preservation use, outcomes, and decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 316 adolescents were counseled about fertility options; 100 (49%) registered female at birth (RFAB) and 50 (48%) registered male at birth (RMAB) adolescents expressed a future desire for children. More than 1/3 had interest in or are still undecided about having a genetic offspring. None of the RFAB TGD adolescents underwent fertility preservation. In total, 20 (22%) RMAB adolescents pursued fertility preservation, 14 before PS and 6 before GAHT. Before PS, three performed testicular sperm extraction (TESE). All others performed semen cryopreservation. The post-thawed semen quality was low. The testicular volume and Tanner stage in the semen cryopreservation group were significantly higher compared to TESE, P = .013 and P = .021, respectively. There was no significant difference in age between those groups.Adolescents experience moderate to high decisional conflict about their fertility choices. RFAB adolescents experience a significantly higher conflict in decision-making compared to RMAB adolescents (40/100 vs 34/100 95% CI [2.1-9.4]). Younger RFAB adolescents experienced more decisional conflict (B =-1,25, 95% CI [-2,25, -0.25]). In RMAB this was not significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;This study helps to further understand TGD adolescents' needs and can further improve the development of tailored fertility counseling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the first European collaborative study on transgender healthcare in adolescents. A limitation of our study is the relatively low response rate to the questionnaires, which varied between 25% and 62%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Many TGD adolescents express a desire for future parenthood yet experience decisional conflict","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"924-936"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574635","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":"Changing or stopping testosterone-lowering medication in men convicted of sexual offenses: clinical evaluation of the COSTLow-R scale.","authors":"Jochen Wolba, Safiye Tozdan, Peer Briken, Roland Freese, Wolfgang Retz, Daniel Turner","doi":"10.1093/jsxmed/qdaf056","DOIUrl":"10.1093/jsxmed/qdaf056","url":null,"abstract":"<p><strong>Background: </strong>Men convicted of sexual offenses (MCSO) can be treated with testosterone-lowering medications (TLM) in order to support the control of paraphilic sexual fantasies and to decrease the risk of sexual recidivism. However, due to partly severe side effects, TLM should not be a lifelong treatment.</p><p><strong>Aim: </strong>The Change or Stop Testosterone-Lowering Medication (COSTLow)-R Scale was developed to assist forensic professionals in deciding on whether to change or stop TLM treatment in MCSO. The current study aimed to evaluate the scale in forensic outpatient aftercare practice.</p><p><strong>Methods: </strong>The COSTLow-R Scale was applied retrospectively in a forensic-psychiatric outpatient institution in Hesse, Germany, on 72 MCSO. TLM was stopped in 30 patients (41.7%). Moreover, 10 forensic professionals of the institution (23.3%) as well as an experienced working group within the institution focusing on the treatment of MCSO, qualitatively evaluated the COSTLow-R Scale by participating in an open designed survey.</p><p><strong>Outcomes: </strong>The COSTLow-R Scale ratings as assessed by forensic professionals were collected. In addition, a survey was performed among these professionals about the usefulness of the scale and their practical experiences with it.</p><p><strong>Results: </strong>TLM stopping decisions were significantly associated with three COSTLow-R Scale items: the compliance for monitoring effects and side effects, the possibility of psychotherapy before TLM treatment, and the therapeutic alliance before starting TLM treatment. In sum, the decision towards stopping TLM was more likely for patients whose compliance was considered higher, and for those who had demonstrated a greater treatment readiness as well as therapeutic alliance before starting TLM. The forensic professionals described the scale as a good and structured tool that displays which aspects are important to consider during TLM treatment decisions.</p><p><strong>Clinical implications: </strong>The COSTLow-R Scale provides structure to the decision whether to change or stop TLM and should thus be implemented in the forensic treatment process of patients with TLM more frequently.</p><p><strong>Strengths & limitations: </strong>Although the small sample size limits generalizability of the findings, the present study was conducted directly in a forensic center and, therefore, has high external validity and a strong impact on the life and health of patients treated with TLM.</p><p><strong>Conclusion: </strong>The results indicate that the COSTLow-R Scale can be a useful instrument facilitating the TLM decision-making process by providing a structured compendium of criteria. Further research is still needed to evaluate the scale and to provide additional evidence for the results of the current study.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"888-897"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797095","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}