-
International Braz J Urol : Official... 2023
Topics: Male; Humans; Premature Ejaculation; Ejaculation; Benzylamines; Naphthalenes; Treatment Outcome
PubMed: 37267615
DOI: 10.1590/S1677-5538.IBJU.2023.9908 -
BMJ (Clinical Research Ed.) Dec 2023To investigate the association of genetically proxied (using a surrogate biomarker) inhibition of phosphodiesterase 5 (PDE5), an established drug target for erectile...
OBJECTIVE
To investigate the association of genetically proxied (using a surrogate biomarker) inhibition of phosphodiesterase 5 (PDE5), an established drug target for erectile dysfunction, with fertility, sexual behaviour, and subjective wellbeing.
DESIGN
Two sample cis-mendelian randomisation study.
SETTING
Summary data on genetic associations obtained from the International Consortium for Blood Pressure and UK Biobank.
PARTICIPANTS
Individuals of European ancestry from the International Consortium for Blood Pressure (n=757 601) for estimating PDE5 inhibition (using the surrogate biomarker of diastolic blood pressure reduction), and UK Biobank (n=211 840) for estimating the fertility, sexual behaviour, and subjective wellbeing outcomes in male participants.
INTERVENTION
Genetically proxied PDE5 inhibition.
MAIN OUTCOME MEASURES
Number of children fathered, number of sexual partners, probability of never having had sexual intercourse, and subjective wellbeing.
RESULTS
Genetically proxied PDE5 inhibition was associated with male participants having 0.28 (95% confidence interval 0.16 to 0.39) more children (false discovery rate corrected P<0.001). This association was not identified in female participants. No evidence was found of an association between genetically proxied PDE5 inhibition and number of sexual partners, probability of never having had sexual intercourse, or self-reported wellbeing in male participants.
CONCLUSIONS
The findings of this study provide genetic support for PDE5 inhibition potentially increasing the number of children fathered by male individuals. Absence of this association in female participants supports increased propensity for sustained and robust penile erections as a potential underlying mechanism. Further studies are required to confirm this, however, and these findings should not promote indiscriminate use of PDE5 inhibitors, which can also have harmful adverse effects.
Topics: Child; Male; Humans; Female; Erectile Dysfunction; Sexual Behavior; Penile Erection; Fertility; Biomarkers
PubMed: 38086555
DOI: 10.1136/bmj-2023-076197 -
Journal of Autism and Developmental... Aug 2023The suggested overlap between autism spectrum disorder (ASD) and gender dysphoria/incongruence (GD/GI) has been much disputed. This review showed a relationship between... (Meta-Analysis)
Meta-Analysis
The suggested overlap between autism spectrum disorder (ASD) and gender dysphoria/incongruence (GD/GI) has been much disputed. This review showed a relationship between ASD traits and GD feelings in the general population and a high prevalence of GD/GI in ASD. Our meta-analyses revealed that the pooled estimate of the prevalence of ASD diagnoses in GD/GI people was 11% (p < .001) and the overall effect size of the difference in ASD traits between GD/GI and control people was significant (g = 0.67, p < .001). Heterogeneity was high in both meta-analyses. We demonstrated that the chances that there is not a link between ASD and GD/GI are negligible, yet the size of it needs further investigation.
Topics: Humans; Gender Dysphoria; Autism Spectrum Disorder; Prevalence
PubMed: 35596023
DOI: 10.1007/s10803-022-05517-y -
BMC Women's Health Jul 2023Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it.
OBJECTIVES
The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia.
DESIGN
A systematic review and meta-analysis was conducted.
METHOD
Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I index.
RESULTS
Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function.
CONCLUSIONS
Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity.
PROSPERO REGISTRATION
CRD42021236155.
Topics: Humans; Female; Dyspareunia; Quality of Life; Physical Therapy Modalities; Pain; Transcutaneous Electric Nerve Stimulation
PubMed: 37482613
DOI: 10.1186/s12905-023-02532-8 -
Journal of Clinical Research in... Aug 2023A significant rise in the number of trans adolescents seeking medical interventions has been reported in recent years. The aim of this study was to report the clinical...
OBJECTIVE
A significant rise in the number of trans adolescents seeking medical interventions has been reported in recent years. The aim of this study was to report the clinical features, treatment, and follow-up of adolescents with gender dysphoria (GD) with our increased experience.
METHODS
Twenty-six male-to-female (MTF) and twenty-seven female-to-male (FTM) adolescents who were referred to the GD-outpatient clinic between 2016 and 2022 were reviewed. The clinical and laboratory findings of thirty transgender adolescents (15 FTM /15 MTF) who received medical intervention were evaluated retrospectively.
RESULTS
Most individuals (60.4%) were admitted between 2020 and 2022, and the remaining (39.6%) were admitted between 2016 and 2019. At the time of referral, median age was 16.3 years [interquartile range (IQR) 1.53; range 13.2-19.4] in 26 MTF, and 16.4 years (IQR 1.74; range 11.7-21.6) in 27 FTM adolescents. The median age at pubertal blockage with gonadotropin-releasing hormone analog and androgen receptor blocker was 16.4 years (IQR 1.4; range 11.7-17.8) in 22 adolescents (9 MTF, 13 FTM), and 17.4 years (IQR 1.4; range 15.5-19.4) in 6 MTF individuals, respectively. Cross-sex hormone therapy was commenced in 21 adolescents (12 MTF, 9 FTM) at the median age of 17.7 years (IQR 0.61; range 16-19.5). Fifteen individuals (8 MTF, 7 FTM) have been transferred to the adult endocrinology department in transition clinics.
CONCLUSION
All treatments were generally well tolerated and effective, including bicalutamide, and no significant side effects were observed. Transition clinics played an important role in the better management of gender reassignment processes.
Topics: Adult; Humans; Male; Child; Female; Adolescent; Infant; Retrospective Studies; Gender Dysphoria; Turkey; Transsexualism; Transgender Persons
PubMed: 36987788
DOI: 10.4274/jcrpe.galenos.2023.2023-1-13 -
Archives of Sexual Behavior Jul 2023Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical...
Gender transition is undertaken to improve the well-being of people suffering from gender dysphoria. However, some have argued that the evidence supporting medical interventions for gender transition (e.g., hormonal therapies and surgery) is weak and inconclusive, and an increasing number of people have come forward recently to share their experiences of transition regret and detransition. In this essay, I discuss emerging clinical and research issues related to transition regret and detransition with the aim of arming clinicians with the latest information so they can support patients navigating the challenges of regret and detransition. I begin by describing recent changes in the epidemiology of gender dysphoria, conceptualization of transgender identification, and models of care. I then discuss the potential impact of these changes on regret and detransition; the prevalence of desistance, regret, and detransition; reasons for detransition; and medical and mental healthcare needs of detransitioners. Although recent data have shed light on a complex range of experiences that lead people to detransition, research remains very much in its infancy. Little is known about the medical and mental healthcare needs of these patients, and there is currently no guidance on best practices for clinicians involved in their care. Moreover, the term detransition can hold a wide array of possible meanings for transgender-identifying people, detransitioners, and researchers, leading to inconsistences in its usage. Moving forward, minimizing harm will require conducting robust research, challenging fundamental assumptions, scrutinizing of practice patterns, and embracing debate.
Topics: Humans; Transgender Persons; Transsexualism; Gender Identity; Uncertainty; Gender Dysphoria; Emotions
PubMed: 37266795
DOI: 10.1007/s10508-023-02626-2 -
Tidsskrift For Den Norske Laegeforening... Jun 2024Good sexual health promotes quality of life and coping skills, and this also applies to older adults. This clinical review article presents updated knowledge on older... (Review)
Review
Good sexual health promotes quality of life and coping skills, and this also applies to older adults. This clinical review article presents updated knowledge on older adults' sexuality, normal challenges related to ageing and conjugal relationships, and sexual challenges caused by chronic diseases, adverse effects of medications, and cognitive failure. The review describes measures to improve sexual health. Healthcare personnel should take the initiative to talk about sexual health with older adults.
Topics: Humans; Sexual Health; Aged; Aging; Female; Male; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Chronic Disease; Sexuality
PubMed: 38832621
DOI: 10.4045/tidsskr.23.0809