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Best Practice & Research. Clinical... Sep 2022Anabolic-androgenic steroid (AAS) have widespread and growing illicit use as image and performance enhancing drugs (IPED), predominantly in young men. Users trying to... (Review)
Review
Anabolic-androgenic steroid (AAS) have widespread and growing illicit use as image and performance enhancing drugs (IPED), predominantly in young men. Users trying to stop AAS are prone to distressing withdrawal symptoms which may trigger relapse in use. It is important to develop therapies to support AAS withdrawal. The illicit nature of AAS use has impeded the robust characterisation of its clinical withdrawal syndrome within any single study. Therefore, we conducted a systematic review summarising the available clinical studies describing symptoms associated with non-medically indicated AAS use, and AAS withdrawal. Reported clinical features of AAS withdrawal include headache, fatigue, myalgia, restlessness, insomnia, low mood and libido, anorexia, suicidal ideation, body image dissatisfaction, and steroid cravings; novel therapies for AAS withdrawal would need evaluation against these symptoms.
Topics: Anabolic Agents; Androgens; Humans; Male; Performance-Enhancing Substances; Steroids; Testosterone Congeners
PubMed: 35999138
DOI: 10.1016/j.beem.2022.101691 -
Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review.The Journal of Sexual Medicine Aug 2021Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs. (Review)
Review
BACKGROUND
Sexual dysfunction may be a side effect of treatment with antipsychotics, antidepressants, and other psychotropic drugs.
AIM
To review the evidence concerning male sexual dysfunctions in patients taking psychotropic drugs to provide specific information to nonpsychiatric physicians for the management of these dysfunctions.
METHODS
A systematic search of Medline and Embase databases was performed up to October 15, 2020. We included randomized controlled trials comparing the effects of psychotropic drugs versus placebo or versus another drug of the same class, for at least 5 weeks.
OUTCOMES
We considered studies whose male population could be evaluated separately from the female population and with a separate analysis of the different phases of the male sex cycle.
RESULTS
We included 41 studies in the final review. There was a significant association between sexual dysfunction and antidepressant drug therapy, compared to placebo (decreased libido OR 1.89, 95% CI:1.40 to 2.56, 22 series, 11 trials, 7706 participants; erectile dysfunction OR = 2.28, 95% CI: 1.31 to 3.97; 11 trials, 3008 participants; ejaculatory dysfunction OR = 7.31, 95% CI: 4.38 to 12.20,19 trials, 3973 participants). When the effects of selective serotonin reuptake inhibitors (SSRIs) were evaluated separately from those of serotonin/norepinephrine reuptake inhibitors (SNRIs), the use of SNRIs but not that of SSRIs was characterized by significantly higher odds of erectile dysfunction compared to placebo. Only limited data were found regarding the effects of antipsychotics on the phases of the male sexual cycle, as it was shown that aripiprazole and risperidone showed lower and higher odds for erectile or ejaculatory dysfunction, respectively, compared to other atypical antipsychotics.
CLINICAL IMPLICATIONS
Treatment of male sexual dysfunction in patients taking psychotropics requires a basic knowledge of the different drugs that affect sexual function with different mechanisms.
STRENGTHS & LIMITATIONS
The effects of psychotropic drugs on erectile function and ejaculation were evaluated separately. The great variability of the mechanisms of action makes it difficult to make comparisons between the effects of the different classes of psychotropic drugs.
CONCLUSIONS
Administration of antipsychotics affects male sexual function with different mechanisms, although the increase in prolactin values associated with the administration of first-generation antipsychotics and some atypical, such as risperidone, seems to play a primary role in determining male sexual dysfunction. Most antidepressants cause decreased libido, ejaculatory and erectile dysfunction, however the administration of SNRIs appears to be possibly associated with a specific risk of erectile dysfunction. Trinchieri M, Trinchieri M, Perletti G, et al. Erectile and Ejaculatory Dysfunction Associated with Use of Psychotropic Drugs: A Systematic Review. J Sex Med 2021;18:1354-1363.
Topics: Antidepressive Agents; Ejaculation; Erectile Dysfunction; Female; Humans; Male; Psychotropic Drugs; Selective Serotonin Reuptake Inhibitors; Sexual Dysfunction, Physiological
PubMed: 34247952
DOI: 10.1016/j.jsxm.2021.05.016 -
Archives of Physical Medicine and... Jan 2023To systematically review how sexuality is experienced by lesbian, gay, bisexual, transgender, queer or questioning, intersex plus (other gender identifies and sexual... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review how sexuality is experienced by lesbian, gay, bisexual, transgender, queer or questioning, intersex plus (other gender identifies and sexual orientations) (LGBTQI+) persons living with chronic disease.
DATA SOURCES
PsycINFO, Embase, MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health, and Web of Science were searched from date of inception to November 2021 for English language publications. Reference lists of relevant publications were also searched.
STUDY SELECTION
Eligible studies reported on sexuality among LGBTQI+ persons living with chronic disease. The search yielded 12,626 records; 665 full texts were assessed for eligibility and 63 documents included (59 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool.
DATA EXTRACTION
Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or with a third author.
DATA SYNTHESIS
A sequential, exploratory mixed-studies approach was used for synthesis. Pooled analysis indicated that among gay and bisexual men living with prostate cancer, 68.3% experienced erectile dysfunction and 62.9% had insufficient quality of erection to engage in anal sex. Among gay and bisexual men living with HIV or AIDS, 29.3% experienced loss of libido and 25.3% experienced erectile dysfunction. Although sexual dysfunction was common, LGBTQI+ persons had difficulty accessing appropriate sexual counseling and identified negative attitudes and heteronormative assumptions by health care providers as significant barriers to sexual health. Interventions to address sexuality focused entirely on reduction of risky sexual behavior among men living with HIV or AIDS. Women, transgender persons, and intersex persons were largely excluded from the research studies.
CONCLUSIONS
Current understandings of the effect of chronic disease on LGBTQI+ sexuality are limited and mostly focus on the male sexual response. LGBTQI+ persons who experience difficulty with sexuality struggle to identify appropriate services, and there is an absence of evidence-based interventions to promote sexual health and well-being in this population.
Topics: Adult; Female; Humans; Male; Acquired Immunodeficiency Syndrome; Erectile Dysfunction; Sexual and Gender Minorities; Sexuality; Chronic Disease; Sexual Dysfunction, Physiological
PubMed: 35973583
DOI: 10.1016/j.apmr.2022.07.018 -
The Journal of Sexual Medicine Jul 2023No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function. (Meta-Analysis)
Meta-Analysis
BACKGROUND
No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function.
AIM
To assess the effects of female SUI and related treatments on male partners' sexual function.
METHODS
A comprehensive search of the PubMed, Embase, Web of Science, Cochrane, and Scopus databases was performed up to September 6, 2022. Studies were included that investigated the effect of female SUI and related treatments on male partners' sexual function.
OUTCOME
Male partners' sexual function.
RESULTS
Of the 2294 citations identified, 18 studies with 1350 participants were included. Two studies assessed the effect of female SUI without treatment on male partners' sexual function, finding that partners had more erectile dysfunction, more sexual dissatisfaction, and less sexual frequency than partners of women without urinary incontinence. Seven studies directly assessed the effect of female SUI treatments on male partners' sexual function by surveying the male partners. Among these, 4 assessed transobturator suburethral tape (TOT) surgery; 1 assessed TOT and tension-free vaginal tape obturator surgery; and the remaining 2 assessed pulsed magnetic stimulation and laser treatment. Among the 4 TOT studies, 3 used the International Index of Erectile Function (IIEF). TOT surgery significantly improved the total IIEF score (mean difference [MD] = 9.74, P < .00001), along with erectile function (MD = 1.49, P < .00001), orgasmic function (MD = 0.35, P = .001), sexual desire (MD = 2.08, P < .00001), intercourse satisfaction (MD = 2.36, P < .00001), and overall satisfaction (MD = 3.46, P < .00001). However, the improvements in IIEF items may be of unclear clinical significance, as 4 points in the erectile function domain of the IIEF are typically defined as the minimal clinically important difference. In addition, 9 studies indirectly assessed the effect of female SUI surgery on male partners' sexual function by surveying patients with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. The results demonstrated no significant differences in erectile function (MD = 0.08, P = .40) or premature ejaculation (MD = 0.07, P = .54).
CLINICAL IMPLICATIONS
The effects of female SUI and related treatments on male partners' sexual function were summarized for the first time, providing a reference for future clinical practice and scientific research.
STRENGTHS AND LIMITATIONS
A limited number of studies that used various scales met the standardized eligibility criteria.
CONCLUSION
Female SUI may affect male partners' sexual function, and female patients' anti-incontinence surgery does not appear to have a clinically significant improvement on the sexual function of their partners.
Topics: Female; Humans; Male; Urinary Incontinence, Stress; Erectile Dysfunction; Sexual Behavior; Coitus; Libido; Suburethral Slings; Treatment Outcome
PubMed: 37291077
DOI: 10.1093/jsxmed/qdad070 -
European Journal of Obstetrics,... Jun 2024To systematically review and conduct a meta-analysis to assess the effectiveness of dienogest (DNG) in the prolonged conservative drug management of deep infiltrating... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review and conduct a meta-analysis to assess the effectiveness of dienogest (DNG) in the prolonged conservative drug management of deep infiltrating endometriosis (DIE). The findings from this study are intended to serve as a valuable reference for clinical decision-making regarding medication in the context of DIE.
METHODS
Following the PRISMA Statement, we searched EMBASE, PubMed, The Cochrane Library, Web of Science, and Medline databases for relevant literature published in the public domain from the date of establishment of the database until October 2023. Subsequently, all English publications on clinical studies using DNG for the treatment of DIE were included. Studies involving surgical intervention or drug therapy for postoperative recurrence were excluded. All literature included in the review underwent risk assessment of bias. Two evaluators independently screened the publications, conducted a quality assessment of each article and extracted data. We used Revman 5.4 for the meta-analysis of the included literature.
RESULTS
Our final analysis consisted of five clinical studies, involving a total of 256 patients. We found that there were significant improvements in the following indicators post-medication as compared to levels before taking the medication: dysmenorrhea (MD = 4.24, 95 % CI: 2.92-5.56, P < 0.00001), non-menstrual pelvic pain (MD = 3.11, 95 % CI: 2.34-3.88, P < 0.00001), dyspareunia (MD = 1.93, 95 % CI: 1.50-2.37, P < 0.00001), dyschezia (MD = 2.48, 95 % CI: 1.83-3.12, P < 0.00001), and rectosigmoid nodule size (MD = 0.32, 95 % CI: 0.18-0.46, P < 0.00001). Compared with pre-medication levels, the following indicators were significantly worse: headache (RR = 0.03, 95 % CI: 0.00-0.23, P = 0.0006), decreased libido (RR = 0.08, 95 % CI: 0.01-0.62, P = 0.02); and there was no significant improvement in dysuria (P > 0.05).
CONCLUSION
DNG showed efficacy in relieving pain-related symptoms and significantly reducing the size of the lesions when used in the drug conservative treatment of DIE.
Topics: Humans; Female; Endometriosis; Nandrolone; Treatment Outcome; Hormone Antagonists
PubMed: 38579545
DOI: 10.1016/j.ejogrb.2024.03.032 -
Medicina (Kaunas, Lithuania) Sep 2022: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA... (Review)
Review
: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. : We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. : One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46-56 years). The median follow-up was 12 months (range 0-60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. : Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential.
Topics: Dyspareunia; Female; Humans; Middle Aged; Orgasm; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Uterine Cervical Neoplasms
PubMed: 36143900
DOI: 10.3390/medicina58091223 -
American Journal of Men's Health 2020Studies reported that was effective in relieving lower urinary tract symptoms (LUTS). This article carried out a systematic review and meta-analysis to compare with... (Meta-Analysis)
Meta-Analysis
Studies reported that was effective in relieving lower urinary tract symptoms (LUTS). This article carried out a systematic review and meta-analysis to compare with tamsulosin in the treatment of benign prostatic hyperplasia (BPH) after at least 6-month treatment cycle. Four studies involving 1,080 patients (543 in the group and 537 in the tamsulosin group) were included in the meta-analysis. The results were as follows: compared with tamsulosin, had a same effect in treating BPH in terms of International Prostate Symptom Score (IPSS) (mean difference [MD] 0.63, 95% confidence interval [CI] [-0.33, 1.59], = 0.20), quality of life (QoL) (MD 1.51, 95% CI [-1.51, 4.52], = 0.33), maximum flow rate (Qmax) (MD 0.27, 95% CI [-0.15, 0.68], = 0.21), postvoid residual volume (PVR) (MD -4.23, 95% CI [-22.97, 14.44], = 0.65), prostate-specific antigen (PSA) (MD 0.46, 95% CI [-0.06, 0.97], = 0.08) with the exception of prostate volume (PV) (MD -0.29, 95% CI [-0.41, -0.17], < 0.00001). For side effects, was well tolerated compared with tamsulosin especially in ejaculation disorders (odds ratio [OR] = 12.56, 95% CI [3.83, 41.18], < 0.0001) and decreased libido (OR = 5.40; 95% CI [1.17, 24.87]; = 0.03). This study indicated that had the same effect in treating BPH compared with tamsulosin in terms of IPSS, QoL, and PVR after at least 6-month treatment cycle, however, the latter had a greater improvement in PV compared with the former. And did not increase the risk of adverse events especially with respect to ejaculation disorders and libido decrease.
Topics: Aged; Aged, 80 and over; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Plant Extracts; Prostatic Hyperplasia; Serenoa; Tamsulosin; Urological Agents
PubMed: 32274957
DOI: 10.1177/1557988320905407 -
Sexual Medicine Reviews Jul 2021The increasing research interest in sexual satisfaction corresponds to a large amount of studies which focus on different singular determinants without establishing a... (Review)
Review
INTRODUCTION
The increasing research interest in sexual satisfaction corresponds to a large amount of studies which focus on different singular determinants without establishing a common model for its explanation.
OBJECTIVES
The purpose of this review is to systematically identify and evaluate the structure and results of the current research about sexual satisfaction in heterosexual women in a long-term relationship.
METHODS
A systematic literature search using Web of Knowledge, ProQuest and PSYNDEX was conducted from January 2004 to October 2019. In total, 1,649 studies published in the last 15 years were extracted from the databases with a systematic keyword search. Through a multistage evaluation process 204 studies met the inclusion criteria and described findings about sexual satisfaction as dependent variable.
RESULTS
Research interest in sexual satisfaction increased notably in the last 5 years. Empirical analyses were predominantly based on data from North America whereas a considerably smaller share of research analyzed samples from Europe or Asia. Relationship variables were the most frequently analyzed predictors and included in more than half of the identified studies. Sexual behavior was most often analyzed in the form of frequency of sexual interactions. Contrariwise, sexual practices, communication about sexuality and sexual desire, and sexual thoughts received limited attention. Demographics were considered in one third of all studies. The inclusion of control variables was rare. Some important studies considered variables closely related to sexual satisfaction such as sexual dysfunction.
CONCLUSION
Relationship satisfaction and the frequency of sexual interactions are identified as the most frequently confirmed predictors of sexual satisfaction across all evaluated studies. Results about the effects of pornography consumption, religion, and relationship duration showed the greatest inconsistency. In general, identified effects were often believed to result from mediator variables like sexual desire or distracting thoughts. Rausch D, Rettenberger M. Predictors of Sexual Satisfaction in Women: A Systematic Review. Sex Med Rev 2021;9:365-380.
Topics: Female; Heterosexuality; Humans; Libido; Orgasm; Sexual Behavior; Sexual Dysfunction, Physiological
PubMed: 34099432
DOI: 10.1016/j.sxmr.2021.01.001 -
Journal of Sex & Marital Therapy 2023Determining the true incidence and identifying the risk factors of low sexual desire (LSD) and hypoactive sexual desire disorder (HSDD) are essential to prevent sexual... (Meta-Analysis)
Meta-Analysis
Determining the true incidence and identifying the risk factors of low sexual desire (LSD) and hypoactive sexual desire disorder (HSDD) are essential to prevent sexual dysfunctions and provide adequate treatment resources. This systematic review and meta-analysis were performed on research articles reporting women with LSD and HSDD in PsycArticles, Scopus, MEDLINE, Web of Science databases, and reference lists till October 2021. All cross-sectional studies published in English that assessed both sexual desire and sexual distress were included. Of 891 full-text articles identified, 24 were eligible, all of which had a low risk of overall bias. We did separate random-effects meta-analyses for LSD and HSDD outcomes. The incidence of LSD and HSDD were 29% and 12%, respectively. Studies that used the convenience sampling method reported a higher incidence of HSDD than studies that used the probability sampling method. No differences were found between the assessment method and across cultures in LSD and HSDD. A majority of studies reviewed addressed demographic (e.g. age, education), physiological (e. g. menopausal status, body mass index), psychological (e.g. depression, daily internal stress), relational (e.g. relationship length, relationship satisfaction), and sexual predictors (e.g. sexual activity, sexual pleasure) between LSD and HSDD. This systematic review may inform researchers, guideline developers, and policy-makers about LSD associated with distress and help health professionals to identify women most at risk.
Topics: Female; Humans; Cross-Sectional Studies; Incidence; Sexual Dysfunctions, Psychological; Sexual Behavior; Libido
PubMed: 37158079
DOI: 10.1080/0092623X.2023.2208564 -
BMC Women's Health Dec 2022To provide an understanding of the changes in sexual function in women with genital warts. (Review)
Review
PURPOSE
To provide an understanding of the changes in sexual function in women with genital warts.
METHODS
In this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included.
RESULTS
19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts.
CONCLUSION
This study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future.
SYSTEMATIC REVIEW REGISTRATION
(PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584 ).
Topics: Humans; Female; Condylomata Acuminata; Prevalence
PubMed: 36503516
DOI: 10.1186/s12905-022-02073-6