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Urologiia (Moscow, Russia : 1999) Dec 2019Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual...
Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual arousal and erectile function. Delayed ejaculation is one of the most studied and rare types of male sexual dysfunctions, which leads to depression, anxiety, and often is a reason of low self-esteem, reduced satisfaction of a man with his partner, and worsening of relationships between partners. In some cases, delayed ejaculation and anejaculation cause infertility. Current views on epidemiology, diagnostics and treatment strategy of delayed ejaculation are presented in the article.
Topics: Ejaculation; Humans; Male; Orgasm; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 32003187
DOI: No ID Found -
Biomedicines Oct 2023Hypericum species are widely acknowledged for their biological attributes, with notable attention being paid to , commonly known as St. John's wort (SJW) within the... (Review)
Review
BACKGROUND
Hypericum species are widely acknowledged for their biological attributes, with notable attention being paid to , commonly known as St. John's wort (SJW) within the Hypericum section of the Hypericaceae family. This species is among the most thoroughly investigated herbal medicines, particularly in terms of its application in the management of mild to moderate depression. SJW is used to treat depression, menopausal symptoms, attention-deficit hyperactivity disorder (ADHD), somatic symptom disorder, obsessive-compulsive disorder, and skin conditions, such as wounds and muscle pain. However, the usefulness and effectiveness of SJW for male sexual and reproductive health (SRH) are not well known.
OBJECTIVE
To assess the current evidence in the literature on the effect of SJW on male SRH.
METHODS
This narrative review followed a predetermined protocol and used MEDLINE and PubMed to identify articles published in English on the effects of SJW on male SRH. The search used various keywords, such as "", "St. John's Wort", and terms related to sexual and reproductive health issues. Articles published between the inception of the database and August 2023 were included.
RESULTS
We identified 12 articles published from 1999 to 2019, the majority of which were experimental and conducted on animals. These studies demonstrate variability in terms of design, sample size, type of SJW extract used, the dosage administered, and duration of treatment. Studies have indicated potential sexual dysfunction (SD) due to SJW, which includes reduced libido, delayed ejaculation, delayed orgasm, and erectile dysfunction. Additionally, reproductive toxicity has been suggested, as evidenced by spermicidal effects through the inhibition of sperm motility, abnormal spermatozoa, chromosomal aberrations, and DNA denaturation. Furthermore, some studies have reported potential adverse events during maternal exposure, inhibition of fertilization, and disruption of reproductive parameters.
CONCLUSIONS
Our review suggests that the safety and efficacy of SJW in the treatment of human SRH remain unclear. Further comprehensive, well-designed studies with larger samples, longer exposure periods, and specific dosages are needed to clarify SJW's effects of SJW. Therefore, consultation with healthcare professionals before using herbal remedies or supplements is crucial.
PubMed: 37893173
DOI: 10.3390/biomedicines11102800 -
The Journal of Sexual Medicine May 2023Criteria for the definition and diagnosis of delayed ejaculation (DE) are yet under consideration.
BACKGROUND
Criteria for the definition and diagnosis of delayed ejaculation (DE) are yet under consideration.
AIM
This study sought to determine an optimal ejaculation latency (EL) threshold for the diagnosis of men with DE by exploring the relationship between various ELs and independent characterizations of delayed ejaculation.
METHODS
In a multinational survey, 1660 men, with and without concomitant erectile dysfunction (ED) and meeting inclusion criteria, provided information on their estimated EL, measures of DE symptomology, and other covariates known to be associated with DE.
OUTCOMES
We determined an optimal diagnostic EL threshold for men with DE.
RESULTS
The strongest relationship between EL and orgasmic difficulty occurred when the latter was defined by a combination of items related to difficulty reaching orgasm and percent of successful episodes in reaching orgasm during partnered sex. An EL of ≥16 minutes provided the greatest balance between measures of sensitivity and specificity; a latency ≥11 minutes was the best threshold for tagging the highest number/percentage of men with the severest level of orgasmic difficulty, but this threshold also demonstrated lower specificity. These patterns persisted even when explanatory covariates known to affect orgasmic function/dysfunction were included in a multivariate model. Differences between samples of men with and without concomitant ED were negligible.
CLINICAL IMPLICATIONS
In addition to assessing a man's difficulty reaching orgasm/ejaculation during partnered sex and the percent of episodes reaching orgasm, an algorithm for the diagnosis of DE should consider an EL threshold in order to control diagnostic errors.
STRENGTHS AND LIMITATIONS
This study is the first to specify an empirically supported procedure for diagnosing DE. Cautions include the use of social media for participant recruitment, relying on estimated rather than clocked EL, not testing for differences between DE men with lifelong vs acquired etiologies, and the lower specificity associated with using the 11-minute criterion that could increase the probability of including false positives.
CONCLUSION
In diagnosing men with DE, after establishing a man's difficulty reaching orgasm/ejaculation during partnered sex, using an EL of 10 to 11 minutes will help control type 2 (false negative) diagnostic errors when used in conjunction with other diagnostic criteria. Whether or not the man has concomitant ED does not appear to affect the utility of this procedure.
Topics: Male; Humans; Orgasm; Ejaculation; Sexual Partners; Erectile Dysfunction; Sexual Dysfunctions, Psychological; Premature Ejaculation
PubMed: 37132032
DOI: 10.1093/jsxmed/qdad058 -
Wiadomosci Lekarskie (Warsaw, Poland :... Oct 2019Sexual disorders are very common problems in the psychiatric patients. Many factors induce sexual dysfunction, e.g. the effects of antidepressants and antipsychotics.... (Review)
Review
Sexual disorders are very common problems in the psychiatric patients. Many factors induce sexual dysfunction, e.g. the effects of antidepressants and antipsychotics. The article reviews literature on sexual disorders in psychiatric diseases such as schizophrenia, bipolar disorder, depressive, anxiety, obsessive-compulsive disorders and eating disorders. Bipolar disorder significantly affects the quality of life and increases the risk of sexual dysfunction. In the manic phase there is an increase in libido, which is associated with the risky sexual behavior. Depressive disorders are associated with reduced libido and dissatisfaction with sexual activity. Panic disorder and obsessive-compulsive disorder are correlated with less frequent sexual contact. Decreased sexual desire and sexual aversion are strongly associated with anxiety disorders. The prevalence of sexual dysfunction in patients with schizophrenia is high among both those treated and untreated. Women suffering from schizophrenia have anorgasmia, decreased libido, vaginal dryness, vaginism, and dyspareunia. Men suffering from schizophrenia as the main complaints give lowering the drive of difficulty in maintaining an erection, delaying orgasm. In patients with eating disorders, libido decreases as well as sexual activity and the level of sexual satisfaction decreases. Satisfaction with sexual life is an important factor affecting the quality of life. Patients rarely deal with problems in sexual life, so questions about this area of life should not be overlooked during a medical interview.
Topics: Female; Humans; Libido; Male; Orgasm; Quality of Life; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological
PubMed: 31982027
DOI: No ID Found -
The World Journal of Men's Health Jul 2024Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship... (Review)
Review
Management of Male Infertility with Coexisting Sexual Dysfunction: A Consensus Statement and Clinical Recommendations from the Asia-Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA).
Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: "low libido", "erectile dysfunction", "ejaculatory dysfunction", "premature ejaculation", "retrograde ejaculation", "delayed ejaculation", "anejaculation", and "orgasmic dysfunction" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient's individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.
PubMed: 37853539
DOI: 10.5534/wjmh.230180 -
The Journal of Sexual Medicine Aug 2022Sexual aversion (SA) is a chronic difficulty impacting sexual, relational and psychological wellbeing. Yet, there is a dearth of studies exploring its prevalence and...
BACKGROUND
Sexual aversion (SA) is a chronic difficulty impacting sexual, relational and psychological wellbeing. Yet, there is a dearth of studies exploring its prevalence and associated factors.
AIM
To estimate the prevalence of SA and examine its correlates among a community sample of Canadian adults.
METHODS
A large web-based sample of the Quebec (Canada) adult population (n = 1,935) completed an online survey on sexual wellbeing. Prevalence rates were estimated for SA and other sexual difficulties. Multivariate logistic regression analyses were used to identify correlates of SA.
OUTCOMES
Demographics (eg, gender, employment status), self-reported experiences of sexual difficulties (low sexual desire and arousal, vaginal dryness, pain during sexual intercourse, erectile difficulties, premature or delayed ejaculation, and orgasm difficulties), and markers of psychosexual wellbeing (eg, psychological distress, performance anxiety) according to the presence or absence of SA were assessed.
RESULTS
The prevalence of SA was 9.7% (95% CI: 8.5-11.2) in the present sample (6.9% [95% CI: 5.1-8.9] in men, 11.3% [95% CI: 9.4-13.4] in women and 17.1% [95% CI: 9.4-27.4] in nonbinary and/or trans individuals). The multivariate logistic regression model explained 31% of the likelihood of experiencing SA. SA was related to psychological distress (aOR: 1.77, 95% CI: 1.33-2.38), sexual satisfaction (aOR: .59, 95% CI:.49-0.70), sexual performance anxiety (aOR: 2.08, 95% CI: 1.45-2.98), and discomfort with sex-related information (aOR: 1.02, 95% CI: 1.01-1.04) CLINICAL IMPLICATIONS: Several psychosexual correlates of SA were documented and could be targeted by practitioners during the assessment and treatment of individuals living with SA.
STRENGTHS AND LIMITATIONS
The study's strengths include its large, gender diverse sample and use of comprehensive diagnostic criteria for SA. Probability-based sampling methods and longitudinal studies should be conducted to address the current study's limitations.
CONCLUSION
SA research is critical to document its prevalence in different sociodemographic groups, explore additional intrapersonal and interpersonal mechanisms involved in SA etiology, and ensure that the needs of people living with SA are met with tailored interventions. David Lafortune, Éliane Dussault, Mathieu Philibert, Natacha Godbout. Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study. J Sex Med 2022;19:1269-1280.
Topics: Adult; Canada; Cross-Sectional Studies; Female; Humans; Male; Orgasm; Prevalence; Sexual Behavior; Sexual Dysfunctions, Psychological; Surveys and Questionnaires
PubMed: 35750625
DOI: 10.1016/j.jsxm.2022.05.142 -
Psychiatria Polska Dec 2022An attempt to assess the impact of dual diagnosis - mental illness and addiction on the occurrence of sexual dysfunctions, and evaluation of problems with sexual...
OBJECTIVES
An attempt to assess the impact of dual diagnosis - mental illness and addiction on the occurrence of sexual dysfunctions, and evaluation of problems with sexual functioning in men treated in a psychiatric ward.
METHODS
140 psychiatrically hospitalized men (mean age 40.4 ± 12.7 years) with the diagnosis of schizophrenia, affective disorders, anxiety disorders, addiction and double diagnosis (schizophrenia and addiction) took part in the study. The Sexological Questionnaire, developed by Professor Andrzej Kokoszka, and the International Index of Erectile Function IIEF-5 were used in the study.
RESULTS
The occurrence of sexual dysfunctions in the study group was reported in 83.6% of patients. The most common was reduction in sexual needs (53.6%) and orgasm delay (40%). Depending on the research tool used, erectile dysfunction appeared in 38.6% of respondents (according to Kokoszka's Questionnaire) and 61.4% of patients (IIEF-5). Severe erectile dysfunction was more common in the group of patients without a partner (12.4% vs. 0; p = 0.000) compared to people in relationships and in the group with anxiety disorders (p = 0.028) compared to groups with other mental disorders. In the group of people with dual diagnosis (DD), sexual dysfunctions were observed more frequently in comparison to patients with schizophrenia (p = 0.034). Treatment lasting over 5 years was more often associated with sexual dysfunctions (p = 0.007). In the DD group, lack of orgasm and excessive sexual needs were more frequent in comparison to people with one diagnosis (p = 0.0145; p = 0.035).
CONCLUSIONS
Sexual dysfunctions are more common in patients with DD in comparison to patients diagnosed with schizophrenia. Lack of a partner and the duration of psychiatric treatment over 5 years is associated with more frequent occurrence of sexual dysfunctions.
Topics: Adult; Humans; Male; Middle Aged; Anxiety Disorders; Diagnosis, Dual (Psychiatry); Erectile Dysfunction; Mental Disorders; Mood Disorders; Premature Ejaculation; Psychiatric Department, Hospital; Schizophrenia; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Sociodemographic Factors; Substance-Related Disorders; Surveys and Questionnaires; Quality of Life
PubMed: 37098195
DOI: 10.12740/PP/OnlineFirst/136102 -
Sexual Medicine Jun 2023Difficulty reaching orgasm/ejaculation during partnered sex, a primary characteristic of delayed or absent ejaculation, affects about 5% to 10% of men, but the reasons...
BACKGROUND
Difficulty reaching orgasm/ejaculation during partnered sex, a primary characteristic of delayed or absent ejaculation, affects about 5% to 10% of men, but the reasons underlying this problem are poorly understood.
AIM
The study sought to gain insight into possible etiologies of delayed ejaculation by assessing men's self-perceptions as to why they experience difficulty reaching orgasm.
METHODS
We drew 351 men reporting moderately severe to severe difficulty reaching orgasm during partnered sex from a sample of over 3000 respondents obtained through an online survey. As part of the 55-item survey, participants responded to 2 questions asking about their self-perceived reasons for having difficulty reaching orgasm and selected from a list of 14 options derived from the research literature, a series of men's focus groups, and expert opinion. The first question allowed respondents to select all the reasons that they felt contributed to the problem, the second to select only the most important reason. In addition, both men with and without comorbid erectile dysfunction were investigated and compared.
OUTCOMES
Hierarchical ordering of men's self-pereceived reasons for having difficulty reaching orgasm, including typal reasons established through principal component analysis.
RESULTS
The major reasons for difficulty were related to anxiety/distress and lack of adequate stimulation, with relationship and other factors endorsed with lower frequency. Further exploration using principal components analysis identified 5 typal reasons, in descending order of frequency: anxiety/distress (41%), inadequate stimulation (23%), low arousal (18%), medical issues (9%), and partner issues (8%). Few differences emerged between men with and without comorbid ED other than ones related to erectile problems, such as higher level of endorsement of medical issues. Typal reasons showed correlations, albeit mostly weak, with a number of covariates, including sexual relationship satisfaction, frequency of partnered sex, and frequency of masturbation.
CLINICAL IMPLICATIONS
Until supplemental medical treatments for delayed ejaculation are developed and approved, a number of men's purported reasons for difficult or absent ejaculation/orgasm-anxiety/distress, inadequate stimulation, low arousal, relationship issues-fall into areas that can be addressed in couples counseling by a trained sex therapist.
STRENGTHS AND LIMITATIONS
This study is unique in scope and robust in sample size. Drawbacks include those associated with online surveys, including possible bias in sample selection, limitation to Western-based samples, and the lack of differentiation between men with lifelong and acquired difficulty.
CONCLUSION
Men who have difficulty reaching ejaculation/orgasm identify putative reasons for their problem, ranging from anxiety/stress, inadequate stimulation, and low arousal to partner issues and medical reasons.
PubMed: 37408873
DOI: 10.1093/sexmed/qfad030 -
Global Spine Journal May 2022Retrospective cohort.
STUDY DESIGN
Retrospective cohort.
OBJECTIVES
Delayed ejaculation (DE) is a distressing condition characterized by a notable delay in ejaculation or complete inability to achieve ejaculation, and there are no existing reports of DE following lumbar spine surgery. Inspired by our institutional experience, we sought to assess national rates of DE following surgery of the lumbar spine.
METHODS
We queried the Optum De-identified Clinformatics Database for adult men undergoing surgery of the lumbar spine between 2003 and 2017. The primary outcome was the development of DE within 2 years of surgery. Multivariable logistic regression was performed to identify factors associated with the development of DE.
RESULTS
We identified 117 918 men who underwent 162 646 lumbar spine surgeries, including anterior lumbar interbody fusion (ALIF), posterior lumbar fusion (PLF), and more. The overall incidence of DE was 0.09%, with the highest rate among ALIF surgeries at 0.13%. In multivariable analysis, the odds of developing DE did not vary between anterior/lateral lumbar interbody fusion, PLF, and other spine surgeries. A history of tobacco smoking (OR = 1.47, 95% CI 1.00-2.16, = .05) and obesity (OR = 1.56, 95% CI 1.00-2.44, = .05) were associated with development of DE.
CONCLUSIONS
DE is a rare but distressing complication of thoracolumbar spine surgery, and patients should be queried for relevant symptoms at postoperative visits when indicated.
PubMed: 33047620
DOI: 10.1177/2192568220962435 -
Sexual Medicine Reviews Dec 2023Sexual health, an integral component of overall well-being, is frequently compromised by common yet underdiagnosed sexual dysfunctions. Traditional interventions...
INTRODUCTION
Sexual health, an integral component of overall well-being, is frequently compromised by common yet underdiagnosed sexual dysfunctions. Traditional interventions encompass pharmaceutical and psychological treatments. Unconventional therapies, like MDMA, offer hope for sexual dysfunction. This review delves into MDMA's effects on sexual responsiveness and its potential role in treating sexual dysfunction.
OBJECTIVES
The purpose of this review is to elucidate effects of MDMA on different domains of the female and male sexual response cycles.
METHODS
We conducted a systematic review on the effects of MDMA on each domain of the female and male sexual response cycles. PubMed, MEDLINE, and EMBASE were queried, and results were screened using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Search terms utilized were "MDMA" or "ecstasy" in combination with "desire," "arousal," "lubrication," "orgasm," "pleasure," "libido," "erection," and "ejaculation." Inclusion criteria for this review were MDMA use by study subjects and sexual outcomes in at least 1 domain of the female and/or male sexual response cycles were described and measured. Randomized controlled trials, cohort studies (both prospective and retrospective), surveys, and literature reviews published between January 2000 and June 2022 were included. Case reports and studies that did not address conditions of interest were excluded from analysis. Duplicated search results were screened out. The remaining studies were then read in full text to ensure they met inclusion and exclusion criteria for analysis.
RESULTS
We identified 181 studies, of which 6 met criteria for assessment of the female sexual response cycle and 8 met criteria for assessment of the male sexual response cycle. Four of 6 studies reported increased sexual desire with MDMA use among women. Arousal and lubrication were improved with MDMA use in 3 of 4 studies, but they were not affected in 1 randomized control study. In men, 7 studies evaluated the effects of MDMA on desire and/or arousal, 5 studies measured impact on erection, 3 on orgasm, and 2 on ejaculation. Sixty percent of interview-based studies reported increased sexual desire in men, while 40% reported mixed or no effect. Two studies reported impairment of erection, 2 reported mixed effects, and 1 reported fear of erection impairment. In both men and women, all studies evaluating orgasm reported delay in achieving orgasm but increased intensity and pleasure if achieved. Primary outcome measures were variable and largely qualitative.
CONCLUSION
Our findings suggest that MDMA generally increases sexual desire and intensifies orgasm when achieved. While producing conflicting evidence on sexual arousal in both sexes, MDMA may impair erectile and ejaculatory function in men.
Topics: Female; Humans; Male; N-Methyl-3,4-methylenedioxyamphetamine; Prospective Studies; Retrospective Studies; Sexual Behavior; Sexual Dysfunction, Physiological
PubMed: 37888490
DOI: 10.1093/sxmrev/qead046