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Langmuir : the ACS Journal of Surfaces... May 2024Although finasteride (FNS) tablets are considered the most effective drug for the treatment of androgenetic alopecia (AGA), their clinical applications are limited due...
Although finasteride (FNS) tablets are considered the most effective drug for the treatment of androgenetic alopecia (AGA), their clinical applications are limited due to the associated side effects including decreased libido, breast enlargement, and liver dysfunction. In this study, we have developed a personalized microneedle (PMN) with a double-layer structure that incorporates FNS-loaded microspheres (MPs) to accommodate irregular skin surfaces. This design enables the sustained release of FNS, thereby reducing potential side effects. The needle body was synthesized with high-strength hyaluronic acid (HA) as the base material substrate. The backing layer utilized methacrylate gelatin (GelMA) with specific toughness, enabling PMN to penetrate the skin while adapting to various skin environments. The length of PMN needles (10 × 10) was approximately 600 μm, with the bottom of the needles measuring about 330 μm × 330 μm. The distance between adjacent tips was around 600 μm, allowing the drug to penetrate the stratum corneum of the skin. The results of the drug release investigation indicated the sustained and regulated release of FNS from PMN, as compared to that of pure FNS and FNS-MPs. Further, the cytotoxicity assay demonstrates that PMS displays good cytocompatibility. Altogether, this mode of administration has immense potential for the development of delivery of other drugs, as well as in the medical field.
Topics: Microspheres; Finasteride; Needles; Administration, Cutaneous; Hyaluronic Acid; Animals; Humans; Drug Delivery Systems; Drug Liberation; Skin
PubMed: 38710593
DOI: 10.1021/acs.langmuir.4c00280 -
Sexual Health May 2024Background The nature of sexual desire is complex, and little phenomenological consensus exists about its meaning. Low sexual desire (LSD) is a commonly reported sexual...
Background The nature of sexual desire is complex, and little phenomenological consensus exists about its meaning. Low sexual desire (LSD) is a commonly reported sexual difficulty among women, but it is less frequently associated with sexual distress. The aim of this qualitative study is to explore women's understanding of sexual desire, and their perceptions of factors that may contribute to LSD, its effects and their methods of seeking help. Methods The research employed a questionnaire with 12 open-ended questions, developed by the researchers based on sexual script theory. Data were collected from 165 heterosexual Turkish women who reported LSD, recruited through social media platforms between August and October 2021. The data were analysed using a contextual form of thematic analysis to identify and explore patterns. Results The ages of the participants ranged from 20 to 63years. The majority of participants held a Bachelor's degree (81.2%) and in a relationship (78.8%). Three main themes emerged from the study: (1) gendered messages concerning sex, (2) multi-level sexual desire, and (3) minimisation. The research revealed that women's sexual desire is often ignored and repressed, and has negative consequences if not expressed in socially acceptable contexts. The causes of LSD in women go beyond personal factors, and include relational and social influences. Women experiencing LSD report distressing effects on their relationships and general wellbeing, yet they tend not to seek help. Conclusions Our findings contribute to a deeper understanding of the factors impacting women's sexual desire and the barriers to seeking help.
Topics: Humans; Female; Turkey; Adult; Qualitative Research; Surveys and Questionnaires; Middle Aged; Libido; Young Adult; Sexual Dysfunctions, Psychological; Sexual Behavior
PubMed: 38709901
DOI: 10.1071/SH23185 -
Journal of Lower Genital Tract Disease Jul 2024We investigated factors associated with "worse than usual" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human...
We investigated factors associated with "worse than usual" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks. Associated factors included spending less time with gay friends (odds ratio [OR] = 2.25, 95% CI = 1.06-4.77), most time "feeling down"(OR = 9.17, 95% CI = 2.94-28.59), reduced libido (OR = 2.90, 95% CI = 1.52-5.52), current anal symptoms (OR = 6.55, 95% CI = 2.54-16.90), recent anal wart diagnosis (OR = 4.33, 95% CI = 1.98-9.49), and fear of developing anal cancer (OR = 9.34, 95% CI = 4.52-19.28).Concerns regarding anal health should be routinely discussed by clinicians, and potentially associated psychosocial, physical, and sexual issues further explored.
Topics: Humans; Male; Cross-Sectional Studies; Middle Aged; Adult; Longitudinal Studies; Aged; Homosexuality, Male; Sexual and Gender Minorities; Papillomavirus Infections; Anus Neoplasms
PubMed: 38709111
DOI: 10.1097/LGT.0000000000000818 -
Biomedicine & Pharmacotherapy =... Jun 2024Late-onset hypogonadism (LOH) is an age-related disease in men characterized by decreased testosterone levels with symptoms such as decreased libido, erectile...
Late-onset hypogonadism (LOH) is an age-related disease in men characterized by decreased testosterone levels with symptoms such as decreased libido, erectile dysfunction, and depression. Thymus quinquecostatus Celakovski (TQC) is a plant used as a volatile oil in traditional medicine, and its bioactive compounds have anti-inflammatory potential. Based on this knowledge, the present study aimed to investigate the effects of TQC extract (TE) on LOH in TM3 Leydig cells and in an in vivo aging mouse model. The aqueous extract of T. quinquecostatus Celakovski (12.5, 25, and 50 µg/mL concentrations) was used to measure parameters such as cell viability, testosterone level, body weight, and gene expression, via in vivo studies. Interestingly, TE increased testosterone levels in TM3 cells in a dose-dependent manner without affecting cell viability. Furthermore, TE significantly increased the expression of genes involved in the cytochrome P450 family (Cyp11a1, Cyp17a1, Cyp19a1, and Srd5a2), which regulate testosterone biosynthesis. In aging mouse models, TE increased testosterone levels without affecting body weight and testicular tissue weight tissue of an aging animal group. In addition, the high-dose TE-treated group (50 mg/kg) showed significantly increased expression of the cytochrome p450 enzymes, similar to the in vitro results. Furthermore, HPLC-MS analysis confirmed the presence of caffeic acid and rosmarinic acid as bioactive compounds in TE. Thus, the results obtained in the present study confirmed that TQC and its bioactive compounds can be used for LOH treatment to enhance testosterone production.
Topics: Animals; Testosterone; Male; Aging; Mice; Plant Extracts; Testis; Thymus Plant; Leydig Cells; Cell Survival; Cell Line; Hypogonadism; Disease Models, Animal
PubMed: 38703505
DOI: 10.1016/j.biopha.2024.116700 -
Clinical and Experimental Dermatology May 2024The potential link between isotretinoin and sexual dysfunction has been reported in various studies. However, such an association has not been explored within the...
BACKGROUND
The potential link between isotretinoin and sexual dysfunction has been reported in various studies. However, such an association has not been explored within the context of a literature review until now.
OBJECTIVES
To evaluate the methodology and quality of studies investigating this association, and to examine the definitions of sexual dysfunction used.
METHODS
A scoping review approach was used to identify peer-reviewed research articles. The search terms used were: "isotretinoin", "sexual dysfunction", "erectile dysfunction", "ejaculatory disorders" "decreased libido", "female sexual interest", "female arousal disorder", "libido", "pelvic pain", "dyspareunia", "orgasmic disorder", "impotence", "ovaries", "fertility" and "menstrual irregularity".
RESULTS
54 peer-reviewed manuscripts consisting of 8 animal studies and 46 human studies consisting of 2,420 patients were included. Of the studies in humans, there were 18 case reports/case series, 2 case-controls, 4 cross-sectional studies, 6 longitudinal studies, 3 pharmacovigilance reports and 13 cohort studies. The most frequently observed dose range of isotretinoin was 0.5-1.0mg/kg/day usually for a duration of 1-6 months. More than half of the studies (54%, n=25) reported a beneficial or neutral effect of isotretinoin on sexual function. The majority of studies (89%, n = 41) were categorized as Oxford evidenced-based-medicine level 4.
CONCLUSIONS
This scoping review revealed very weak evidence supporting a link between isotretinoin and sexual dysfunction. Notably, the diverse definitions of sexual dysfunction pose a significant challenge for comparative analysis. The authors advocate for a standardized definition of sexual dysfunction and a framework for determining causality in order to contribute to a more comprehensive understanding of the relationship between isotretinoin and sexual dysfunction.
PubMed: 38703072
DOI: 10.1093/ced/llae168 -
Journal of Clinical PsychopharmacologyPrior studies indicate that neuroactive steroids mediate some of alcohol's effects. Dutasteride, widely used to treat benign prostatic hypertrophy, is an inhibitor of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Prior studies indicate that neuroactive steroids mediate some of alcohol's effects. Dutasteride, widely used to treat benign prostatic hypertrophy, is an inhibitor of 5-alpha reductase enzymes, which play a central role in the production of 5α-reduced neuroactive steroids. The purpose of this study was to test dutasteride's tolerability and efficacy for reducing drinking.
METHODS
Men (n = 142) with heavy drinking (>24 drinks per week) and a goal to either stop or reduce drinking to nonhazardous levels were randomized to placebo or 1 mg dutasteride daily for 12 weeks. We hypothesized that dutasteride-treated patients would be more successful in reducing drinking.
RESULTS
Generalized linear mixed models that included baseline drinking, treatment, time and their 2-way interaction identified significant interactions of treatment-time, such that dutasteride treatment reduced drinking more than placebo. During the last month of treatment, 25% of dutasteride-treated participants had no hazardous drinking (no heavy drinking days and not more than 14 drinks per week) compared with 6% of placebo-treated participants (P = 0.006; NNT = 6). Sensitivity analysis identified baseline drinking to cope as a factor associated with larger reductions in drinking for dutasteride compared with placebo-treated participants. Dutasteride was well tolerated. Adverse events more common in the dutasteride group were stomach discomfort and reduced libido.
CONCLUSION
Dutasteride 1 mg daily was efficacious in reducing the number of heavy drinking days and drinks per week in treatment-seeking men. The benefit of dutasteride compared with placebo was greatest for participants with elevated baseline drinking to cope motives.
Topics: Humans; Dutasteride; Male; 5-alpha Reductase Inhibitors; Middle Aged; Alcohol Drinking; Adult; Double-Blind Method; Treatment Outcome; Aged; Azasteroids
PubMed: 38684046
DOI: 10.1097/JCP.0000000000001849 -
Experts' view on the role of oestrogens in combined oral contraceptives: emphasis on oestetrol (E4).Frontiers in Global Women's Health 2024The evolution of contraception has been crucial for public health and reproductive well-being. Over the past 60 years, combined oral contraceptives (COCs) have remained...
INTRODUCTION
The evolution of contraception has been crucial for public health and reproductive well-being. Over the past 60 years, combined oral contraceptives (COCs) have remained an important part of the contraceptive landscape worldwide; continued development has worked toward maintaining efficacy and improving safety.
METHODS
Seven global experts convened to discuss the clinical relevance of the oestrogen in COCs, focusing on the impact of the new oestrogen, oestetrol (E4). Participants then commented through an online forum on the summary content and other participants' feedback. We prepared this report to describe the experts' views, their follow-up from the open forum and the evidence supporting their views.
RESULTS
Ethinylestradiol (EE) and oestradiol (E2) affect receptors similarly whereas E4 has differential effects, especially in the liver and breast. Adequate oestrogen doses in COCs ensure regular bleeding and user acceptability. EE and E4 have longer half-lives than E2; accordingly, COCs with EE and E4 offer more predictable bleeding than those with E2. Oestrogen type and progestin influence VTE risk; E2 poses a lower risk than EE; although promising, E4/DRSP VTE risk is lacking population-based data. COCs alleviate menstrual symptoms, impact mental health, cognition, libido, skin, and bone health.
CONCLUSION
Oestrogens play an important role in the contraceptive efficacy, bleeding patterns, and overall tolerability/safety of COCs. Recent studies exploring E4 combined with DRSP show promising results compared to traditional formulations, but more definitive conclusions await further research.
PubMed: 38655395
DOI: 10.3389/fgwh.2024.1395863 -
Journal of Sex & Marital Therapy 2024With growing interest in developing digital health tools for treating sexual dysfunction, this pilot study aimed to determine feasibility and gather preliminary efficacy... (Review)
Review
With growing interest in developing digital health tools for treating sexual dysfunction, this pilot study aimed to determine feasibility and gather preliminary efficacy data of a self-led online mindfulness intervention in comparison to an online psychoeducational intervention for women's low sexual desire in a community sample ( = 57). After a four-week intervention, participants showed overall improvements on sexual functioning, orgasm, sexual self-pleasure, sexual self-image, and sexual distress, in both treatment arms. Majority completed assigned homework and felt the intervention enhanced their sexual well-being. This study supports the feasibility of a self-led online mindfulness intervention that could help inform future programs.
Topics: Humans; Female; Mindfulness; Adult; Sexual Dysfunctions, Psychological; Pilot Projects; Libido; Middle Aged; Internet-Based Intervention
PubMed: 38650453
DOI: 10.1080/0092623X.2024.2343286 -
Hormones and Behavior Jun 2024Many women experience sexual side effects, such as decreased libido, when taking hormonal contraceptives (HCs). However, little is known about the extent to which libido...
Many women experience sexual side effects, such as decreased libido, when taking hormonal contraceptives (HCs). However, little is known about the extent to which libido recovers after discontinuing HCs, nor about the timeframe in which recovery is expected to occur. Given that HCs suppress the activities of multiple endogenous hormones that regulate both the ovulatory cycle and women's sexual function, resumption of cycles should predict libido recovery. Here, using a combination of repeated and retrospective measures, we examined changes in sexual desire and partner attraction (among partnered women) across a three-month period in a sample of Natural Cycles users (Survey 1: n = 1596; Survey 2: n = 550) who recently discontinued HCs. We also tested whether changes in these outcomes coincided with resumption of the ovulatory cycle and whether they were associated with additional factors related to HC use (e.g., duration of HC use) or relationship characteristics (e.g., relationship length). Results revealed that both sexual desire and partner attraction, on average, increased across three months after beginning to use Natural Cycles. While the prediction that changes in sexual desire would co-occur with cycle resumption was supported, there was also evidence that libido continued to increase even after cycles resumed. Together, these results offer new insights into relationships between HC discontinuation and women's sexual psychology and lay the groundwork for future research exploring the mechanisms underlying these effects.
Topics: Humans; Female; Libido; Adult; Menstrual Cycle; Young Adult; Sexual Behavior; Sexual Partners; Mobile Applications; Longitudinal Studies; Retrospective Studies; Adolescent; Contraceptive Agents, Hormonal
PubMed: 38640590
DOI: 10.1016/j.yhbeh.2024.105546 -
Hormones and Behavior Jun 2024Previous research on the endogenous effects of ovarian hormones on motivational states in women has focused on sexual motivation. The Motivational Priority Shifts...
Previous research on the endogenous effects of ovarian hormones on motivational states in women has focused on sexual motivation. The Motivational Priority Shifts Hypothesis has a broader scope. It predicts a shift from somatic to reproductive motivation when fertile. In a highly powered preregistered online diary study across 40 days, we tested whether 390 women report such an ovulatory shift in sexual and eating motivation and behaviour. We compared 209 naturally cycling women to 181 women taking hormonal contraceptives (HC) to rule out non-ovulatory changes across the cycle as confounders. We found robust ovulatory decreases in food intake and increases in general sexual desire, in-pair sexual desire and initiation of dyadic sexual behaviour. Extra-pair sexual desire increased mid-cycle, but the effect did not differ significantly in HC women, questioning an ovulatory effect. Descriptively, solitary sexual desire and behaviour, dyadic sexual behaviour, appetite, and satiety showed expected mid-cycle changes that were diminished in HC women, but these failed to reach our strict preregistered significance level. Our results provide insight into current theoretical debates about ovulatory cycle shifts while calling for future research to determine motivational mechanisms behind ovulatory changes in food intake and considering romantic partners' motivational states to explain the occurrence of dyadic sexual behaviour.
Topics: Humans; Female; Motivation; Ovulation; Adult; Sexual Behavior; Young Adult; Menstrual Cycle; Eating; Libido; Adolescent; Appetite; Contraceptives, Oral, Hormonal
PubMed: 38636206
DOI: 10.1016/j.yhbeh.2024.105542