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Medical Journal, Armed Forces India 2024The existing literature on alcohol-induced sexual dysfunction has mainly deliberated on erectile dysfunction and premature ejaculation, ignoring other important domains...
BACKGROUND
The existing literature on alcohol-induced sexual dysfunction has mainly deliberated on erectile dysfunction and premature ejaculation, ignoring other important domains of sexual dysfunctions (viz sexual pleasure, sexual desire, arousal, orgasmic function). This study was undertaken to assess the extent of alcohol-associated sexual dysfunction and to compare their severity with the severity of alcohol dependence in males.
METHODS
A cross-sectional descriptive study design recruited 78 male patients and an assessment was conducted using the male clinical version, , , Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and International Classification of Diseases-10 (ICD-10). A correlation between years of alcohol consumed and its effect on various domains of sexual dysfunction was also carried out using Pearson's correlation coefficient.
RESULTS
Seventy-seven percent of the study population had complaints of sexual dysfunction in one or more domains, with reduced sexual pleasure (71.8%) as the most common followed by low sexual desire (in terms of frequency) in 61.5% and erectile dysfunction in 43.6%. The severity of the sexual dysfunction was found to be directly proportional to the severity of alcohol dependence with almost 100 percent of the patients with severe alcohol dependence having sexual dysfunction in all the domains.
CONCLUSION
The most common sexual dysfunction reported in the current study was decreased sexual pleasure (71.8%) followed by low sexual desire 61.5% (in terms of frequency). These findings emphasize the fact, that alcohol significantly compromises almost all domains of sexual functioning in addition to erectile dysfunction.
PubMed: 38525459
DOI: 10.1016/j.mjafi.2022.05.002 -
Andrology Mar 2024Primary premature ejaculation (PPE) is a common male neurobiological disorder. Currently, there is consensus that the impairment in central serotonin (5-HT)...
INTRODUCTION
Primary premature ejaculation (PPE) is a common male neurobiological disorder. Currently, there is consensus that the impairment in central serotonin (5-HT) neurotransmission constitutes a key pathogenic factor in PPE. Selective serotonin reuptake inhibitors (SSRIs) serve as the primary pharmacological intervention; however, a comprehensive elucidation of their mechanism of action remains incomplete. Owing to significant individual variability in efficacy, SSRIs exhibit a high discontinuation rate. Hence, there is an urgent need to address the selection of SSRIs for PPE treatment.
OBJECTIVE
This study aims to investigate the characteristics of tryptophan (TRP) metabolism in patients with PPE and to assess its influence on the efficacy of SSRIs.
METHODS
The exploratory study included a total of 16 patients with PPE and 16 control subjects who were healthy men without any sexual dysfunction. Upon enrollment in the study, all participants underwent a thorough medical history review and physical examination. Subsequently, their serum levels of TRP, its metabolites, large neutral amino acids (LNAAs), and metabolite ratios were assessed using a liquid chromatography-mass spectrometry (LC-MS) assay. After a period of 4 weeks of dapoxetine treatment, all patients with PPE underwent reassessment using the Premature Ejaculation Diagnostic Tool (PEDT) score and intravaginal ejaculatory latency time (IELT) test.
RESULTS
The ratio of serum TRP to other LNAAs (TRP/LNAAs) in patients with PPE was found to be significantly lower compared to the control group (P < 0.05). Conversely, the ratio of kynurenine to TRP (KYN/TRP) was observed to be significantly higher in the PPE patients compared to the control group (P < 0.05). Including the serum TRP/LNAAs ratio and KYN/TRP ratio in the prediction model yielded the highest prediction efficiency for PPE. There was a significant negative correlation between the ratio of TRP/LNAAs before the treatment and the IELT after 4 weeks of the treatment. Additionally, there was a significant positive correlation observed between the ratio of TRP/LNAAs before the treatment and the PEDT score after 4 weeks of the treatment.
CONCLUSIONS
This study demonstrates that the reduction in the TRP/LNAAs ratio and the elevation of the KYN/TRP ratio are significant characteristics associated with PPE. These findings suggest that diminished tryptophan availability in the brain and the activation of the kynurenine (KYN) pathway may play a role in the pathogenesis of PPE. The TRP/LNAAs ratio has potential as a reliable indicator of central serotonin (5-HT) levels. Considering the TRP/LNAAs ratio when selecting SSRIs for the treatment of PPE may enhance the response rate of this medication.
PubMed: 38511846
DOI: 10.1111/andr.13632 -
European Review For Medical and... Mar 2024The autonomic nervous system (ANS) plays an important role in maintaining physiological regulation. It regulates the body's response to many variable situations....
OBJECTIVE
The autonomic nervous system (ANS) plays an important role in maintaining physiological regulation. It regulates the body's response to many variable situations. Orthostatic intolerance (OI) is one of the most important signs of autonomic dysfunction. Autonomic dysfunction is known to cause premature ejaculation (PE) by disturbing the balance in erection and ejaculation cycles. Considering that OI may develop due to autonomic dysfunction in patients with PE, we hypothesized that OI symptoms would increase in these patients. The aim of our study was to investigate the relationship between orthostatic intolerance and PE.
PATIENTS AND METHODS
This case-control study included a total of 39 patients with PE and 47 volunteers without PE. All subjects were assessed using the self-reported Orthostatic Grading Scale (OGS). In addition, the validated five-item Turkish version of the Premature Ejaculation Diagnostic Tool (PEDT) was used to evaluate PE. The PE group included patients with a PEDT score ≥ 11.
RESULTS
The mean ages of the PE and control groups were 38.2 ± 7.8 and 40.5 ± 9.1 years, respectively (p = 0.137). The mean PEDT scores of the PE and control groups were 13.9 ± 3.6 and 6.6 ± 2.9, respectively (p < 0.0001), and their mean OGS scores were 5.6 ± 2.4 and 1.6 ± 1.3, respectively (p < 0.0001). A statistically significant correlation was found between the PEDT and OGS scores (r: 0.686, p < 0.0001).
CONCLUSIONS
The orthostatic intolerance symptoms of patients with PE were higher than those of the control group. There was a correlation between the severity of PE and the severity of orthostatic intolerance. This is the first study in the literature to reveal a relationship between orthostatic intolerance and PE.
Topics: Male; Humans; Adult; Middle Aged; Premature Ejaculation; Case-Control Studies; Orthostatic Intolerance; Autonomic Nervous System Diseases; Autonomic Nervous System
PubMed: 38497876
DOI: 10.26355/eurrev_202403_35607 -
Journal of Hazardous Materials May 2024This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The... (Observational Study)
Observational Study
This study aimed to explore the associations between air pollution and male sexual function. A total of 5047 male subjects in China were included in this study. The average air pollution exposure (PM, PM, SO, CO, NO, and O) for the preceding 1, 3, 6, and 12 months before the participants' response was assessed. Male sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT). Generalized linear models were utilized to explore the associations between air pollution and male sexual function. K-prototype algorithm was conducted to identify the association among specific populations. Significant adverse effects on the IIEF-5 score were observed with NO exposure during the preceding 1, 3, and 6 months (1 m: β = -5.26E-05; 3 m: β = -4.83E-05; 6 m: β = -4.23E-05, P < 0.05). PM exposure during the preceding 12 months was found to significantly negatively affect the PEDT after adjusting for confounding variables. Our research indicated negative correlations between air pollutant exposures and male sexual function for the first time. Furthermore, these associations were more pronounced among specific participants who maintain a normal BMI, exhibit extroverted traits, and currently engage in smoking and alcohol consumption.
Topics: Humans; Male; Nitrogen Dioxide; Air Pollution; Air Pollutants; China; Particulate Matter
PubMed: 38492404
DOI: 10.1016/j.jhazmat.2024.134010 -
Multiple Sclerosis and Related Disorders May 2024To validate and culturally adapt the Sexual Health Inventory for Men (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT), to compare the frequency and severity...
PURPOSE
To validate and culturally adapt the Sexual Health Inventory for Men (IIEF-5) and the Premature Ejaculation Diagnostic Tool (PEDT), to compare the frequency and severity of erectile dysfunction (ED) and premature ejaculation (PE) in male individuals with MS (mwMS) in comparison with healthy controls (HC) and to investigate predictors of the severity of ED and PE in mwMS.
METHODS
216 consecutive mwMS and 37 HC completed IIEF-5 and PEDT. Additionally, 114 mwMS completed the Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-2), Composite Autonomic System Score-31 (COMPASS-31), and the 5-level EQ-5D questionnaire.
RESULTS
The test-retest reliability was satisfactory for both questionnaires, with acceptable reliability for both questionnaires. mwMS scored less on IIEF-5 compared to HC (23, IQR 18.25-25 vs 24, IQR 20.25-25, p = 0.028). ED was present in 39.4 % of mwMS and 27.8 % of HC (p = 0.198). Definite PE was present in 12.1 %, and possible PE in 7.8 % of mwMS; and 5.6 % and 11.1 % of HC respectively (p = 0.496). An increase in EDSS was a positive predictor (Exp(B) 1.455, 95 %CI 1.135-1.886, p = 0.003) and the presence of cremasteric reflex was a negative predictor (Exp(B) 0.381, 95 %CI 0.183-0.790, p = 0.010) for the presence of ED. For the PE, disease duration was the only positive predictor in a univariable logistic regression (Exp(B) 1.084, 95 %CI 1.019-1.153, p = 0.070).
CONCLUSION
SD is frequent in mwMS with EDSS being a positive and the presence of cremasteric reflex a negative predictor of ED and disease duration a positive predictor of PE symptoms.
Topics: Humans; Male; Adult; Premature Ejaculation; Multiple Sclerosis; Erectile Dysfunction; Middle Aged; Reproducibility of Results; Severity of Illness Index; Sexual Dysfunction, Physiological; Surveys and Questionnaires
PubMed: 38492318
DOI: 10.1016/j.msard.2024.105531 -
Arab Journal of Urology 2024to compare the results of using Dapoxetine and HA (hyaluronic acid) gel injection by Five puncture technique in the treatment of premature ejaculation (PE).
OBJECTIVE
to compare the results of using Dapoxetine and HA (hyaluronic acid) gel injection by Five puncture technique in the treatment of premature ejaculation (PE).
METHODS
100 sexually active heterosexuals circumcised males with lifelong PE were included in the study. Group A patients were treated with on-demand Dapoxetine, while group B was treated with HA gel glans penis injection using a five-puncture technique. Both groups were evaluated at 1,3 and 6 months post-treatment using IELT.
RESULTS
There were no significant differences between both groups regarding patient demographic. Mean pretreatment IELT in groups A and B were 45.82 ± 7.44 and 46.18 ± 7.82 receptively. There was no significant difference between both groups. After treatment, both groups show significant ILET improvement during the 1,3, and 6 months follow-up with a value < 0.001. However, when comparing the improvement of ILET in group A (Dapoxetine) and group B (HA injection), there were high significance differences in favor of group B in the 1st,3rd, and 6th-month follow-up.
CONCLUSION
Although both treatment modalities have improved IELT and premature ejaculation, but HA injection with five punctures technique was significantly better than oral Dapoxetine with self-limited side effects.
PubMed: 38481413
DOI: 10.1080/2090598X.2023.2245598 -
Arab Journal of Urology 2024To compare the efficacy of tadalafil alone, dapoxetine alone, and tadalafil with dapoxetine as a combination therapy for the treatment of premature ejaculation.
OBJECTIVE
To compare the efficacy of tadalafil alone, dapoxetine alone, and tadalafil with dapoxetine as a combination therapy for the treatment of premature ejaculation.
PATIENTS AND METHODS
Eligible patients attended our andrology clinic with premature ejaculation were randomly allocated into three groups: group A (92 participants) received on-demand tadalafil, 5 mg; group B (91 participants) were given on-demand dapoxetine, 30 mg; and group C (89 participants) received on-demand combination of tadalafil, 5 mg, and dapoxetine, 30 mg. We assessed the changes in the intravaginal ejaculatory latency time (IELT) and the satisfaction scores 1, 2, and 3 months after treatment.
RESULTS
Highly statistically significant improvements were found in the mean IELT and satisfaction scores 1, 2, and 3 months post-treatment in all groups ( = <0.001). Post hoc analysis suggested this improvement was more pronounced in group C ( < 0.001).
CONCLUSION
Both tadalafil and dapoxetine are effective in the treatment of patients with premature ejaculation, but the combination of both drugs gives better results.
PubMed: 38481411
DOI: 10.1080/20905998.2023.2277081 -
Arab Journal of Urology 2024Premature ejaculation (PE) is a common sexual dysfunction that harms both sex partners.
Combined on-demand sildenafil citrate and tramadol hydrochloride is an effective and safe treatment for premature ejaculation: A randomized placebo-controlled double-blind clinical trial.
BACKGROUND
Premature ejaculation (PE) is a common sexual dysfunction that harms both sex partners.
AIM
To evaluate the safety, efficacy and impact on sexual satisfaction scores of the combined use of tramadol HCl and sildenafil citrate for the treatment of PE.
METHODS
One hundred and sixty otherwise healthy males complaining of PE (primary/secondary) were enrolled in this randomized, double-blind, placebo-controlled study. Only 155 patients (age range 22-48 years) completed the study. Of them, 81 patients had primary PE, and 74 had secondary PE. The comparative groups included the placebo group ( = 34), sildenafil citrate 50 mg group ( = 39), tramadol HCl 100 mg group ( = 40), and the combination therapy group ( = 42). The treatment duration for all groups was 10 weeks.
OUTCOMES
This combination is safe and effective.
RESULTS
Five patients discontinued the study, all from the placebo group, due to a lack of improvement over the treatment course. No significant differences were reported between groups before treatment as regards Intravaginal ejaculatory Latency Time (), satisfaction score (), age (), or duration of marriage (). There was a significant improvement in IELT after treatment with a placebo (), associated with an insignificant improvement in satisfaction score (). In the other three groups, there was a significant improvement in IELT after treatment ( for all), which coincided with a significant improvement in satisfaction scores in all three groups ( for all).
CLINICAL IMPLICATIONS
We recommend this combination in the treatment of premature ejaculation.
STRENGTHS
It is a prospective randomized double-blind placebo-controlled clinical trial.
LIMITATIONS
Limited number of participants.
CONCLUSION
Combined therapy of PE, whether primary or secondary, with sildenafil citrate 50 mg and tramadol HCl 100 mg is safe and effective; and its therapeutic effect is superior to the utilization of either agent alone.
PubMed: 38481408
DOI: 10.1080/20905998.2023.2287869 -
World Journal of Urology Mar 2024The effect of overactive bladder (OAB) on sexual health has been evaluated extensively for women but much less for men. Therefore, the aim of this study was to evaluate...
PURPOSE
The effect of overactive bladder (OAB) on sexual health has been evaluated extensively for women but much less for men. Therefore, the aim of this study was to evaluate the relationship between OAB and men's sexual activity and the effect of OAB on erectile dysfunction (ED) and premature ejaculation (PE) in a large representative cohort of men at the population level.
METHODS
This study was based on computer-assisted web interviews that used validated questionnaires. The most recent census and the sample size estimation calculations were employed to produce a population-representative pool.
RESULTS
The study included 3001 men, representative of the population in terms of age and place of residence. The frequency of sexual intercourse was higher for respondents without OAB symptoms compared with persons who had OAB (p = 0.001), but there was no association between OAB symptoms and number of sexual partners (p = 0.754). Regression models did not confirm the effect of OAB on sexual activity (odds ratio 0.993, CI 0.974-1.013, p = 0.511). Both ED and PE were more prevalent in respondents with OAB symptoms compared with persons who lacked those symptoms (p < 0.001). Importantly, the effect of OAB on ED or PE was independent of age, comorbidities, and lifestyle habits (regression coefficients of 0.13 and 0.158 for ED and PE, respectively).
CONCLUSION
Overactive bladder did not significantly affect men's sexual activity, but it significantly correlated with ED and PE. Our results suggest a need in daily clinical practice to screen for OAB symptoms for persons who report ED or PE.
Topics: Male; Humans; Female; Premature Ejaculation; Erectile Dysfunction; Urinary Bladder, Overactive; Sexual Behavior; Surveys and Questionnaires; Ejaculation
PubMed: 38478079
DOI: 10.1007/s00345-024-04841-5 -
Journal of the College of Physicians... Mar 2024To assess the impact of vitamin B12 levels in the failure of the dapoxetine used in premature ejaculation (PE) treatment.
OBJECTIVE
To assess the impact of vitamin B12 levels in the failure of the dapoxetine used in premature ejaculation (PE) treatment.
STUDY DESIGN
Experimental study. Place and Duration of the Study: Andrology Clinic, between May and December 2020.
METHODOLOGY
Patients with premature ejaculation complaints completed the Premature Ejaculation Diagnostic Tool (PEDT) questionnaire. Patients were also asked to fill in the Premature Ejaculation Profile (PEP) surveys. Intravaginal ejaculation latency time (IELT) were recorded based on the estimates of patients. Serum vitamin B12 levels were evaluated based on blood samples. All patients were advised to use dapoxetine 30 mg, 1-3 hours prior to intercourse. After four weeks, patients were asked to complete the PEP questionnaire again. IELT times were recorded.
RESULTS
A total of 62 patients were included in the study. A total of 39 patients (62.90%) were satisfied with the treatment of the dapoxetine. In comparison to patients who benefited from dapoxetine treatment and those who did not, vitamin B12 levels of patients who did not benefit from dapoxetine were found to be significantly lower (p=0.005).
CONCLUSION
Vitamin B12 deficiency can reduce the effectiveness of dapoxetine treatment in patients with PE. It is important to evaluate serum vitamin B12 levels for the evaluation of patients with PE.
KEY WORDS
Premature ejaculation, Dapoxetine, Vitamin B12, Serotonin, Treatment.
Topics: Male; Humans; Premature Ejaculation; Treatment Outcome; Ejaculation; Vitamin B 12; Benzylamines; Naphthalenes
PubMed: 38462874
DOI: 10.29271/jcpsp.2024.03.351