-
The Primary Care Companion For CNS... May 2024Sexual dysfunction (SD) can interfere with sexual desire and satisfaction and is associated with an impairment in one's emotional, mental, physical, and social...
Sexual dysfunction (SD) can interfere with sexual desire and satisfaction and is associated with an impairment in one's emotional, mental, physical, and social function. Despite its importance, SD remains understudied in Lebanon, possibly due to its sensitive nature. Therefore, this research aimed to address this gap by examining the relationship between SD and certain psychological and behavioral factors. The objective was to investigate the relationship between SD and eating attitudes, depression, anxiety, and mindfulness among university students in Lebanon using a cluster analysis approach. This cross-sectional study was carried out between July and September 2021. Using the snowball technique, a sample of 363 Lebanese university students was recruited. SD was measured using the Sexual Dysfunction Questionnaire, with higher scores indicating higher sexual arousal/desire. Eating attitudes, anxiety, depression, and mindfulness were measured using the Eating Attitude Test, Lebanese Anxiety Scale, Patient Health Questionnaire, and Freiburg Mindfulness Inventory, respectively. Participants were divided into 3 clusters: cluster 1 "moderate well being" (n = 109, 30.0%) was characterized by moderate eating attitudes, anxiety, depression, and mindfulness; cluster 2 "positive well-being" (n = 186, 51.2%) was characterized by having the lowest mean eating attitude, anxiety, and depression scores, while having the highest mean mindfulness score; and cluster 3 "negative well-being" (n = 68, 18.7%) was characterized by the highest mean eating attitude, anxiety, and depression scores, while having the lowest mean mindfulness score. Females compared to males (β = -0.87) and belonging to cluster 2 (β = -1.32) or cluster 3 (β = -1.32) were significantly associated with less sexual arousal. The results align with previous findings suggesting that mindfulness has a role in SD. The current study highlights the importance of taking into consideration factors that interplay with SD. Mental health providers should consider integrating aspects of mindfulness into their practice when working with patients with SD. Additionally, addressing the taboo surrounding sexual health will be crucial to destigmatize this topic. The findings emphasize the need for accessible campaigns by sexual health organizations to raise awareness. .
Topics: Humans; Female; Male; Mindfulness; Students; Cross-Sectional Studies; Young Adult; Universities; Depression; Lebanon; Anxiety; Adult; Sexual Dysfunctions, Psychological; Sexual Dysfunction, Physiological; Adolescent; Surveys and Questionnaires
PubMed: 38815268
DOI: 10.4088/PCC.23m03682 -
Scientific Reports May 2024Extracellular vesicles have emerged as important mediators of cell-to-cell communication in the pathophysiology of fibrotic diseases. One such disease is Peyronie's...
Extracellular vesicles have emerged as important mediators of cell-to-cell communication in the pathophysiology of fibrotic diseases. One such disease is Peyronie's disease (PD), a fibrotic disorder of the penis caused by uncontrolled transformation of resident fibroblasts to alpha-smooth muscle actin positive myofibroblasts. These cells produce large amounts of extracellular matrix, leading to formation of a plaque in the penile tunica albuginea (TA), causing pain, penile curvature, and erectile dysfunction. We have used primary fibroblasts derived from the TA of PD patients to explore the role of transforming growth factor beta 1 (TGF-β1), a key signalling factor in this process. TGF-β1 treatment elicited a range of responses from the myofibroblasts: (i) they secreted extracellular vesicles (EVs) that were more numerous and differed in size and shape from those secreted by fibroblasts, (ii) these EVs prevented TGF-β1-induced transformation of fibroblasts in a manner that was dependent on vesicle uptake and (iii) they prevented phosphorylation of Erk1/2, a critical component in modulating fibrogenic phenotypic responses, but did not affect TGF-β1-induced Smad-signalling. We posit that this effect could be linked to enrichment of TSG-6 in myofibroblast-derived EVs. The ability of myofibroblast-derived vesicles to prevent further myofibroblast transformation may establish them as part of an anti-fibrotic negative feedback loop, with potential to be exploited for future therapeutic approaches.
Topics: Extracellular Vesicles; Transforming Growth Factor beta1; Humans; Myofibroblasts; Phosphorylation; Male; Fibroblasts; Cell Adhesion Molecules; MAP Kinase Signaling System; Penile Induration; Mitogen-Activated Protein Kinase 3; Cells, Cultured; Mitogen-Activated Protein Kinase 1; Signal Transduction
PubMed: 38811625
DOI: 10.1038/s41598-024-62123-x -
World Journal of Urology May 2024Platelet-rich plasma (PRP) as a regenerative therapy has gained interest in the field of andrology for the treatment of erectile dysfunction (ED) and Peyronie's disease...
PURPOSE
Platelet-rich plasma (PRP) as a regenerative therapy has gained interest in the field of andrology for the treatment of erectile dysfunction (ED) and Peyronie's disease (PD). This systematic review aims to critically evaluate the current evidence on the use of PRP for these conditions.
METHODS
We performed a systematic literature search according to the PRISMA guidelines using PubMed and Scopus databases in December 2023. Studies were included if they evaluated the effect of PRP therapy for ED or PD in humans.
RESULTS
We identified 164 articles, 17 of which were included, consisting of 11 studies on ED, 5 studies on PD, and 1 study on both. We included four randomized controlled trials, 11 prospective cohort studies, and three retrospective cohort studies including a total of 1099 patients. The studies on ED and PD generally showed small to moderate benefits with mild and transient side effects and no major adverse events were reported. General limitations included variations in PRP protocols, small sample sizes, short follow-up periods, and lack of control groups except in the three randomized trials on ED and the one on PD.
CONCLUSION
The literature on PRP therapy in andrology is limited and difficult to interpret due to variations in protocols and methodological drawbacks. Further research is necessary to determine the optimal preparation and treatment protocols for PRP therapy and clarify its effectiveness in andrology.
Topics: Humans; Penile Induration; Platelet-Rich Plasma; Male; Erectile Dysfunction
PubMed: 38811395
DOI: 10.1007/s00345-024-05065-3 -
Asian Pacific Journal of Cancer... May 2024The prevention of cervical cancer can be achieved by treating high-grade cervical precancerous lesions. Treatment options for cervical precancer include excisional... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Comparison of Sexual Function after Thermal Ablation Versus Loop Electrosurgical Excision Procedure (LEEP) for Cervical Intraepithelial Neoplasia (CIN 2 and 3): A Randomized Controlled Trial.
BACKGROUND
The prevention of cervical cancer can be achieved by treating high-grade cervical precancerous lesions. Treatment options for cervical precancer include excisional procedures, and ablation treatments. Despite the long pre-invasive course of the disease, literature addressing sexual function post-treatment for cervical pre-invasive lesions is scarce. This study aims to bridge this gap and assess the sexual function and the acceptability, efficacy, safety, and complications of loop electrosurgical excision procedure (LEEP) versus thermal ablation.
METHODS
The prospective open-label randomized controlled trial recruited women aged 22-55 with histologically confirmed Cervical Intraepithelial Neoplasia (CIN) 2 and 3 lesions. Participants were randomly allocated to either thermal ablation or LEEP. All cases were followed up with a Pap smear at three- and six-months post treatment. Sexual health assessments were conducted using a questionnaire at baseline and 3 months post-procedure. Secondary outcome measures included comparison of acceptability, pain, and side effects between the two treatment measures.
RESULTS
Out of 1356 screened cases, 60 were included in the study and randomized in two groups. The groups had similar baseline characteristics. Duration of LEEP was longer than thermal ablation (25.33 vs. 20.67 minutes), with higher pain reported 10 minutes post-procedure in the LEEP group. Three months post-procedure, both groups showed comparable acceptability and symptom relief. Sexual function parameters significantly improved in the thermal ablation group compared to LEEP, including satisfaction, desire, lubrication, flexibility, and ability to reach climax.
CONCLUSION
LEEP and thermal ablation are effective treatments for CIN with similar efficacy at 6 months. Thermal ablation demonstrated advantages in procedure time and post-procedural pain but exhibited varying effects on sexual function, improving satisfaction and desire. In contrast, LEEP showed a decrease in satisfaction and potential alterations in lubrication and flexibility. Larger-sample, longer-term studies are recommended for further insights.
Topics: Humans; Female; Electrosurgery; Adult; Uterine Cervical Dysplasia; Prospective Studies; Uterine Cervical Neoplasms; Middle Aged; Young Adult; Follow-Up Studies; Prognosis; Sexual Behavior; Sexual Dysfunction, Physiological; Ablation Techniques
PubMed: 38809642
DOI: 10.31557/APJCP.2024.25.5.1699 -
Sexual Medicine Apr 2024Recurrent pregnancy loss (RPL) is a severe traumatic event for women of childbearing age. However, the association between RPL and female sexual dysfunction was unknown.
BACKGROUND
Recurrent pregnancy loss (RPL) is a severe traumatic event for women of childbearing age. However, the association between RPL and female sexual dysfunction was unknown.
AIM
The study sought to investigate the association between RPL and sexual dysfunction, and to explore the risk factors of sexual dysfunction for RPL patients.
METHODS
A multicenter cross-sectional study involving both RPL patients and healthy women was performed in 3 different hospitals in West China from May 2021 to January 2023. Baseline information including sociodemographic data and disease histories were collected. The Female Sexual Function Index (FSFI) was used to assess the sexual function of participants.
OUTCOMES
The main outcome was the proportion of women at increased risk of sexual dysfunction (total FSFI scores <26.55), and the secondary outcome was risk factors of sexual dysfunction in RPL patients.
RESULTS
A total of 233 RPL patients and 185 healthy women were included in this study. RPL patients had significantly lower total FSFI scores (median 31.7 [interquartile range, 26.6-33.5] vs 33.0 [interquartile range, 31.2-34.1]; .001) and a significantly higher risk of sexual dysfunction than healthy women (24.9% vs 8.6%; .001). Body mass index >24 kg/m (adjusted odds ratio [OR], 4.132; 95% confidence interval [CI], 1.902-8.976, .001), working >8 h/d (adjusted OR, 2.111; 95% CI, 1.020-4.369, .044), and unexplained RPL (adjusted OR, 3.785; 95% CI, 1.967-7.280, .001) were independent risk factors of sexual dysfunction for RPL patients.
CLINICAL IMPLICATIONS
RPL patients, especially those patients with the previously mentioned risk factors, should be focused on the risk of sexual dysfunction, and appropriate preventions could be applied.
STRENGTH AND LIMITATIONS
We explored the association between RPL and sexual dysfunction and explored the risk factors of sexual dysfunction among RPL patients for the first time, and the multicenter data increased the generalizability of results. However, the cross-sectional design did not provide an exact causal relationship between RPL and sexual dysfunction, and potential risk factors related to mental health were not investigated.
CONCLUSION
RPL patients were at an increased risk of sexual dysfunction. Overweight, fatigue caused by work, and unexplained RPL were risk factors of sexual dysfunction for RPL patients.
PubMed: 38803794
DOI: 10.1093/sexmed/qfae031 -
International Journal of General... 2024This study aims to evaluate the epidemiological features of sexual dysfunction in people aged more than 65 years in parts of China, and to investigate the independent...
OBJECTIVE
This study aims to evaluate the epidemiological features of sexual dysfunction in people aged more than 65 years in parts of China, and to investigate the independent significant risk factors.
METHODS
According to the population distribution of five communities in Xiamen and Chongqing, we have randomly enrolled 2403 people more than 65 years-of-age. We collected data information through a questionnaire survey. Then demonstrated the current condition of sexual dysfunction in the samples by statistical analysis, and multivariable logistic regression was used to disclose the risk factors of sexual dysfunction in the older adults.
RESULTS
According to this study, about 10.48% of the elderly had sexual dysfunctions of different degrees and duration. The proportion of men was about twice that of women (14.5% of males and 7.3% of females). During the course of the disease, 3.19% (43/1344) of women and 3.31% (35/1059) of men had more than 15 years duration of sexual dysfunction. In severity, 5.7% (77/1344) of women and 7.0% (74/1059) of men had very severe sexual dysfunction. There were statistically significant differences in BMI, smoking, drinking history, hypertension, depression incidence or median (p<0.05). Alcohol consumption history [OR = 1.711, 95% CI: 1.124-2.604, p = 0.012] and depression [OR = 2.107, 95% CI: 1.109-4.356, p =0.044] were independent risk factors for sexual dysfunction.
CONCLUSION
The prevalence of sexual dysfunction was low among elderly in the southern part of China. But the course of the disease is long and the degree of the disease is very severe. Elderly with a history of drinking and depression are more prone to sexual dysfunction.
PubMed: 38803552
DOI: 10.2147/IJGM.S462124 -
Frontiers in Endocrinology 2024Gender-affirming hormone therapy (GAHT) is a common medical intervention sought by transgender and gender diverse (TGD) individuals. Initiating GAHT in accordance with...
BACKGROUND
Gender-affirming hormone therapy (GAHT) is a common medical intervention sought by transgender and gender diverse (TGD) individuals. Initiating GAHT in accordance with clinical guideline recommendations ensures delivery of high-quality care. However, no prior studies have examined how current GAHT initiation compares to recommended GAHT initiation.
OBJECTIVE
This study assessed guideline concordance around feminizing and masculinizing GAHT initiation in the Veterans Health Administration (VHA).
METHODS
The sample included 4,676 veterans with a gender identity disorder diagnosis who initiated feminizing (=3,547) and masculinizing (=1,129) GAHT between 2007 and 2018 in VHA. Demographics and health conditions on veterans receiving feminizing and masculinizing GAHT were assessed. Proportion of guideline concordant veterans on six VHA guidelines on feminizing and masculinizing GAHT initiation were determined.
RESULTS
Compared to veterans receiving masculinizing GAHT, a higher proportion of veterans receiving feminizing GAHT were older (≥60 years: 23.7% vs. 6.3%), White non-Hispanic (83.5% vs. 57.6%), and had a higher number of comorbidities (≥7: 14.0% vs. 10.6%). A higher proportion of veterans receiving masculinizing GAHT were Black non-Hispanic (21.5% vs. 3.5%), had posttraumatic stress disorder (43.0% vs. 33.9%) and positive military sexual trauma (33.5% vs.16.8%; all p-values<0.001) than veterans receiving feminizing GAHT. Among veterans who started feminizing GAHT with estrogen, 97.0% were guideline concordant due to no documentation of contraindication, including venous thromboembolism, breast cancer, stroke, or myocardial infarction. Among veterans who started spironolactone as part of feminizing GAHT, 98.1% were guideline concordant as they had no documentation of contraindication, including hyperkalemia or acute renal failure. Among veterans starting masculinizing GAHT, 90.1% were guideline concordant due to no documentation of contraindications, such as breast or prostate cancer. Hematocrit had been measured in 91.8% of veterans before initiating masculinizing GAHT, with 96.5% not having an elevated hematocrit (>50%) prior to starting masculinizing GAHT. Among veterans initiating feminizing and masculinizing GAHT, 91.2% had documentation of a gender identity disorder diagnosis prior to GAHT initiation.
CONCLUSION
We observed high concordance between current GAHT initiation practices in VHA and guidelines, particularly for feminizing GAHT. Findings suggest that VHA clinicians are initiating feminizing GAHT in concordance with clinical guidelines. Future work should assess guideline concordance on monitoring and management of GAHT in VHA.
Topics: Humans; Female; United States; Male; Middle Aged; Practice Guidelines as Topic; Transgender Persons; Adult; United States Department of Veterans Affairs; Veterans; Sex Reassignment Procedures; Guideline Adherence; Aged; Gender Dysphoria; Transsexualism; Veterans Health; Hormone Replacement Therapy; Practice Patterns, Physicians'
PubMed: 38800485
DOI: 10.3389/fendo.2024.1086158 -
BioRxiv : the Preprint Server For... May 2024The mitochondrial pyruvate carrier (MPC) occupies a critical node in intermediary metabolism, prompting interest in its utility as a therapeutic target for the treatment...
OBJECTIVE
The mitochondrial pyruvate carrier (MPC) occupies a critical node in intermediary metabolism, prompting interest in its utility as a therapeutic target for the treatment of obesity and cardiometabolic disease. Dysregulated nutrient metabolism in adipose tissue is a prominent feature of obesity pathophysiology, yet the functional role of adipose MPC has not been explored. We investigated whether the MPC shapes the adaptation of adipose tissue to dietary stress in female and male mice.
METHODS
The impact of pharmacological and genetic disruption of the MPC on mitochondrial pathways of triglyceride assembly (lipogenesis and glyceroneogenesis) was assessed in 3T3L1 adipocytes and murine adipose explants, combined with analyses of adipose MPC expression in metabolically compromised humans. Whole-body and adipose-specific glucose metabolism were subsequently investigated in male and female mice lacking adipocyte MPC1 () and fed either standard chow, high-fat western style, or high-sucrose lipid restricted diets for 24 weeks, using a combination of radiolabeled tracers and GC/MS metabolomics.
RESULTS
Treatment with UK5099 or siMPC1 impaired the synthesis of lipids and glycerol-3-phosphate from pyruvate and blunted triglyceride accumulation in 3T3L1 adipocytes, whilst MPC expression in human adipose tissue was negatively correlated with indices of whole-body and adipose tissue metabolic dysfunction. Mature adipose explants from mice were intrinsically incapable of incorporating pyruvate into triglycerides. , MPC deletion restricted the incorporation of circulating glucose into adipose triglycerides, but only in female mice fed a zero fat diet, and this associated with sex-specific reductions in tricarboxylic acid cycle pool sizes and compensatory transcriptional changes in lipogenic and glycerol metabolism pathways. However, whole-body adiposity and metabolic health were preserved in mice regardless of sex, even under conditions of zero dietary fat.
CONCLUSION
These findings highlight the greater capacity for mitochondrially driven triglyceride assembly in adipose from female versus male mice and expose a reliance upon MPC-gated metabolism for glucose partitioning in female adipose under conditions of dietary lipid restriction.
PubMed: 38798427
DOI: 10.1101/2024.05.11.593540 -
Cephalalgia : An International Journal... May 2024The development and approval of antibodies targeting calcitonin gene-related peptide or its receptor mark a revolutionary era for preventive migraine treatment....
BACKGROUND
The development and approval of antibodies targeting calcitonin gene-related peptide or its receptor mark a revolutionary era for preventive migraine treatment. Real-world evidence sheds light on rare, stigmatized or overlooked side effects of these drugs. One of these potential side effects is sexual dysfunction.
CASE REPORTS
We present two cases of one 42-year-old and one 45-year-old female patient with chronic migraine who both reported sexual dysfunction as a possible side effect of treatment with galcanezumab, a monoclonal antibody targeting calcitonin gene-related peptide.
DISCUSSION
As calcitonin gene-related peptide is involved in vaginal lubrication as well as genital sensation and swelling, inhibiting the calcitonin gene-related peptide pathway may lead to sexual dysfunction as a potential side effect.
CONCLUSION
Sexual dysfunction in female migraine patients might be a rare and overlooked side effect of monoclonal antibodies targeting the calcitonin gene-related peptide pathway. Considering the discomfort and stigma surrounding both migraine and sexual dysfunction, we advocate for an open attitude and awareness among clinicians toward such side effects.
Topics: Humans; Female; Migraine Disorders; Middle Aged; Calcitonin Gene-Related Peptide; Adult; Antibodies, Monoclonal, Humanized; Sexual Dysfunction, Physiological; Calcitonin Gene-Related Peptide Receptor Antagonists; Antibodies, Monoclonal
PubMed: 38796855
DOI: 10.1177/03331024241248837