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Journal of Neurology May 2024Multiple sclerosis (MS) is a chronic neuroinflammatory disease with highest incidence during the period of optimal reproductive health. This scoping review aimed to... (Review)
Review
BACKGROUND
Multiple sclerosis (MS) is a chronic neuroinflammatory disease with highest incidence during the period of optimal reproductive health. This scoping review aimed to identify and summarize available data on sexual/reproductive health in males with MS (MwMS).
METHODS
This review was based on PRISMA extension for Scoping Review. PubMed database was searched for keyword "multiple sclerosis" alongside keywords "sexual health", "reproductive health", "family planning", "male fertility", "male infertility", "sexual dysfunction", and "erectile dysfunction", iteratively using the "AND" logical operator. Descriptive analysis was performed on the included articles.
RESULTS
Thirty-four studies were included, and four topics emerged: sexual dysfunction, erectile dysfunction, fertility, and family planning. Sexual dysfunction is common in MwMS (35-72%), yet only a minority of MwMS discuss their sexual health with their treatment teams. Both MS disability and depression were associated with sexual dysfunction in MwMS, with erectile dysfunction and decreased libido as the most prevalent aspects of sexual dysfunction. Positively, phosphodiesterase-5 inhibitors appear effective for treating erectile dysfunction and improving sexual quality of life in MwMS. There may also be a relationship between MS and male infertility, though changes in sexual behavior may underlie this association. Finally, a prominent knowledge gap was observed for disease-modifying therapy use and family planning in MwMS.
CONCLUSION
Sexual dysfunction is common, impacted by MS severity, and associates with decreased quality of life in MwMS. Communication barriers regarding sexual and reproductive health appear to exist between MwMS and providers, as do literature gaps related to MS therapeutics and sexual/reproductive health.
Topics: Humans; Multiple Sclerosis; Male; Sexual Dysfunction, Physiological; Reproductive Health; Sexual Health; Erectile Dysfunction
PubMed: 38416171
DOI: 10.1007/s00415-024-12250-2 -
Scientific Reports Feb 2024The purpose of this study is to investigate the role of core muscles in female sexual dysfunction (FSD) and develop comprehensive rehabilitation programs to address this...
The purpose of this study is to investigate the role of core muscles in female sexual dysfunction (FSD) and develop comprehensive rehabilitation programs to address this issue. We aim to answer the following research questions: what are the roles of core muscles in FSD, and how can machine and deep learning models accurately predict changes in core muscles during FSD? FSD is a common condition that affects women of all ages, characterized by symptoms such as decreased libido, difficulty achieving orgasm, and pain during intercourse. We conducted a comprehensive analysis of changes in core muscles during FSD using machine and deep learning. We evaluated the performance of multiple models, including multi-layer perceptron (MLP), long short-term memory (LSTM), convolutional neural network (CNN), recurrent neural network (RNN), ElasticNetCV, random forest regressor, SVR, and Bagging regressor. The models were evaluated based on mean squared error (MSE), mean absolute error (MAE), and R-squared (R) score. Our results show that CNN and random forest regressor are the most accurate models for predicting changes in core muscles during FSD. CNN achieved the lowest MSE (0.002) and the highest R score (0.988), while random forest regressor also performed well with an MSE of 0.0021 and an R score of 0.9905. Our study demonstrates that machine and deep learning models can accurately predict changes in core muscles during FSD. The neglected core muscles play a significant role in FSD, highlighting the need for comprehensive rehabilitation programs that address these muscles. By developing these programs, we can improve the quality of life for women with FSD and help them achieve optimal sexual health.
Topics: Female; Humans; Sexual Dysfunctions, Psychological; Sexual Dysfunction, Physiological; Quality of Life; Muscles; Machine Learning
PubMed: 38413786
DOI: 10.1038/s41598-024-54967-0 -
BMC Urology Feb 2024Compared to a Western diet, the Mediterranean diet moves away from red meat and processed foods. Universally regarded as a healthier dietary alternative, the... (Review)
Review
Compared to a Western diet, the Mediterranean diet moves away from red meat and processed foods. Universally regarded as a healthier dietary alternative, the Mediterranean diet has garnered scientific endorsement for its ability to confer an array of compelling benefits. These health benefits encompass not only a lowered incidence of Type 2 diabetes with a reduction in obesity, but also a robust protective effect on cardiovascular health. Extensive literature exists to corroborate these health benefits; however, the impact of a Mediterranean diet on urologic diseases, specifically sexual dysfunction, lower urinary tract symptoms, stone disease, and urologic cancers are not well studied. Understanding how dietary habits may impact these urologic conditions can contribute to improved prevention and treatment strategies.A total of 955 papers from PubMed and Embase were systematically reviewed and screened. After exclusion of disqualified and duplicated studies, 58 studies consisting of randomized controlled trials, cohort studies, cross sectional studies, reviews and other meta-analyses were included in this review. 11 primary studies were related to the impact of a Mediterranean diet on sexual dysfunction, 9 primary studies regarding urinary symptoms, 8 primary studies regarding stone disease, and 9 primary studies regarding urologic cancers. All primary studies included were considered of good quality based on a New-Castle Ottawa scale. The results demonstrate a Mediterranean diet as an effective means to prevent as well as improve erectile dysfunction, nephrolithiasis, lower urinary tract symptoms, and urinary incontinence. The review highlights the need for additional research to study the impact of diet on urologic cancers and other urologic conditions such as premature ejaculation, loss of libido, female sexual dysfunction, and overactive bladder.
Topics: Male; Humans; Female; Diet, Mediterranean; Diabetes Mellitus, Type 2; Cross-Sectional Studies; Urologic Diseases; Premature Ejaculation; Urologic Neoplasms; Lower Urinary Tract Symptoms; Cardiovascular Diseases
PubMed: 38408996
DOI: 10.1186/s12894-024-01432-9 -
BMC Women's Health Feb 2024Sexual satisfaction is a crucial part of a fulfilled life, and the ability to have satisfying sexual function is crucial to one's sexual health. This study investigated... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Sexual satisfaction is a crucial part of a fulfilled life, and the ability to have satisfying sexual function is crucial to one's sexual health. This study investigated the effect of the combined administration of saffron and vitamin E and vitamin E alone on the sexual function of women in their reproductive years.
METHODS
A triple-blind randomized controlled trial was conducted with 50 participants experiencing sexual dysfunction without comorbid sleep disorders or severe depression. They were allocated into two groups using a block randomization method (stratified based on the severity of moderate or mild/normal depression). During the 8-week intervention period, participants in the experimental group were administered a 15 mg saffron capsule (safrotin) in the morning and a combination capsule containing 15 mg saffron and 50 mg vitamin E (safradide) in the evening. During the same period, the control group consumed one saffron placebo capsule in the morning and one capsule containing 50 mg of vitamin E and saffron placebo in the evening (in identical appearance to safradide). The Female Sexual Function Index was used to assess sexual function, and the Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to measure levels of depression, anxiety, and stress. These measures were administered at baseline as well as four and eight weeks post-intervention, with an additional measurement taken four weeks after the intervention ceased. The repeated measures ANOVA, ANCOVA, and Mann-Whitney U tests were used to compare the groups.
RESULTS
Following the intervention, the experimental group (saffron and vitamin E) demonstrated a statistically significant increase in the overall mean score of sexual function compared to the control group (placebo of saffron and vitamin E) (adjusted mean difference (AMD): 4.6; 95%CI: 3.1 to 6.1; p < 0.001). The mean scores for sexual function dimensions, namely libido, arousal, orgasm, and satisfaction, except for pain, were consistently higher than those of the control group across all time points (p < 0.001). Additionally, the mean score for lubrication was significantly higher only at the eighth-week measurement (p = 0.004). The mean depression score in the experimental group was significantly lower than in the control group at all-time points, i.e., four (p = 0.011) and eight weeks after the intervention (p = 0.005), and four weeks after the end of the intervention (p = 0.007). The experimental group exhibited a statistically significant decrease in mean anxiety score compared to the control group at four weeks into the intervention (p = 0.016) and four weeks following the end of the intervention (p = 0.002). At eight weeks post-intervention, however, there was no significant difference between the groups (p = 0.177). Additionally, the experimental group exhibited a significant reduction in the overall mean stress score compared to the control group after the intervention (AMD: -2.3; 95%CI: -3.1 to -1.5; p < 0.001).
CONCLUSION
Using the combination of saffron and vitamin E is more effective in improving sexual function and its domains compared to vitamin E alone in women of reproductive age with sexual dysfunction without severe depression. Also, it diminishes the degree of depression, anxiety, and stress more compared to vitamin E alone. However, further research is required to arrive at a more definitive conclusion.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT): IRCT20100414003706N36. Date of registration: 17/05/2020; URL: https://en.irct.ir/trial/45992 ; Date of first registration: 21/05/2020.
Topics: Humans; Female; Crocus; Vitamin E; Iran; Anxiety; Sexual Dysfunction, Physiological
PubMed: 38408971
DOI: 10.1186/s12905-024-02980-w -
Proceedings of the National Academy of... Feb 2024Despite numerous female contraceptive options, nearly half of all pregnancies are unintended. Family planning choices for men are currently limited to unreliable condoms...
Despite numerous female contraceptive options, nearly half of all pregnancies are unintended. Family planning choices for men are currently limited to unreliable condoms and invasive vasectomies with questionable reversibility. Here, we report the development of an oral contraceptive approach based on transcriptional disruption of cyclical gene expression patterns during spermatogenesis. Spermatogenesis involves a continuous series of self-renewal and differentiation programs of spermatogonial stem cells (SSCs) that is regulated by retinoic acid (RA)-dependent activation of receptors (RARs), which control target gene expression through association with corepressor proteins. We have found that the interaction between RAR and the corepressor silencing mediator of retinoid and thyroid hormone receptors (SMRT) is essential for spermatogenesis. In a genetically engineered mouse model that negates SMRT-RAR binding (SMRT mice), the synchronized, cyclic expression of RAR-dependent genes along the seminiferous tubules is disrupted. Notably, the presence of an RA-resistant SSC population that survives RAR de-repression suggests that the infertility attributed to the loss of SMRT-mediated repression is reversible. Supporting this notion, we show that inhibiting the action of the SMRT complex with chronic, low-dose oral administration of a histone deacetylase inhibitor reversibly blocks spermatogenesis and fertility without affecting libido. This demonstration validates pharmacologic targeting of the SMRT repressor complex for non-hormonal male contraception.
Topics: Humans; Female; Male; Animals; Mice; DNA-Binding Proteins; Repressor Proteins; Co-Repressor Proteins; Nuclear Receptor Co-Repressor 2; Tretinoin; Contraception; Nuclear Receptor Co-Repressor 1
PubMed: 38377195
DOI: 10.1073/pnas.2320129121 -
Indian Journal of Dermatology 2023Testicular involvement in leprosy is neglected as it is insidious and silent, although it can have an impact on quality of life. Our study aimed at evaluating and...
BACKGROUND AND OBJECTIVES
Testicular involvement in leprosy is neglected as it is insidious and silent, although it can have an impact on quality of life. Our study aimed at evaluating and estimating the frequency of the hormonal, radiological and clinical parameters in these patients.
MATERIALS AND METHODS
A cross-sectional study was conducted including 31 male leprosy patients attending our OPD. After detailed clinical assessment, patients were subjected to ultrasonological with Doppler examination of the scrotum and hormonal evaluation by ELISA technique for serum follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone.
RESULTS
Thirty-one patients were included with ages ranging from 19 to 54 with a mean of 34 years. Decreased libido (19.3%) was significantly observed in the abnormal FSH ( < 0.01) and testosterone ( < 0.01) groups. The majority of the clinical findings such as erectile dysfunction, infertility and altered pubic hair pattern were seen in the lepromatous spectrum. Six (19.6%) patients had increased LH and FSH. Twenty-three (74%) had testicular atrophy (<12 ml) as assessed by USG. There was a significant association between the bilateral decreased testicular volumes (TVs) and FSH ( = 0.016 on the left and < 0.01 on the right). Four of 31 patients had altered testicular echo texture of which two belong to the BL spectrum. The increase in the resistive index (RI) corresponded significantly to the decreased TV ( < 0.01) albeit on the left side only.
CONCLUSION
A sizeable proportion (74%) of the study sample had testicular atrophy. The significant association between increased RI and testicular atrophy, especially in patients with infertility, emphasises the ancillary role of Doppler indices in methodical diagnosis. Risk factors noted in the study include increased bacillary index, delayed initiation of treatment and recurrent ENL. Early detection, early initiation of MDT and specific therapies such as testosterone replacement can help improve the quality of life.
PubMed: 38371536
DOI: 10.4103/ijd.ijd_539_23 -
Sexual Medicine Reviews Mar 2024Living kidney donations (LKDs) face a persistent demand for patients with end-stage renal disease, emphasizing the importance of LKDs' growth and success. Although...
INTRODUCTION
Living kidney donations (LKDs) face a persistent demand for patients with end-stage renal disease, emphasizing the importance of LKDs' growth and success. Although living kidney donors generally exhibit excellent survival rates, little research has explored the development of long-term sexual dysfunction following LKD.
OBJECTIVES
This study aimed to analyze differences in 5-year sexual dysfunction outcomes between male and female living kidney donors, utilizing the TriNetX database, a federated network of electronic medical records from multiple U.S. healthcare organizations.
METHODS
A propensity score-matched cohort study compared 45-year sexual dysfunction outcomes in adult male and female living kidney donors from December 2013 to December 2022. Cohorts were matched on age; sex; race and ethnicity; diabetes, cardiovascular, genitourinary, and psychiatric comorbidities; lifestyle-related factors; and medications that may impact normal sexual functioning. Primary outcomes included hazard ratio (HR) for decreased libido, sexual dysfunction (composite of male erectile dysfunction, ejaculatory disorders, vaginismus/dyspareunia, infertility, orgasmic disorders, arousal/desire disorders), and sexually transmitted diseases. Secondary outcomes assessed sex counseling and interpersonal relationship issues with spouses or partners.
RESULTS
The matched cohorts included 2315 patients each (male, female), and the mean age was 42.3 ± 12.5 years. At 5 years, male donors had a significantly higher HR for sexual dysfunction (HR, 3.768; 95% confidence interval, 1.929-7.358). Erectile dysfunction occurred in 1% of male patients, while vaginismus/dyspareunia affected <1% of female patients. Other sexual disorders, decreased libido, sexually transmitted diseases, and incidences of sexual and interspousal counseling were not significantly different.
CONCLUSION
Male living kidney donors faced a higher risk of developing sexual dysfunction 5 years after donation. While LKD remains a safe and viable alternative, clinicians and donors should be mindful of the potential association with sexual dysfunction postdonation. Further research may enhance support for the well-being of living kidney donors.
Topics: Adult; Humans; Male; Female; Middle Aged; Dyspareunia; Kidney Transplantation; Cohort Studies; Vaginismus; Sexual Dysfunction, Physiological; Erectile Dysfunction; Sexually Transmitted Diseases
PubMed: 38364301
DOI: 10.1093/sxmrev/qeae003 -
La Revue Du Praticien Oct 2023SEXUAL DYSFUNCTION AFTER PROSTATE CANCER TREATMENT. Changes in sexuality after prostate cancer treatment are very common, significantly impacting quality of life....
SEXUAL DYSFUNCTION AFTER PROSTATE CANCER TREATMENT. Changes in sexuality after prostate cancer treatment are very common, significantly impacting quality of life. Psychologically, body image, self-esteem and interpersonal relationships are negatively affected. The main treatments for prostate cancer (prostatectomy, radiotherapy, hormone therapy) lead systematically to sexual dysfunctions: erectile dysfunction, low libido, orgasmic dysfunction, sexual incontinence, loss of penile length and girth, penile curvature. In addition to the lifestyle modification strategies, clear and appropriate information on sexual dysfunction secondary to prostate cancer management and on treatment should be provided during a dedicated consultation. The treatments include pharmacological and non-pharmacological treatments, particularly surgery, with the aim of minimizing the negative impact of prostate cancer treatments on sexual function.
Topics: Male; Humans; Quality of Life; Prostatic Neoplasms; Erectile Dysfunction; Sexual Behavior; Interpersonal Relations
PubMed: 38354013
DOI: No ID Found