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CMAJ : Canadian Medical Association... Sep 2016Physicians diagnose and treat suspected hypogonadism in older men by extrapolating from the defined clinical entity of hypogonadism found in younger men. We conducted a... (Review)
Review
BACKGROUND
Physicians diagnose and treat suspected hypogonadism in older men by extrapolating from the defined clinical entity of hypogonadism found in younger men. We conducted a systematic review to estimate the accuracy of clinical symptoms and signs for predicting low testosterone among aging men.
METHODS
We searched the MEDLINE and Embase databases (January 1966 to July 2014) for studies that compared clinical features with a measurement of serum testosterone in men. Three of the authors independently reviewed articles for inclusion, assessed quality and extracted data.
RESULTS
Among 6053 articles identified, 40 met the inclusion criteria. The prevalence of low testosterone ranged between 2% and 77%. Threshold testosterone levels used for reference standards also varied substantially. The summary likelihood ratio associated with decreased libido was 1.6 (95% confidence interval [CI] 1.3-1.9), and the likelihood ratio for absence of this finding was 0.72 (95% CI 0.58-0.85). The likelihood ratio associated with the presence of erectile dysfunction was 1.5 (95% CI 1.3-1.8) and with absence of erectile dysfunction was 0.83 (95% CI 0.76-0.91). Of the multiple-item instruments, the ANDROTEST showed both the most favourable positive likelihood ratio (range 1.9-2.2) and the most favourable negative likelihood ratio (range 0.37-0.49).
INTERPRETATION
We found weak correlation between signs, symptoms and testosterone levels, uncertainty about what threshold testosterone levels should be considered low for aging men and wide variation in estimated prevalence of the condition. It is therefore difficult to extrapolate the method of diagnosing pathologic hypogonadism in younger men to clinical decisions regarding age-related testosterone decline in aging men.
Topics: Adult; Aged; Aged, 80 and over; Aging; Erectile Dysfunction; Humans; Hypogonadism; Libido; Likelihood Functions; Male; Middle Aged; Prevalence; Testosterone
PubMed: 27325129
DOI: 10.1503/cmaj.150262 -
American Journal of Obstetrics and... Mar 1999Ovarian hormones-estrogens, androgens, and progesterone-produce a myriad of effects in the nervous system. The effects of androgens in the brain are mediated through... (Review)
Review
Ovarian hormones-estrogens, androgens, and progesterone-produce a myriad of effects in the nervous system. The effects of androgens in the brain are mediated through androgen-specific receptors and by the aromatization of testosterone to estradiol. Alterations in the circulating levels of androgens play an important role in psychologic and sexual changes that occur after menopause. The effects of short-term estrogen therapy in improving psychologic symptoms, maintaining vaginal lubrication, decreasing vaginal atrophy, and increasing pelvic blood flow in postmenopausal women are well documented. However, some patients require more than estrogen alone to improve psychologic dysfunction, decreased sexual desire, or other sexual problems associated with menopause. Results from clinical studies show that hormone replacement therapy with estrogen plus androgens provides greater improvement in psychologic (eg, lack of concentration, depression, and fatigue) and sexual (eg, decreased libido and inability to have an orgasm) symptoms than does estrogen alone in naturally and surgically menopausal women.
Topics: Affect; Androgens; Female; Hormone Replacement Therapy; Humans; Libido; Postmenopause; Quality of Life
PubMed: 10076172
DOI: 10.1016/s0002-9378(99)70727-1 -
Journal of Dairy Science Jan 1983Development of sexual behavior, puberty, and social behavior is described in bulls. Normal mating behavior is discussed, including the relative importance of visual and... (Review)
Review
Development of sexual behavior, puberty, and social behavior is described in bulls. Normal mating behavior is discussed, including the relative importance of visual and olfactory cues as stimuli. The influence of sexual preparation on quantitative and qualitative seminal characteristics is reviewed. Attention is drawn to the strong genetic influences on libido and mating ability in bulls. The evidence for biostimulation in cattle is examined, with the conclusion that more investigation and exploitation of this phenomenon is warranted.
Topics: Animals; Cattle; Copulation; Estrus; Female; Fertility; Libido; Male; Ovulation; Pregnancy; Pregnancy, Animal; Semen; Sexual Behavior, Animal; Social Behavior; Sperm Motility
PubMed: 6339576
DOI: 10.3168/jds.S0022-0302(83)81770-6 -
Evolutionary Psychology : An... Jul 2013Although female use of hormonal contraceptives (HCs) has been associated with a variety of physical side effects, the psychological and behavioral side effects have... (Review)
Review
Although female use of hormonal contraceptives (HCs) has been associated with a variety of physical side effects, the psychological and behavioral side effects have received comparatively little attention until recently. Indeed, the long-term impact of HC use on human psychology has been vastly under-researched and has only recently become a focus for mainstream scholars. Women who use HCs report higher rates of depression, reduced sexual functioning, and higher interest in short-term sexual relationships compared to their naturally-cycling counterparts. Also, HC use may alter women's ability to attract a mate, as well as the mate retention behaviors in both users and their romantic partners. Some evidence even suggests that HC use alters mate choice and may negatively affect sexual satisfaction in parous women, with potential effects on future offspring. Interestingly, HCs have become a standard method of population control for captive nonhuman primates, opening up exciting avenues for potential comparative research. Here, the existing literature on the psychobehavioral effects of HCs in humans and nonhuman primates is reviewed and discussed. The potential resulting downstream consequences for the path of human evolution and recommendations for how future research could tease apart the underlying causes of these psychobehavioral effects of HC use are discussed, including suggestions for research involving nonhuman primates.
Topics: Adult; Contraceptives, Oral, Hormonal; Depression; Female; Humans; Libido; Personal Satisfaction; Sexual Partners
PubMed: 23864301
DOI: 10.1177/147470491301100315 -
Clinical Interventions in Aging 2008Estrogen-containing hormone therapy (HT) is the most widely prescribed and well-established treatment for menopausal symptoms. High quality evidence confirms that... (Review)
Review
Estrogen-containing hormone therapy (HT) is the most widely prescribed and well-established treatment for menopausal symptoms. High quality evidence confirms that estrogen effectively treats hot flushes, night sweats and vaginal dryness. Progestins are combined with estrogen to prevent endometrial hyperplasia and are sometimes used alone for hot flushes, but are less effective than estrogen for this purpose. Data are conflicting regarding the role of androgens for improving libido and well-being. The synthetic steroid tibolone is widely used in Europe and Australasia and effectively treats hot flushes and vaginal dryness. Tibolone may improve libido more effectively than estrogen containing HT in some women. We summarize the data from studies addressing the efficacy, benefits, and risks of androgens, progestins and tibolone in the treatment of menopausal symptoms.
Topics: Affect; Androgens; Cognition; Estrogen Receptor Modulators; Estrogen Replacement Therapy; Female; Hot Flashes; Humans; Libido; Menopause; Middle Aged; Norpregnenes; Progestins; Testosterone
PubMed: 18488873
DOI: 10.2147/cia.s1043 -
Animals : An Open Access Journal From... Jun 2022Strategies to control boar taint (BT) in meat relies on the reduction of skatole, indole, and androstenone concentration. This might have unfavorable effects on the...
Strategies to control boar taint (BT) in meat relies on the reduction of skatole, indole, and androstenone concentration. This might have unfavorable effects on the libido of breeding boars. The association between BT compound concentration in backfat and libido was investigated in 391 commercial breeding boars. Six sexual behavior traits (SBT; sexual arousal, salivation, mounting performance, interest in the dummy sow, penis unsheathing, and overall libido score) were scored during the training of the boars with the dummy sow. Variation in SBT was analyzed by proportional-odds cumulative logistic models. Overall, indole, skatole, and androstenone concentrations were weakly associated with libido. Farm of origin, age at training or body weight, and BT compound levels were poor predictors of boar performance (the area under the ROC curve ranged from 0.60 to 0.69). This indicates that BT compound concentrations were weakly associated with libido, even though the probability of observing good SBT scores increased with high levels of androstenone, intermediate or low levels of skatole, and intermediate to high levels of indole. Hence, practices aiming at reducing androstenone, and controlling the concentrations of skatole and indole to intermediate levels are not expected to impair the libido of young boars.
PubMed: 35739836
DOI: 10.3390/ani12121499 -
Tidsskrift For Den Norske Laegeforening... Feb 2008Sexuality is an important part of most men's quality of life. Reduced sexual function is common and can be treated. (Review)
Review
BACKGROUND
Sexuality is an important part of most men's quality of life. Reduced sexual function is common and can be treated.
MATERIAL AND METHODS
The article is based on relevant publications retrieved from Medline, recent textbooks and the authors' clinical experience.
RESULTS AND INTERPRETATION
Numerous aspects affect sexual function in men. The following is discussed; prevalence of sexual dysfunction in men, symptoms, diagnostic approaches and treatment options for premature ejaculation, delayed ejaculation, anejaculation, retrograde ejaculation, erectile dysfunction with organic cause, congenital penile curvature, Peyronie's disease, reduced sexual desire and hypogonadism. Medical doctors need to know about sexual medicine and to be able to communicate well with patients about these issues.
Topics: Ejaculation; Erectile Dysfunction; Humans; Hypogonadism; Libido; Male; Orgasm; Penis; Physician-Patient Relations; Sexual Dysfunction, Physiological; Sexuality
PubMed: 18274579
DOI: No ID Found -
Topics in Spinal Cord Injury... 2017Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic... (Review)
Review
Sexuality is an important part of life, and it is necessary for clinicians to have a specific format in which to address sexual issues with their patients. A systematic approach to working with patients with spinal cord injury (SCI) to improve their sexual functioning and response is presented. Nonjudgmental communication about sexual concerns is followed by a detailed pre- and postinjury medical, psychosocial, and sexual history. If preexisting sexual issues are present, it is recommended that the patient be referred for assessment and treatment of these separate from the patient's SCI-related concerns. Physical examination, with special attention to issues that could impact the patient's sexuality, is followed by a detailed neurologic assessment with specific attention to the T11-L2 and S3-5 spinal segments. Education of the patient with regard to his or her sexual potential and the need to be flexible in his or her sexual repertoire is followed by self-exploration and practice. Routine follow-up is suggested after patient's initial sexual exploration. Treatment of confounding and iatrogenic factors related to SCI is followed by more sexual experience. Afterwards the clinician is encouraged to use simple techniques to treat sexual issues and follow-up with the patient to assess the outcome. A structured program utilizing vibratory stimulation with or without midodrine is described as a way to achieve ejaculation and potentially orgasm, and techniques for treating severe autonomic dysreflexia are discussed. If these interventions do not alleviate the patient's sexual concerns, the clinician should refer the patient for more specialized consultation.
Topics: Female; Humans; Libido; Male; Orgasm; Personal Satisfaction; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Health; Spinal Cord Injuries
PubMed: 29339878
DOI: 10.1310/sci2301-57 -
International Journal of Environmental... Oct 2019Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish...
Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish women's sexual activity during each trimester of pregnancy. A total of 624 women were included in the study and filled in the questionnaire three times, once during each trimester of pregnancy. The first part of the survey included questions about socio-demographic characteristics, obstetric history, and medical details of a given pregnancy. The second part was the Polish version of the female sexual function index (FSFI) questionnaire. Comparison of the mean scores for the overall sexual function of each trimester revealed clinically relevant sexual dysfunction in the second and third trimesters (mean values 25.9 ± 8.7 and 22.7 ± 8.7, respectively; < 0.01). Women were most sexually active during their second trimester. In the first trimester of pregnancy, women were most likely to choose intercourse in the missionary position. Women with vocational education were characterized by the lowest and homogenous FSFI values. Total FSFI score depended on the martial status-the highest value pertained to married women (25.2 ± 6.9; = 0.02).
Topics: Adolescent; Adult; Cross-Sectional Studies; Emotions; Female; Humans; Libido; Marriage; Pregnancy; Pregnancy Trimesters; Reproductive History; Sexual Behavior; Sexual Dysfunction, Physiological; Socioeconomic Factors; Young Adult
PubMed: 31671702
DOI: 10.3390/ijerph16214216 -
Archives of Sexual Behavior Nov 2022While most studies on sexuality in later life report that sexual desire declines with age, little is known about the exact nature of age effects on sexual desire. Using...
While most studies on sexuality in later life report that sexual desire declines with age, little is known about the exact nature of age effects on sexual desire. Using self-reported dyadic sexual desire relating to a partner, dyadic sexual desire relating to an attractive person, and solitary sexual desire from a large (N > 8000) and age diverse (14.6-80.2 years) online sample, the current study had three goals: First, we investigated relationships between men and women's sexual desire and age. Second, we examined whether individual differences such as gender/sex, sexual orientation, self-rated masculinity, relationship status, self-rated attractiveness, and self-rated health predict sexual desire. Third, we examined how these associations differed across sexual desire facets. On average, the associations between age and both men and women's sexual desire followed nonlinear trends and differed between genders/sexes and types of sexual desire. Average levels of all types of sexual desire were generally higher in men. Dyadic sexual desire related positively to self-rated masculinity and having a romantic partner and solitary desire was higher in people with same-sex attraction. We discuss the results in the context of the evolutionary hypothesis that predict an increase of sexual desire and female reproductive effort prior to declining fertility. Our findings both support and challenge beliefs about gender/sex specificity of age effects on sexual desire and highlight the importance of differentiating between desire types.
Topics: Female; Humans; Male; Adolescent; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Libido; Sexual Behavior; Men; Masculinity; Sexuality; Sexual Partners
PubMed: 35916987
DOI: 10.1007/s10508-022-02375-8