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Weizhao Lu Wei Guo Dong Cui Kejiang Dong Jianfeng Qiu 《The journal of sexual medicine》2019,16(5):711-720
Background
Perimenopause is associated with increased risk of depression, vasomotor symptoms, and sexual dysfunction.Aims
To explore the effect of sex hormones on the functional connectivity (FC) of different brain regions related to sexual function in perimenopausal women.Methods
32 premenopausal women (mean age, 47.75 ± 1.55 years) and 25 perimenopausal women (mean age, 51.60 ± 1.63 years) underwent sex hormone level measurements and resting-state fMRI.Main Outcome Measures
Serum levels of sex hormones, including prolactin (PRL), follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), free testosterone (free-T), and progesterone (P), were measured. 10 brain regions related to sexual function were selected according to a meta-analysis, and FCs of the selected regions of interest were calculated as Pearson’s correlation coefficient.Results
Compared with premenopausal women, perimenopausal women showed increased FC between the right area 13 (A13_r) and the right medial superior frontal gyrus (mSFG), between the left dorsal granular insula (dIg_L) and the right superior frontal gyrus (SFG) (Gaussian random field-corrected at the voxel level, P < .001, and cluster level, P < .025). Furthermore, the PRL level was negatively correlated with the FC of A13_R with the right mSFG and the FC of dIg_L with the right SFG.Clinical Translation
These findings may be applicable to assessing brain dysfunction with FC changes in women approaching menopause.Strengths & Limitations
This study is the first to evaluate a direct relationship between sex hormone levels and brain FC changes in women approaching menopause. Sexual function was not assessed, which may weaken the conclusions related to sexual function.Conclusions
The results show that women approaching menopause suffered from aberrant intrinsic FC in regions related to sexual function, and reveal a direct relationship between serum sex hormone levels and FC changes related to sexual function.Lu W, Guo W, Cui D, et al. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019;16:711–720. 相似文献3.
Timm B. Poeppl Berthold Langguth Angela R. Laird Simon B. Eickhoff 《The journal of sexual medicine》2019,16(5):614-617
Introduction
About 30–40% of the population report sexual dysfunction. Although it is well known that the brain controls sexual behavior, little is known about the neural basis of sexual dysfunction.Aim
To assess convergence of altered brain activity associated with sexual dysfunction across available functional imaging studies.Methods
We used activation likelihood estimation meta-analysis to quantify interstudy concordance across 14 functional imaging studies reporting 179 foci from 40 individual analyses involving 191 subjects with sexual dysfunction and 123 controls.Main Outcome Measure
Activation likelihood estimation scores were used to assess convergence of findings.Results
Consistently decreased brain activity associated with sexual dysfunction was identified in the dorsal anterior cingulate cortex, ventral striatum, dorsal midbrain, anterior midcingulate cortex, and lateral orbitofrontal cortex.Clinical Implication
These findings can serve as a basis for further studies on the pathophysiology of this highly common disorder with the view to development of more-specific treatment strategies.Strength & Limitations
Findings are based on an observer-independent meta-analysis that provides robust evidence for and anatomic localization of altered brain activity related to sexual dysfunction. Our analysis cannot distinguish between the putative sources of sexual dysfunction, but it provides a more ubiquitous and general pattern of related altered neural activity.Conclusion
The identified regions have previously been shown to be critically involved in mediating sexual arousal and to be part of the sympathetic division of the autonomic nervous system. This suggests that the disturbance of brain activity associated with sexual dysfunction primarily affects sexual arousal already at early stages that are controlled by the sympathetic nervous system.Poeppl TB, Langguth B, Laird AR, et al. Meta-analytic Evidence for Neural Dysactivity Underlying Sexual Dysfunction. J Sex Med 2019;16:614–617. 相似文献4.
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Mylene Bolmont Francesco Bianchi-Demicheli Matthieu P. Boisgontier Boris Cheval 《The journal of sexual medicine》2019,16(2):195-202
Introduction
Vision of the human body has been shown to be key in eliciting sexual desire. However, whether the visual pattern characterizing sexual desire is different in women and men is still unclear.Aim
To investigate the effect of gender on visual patterns triggered by an identical set of stimuli depicting attractive heterosexual couples.Methods
Heterosexual women and men (n = 106) were tested on a picture-viewing task associated with eye tracking. The context of sexual desire was activated by asking the participant whether they perceived such desire while looking at sensual pictures of heterosexual couples. Data were analyzed using mixed-subject design analyses of variance.Main Outcome Measure
Fixation durations were used to investigate visual patterns. 2 areas of interest were created to investigate visual patterns (face vs body area).Results
Results showed longer fixations on body rather than face areas irrespective of participant gender. Moreover, all participants looked longer at women’s than men’s bodies and at the faces of the opposite sex.Clinical Implications
These findings shed light on the automatic processes underlying sexual desire, which has the potential to improve the care of patients suffering from sexual disorders by optimizing interventions.Strengths & Limitations
The strengths of this study are the use of an eye-tracking paradigm, the dissociation between 2 fixation areas (ie, face and body), and the use of an identical set of stimuli allowing an accurate between-gender comparison of the visual pattern. The limitations are the small sample size, the use of healthy heterosexual individuals, and the absence of measures of sexual arousal and genital response.Conclusions
These findings confirm the association between the human body and sexual desire. They also reveal the unique attentional attractiveness of woman’s bodies across genders.Bolmont M, Bianchi-Demicheli F, Boisgontier MP, et al. The Woman’s Body (Not the Man’s One) Is Used to Evaluate Sexual Desire: An Eye-Tracking Study of Automatic Visual Attention. J Sex Med 2019;16:195–202. 相似文献6.
Daniela Botta Filippo Maria Nimbi Francesca Tripodi Marco Silvaggi Chiara Simonelli 《The journal of sexual medicine》2019,16(3):463-473
Background
Published studies show good psychological health of people involved in bondage-discipline, dominance-submission, and sadism-masochism (BDSM) activities; nevertheless, there are few studies on characteristics related to gender, role in the BDSM scene, sexual functioning, and satisfaction among BDSM practitioners.Aim
The aim of this study was to explore gender and role differences, prevalence of sexual complaints, related distress, and sexual satisfaction in BDSM participants compared with the general population.Methods
A group of 266 Italian consensual BDSM participants (141 men and 125 women) were recruited with a snowball sampling technique. An anonymous protocol, including self-reported ad hoc and validated questionnaires, was used. The control group was composed of 100 men and 100 women who were not significantly different from the BDSM group for the sociodemographic data and were randomly extracted from an Italian database on sexual functioning of the general population.Main Outcome Measures
Self-reported demographic factors, including favorite and most frequent BDSM practices, the Sexual Complaint Screener, and the Sexual Satisfaction Scale, were completed by the participants.Results
The mean age of the BDSM group was 41.42 ± 9.61 years old (range 18–74). Data showed a varied outlook of practices, fantasies, rules, and roles. With regard to concerns about BDSM activities (fantasies and behaviors), participants reported a very low self-declared degree of distress. The dominant and switch groups appear to be more satisfied and less concerned about sexuality than the general population and the submissive group. Role in the BDSM scene was the only significant predictor of sexual satisfaction, showing a medium effect size.Clinical Implications
Results from this study could be helpful to inform sexual health care professionals and to reduce the stigma related to the BDSM population.Strengths & Limitations
In general, this study may help to describe better some characteristics related to gender, role, sexual preferences, function, and satisfaction. The main limitation regards the sampling method, which does not allow us to consider the group as representative of BDSM participants in general.Conclusion
Data showed a varied outlook of practices, fantasies, rules, and roles in both BDSM men and women. BDSM participants (especially dominant and switch groups) appear to be more satisfied and less concerned about sexuality than the general population. This is an attempt to increase the attention of researchers and health care professionals to this important topic and to improve the care provided to people with specific preferences and behaviors.Botta D, Nimbi FM, Tripodi F, et al. Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM? J Sex Med 2019;16:463–473. 相似文献7.
Introduction
Specific sexual activities during partnered sex are likely to affect orgasmic parameters, such as latency, pleasure, and difficulty, but such relationships have not been examined in detail.Aim
To ascertain whether specific kinds of sexual activities account for variation in orgasmic latency, pleasure, and difficulty during partnered sex.Method
Participants were 2,068 women drawn from community-based samples in the United States and Hungary who completed an investigator-derived questionnaire regarding their sexual history and response, including items related to frequency of masturbation and partnered sex, sexual desire, sexual arousal, orgasmic response, orgasmic latency, distress, partner distress, and sexual satisfaction.Main Outcome Measures
Self-reported orgasmic latency, pleasure, and difficulty during partnered sex were assessed.Results
Orgasmic pleasure and orgasmic difficulty were related to the types of sexual activities incorporated into partnered sex. Nevertheless, relationship satisfaction played as large a role in both orgasmic parameters. Orgasmic latency, on the other hand, was less affected by the type of sexual activity during partnered sex, but it was also affected by relationship satisfaction and orgasmic difficulty.Clinical Implication
Addressing relationship satisfaction and expanding the behavioral repertoire of activities during partnered sex may increase sexual satisfaction and mitigate orgasmic difficulty.Strength & Limitations
The study, well powered and drawing from a multinational population, is 1 of the few to analyze specific types of sexual activity and stimulation during partnered sex. Major limitations were the younger age and self-selection of the sample.Conclusion
Type and conventionality of sexual activities during partnered sex affect orgasmic pleasure and difficulty.Rowland DL, Kolba TN. Relationship of Specific Sexual Activities to Orgasmic Latency, Pleasure, and Difficulty during Partnered Sex. J Sex Med 2019;16:559–568. 相似文献8.
Introduction
Pregnancy is characterized by physical, hormonal, and psychological changes that can affect women’s sexuality, and, for those who are in a dyadic relationship, it also affects the couple’s sexual relationship. On the other hand, the pregnancy state can function as a protective factor for body dissatisfaction as women embrace a new phase of the life cycle when body changes, namely more body volume, are expected.Aim
To examine whether the effect of body dissatisfaction on sexual distress is mediated by cognitive distraction with the appearance of the body and to test a moderated mediation model of the impact of body dissatisfaction on sexual distress, with pregnancy used as the moderating factor.Methods
In this cross-sectional study, 87 cisgender heterosexual women (50.6% pregnant; n = 44), aged between 25 and 40 years old (mean = 31.93; SD = 3.46) involved in an exclusive and committed dyadic relationship completed a web-based questionnaire.Main Outcome Measures
Validated measures consisted of a validated general measure of body dissatisfaction (global body dissatisfaction scale), sexual distress (adapted from the National Survey of Sexual Attitudes and Lifestyles), and cognitive distraction based on body appearance during sexual activity (body appearance cognitive distraction scale).Results
Results indicated that body dissatisfaction and sexual distress are related, but they are fully mediated by cognitive distraction. The mediation effect of cognitive distraction did not differ significantly by pregnancy status, after controlling for the trimester of pregnancy.Clinical Implications
This study advances our understanding of sexuality during pregnancy by evaluating sexual distress and establishing that it is a clinically relevant variable related to body dissatisfaction that deserves attention from healthcare providers.Strength & Limitations
This preliminary study uses a robust method of data analysis to test a theory-based cognitive model of sexual distress in pregnant women; however, no causality can be established.Conclusion
The data highlights that pregnancy may not be a protective factor for the impact of body dissatisfaction on sexual distress.Pascoal PM, Rosa PJ, Coelho S. Does Pregnancy Play a Role? Association of Body Dissatisfaction, Body Appearance Cognitive Distraction, and Sexual Distress. J Sex Med 2019;16:551–558. 相似文献9.
Lee Smith Igor Grabovac Nicola Veronese Pinar Soysal Ahmet Turan Isik Brendon Stubbs Lin Yang Sarah E. Jackson 《The journal of sexual medicine》2019,16(3):427-433
Introduction
One factor that may plausibly be associated with sexual dysfunction is sleep disturbance. Like sexual problems, complaints of sleep disturbance increase with age and are commonly reported by older adults.Aims
To examine associations between sleep quality, duration, and a range of sexual problems in a large, representative sample of older adults.Methods
Data were from 2,568 men and 1,376 women (age ≥50 years) participating in Wave 6 of the English Longitudinal Study of Ageing (2012–2013). Sleep quality, duration, and problems with erectile function, sexual arousal, and orgasmic experience were self-reported; associations were examined using logistic regression models. Covariates included age, ethnicity, partner status, wealth, limiting long-standing illness, smoking, alcohol consumption, physical activity, and depressive symptoms.Main Outcome Measure
Participants self-reported problems with erectile function, sexual arousal, and orgasmic experience.Results
In women, moderate (odds ratio [OR] = 1.53, 95% CI 1.09–2.13, P = .013) and low sleep quality (OR = 1.70, 95% CI 1.24–2.32, P = .001) were associated with increased odds of arousal problems relative to high sleep quality. In men, moderate sleep quality was associated with increased odds of erectile difficulties (OR = 1.47, 95% CI 1.16–1.85, P = .001), the difference between low and high sleep quality did not reach statistical significance (OR = 1.24, 95% CI 0.97–1.58, P = .091). Sleep quality was not associated with difficulty achieving an orgasm in men, but in women low sleep quality was associated with increased odds of orgasmic difficulty (OR = 1.63, 95% CI 1.18–2.25, P = .003). No associations between sleep duration and problems with sexual function were observed in women, but, in men, long sleep was associated with higher odds of difficulty achieving orgasm (OR = 1.75, 95% CI 1.04–2.95, P = 0.036) relative to optimal sleep duration.Clinical Implications
Older adults presenting sleep problems should be screened for sexual dysfunction and vice versa.Strength & Limitations
Strengths of this study include the large representative sample of older English adults, the assessment of several aspects of sexual dysfunction and sleep, and the inclusion of potentially important confounding variables into statistical models. However, the study was cross-sectional, meaning we were unable to ascertain the direction of the observed associations.Conclusion
Sleep problems are associated with sexual dysfunction in older English adults, although some variation is noted between men and women.Smith L, Grabovac I, Veronese N, et al. Sleep Quality, Duration, and Associated Sexual Function at Older Age: Findings From the English Longitudinal Study of Ageing. J Sex Med 2019;16:427–433. 相似文献10.
Roman Chmel Marta Nováčková Tomáš Fait Libor Zámečník Lucie Krejčová Zlatko Pastor 《The journal of sexual medicine》2019,16(2):257-266
Background
Surgery is the optimal treatment for a severe form of clitoral phimosis (CP) that is initiated by lichen sclerosus (LS) and causes female sexual dysfunction.Aim
We aimed to determine the etiology of clitoral phimosis, its influence on sexual function, and outcomes after surgical treatment.Methods
In this prospective cohort study, we observed the occurrence of clitoral phimosis and related changes in a group of 3,650 sexually active heterosexual women with a mean age of 34.8 ± 14.9 years (20–45 years) from September 2014 to September 2016. Ultimately, we compared the changes in sexual function and distress and satisfaction with postoperative genital appearance in 9 patients with severe clitoral phimosis at 12 months after surgical treatment.Main Outcome Measures
Sexual function was evaluated using the Female Sexual Distress Scale–Revised and the Female Sexual Function Index, and the patient’s genital self-image was evaluated using the Female Genital Self-Image Scale; gynecologic examinations were performed on all patients.Results
Various forms of CP were found in 46 of 3,650 patients (1.3%). Severe forms of CP were found in 9 cases, but it was complicated by stenosis of vaginal introitus in only 2 cases. These 9 patients underwent circumcision, and 2 of them underwent perineoplasty. Female sexual dysfunction occurred mainly in those with LS and severe forms of phimosis. Sexual function, as indicated by the total Female Sexual Function Index score, was significantly improved at 12 months after surgery (17.9 ± 0.9 vs 26.6 ± 0.5; P < .001). The Female Genital Self-Image Scale score assessing genital perception was significantly higher after surgery than before in women who underwent clitoral circumcision (20 ± 3.0 vs 12.3 ± 3.3; P < .001). The Female Sexual Distress Scale–Revised score was significantly lower after surgery than before (21.3 ± 6.2 vs 33.8 ± 6.9; P < .001). Sexual function in 2 women with CP and stenosis of vaginal introitus improved after surgery, but the sexual distress level did not decrease significantly.Clinical Implications
The results of this study will help clinicians to centralize treatment methods and advise patients on the management of clitoral phimosis.Strengths & Limitations
This is a study evaluating postoperative results of sexual function, distress, and satisfaction with genitalia in women with severe CP, using validated questionnaires. However, the small number of patients and the absence of an appropriate control group are limitations.Conclusion
Surgical treatment of clitoral phimosis can improve sexual function, but because LS—a common underlying cause—is chronic in nature, patients may experience recurrence.Chmel R, M Nová?ková, Fait T, et al. Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes. J Sex Med 2019;16:257–266. 相似文献11.
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Capri G. Foy Jill C. Newman Dan R. Berlowitz Laurie P. Russell Paul L. Kimmel Virginia G. Wadley Holly N. Thomas Alan J. Lerner William T. Riley 《The journal of sexual medicine》2019,16(2):235-247
Introduction
Erectile function, an important aspect of quality of life, is gaining increased research and clinical attention in older men with hypertension.Aim
To assess the cross-sectional association between blood pressure measures (systolic blood pressure [SBP]; diastolic blood pressure [DBP]; and pulse pressure [PP]) and (i) sexual activity and (ii) erectile function in hypertensive men.Methods
We performed analyses of 1,255 male participants in a larger randomized clinical trial of 9,361 men and women with hypertension aged ≥50 years.Main Outcome Measures
The main outcome measures were self-reported sexual activity (yes/no) and erectile function using the 5-item International Index of Erectile Function (IIEF-5).Results
857 participants (68.3%) reported being sexually active during the previous 4 weeks. The mean (SD) IIEF-5 score for sexually active participants was 18.0 (5.8), and 59.9% of the sample reported an IIEF-5 score <21, suggesting erectile dysfunction (ED). In adjusted logistic regression models, neither SBP (adjusted odds ratio = 0.998; P = .707) nor DBP (adjusted odds ratio = 1.001; P = .929) was significantly associated with sexual activity. In multivariable linear regression analyses in sexually active participants, lower SBP (β = ?0.04; P = .025) and higher DBP (β = 0.05; P = .029) were associated with better erectile function. In additional multivariable analyses, lower PP pressure was associated with better erectile function (β = ?0.04; P = .02).Clinical Implications
Blood pressure is an important consideration in the assessment of erectile function in men with hypertension.Strengths & Limitations
Assessments of blood pressure and clinical and psychosocial variables were performed using rigorous methods in this multi-ethnic and geographically diverse sample. However, these cross-sectional analyses did not include assessment of androgen or testosterone levels.Conclusions
Erectile dysfunction was highly prevalent in this sample of men with hypertension, and SBP, DBP, and PP were associated with erectile function in this sample.Foy CG, Newman JC, Berlowitz DR, et al. Blood Pressure, Sexual Activity, and Erectile Function in Hypertensive Men: Baseline Findings from the Systolic Blood Pressure Intervention Trial (SPRINT). J Sex Med 2019;16:235–247. 相似文献13.
Dennis H. Li Thomas A. Remble Kathryn Macapagal Brian Mustanski 《The journal of sexual medicine》2019,16(2):267-277
Introduction
Sexual function and satisfaction are understudied aspects of adolescent and young adult sexual wellbeing, and even less is known about sexual minority youth who are vulnerable to unique lesbian, gay, bisexual, and transgender (LGBT)–related stigma.Aim
We aimed to describe sexual functioning (sexual interest, erectile function, orgasm satisfaction, global satisfaction with one’s sex life, and anal discomfort) and examine its associations with demographics, sexual and relationship behavior, and minority stressors (internalized stigma, victimization, microaggressions, and perceived LGBT acceptance within residential neighborhood) among a cohort of young men who have sex with men (YMSM) aged 16–29.Methods
Data for this cross-sectional analysis came from an ongoing longitudinal study of HIV and substance use among YMSM (analytic N = 678). We conducted univariate and bivariate analyses and multivariable linear regression, controlling for age, race/ethnicity, and sexual orientation as well as sexual and relationship characteristics that were significant at the bivariate level.Main Outcome Measure
We assessed sexual functioning in the previous 30 days using the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Measures Brief Profile for Males.Results
YMSM in our sample reported high levels of sexual functioning that were significantly greater than an adult clinical reference population. However, 13.9% of the sample reported having any difficulty with erections, 6.9% reported having less than “good” satisfaction with orgasms, 20.0% reported being “somewhat” or less satisfied with their sex lives, and 9.1% reported experiencing problems during receptive anal sex at least “sometimes.” Most associations between minority stressors and sexual functioning domains that were significant at the bivariate level attenuated to non-significance in multivariable analyses. Internalized stigma remained negatively associated with global satisfaction, whereas perceived neighborhood acceptance remained positively associated with orgasm satisfaction. Being sexually active was significantly associated with increased sexual interest and orgasm satisfaction. Having had a recent serious partner was significantly associated with sexual interest and global satisfaction. Negative effects were found for having had casual partners and being HIV positive.Clinical Implications
Although most YMSM have high sexual functioning, a minority report problems and dissatisfaction that may warrant intervention.Strengths & Limitations
Our study was limited by its cross-sectional design, measurement limitations, and generalizability to other populations, but it is one of the first to examine sexual functioning among YMSM, using a large, diverse community sample.Conclusion
Public health research and practice must continue to combat LGBT stigma and include sexual functioning as integral to healthy sexuality.Li DH, Remble TA, Macapagal K, et al. Stigma on the Streets, Dissatisfaction in the Sheets: Is Minority Stress Associated with Decreased Sexual Functioning Among Young Men Who Have Sex with Men? J Sex Med 2019;16:267–277. 相似文献14.
Jonas Hallberg Viktor Kaldo Stefan Arver Cecilia Dhejne Jussi Jokinen Katarina Görts Öberg 《The journal of sexual medicine》2019,16(5):733-745
Background
Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously.Aim
To investigate the efficacy of group-administered CBT for HD.Methods
Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months.Outcomes
The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8).Results
A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment.Clinical Implications
CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings.Strengths & Limitations
This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown.Conclusion
This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.Hallberg J, Kaldo V, Arver S, et al. A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men. J Sex Med 2019;16:733–745. 相似文献15.
Background
Chronic hepatitis C virus (HCV) infection is a global health burden that affects quality of life, with a negative impact on sexual functioning (SF).Aim
To study male sexual dysfunction (MSD) among Egyptian men with chronic HCV infection and the impact of therapy with direct-acting antiviral drugs (DAAs) on their sexual health.Methods
The self-administered International Index of Erectile Function (IIEF) questionnaire was completed by 400 sexually active male patients with chronic HCV infection without liver cirrhosis before the initiation of therapy with DAAs and then again at the completion of therapy. We compared these baseline questionnaires with those completed by a similar number of age-matched and socioeconomic status–matched controls. In the patients with HCV infection, we also compared IIEF questionnaires completed before and after DAA therapy.Main Outcome Measure
We determined the proportions of patients and controls who were dissatisfied with their sexual life and the impact of clearing HCV infection on MSD and evaluated the impact of DAA therapy on the total IIEF score and scores in all IIEF domains.Results
Men with chronic HCV infection before DAA treatment had significantly higher erectile dysfunction (ED) scores compared with controls, and scores increased with age (P < .0001). The average scores in all IIEF domains was significantly lower in the patients compared with controls in all age groups. Men with chronic HCV infection had significantly higher ED scores before cure than after cure (P < .0001).Clinical Implications
Given the high prevalence of MSD in patients with chronic HCV infection, and given that curing the HCV virus can improve the MSD associated with HCV infection, it is recommended that sexual quality of life in men with HCV be addressed as part of the evaluation protocol before initiation of DAA treatment and again after cure in an effort to improve this particular aspect of quality of life.Strengths & Limitations
This is the first study to report on MSD in the era of DAA therapy in Egyptian men with chronic HCV infection before the development of cirrhosis, with a relatively large study population. The use of a detailed version of the IIEF questionnaire reinforces the validity of our study.Conclusion
Chronic HCV infection negatively impacts MSD, affecting all domains of the IIEF, and effects increase with age. The MSD associated with HCV infection is significantly improved in patients who are cleared of the virus. These findings require further confirmation and need to be addressed as part of a comprehensive therapeutic plan to improve patients’ quality of life.Elshimi E, Morad W, Mohamad NE. Male Sexual Dysfunction Among Egyptian Patients with Chronic Hepatitis C Virus Infection Before and After Direct-Acting Antiviral Drugs. J Sex Rev 2019;16:402–409. 相似文献16.
Koen I. Neijenhuijs Nienke Hooghiemstra Karen Holtmaat Neil K. Aaronson Mogens Groenvold Bernhard Holzner Caroline B. Terwee Pim Cuijpers Irma M. Verdonck-de Leeuw 《The journal of sexual medicine》2019,16(5):640-660
Introduction
The Female Sexual Function Index (FSFI) is a patient-reported outcome measure measuring female sexual dysfunction. The FSFI-19 was developed with 6 theoretical subscales in 2000. In 2010, a shortened version became available (FSFI-6).Aim
To investigate the measurement properties of the FSFI-19 and FSFI-6.Methods
A systematic search was performed of Embase, Medline, and Web of Science for studies that investigated measurement properties of the FSFI-19 or FSFI-6 up to April 2018. Data were extracted and analyzed according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Evidence was categorized into sufficient, insufficient, inconsistent, or indeterminate, and quality of evidence as very high, high, moderate, or low.Main Outcome Measures
The Main Outcome Measure is the evidence of a measurement property, and the quality of evidence based on the COSMIN guidelines.Results
83 studies were included. Concerning the FSFI-19, the evidence for internal consistency was sufficient and of moderate quality. The evidence for reliability was sufficient but of low quality. The evidence for criterion validity was sufficient and of high quality. The evidence for structural validity was inconsistent of low quality. The evidence for construct validity was inconsistent of moderate quality. Concerning the FSFI-6, the evidence for criterion validity was sufficient of moderate quality. The evidence for internal consistency was rated as indeterminate. The evidence for reliability was inconsistent of low quality. The evidence for construct validity was inconsistent of very low quality. No information was available on structural validity of the FSFI-6, and measurement error, responsiveness, and cross-cultural validity of both FSFI-6 and FSFI-19.Clinical Implications
Conflicting and lack of evidence for some of the measurement properties of the FSFI-19 and FSFI-6 indicates the importance of further research on the validity of these patient-reported outcome measures. We advise researchers who use the FSFI-19 to perform confirmatory factor analyses and report the factor structure found in their sample. Regardless of these concerns, the FSFI-19 and FSFI-6 have strong criterion validity. Pragmatically, they are good screening tools for the current definition of female sexual dysfunction.Strength & Limitation
A strong point of the review is the use of predefined guidelines. A limitation is the use of a precise rather than a sensitive search filter.Conclusions
The FSFI requires more research on structural validity (FSFI-19 and FSFI-6), reliability (FSFI-6), construct validity (FSFI-19), measurement error (FSFI-19 and FSFI-6), and responsiveness (FSFI-19 and FSFI-6). Further corroboration of measurement invariance (both across cultures and across subpopulations) in the factor structure of the FSFI-19 is necessary, as well as tests for the unidimensionality of the FSFI-6.Neijenhuijs KI, Hooghiemstra N, Holtmaat K, et al. The Female Sexual Function Index (FSFI)—A Systematic Review of Measurement Properties. J Sex Med 2019;16:640–660. 相似文献17.
Shankun Zhao Jiamin Wang Qiang Xie Lianmin Luo Zhiguo Zhu Yangzhou Liu Jintai Luo Zhigang Zhao 《The journal of sexual medicine》2019,16(3):434-446
Background
Mounting evidence has emerged suggesting that patients with Parkinson’s disease (PD) are susceptible to sexual dysfunction (SD).Aim
To better clarify the relationship between PD and SD.Methods
PubMed, Embase, Cochrane Library database, and PsychINFO database were systematically searched for pertinent studies evaluating sexual function in the patients with PD. This systematic review and meta-analysis have been registered on PROSPERO (ID: CRD42018108714; http://www.crd.york.ac.uk/PROSPERO).Outcomes
The association between PD and SD was assessed using relative risk (RR) with 95% CI. The quality of evidence was ranked by the GRADE profiler.Results
11 observational studies met the predefined criteria for inclusion, enrolling 30,150 subjects from both the PD group and healthy control group (mean age 54.6–75.1 years). Synthesis results revealed that PD was associated with an elevated risk of SD in males (7 studies; 1.79; 95% CI = 1.26–2.54, P = .001; heterogeneity: I2 = 73.2%, P < .001). However, when restricted to female subjects, the combined RR from 3 eligible studies suggested a lack of significant association between PD and SD (RR = 1.3, 95% CI = 0.64–2.61, P = .469; heterogeneity: I2 = 80.0%, P = .007). The GRADE profiler indicated the overall quality of the evidence was low in studies including males and very low in studies including females.Clinical Implications
The current meta-analysis indicated that men with PD were more likely to experience SD than those without PD. In female subjects, however, PD seemed to not be associated with a high prevalence of SD compared with healthy controls. Based on these findings, patients with PD should be routinely assessed for sexual functioning, especially males.Strengths & Limitations
This is the first systematic review and meta-analysis of the association between PD and the risks of SD in both males and females. However, substantial heterogeneities were detected across the included studies.Conclusion
A hazardous effect of PD for developing SD was detected in men but not in women. As a result, sexual function assessment and appropriate therapy are recommended for men with PD in clinical practice.Zhao S, Wang J, Xie Q, et al. Parkinson’s Disease Is Associated with Risk of Sexual Dysfunction in Men but Not in Women: A Systematic Review and Meta-Analysis J Sex Med 2019;16:434–446. 相似文献18.
19.
David Shveiky Loral Patchen Henry H. Chill Marieta Pehlivanova Helain J. Landy 《Journal of pediatric and adolescent gynecology》2019,32(2):135-138
Study Objective
The objective of this study was to describe prevalence and location of obstetric lacerations in adolescents.Design
Retrospective cohort study.Setting
We performed an analysis of the Consortium on Safe Labor database including tertiary care university-affiliated urban hospitals.Participants
All primiparous women who delivered vaginally were included.Interventions
Vaginal and perineal lacerations were compared between age groups 15 or younger, 16-21, 22-34, 35-39, and older than 40 years.Main Outcome Measures
Outcome measures included vaginal, perineal, labial, and periurethral lacerations. χ2 and Fisher exact tests were used as appropriate, with P < .05 considered significant.Results
A total of 9777 patients were included in the analysis. Young adolescents and adolescents had significantly higher rates of labial and periurethral lacerations compared with individuals aged 22-34 years. The prevalence of third- and fourth-degree perineal tears increased with age.Conclusion
Adolescent primiparous women are less likely to have severe perineal obstetric tears, but have higher rates of labial and periurethral tears. 相似文献20.