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Sexual Problems Can Persist Two Years After Colorectal Cancer Diagnosis

Mar 12, 2019

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Supplements, Heart Disease, and Erectile Dysfunction

Mar 04, 2019

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Treating Peyronie’s Disease with Penile Stretching

Feb 24, 2019

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Prostate Cancer is a “Couples Disease,” Scientists Say

Feb 18, 2019

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Clomiphene Citrate Might Preserve Fertility in Men with Low Testosterone

Feb 12, 2019

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How Does Testicle Removal Affect a Man’s Sex Life?

Feb 05, 2019

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Peyronie’s Disease Surgery: Can Penile Length be Preserved?

Jan 29, 2019

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Hormone Kisspeptin Linked to Sexual Arousal

Jan 22, 2019

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Want to Increase Your Penis Size? There Could Be Complications

Jan 15, 2019

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News

Vapers Beware: E-Liquids Could Contain Erectile Dysfunction Drugs

Jan 08, 2019

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Stigma, Body Image Concerns May Affect Sexuality in People With Focal Dystonia

Dec 31, 2018

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Study Examines Sexuality in People with Dementia

Dec 24, 2018

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Breast Cancer Treatment Could Preserve Ovarian Function

Dec 18, 2018

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What’s Really in Your Dietary Supplement?

Dec 11, 2018

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Man Develops Red-Tinted Vision After Sildenafil Overdose

Dec 04, 2018

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FDA Approves HPV Vaccine For Adults

Nov 26, 2018

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News

Could Erectile Dysfunction Be Genetic?

Nov 19, 2018

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One in Three Male Childhood Cancer Survivors Has Erectile Dysfunction, Study Finds

Nov 13, 2018

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Electrical Nerve Stimulation Might Help Women with Sexual Problems

Nov 07, 2018

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Counseling Cancer Survivors With Vaginal Pain

Nov 03, 2018

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Fewer Biological Boys Referred to Gender Identity Clinic

Oct 23, 2018

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Study: Antidepressant Lurasidone Has Fewer Sexual Side Effects

Oct 16, 2018

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For Women, Placebo Effect Might Explain Improvement in Sexual Function

Oct 08, 2018

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Conversations About Sexuality and Fertility Should Start Early, Experts Say

Oct 03, 2018

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Fistulas Cause Sexual and Emotional Stress in Malawi

Sep 25, 2018

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FDA: Energy-Based Devices Not Recommended for “Vaginal Rejuvenation”

Sep 18, 2018

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News

Stem Cell Therapy for Men’s Sex Health Needs More Research

Sep 11, 2018

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Prostate Treatments May Have Sexual Side Effects, But Patients Not Always Aware

Sep 05, 2018

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Ospemifene Leads to Healthier Genitals, Less Pain for Postmenopausal Women

Aug 28, 2018

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News

Low Testosterone Linked to Chronic Diseases

Aug 21, 2018

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CPAP Use Linked to Better Sex in Patients with Obstructive Sleep Apnea

Aug 14, 2018

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Penile Implants Preferred Over Other ED Therapies

Aug 08, 2018

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Penile Implants Not Always Covered by Insurance

Jul 31, 2018

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In Older Men, Erectile Dysfunction Could Increase Risk for Heart Problems

Jul 25, 2018

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Fewer Men Prescribed Testosterone After FDA Advisory

Jul 17, 2018

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FDA Approves Imvexxy for Treatment of Post-Menopausal Pain

Jul 10, 2018

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Sex Talks are Challenging for Parents of LGBTQ Teens

Jul 03, 2018

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Cycling Has No Impact on Women’s Sexual or Urinary Health, Study Finds

Jun 24, 2018

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Survey Reveals the Emotional Impact of Prostate Cancer

Jun 19, 2018

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Lifestyle Changes Might Improve Sexual Health

Jun 10, 2018

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World’s First Penis and Scrotum Transplant Takes Place in the United States

Jun 04, 2018

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ASCO Guidelines Address Cancer Patients’ Sexual Health

May 28, 2018

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U.S. Preventive Services Task Force Makes Recommendations on Prostate Cancer Screening

May 22, 2018

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Sex Aids Not Always Available at Cancer Centers

May 16, 2018

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Daily Flibanserin “Generally Safe” for Some Postmenopausal Women, Study Finds

May 08, 2018

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U.S. House Resolution: Continue Health Coverage for Certain Men with Incontinence and ED

Apr 30, 2018

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Avoid These Erectile Dysfunction (ED) Products, FDA Warns

Apr 30, 2018

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More Americans Having Gender-Affirming Surgery

Apr 18, 2018

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Scientists Investigate Health Risks of Testosterone Replacement Therapy

Apr 10, 2018

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Women With Breast Implants Warned About Rare Lymphoma

Apr 02, 2018

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SMSNA Releases Position Statement on Restorative Therapies for Erectile Dysfunction (ED)

Mar 27, 2018

The Sexual Medicine Society of North America (SMSNA) is concerned about the internet promotions and expense of Regenerative/Restorative therapies for Erectile Dysfunction and Peyronie’s Disease. The SMSNA strongly supports advancing health care delivery to patients with sexual dysfunctions, but at the same time wants to warn consumers about the difference between investigational therapies and FDA approved therapies.

"Given the current lack of regulatory agency approval for any restorative (regenerative) therapies for the treatment of ED and until such time as approval is granted, SMSNA believes that the use of shock waves or stem cells or platelet rich plasma is experimental and should be conducted under research protocols in compliance with Institutional Review Board approval.”

The complete Position Statement can be found here.

News

Childhood Sexual Abuse Linked to Sexual Problems in Women

Mar 26, 2018

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Male Childhood Cancer Survivors May Face Sexual Problems, Infertility as Adults

Mar 20, 2018

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Inhibition May Hinder Women’s Orgasms

Mar 13, 2018

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Special Therapy Addresses Body Image in Breast Cancer Survivors

Mar 06, 2018

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Relaxation Technique Might Improve Arousal in Women

Feb 27, 2018

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Aromatase Inhibitors Linked to Low Sexual Desire, Bowel Problems

Feb 19, 2018

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Why Do Transmen Have Surgery?

Feb 13, 2018

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Prostate Cancer Treatment Affects Both Patients and Partners

Feb 06, 2018

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Sexual Problems Continue for Young Cancer Survivors

Jan 30, 2018

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Transgender Americans Struggle for Proper Healthcare

Jan 23, 2018

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PTSD Linked to Sexual Problems in Midlife Women

Jan 16, 2018

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Transgender Men Satisfied with Penile Implants

Jan 09, 2018

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News

Are These Words Forbidden at the CDC?

Jan 02, 2018

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Low Desire Common in Midlife Women

Dec 26, 2017

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Generic Viagra Now Available in United States

Dec 19, 2017

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Drug Found to Clear Genital Psoriasis in Most Patients

Dec 12, 2017

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For Breast Cancer Survivors, Sexual Concerns May Last Years

Dec 05, 2017

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Poor Health and Lack of Communication Related to Low Sexual Interest, Study Says

Nov 28, 2017

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Sexual Incontinence Needs Attention, Researchers Say

Nov 21, 2017

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Men May Fracture Penis During “Doggy Style” Sex

Nov 14, 2017

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What Happens in Women’s Brains During Orgasm?

Nov 07, 2017

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Breast Cancer Has Sexual Impact on Both Survivors and Partners

Oct 31, 2017

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Vaginal Estrogen Could Be a Menopause Management Option for Women with Breast Cancer

Oct 24, 2017

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Scientists Explore Web-Based Educational Tools for Young Adults with Cancer

Oct 17, 2017

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Prescriptions Too Costly for Many Cancer Survivors

Oct 09, 2017

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Women With Overactive Bladder (OAB) at Higher Risk for Sexual Dysfunction

Oct 02, 2017

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More Sex Might Mean More Brain Power in Older Adults

Sep 26, 2017

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Study Addresses Psychological Aspects of Female Sexual Problems

Sep 19, 2017

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Men with ED May Have Higher Risk of Parkinson’s Disease

Sep 12, 2017

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Emotional Aspects of Sex Important for Midlife Women

Sep 06, 2017

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Some Men Regret Prostate Cancer Treatment Decisions

Aug 28, 2017

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Body Image, Binge Eating, and Sexual Dysfunction in Women

Aug 22, 2017

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Rectal Cancer Survivors Can Face Sexual Challenges

Aug 15, 2017

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News

Gaming Might Affect Sexual Desire and Ejaculation in Men

Aug 01, 2017

Gaming Might Affect Sexual Desire and Ejaculation in Men

From Tetris to Pokémon to Halo, videogames have been a popular form of entertainment for decades. And during that time, scientists have investigated how playing videogames affects one’s health. But how about sexual health?

In a recent Journal of Sexual Medicine study, experts found that gaming might affect men’s sexual function, in positive and negative ways.

Using social media, researchers recruited 396 men who ranged in age from 18 to 50. On average, the men were about 28 years old. All participants had had intercourse during the previous month; roughly 70% were in stable relationships. About 72% said they were “gamers” - they played videogames for at least an hour every day. The rest spent less time gaming and were considered “non-gamers.”

The men filled out two online questionnaires designed to evaluate sexual health. The International Index of Erectile Function (IIEF) focuses on five aspects: erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. It is often used to diagnose men with erectile dysfunction (ED), the inability to get and keep an erection firm enough for sex.

The men also completed the Premature Ejaculation Diagnostic Tool (PEDT). As the name suggests, this questionnaire is used to assess premature ejaculation (PE).  Men with PE climax before they wish to, usually within two minutes of penetrating their partner.

They also answered questions about their relationship status, gaming habits, and sexual activity.

Looking at the IIEF results, the researchers found few differences between gamers and non-gamers for erectile function, orgasmic function, and overall sexual satisfaction. However, non-gamers had slightly better median scores for sexual desire. In other words, they felt slightly more sexual desire than the gamers did.

PEDT results showed that none of the gamers had PE. In contrast, 69% of the non-gamers either had PE or “probable” PE based on their questionnaire scores.

Why was there a connection between gaming and sexual health? It’s possible that videogame “rewards” are related to dopamine levels in the brain, the researchers said. Dopamine is a neurotransmitter involved with forms of pleasure, including ejaculation and orgasm. When gamers do well, their dopamine levels go up.

The study authors also pointed out that “videogame stress” could lead to higher levels of prolactin, which could impair sexual function.

They added that more research is needed to fully understand the association between videogames and sexual health. In time, however, this understanding might help doctors who treat men with PE or low desire.

The study was first published online in June in the Journal of Sexual Medicine.

Resources

The Journal of Sexual Medicine

Sansone, Andrea, MD, et al.

“Relationship Between Use of Videogames and Sexual Health in Adult Males”

(Full-text. Published online: June 1, 2017)

http://www.jsm.jsexmed.org/article/S1743-6095(17)31149-9/fulltext

MedlinePlus

“Prolactin blood test”

(Review date: August 7, 2016)

https://medlineplus.gov/ency/article/003718.htm

Psychology Today

“Dopamine”

https://www.psychologytoday.com/basics/dopamine

News

Cancer Organizations Stress Importance of Comprehensive and Affordable Healthcare

Jul 24, 2017

A group of 33 cancer-related organizations have banded together to support cancer patients and survivors in light of proposed healthcare legislation under debate in the United States.

The organizations include the National Coalition for Cancer Survivorship (NCCS), the American Society for Clinical Oncology (ASCO), and the Association of Oncology Social Work. Groups that support patients with specific cancers, such as the Susan G. Komen organization (breast cancer), the Colon Cancer Alliance, the Lymphoma Research Foundation, and National Brain Tumor Society are also involved. (See the complete list below.)

In particular, the organizations oppose the Better Care Reconciliation Act (BCRA) and its revised version released on July 13th. The organizations are concerned that healthcare coverage will become unaffordable and unattainable for millions of Americans.

The bill proposes cuts to Medicaid, which provides health coverage to low-income patients. It would also limit coverage options for people with pre-existing conditions.

“The Senate’s BCRA, just as the House’s AHCA [American Health Care Act], is a direct threat to America’s 16 million cancer patients and survivors who rely on timely and uninterrupted access to comprehensive and affordable health care,” said NCCS CEO Shelley Fuld Nasso in a press release on July 13th.

“It is time to end this threat that is causing fear and anxiety throughout the cancer community, and work towards bipartisan solutions to strengthen current law,” she added.

In a statement released July 14th, ASCO President Bruce E. Johnson, MD, FASCO discussed some of the reasons the U.S. healthcare debate is so important for cancer patients. “When individuals with cancer do not have adequate health insurance coverage they are diagnosed with more advanced cancers, receive care later in their disease course, have less access to needed medical care, and have worse outcomes than those with better coverage.”

“We urge policymakers to ensure that robust requirements are maintained to ensure that all health plans cover the full scope of services and therapies that cancer patients require,” said Dr. Johnson.

The complete list of organizations is as follows:

  • American Society for Clinical Oncology (ASCO)
  • American Society for Radiation Oncology (ASTRO)
  • Association of Community Cancer Centers (ACCC)
  • Association of Oncology Social Work
  • Blue Faery: The Adrienne Wilson Liver Cancer Association
  • CancerCare
  • Cancer Support Community
  • Children’s Cause for Cancer Advocacy
  • Colon Cancer Alliance
  • Cutaneous Lymphoma Foundation
  • Critical Mass
  • Deadliest Cancers Coalition
  • Fight Colorectal Cancer
  • FORCE: Facing Our Risk of Cancer Empowered
  • Inflammatory Breast Cancer Research Foundation
  • LIVESTRONG
  • Living Beyond Breast Cancer
  • Lung Cancer Alliance
  • LUNGevity
  • Lymphoma Research Foundation
  • Melanoma Research Alliance
  • National Brain Tumor Society
  • National Breast Cancer Coalition
  • National Coalition for Cancer Survivorship
  • National Comprehensive Cancer Network
  • National Patient Advocate Foundation
  • Oncology Nursing Society
  • Ovarian Cancer Research Fund Alliance
  • Sarcoma Foundation of America
  • Stupid Cancer
  • Susan G. Komen
  • Triage Cancer
  • Us TOO International
  • Young Survival Coalition

Resources

American Society for Clinical Oncology

Johnson, Bruce E., MD, FASCO

“ASCO Remains Opposed to Senate Healthcare Bill, Urges Protections for Access to High-Quality Care”

(July 14, 2017)

http://www.asco.org/about-asco/press-center/news-releases/asco-remains-opposed-senate-healthcare-bill-urges-protections

National Coalition for Cancer Survivorship

“NCCS and 33 Cancer-Related Patient Advocacy and Professional Organizations Jointly Oppose Senate’s Revised BCRA”

(News release. July 13, 2017)

https://www.canceradvocacy.org/nccs-news/nccs-32-cancer-related-organizations-jointly-oppose-senate-revised-bcra/?mc_cid=2be8d116e8&mc_eid=c0c139ad7b

Shots

Grayson, Gisele, Alyson Hurt, and Alison Kodjak

“CHART: Who Wins, Who Loses With Senate Health Care Bill”

(June 22, 2017)

http://www.npr.org/sections/health-shots/2017/06/22/533942041/who-wins-who-loses-with-senate-health-care-bill

News

Range of Priorities Found in Individuals Seeking Female-to-Male Transition

Jul 11, 2017

Range of Priorities Found in Individuals Seeking Female-to-Male Transition

When people with gender dysphoria decide to undergo a female-to-male transition, there is a large variation in their priorities, according to new research in the Journal of Sexual Medicine.

Gender dysphoria refers to a mismatch between a persons’ birth gender and the gender they identify with. An individual may be born with female reproductive organs, but feel more male then female. Sometimes, people take hormones or undergo surgery to transition to their desired gender.

Surgery for female-to-male transitions involves the creation of male genitalia. There are several different ways to accomplish this, but each technique has its pros and cons. For example, a procedure called metoidioplasty uses tissue from the clitoris to form a penis. Afterward, the patient can usually feel sexual sensations, but may not be able to urinate standing up. Also, the penis may be too small to penetrate a partner during intercourse.

What aspects are most important to patients? To answer this question, researchers surveyed 47 Swedish transmen between the ages of 18 and 52 who were considering surgical transition from female to male.

The participants showed a wide range of preferences. For many, the ability to feel sexual sensations, reach orgasm, and have erections with the new penis was high on the priority list.

Low priority items included removal of the vagina and minimal scarring. Most respondents were not concerned about having a particular size penis (most said “normal”). And the use of human tissue for a new penis did not seem essential.  

The respondents had mixed feelings about urinating while standing. Some rated this attribute as most important, but others considered it less important.

More than half said they would be willing to consider a penis transplant from a deceased person, an approach that is now being investigated. However, many were not sure whether they would be open to immunotherapy, which lowers the risk of transplant rejection.

About three-quarters of the respondents identified themselves as male. For this group, removing the vagina was a priority. This group also emphasized the need for a “passable” penis that would not seem unusual in a dressing room.

The study results could help doctors and surgeons better understand the needs of their female-to-male patients, the authors noted. In turn, surgical procedures might be tailored to patient’s priorities. And patients may have a better sense of their surgical options.

“Patients must always be instructed on all available techniques in current use and their specific benefits and limitations to make an informed choice,” the authors wrote.

Resources

The Journal of Sexual Medicine

Jacobsson, Josephine, MD, et al.

“Patients’ Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia—A Pilot Study of 47 Patients in Sweden”

(Full-text. Published online: May 3, 2017)

http://www.jsm.jsexmed.org/article/S1743-6095(17)30433-2/fulltext

News

How Does Obesity Affect Sexual Function?

Jun 27, 2017

How Does Obesity Affect Sexual Function?

Obesity rates are increasing around the world. In fact, an estimated 1 billion people are considered overweight, and 300 million are obese.

Past research has shown an association between obesity and sexual problems. But just how does obesity contribute to sexual dysfunction? To address this question, researchers reviewed scientific databases and published their findings in Sexual Medicine Reviews.

They explained several ways extra weight might lead to sexual problems:

  • Biological mechanisms. Having excess fat tissue can disrupt hormonal and chemical processes needed for good sexual function. For example, fat tissue may be linked to lower levels of an enzyme needed for the production of nitric oxide, an important neurotransmitter for erections.
  • Comorbidities. Many obese people also have conditions that can cause sexual dysfunction, including metabolic syndrome, diabetes, and heart disease. For instance, men with diabetes are more likely develop erectile dysfunction (ED) than non-diabetic men. And they often start having trouble with erections at an earlier age. Diabetic women often have trouble with desire, arousal, and vaginal lubrication.
  • Psychological and emotional factors. In many cultures, “thin is in.” Obese men and women might be viewed as unattractive and are often the subject of cruel jokes and discrimination, which can damage their body image and self-esteem. Their ability to participate in everyday activities might be restricted by their weight. Or, they may shy away from socializing or seeking sexual partners. Overall, depression and anxiety related to obesity can take a toll on sexual health.

Often, a combination of factors is involved. For example, an obese man with ED might feel self-conscious about his weight and his erection troubles. He may also feel anxious about his attractiveness and about pleasing his partner. Thus, both physical and psychological factors can contribute to his ability to perform sexually.

Can weight loss help? It might. Following a healthy diet and exercising regularly can help lower one’s risk for diabetes and heart disease, which in turn could improve sexual function. Studies of bariatric surgery and sexuality have had encouraging results.

The review authors called on healthcare providers and therapists to address sexual health concerns in overweight and obese patients.

“Not only might they – in a non-castigating and supporting manner – point out the biological and psychological effects that decrease the desire for sexual engagement and sexual response, but they also are well-positioned to discuss other health-related complications from obesity,” the authors wrote.

Resources

Sexual Medicine Reviews

Rowland, David L, PhD, et al.

“Sexual Function, Obesity, and Weight Loss in Men and Women”

(Full-text. Published online: April 26, 2017)

http://www.smr.jsexmed.org/article/S2050-0521(17)30036-7/fulltext

News

Benzocaine Wipes Might Help Men with Premature Ejaculation

Jun 13, 2017

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News

Yoga May Help Prostate Cancer Patients Cope with Radiation Side Effects

May 24, 2017

Yoga May Help Prostate Cancer Patients Cope with Radiation Side Effects

Men coping with side effects from prostate cancer treatment might want to consider taking a yoga class.

In a recent study, men who practiced yoga while receiving external beam radiation therapy became less fatigued than men who didn’t. Their sexual and urinary function remained stable, too.

External beam radiation therapy uses high-energy beams to weaken cancer cells’ ability to divide and grow. While the therapy is effective, many men experience side effects, including fatigue, sexual problems (such as erectile dysfunction), and trouble with urination.

Fifty men with localized prostate cancer participated in the study. (Their cancer had not spread to other parts of the body.) All of them underwent external beam radiation therapy for six to nine weeks. During this time, twenty-two men attended yoga classes twice a week. Twenty-eight did not.

The men in the yoga group practiced the Eischens type of yoga, which focuses more on energy than other types. Each 75-minute session included a variety of poses in sitting, standing, and reclining positions. The men used props, and poses were modified as needed.

Shortly before the study began and throughout the study period, all the men completed questionnaires designed to assess their levels of fatigue, sexual function, urinary function, and quality of life.

The men had similar levels of fatigue at the start of the study. Over time, however, the men in the yoga group had less fatigue while the men who did not practice yoga became more fatigued.

“Levels of patient-reported fatigue are expected to increase by around the fourth or fifth week of a typical treatment course, but that did not happen in the yoga group,” lead researcher Neha Vapiwala, MD, an associate professor of radiation oncology at the Perelman School of Medicine at the University of Pennsylvania said in a news release.

“Both the severity of the fatigue as well as the patients’ ability to go about their normal lives appeared to be positively impacted in the yoga group,” Dr. Vapiwala added.

Erectile function appeared to be somewhat better for the yoga group, too. The research team used the International Index of Erectile Function (IIEF) questionnaire to assess this aspect of the men’s sexual health. The IIEF is scored on a 1 – 25 point scale. Men with scores under 12 points are usually diagnosed with moderate to severe ED. In this study, scores for men in both groups were around 11 points starting out. Over time, scores for the men in the yoga group stayed roughly the same, but men in the non-yoga group saw their scores decrease.

Urinary function seemed to be better for men in the yoga group, too. It’s possible that strengthening pelvic floor muscles through yoga could help both sexual and urinary function, Dr. Vapiwala suggested.

As treatment continued, both groups of men improved in their emotional well-being, although this result happened more quickly for the yoga group.

The study was published online by the International Journal of Radiation Oncology, Biology, and Physics in March as an article in press.

Resources

HealthDay

Preidt, Robert

“It's Yoga to the Rescue for Prostate Cancer Patients”

(April 13, 2017)

https://consumer.healthday.com/fitness-information-14/yoga-health-news-294/it-s-yoga-to-the-rescue-for-prostate-cancer-patients-721441.html

International Journal of Radiation Oncology, Biolog7, and Physics

Ben-Josef, Avital Mazar, DMD, E- RYT, et al.

“Impact of Eischens Yoga During Radiation Therapy on Prostate Cancer Patient Symptoms and Quality of Life: A Randomized Phase II Trial”

(Article in press. Abstract. Published online: March 30, 2017)

http://www.redjournal.org/article/S0360-3016(17)30744-7/abstract

Mayo Clinic

“External beam radiation for prostate cancer”

(May 18, 2016)

http://www.mayoclinic.org/tests-procedures/external-beam-radiation-for-prostate-cancer/home/ovc-20204694

Medscape

Mulcahy, Nick

“Really, Men With Prostate Cancer Do Yoga”

(April 18, 2017)

http://www.medscape.com/viewarticle/878696

Penn Medicine News

“Clinical Trial Shows Benefit of Yoga for Side Effects of Prostate Cancer Treatment”

(News release. April 6, 2017)

https://www.pennmedicine.org/news/news-releases/2017/april/clinical-trial-shows-benefit-of-yoga-for-side-effects-of-prostate-cancer-treatment

Time.com

MacMillan, Amanda

“Yoga May Help the Side Effects of Cancer Treatment”

(April 10, 2017)

http://time.com/4733412/yoga-cancer-treatment-fatigue-pain/

News

Survey: Condom Use Rates are Low in the U.S.

May 09, 2017

Survey: Condom Use Rates are Low in the U.S.

Only one in four Americans between the ages of 18 and 44 used a condom the last time they had sex, according to a recent survey.

Condom use among people at high risk for HIV is also low, the survey revealed.

Condoms are known to reduce the risk of unplanned pregnancy and transmission of sexually transmitted infections (STIs), like HIV, chlamydia, and syphilis. But how prevalent is condom use?

Researchers analyzed data from the National Survey of Family Growth, which has been collecting information on marriage, divorce, family life, and reproductive health in the United States since 1973. For this study, the researchers focused on the 2006 – 2010 and 2011 – 2013 survey cycles.

In particular, the researchers looked at data for heterosexuals between the ages of 18 and 44 who had had vaginal or anal sex within the year before their survey interview. In total, the respondents included 13,588 women and 10,904 men, and answers pertained only to their last sexual encounter.

They also considered “HIV-related sexual risk behaviors,” which included sex with four or more opposite-sex partners, sex in exchange for money or drugs, sex with an injection drug user, sex with an HIV-positive partner, and sex with a partner who had had other partners. Men who had sex with men and women who had sex with men who had sex with men were also considered at higher risk.

Overall, the rate of condom use was just under 25%. For those who reported at least one risky behavior, the rate was 34%.

Younger people were more likely to use condoms, the researchers noted, perhaps because public health campaigns promoting safe sex are often targeted to this age group. “Continued efforts are needed for sexual health promotion in older individuals,” they wrote.

Condom use was also higher among single respondents; 51% of single men and 37% of single women said they had used a condom the last time they had had sex. The rate for married or cohabitating men was 16%; for women, it was 13%. Couples in committed relationships might be less likely to use condoms because they are trying to conceive, using other forms of birth control, or in monogamous relationships.

Regardless of marital status, healthcare providers should counsel patients on condom use, especially if they engage in high risk sexual behaviors, the authors said, explaining that women should be able to negotiate condom use if necessary.

The researchers also expressed concern that condom use was lower for those who had anal sex. People may not think they need condoms for anal sex, since it cannot lead to pregnancy. But they might not know that STIs can still be spread through anal sex.

The researchers acknowledged some limitations. For example, respondents who did not use condoms at their last sexual encounter could still be regular condom users.

Still, the authors saw a need for continued education on condom use, especially people at risk for HIV, those who engage in anal sex, and those with many sex partners.

The study was published last month in the Journal of Sexual Medicine.

Resources

Centers for Disease Control and Prevention/National Center for Health Statistics

“About the National Survey of Family Growth”

(Page last updated: May 13, 2016)

https://www.cdc.gov/nchs/nsfg/about_nsfg.htm

The Journal of Sexual Medicine

Nasrullah, MD, MPH, PhD, et al.

“Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006–2010 and 2011–2013”

(Full-text. April 2017)

 http://www.jsm.jsexmed.org/article/S1743-6095(17)30121-2/fulltext

News

Americans Are Having Less Sex Nowadays

Apr 25, 2017

Americans Are Having Less Sex Nowadays

A new study in the Archives of Sexual Behavior has found that Americans are having less sex than they did two decades ago. And partnered people – those who are married or living together - have seen a significant decline in sexual frequency.

The findings are based on data from the General Social Survey (GSS). Started in 1972, the GSS tracks sociological trends in the United States, addressing topics like crime, finances, civil liberties, and stress. This particular study involved 26,620 Americans who participated in the survey between 1989 and 2014.

Overall, the study found that during between 2010 and 2014, Americans had sex nine fewer times each year compared to the period of 1995 to 1999. This was the case for all genders and races and in all areas of the country. Educational level and work status did not appear to make a difference either.

Other key findings include the following:

·         The largest drop in sexual frequency occurred among people in their 50s, those who had children in school, and those who did not watch pornography.

·         Millennials and the following generation (iGen or Generation Z) had less sex than their counterparts born in the 1930s did at the same age.

·         On average, twentysomethings had sex over 80 times each year. This rate fell to about 60 times for people in their mid-40s and 20 times for those in their mid-60s.

·         Respondents had sex most often around age 25. After that, frequency decreased by about 3.2% each year.

·         Sexual activity declined for partnered people, which “[reduces] the marital/partnered advantage,” the authors wrote.

“These data show a major reversal from previous decades in terms of marriage and sex,” lead author Jean M. Twenge said in an interview with San Diego State University. Dr. Twenge is a professor of psychology at that school.

“In the 1990s, married people had sex more times per year than never-married people, but by the mid-2000s that reversed, with the never-married having more sex,” she added.

Why are Americans having less sex? The study didn’t specify a cause, but the authors did suggest some possibilities, including more time with other forms of entertainment, like social media and technology. Depression might also be a factor, especially when antidepressants can have sexual side effects.

The study authors also explained that fewer Americans are in couples nowadays and single people tend to have sex less often.

Interestingly, longer work hours and use of pornography were not associated with a decline in sexual activity, according to the study. In fact, respondents who worked longer hours tended to have more sex.

Resources

Archives of Sexual Behavior

Twenge, Jean M., et al.

“Declines in Sexual Frequency among American Adults, 1989–2014”

(Published online: March 6, 2017)

https://link.springer.com/article/10.1007/s10508-017-0953-1

National Opinion Research Center (NORC) at the University of Chicago

“About the GSS”

http://gss.norc.org/About-The-GSS

The New York Times

Haag, Matthew

“It’s Not Just You. Americans Are Having Less Sex.”

(March 8, 2017)

https://www.nytimes.com/2017/03/08/us/americans-less-sex-study.html

San Diego State University

Jacobs, Gina

“New Study Shows Americans are Having Sex Less Often”

(March 7, 2017)

http://newscenter.sdsu.edu/sdsu_newscenter/news_story.aspx?sid=76628

Washington Post

Bahrampour, Tara

“Americans are having less sex than they once did”

(March 7, 2017)

https://www.washingtonpost.com/local/social-issues/americans-having-less-sex-than-they-once-did/2017/03/06/e367ce58-0298-11e7-b9fa-ed727b644a0b_story.html?utm_term=.0d31af509d75

News

BPH Drugs Associated with Higher Risk of Depression and Self-Harm but Not Suicide

Apr 12, 2017

BPH Drugs Associated with Higher Risk of Depression and Self-Harm but Not Suicide

Men who take certain medications for an enlarged prostate or hair loss could be at higher risk for depression and self-harm, according to new research published in JAMA Internal Medicine.

However, they are not at higher risk for suicide, the study suggests.

The drugs in question are known as 5-alpha-reductase inhibitors (5ARIs) and are often prescribed for each condition. Two examples are finasteride and dutasteride.

When a man has an enlarged prostate (also called benign prostatic hyperplasia or BPH) the tissue of his prostate gland grows inward. Sometimes, it grows so much that it squeezes the urethra, making urination difficult.

Interest in 5ARIs and men’s mental health has been present for several years, with both the U.S. Food and Drug Administration (FDA) and Health Canada expressing concerns. But little was known about the potential link.

For this study, researchers used medical databases to identify 93,197 men in Ontario who had filled a prescription for an 5ARI between 2003 and 2013. All of the men were over 66 years old.

The researchers then identified an equal number of men of the same age who had not filled a 5ARI prescription. These men matched the first group in age, health status, and use of other medications.

They found that the men who took 5ARIs were at higher risk for self-harm during the first 18 months after they started the drug. This risk appeared to drop after the 18-month point.

Similarly, the men who took 5ARIs were also at higher risk for depression.

After 18 months, depression risk decreased, although it was still higher than the depression risk among men who didn’t take 5ARIs.

While the study shows an increased risk for self-harm and depression, the overall risk is actually quite low. Lead author Dr. Blayne Welk of Ontario’s Western University and the Institute for Clinical Evaluative Sciences told Reuters Health that “you’d need 470 men to take this medication for a full year to have a new case of depression.”

Overall, the study authors concluded that the benefits of 5ARIs “likely” outweigh the risks. However, men taking these medications should be aware of these side effects and seek help immediately should they start feeling depressed.

“The relatively small magnitude of these risks should not dissuade physicians from prescribing these medications in appropriate patients. This research may help physicians counsel patients on the risks of 5ARIs,” the authors wrote.

Resources

JAMA Internal Medicine

Welk, Blayne, MD, MSc, et al.

“Association of Suicidality and Depression With 5α-Reductase Inhibitors”

(Full-text. March 20, 2017)

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2610105

Reuters Health

Seaman, Andrew M.

“Prostate, hair loss drugs tied to mental health risk, but not suicide”

(March 21, 2017)

http://www.reuters.com/article/us-health-drug-prostate-idUSKBN16S2AT

News

Past Childhood Experiences Could Influence Sexual Satisfaction in Adulthood

Mar 29, 2017

Past Childhood Experiences Could Influence Sexual Satisfaction in Adulthood

When someone has a sexual problem, it’s not unusual for there to be lots of factors involved. There could be a medical issue, relationship strain, or miscommunication between partners. Sometimes, events that take place during childhood come into play.

Many sex therapy patients work through past childhood sexual abuse. But can other childhood experiences add to sexual problems? Recently, scientists addressed this in relation to sexual satisfaction in the Journal of Sexual Medicine.

The researchers focused on what they called cumulative adverse childhood experiences (CACEs). While such experiences do include sexual abuse, they also include other negative experiences caused by adults:

·         Physical abuse – slapping, burning, hitting, kicking, pushing, and shoving

·         Psychological abuse – ridiculing, humiliating, making the child feel unimportant

·         Psychological neglect – ignoring the child

·         Physical neglect – shutting the child in a room for a long duration, refusing to provide food, clean clothing, baths, and medical care

Witnessing violence between parents (or caretaking adults) and bullying by other children also fall into the CACE category.

Three hundred seven people took part in the study. All of them were sex therapy clients and their average age was 38 years. Fifty-five percent were women. The participants were seeking help for a variety of sexual issues, including low desire, erectile dysfunction, premature ejaculation, and problems with orgasms and sexual pain.

The group completed a number of medical questionnaires designed to assess CACEs (experiences before age 18), psychological health, and relationships. The participants’ feelings about their own sexual relationships were evaluated with a tool called the Global Measure of Sexual Satisfaction (GMSEX). Scores on this questionnaire can range from 5 to 35. Higher scores on the GMSEX mean greater sexual satisfaction.

The researchers found that 58% of the women and 52% of the men had at least four types of CACEs. Sexual satisfaction was similar for both men and women, with average GMSEX scores of 21 points.

The results could help sex therapists better understand their patients’ backgrounds, the authors suggested, noting that a “one-size-fits-all approach to sexual difficulty treatment, especially in CACE survivors, might not be optimal.”

They added that future research could concentrate on how CACEs affect the sex lives of couples as well as individuals.

Resources

The Journal of Sexual Medicine

Bigras, Noémie, MA, et al.

“Cumulative Adverse Childhood Experiences and Sexual Satisfaction in Sex Therapy Patients: What Role for Symptom Complexity?”

(Full-text. Published online: February 12, 2017)

http://www.jsm.jsexmed.org/article/S1743-6095(17)30061-9/fulltext

News

About 2 in 3 Women Would Take a Sex Health Drug

Mar 21, 2017

About 2 in 3 Women Would Take a Sex Health Drug

Are women interested in sexuality-boosting medication? And if so, what results would they like to see? These questions and more were the focus of a survey published recently in the Journal of Sexual Medicine.

While sex health drugs like Viagra have been available for men for several years, medications for women are fairly new. Generally, women’s sexual problems have been treated with counseling and therapy.

In August 2015, the U.S. Food and Drug Administration (FDA) approved flibanserin (Addyi) for the treatment of hypoactive sexual desire disorder (HSDD). Women with HSDD struggle with low libido that can’t be explained by another medical condition or a medication they’re taking. The situation causes great distress and can affect a woman’s personal relationships.

Despite its goal of improving sexual desire in women with HSDD and increasing the number of positive sexual encounters, flibanserin has not been widely used. This study assessed women’s feelings about sexuality boosting medication.

The researchers surveyed 159 women in Switzerland. The women ranged in age from 18 to 73 years with an average age of 32 years. They answered a wide range of questions about their sex lives, relationships, and personalities. They also answered questions on their willingness to take a sex health drug and what they would expect from such a medication.

Sixty-one percent said they were open to the idea, and women with poorer sexual function were more likely to feel this way. Of those who would not take a sex health drug, 45% said they did not want to use a medication for sexual purposes and 35% said they were satisfied with their level of sexual desire, so they would have no need for a drug.

When asked which particular aspects of sex they would like to see enhanced, orgasm frequency and intensity were the two top responses. Increased desire was another concern. Overall, about three-quarters said they would like to improve their sexual satisfaction and almost half hoped they could have more fun during sex.

The researchers found that women who were more conscientious were less willing to take a sex health drug, in contrast to less conscientious women who were more willing. The latter group might have had a “more flexible and spontaneous mindset,” the authors noted.

The researchers were unsure whether medications for sexual problems would become the norm, however.

“In recent decades, the female sexual dysfunction treatment paradigm has been mostly limited to cognitive-behavioral psychotherapy, and according to our study data, it is still doubtful whether expanding it to include drug treatment would provide additional benefits,” they wrote.

Resources

The Journal of Sexual Medicine

Gutsche, Melanie, MSc and Andrea Burri, PhD

“What Women Want—An Explorative Study on Women's Attitudes Toward Sexuality Boosting Medication in a Sample of Swiss Women”

(Full-text. Published online: January 24, 2017)

http://www.jsm.jsexmed.org/article/S1743-6095(17)30002-4/fulltext

News

After-Sex Antibiotic Could Reduce STI Rates

Mar 07, 2017

After-Sex Antibiotic Could Reduce STI Rates

Taking the antibiotic doxycycline within 72 hours of condomless sex might reduce the risk of sexually-transmitted infections (STIs) in men who have sex with men (MSM), according to a new study.

The findings, presented last month at the 2017 Conference on Retroviruses and Opportunistic Infections in Seattle, found that risk was cut by 47%. But the researchers cautioned that more study is needed before this strategy can be recommended to doctors and patients.

The study involved 232 MSM who did not have HIV, but were taking on-demand medications for HIV prevention. Half of the men were instructed to take two 100-mg pills of doxycycline within 72 hours of having sex without a condom, not exceeding 6 pills per week. The other half did not take doxycycline. All of the men were given condoms and received safe sex counseling. Every eight weeks, they were tested for HIV, gonorrhea, chlamydia, and syphilis. The median follow-up time was 8.7 months.

Overall, 73 patients contracted a bacterial STI – 28 in the doxycycline group and 45 in the non-treatment group. 71% of the STIs were asymptomatic, which means that the men did not have any symptoms, nor did they feel sick.

Seven of the men in the doxycycline group developed chlamydia infections, compared to 21 in the non-treatment group. Three men taking doxycycline developed syphilis, compared to 10 in the non-treatment group.

Rates of gonorrhea were not much different between the groups, with 25 men in the doxycycline group and 22 in the non-treatment group developing infections.

Side effects did not appear to be a problem for either group, although more men in the doxycycline group experienced gastrointestinal pain, nausea, or vomiting.

There is still more to learn about the protocol, however. Scientists are not sure how well the strategy would work over a longer term. Also, it is unclear whether antibiotic resistance would be a problem and, if so, to what extent.

Resources

BETA

Newman, Emily

“Research shows 47% reduction in STIs among gay men who took doxycycline after sex”

(February 16, 2017)

https://betablog.org/research-shows-47-reduction-stis-among-gay-men-took-doxycycline-sex/

Conference on Retroviruses and Opportunistic Infections 2017

Molina, Jean-Michel, et al.

“On Demand Post Exposure Prophylaxis with Doxycycline for MSM Enrolled in a Prep Trial”

(Abstract 91LB. Presented February 16, 2017)

http://www.croiconference.org/sessions/demand-post-exposure-prophylaxis-doxycycline-msm-enrolled-prep-trial

Medscape Medical News

Boerner, Heather

“Antibiotics After Sex Nearly Halves Incidence of STIs”

(February 16, 2017)

http://www.medscape.com/viewarticle/875892

News

FDA Approves Intrarosa for Sexual Pain in Postmenopausal Women

Feb 21, 2017

FDA Approves Intrarosa for Sexual Pain in Postmenopausal Women

Postmenopausal women who experience moderate to severe pain during intercourse may have a new treatment option.

Last November, the U.S. Food and Drug Administration (FDA) approved a drug called Intrarosa (prasterone) for sexual pain caused by vulvar and vaginal atrophy (VVA) due to menopause.

When a woman goes through menopause, her body starts producing less estrogen, a hormone that keeps the vagina and vulva healthy. In particular, estrogen helps keep the vagina flexible and lubricated during sex.

For many women, declining estrogen levels bring about cellular changes to the vagina and vulva, leaving them dry and brittle. With poorer lubrication and less elasticity in the vagina, intercourse can become uncomfortable or painful.

The active ingredient in Intrarosa is the hormone dehydroepiandrosterone (DHEA), which changes to estrogen. The drug is administered as a daily vaginal insert. In general, women are advised to place one insert into the vagina each night at bedtime, using a special applicator.  

The effectiveness of Intrarosa was tested in two 12-week clinical trials of 406 postmenopausal women between the ages of 40 and 80 who had moderate to severe pain during intercourse. The women were randomly assigned to try Intrarosa or a placebo insert. Those who used Intrarosa reported less severe sexual pain.

The most common side effects were vaginal discharge and an abnormal Pap smear.

Women who have vaginal bleeding should talk to their doctor before using Intrarosa. In addition, women who have a history of breast cancer should not use Intrarosa at all.

The FDA warns that while Intrarosa contains DHEA and has been approved to treat sexual pain in postmenopausal women, other products containing DHEA, such as dietary supplements, have not.

“The efficacy and safety of those products have not been established for diagnosing, curing, mitigating, treating, or preventing of any disease,” the agency said in a press statement.

Resources

Mayo Clinic

“DHEA – Background”

(Last updated: July 1, 2014)

http://www.mayoclinic.org/drugs-supplements/dhea/background/hrb-20059173

MedPage Today

Walker, Molly

“FDA Approves Intrarosa for Sexual Symptoms of Menopause”

(November 17, 2016)

http://www.medpagetoday.com/obgyn/menopause/61522

SexHealthMatters.org

“Vulvar and Vaginal Atrophy”

(June 26, 2013)

https://www.sexhealthmatters.org/sex-health-blog/vulvar-and-vaginal-atrophy

U.S. Food and Drug Administration

“FDA approves Intrarosa for postmenopausal women experiencing pain during sex”

(News Release. November 17, 2016)

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm529641.htm

"Full Prescribing Information”

(Revised: November 2016)

http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/208470s000lbl.pdf

News

Heat-activated Penile Implant Could Be Available in 5 – 10 Years

Feb 07, 2017

Heat-activated Penile Implant Could Be Available in 5 – 10 Years

Scientists have created a heat-activated penile implant that, in time, could be an additional option for men with erectile dysfunction (ED).

ED – the inability to get and keep an erection firm enough for sex - is a common problem for men, especially as they get older. It is often a complication of other medical conditions, like diabetes or heart disease. Men may also develop ED after cancer treatment or an injury to the genitals.

Several ED treatments are available, including oral medications like Viagra, Levitra, and Cialis. However, these medications do not work for all men, and some patients cannot take them because of interactions with other drugs. Injections, suppositories, vacuum devices are alternatives, but they aren’t suitable for all men.

When these ED treatment options aren’t viable, many men turn to penile implants. Nowadays, the most popular type of implant an inflatable device. Spongy tissue in the penis is replaced with cylinders. When a man wants an erection, he activates a special pump in the scrotum, which fills the cylinders with fluid. When he is finished with sexual activity, he can deactivate the pump and the penis goes flaccid again.

While effective, inflatable implants require a rather complicated surgical process because they have separate components. Placing the heat-activated implant could be simpler, scientists say.

The new implant is made from a nickel-titanium alloy called Nitinol, a flexible metal with other medical applications. For example, stents – tubes used to keep arteries open – are sometimes made of Nitinol.

Nitinol’s chemical properties allow it to “remember” a different shape and assume that shape when heated. In the case of a penile implant, a man would wave a remote-control device over his penis when he wanted an erection. The device would heat the implant to a temperature just a few degrees above the man’s normal body temperature, causing the implant to expand in length and girth. The device would then be deactivated when desired.

Study co-author Brian Le of the University of Wisconsin-Madison and his colleagues are now working on the remote-control device. If further studies and trials are successful, the implant could be available in five to ten years.

“We’re hoping that, with a better device, a better patient experience, and a simpler surgery, more urologists would perform this operation, and more patients would want to try the device, “Dr. Le said in a university press release.

Results of the scientists’ work with a Nitinol prototype implant were published online in September in the journal Urology.

Resources

University of Wisconsin-Madison

Smith, Susan Lampert

“Heat-activated penile implant might restore sexual function in men with E.D.”

(December 28, 2016)

http://news.wisc.edu/heat-activated-penile-implant-might-restore-sexual-function-in-men-with-ed/

Urology

Le, Brian, et al.

“A Novel Thermal-activated Shape Memory Penile Prosthesis: Comparative Mechanical Testing”

(Full-text. Published online: September 14, 2016)

http://www.goldjournal.net/article/S0090-4295(16)30600-8/fulltext

News

Radiation to Penile Bulb Might Result in Severe ED, Study Suggests

Jan 24, 2017

Radiation to Penile Bulb Might Result in Severe ED, Study Suggests

Erectile dysfunction (ED) is a common side effect of radiation therapy for prostate cancer. However, new research suggests that avoiding the penile bulb – the base of the penis – during treatment might decrease ED severity.

The study, sponsored by the Institute of Cancer Research (ICR) in London, focused specifically on image-guided radiation therapy (IGRT). This type of therapy uses images of the prostate to help doctors pinpoint exactly where the radiation should be targeted, improving the accuracy of the treatment.

Could aiming for – or avoiding – certain areas affect a man’s erections after treatment? Researchers turned to a larger study on prostate cancer (the CHHiP trial) to learn more.

They looked at data from a subgroup of 182 men who had localized prostate cancer. (Localized means that prostate cancer cells had not spread to other parts of the body.) None of the men had ED before undergoing IGRT. Between 35 and 55 months after treatment, the men completed questionnaires related to their sexual health and erections.

The scientists also wanted to know how much radiation each man had received on his penile bulb. This information was available for 90 men.

Forty-one men from this group had severe ED after IGRT. They also had the highest amounts of radiation directed at the penile bulb.

The findings suggest that avoiding the penile bulb during IGRT would have sexual benefits for men with localized prostate cancer. However, the results need to be validated with more research, the authors said.

“While finding new and better treatments for men with prostate cancer is important, it’s also essential that we find ways of diminishing the side-effects of these treatments,” said researcher David Dearnaley in an ICR news article.

Professor Dearnaley is Professor of Uro-Oncology at the ICR and Consultant Clinical Oncologist at The Royal Mardsen hospital

He added, “Erectile dysfunction can be very distressing for the patients I deal with every day. If doctors can plan radiotherapy treatment so that it avoids the penile bulb – the area at the base of the penis – we may have a real chance of reducing the severity of erectile dysfunction in these patients.”

The study was published in the International Journal of Radiation Oncology in October 2016.

Resources

American Cancer Society

“Radiation therapy for prostate cancer”

(Last revised: March 11, 2016)

http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-treating-radiation-therapy

Healthline.com

“Bulb of penis”

(Reviewed: March 31, 2015)

http://www.healthline.com/human-body-maps/bulb-penis

The Institute of Cancer Research

“Avoiding penile bulb with radiotherapy could save men with prostate cancer from harmful side-effects”

(November 28, 2016)

http://www.icr.ac.uk/news-archive/avoiding-penile-bulb-with-radiotherapy-could-save-men-with-prostate-cancer-from-harmful-side-effects

International Journal of Radiation Oncology

Murray, J., et al.

“Effect of Dose and Image Guided Radiation Therapy (IGRT) on Patient-Reported Sexual Function in Prostate Radiation Therapy”

(Full-text. October 1, 2016)

http://www.redjournal.org/article/S0360-3016(16)31533-4/fulltext

Memorial Sloan Kettering Cancer Center

“Image-Guided Radiation Therapy”

(Last updated: April 21, 2016)

https://www.mskcc.org/cancer-care/patient-education/image-guided-radiation-therapy

Prostate Cancer News Today

Fernandes, Joana, PhD

“Prostate Radiation Therapy Induces Changes in Penile Bulb, Causing Erectile Dysfunction”

(December 5, 2016)

https://prostatecancernewstoday.com/2016/12/05/prostate-radiation-therapy-can-cause-erectile-dysfunction-changes-penile-bulb-volume

News

What Should Physical Therapists Know About Female Sexual Pain?

Jan 09, 2017

What Should Physical Therapists Know About Female Sexual Pain?

Understanding the biopsychosocial aspects of sexual pain could help physical therapists treat women, according to a recent study in Sexual Medicine Reviews.

Female sexual pain is a common – but complex - problem for women. Physical causes can include gynecological, urinary, gastrointestinal, and muscular problems. Sometimes, a combination of these factors leads to sexual pain.

Cultural and religious beliefs may also be involved. Women may not feel comfortable with the ideas of discussing or treating sexual pain. Healthcare providers may feel uncomfortable too, and they might not refer patients to appropriate specialists.

The study authors pinpointed several areas to consider when assessing and treating female sexual pain.

First, a complete physical examination that includes the vaginal, rectal, vulvar, and anal areas is essential. Other medical conditions, such as hormonal and autoimmune disorders should also be evaluated.

Providers should also consider how the central nervous system responds to the anticipation of pain. If a woman perceives a threat to her body, her central nervous system may react with a “protective pain response that is unrelated to the health of the pelvic muscles, skin or the visceral systems and might be the driving force in the perpetuation of hypersensitivity,” the authors explained.

Second, it is important for patients to feel some hope that their pain can be successfully treated. Choosing certain words to describe the pain, such as persistent instead of chronic is one approach.

Third, taking a complete patient history can provide helpful clues that can inform treatment. “Through a careful history, the clinician might be able to identify personal challenges or threats that were present for the patient when the pain began,” the authors noted. A number of validated assessment tools can be used as well.

Fourth, patients can benefit from understanding pain biology and, in turn, re-think their responses to pain and become less fearful. “Educating patients about pain can change their pain levels more than any current modality for persistent pain,” the authors wrote.

They suggested that physical therapists undergo further training in these areas so that they can address the many complexities of female sexual pain.

Resources

Sexual Medicine Reviews

Vandyken, Carolyn, PT, Cred MDT, CCMA (Acup) and Sandra Hilton, PT, DPT, MS

“Physical Therapy in the Treatment of Central Pain Mechanisms for Female Sexual Pain”

(Published online: August 3, 2016)

http://www.smr.jsexmed.org/article/S2050-0521(16)30025-7/fulltext