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Concussions in NFL Players Could be Linked to Sexual Problems Later in Life

Concussions in NFL Players Could be Linked to Sexual Problems Later in Life A history of concussion might influence sexual function later in life, according to a recent study of professional football players.

A concussion is a type of traumatic brain injury sustained during a forceful blow to the head. Symptoms may include headache, nausea, confusion, dizziness, disorientation, and memory problems. Some people with concussions lose consciousness.

The researchers surveyed 3,506 men who had played American-style football for the National Football League (NFL) after 1960. (After that date, most players wore hard plastic helmets.) The respondents ranged in age from 24 to 89 years, with an average age of 52. They had played for an average of 7 seasons.

The men reported on concussion symptoms experienced while practicing or playing football. They also told researchers whether a doctor had ever suggested treatment or prescribed medication for ED or testosterone deficiency.

Testosterone is an important hormone for men’s sexual function. When men have low levels of testosterone, they might become less interested in sex and have difficulty getting erections.

ED was a problem for almost 23 percent of the men, and about half of them took medication for it.

About 18% of the respondents said they had low testosterone, and about 40% took medication.

 

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Sexually Active Men Might Have Milder Parkinson’s Symptoms, Study Suggests

Sexually Active Men Might Have Milder Parkinson’s Symptoms, Study SuggestsHaving sex might be linked to milder symptoms of Parkinson’s disease in men, reports a recent study in the European Journal of Neurology.

Italian researchers found that sexually-active men reported a better quality of life than those who were not having sex.

Parkinson’s disease is a neurological movement disorder that occurs when the brain does not produce enough of the neurotransmitter dopamine. As a result, a person can develop motor (movement) symptoms like slow movement, tremor, and stiffness. Non-motor symptoms, such as sexual dysfunction, apathy (lack of emotion), and cognitive decline are also possible.

The study involved 355 people (238 men and 117 women) with early-stage Parkinson’s disease.

The participants filled out several questionnaires and answered interview questions about non-motor symptoms, motor disabilities, cognitive abilities, depression, and health-related quality of life. These assessments were done three times over the course of the study: once at the beginning, again at a 12-month follow-up visit, and again 9-16 months after that follow-up visit.

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Stereotactic Radiotherapy: More Research Needed on Sexual Outcomes

Stereotactic Radiotherapy: More Research Needed on Sexual OutcomesMen who undergo stereotactic radiotherapy for prostate cancer may have a shorter treatment time, but they could still face sexual difficulties that are comparable to other forms of treatment, according to new research in the Journal of Sexual Medicine.

Men with prostate cancer usually have several treatment options available to them, such as hormone therapy (sometimes called androgen deprivation therapy), surgery (radical prostatectomy – removal of the prostate gland), and radiotherapy.

Experts say that over the long term, one treatment isn’t necessarily better than another. So when men go over their options with their cancer care team, they often look at how treatment might affect their quality of life.

Unfortunately, many men develop sexual issues, especially erectile dysfunction (ED), after prostate cancer treatment. Radiation, for example, can damage nerves and other tissues that are essential for firm erections.

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Peyronie’s Disease: Testosterone Levels Not Linked to Extent of Penis Curve

Peyronie’s Disease: Testosterone Levels Not Linked to Extent of Penis Curve For men with Peyronie’s disease, the degree of penis curvature doesn’t appear to be affected by low testosterone levels, according to a July 2019 study in the Journal of Sexual Medicine.

A bent penis is one of the main characteristics of Peyronie’s disease. The curve is caused by plaques that form on the tunica albuginea, the tissue that surrounds two spongy chambers that fill with blood during an erection. The plaques make the penis less flexible, and the penis bends, making intercourse a challenge.

Previous research has suggested that the severity of the curve might be linked to a man’s testosterone levels. In the current study, researchers further investigated this idea.

They recruited 184 men with Peyronie’s disease to participate. The men’s average age was 54 years, and they had had Peyronie’s disease for an average of 18 months. About three-quarters of them were still able to have intercourse.

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Testosterone Therapy Might be Appropriate for Postmenopausal Women

Testosterone Therapy Might be Appropriate for Postmenopausal WomenTestosterone therapy might benefit some older women with low libido accompanied by distress. But further research is still necessary, experts say.

The hormone testosterone is often associated with men, as it helps with the development and maintenance of male characteristics, like a deeper voice and facial hair. It drives men’s libidos, too.

When men’s bodies don’t produce enough testosterone, replacement therapy is an option. For many, the treatment boosts wellbeing, mood, and sex drive.

Can it do the same for women? That question has been debated for some time. Women’s bodies make testosterone, too, but in much smaller amounts. And it has not been completely clear whether testosterone therapy is safe and effective for women.

To learn more, researchers analyzed 36 studies published between 1990 and 2018. Overall, the studies involved almost 8,500 women who had gone through menopause. All of the women underwent testosterone therapy for at least 12 weeks.

Many women experienced sexual improvements with therapy. Desire, arousal, and sexual pleasure increased, and some women reported having better sex more frequently. Fewer sexual concerns and less distress were also noted.

None of the women had serious side effects, but some developed acne and hair growth.

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Intervention May Help Men Comply with Injection Therapy

Intervention May Help Men Comply with Injection Therapy Prostatectomy – the surgical removal of the prostate gland – is a “gold-standard” treatment for prostate cancer. However, surgery can damage nerves that are essential for erections, leaving some men with erectile dysfunction (ED) that can take time to resolve. Some nerves take two years to recover.

In the meantime, many men undergo penile rehabilitation therapy, which may include self-injecting medication into the penis to induce erections. The reasoning behind this protocol is that “medication-assisted erections” can help erections come back naturally.

Unfortunately, complying with this therapy can be difficult. The idea of injecting the penis with anything can make men understandably squeamish, and they might not see results right away. The process can be frustrating. Many men feel anxious and avoid the therapy and sexual situations altogether.

A new intervention called Acceptance and Commitment Therapy for erectile dysfunction (ACT-ED) could help. In a July 2019 Journal of Sexual Medicine article, experts discussed an ACT-ED pilot study.

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Sexual Effects of ADHD Different in Men and Women

Sexual Effects of ADHD Different in Men and WomenAttention deficit hyperactivity disorder (ADHD) could affect the severity of hypersexuality in both men and women, but a link with problematic pornography use appears to be stronger in men, new research suggests. 


Often diagnosed in childhood, ADHD is characterized by restlessness, impulsiveness, and risky behavior. ADHD can continue into adulthood. In fact, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), estimates that about 10 million adults have ADHD. It is more common in males than in females. 


Hypersexuality is an obsession with sex with urges that are hard to manage. A hypersexual person might masturbate often, seek multiple sexual partners, and engage in unsafe sexual behaviors in order to satisfy their urges. 


A person who has problems with pornography might view pornographic material excessively, to the point that it interferes with daily life and functioning. 


In March 2019, the Journal of Sexual Medicine published a study that investigated ADHD symptoms, hypersexuality, and problematic pornography use in relation to each other. Researchers also questioned how situations might be different for men and for women. 

 

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Fibrosis Could Be Key to Understanding Peyronie’s Disease

Fibrosis Could Be Key to Understanding Peyronie’s DiseasePeyronie’s disease is a complicated condition, especially since scientists still aren’t sure of its exact cause. And while current treatments, like surgery and injection therapy, can be effective, they manage symptoms rather than target causes. 


With this in mind, a team of scientists decided to further investigate potential causes of Peyronie’s disease to see how future treatments might develop. They published their findings in April 2019 in the journal Sexual Medicine Reviews


Men with Peyronie’s disease have a distinct curve in their penis. The curve comes from the formation of hardened, fibrous plaques on the tunica albuginea – the membrane that surrounds two chambers of the penis that fill with blood during an erection (corpora cavernosa). 


In its first stage, Peyronie’s disease can be painful. By its second stage, the condition typically results in “a stable, permanent, more-often-then-not painless deformity.” However, that deformity can make intercourse difficult, and some men develop erectile dysfunction (ED).

 

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Sex and Fertility Issues May Continue Two Years After Testicular Cancer Diagnosis

Sex and Fertility Issues May Continue Two Years After Testicular Cancer DiagnosisBased on the data, 26% of the men reported sexual difficulties. About 18% said they weren’t satisfied with their sex lives, and 17% said they had little interest in sex. About 8% had problems with erections.

Just over a quarter of men with testicular cancer experience sexual problems two years after their cancer diagnosis, according to new research in the Journal of Sexual Medicine.

Testicular cancer affects the testes – two small glands that produce sperm cells along with the hormone testosterone. Overall, testicular cancer is rare, but it’s the most common form of cancer for American men between the ages of 15 and 35.

Fortunately, testicular cancer is quite curable, with an estimated 5-year survival rate of 97% in men who receive proper treatment. Men might have surgery to remove the affected testicle and surrounding lymph nodes. Radiation and chemotherapy are other common treatments.

Still, men with testicular cancer often worry about their sexuality and fertility, and these concerns may linger for some time after diagnosis. In this study, researchers from Sweden investigated the prevalence of these concerns after two years.

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Testosterone Supplement Claims Not Always Backed by Medical Research

Testosterone Supplement Claims Not Always Backed by Medical Research“Testosterone boosting” (sometimes called “T boosting”) supplements may claim to improve a man’s testosterone levels along with his libido, muscle mass, and energy. But there is little scientific research available to substantiate such claims, according to a recent study in the World Journal of Men’s Health.

Men’s testosterone levels gradually decline as they get older. For some men, this drop leads to fatigue, moodiness, less interest in sex, and reduced muscle mass. Testosterone replacement therapy (TRT) is sometimes prescribed to alleviate these symptoms.

However, some men decide to try dietary supplements instead, feeling that it is a more “natural” approach. But supplements aren’t regulated by the U.S. Food and Drug Administration (FDA), and their manufacturers aren’t supposed to make claims that their products can treat medical conditions. Yet some still do.

“Many supplements on the market merely contain vitamins and minerals, but don’t do anything to improve testosterone,” study co-author Mary K. Samplaski said in a University of Southern California report. “Often, people can be vulnerable to the marketing component of these products, making it difficult to tease out what is myth and what is reality.”

Researchers used the search terms “testosterone booster” and “testosterone supplement” to conduct a Google search of these supplements. They studied the ingredients and manufacturers’ claims for 50 products.

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News

Women with Colorectal and Anal Cancer Need Sexual Support

Women with Colorectal and Anal Cancer Need Sexual SupportUnderstanding the sexual impact of treatment is important for women with colorectal and anal cancer, and support is essential, experts report in a recent Sexual Medicine Reviews study.

The term colorectal cancer refers to cancers of the colon (the large intestine) and the rectum (the lower portion of the large intestine). Anal cancer affects the anus, the area connected to the rectum that allows waste to pass out of the body.

Treatments for these cancers may include surgery, chemotherapy, radiation therapy, or a combination of these approaches. Patients might need a stoma (an opening in the abdomen) so that their waste can pass into a special collection bag.

After treatment, many women feel less desire for sex, experience poor arousal, and have difficulty reaching orgasm. Pain and vaginal dryness are common. Some women struggle with poor body image, feeling less feminine and less attractive. Anxiety may also be an issue. A woman may worry about her partner’s response to a waste bag or whether the bag will leak during intimacy.

To learn more about women’s experiences with sexuality following colorectal and anal cancer treatment, researchers conducted a two-part study.

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Peyronie’s Disease: Which Treatment is Most Cost-Effective?

A penile traction therapy called RestoreX might be the most cost-effective treatment option for men with Peyronie’s disease, but goals and preferences still play an important role in patient choice, experts say in a recent Journal of Sexual Medicine study.

When a man has Peyronie’s disease, areas of hardened scar tissue called plaques form on his penis. The plaques make the penis less flexible, and as a result, the penis bends. In some cases, the curvature is enough to make intercourse difficult.

There are several ways to treat Peyronie’s disease, but three common ones are:

  • ·         Surgery to correct the curvature and straighten the penis.
  • ·         Injections of collagenase Clostridium histolyticum (CCH) directly into the plaques.
  • ·         Traction therapy – stretching the penis with a device like the RestoreX, which is used 30-90 minutes every day.

Researchers looked at data from 201 men who had been treated for Peyronie’s disease. One hundred fifteen men had CCH injections, 23 underwent surgery, and 63 used the RestoreX traction device.

For this study, success was defined as a curvature improvement of at least 20 degrees, an accepted benchmark based on past research. The men’s progress was followed for 10 years after treatment. Costs were calculated based on payer costs, such as Medicare reimbursements.

Overall, 96% of the men in the surgery group, 66% of the CCH group, and 48% of the RestoreX group met the success benchmark.

After considering 10 years of follow-up, the RestoreX was considered the most cost-effective treatment option, with an average per-patient cost of $883. Surgery came in second at an average of $11,419 per patient, and CCH was the most expensive with an average per-patient cost of $33,628.  was the most

However, each per-patient cost was not necessarily what each patient paid individually for his treatment. The figures did not take insurance or manufacturers’ rebates into account. In fact, surgery cost more than CCH when patient out-of-pocket costs were determined.

Cost-effectiveness could also depend on complication rates (such as during and after surgery), patients’ goals, and patients’ treatment preferences. For some men with Peyronie’s, decreasing curvature isn’t always the first priority. Penile shortening, deformity, erectile dysfunction, pain, and other concerns may be more important. So while one treatment could be more cost-effective than another, it might not meet the patient’s goals. In addition, men may prefer one type of treatment over another, such as RestoreX over surgery.

“Ultimately, the preferred treatment option for patients is only partially driven by cost-effectiveness analyses and is dependent on patient preference and goals of therapy, provider experience, insurance coverage, and clinical considerations,” the authors concluded.

For more information about Peyronie’s disease and its treatment, please see these links:

Treating Peyronie’s Disease Without Surgery

About 20% of Men with Peyronie’s Disease Stop Injection Therapy Early

Peyronie’s Disease: RestoreX Traction Device Investigated With Injection Therapy

Peyronie’s Disease: Treatment Priorities May Guide Intralesional Injection Choice

Treating Peyronie’s Disease with Penile Stretching

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

Resources

The Journal of Sexual Medicine

Wymer, Kevin, MD, et al.

“Comparative Cost-effectiveness of Surgery, Collagenase Clostridium Histolyticum, and Penile Traction Therapy in Men with Peyronie’s Disease in an Era of Effective Clinical Treatment”

(Full-text article in press. Published online: July 24, 2019)

https://www.jsm.jsexmed.org/article/S1743-6095(19)31269-X/fulltext

News

Study Examines Sexual Benefits of Testosterone Therapy

Study Examines Sexual Benefits of Testosterone TherapyMen with very low testosterone may see improvements in sexual function with testosterone replacement therapy (TRT), according to a recent review of medical studies.

Experts note that TRT may improve erections in men with very low testosterone levels. However, TRT is not a standard treatment for erectile dysfunction (ED).

After analyzing studies involving both animal and human subjects, researchers got a better understanding of how testosterone affects male sexuality and more specifics on how TRT may help.

Produced by two glands called the testes (testicles), testosterone is sometimes referred to as a “male” hormone because it plays such a large role in masculinity. (Women’s bodies make testosterone, too, but in smaller amounts.) Characteristics like facial hair, muscle mass, and a deeper voice are all driven by testosterone. The hormone is important for a man’s sex drive and erections, too.

Sometimes, men’s bodies don’t produce enough testosterone because of problems with the testes themselves or with areas of the brain that trigger testosterone production. This is called hypogonadism. Men in this situation may undergo testosterone replacement therapy in the form of gels, patches, and injections. In March 2019, the U.S. Food and Drug Administration (FDA) approved a pill form of TRT for certain hypogonadal men.

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9-11 Responders Have Higher Rates of Prostate Cancer

9-11 Responders Have Higher Rates of Prostate CancerRates of prostate cancer are higher among first responders who handled operations at New York City’s World Trade Center (WTC) following the terrorist attacks on September 11, 2001. And now, scientists think they might have an explanation.

Their research, published in June 2019 in Molecular Cancer Research, suggests that toxic dust inhaled at the WTC site could be to blame.

The dust contains “carcinogens and tumor-promoting agents,” that could be linked to DNA damage, cell proliferation, and chronic inflammation, the authors wrote.

The researchers compared two groups of prostate tissue samples. The first came from 15 men who had been exposed to WTC dust and developed prostate cancer. The second came from men who had prostate cancer, but had not been exposed to WTC dust.

When comparing the samples, the scientists discovered that the men exposed to WTC dust showed greater degrees of inflammation and genetic change that could contribute to cancer.

Next, the researchers worked with rats to learn more about WTC dust and prostate inflammation. After 30 days of dust exposure, the rats had genetic changes in their prostate tissue related to inflammation.

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Premature Ejaculation: Do Topical Treatments Work?

Premature Ejaculation: Do Topical Treatments Work? Topical treatments for premature ejaculation (PE) can be effective, but formal medical research on such products is limited, researchers say in a new Sexual Medicine Reviews paper.

Men with PE climax before they want to and often feel that they can’t control the timing of their ejaculation. For some men, the problem occurs from their first sexual experience (lifelong PE). For others, it starts happening after a period of normal sexual functioning (acquired PE). Either way, PE can be distressing for couples who wish their sexual encounters could last a bit longer.

While the time frame considered bothersome varies from couple to couple, the International Society for Sexual Medicine (ISSM) considers PE to be ejaculation that occurs within one minute from vaginal penetration (lifelong PE) or within three minutes of penetration (acquired). According to the ISSM definition, the situation occurs most of the time and has a negative effect on a person’s wellbeing. (For example, a man with PE might avoid sexual relationships because he is so anxious about disappointing a partner.)

PE is one of the most common sexual complaints among men, but it’s sometimes challenging to treat. Currently, topical medications – ones that can be applied directly to the penis as creams or sprays – are the “first line” therapies, but they haven’t been widely researched by scientists.

To learn more, researchers analyzed medical studies and clinical experiences. Based on their review, they commented on several types of PE treatments:

  • EMLA cream. This cream, called “eutectic mixture of local anesthetics” or EMLA, combines lidocaine and prilocaine, two medications that cause numbness. In the studies, patients used the cream 10 to 30 minutes before having intercourse. Most of them saw improvements in their PE symptoms. To avoid transferring the cream to a partner, experts recommend washing the penis before sex and using a condom.
  • Lidocaine and prilocaine spray. This preparation comes in a metered dose, which means men should get the same amount of spray every time they use it. Studies have found that men using the spray took longer to climax compared to men who used a placebo spray.
  • Severance secret cream. The nine ingredients in this cream derive from natural products and include ginsenoside, eugenol, and bufosterioid. The cream is meant to provide numbness and might help with erections, too. In studies, men with PE had improvements and any side effects were mild.
  • Resiniferatoxin. This substance, which comes from cactus plants, is intended for men with lifelong PE. In studies, men were instructed to soak the tip of their penis in a solution for 30 minutes, then wash it before intercourse. The treatment was found to be more effective for uncircumcised men. Some men experienced pain, swelling, discomfort while urinating, and reddening of the skin.
  • Over-the-counter treatments. The researchers found no controlled studies of over-the-counter treatments in terms of safety of effectiveness.
  • Medicated latex condoms. No controlled trials of medicated condoms were found; instead, the researchers consulted online forums. The condoms discussed contained benzocaine, an anesthetic. Forum participants noted that the condoms were easy to use and worked quickly, but there were instances of decreased sensitivity. Some men developed contact dermatitis as well.

The study authors added that psychotherapy, paired with medical treatments, may also help men with PE.

Overall, they concluded that topical treatments “are an effective and well-tolerated option for treatment of PE.” However, they recommended more research on effectiveness and safety.

Resources

Sexual Medicine Reviews

Butcher, Michael J., DO, et al.

“Topical Agents for Premature Ejaculation: A Review”

(Full-text. Article in press. Published online: April 12, 2019)

https://www.smr.jsexmed.org/article/S2050-0521(19)30020-4/fulltext

News

About 20% of Men with Peyronie’s Disease Stop Injection Therapy Early

About 20% of Men with Peyronie’s Disease Stop Injection Therapy EarlyApproximately one in five men who start intralesional injection therapy to treat Peyronie’s disease don’t complete the recommended eight-injection protocol, according to new research in Sexual Medicine Reviews.

A review of 15 relevant studies found that discontinuation rates ranged from 13% to 56%, depending on the study design.

Peyronie’s disease is characterized by areas of hardened scar tissue called plaques. Because the plaques make the penis less flexible, a distinct bend develops. For some men, the curve makes intercourse quite difficult. Experts aren’t sure what causes the condition, but some believe it stems from an injury to the penis that doesn’t heal properly.

Treatments for Peyronie’s disease vary depending on the symptoms. Surgery to straighten the penis is one option. But some men undergo a less invasive route – intralesional injections. This therapy involves injecting a substance called Clostridium histolyticum (CCh) directly into the plaques.

Injections can be effective, but the process takes time. Therapy usually includes eight injections given periodically over several months at a doctor’s office. Men may experience pain, itching, swelling, bruising, or bleeding. They might need to abstain from sex. The cost of treatment, if not covered by medical insurance, can be burdensome, too.

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News

FDA Approves Vyleesi for Women with HSDD

The U.S. Food and Drug Administration (FDA) has approved a drug called Vyleesi for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women.

HSDD is a lack of sexual desire that can’t be explained by other medical or psychiatric conditions and causes distress. In addition, HSDD is not related to relationship conflict or medication side effects. It can be frustrating for both women and their partners, who may have enjoyed a satisfying sexual relationship before.

Vyleesi (bremelanotide) has been approved for women with acquired, generalized HSDD. This means that the HSDD occurs after a period of normal sexual functioning and that it happens in all sexual situations, not just every once in a while or with specific partners.

Vyleesi works by activating cells called melanocortin receptors, but scientists aren’t sure why it helps with desire and distress. The drug is injected under the skin of the thigh or abdomen about 45 minutes before sex, although this time frame may be adjusted based on personal experience.

Women should not use Vyleesi more than once every 24 hours and should not take more than 8 doses per month.

To test Vyleesi’s effectiveness and safety, scientists conducted two clinical trials involving 1,247 premenopausal women with HSDD. About a quarter of the women who took Vyleesi had improvements in desire. For women who took a placebo, the rate was 17%.

About 35% of the women who took Vyleesi saw their distress levels go down as well, compared to 31% of the placebo group.

Both groups had similar rates of satisfying sexual events.

In the trials, nausea seemed to be the biggest side effect of Vyleesi, affecting about 40% of women. Some women reported flushing, injection site reactions, and headache. About 1% of the women developed darkened gums and parts of the skin, including their face and breasts.

Experts advise against the use of Vyleesi in these circumstances:

  • If women have uncontrolled high blood pressure, known heart disease, or a high risk for heart disease. Blood pressure may increase after taking Vyleesi, although it usually goes back to normal within 12 hours.
  • If women take naltrexone-containing medication by mouth. Vyleesi can decrease levels of naltrexone, a drug used to treat alcohol and opioid dependence.

Vyleesi should go on sale later this year, according to a New York Timesreport.

Another drug, Addyi (flibanserin), was approved for some women with HSDD in 2015. (See recent news about Addyi here.)

Resources

The New York Times

Thomas, Katie

“New Sex Drug for Women to Improve Low Libido Is Approved by the F.D.A.”

(June 21, 2019)

https://www.nytimes.com/2019/06/21/health/vyleesi-libido-women.html

U.S. Food and Drug Administration

“FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women”

(Press release. June 21, 2019)

https://www.fda.gov/news-events/press-announcements/fda-approves-new-treatment-hypoactive-sexual-desire-disorder-premenopausal-women

News

FDA Warns Against Three “Sexual Enhancement” Supplements

FDA Warns Against Three “Sexual Enhancement” SupplementsThe manufacturer of a supplement called The Beast has issued a voluntary recall of the product after the U.S. Food and Drug Administration (FDA) discovered an erectile dysfunction (ED) drug among the ingredients.

The agency has advised consumers to stop using The Beast capsules and return them to the place of purchase.

The capsules are manufactured by Stiff Boy, LLC. and distributed online in the United States. They are touted to enhance sexual performance, but their safety and efficacy have not been proven by the FDA.

In laboratory tests, the FDA found that The Beast contains sildenafil, the active ingredient in Viagra, a drug commonly prescribed to men with erectile dysfunction (ED).

Sildenafil is classified as a phosphodiesterase type 5 (PDE 5) inhibitor and is available only by prescription.

While PDE 5 inhibitors are an effective ED treatment for many men, they are not safe for all patients. Men who take nitrates for conditions like diabetes, high blood pressure, high cholesterol, and heart disease should never take PDE 5 inhibitors because drug interactions can cause a dangerous drop in blood pressure.

As of now, no adverse events related to The Beast have been reported. The manufacturer has notified customers of the recall by email and is arranging for product returns. Customers may contact Stiff Boy, LLC by phone at (914) 281-4059 or email at info@youcanbeabeast.com with any questions.

Last month, the FDA advised consumers not to purchase or use two other “sexual enhancement” supplements for similar reasons:

  • Man Fuel Xtreme Edition was found to contain sildenafil and structurally similar compounds dithiodesmethyl carbodenafil and desmethyl carbodenafil.
  • Man Fuel Male Enhancement Shooter (Tropical Fruit Flavor) was found to contain tadalafil (the active ingredient in the ED drug Cialis, also a PDE5 inhibitor) and the structurally similar compound desmethyl carbodenafil.

Consumers who have had side effects from using any of these products should contact their healthcare provider. They may also make a report to the FDA’s MedWatch Adverse Reporting program.

Resources

Urology Place

“FDA Announces New Supplement Recall”

(June 6, 2019)

https://community.auanet.org/blogs/policy-brief/2019/06/05/fda-announces-new-supplement-recall

U.S. Food and Drug Administration (FDA)

“Public Notification: Man Fuel Male Enhancement Shooter (Tropical Fruit Flavor) contains hidden drug ingredients”

(May 22, 2019)

https://www.fda.gov/drugs/medication-health-fraud/public-notification-man-fuel-male-enhancement-shooter-tropical-fruit-flavor-contains-hidden-drug

“Public Notification: Man Fuel Xtreme Edition contains hidden drug ingredients”

(May 22, 2019)

https://www.fda.gov/drugs/medication-health-fraud/public-notification-man-fuel-xtreme-edition-contains-hidden-drug-ingredients

“STIFF BOY LLC. Issues Voluntary Nationwide Recall of THE BEAST Capsules Due to Presence of Undeclared Sildenafil”

(June 3, 2019)

 https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/stiff-boy-llc-issues-voluntary-nationwide-recall-beast-capsules-due-presence-undeclared-sildenafil

News

Genetic Vitamin D Deficiency Associated with Low Testosterone

Genetic Vitamin D Deficiency Associated with Low TestosteroneMen with genetic vitamin D deficiency could be at greater risk for low testosterone, according to a recent study in the Journal of Clinical Endocrinology & Metabolism.

The finding is based on a study of 4,254 Chinese men whose genetic information was available through an additional study.

Vitamin D is essential for skeletal health, as it absorbs calcium, one of the primary components of bones. Vitamin D also helps nerves, muscles, and the immune system work properly.

Testosterone is predominantly a male hormone, although women’s bodies produce it in smaller amounts. It’s responsible for most masculine traits, like facial hair, a deeper voice, and increased muscle mass. It also fuels a man’s libido and helps with erections.

Men with low testosterone often feel tired, moody, and less interested in sex. (Learn more about low testosterone here.)

Past research has linked vitamin D deficiency has been linked to low testosterone, although it’s unclear why. In January 2018, a study in the International Journal of Endocrinology suggested that taking vitamin D supplements might improve sexual health.

What makes the current study from China different is that the study subjects had genetic vitamin D deficiency. “Whether vitamin D supplementation can raise androgen [e.g., testosterone] levels merits further investigation in long-term randomized control trials,” the authors wrote.

They explained that their study included only Asian men. Men from other backgrounds might not have the same results.

Men who are concerned about their vitamin D levels, testosterone levels, or sexual health are encouraged to see their healthcare provider.

Check out these links for more information:

Low Testosterone Could Be Linked to Vitamin D Deficiency

Vitamin D and Erectile Dysfunction

Resources

International Society for Sexual Medicine

“Vitamin D Important for Men’s Sexual Health, Study Finds”

(April 2, 2018)

https://www.issm.info/news/sex-health-headlines/vitamin-d-important-for-mens-sexual-health-study-finds/

The Journal of Clinical Endocrinology & Metabolism

Chen, Chi, et al.

“Causal link between vitamin D and total testosterone in men: A mendelian randomization analysis”

(Abstract. Published: March 21, 2019)

https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/jc.2018-01874/5393291?redirectedFrom=fulltext

Mayo Clinic

“Vitamin D”

(October 18, 2017)

https://www.mayoclinic.org/drugs-supplements-vitamin-d/art-20363792

Medline Plus

“Vitamin D”

(Page last updated: May 9, 2019)

https://medlineplus.gov/vitamind.html

Medscape Medical News

Harrison, Pam

“Low Vitamin D Tied to Testosterone Dip in Healthy Men”

(May 27, 2015)

https://www.medscape.com/viewarticle/845483

Renal and Urology News

Akirov, Amit, MD

“Genetically Determined Low Vitamin D Concentrations Associated With Low Testosterone Levels”

(April 24, 2019)

https://www.renalandurologynews.com/home/departments/mens-health-update/hypogonadism/genetically-determined-low-vitamin-d-concentrations-associated-with-low-testosterone-levels/

News

Not Having Sex? You’re Far From Alone

Not Having Sex? You’re Far From AloneTwenty-three percent of Americans had no sex at all in the past year, according to a recent Washington Postreport.

This percentage is the highest in 30 years, a 4% increase from 1989, thePost said.

The data comes from the General Social Survey (GSS), a project conducted by the National Opinion Research Center at the University of Chicago.

Younger people in particular seem to be having less sex. In 18- to 29-year-olds, the percentage of people not having sex rose from 14% in 1989 to 23% in 2018.

The change was most dramatic for men aged 18 to 30. In 1989, roughly 15% of men reported having no sex during the previous year. In 2018, the rate was 28%. (The 2018 rate for women in that age group was 18%.)

What’s behind “the Great American Sex Drought”? It’s hard to say, exactly, but the Post offered some explanations:

  • People are aging. While many people enjoy sex well into their golden years, others struggle with sexual dysfunction and health conditions that can make sex difficult, like diabetes, heart disease, and arthritis. Also, older people don’t always have partners.
  • Younger people aren’t always pairing off. Many people spend their twenties working on their careers and don’t marry or commit to long term relationships until they’re older.
  • Technology gets in the way. Emails, texts, videos, games, and other forms of electronic networking and entertainment can be distracting, taking couples’ minds off of sex and intimacy. (This 2014 blog post explains these trends more.)

The recent survey results aren’t the first time scientists have found reduced sexual frequency. In 2017, a study in the Archives of Sexual Behavior reported on GSS survey results from 2010 to 2014. During that time, Americans had sex nine fewer times annually than they did from 1995 to 1999. In addition, millennials (born between 1981 and 1996) and Generation Z (born between 1997 and 2012) had less sex than people the same age did during the 1930s.

Resources

Pew Research Center

Dimock, Michael

“Defining generations: Where Millennials end and Generation Z begins”

(January 17, 2019)

https://www.pewresearch.org/fact-tank/2019/01/17/where-millennials-end-and-generation-z-begins/

SexHealthMatters

“Americans Are Having Less Sex Nowadays”

(April 25, 2017)

https://www.sexhealthmatters.org/news/americans-are-having-less-sex-nowadays

Today.com

Holohan, Meghan

“America is in a 'sex drought' and here's why it matters”

(April 12, 2019)

https://www.today.com/health/americans-are-having-less-sex-here-s-why-it-matters-t151817

Washington Post

Ingraham, Christopher

“The share of Americans not having sex has reached a record high”

(March 29, 2019)

https://www.washingtonpost.com/business/2019/03/29/share-americans-not-having-sex-has-reached-record-high/?utm_term=.2ea0d1651b22

News

Peyronie’s Disease: RestoreX Traction Device Investigated With Injection Therapy

Peyronie’s Disease: RestoreX Traction Device Investigated With Injection TherapyMen with Peyronie’s disease may benefit from combining injection therapy with a particular traction therapy, experts report.

Peyronie’s disease involves the formation of plaques on the penis, just below the skin’s surface. These hardened areas make the penis less flexible, and erections take on a distinct curve.

The condition is often treated surgically, but men do have some non-surgical options. Some have medication injected directly into the plaques; a common one is called collagenase Clostridium histolyticum (CCH). Others use a traction device designed to straighten the curve and improve penile length. And some have a combination of both therapies.

Several traction devices have been developed for Peyronie’s disease treatment. But studies on their effectiveness have had mixed results, and men must use the devices for at least three to five hours a day.

Scientists created the RestoreX device with improvements in mind. It uses greater traction force, and men can use it for a shorter time period each day (generally 30 to 90 minutes).

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News

After ADT, Testosterone Levels Don’t Always Recover

After ADT, Testosterone Levels Don’t Always RecoverMany men undergo androgen deprivation therapy (ADT) as part of their prostate cancer treatment. But even two years after ADT ends, patients may still struggle with low testosterone, according a recent report.

The term androgens refer to male hormones like testosterone. This hormone is important for men’s health, but it can also fuel the growth of prostate cancer cells. ADT reduces the amount of testosterone in a man’s body, cutting off the cancer’s power supply.

ADT is more common in men with intermediate- and high-risk prostate cancer as well as men whose cancer has spread beyond the prostate gland.

Decreasing testosterone in this way has its drawbacks, however. Low testosterone is linked to lower bone density, leaving men at higher risk for osteoporosis. Men with low testosterone are also more likely to develop diabetes and heart disease.

There are sexual side effects as well, including diminished libido, orgasm difficulties, and erectile dysfunction.

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News

Healthcare Providers Need to Consider Needs of Transgender Adolescents

Healthcare Providers Need to Consider Needs of Transgender AdolescentsMore adolescents are identifying as transgender, and doctors need to stay up to date on transgender healthcare needs, according to a recent review in the Canadian Medical Association Journal (CMAJ).

Gender dysphoria occurs when a person identifies as a gender other than one’s birth gender. For example, a child born male might feel more female and prefer clothes and activities that are typically associated with girls.

Often, people with gender dysphoria feel that they are born in the “wrong” gender. Many decide to live as their desired gender and physically transition by undergoing hormone therapy and gender affirmation surgery.

While the study authors acknowledged the need for shared decision making among doctors, families, and patients with gender dysphoria, they emphasized that adolescent’s wishes should come first.

“Ideally, the approach to youth with gender dysphoria revolves around collaborative decision-making among the youth, family or guardians, and care providers,” the authors wrote. “The youth’s voice is always paramount.”

The authors also commented on medications that suppress the onset of puberty.

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News

Prostate Cancer Survivors and Partners Want Information on Sexual Recovery

Prostate Cancer Survivors and Partners Want Information on Sexual RecoveryAfter prostate cancer treatment, men and their partners often need guidance on the sexual aspects of recovery. What do they look for? A recent study investigated this question.

Erectile dysfunction (ED) is one of the most common sexual problems faced by prostate cancer survivors, but it is not the only one. Low sex drive and arousal difficulties are possible. Some men find that their orgasms aren’t as intense as they were before cancer. Many struggle with anxiety and depression.

Partners feel the effects, too. Changes in intimacy, along with adjustments in relationship roles, can be a challenge.

Unfortunately, a man’s cancer care team might not address the sexual effects of treatment. In the study, researchers wanted to learn more about patients’ and partners’ experiences. They also wondered if patients and partners would be open to using online support for sexual problems.

They conducted a series of interviews and focus groups with 14 prostate cancer patients and 10 partners (8 women and 2 men). (Note: The partners were not necessarily in relationships with the patients.)

The patients’ average age was 62 years, with 6 to 36 months passing between their cancer treatment and the study. The partners’ average age was 63 years. Most of the participants had been in committed relationships for a long time – an average of 19 years for the patients and 39.5 years for the partners.

All of the participants filled out validated questionnaires about their sexual function.

After listening to the participants, the researchers identified several themes:

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News

Study Analyzes Sexual Dysfunction in Female Adult Entertainers

Almost a quarter of female adult entertainers have some degree of sexual dysfunction, according to a recent anonymous survey.

This rate is lower than the estimated 43% sexual dysfunction rate for women in the United States, the researchers noted.

Adult entertainment is a broad industry that includes the making of pornographic films. Actors in such films may be expected to perform sex acts as part of their professional activities. Until this study, it was unclear to what extent female adult entertainers experienced sexual problems.

In collaboration with the Free Speech Coalition and the North American Trade Association of the Adult Industry, researchers sent anonymous online surveys to a group of female adult entertainers. They compiled the results from 96 respondents.

The women’s ages ranged from 20 to 66, with an average of 34 years. They all had biological vaginas. In other words, they had not undergone male-to-female gender affirming surgery. About 15% of the women had gone through menopause.

In general, the women said their personal sex lives were more satisfying than their professional sex lives.

The survey included an assessment tool called the Female Sexual Function Index (FSFI), which is commonly used in studies of women’s sexual problems. Women whose FSFI scores are 26.55 points or less are considered to be at risk for sexual dysfunction. Just under a quarter of the women fell into this category, reporting less personal sexual satisfaction, less frequent sex, and fewer satisfying sexual encounters than women without sexual dysfunction.

“This trend suggests that engaging in professional sex work is not strongly associated with FSD [female sexual dysfunction] in these women; biopsychosocial factors, which drive FSD in the general population, may be driving FSD in entertainers as well,” the authors wrote.

“Given the explosive growth of pornography production and use in the Internet age, there is an imperative to study the impact of pornography, not only on those who consume it but also on the growing population of men and women in front of the camera,” they added.

The study was published online in the Journal of Sexual Medicine in April 2019.

Resources

The Journal of Sexual Medicine

Dubin, Justin M. MD, et al.

“Evaluation of Indicators of Female Sexual Dysfunction in Adult Entertainers”

(Full-text. Published online: April 4, 2019)

https://www.jsm.jsexmed.org/article/S1743-6095(19)30425-4/fulltext

News

Penile Sensitivity Ratio Could Standardize Assessment

Penile Sensitivity Ratio Could Standardize AssessmentSensitivity in the penis can change with a man’s health. Assessing such changes can be a challenge, as different methods are used. However, researchers have come up with a suggested standardized parameter – the penile sensitivity ratio (PSR) – to make the process easier.

Using the PSR could help physicians determine where a man’s penile sensitivity stands in comparison to other men. It may also help doctors understand sensitivity changes that occur from treatments like surgery or chemotherapy.

Researchers developed the PSR through biothesiometry, an approach used to diagnose and monitor neuropathy (nerve damage). Their study involved 1,239 men with an average age of 53 years. All of the men were patients who were seen at the same clinic for sexual problems. Just over half the men had Peyronie’s disease. Others had diabetes or problems with ejaculation. About 20% said they felt less sensitivity in their penis.

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News

Prostate Cancer Survivors Need Sexual “Support”

Prostate Cancer Survivors Need Sexual “Support”Most men experience sexual problems, especially erectile dysfunction (ED), after prostate cancer treatment. But for many, these problems aren’t addressed by doctors, according to a recent survey of men in the United Kingdom.

Prostate cancer treatments can affect a man’s sexual function in a number of ways. The prostate gland itself is surrounded by nerves that help make erections happen. Unfortunately, surgery and radiotherapy can damage these nerves, and ED follows.

Hormonal therapy can take a toll as well. Hormones called androgens spur the growth of prostate cancer cells. Limiting this fuel can slow down the cancer, but one hormone, testosterone, is essential for men’s sex drive and erections. When levels drop, sexual function is often compromised.

Almost 36,000 men with prostate cancer took part in the survey, answering questions about their experiences with urinary incontinence, sexual function, daily living, pain, anxiety, depression, and quality of life. The men’s median age was 71 years, and the survey was completed from 18 to 24 months following their cancer diagnosis.

Overall, 81% of the men reported having poor erections, which were most common in men with advanced disease. About 45% of the men said sexual problems caused them distress.

Hormonal treatment was associated with the highest rate of sexual dysfunction at 94%, followed by surgery (84%), and radiotherapy (79%).

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News

FDA Approves Testosterone in Pill Form

FDA Approves Testosterone in Pill FormThe U.S. Food and Drug Administration (FDA) has approved an oral form of testosterone therapy for some men with hypogonadism (low testosterone).

Jatenzo is a capsule, offering men an alternative to testosterone preparations that are injected or applied directly to the skin.

The drug is approved only for men whose ability to produce testosterone is caused by medical conditions like Klinefelter syndrome and pituitary gland tumors. It is not approved for men who experience natural declines in testosterone as they age.

“It’s important to emphasize that this drug should not, like other testosterone treatments, be used to treat older men with ‘age-related hypogonadism,’” said Dr. Hylton V. Joffe of the FDA’s Center for Drug Evaluation and Research in a press release.

He added, “The benefits of testosterone therapy, including Jatenzo, have not been established for this use, and Jatenzo’s effects on raising blood pressure can increase the risks of heart attack, stroke, and cardiovascular death in this population.”

In a four-month clinical trial of 166 men, 87% of the men taking Jatenzo saw their testosterone levels reach a normal range, the FDA reported.

The most commonly reported side effects were headache, increased red blood cell count, higher prostate-specific antigen levels, decreased HDL (“good”) cholesterol, high blood pressure, and nausea.

In accordance with FDA rules, Jatenzo comes with a boxed warning on its label. Boxed warnings let consumers know about potentially life-threatening risks associated with a certain drug.

There are concerns that Jatenzo could cause dangerous spikes in blood pressure, increasing the risk for heart attack, stroke, and deaths related to heart disease. Before prescribing Jatenzo, doctors should make sure a patient’s blood pressure is under control, the FDA said. Blood pressure should also be checked regularly.

Please see these links to learn more about hypogonadism and testosterone replacement therapy:

Low Testosterone

What Should Men Know About Topical Testosterone?

Self-Injectable Testosterone Now Available

Testosterone Therapy Impedes Diabetes Progress, Study Finds

Resources

FDA.gov

“FDA approves new oral testosterone capsule for treatment of men with certain forms of hypogonadism”

(New release. March 27, 2019)

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm634585.htm

“A Guide to Drug Safety Terms at FDA”

(November 2012)

https://www.fda.gov/downloads/forconsumers/consumerupdates/ucm107976.pdf

Medscape Medical News

Brooks, Megan

“FDA OKs Jatenzo Oral Testosterone Replacement for Certain Forms of Hypogonadism”

(March 27, 2019)

https://www.medscape.com/viewarticle/911014

News

Sex Health Drugs are Expensive. What Can Consumers Do?

Sex Health Drugs are Expensive. What Can Consumers Do? Are prescription drug prices too high in the United States?

If you said yes, you’re in good company. In a recent survey by the Henry J. Kaiser Family Foundation, 79% of respondents said they thought drug costs were “unreasonable.” Just 17% thought prices were “reasonable.”

The 1,440 respondents answered the survey questions by telephone over a ten-day period in February. Forty-two percent of the respondents were age 65 or older.

Almost a quarter of the people who took prescription drugs said they had difficulty paying for them.

Affording medications for sex health issues can be particularly troublesome. Many drugs are not covered by insurance plans or Medicare, so some consumers pay out of pocket or just don’t take the drug at all because of costs.

In December 2018 a Journal of Sexual Medicine study reported that, depending on the type of pharmacy dispensing the medication, a prescription for sildenafil [the active ingredient in the erectile dysfunction (ED) drug Viagra] could cost anywhere from $48 to $500. (See more details about the study, along with price ranges for other ED drugs, here.)

Addyi, a drug for women with hypoactive sexual desire disorder (HSDD) had a price cut last year, from $800 to $400 for a monthly prescription, according to Bloomberg. The price was further lowered to $99 for women without insurance coverage, but even that cost could be beyond the reach of the average consumer.

While generics usually cost less, they can still be quite expensive.

Why do prescriptions cost so much? Drug manufacturers set their own prices and raise them regularly, experts say, because rules in the United States allow it. High demand can drive up the prices. Patent rules and complex negotiations between drug manufacturers and insurers are also involved with pricing.

Lowering drug costs may seem daunting, there are steps consumers can take to get keep more money their wallet:

  • Ask your doctor if there are non-drug alternatives. For example, men with erectile dysfunction might see their erections improve by managing related health conditions, like diabetes and heart disease.
  • Ask about generics. These drugs are usually less expensive.
  • Ask your health insurance company whether certain drugs can be purchased with lower copays. You might also ask if you can save money by ordering prescriptions by mail or through a preferred pharmacy.
  • Contact the drug manufacturer and ask about special programs for consumers who cannot afford their medication. Some companies offer coupons and discounts. (Your pharmacist might have this information, too.)
  • Check with your state government to see if there are any pharmaceutical assistance programs available to you.

Resources

AARP.com

“5 Ways to Lower Drug Costs”

(April 21, 2017)

https://www.aarp.org/health/drugs-supplements/info-2017/lower-rx-prices-drug-costs.html

“How to Pay Less for Drugs”

(April 21, 2017)

https://www.aarp.org/health/drugs-supplements/info-2017/pay-less-drugs-rx.html

“Why Our Drugs Cost So Much”

(May 1, 2017)

https://www.aarp.org/health/drugs-supplements/info-2017/rx-prescription-drug-pricing.html

Bloomberg.com

Koons, Cynthia

“Drugmaker Revives Female Libido Pill at Half the Price”

(June 11, 2018)

https://www.bloomberg.com/news/articles/2018-06-11/drugmaker-revives-female-libido-pill-addyi-at-half-the-price

CNBC.com

Blumberg, Yoni

“Here’s why many prescription drugs in the US cost so much—and it’s not innovation or improvement”

(January 14, 2019)

https://www.cnbc.com/2019/01/10/why-prescription-drugs-in-the-us-cost-so-much.html

Health Affairs

Hernandez, Immaculada, et al.

“The Contribution Of New Product Entry Versus Existing Product Inflation In The Rising Costs Of Drugs”

(January 2019)

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.05147

The Journal of Sexual Medicine

Mishra, Kirtishri, MD, et al.

“Variability in Prices for Erectile Dysfunction Medications—Are All Pharmacies the Same?”

(Full-text. December 2018)

https://www.jsm.jsexmed.org/article/S1743-6095(18)31262-1/fulltext

Kaiser Health News

Andrews, Michelle

“The High Cost Of Sex: Insurers Often Don’t Pay For Drugs To Treat Problems”

(February 19, 2019)

https://khn.org/news/the-high-cost-of-sex-insurers-often-dont-pay-for-drugs-to-treat-problems/

KFF.org

Kirzinger, Ashley, et al.

“KFF Health Tracking Poll – February 2019: Prescription Drugs”

(March 1, 2019)

https://www.kff.org/health-reform/poll-finding/kff-health-tracking-poll-february-2019-prescription-drugs/?utm_campaign=KFF-2019-February-Poll-High-Prescription-Drug-Prices&utm_source=hs_email&utm_medium=email&utm_content=2&_hsenc=p2ANqtz-8LzrhASGyJ3Vy-Nx24NHe8KZQ0ZHCfPfHaWaMtAHyNgIPHeTx0pD0pmtki-0Zs865Ek8xC5sRJYdwI4WdUe00240oLUA&_hsmi=2

“Poll: Nearly 1 in 4 Americans Taking Prescription Drugs Say It’s Difficult to Afford Their Medicines, including Larger Shares Among Those with Health Issues, with Low Incomes and Nearing Medicare Age”

(Press release. March 1, 2019)

https://www.kff.org/health-costs/press-release/poll-nearly-1-in-4-americans-taking-prescription-drugs-say-its-difficult-to-afford-medicines-including-larger-shares-with-low-incomes/

SexHealthMatters.org

“Does Medicare Cover Erectile Dysfunction Treatments?”

(October 8, 2018)

https://www.sexhealthmatters.org/sex-health-blog/does-medicare-cover-erectile-dysfunction-treatments

“For Erectile Dysfunction Drugs, It Pays to Shop Around”

https://www.sexhealthmatters.org/did-you-know/for-erectile-dysfunction-drugs-it-pays-to-shop-around

News

Testosterone Therapy Impedes Diabetes Progress, Study Finds

Testosterone Therapy Impedes Diabetes Progress, Study FindsTestosterone therapy might slow down the path to type 2 diabetes in some men, experts report in Diabetes Care.

The finding applies to men who have both prediabetes and low testosterone.

People with prediabetes have higher-than-normal blood sugar levels, but these levels are not high enough for an official diabetes diagnosis. However, prediabetes increases a person’s risk for type 2 diabetes as well as heart disease and stroke.

Prediabetes can be a wake-up call. People with prediabetes may be able to lower their risk for more serious health conditions by making healthier lifestyle choices.

Men with testosterone deficiency (hypogonadism) are also at higher risk for type 2 diabetes.

The study involved 316 men with prediabetes, low testosterone levels (less than or equal to 12.1 nmol/L), and symptoms of hypogonadism, which may include low sex drive, fatigue, moodiness, and decreased muscle mass.

Two hundred twenty-nine men received testosterone therapy; the remaining 87 men received no treatment. For eight years, the researchers assessed the men’s health twice annually.

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News

Peyronie’s Disease: Treatment Priorities May Guide Intralesional Injection Choice

Peyronie’s Disease: Treatment Priorities May Guide Intralesional Injection ChoiceMen who opt to treat Peyronie’s disease through intralesional injections have several drug options available. Which should they choose? The answer may depend on their overall treatment priorities, according to a recent literature review in the Journal of Sexual Medicine.

One of the more prominent symptoms of Peyronie’s disease is the formation of plaques – areas of hardened scar tissue – beneath the skin of the penis. Plaques make the penis less flexible, resulting in a distinct curve. Some men experience pain, and intercourse can become difficult. Erectile dysfunction is common as well.

During intralesional injections, a healthcare provider uses a needle to deliver medication directly into the plaques. Men may need several injections spread out over many weeks. (Other treatments for Peyronie’s disease include oral medications and, in more severe cases, surgery.)

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News

Sexual Problems Can Persist Two Years After Colorectal Cancer Diagnosis

Sexual Problems Can Persist Two Years After Colorectal Cancer DiagnosisCancer and its treatment can affect sexual health in profound ways, and for colorectal cancer survivors, these effects may continue for two years after diagnosis, according to new research in the Journal of Sexual Medicine.  

In addition, sexual health concerns are not always discussed with healthcare providers, the study authors reported.

Colorectal cancer affects either the colon (the large intestine) or the rectum (the end of the colon). It may be treated with surgery, chemotherapy, radiation therapy, or with targeted therapy drugs.

Unfortunately, most men and about half of women with colorectal cancer have sexual difficulties. Patients often cope with incontinence, rectal discharge, and gas. They may have depression, anxiety, and body image concerns, too. For example, some patients have ostomy procedures, which reroute waste through an opening in the body (a stoma) into a special waste collection bag. Some feel self-conscious about their ostomy bag. (Learn more about sexual challenges specific to rectal cancer patients here.)

The study involved 487 colorectal cancer survivors (258 men and 229 women) in France. Their ages ranged from 20 to 84 years. Just under a quarter of the participants had been diagnosed with rectal cancer; the rest had had colon cancer.

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News

Supplements, Heart Disease, and Erectile Dysfunction

Supplements, Heart Disease, and Erectile Dysfunction Studies show that vitamins and supplements don’t protect against heart disease, but people continue to buy them anyway. Could this have implications for sexual health? It might.

In May 2018, the Journal of the American College of Cardiology published a review of 179 medical studies on vitamin and mineral supplements used for preventing or treating heart disease. The research team focused on four particular supplements: multivitamins, vitamin D, calcium, and vitamin C. But they found “no consistent benefit” for the prevention of heart disease, heart attack, stroke, or deaths from any cause. (Folic acid was found to decrease stroke risk, however.)

“Despite high use, there is no agreement on whether individual vitamins or minerals or combination supplements should be taken to prevent or treat heart disease,” the American College of Cardiology said in a press release.

“Current recommendations to adopt healthy diets that are heavy in plant-based foods from which these vitamins are derived naturally should be reinforced,” the organization explained.

Still, vitamins and supplements are popular. In 2016, the Journal of the American Medical Association (JAMA) reported that 52% of almost 38,000 study participants used some form of supplement in the 2011-2012 time period.

And last month, in an article for Medscape, Dr. Christopher Labos discussed the reasons why people may take vitamins and supplements even if they don’t have to. “Ultimately, it seems that many people use vitamins and supplements because they believe that it will make them healthier,” he wrote.

So what is the connection with sexual health? The answer is two-fold.

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News

Treating Peyronie’s Disease with Penile Stretching

Treating Peyronie’s Disease with Penile Stretching Techniques that stretch the penis could be effective for treating Peyronie’s disease, according to a review of medical literature.

Peyronie’s disease occurs when scarring develops just below the skin of the penis. These areas form hardened plaques that limit flexibility. As a result, the penis bends. Sometimes, the curve is so severe that intercourse becomes extremely difficult or even impossible. Men may experience pain, penile shortening, and erectile dysfunction (ED).

There are two phases of Peyronie’s disease. First is the acute phase, when plaques form and the penis starts to bend. Erections may become painful. The chronic phase follows. At this point, the plaques and curve become stable and don’t typically worsen. Pain usually subsides during the chronic phase as well.

Treatment for Peyronie’s disease might include oral medications, injections of medicine directly into the plaques, and surgery. However, stretching therapies might be worth considering, scientists report.

They analyzed medical studies that focused on two stretching approaches:

  • Traction therapy. Men who go this route wear a special device that pulls the penis in the opposite direction of the curve, thus keeping it straight. The device is worn for several hours a day.

 

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News

Prostate Cancer is a “Couples Disease,” Scientists Say

Prostate Cancer is a “Couples Disease,” Scientists SayWhen a man has prostate cancer, his partner may feel the effects, too.

Those effects might not be direct, but they can greatly change a partner’s quality of life, according to a recent article in Urologic Nursing.

Prostate cancer is a “slow-growing disease,” the authors explained. Most men have a good prognosis, and treatment often focuses on a man’s quality of life in addition to the cancer itself.

Treatment can have side effects, however. Urinary incontinence and sexual problems frequently occur, and they may be permanent. Past research has analyzed patients’ views on their treatment. But for partners, little was known.

For the current study, researchers looked at 13 peer-reviewed, medical articles concerning prostate cancer and partners, focusing on papers that included comments from partners themselves.

Reading through the partner quotations, the researchers noticed some common threads (quotations from partners are in italics):

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News

Clomiphene Citrate Might Preserve Fertility in Men with Low Testosterone

Clomiphene Citrate Might Preserve Fertility in Men with Low TestosteroneMen with low testosterone might consider taking clomiphene citrate instead of undergoing testosterone replacement therapy, especially if they wish to father children later on, according to new research.

Clomiphene citrate therapy has been an off-label treatment for low testosterone, since the 1970s, the authors said.

Men’s testosterone levels gradually decline as they get older. This hormonal drop can leave men feeling tired and depressed. Their sex drive and erections might suffer, and their muscles could weaken.

Testosterone replacement therapy can boost a man’s levels and relieve his symptoms. It is usually administered through gels, patches, injections, or implanted pellets.

However, one problem with replacement therapy is its potential effects on fertility.

Typically, when a man’s body needs to make testosterone, the pituitary gland “notices” the deficit and releases two hormones – luteinizing hormone (LH) and follicle-stimulating hormone (FSH) – to start testosterone production in the testes. These hormones also help with the development of sperm.

When a man has synthetic testosterone in his system, his pituitary gland doesn’t register any deficit, so LH and FSH aren’t sent to the testes and less sperm is produced.

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News

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

How Does Testicle Removal Affect a Man’s Sex Life?A new study has examined sexual function and quality of life for survivors of bilateral testicular cancer.

Testicular cancer affects the testicles (or testes), two small glands located in the scrotum. The testes are responsible for producing sperm cells and male sex hormones like testosterone.

One way oncologists classify testicular cancer is by its location. Unilateral cancer affects just one testicle. Bilateral cancer affects both testicles, either at once or at separate times. According to the American Society of Clinical Oncology, about 2% of men with testicular cancer have the bilateral type.

Some men have one or both testicles surgically removed in a procedure called an orchiectomy. Men who have one remaining testicle usually have normal sexual function afterward, as the testicle can still make enough testosterone and sperm on its own. But if both testicles are removed, the lack of testosterone can lead to sexual problems like low desire and erectile dysfunction (ED). Men will also become infertile if both testicles are removed.

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News

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

Peyronie’s Disease Surgery: Can Penile Length be Preserved?Men with Peyronie’s disease should be aware of possible penile shortening after surgical treatment, experts say. But some procedures might be able to preserve length.

Peyronie’s disease is a benign condition characterized by areas of hardened scar tissue called plaques that form just beneath the skin of the penis. Typically, Peyronie’s disease goes through two phases. During the first (active) phase, men usually experience pain, and their penis starts to curve. In the second (stable) phase, pain tends to subside, but the curve remains, and some men have trouble with erections. Sometimes, the curve is so severe that intercourse becomes impossible.

Not surprisingly, Peyronie’s disease can lead to emotional distress and sexual dissatisfaction. Once the curve has stabilized, many men opt for surgical treatment. However, surgery has some drawbacks, including penile shortening.

This loss of length can worsen emotional distress. Men often associate their penis size with their masculinity. Having it reduced may make them feel like less of a man.

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News

Hormone Kisspeptin Linked to Sexual Arousal

Hormone Kisspeptin Linked to Sexual ArousalA hormone called kisspeptin might eventually be useful in the treatment of pychosexual and mood disorders, new research suggests.

The hormone could be involved with sexual behaviors, but more research is needed, scientists say.

Produced in the brain by the hypothalamus, kisspeptin triggers a series of chemical processes that ultimately results in production of the sex hormones testosterone and oestradiol and, in turn, the production of sperm and egg cells. It is sometimes called the “master regulator of reproduction.” (The hormone was discovered in 1996 in Hershey, Pennsylvania, home of the Hershey Company, which is known for its chocolate kisses candy.)

Researchers from Imperial College London wanted to know more about kisspeptin’s effects on the resting brain. “At rest” refers to times when the brain is not focused on a particular task.

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Want to Increase Your Penis Size? There Could Be Complications

Want to Increase Your Penis Size? There Could Be Complications

Are you or your partner ready to go under the knife for a bigger penis? Would you undergo injections to make it wider? These are just two penis enlargement options men consider, and while some patients find success, experts warn that such procedures can be quite risky.

Penis size has been a concern for men since ancient times. The penis is a symbol of masculinity, and for some, this symbol isn’t as large as they believe it should be. Others worry about pleasing a sexual partner.

Men may also seek penis enlargement if they’ve had birth defects or injuries that impair the function of their penis.

Generally, penis enlargement is accomplished through surgery or injections. But the procedures don’t always go smoothly. Infection, scarring, sexual problems, and penile deformity are just some of the potential complications. Fat injected into the penis can be reabsorbed by the body, and filler materials can move around, leading to an uneven look.

A recent report in the Journal of Sexual Medicine describes the situations of eleven men who needed treatment after their penis enlargement procedure went awry.

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Vapers Beware: E-Liquids Could Contain Erectile Dysfunction Drugs

E-Liquids Could Contain Erectile Dysfunction DrugsThe U.S. Food and Drug Administration (FDA) has warned vapers (consumers of e-cigarettes) to avoid two particular e-liquids - E-Cialis HelloCig E-Liquid and E-Rimonabant HelloCig E-Liquid – because they contain undeclared erectile dysfunction (ED) drugs.

An e-liquid (sometimes called e-juice) is a substance used for vaping (smoking e-cigarettes). Usually, e-liquids contain nicotine, flavoring, and other chemicals.

In a laboratory analysis, the FDA found sildenafil and tadalafil in the E-Cialis HelloCig E-Liquid product and sildenafil in E-Rimonabant HelloCig E-Liquid. Both products are sold by HelloCig Electronic Technology Co., Ltd.

Sildenafil and tadalafil are the active ingredients in Viagra and Cialis, respectively. These drugs are phosphodiesterase type 5 (PDE5) inhibitors and work by increasing blood flow to the penis to produce a firm erection. These medications are available only by prescription and should be used under a doctor’s care.

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

Stigma, Body Image Concerns May Affect Sexuality in People With Focal DystoniaSexual dysfunction is a common problem for people with some forms of focal dystonia, scientists report.

Dystonia is a movement disorder that causes a person’s muscles to contract. A person with dystonia cannot control these movements. A focal dystonia occurs when the contraction happens in one part of the body, such as the neck, leg, or arm.

In a recent study, researchers investigated sexual problems in people with two specific types of dystonia: cervical dystonia, which affects the neck, and blepharospasm, which affects the eyelids.

One hundred ninety-four people participated in the study. Of these, 65 people had cervical dystonia and 54 had blepharospasm. The remaining 75 people served as a control group for comparison. They did not have dystonia but were similar in gender and age.

Each participant filled out a sexual health assessment questionnaire called the Arizona Sexual Experience Scale. This tool helps clinicians evaluate sexual function in terms of sex drive, sexual arousal, vaginal lubrication or erections, ability to reach orgasm, and satisfaction with orgasm. The study subjects were also evaluated for depression.

The participants’ average age was about 60 years, and 61% of them were male.

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Study Examines Sexuality in People with Dementia

Study Examines Sexuality in People with DementiaPeople with dementia may still be sexually active, especially if they have a partner, experts report in a new study.

With the number of dementia patients expected to rise over the next few decades, the findings may help doctors and caregivers who work with this population.

The study, published in October 2018 in the Journal of the American Geriatrics Society focused on 3,196 adults (1,682 women and 1,514 men) who were participants in the National Social Life, Health, and Aging Project (NSHAP), a national study of older adults conducted by scientists at the University of Chicago.

All of the participants lived in their homes and were not residents of skilled nursing facilities. They ranged in age from 62 and 91, with an average age of 72.

About 55% of the participants (1,752 people) had normal cognitive function. Twenty-seven percent (865 people) had mild cognitive impairment – problems with memory that are noticeable but do not interfere with daily life. The rest of the patients (579 people) had dementia – memory loss and cognitive difficulties that prevent them from functioning normally. Alzheimer’s disease is the most common form of dementia, but there are several other types.

(Note: The NSHAP excluded people who were cognitively unable to participate or give consent. The authors noted that in their study sample, people with dementia were likely to be at an earlier stage of the disease.)

In the overall group, most people felt positively about sex, but weren’t having sex as much as they would like.

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Breast Cancer Treatment Could Preserve Ovarian Function

Breast Cancer Treatment Could Preserve Ovarian FunctionOvarian function could be preserved for some women with breast cancer, reducing their chances of undergoing early menopause and potentially increasing their chances of becoming pregnant, according to the results of the Prevention of Early Menopause Study (POEMS).

Researchers have found that adding injections of a drug called goserelin to standard chemotherapy lowered the risk of ovarian failure in women with hormone-receptor negative breast cancer.

Breast cancer is classified by its hormone receptor status. Found in cancer cells, receptors are proteins that attach to the hormones estrogen and progesterone. Unfortunately, these hormones spur the growth of more cancer cells. Women with hormone-receptor positive breast cancer might take hormone therapy drugs to control the cancer.

Not all breast cancers have hormone receptors, however. Women with hormone-receptor negative breast cancer would not take hormone therapy drugs. This type of cancer is more common in women who have not gone through menopause yet.

Chemotherapy, a common breast cancer treatment, can damage the ovaries, leading to early menopause. At this point, women can no longer become pregnant and may develop sexual problems, such as vaginal dryness.

In the POEMS, researchers wanted to see whether early menopause could be avoided in women with hormone-receptor negative breast cancer.

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What’s Really in Your Dietary Supplement?

What’s Really in Your Dietary Supplement?It’s not uncommon for dietary supplements to contain hidden ingredients, and a new report emphasizes this public health concern.

According to the U.S. Food and Drug Administration (FDA), dietary supplements are defined “as products taken by mouth that contain a ‘dietary ingredient.’ Dietary ingredients include vitamins, minerals, amino acids, and herbs or botanicals, as well as other substances that can be used to supplement the diet.” Supplements are not intended to treat medical conditions.

Supplements can be found in pill and liquid forms. Energy bars are another type of dietary supplement. In the United States, federal law dictates that such products be labeled as dietary supplements, and the FDA monitors any adverse events related to the products. However, FDA approval is not required for the production and selling of supplements.

 “As its resources permit, FDA also reviews product labels and other product information, such as package inserts, accompanying literature, and Internet promotion,” the FDA explains on its website.

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Man Develops Red-Tinted Vision After Sildenafil Overdose

Man Develops Red-Tinted Vision After Sildenafil Overdose A 31-year-old man experienced long-term vision damage after taking an exceedingly high dose of the erectile dysfunction (ED) drug sildenafil citrate, according to a recent case study in Retinal Cases & Brief Reports.

Sildenafil citrate is the active ingredient in Viagra. It is commonly prescribed for men who cannot get an erection firm enough for sex, but men with pulmonary hypertension may also take it. (Pulmonary hypertension is a type of high blood pressure that affects the lungs.)

Unfortunately, experts don’t know exactly how much sildenafil the man took, but they do know it was over 50 mg.

The man purchased the drug in a liquid form from an online retailer. The instructions recommended a dose of 50 mg, but the man said he took more than that.

Not long after, he started having trouble with his color vision, seeing things with a red tint. The problem happened with both of his eyes.

While vision problems can be a side effect of sildenafil citrate, they usually get better within 24 hours.

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FDA Approves HPV Vaccine For Adults

FDA Approves HPV Vaccine For AdultsThe U.S. Food and Drug Administration (FDA) has approved the use of HPV vaccine Gardasil 9 in adults aged 27 to 45.

The vaccine was previously approved for both males and females between 9 and 26. The new approval extends this target age group.

HPV stands for human papillomavirus, a common sexually transmitted infection. There are over 150 types of HPV, according to the U.S. Centers for Disease Control and Prevention (CDC). The CDC estimates that 80% of people will get an HPV infection at some point in their lives. Every year, about 14 million Americans become infected.

Most of the time, HPV infections clear up on their own without causing any symptoms. But certain types of HPV can lead to genital warts and cancers of the cervix, vulva, vagina, penis, or anus. Some head and neck cancers care caused by HPV as well.

Gardasil 9 protects against nine types of HPV, as long as a person has not been exposed to any of those types before. For this reason, experts recommend vaccination before a person becomes sexually active – before exposure to any HPV type.

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Could Erectile Dysfunction Be Genetic?

Could Erectile Dysfunction Be Genetic? If a man’s father or grandfather has erectile dysfunction (ED), could the man be at higher risk? Scientists might be closer to an answer.

ED – an inability to get or keep an firm erection – affects millions of men around the world and becomes more common as men get older. The condition is often related to other health problems, like diabetes, heart disease, or multiple sclerosis. But past research on twins has suggested that about a third of ED cases are genetic.

Scientists think they have found a specific genetic location (called the genetic locus) in the human DNA that affects erections. They published their findings in the Proceedings of the National Academy of Sciences of the United States of America last month.

The location is near the SIM1 gene, which is thought to be related to obesity.

The researchers examined data from two genome-wide association studies. The first study used genetic information from the Genetic Epidemiology Research on Adult Health and Aging cohort, a division of the Kaiser Permanente Research Program on Genes, Environment and Health.

This project involved 36,648 men with ED who had completed an ED survey or been treated for ED.

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

One in Three Male Childhood Cancer Survivors Has Erectile Dysfunction, Study FindsAlmost 30% of male childhood cancer survivors develop erectile dysfunction (ED) as adults, according to a research letter published last month in JAMA Oncology.

After examining sexual health data from 956 men, researchers determined that 29% had ED.

ED is an inability to get and keep an erection firm enough for sex. It can have a variety of causes, both physical and psychological. (Learn more about ED and its treatment here.)

Treatment for childhood cancer, such as radiation, chemotherapy, and surgery, can affect a patient’s sexual function later on.

For example, surgery and radiation may affect glands responsible for the production of testosterone, an important hormone for male sexuality. And damage to pelvic nerves and blood vessels in the penis might be unavoidable during surgery.

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Electrical Nerve Stimulation Might Help Women with Sexual Problems

Electrical Nerve Stimulation Might Help Women with Sexual ProblemsPlacing electrodes on the ankle may not sound like it would help a woman’s sexual function, but scientists say it’s a path worth pursuing.

Between 40% and 45% of women have some degree of sexual dysfunction, such as poor lubrication, low desire, or trouble reaching orgasm. Unfortunately, these symptoms aren’t always easy to treat.

Researchers from the University of Michigan were intrigued to learn that a process called neuromodulation – stimulating certain nerves through electrodes – could benefit women with bladder problems. The stimulation helps nerve cells work together for better bladder control.

The nervous system is a complex network. Nerves associated with pelvic organs branch out from the spinal cord, and some appear to overlap with nerves in the foot. This is why the ankle became an area of interest.

Some women who underwent neuromodulation for bladder issues reported sexual improvements. The research team wondered whether this would be the case for women without bladder problems.

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Counseling Cancer Survivors With Vaginal Pain

Counseling Cancer Survivors With Vaginal PainNurses are encouraged to consider a counseling model when treating female cancer survivors with sexual pain, according to a paper published last year in Nursing2017.

The model is called the Minimizing Pain with Vaginal Penetration Model (MPVP). As the name suggests, it targets pain with penetration. It also addresses other effects of sexual pain, such as low desire.

The medical term for painful intercourse is dyspareunia. In cancer survivors, it is linked to three specific situations:

Vaginal Dryness

Typically, when a woman becomes sexually aroused, her vagina lubricates to prepare for penetration and make it more comfortable. But some cancer treatments disrupt this process. For example, surgical removal of the ovaries or chemotherapy might reduce a woman’s levels of estrogen, a hormone that is essential for vaginal health. Other treatments, like radiation and medications, can lead to vaginal dryness, too.

Nurses should counsel women about vaginal lubricants and moisturizers, the authors explained. Both products, which are available over the counter, can help with vaginal dryness, but they are used in different ways. Lubricants are applied as needed just before sex, but moisturizers are used every few days regardless of whether a woman is sexually active.

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Fewer Biological Boys Referred to Gender Identity Clinic

Fewer Biological Boys Referred to Gender Identity ClinicThe number of biological boys referred to the world’s largest gender identity clinic has dropped over the years, experts report.

The study, recently published in the Journal of Sexual Medicine, focused on children with gender dysphoria.

Gender dysphoria refers to situations in which people feel uncomfortable or unhappy with their biological sex at birth and identify with another gender. For example, a biological boy might feel that he is meant to be a girl and prefer toys or clothes that are traditionally considered feminine. Similarly, a biological girl might wish she was a boy and choose more masculine toys and clothes.

Children who show tendencies toward gender dysphoria are usually referred to a gender identity clinic, where they receive counseling and, if they decide to, hormone therapy to either suppress puberty (allowing them more time to think about their path forward) or start their transition from one sex to another. When they get older, they might undergo gender-affirming surgery.

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Study: Antidepressant Lurasidone Has Fewer Sexual Side Effects

Study: Antidepressant Lurasidone Has Fewer Sexual Side EffectsPeople with a certain form of depression might benefit from a drug called lurasidone, which has fewer sexual side effects than other depression medications, according to a recent clinical trial.

Depression is linked several sexual difficulties, including low desire, poor arousal, and trouble reaching orgasm. Experts estimate that up to 85% of people with untreated depression experience some degree of sexual dysfunction.

Unfortunately, medications used to treat depression, such as selective serotonin reuptake inhibitors (SSRIs), have sexual side effects that can make things worse. Many people stop taking their medicine because of these side effects.

The drug lurasidone is classified as an atypical antipsychotic drug. It is used to treat mental health conditions like schizophrenia, bipolar disorder, and depression.

The clinical trial focused on a group of 209 people who had major depressive disorder, which can be severe. In addition to depression, the participants had subthreshold hypomanic symptoms. (Sometimes, doctors refer to these symptoms as “mixed features.”) This means that they had symptoms of mania, such as distractedness, little need for sleep, or being more talkative. However, these manic symptoms were not severe enough to interfere with the participants’ everyday lives.

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For Women, Placebo Effect Might Explain Improvement in Sexual Function

For Women, Placebo Effect Might Explain Improvement in Sexual Function Treatments for female sexual dysfunction are “minimally superior to placebo,” according to new research in the journal Obstetrics and Gynecology.

Researchers reached this conclusion after analyzing eight medical studies on treatments for women’s sexual difficulties, including hypoactive sexual desire disorder (HSDD) and problems with arousal, sexual pain, and orgasm.

Flibanserin, ospemifene, and intravaginal prasterone were some of the treatments used.

The analysis was sparked by previous research showing a “marked” placebo effect in clinical trials of treatments for women’s sexual dysfunction.

What is a placebo effect?

When researchers test new medications or therapies, a placebo group is a key component of the study. Some of the study participants take the drug or undergo the therapy. But the rest take a placebo, such as sugar pill, instead of the tested treatment. Participants don’t know whether they are in the treatment group or the placebo group. In this way, researchers can get a better idea of whether outcomes (such as side effects or improvement of symptoms) are likely to be from the drug or from other factors.

Sometimes, people in placebo groups respond in a similar way as those in the treatment group. This is called aplacebo effect. For example, let’s imagine that Maria and Laura are taking part in a trial for a pain medication. Maria takes the drug and feels better. Laura takes the drug and feels better, too. Does that mean the drug has no effect? Not necessarily.

The force behind placebo effect is difficult to explain, but some experts think a patient’s expectations are involved. Laura, knowing that she is participating a study of pain medication, might see improvements because she expects to. 

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Conversations About Sexuality and Fertility Should Start Early, Experts Say

Conversations About Sexuality and Fertility Should Start Early, Experts SaySometimes, children develop medical conditions that could impair their sexual function and fertility as adults. For example, some forms of cancer or disorders of sex development can have a dramatic impact on reproductive health. And eventually, patients and their parents need to be informed.

However, these discussions don’t always occur, or if they do, the information might be incomplete or inconsistent. Some doctors aren’t fully trained in these areas, and patients and families are often confused and anxious. Adolescents might be reluctant to date and have serious relationships because they are unsure about sexuality.

How should doctors and parents approach these conversations? What should children know about their situations? And when should they be told? Recently, the journal Pediatrics addressed some of these questions in a clinical report.

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Fistulas Cause Sexual and Emotional Stress in Malawi

Fistulas Cause Sexual and Emotional Stress in MalawiSexual problems and emotional stress are common after vesicovaginal fistula surgery, according to a recent study of women in Malawi.

A vesicovaginal fistula is a hole that forms between the vagina and the bladder. When this happens, urine can pass through the hole and leak out of the vagina. Urinary incontinence may be persistent, and it can happen during intercourse, too.

The women in the study had obstetric fistulas, which are caused by obstructive labor, when a baby’s pathway out of the birth canal is blocked.

Such fistulas can be surgically repaired, but recovery takes time. In Malawi, the recommended recovery period includes 6 months of pelvic rest, during which nothing should penetrate the vagina. After surgery, incontinence is often cured, but damage to pelvic tissue makes sexual dysfunction a concern.

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

FDA: Energy-Based Devices Not Recommended for “Vaginal Rejuvenation” The U.S. Food and Drug Administration (FDA) is warning women and healthcare providers about the use of energy-based devices for vaginal “rejuvenation” procedures.

The devices, which use radiofrequency or laser components, are currently approved for destroying abnormal or precancerous cervical or vaginal tissue. They may also be used to treat genital warts.

However, they are not approved for vaginal rejuvenation and have been linked to side effects like vaginal burns, scarring, painful intercourse, and chronic pain.

The agency called vaginal rejuvenation an “ill-defined term,” but it includes non-surgical treatment for conditions like vaginal laxity (looseness in the vagina), vaginal atrophy (including dryness and itching), painful intercourse, painful urination, and reduced sexual sensation.

The devices might be used in vaginal cosmetic procedures as well.

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

Stem Cell Therapy for Men’s Sex Health Needs More ResearchCan stem cells help men with erectile dysfunction (ED) or Peyronie’s disease? Scientists have been investigating the use of one particular type of stem cell, but the data for these purposes are “deficient” according to a new study in Sexual Medicine Reviews.

The authors analyzed several medical studies on the subject.

There are over 200 types of cells in the human body. What distinguishes stem cells is their ability to develop into other types of cells. One common example of stem cell therapy is bone marrow transplantation, but scientists are looking for ways that stems cells might treat illnesses like diabetes and heart disease.

In time, ED and Peyronie’s disease might also be treated with stem cells. In the study, researchers focused on stromal vascular faction (SVF), described as “the heterogenous mixture” that forms adipose-derived stem cells. (Adipose is another term for fat. These stem cells come from fat tissue.)

SVF is “ideal” for the formation of new blood vessels, the authors noted, making them particularly interesting for ED therapies. Often, erection problems occur because blocked blood vessels can’t allow enough blood to flow into the penis.

Scientists also think that SVF might regenerate damaged tissue.

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

Prostate Treatments May Have Sexual Side Effects, But Patients Not Always AwareSome treatments for an enlarged prostate and related urinary symptoms have sexual side effects. However, doctors don’t always let patients know about them, according to a recent survey.

The medical term for an enlarged prostate is benign prostatic hyperplasia (BPH). As men get older, their prostate gland grows inward. For some men, the process causes urinary problems, since the enlarged tissue squeezes the urethra.

Unfortunately, some treatments have sexual side effects. For example, men who take medications called 5α-reductase inhibitors (5-ARIs, such as dutasteride and finasteride) may have trouble with erections or ejaculation. Their sex drive can decrease, too. Men who have surgery for BPH might develop retrograde ejaculation, when semen travels backward into the bladder instead of forward out of the penis.

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Ospemifene Leads to Healthier Genitals, Less Pain for Postmenopausal Women

Ospemifene Leads to Healthier Genitals, Less Pain for Postmenopausal WomenA drug called ospemifene can improve genital tissue and sexual function in postmenopausal women, according to new research in Sexual Medicine.

The drug, marketed under the brand name Osphena, was approved by the U.S. Food and Drug Administration (FDA) in 2013 to treat moderate to severe dyspareunia - painful intercourse - in women past menopause.

Painful sex is a common problem after menopause. Estrogen is essential for keeping the vagina moist and flexible. Production of this hormone declines dramatically at menopause, and many women experience vaginal dryness and sexual discomfort as a result.

Ospemifene works like estrogen, restoring vaginal tissues.

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Low Testosterone Linked to Chronic Diseases

Low Testosterone Linked to Chronic DiseasesMen with low total testosterone may be more likely to have two or more chronic diseases, according to recent research in Scientific Reports.

The association was especially strong for younger and older men, the study found.

Scientists looked at data from 2,161 men age 20 and older who were participants in the National Health and Nutrition Examination Survey, an ongoing project that uses interviews and physicals to assess the health and nutrition of people living in the United States.

The men were divided into three groups based on age: 20 to 39.9 years, 40 to 59.9 years, and 60 and over.

The researchers also determined whether the men had multimorbidities – two or more chronic conditions – focusing on diabetes, high blood pressure, arthritis, heart disease, stroke, emphysema, high levels of triglycerides, low-HDL (“good”) cholesterol, and clinical depression.

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

CPAP Use Linked to Better Sex in Patients with Obstructive Sleep ApneaUsing a CPAP machine can improve sexual quality of life in people with obstructive sleep apnea (OSA), experts say. And women might fare better than men.

People with OSA have trouble breathing during sleep because their throat muscles relax, blocking their airway. As a result, they stop breathing for short periods, on and off, during the night. A CPAP device keeps the airway open, allowing the wearer to breathe normally and sleep more soundly. (CPAP stands for continuous positive airway pressure.)

It’s common for people with OSA to develop sexual problems like low libido and erectile dysfunction (ED).

In past studies, CPAP treatment has been linked to better sexual function, at least in men. Information on its effects in women is limited. The current study, published in July 2018 in JAMA Otolaryngology - Head & Neck Surgery, focused on how patients themselves viewed their sexual health after using CPAP.

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Penile Implants Preferred Over Other ED Therapies

Penile Implants Preferred Over Other ED TherapiesErectile dysfunction (ED) can be treated in several ways, from pills to self-injections to surgical penile implants. Which method is more satisfactory for patients? New research suggests implants.

Generally, ED treatment starts conservatively with medication, and implants are considered a last resort. (Implants are sometimes called penile prostheses.)

Penile implants allow men to create an erection on demand. For example, men with 3-piece inflatable devices have a special pump implanted in their scrotum. To achieve an erection, they squeeze the pump, which triggers fluid to move from a reservoir to cylinders in the penis. The fluid keeps the erection rigid, much like blood does in a natural erection. When men are finished with sexual activity, they just deactivate the pump.

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Penile Implants Not Always Covered by Insurance

Penile Implants Not Always Covered by InsuranceU.S. health insurers do not always cover penile implant procedures, and those that do may vary their coverage depending on a patient’s location, according to a recent study.

Penile implants, sometimes called penile prostheses, are a common treatment for erectile dysfunction (ED). The devices are surgically implanted and allow a man to achieve an erection at any time. (Learn more about penile implants here.)

Implants are often a last resort for men with ED. Patients may choose implants after trying other ED treatments, like pills, injections, and vacuum devices.

Many men with ED are prostate cancer survivors. But insurance coverage for ED treatment after prostate cancer treatment is not a federally protected right. (In contrast, breast cancer survivors who undergo breast reconstruction after mastectomy usually have coverage protected by the women’s Health and Cancer Rights Act of 1998.)

With this disparity in mind, a team of researchers from Texas set out to discover how many men had insurance coverage for ED and, more specifically, penile implants. They presented their findings at the May 2018 annual meeting of the American Urological Association.

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

In Older Men, Erectile Dysfunction Could Increase Risk for Heart ProblemsErectile dysfunction (ED) – the inability to get an erection firm enough for intercourse – is linked to a greater risk for cardiovascular events like heart attack and stroke in older men, according to a recent study.

The research team found that this link is strong even when other heart-related risk factors, such as high cholesterol, smoking, and high blood pressure, are accounted for.

ED and heart disease have a lot in common. Obesity, high blood pressure, diabetes, smoking, and metabolic syndrome can play roles in both conditions. Until this study, however, researchers did not know much about ED as an “independent predictor” of heart disease. In other words, they weren’t sure how much ED was involved on its own.

The research team used data from the Multi-Ethnic Study of Atherosclerosis (MESA). (Atherosclerosis is the medical term for “hardening of the arteries,” occurring when plaque builds up on artery walls.) They started by looking at the records of 1,914 men who ranged in age from 60 to 78. About 46% of these men had ED.

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Fewer Men Prescribed Testosterone After FDA Advisory

Fewer Men Prescribed Testosterone After FDA AdvisoryEver since the U.S. Food and Drug Administration (FDA) expressed safety concerns about testosterone replacement therapy in 2015, the number of testosterone prescriptions has declined, according to recent research.

The drop has occurred even though the number of men seeking help for symptoms of low testosterone has remained steady over the same time period.

The findings were presented at the annual meeting of the American Urological Association, held in May 2018.

The medical term for low testosterone ishypogonadism,and doctors often prescribe testosterone replacement therapy to men whose bodies don’t make adequate amounts of this hormone on their own. Sometimes, this happens when the testes (the glands that produce testosterone) aren’t working properly. In other cases, there might be a problem with the part of the brain that triggers testosterone production.

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FDA Approves Imvexxy for Treatment of Post-Menopausal Pain

FDA Approves Imvexxy for Treatment of Post-Menopausal PainStarting this month, post-menopausal women could have a new treatment option for painful intercourse.  

In May 2018, the U.S. Food and Drug Administration (FDA) approved Imvexxy, an estradiol vaginal insert for women with moderate-to-severe sexual pain. According to a press statement, TherapeuticsMD, the drug’s manufacturer, expects Imvexxy to be available in July.

Sexual pain is a common problem after menopause, when a woman’s estrogen levels drop considerably. Estrogen is important for keeping vaginal tissue healthy and flexible. When levels decline, the vagina can shorten and narrow, with the walls becoming dry and brittle. Women may find that their vagina is less lubricated during sex. Together, these symptoms can lead to uncomfortable friction, tearing, and bleeding during vaginal intercourse.

The medical term for this situation is vaginal and vulvar atrophy (VVA). An estimated 50% of postmenopausal women experience it to some degree. Unfortunately, VVA does not improve on its own.

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Sex Talks are Challenging for Parents of LGBTQ Teens

Sex Talks are Challenging for Parents of LGBTQ TeensHeterosexual parents of LGBTQ adolescents don’t always know how to discuss sex, a new study says.

“Healthy parent-adolescent relationships and effective parenting are robust predictors of sexual health in heterosexual adolescents,” the authors wrote in the journal Sexuality Research and Social Policy. But they added that LGBTQ teens struggle more with sexual health issues compared to their straight and cisgender counterparts.

Researchers from Northwestern University’s Institute for Sexual and Gender Minority Health (ISGMH) asked 44 parents of lesbian, gay, bisexual, transgender, and queer (LGBTQ) teens to participate in online focus groups and discuss their experiences and challenges guiding their children’s sexual knowledge. Their children were between the ages of 13 and 17.

Some parents were unsure of how to discuss LGBTQ sexual experiences when they had not had them themselves. Some were not clear on the mechanics and lacked a frame of reference, so providing guidance was difficult. Some were uncomfortable discussing sex in general.

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

Cycling Has No Impact on Women’s Sexual or Urinary Health, Study FindsWomen who cycle are not more likely to have sexual or urinary problems compared to those who run or swim, according to a new study in the Journal of Sexual Medicine.

However, urinary tract infections (UTIs), genital numbness, and saddle sores were more commonly reported by cyclists.  

In the past, researchers have raised concerns that bicycle saddles (seats) and handlebar positions might lead to sexual dysfunction because pressure can compress nerves in the perineum – the area between the anus and the vulva.

To learn more, the research team surveyed 3,118 women. About two-thirds were cyclists; the rest were runners and swimmers recruited to serve as a comparison group.

Overall, thirteen percent were considered high-intensity cyclists who had been cycling for over two years, cycled at least three times a week, and had a daily cycling average of 25 miles or more. The rest of the women were low-intensity cyclists – women who cycled regularly, but not as much as the high-intensity group.

The women completed questionnaires to assess their sexual function and urologic health. They also answered questions about past UTIs, genital numbness, and saddle sores. Cyclists provided information on the types of bikes, seats, and shorts they used, how much they stood while cycling, the height of their handlebars, and the usual terrain they cycled on (such as city streets or off road).

Most of the women were younger than 40 years old, and most were sexually active.

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Survey Reveals the Emotional Impact of Prostate Cancer

Prostate cancer packs an emotional punch as well as a physical one, a new survey reveals.

Life-changing, frightening, and sad were just some of the answers survey respondents gave when asked to sum up prostate cancer in one word.

The “Prostate Cancer in America 2018” survey included 953 people: 928 men who had been diagnosed with prostate cancer and 25 prostate cancer caregivers.

Sixty-one percent of the men did not have prostate cancer symptoms when their diagnosis was made. Instead, they were visiting their doctor for another medical concern.

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Lifestyle Changes Might Improve Sexual Health

Lifestyle Changes Might Improve Sexual HealthLifestyle changes, such as quitting smoking, getting more exercise, and eating healthier foods, are sometimes recommended to people with sexual problems. But how much of an effect do such changes have? Scientists considered this question in a recent Journal of Sexual Medicine study.

In particular, they looked at the ways six lifestyle factors — cigarette smoking, alcohol use, physical activity, diet, caffeine consumption, and cannabis use — affected three sexual health outcomes — female sexual dysfunction, erectile dysfunction (ED), and premature ejaculation.

Female sexual dysfunction includes a wide range of sexual issues, such as vaginal dryness, low interest or desire, and pain during intercourse. An estimated 41% of premenopausal women worldwide have some degree of sexual dysfunction.

The researchers reviewed 89 medical studies related to lifestyle and sexual problems. Overall, the studies included almost 350,000 people around the globe. On average, the participants were around 49 years old.

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

World’s First Penis and Scrotum Transplant Takes Place in the United StatesA U.S. military veteran has received the world’s first total penis and scrotum transplant.

The 14-hour operation was performed by a team of 11 surgeons at Johns Hopkins Hospital in Baltimore at the end of March.  

“We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man," said surgeon W.P. Andrew Lee, professor and director of plastic and reconstructive surgery at Johns Hopkins University's School of Medicine in a statement.

The recipient, who asked to remain anonymous, was severely wounded by an improvised explosive device while serving in Afghanistan. In addition to his genitals, he lost both legs.

The first successful penis transplant took place in South Africa in 2014. What makes the Johns Hopkins transplant different is the extensive amount of tissue involved.

Surgeons harvested a penis, scrotum, and part of an abdominal wall from a deceased donor. They then attached the tissue by connecting a complex network of veins, arteries, and nerves. The urethra – the tube that allows urine and semen to leave the body – was also attached.

The surgeons expect the veteran’s urinary and sexual function to be restored in several months, but they are not yet sure how much function will be recovered.

The recipient will not be able to father biological children. While the donor’s scrotum was transplanted, his testicles were not. This was an ethical decision on the surgeons’ part, as sperm created from donor testicles would carry the donor’s DNA, not the recipient’s.

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ASCO Guidelines Address Cancer Patients’ Sexual Health

ASCO Guidelines Address Cancer Patients’ Sexual HealthNew guidelines from the American Society of Clinical Oncology (ASCO) encourage healthcare providers to discuss sexual health with their cancer patients.

The guidelines were adapted from 2016 guidelines set forth by Cancer Care Ontario (CCO), a Canadian organization that advises healthcare professionals and policy makers.

“The ASCO Expert Panel determined that the recommendations from the 2016 CCO guidelines are clear, thorough, and based on the most relevant scientific evidence,” wrote the authors of the ASCO guidelines, who added modifications to suit a “broader audience.”

The guidelines apply to men and women of all sexual orientations (and their partners) who are age 18 and over.

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

U.S. Preventive Services Task Force Makes Recommendations on Prostate Cancer Screening Men between the ages of 55 and 69 should “make an individual decision” about PSA testing for prostate cancer, according to new recommendations from the U.S. Preventive Services Task Force (USPSTF).

Such decisions should be made after discussing the potential benefits and harms of screening with a doctor, the panel of experts said, adding that men age 70 and over should not be regularly screened, as the “potential benefits do not outweigh the harms.”

The USPSTF is a volunteer group of specialists in a wide range of medical areas, including internal medicine, family medicine, pediatrics, behavioral health, and nursing. The members review scientific evidence to make recommendations on preventive practices, like getting screened for diseases, following healthy habits, and taking certain medications.

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Sex Aids Not Always Available at Cancer Centers

Sex Aids Not Always Available at Cancer CentersCancer survivors can face a number of sexual issues after treatment, but most cancer centers don’t carry aids that could help them, according to a recent survey.

Many men develop erectile dysfunction (ED) and low testosterone after cancer treatment. For women, treatment often induces medical menopause, leading to low sex drive and poor vaginal lubrication. Stress, anxiety, and depression often associated with cancer and its treatment can impair sexual function, too.

Products like vacuum erection devices and vaginal moisturizers and lubricants can help. But such products aren’t always available at cancer centers, and patients may not know where to get them.

For the study, a team of researchers contacted twenty-five cancer centers and asked about the aids they carried for patients with sexual dysfunction. Information for men and women was gathered in separate phone calls.

Two centers did not respond to inquiries.

About 87% of the responding centers did not stock any sexual aids for men. One of them had a vacuum device, and two offered penile support rings.

Six centers sold aids for women, such as moisturizers, lubricants, and vaginal dilators.

Only one center had an adequate supply of aids for both men and women.

When asked how they responded to requests for sexual health aids, many centers said they referred patients to local pharmacies or the internet.

The authors noted that the availability of sexual health products is “very low,” especially compared to other items used by cancer survivors, like wigs and prosthetics.

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

Daily Flibanserin “Generally Safe” for Some Postmenopausal Women, Study FindsFlibanserin, a drug used to treat low sexual desire, is “generally safe and well-tolerated” for both premenopausal and naturally postmenopausal women, according to trial results published in the Journal of Sexual Medicine.

More specifically, the drug is designed to treat hypoactive sexual desire disorder (HSDD). Women with HSDD lose interest in sex for reasons that can’t be readily explained. This lack of libido is persistent. The women do not desire sex with a partner, nor do they have sexual fantasies.

One of the diagnostic criteria of HSDD is distress. Women with HSDD feel distress about their situation. Indeed, HSDD can take its toll on relationships, and partners may wonder why the sexual interest isn’t there, especially if they have enjoyed a healthy sexual relationship in the past. Women may miss the intimacy they once shared with their partner.

Flibanserin, marketed under the brand name Addyi, works by rebalancing two neurotransmitters in the brain: dopamine and norepinephrine. In 2015, the drug was approved by the U.S. Food and Drug Administration (FDA) in for use in premenopausal women with acquired, generalized HSDD. Acquired means that their HSDD started after a period of normal sexual function. Generalized means that their lack of sex drive occurs almost all the time, not just in certain situations.

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

U.S. House Resolution: Continue Health Coverage for Certain Men with Incontinence and ED The United States House of Representatives is considering a resolution that would protect Medicare and Veterans’ Administration (VA) benefits for men who need urological therapies after treatment for prostate cancer and other health conditions.

Previously presented in 2016, Resolution 812 was reintroduced to the House by Congressman Erik Paulsen, a Republican from Minnesota, on April 10th. It was co-sponsored by Congressman Donald Payne, Jr., a Democrat from New Jersey.

According to the resolution, an estimated 2.9 million men in the United States have prostate cancer, and over 164,000 men will be diagnosed this year. Prostate cancer is the second leading cause of death for American men.

The Sexual Medicine Society of North America (SMSNA), along with the American Urological Association (AUA), supports the congressmen's efforts to advocate for men with prostate cancer through House Resolution 812. Dr. Hossein Sadeghi-Nejad, SMSNA’s President-Elect, says, “There will be an estimated 19 million cancer survivors in the United States by the year 2024.”

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Avoid These Erectile Dysfunction (ED) Products, FDA Warns

Avoid These ED Products, FDA WarnsMen should avoid certain erectile dysfunction (ED) products advertised on the radio, the U.S. Food and Drug Administration (FDA) advises.

Commercials for these products have been broadcast on iHeart Radio and other outlets. The advertisements use phrases like the following:

  • A healthy man alternative to the little blue pill
  • Healthy man
  • The power pill

The FDA reports that the drugs contain 100 mg of sildenafil, the active ingredient in the ED drug Viagra. While drugs like Viagra can be an effective way to treat ED, they are not safe for all men. For example, men who take nitrates for conditions like diabetes, high blood pressure, high cholesterol, and heart disease should not take ED drugs at all because the interaction can cause a dangerous drop in blood pressure.

Also, the 100 mg dose in the advertised products can be unsafe for elderly men and men with liver and kidney problems.

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More Americans Having Gender-Affirming Surgery

More Americans Having Gender-Affirming SurgeryThe number of people undergoing gender-affirming surgery in the United States has increased four-fold since 2000, according to a recent study in JAMA Surgery.

More of those surgeries are now covered by insurance, too.

Gender-affirming surgery is one way to treat gender dysphoria. People with gender dysphoria feel a mismatch between their birth gender and the gender they identify with. For example, a person may be born genetically male, but feel more female.

Many transgender individuals decide to physically transition from their birth gender to their desired gender. The process usually starts with hormone therapy. In younger patients, hormones might be used to suppress puberty. In adults, hormones can help the body develop desired secondary sex characteristics like facial hair or breasts.

Gender-affirming surgery is a next step. During surgery, natal reproductive organs are removed, and organs of the desired gender are created. For instance, the penis may be removed, and a vagina formed. Or, the uterus and ovaries may be removed, and a penis created. Sometimes, other surgeries are performed to make the body look more masculine or feminine.

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Scientists Investigate Health Risks of Testosterone Replacement Therapy

Scientists Investigate Health Risks of Testosterone Replacement TherapyNew research suggests that men on testosterone replacement therapy (TRT) are not at higher risk for cardiovascular events or blood clots but might be more likely to have obstructive sleep apnea.

Testosterone is important for men, as it is responsible for masculine features, such as facial hair and muscle mass. The hormone also drives a man’s libido.

However, sometimes men’s bodies don’t make enough testosterone. This can happen if there is a problem with the testes (the glands that make the hormone) or the pituitary gland (the area of the brain that spurs production.)

Men’s testosterone levels gradually drop as they get older, too. As a result, they might become less interested in sex, have trouble with erections, feel moody and tired, and gain weight.

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Women With Breast Implants Warned About Rare Lymphoma

Women With Breast Implants Warned About Rare LymphomaThe U.S. Food and Drug Administration (FDA) has reported an increase in certain non-Hodgkin’s lymphoma cases among women with breast implants.

The type of lymphoma is called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Lymphoma is cancer of the lymphatic system, which is part of the body’s immune system. BIA-ALCL is not breast cancer.

BIA-ALCL is rare. Based on medical device reports, the FDA counted 414 total cases of BIA-ALCL as of September 30, 2017. Nine patients had died from the illness.

However, it is difficult to know exactly how many cases exist, as BIA-ALCL information is not widely reported around the world. However, it seems to be more common in women with textured implants.

Breast implants come in several different shapes, sizes, and types. Smooth implants are usually softer but can shift their position. Textured implants are more likely to stay in place because of scar tissue that forms around the implants. Either type of implant may need to be replaced eventually.

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

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.

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Childhood Sexual Abuse Linked to Sexual Problems in Women

Childhood Sexual Abuse Linked to Sexual Problems in WomenWomen who have been sexually abused as children develop more sexual problems than their non-abused peers, according to a recent review of medical literature by American scientists.

In an effort to understand more about prevalence of sexual dysfunction in victims of childhood sexual abuse (CSA), the research team analyzed previous scientific reports on the topic. They published their findings in the journal Sexual Medicine Reviews in January.

They defined childhood sexual abuse (CSA) as “unwanted sexual contact between a child and an adult.” Such contact might involve vaginal or anal penetration, forced sexual touching, or oral sex. Contact doesn’t necessarily mean touch, however. Exposure to one’s genitals can be considered abuse, too.

Many women are victims of childhood sexual abuse, they added. In one study of women in 22 countries, 20% of the respondents had experienced it. Other studies of American women estimated that between 17% and 51% of women had CSA histories.

It’s difficult to know how many women with CSA histories have sexual problems. That’s because various studies used different definitions of both CSA and sexual dysfunction. They also involved different groups of women, such as women who were being treated for sexual problems or female college students. They estimated that in general, between 25% and 59% of women with CSA histories have some degree of sexual dysfunction.

The research team explained that issues with desire, arousal, orgasm, and pain are especially troublesome in women with childhood sexual abuse histories.

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

Male Childhood Cancer Survivors May Face Sexual Problems, Infertility as AdultsWhen childhood cancer survivors enter adulthood, they may develop sexual issues caused by their cancer treatment. Surgery, radiation, chemotherapy – and the emotional impact of treatment – can all negatively affect later sexuality. Sometimes, these issues are overlooked at the time of treatment. After all, the primary goal of treatment is to fight cancer. Sexuality may be less of a priority, especially if the patient is a child.

Still, childhood cancer survival rates have improved over the years, and these issues remain as patients get older.

Recently, a team of experts discussed four issues specific to adolescent boys and young men -- sexual dysfunction, erectile dysfunction (ED), hypogonadism (low testosterone), and infertility – in the journal Sexual Medicine Reviews.

The scientists analyzed a number of previously published reports to learn more about how often such problems occur, what causes them, and what men can do. Their findings might help both doctors and patients find solutions.

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Inhibition May Hinder Women’s Orgasms

Inhibition May Hinder Women’s OrgasmsSexual inhibition can lead to orgasm issues in women, new research suggests.

Problems with orgasms are common in women, with an estimated 10% to 40% of women reporting difficulty. Some women never reach orgasm. The causes are often both physical and psychological. Stress, anxiety, medical conditions like diabetes, and even anatomy can contribute to whether a woman climaxes or not.

Last month, the Journal of Sexual Medicine published a study that sheds some light on some of the psychological traits that might affect orgasm. Researchers asked a group of 1,002 women between the ages of 18 and 72 (average age 26 years) to complete a series of questionnaires to assess their personalities, levels of sexual inhibition and sexual excitation, beliefs about sex, and their sexual activities (how often they had sex and how frequently they reached orgasm.)

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Special Therapy Addresses Body Image in Breast Cancer Survivors

Special Therapy Addresses Body Image in Breast Cancer Survivors Researchers in Canada have developed a promising program that aims to help breast cancer survivors with body image.

Restoring Body Image After Cancer (ReBIC) is a group therapy approach that combines guided imagery with talk therapy in a supportive environment.

Body image concerns are common in breast cancer survivors, who are adjusting to a body that isn’t quite the same as it was before cancer. Women may have lost one or both breasts to surgery or their hair to chemotherapy. Removal of lymph nodes can lead to lymphedema – a swelling of the arms or legs. Treatment can trigger early menopause as well.

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Relaxation Technique Might Improve Arousal in Women

A relaxation technique called autogenic training could help premenopausal women with sexual arousal, according to new research in the Journal of Sexual Medicine.

More research is needed, but if further studies find the approach effective, it could be a viable treatment for a challenging condition.

Sexual arousal refers to the physical and psychological processes that start once a woman is sexually stimulated. For example, if her partner kisses or caresses her in a sexual way, blood flows to her vaginal walls, which become lubricated and ready for penetration. Her clitoris and labia fill with blood as well.

However, for some women, this process doesn’t happen as it should. They also might not feel mentally “turned on” by their partner.

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Aromatase Inhibitors Linked to Low Sexual Desire, Bowel Problems

Aromatase Inhibitors Linked to Low Sexual Desire, Bowel Problems Women who take drugs called aromatase inhibitors (AIs) for breast cancer are more likely to have low sexual desire and trouble with bowel movements, even ten years after their cancer diagnosis, experts report.

AIs are used by post-menopausal women with hormone receptor positive breast cancer. With this type of cancer, hormones like estrogen fuel the growth of cancer cells. AIs work by reducing the amount of estrogen in a woman’s body, thus limiting the estrogen available to cancer cells.

The drugs are usually taken for five years, although some women take tamoxifen (another breast cancer drug) for two or three years beforehand. AIs can be taken for up to ten years after cancer diagnosis.

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Why Do Transmen Have Surgery?

Why Do Transmen Have Surgery? When making a gender transition, people have a number of decisions to make. How can doctors best advise them? A recent Journal of Sexual Medicine study explored this question.

Many transgender individuals decide to have gender-confirmation surgery, during which the attributes of their birth gender are changed to accommodate their desired gender. For example, transmen who have female-to-male surgery may have their breasts removed and a penis surgically created.

Transmen have several surgical choices. They may opt for phalloplasty, during which a penis is created using tissue from the forearm or thigh. Or, they may opt for metoidioplasty, which uses the existing clitoris after it has elongated from testosterone therapy.

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Prostate Cancer Treatment Affects Both Patients and Partners

Prostate Cancer Treatment Affects Both Patients and PartnersRadical prostatectomy – the surgical removal of the prostate gland – is an effective treatment for prostate cancer, but it can also have sexual complications for both patients and partners.

Recently, two scientists from Emory University analyzed medical studies to learn more about that factors that influence sexual satisfaction for couples after prostatectomy. They published their findings in Sexual Medicine Reviews last fall.

Looking at twelve studies on the subject published between January 2000 and May 2017, the researchers discovered that most research in this area focuses on married heterosexual couples instead of unmarried or same-sex partners.

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Sexual Problems Continue for Young Cancer Survivors

Sexual Problems Continue for Young Cancer SurvivorsCancer and its treatment can lead to a number of sexual problems for patients and survivors, including painful intercourse, erectile dysfunction (ED), and trouble with orgasm. Now, new research suggests that over half of younger survivors experience such problems, some for at least two years.

Researchers asked a group of young adult cancer patients between the ages of 18 and 39 to complete a questionnaire on medical outcomes and sexual functioning. One hundred twenty-three people filled out the questionnaire within four months of their cancer diagnosis. One hundred seven repeated the process six months later, and 95 did so a third time at a 24-month follow up point.

Each time the researchers tallied the results, they found that over half of the respondents reported sexual problems and that the probability of dysfunction and psychological distress increased over time. Two years after diagnosis, about 53% still had some degree of sexual dysfunction.

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Transgender Americans Struggle for Proper Healthcare

Transgender Americans Struggle for Proper HealthcareAccess to healthcare isn’t always so easy for transgender Americans.

A recent survey of 489 LGBTQ (lesbian, gay, bisexual, transgender, and queer) adults revealed that almost a third of transgender respondents had “no regular doctor or form of health care.”

The telephone survey was conducted for National Public Radio, the Robert Wood Johnson Foundation, and Harvard T. H. Chan School of Public Health early last year as part of a larger study of discrimination that included 3,453 adults over age 18. The subgroup of LGBTQ respondents contributed to the current analysis.

For many transgender individuals, general discrimination is a way of life. Thirty-eight percent reported hearing slurs and 28% had heard insensitive or offensive comments. Eighteen percent said that other people had acted afraid of them. Almost a quarter felt unwelcome in a particular neighborhood or were told they didn’t belong there. Twenty-seven percent had considered moving to a new community because of discrimination where they currently lived.

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PTSD Linked to Sexual Problems in Midlife Women

PTSD Linked to Sexual Problems in Midlife WomenPosttraumatic stress disorder (PTSD) and a history of personal violence is linked to menopause-related sexual dysfunction in midlife women, according to recent research.

While these factors do affect younger women, less was known about the effects on middle-aged and older women, the authors explained.

They examined data from 2,016 women between the ages of 40 and 80 (average age 61 years) from a variety of ethnic groups who were participants in the Kaiser Permanente Northern California healthcare system. The women filled out questionnaires related to PTSD, interpersonal violence, menopause symptoms, and sexual dysfunction.

Twenty-two percent of the women had “clinically significant” symptoms of PTSD. Sixteen percent and 21% had been victims of physical and emotional intimate partner violence, respectively. Nineteen percent had been sexually assaulted.

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Transgender Men Satisfied with Penile Implants

Transgender Men Satisfied with Penile Implants Transgender men tend to be satisfied with inflatable penile implants after gender reassignment surgery, according to a recent study in BJU International.

About 88% of 104 patients surveyed said they were fully satisfied with their prostheses, scientists reported. And 60% of the patients’ partners were satisfied as well.

One of the most complex aspects of female-to-male gender reassignment surgery is the creation of a penis that looks realistic and functions well for both urination and sexual relationships. Many transgender men want to urinate standing up and have the ability to penetrate a partner during intercourse.

However, some transgender men can’t get a rigid erection. That’s because the new penis does not have the corpora cavernosa – two areas of spongy tissue that fill with blood when a man is sexually aroused. The blood is what gives an erection its firmness.

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Are These Words Forbidden at the CDC?

Are These Words Forbidden at the CDC? Controversy over alleged banned words erupted at the U.S. Centers for Disease Control and Prevention (CDC) last month.

Based in Atlanta, Georgia, the CDC is an operating component of the U.S. Department of Health and Human Services.

According to media coverage based on reports from CDC policy analysts, CDC personnel were told not to use the following words in budget-related documents:

  • Diversity
  • Entitlement
  • Evidence-based
  • Fetus
  • Science-based
  • Transgender
  • Vulnerable

It was unclear why the words were being forbidden, but the instructions were said to have come from the Trump administration.

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Low Desire Common in Midlife Women

Low Desire Common in Midlife WomenMany women lose interest in sex at midlife, and doctors should consider addressing the problem, experts say.

In a recent study of 2,020 Australian women between the ages of 40 and 65, almost 70% had low sexual desire, based on their scores on validated questionnaires.

Other assessments showed that 41% of the women felt distress over their sexual lives, and 32% could be diagnosed with hypoactive sexual desire disorder (HSDD).

It’s not unusual for women to experience drops in libido from time to time. However, women with HSDD have a chronic lack of sexual interest that can’t be easily explained, along with feelings of distress. Not surprisingly, HSDD can cause conflict in relationships and leave women and their partners feeling anxious or depressed.

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Generic Viagra Now Available in United States

Generic Viagra Now Available in United StatesMen with erectile dysfunction (ED) now have an effective, but less expensive, alternative to Viagra.

Two generic versions of sildenafil citrate, the active ingredient in Viagra, came on the market on December 11th.

Sildenafil citrate is classified as a phosphodiesterase type 5 (PDE5) inhibitor. This class of drugs improves erections by relaxing smooth muscle tissue in the penis, allowing arteries to expand and blood to flow in during sexual stimulation. Adequate blood flow in the penis is critical for a firm erection suitable for sex.

Other examples of PDE5 inhibitors are Levitra (vardenafil), Cialis (tadalafil), and Stendra (avanafil).

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Drug Found to Clear Genital Psoriasis in Most Patients

Drug Found to Clear Genital Psoriasis in Most PatientsA drug called ixekizumab might improve the sex lives of people suffering from genital psoriasis.

In a recent clinical trial, almost three-quarters of the 149 participants saw their genital psoriasis clear up significantly.

Psoriasis is a skin disorder that causes skin cells to accumulate and form thick, scaly patches. These areas can be painful and itchy.

Sometimes, psoriasis forms on the genitals, making sex uncomfortable. It can take an emotional toll on sexuality as well. Psoriasis is not contagious, so it can’t be transmitted between sex partners. But people with psoriasis often worry about a partner’s reaction and many feel unattractive and reluctant to start new relationships. (For more information on how psoriasis affects sexuality, click here.)

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For Breast Cancer Survivors, Sexual Concerns May Last Years

For Breast Cancer Survivors, Sexual Concerns May Last YearsFor breast cancer survivors, sexual problems related to treatment may last for several years, according to a recent study in BMC Cancer.

Issues like low desire, poor body image, painful and less frequent intercourse, and difficulty with arousal and orgasms are common in women who have had breast cancer. Many women also experience depression and relationship conflict, which can contribute to sexual dysfunction and poor quality of life overall.

To learn more, a team of researchers from Austria asked 105 breast cancer survivors to complete a series of questionnaires that assessed their sexual health, feelings about body image, anxiety, depression, and menopausal status. For comparison, a group of 97 women without a history of breast cancer also completed the questionnaires. In both groups, the women’s average age was 49 years.

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

Poor Health and Lack of Communication Related to Low Sexual InterestWhy might people lose interest in sex? Recently, scientists provided their insights in the journal BMJ Open, and their findings differed somewhat for British men and women.

Low sexual interest is fairly common. However, past studies on the subject have focused more on women than on men. This study included both women and men who were participants in the United Kingdom’s third National Survey of Sexual Attitudes and Lifestyles. The scientists wanted to learn more about the prevalence of low sexual interest and any contributing factors.

They collected data from 6,669 women and 4,839 men between the ages of 16 and 74 who were interviewed between 2010 and 2012. Each participant had had at least one sexual partner (opposite-sex or same-sex) during the previous year.

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