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Electrical Nerve Stimulation Might Help Women with Sexual Problems

Nov 07, 2018

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

Nov 03, 2018

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

Oct 23, 2018

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

Oct 16, 2018

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

Oct 08, 2018

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

Oct 03, 2018

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

Sep 25, 2018

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”

Sep 18, 2018

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

Sep 11, 2018

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

Sep 05, 2018

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

Aug 28, 2018

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

Aug 21, 2018

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

Aug 14, 2018

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

Aug 08, 2018

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

Jul 31, 2018

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

Jul 25, 2018

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

Jul 17, 2018

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

Jul 10, 2018

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

Jul 03, 2018

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

Jun 24, 2018

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

Jun 19, 2018

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

Jun 10, 2018

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

Jun 04, 2018

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

May 28, 2018

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

May 22, 2018

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

May 16, 2018

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

May 08, 2018

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

Apr 30, 2018

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

Apr 30, 2018

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

Apr 18, 2018

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

Apr 10, 2018

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

Apr 02, 2018

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)

Mar 27, 2018

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

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

The complete Position Statement can be found here.

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Childhood Sexual Abuse Linked to Sexual Problems in Women

Mar 26, 2018

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

Mar 20, 2018

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

Mar 13, 2018

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

Mar 06, 2018

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

Feb 27, 2018

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

Feb 19, 2018

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?

Feb 13, 2018

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

Feb 06, 2018

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

Jan 30, 2018

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

Jan 23, 2018

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

Jan 16, 2018

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

Jan 09, 2018

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?

Jan 02, 2018

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

Dec 26, 2017

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

Dec 19, 2017

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

Dec 12, 2017

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

Dec 05, 2017

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

Nov 28, 2017

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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Sexual Incontinence Needs Attention, Researchers Say

Nov 21, 2017

Sexual Incontinence Needs Attention, Researchers SaySexual incontinence – urine leakage during sexual activities – can be treated effectively, but many people aren’t aware of their options, a new study suggests.

The Duke University research team wrote that sexual incontinence “is a prevalent condition that is underdiagnosed and undertreated.”

They reviewed medical literature on the subject published between 1996 and 2017 and identified three types of sexual incontinence. Foreplay incontinence occurs before any type of penetration. Coital incontinence happens during intercourse. And climacturia is urine leakage during orgasm.

Sexual incontinence can happen to both men and women, who may or may not have other types of urinary incontinence, such as overactive bladder.

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Men May Fracture Penis During “Doggy Style” Sex

Nov 14, 2017

Men May Fracture Penis During “Doggy Style” SexWhich sexual positions are more likely to cause a penis fracture?

According to new research published in the International Journal of Impotence Research, the “doggy style” and man-on-top positions are the most concerning.

Penis fracture actually refers to a tear in the tunica albuginea. This membrane surrounds the corpora cavernosa – two chambers that fill with blood during an erection. The tunica albuginea keeps blood inside the penis, keeping the erection rigid.

Men who fracture their penis often do so during rigorous intercourse. It can happen during masturbation, too. Some men even fracture their penis during sleep by rolling over during a nocturnal erection.

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What Happens in Women’s Brains During Orgasm?

Nov 07, 2017

What Happens in Women’s Brains During Orgasm? Certain parts of the brain reach “peak levels of activity” when women have orgasms, a team of Rutgers University scientists report.

How do they know? They studied the brain function of 10 women who climaxed during an fMRI scan.

The term fMRI refers to functional magnetic resonance imaging, a procedure that allows scientists to assess how certain activities affect the brain. The approach has been used to study women’s orgasms before, but results have been inconsistent, as it takes women varying amounts of time to reach orgasm. Also, it’s important to keep the head still during an fMRI, which is difficult during orgasm.

For this study, the researchers devised a special device that could keep the head in place.

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Breast Cancer Has Sexual Impact on Both Survivors and Partners

Oct 31, 2017

Scientists estimate that between 45% and 77% of breast cancer survivors develop sexual problems after treatment, from low desire and poor lubrication to painful intercourse. However, new research suggests that their partners are also affected sexually and that both members of the couple could benefit from counseling.

The September 2017 study, published in the Journal of Sexual Medicine, analyzed the sexual experiences of female breast cancer survivors who had formal sexual dysfunction diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), a resource published by the American Psychiatric Association.

One hundred sixty-nine women and 67 male partners, all living in the Netherlands, took part in the study. The participants provided information about their sexual function, psychological distress, and relationships.

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

Oct 24, 2017

Vaginal Estrogen Could Be a Menopause Management Option for Women with Breast CancerVaginal estrogen might be an appropriate way to treat menopausal symptoms in some women with a history of breast cancer, according to a Committee Opinion statement from the American Congress of Obstetricians and Gynecologists (ACOG).

At menopause, a woman’s body produces less estrogen, the female sex hormone. Among other roles, estrogen is essential for vaginal health; it keeps the vagina moist and flexible. Without it, the vagina can become dry and brittle. Menopausal women often have pain during intercourse because of poor vaginal lubrication. They may also have urinary trouble, too.

In North America, the average age of menopause is 51, but cancer treatments can induce menopause much earlier. Chemotherapy may damage the ovaries, the glands that produce estrogen. If the ovaries are surgically removed, menopause will occur immediately.

Some types of breast cancer are fueled by estrogen. Treatment may involve the temporary shutdown of the ovaries through medication so that less estrogen will be available to feed the cancer cells. Some women have their ovaries removed for the same reason.

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

Oct 17, 2017

Adolescents and young adults with cancer could benefit from a web-based tool that helps them learn about sexuality and fertility, new research reports.

Cancer patients often face sexual problems, including low libido, trouble with orgasm, vaginal dryness, and erectile and ejaculatory disorders. They may also worry about their ability to have children in the future. While all of these concerns can be distressing, healthcare providers don’t always address them.

The study, published last summer in the journal Supportive Care in Cancer, aimed to determine whether cancer patients would be interested in using a web-based tool to learn more about sexuality or fertility, if such a tool would be easy to use, and if it would be effective in a preliminary trial.

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Prescriptions Too Costly for Many Cancer Survivors

Oct 09, 2017

Prescriptions Too Costly for Many Cancer SurvivorsCancer survivors in the United States are more likely to leave their prescriptions unfilled than those without cancer, new research shows.

The main reason? Cost.

“Spending on prescription drugs to treat cancer has been increasing in the United States, and many newer cancer drugs have annual price tags of $100,000 or more,” K. Robin Yabroff of the National Cancer Institute told Reuters Health.

Dr. Yabroff co-authored a study on the subject that was published in August in the Journal of the National Cancer Institute.

The research team looked at data from the 2010-2015 National Health Interview Survey and determined the rates of limited prescription drug access in the U.S.

Overall, these rates decreased during the time period studied.

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

Oct 02, 2017

Women With OAB at Higher Risk for Sexual Dysfunction

Women with overactive bladder (OAB) are prone to having sexual problems, scientists say. And for postmenopausal women, the severity of those problems is connected to the severity of their OAB. 

The Urological Care Foundation estimates that about 33 million Americans suffer from OAB. Up to 40% of American women have symptoms, which can include an uncontrollable urge to urinate, needing to use the bathroom more often (during the day and at night), and leaking urine (incontinence). OAB can take a great emotional toll as well, with many women feeling embarrassed and depressed. 

To find out more about the severity of OAB and its effects on women’s sex lives, researchers recruited 267 to take part in a study. All the women had been previously diagnosed with OAB and were patients in a hospital department that treated pelvic floor dysfunction. Their average age was 50 years, and just over 70% had a regular sexual partner. 

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More Sex Might Mean More Brain Power in Older Adults

Sep 26, 2017

More Sex Might Mean More Brain Power in Older AdultsStaying sexually active later in life may help preserve adults’ cognitive abilities, new research suggests. And it appears that having sex frequently is better for the brain.

Many experts believe that staying mentally sharp, maintaining social relationships, and being physically active goes a long way in keeping the brain healthy as people age. Scientists aren’t sure whether sex is considered a social or physical activity (or both), but some feel it could also be good for cognition.

The study, published in June in the Journals of Gerontology: Psychological Sciences built upon previous research with similar findings. That study found an association between sex and improved cognition in general, but it wasn’t clear whether improvements were seen in specific cognitive abilities. That’s where the current study focused.

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Study Addresses Psychological Aspects of Female Sexual Problems

Sep 19, 2017

Study Addresses Psychological Aspects of Female Sexual Problems

When treating sexual problems in women, healthcare providers should consider mental health, according to new research in the Journal of Sexual Medicine.

Women’s sexual response can be quite complex. There are physical manifestations, like arousal, vaginal lubrication, and orgasm. But emotional and psychological issues can disrupt the physical process. For example, a woman who is anxious about a partner’s infidelity may not feel as aroused as before. A woman who is worried about a conflict at work might not be as focused on sexual activity and take longer to reach orgasm.

In the new study, researchers from the University of Ottawa looked at the ways certain psychological factors might influence three sexual outcomes in women:

  • Sexual function – a woman’s physical responses to sexual stimulation
  • Sexual quality of life –emotional and physiologic aspects of sex
  • Sexual frequency –how often a woman engages in partnered or solo sexual activity

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

Sep 12, 2017

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

Men with erectile dysfunction (ED) could be more likely to develop Parkinson’s disease, according to a recent study in the Journal of Clinical Neurology.

Risk could be even higher for men who have diabetes or high blood pressure in addition to ED, the researchers found.

Parkinson’s disease is a neurological disorder caused by inadequate supplies of dopamine, a neurotransmitter involved with body movement. When a person has Parkinson’s, dopamine-producing neurons in the brain shut down. The resulting decline in dopamine leads to stiffness, tremors, poor balance, and a slow gait.

Parkinson’s can impair the autonomic nervous system. This system controls body functions that people normally don’t think about, like digestion and blood pressure. The autonomic nervous system is involved with erections, too. A man doesn’t need to “tell” his body to have an erection. Instead, he is sexually stimulated by something - a touch, a smile, an erotic voice – and an erection begins.

Researchers from Taiwan considered the role of the autonomic nervous system in both ED and Parkinson’s. They wanted to know how common Parkinson’s was in men with ED.

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Emotional Aspects of Sex Important for Midlife Women

Sep 06, 2017

Emotional Aspects of Sex Important for Midlife Women

When it comes to sex, what do midlife women value most? And how do they think sexual problems should be treated?

A team of researchers from the University of Pittsburgh and the University of Utah recently asked 39 women those questions and published their results in the Journal of Sexual Medicine.

Sexual problems are common in women, especially as they go through menopause. However, not much is known about midlife women’s priorities for their sexual relationships and treatments.

The women’s average age was 53, but they ranged in age from 45 to 59. They were given the choice to participate in individual interviews or one of three focus groups. In this way, the researchers hoped to get a full range of responses from women who preferred to talk privately and those who preferred sharing their ideas in a group.

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Some Men Regret Prostate Cancer Treatment Decisions

Aug 28, 2017

Some Men Regret Prostate Cancer Treatment Decisions

Almost 15% of long-term prostate cancer survivors regret their treatment decisions, according to new research in the Journal of Clinical Oncology.

The findings underscore the need for informative discussions between doctors and patients, the authors said.

Prostate cancer affects the prostate gland. This small organ produces the fluid that, when mixed with sperm from the testes, forms semen. There are several ways to treat prostate cancer, including surgical removal of the prostate (called a radical prostatectomy), radiation treatment, hormone therapy, and chemotherapy. Some men develop sexual and urinary problems after these methods. Erectile dysfunction (ED) is a common side effect.

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Body Image, Binge Eating, and Sexual Dysfunction in Women

Aug 22, 2017

Researchers Look at Connections Among Body Image, Binge Eating, and Sexual Dysfunction in Women

Poor body image esteem and binge-eating tendencies in women are linked to sexual distress and dysfunction, according to new research in the Journal of Sexual Medicine.

Body esteem and dissociation during sex are particularly linked, the researchers found.

It’s not uncommon for women with eating disorders to experience sexual problems, such as low desire, poor arousal, vaginismus, or trouble with orgasm.

In fact, some of the same factors that contribute to eating disorders also impact sexual function. One is body esteem. A woman may feel that she is not thin enough, undergo a strict diet, then eat excessively (binge eating). The guilt and shame she feels may prompt her to vomit or exercise vigorously.

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Rectal Cancer Survivors Can Face Sexual Challenges

Aug 15, 2017

Rectal Cancer Survivors Can Face Sexual Challenges

Survivors of rectal cancer often experience sexual problems, which can be physical, psychological, or both.

Rectal cancer affects the rectum, a part of the digestive system located between the colon and the anus. After food is processed by the colon, waste products are stored by the rectum until they are ready to exit the body through the anus.

Surgery is one way to treat rectal cancer. In some cases, the cancerous tissue is removed and the healthy parts of the rectum, colon, and anus are sewn together. This process is called anastomosis.

However, if the cancer is near the anus, surgeons may create an opening called a stoma for waste to pass through. When a person has a stoma, he or she needs to wear a special waste collection bag. This procedure is called an ostomy.

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Gaming Might Affect Sexual Desire and Ejaculation in Men

Aug 01, 2017

Gaming Might Affect Sexual Desire and Ejaculation in Men

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

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

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

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

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

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

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

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

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

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

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

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

Resources

The Journal of Sexual Medicine

Sansone, Andrea, MD, et al.

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

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

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

MedlinePlus

“Prolactin blood test”

(Review date: August 7, 2016)

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

Psychology Today

“Dopamine”

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

News

Cancer Organizations Stress Importance of Comprehensive and Affordable Healthcare

Jul 24, 2017

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

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

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

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

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

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

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

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

The complete list of organizations is as follows:

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

Resources

American Society for Clinical Oncology

Johnson, Bruce E., MD, FASCO

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

(July 14, 2017)

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

National Coalition for Cancer Survivorship

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

(News release. July 13, 2017)

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

Shots

Grayson, Gisele, Alyson Hurt, and Alison Kodjak

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

(June 22, 2017)

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

News

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

Jul 11, 2017

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

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

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

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

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

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

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

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

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

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

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

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

Resources

The Journal of Sexual Medicine

Jacobsson, Josephine, MD, et al.

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

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

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

News

How Does Obesity Affect Sexual Function?

Jun 27, 2017

How Does Obesity Affect Sexual Function?

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

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

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

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

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

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

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

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

Resources

Sexual Medicine Reviews

Rowland, David L, PhD, et al.

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

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

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

News

Benzocaine Wipes Might Help Men with Premature Ejaculation

Jun 13, 2017

Benzocaine Wipes Might Help Men with Premature Ejaculation

Men with premature ejaculation (PE) may eventually have a new treatment option: benzocaine wipes.

Research presented at the annual meeting of the American Urological Association (AUA) in May 2017 found that men using a 4% benzocaine wipe improved their intravaginal ejaculatory latency time – the amount of time between penetrating a partner and ejaculating.

PE is thought to be the most common sexual complaint for men. It occurs in an estimated one in three men between the ages of 18 and 59, according to the AUA.

Men with PE ejaculate before they wish to, usually within 2 minutes of partner penetration. They find ejaculation difficult to control and, often, feel great distress. Unfortunately, there are few effective treatment options, although some men use creams, ointments, or sprays to desensitize the penis. Others try techniques like using condoms or masturbating before intercourse. Sometimes, sex therapy can help.

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News

Yoga May Help Prostate Cancer Patients Cope with Radiation Side Effects

May 24, 2017

Yoga May Help Prostate Cancer Patients Cope with Radiation Side Effects

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources

HealthDay

Preidt, Robert

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

(April 13, 2017)

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

International Journal of Radiation Oncology, Biolog7, and Physics

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

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

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

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

Mayo Clinic

“External beam radiation for prostate cancer”

(May 18, 2016)

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

Medscape

Mulcahy, Nick

“Really, Men With Prostate Cancer Do Yoga”

(April 18, 2017)

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

Penn Medicine News

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

(News release. April 6, 2017)

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

Time.com

MacMillan, Amanda

“Yoga May Help the Side Effects of Cancer Treatment”

(April 10, 2017)

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

News

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

May 09, 2017

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources

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

“About the National Survey of Family Growth”

(Page last updated: May 13, 2016)

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

The Journal of Sexual Medicine

Nasrullah, MD, MPH, PhD, et al.

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

(Full-text. April 2017)

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

News

Americans Are Having Less Sex Nowadays

Apr 25, 2017

Americans Are Having Less Sex Nowadays

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

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

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

Other key findings include the following:

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

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

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

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

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

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

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

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

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

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

Resources

Archives of Sexual Behavior

Twenge, Jean M., et al.

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

(Published online: March 6, 2017)

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

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

“About the GSS”

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

The New York Times

Haag, Matthew

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

(March 8, 2017)

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

San Diego State University

Jacobs, Gina

“New Study Shows Americans are Having Sex Less Often”

(March 7, 2017)

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

Washington Post

Bahrampour, Tara

“Americans are having less sex than they once did”

(March 7, 2017)

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

News

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

Apr 12, 2017

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Resources

JAMA Internal Medicine

Welk, Blayne, MD, MSc, et al.

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

(Full-text. March 20, 2017)

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

Reuters Health

Seaman, Andrew M.

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

(March 21, 2017)

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

News

Past Childhood Experiences Could Influence Sexual Satisfaction in Adulthood

Mar 29, 2017

Past Childhood Experiences Could Influence Sexual Satisfaction in Adulthood

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

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

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

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

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

·         Psychological neglect – ignoring the child

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

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

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

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

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

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

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

Resources

The Journal of Sexual Medicine

Bigras, Noémie, MA, et al.

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

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

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

News

About 2 in 3 Women Would Take a Sex Health Drug

Mar 21, 2017

About 2 in 3 Women Would Take a Sex Health Drug

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

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

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

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

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

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

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

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

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

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

Resources

The Journal of Sexual Medicine

Gutsche, Melanie, MSc and Andrea Burri, PhD

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

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

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

News

After-Sex Antibiotic Could Reduce STI Rates

Mar 07, 2017

After-Sex Antibiotic Could Reduce STI Rates

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

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

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

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

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

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

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

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

Resources

BETA

Newman, Emily

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

(February 16, 2017)

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

Conference on Retroviruses and Opportunistic Infections 2017

Molina, Jean-Michel, et al.

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

(Abstract 91LB. Presented February 16, 2017)

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

Medscape Medical News

Boerner, Heather

“Antibiotics After Sex Nearly Halves Incidence of STIs”

(February 16, 2017)

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

News

FDA Approves Intrarosa for Sexual Pain in Postmenopausal Women

Feb 21, 2017

FDA Approves Intrarosa for Sexual Pain in Postmenopausal Women

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

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

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

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

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

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

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

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

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

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

Resources

Mayo Clinic

“DHEA – Background”

(Last updated: July 1, 2014)

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

MedPage Today

Walker, Molly

“FDA Approves Intrarosa for Sexual Symptoms of Menopause”

(November 17, 2016)

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

SexHealthMatters.org

“Vulvar and Vaginal Atrophy”

(June 26, 2013)

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

U.S. Food and Drug Administration

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

(News Release. November 17, 2016)

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

"Full Prescribing Information”

(Revised: November 2016)

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

News

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

Feb 07, 2017

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

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

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

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

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

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

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

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

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

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

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

Resources

University of Wisconsin-Madison

Smith, Susan Lampert

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

(December 28, 2016)

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

Urology

Le, Brian, et al.

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

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

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

News

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

Jan 24, 2017

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

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

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

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

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

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

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

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

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

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

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

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

Resources

American Cancer Society

“Radiation therapy for prostate cancer”

(Last revised: March 11, 2016)

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

Healthline.com

“Bulb of penis”

(Reviewed: March 31, 2015)

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

The Institute of Cancer Research

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

(November 28, 2016)

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

International Journal of Radiation Oncology

Murray, J., et al.

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

(Full-text. October 1, 2016)

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

Memorial Sloan Kettering Cancer Center

“Image-Guided Radiation Therapy”

(Last updated: April 21, 2016)

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

Prostate Cancer News Today

Fernandes, Joana, PhD

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

(December 5, 2016)

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

News

What Should Physical Therapists Know About Female Sexual Pain?

Jan 09, 2017

What Should Physical Therapists Know About Female Sexual Pain?

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

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

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

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

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

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

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

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

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

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

Resources

Sexual Medicine Reviews

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

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

(Published online: August 3, 2016)

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

News

Kink-oriented Individuals Address Healthcare Concerns

Dec 19, 2016

Kink-oriented Individuals Address Healthcare Concerns

Individuals who engage in kink sexual behaviors can have special healthcare needs, but they may not always see a doctor because of the stigma associated with kink sexuality, experts report.

The word kink is used to describe sexual activities outside the mainstream. These activities can include bondage, discipline, domination and submission as well as sadism and masochism. Sometimes the acronym BDSM is used to refer to these activities.

Kink sexual practices often involve power roles, with one participant taking a dominant or “top” role, while the other is in a more submissive or “bottom” position. Activities are always between consenting adults, and the specifics are usually negotiated between partners. However, some activities, such as punching or whipping, can cause injury or increase the risk of sexually-transmitted infections or blood-borne illnesses.

Seeking care for kink-related health concerns can be a challenge for those who participate. Recently, a team of healthcare providers and researchers formed the Kink Health Project to learn more about the kink community and their experience with medical care in the San Francisco Bay area.

The team conducted focus groups and interviews with 115 kink-orientated individuals between the ages of 23 and 69. The participants’ average age was 46 years. Forty-four percent of them had seen a doctor for a kink-related issue. Among those who had a primary doctor, only 38% had revealed their kink orientation to that doctor.

Bruising and open wounds were some of the more common kink-related health concerns. For example, one participant mentioned using a knife to scratch his partner, causing moderate bleeding. Others reported having multiple partners and non-traditional social structures, such as non-monogamous relationships, that healthcare providers might not understand.

Often, participants preferred to seek medical advice within the kink community rather than from a doctor. Many were afraid of being judged for their behavior. Some would lie to doctors about the source of their concerns. For example, one man told his doctor that his bruises were caused by rugby.

Fear of being investigated for abuse was a serious concern among the participants. “I know that what I’m doing is safe and consensual,” one woman explained, “but I worry if I ever went to the doctor and was covered with bruises they would not understand that they were consensual behaviors.”

However, many participants reported positive experiences with their doctors. One woman described her OB/GYN, who was open to explaining what types of kink activities would be safe during pregnancy.

The authors acknowledged that their findings may not apply to all everyone who engages in kink behaviors. “San Francisco is well known for its sexual open-mindedness, and we could have encountered different results if we had conducted the study in other parts of the United States or in other nations,” they wrote.

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

Resources

The Journal of Sexual Medicine

Waldura, Jessica F., MD, et al.

“Fifty Shades of Stigma: Exploring the Health Care Experiences of Kink-Oriented Patients”

(Full-text. First published online: October 27, 2016)

http://www.jsm.jsexmed.org/article/S1743-6095(16)30428-3/fulltext

News

Study Examines Body Esteem in Female Survivors of Childhood Sexual Abuse

Dec 06, 2016

Study Examines Body Esteem in Female Survivors of Childhood Sexual Abuse

Body esteem tends to be lower in women who have been sexually abused as children, experts say. And this lower esteem can lead to more inhibited sexual responses.

Similar to self-esteem, body esteem refers to how people feel about their body. Do they feel attractive and healthy? Or do they find fault with certain body parts? These are common questions, but for women with a history of childhood sexual abuse, body esteem is particularly important. Studies have shown that women in this category feel less attractive than women without a history of abuse.

A new study, recently published in the Journal of Sexual Medicine, examined how body esteem influenced feelings about sex in women with and without a history of childhood sexual abuse.

Two hundred twenty-two women participated in the study. One hundred thirty-nine of them had a history of childhood sexual abuse, defined as any unwanted sexual contact before the age of 18. The remaining 83 women had not experienced sexual abuse as children. The women ranged in age from 18 to 64; their average age was 34 years.

The participants completed several questionnaires concerning their experiences with childhood sexual abuse, depression, body esteem, and feelings about sex.

When compared to the women who had not been abused, those with an abuse history were more likely to feel depressed and have significantly lower body esteem, especially in terms of sexual attractiveness. They also tended to feel more inhibited about sex.

It’s possible that the abused women had lower body esteem because they associated specific body parts with the abuse, the authors noted.

They added that women who have experienced sexual abuse often feel anxious and fearful in sexual situations, which might prompt them to “avoid the threat.”

The authors acknowledged some limitations in their research. For example, they did not assess to what degree a woman’s religious beliefs affected her attitudes toward sex. They also did not know if women received counseling for childhood sexual abuse before the study.

Comparing these results to those of women who had been abused (but not sexually) during childhood might provide further insights, they said.

The authors also suggested that healthcare providers who work with adult survivors of childhood sexual abuse consider building positive body esteem into their treatment plans.

Resources

The Journal of Sexual Medicine

Kilimnik, Chelsea D., MSc and Cindy M. Meston, PhD

“Role of Body Esteem in the Sexual Excitation and Inhibition Responses of Women With and Without a History of Childhood Sexual Abuse”

(Full-text. First published online: September 27, 2016)

http://www.jsm.jsexmed.org/article/S1743-6095(16)30406-4/fulltext

News

Survey Addresses Patients’ Views on Sexual Health

Nov 22, 2016

Survey Addresses Patients’ Views on Sexual Health

How important is sexual health and satisfaction to a person’s quality of life? The answer depends on age, gender, sexual activity status, and overall health, according to a new study in the Journal of Sexual Medicine.

Sexual dysfunction - such as erectile dysfunction (ED) in men and painful intercourse for women – are common, especially for people with medical conditions like diabetes, heart disease, cancer, high blood pressure, depression, and anxiety. But sexual problems aren’t always discussed during doctor’s appointments. Some assume that doctors or patients will bring up the subject if it’s really important.

The importance of sex to one’s overall well-being hasn’t been widely studied by medical researchers. A group of American scientists decided to learn more.

They asked 3,515 people to complete an online questionnaire. The group was almost equally split between men and women, and their average age was 49.

Importance of Sexual Health

Among the entire group, about 43% of the women and 62% of the men said that sexual health was important to their quality of life. Participants who were in better overall health tended to rate sexual health as important, too.

Respondents who were not sexually active were less likely to consider sexual health to be highly important.

The researchers also examined how specific health conditions (arthritis, rheumatism, cancer, heart disease, depression, anxiety, diabetes, and high blood pressure) affected the respondents’ views. However, none of these conditions influenced the ratings.

Sexual Satisfaction

What factors contributed to satisfaction with one’s sex life? To find out, the authors analyzed information from the 55% of the men and 45% of the women who said they’d been sexually active within the last month. Findings were based on scores on one portion of the questionnaire designed to evaluate sex life satisfaction.

They found that people in their mid-to-late thirties were the most satisfied with their sex life. After age 70, satisfaction rates decreased. Health status was also an important factor, as people who rated their overall health as excellent were more satisfied than those who said they were in fair or poor health.

Certain health conditions did influence satisfaction with one’s sex life. High blood pressure was the biggest factor for women. For men, depression and anxiety had the greatest impact on satisfaction.

The authors pointed out that physical health isn’t the only factor that determines satisfaction with one’s sex life. Beliefs on what makes a satisfying sex life are quite personal, they noted.

Race was a factor only for men. Latino and Hispanic men were more likely to say sexual health was highly important, and black men had better scores on the sex life satisfaction assessment.

The survey results can be useful for healthcare providers, the authors explained, recommending that practices have “resources in place” to address patients’ sexual health issues.

“These resources should be available for all patients across the lifespan,” they added.   

Resources

The Journal of Sexual Medicine

Kathryn E. Flynn, PhD, et al.

“Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults”

(Full-text. Published online: September 23, 2016)

http://www.jsm.jsexmed.org/article/S1743-6095(16)30376-9/abstract

News

Can Disclosing a Sexual Assault Help a Woman’s Sexual Functioning?

Nov 08, 2016

Can Disclosing a Sexual Assault Help a Woman’s Sexual Functioning?

It’s not uncommon for women to have sexual problems after a sexual assault. However, new research suggests disclosing the assault to someone might alleviate those problems to some extent.

Experts estimate that between 13% and 45% of women will be the victim of an adult sexual assault (ASA) at some point in their lives. ASA is defined as “any unwanted or non-consensual sexual experience” occurring after age 14.

But not all women tell others about their assault. Some worry that others won’t believe them or that they’ll be blamed for what happened.

Some women find that their sexual interest wanes after ASA. They might have trouble becoming aroused or reaching orgasm. Or sex might be painful. These issues might last for years.

Researchers from the University of Washington in Seattle wanted to know more about how disclosing an assault might affect a woman’s sexual health later on. They recruited 652 women between the ages of 21 and 30 to participate in an online survey. About three-quarters of the women had experienced a sexual assault. Of these, 83% had disclosed the assault to someone.

The scientists found that disclosing the assault could indirectly help with sexual function by lessening the impact of trauma symptoms. It’s possible that exposure to positive sexual experiences could create a “corrective learning experience” for the women, in which they can focus on the positive aspects of sex.

More research is still needed, the authors added. Future studies might focus on ASA victims’ feelings about non-penetrative sexual activities, such as oral sex. They might examine whether the time frame between assault and disclosure plays a role or how the reactions to the disclosures might ultimately affect the women.

Resources

The Journal of Sexual Medicine

Staples, Jennifer M., MS, et al.

“Sexual Assault Disclosure and Sexual Functioning: The Role of Trauma Symptomatology”

(Full-text. Published online: August 30, 2016)

http://www.jsm.jsexmed.org/article/S1743-6095(16)30363-0/abstract

News

FDA Announces New Testosterone Labeling Rules

Nov 01, 2016

FDA Announces New Testosterone Labeling Rules

Labels on all testosterone products must now include information about the risk of abuse, according to a ruling issued by the U.S. Food and Drug Administration (FDA) last week.

The agency explained that the labeling change stems from published literature and case reports on the abuse of testosterone and other anabolic androgenic steroids.

Produced by the testes, testosterone is an important hormone for men. It creates and maintains many of their masculine characteristics, including facial hair, muscle mass, and a deep voice. It is also involved with sex drive and erections.

Doctors may prescribe testosterone when men’s bodies don’t produce enough of it on their own. For example, certain genetic conditions, chemotherapy, infection, and injury to the testes can all affect a man’s testosterone production. Currently, the FDA approves the use of testosterone for men in these situations.

However, testosterone levels naturally decline as men get older. As a result, men may feel weak, fatigued, and irritable. They may also lose interest in sex and have problems getting erections. Sometimes, doctors prescribe testosterone to treat these symptoms.

Some men abuse testosterone, taking more than the recommended dose and/or taking it with other anabolic androgenic steroids. Some athletes and bodybuilders take testosterone or other drugs to enhance their performance.

The FDA reports that testosterone abuse can damage the heart, brain, liver, and the endocrine system. It may also affect a man’s mental health.

“Reported serious adverse outcomes include heart attack, heart failure, stroke, depression, hostility, aggression, liver toxicity, and male infertility,” the FDA said in a press statement, adding that men undergoing withdrawal from testosterone may have symptoms such as “depression, fatigue, irritability, loss of appetite, decreased libido, and insomnia.”

The FDA also advised healthcare providers to measure a man’s testosterone if they suspect he is abusing the hormone.

Resources

LiveScience.com

Rettner, Rachel

“Prescription Testosterone Gets New Warning”

(October 25, 2016)

http://www.livescience.com/56640-prescription-testosterone-warning.html

 

MD Magazine

Black, Ryan

“FDA Announces Stern New Warning Labels for Testosterone Treatments”

(October 25, 2016)

http://www.hcplive.com/medical-news/fda-announces-stern-new-warning-label-requirements-for-testosterone-treatments

 

Medscape

Brooks, Megan

“FDA Adds New Warnings to All Testosterone Product Labels”

(October 25, 2016)

http://www.medscape.com/viewarticle/870932

 

Reuters

Clarke, Toni

“U.S. FDA adds abuse warning to prescription testosterone”

(October 25, 2016)

http://www.reuters.com/article/health-testosterone-fda-idUSL1N1CV1MA

 

U.S. Food and Drug Administration

“FDA approves new changes to testosterone labeling regarding the risks associated with abuse and dependence of testosterone and other anabolic androgenic steroids (AAS)”

(Press statement. October 25, 2016)

http://www.fda.gov/Drugs/DrugSafety/ucm526206.htm

News

Women’s Sexuality Affected by Body Image and Relationship Quality, Study Says

Oct 18, 2016

Women’s Sexuality Affected by Body Image and Relationship Quality, Study Says

A woman’s acceptance of her body and the quality of her relationship with her sex partner may influence her overall sexual function, according to a new study.

Researchers from Germany noted that good sexual health involves a person’s “emotional, mental, and social well-being” and is so much more than simply physical function. To learn more, they designed a study to examine the roles of body image and partnership quality.

The participants were 2,685 women age 35 or under who were medical students in Germany, Austria, and Switzerland. Their average age was 24 years. Each woman completed an anonymous online questionnaire and answered questions about their age, weight, relationship status, partnership quality, physical health, smoking status, alcohol use, history of pregnancy, and use of birth control pills.

The assessment included the Female Sexual Function Index (FSFI), a tool that is often used in medical research on female sexuality. The FSFI includes questions on a woman’s experiences with desire, arousal, vaginal lubrication, sexual satisfaction, pain, and orgasm during the previous four weeks. Lower scores on the FSFI correspond with poorer sexual function.

Also included was a questionnaire called the Self-Acceptance of the Body Scale, designed to help researchers learn about a person’s feelings about his or her own body. The woman were asked to rate their agreement with certain statements, such as “I would like to change certain parts of my body” and “I am satisfied with my appearance.”

The women categorized their relationship status using one of four terms: enamoredness, love, friendship, or conflicted.

Ninety-two percent of the women had been sexually active within the previous four weeks and almost three-quarters of them had been in a steady relationship during the previous six months. Based on FSFI scores, about 39% could be considered to have a sexual dysfunction. However, some experts feel that FSFI scores are not useful for women who are not sexually active. With this in mind, the researchers based their analysis only on sexually active women.

In this group, women who were in a steady partnership and had greater body self-acceptance tended to have higher FSFI scores. Those who called their relationship “enamored” or “loving” had the highest FSFI scores of all.

Single women and those who classified their sexual relationships as “friendship” or “conflicted” had lower FSFI scores.

While a cause and effect relationship could not be determined from the data, the researchers suggested that good relationships and positive body self-acceptance could act as “buffers” in certain situations. For example, single women and those in conflicted relationships might have better sexual function if they have a high degree of body self-acceptance. And having a good, steady relationship might contribute to better sexual function in women with low body self-acceptance.

Helping young women develop a positive body image might ultimately improve their sexual health, the authors wrote.

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

Resources

The Journal of Sexual Medicine

Wallwiener, Stephanie, MD, et al.

“Sexual Function Is Correlated With Body Image and Partnership Quality in Female University Students”

(Full-text. Published online: August 26, 2016)

http://www.jsm.jsexmed.org/article/S1743-6095(16)30362-9/abstract

News

Glaucoma and Erectile Dysfunction (ED) May Be Linked

Oct 04, 2016

Glaucoma and Erectile Dysfunction (ED) May Be Linked

Researchers from the University of British Columbia in Canada have found a link between glaucoma and erectile dysfunction (ED) – the inability to get and keep an erection firm enough for intercourse.

The study, published recently in the Journal of Glaucoma, found that men with glaucoma are over two and a half times more likely to have ED than men without the eye disease.

Glaucoma is the result of damage to the optic nerve, which is connected to the retina. When a person sees an image, the retina sends a message to the brain. The brain uses this information to interpret what is being seen. Glaucoma is often caused by excess fluid at the front of the eye, which increases pressure. But it can also be caused by inflammation and eye injury.

The scientists collected data from 128 men over age 40 who were patients at an ophthalmology clinic. Sixty-one men had open-angle glaucoma, the most common type. The remaining 67 patients did not have glaucoma.

Each man completed a questionnaire called the Index of Erectile Dysfunction (IIEF), which is commonly by scientists to assess sexual function.

Based on IIEF scores, the researchers determined that 40% of the men with glaucoma had ED. Severity of both conditions was correlated – the more severe the glaucoma, the more severe the ED.

The researchers also considered other factors that can contribute to ED, such as diabetes, high blood pressure, high lipid levels, and smoking, but the association between glaucoma and ED remained.

The findings do not mean that glaucoma causes ED or vice versa. It simply means that there is an association.

It was not clear why the two conditions were related, but the scientists thought that inflammation in the blood vessels could be involved. Problems with blood flow can cause problems with the eyes and with erections.

Resources

American Academy of Ophthalmology

Boyd, Kierstan

“Causes of Glaucoma”

(December 29, 2015)

http://www.aao.org/eye-health/diseases/what-is-glaucoma

 

Boyd, Kierstan

“What Is Glaucoma?”

(January 10, 2015)

http://www.aao.org/eye-health/diseases/what-is-glaucoma

 

Journal of Glaucoma

Law, Geoffrey BScH, et al.

“Correlation in Severity Between Glaucoma and Erectile Dysfunction”

(Abstract. September 2016)

http://journals.lww.com/glaucomajournal/Abstract/2016/09000/Correlation_in_Severity_Between_Glaucoma_and.2.aspx

 

National Post

Blackwell, Tom

“Glaucoma and impotence unexpectedly linked in new study from UBC”

(August 29, 2016)

http://news.nationalpost.com/health/glaucoma-and-impotence-unexpectedly-linked-in-new-study-from-ubc?__lsa=a587-62c0

News

Does a Man’s Sexual Interest Affect His Partner’s Sexual Function?

Sep 21, 2016

Does a Man’s Sexual Interest Affect His Partner’s Sexual Function?

How might a man’s sexual issue affect the sexuality of his female partner? It’s a complicated question, but a new study by Italian scientists suggests that the way women perceive their partner’s sexual interest could be a factor.

Past research has focused on sexual problems like erectile dysfunction (ED), premature ejaculation (PE), and delayed ejaculation (DE) and their effects on women’s sexual health. However, for many of these studies, the focus was on diagnosing and treating a man’s sexual problem.

In this study, the researchers wanted to know more about how a man’s sexual factors – considered from a woman’s point of view – might influence female sexual function.

The study involved 156 heterosexual women who had been in a stable relationship during the previous six months. On average, the women were around 47 years old; their partners’ average age was 50. Eighty-three percent of the couples were living together.

Each woman completed a questionnaire called the Female Sexual Function Index (FSFI). This is one of the most common tools used to assess female sexual problems, covering the domains of sexual desire, arousal, vaginal lubrication, orgasm, pain, and overall sexual satisfaction. Higher scores on the FSFI mean better sexual function.

The women also had physical exams and answered questions about their psychological well-being, sexual desire, lifestyles, medications, and relationships with their partners.

About 37% of the women had a partner with a sexual problem. About a third felt their partner had lost his desire for them. Almost a quarter of the partners had ED, 14% had PE, and 8% had delayed ejaculation.

After analyzing the data, the researchers discovered that FSFI scores tended to go down when the couple had disagreements and did not live together. Scores also went down when women had intercourse just to please their partner.

In contrast, FSFI scores generally increased when women had intercourse more often or when they were trying to conceive a child.

Women who perceived low desire in their partner had lower FSFI scores overall as well as in the arousal, lubrication, orgasm, satisfaction, and pain domains. However, no correlation was found between FSFI scores and a partner’s problems with erectile dysfunction, premature ejaculation, or delayed ejaculation.

In addition, women who felt their partner had less sexual interest tended to masturbate more often, have intercourse less often, and feel that the man did not care about the woman’s sexual pleasure.

“It can be speculated that erectile function and ejaculatory behavior are not the most pressing concerns in the perspective of women with [female sexual dysfunction],” wrote the study authors. “Conversely, among factors related to their partner’s sexuality, feeling unloved and/or undesired is the main determinant of sexual impairment.”

The study was published online in July in the journal Andrology.

Resources

Andrology

Maseroli, E., et al.

“Which are the male factors associated with female sexual dysfunction (FSD)?”

(Full-text. First published: July 13, 2016)

http://onlinelibrary.wiley.com/doi/10.1111/andr.12224/full

News

Dapoxetine is Safe and Effective for Premature Ejaculation, Study Says

Sep 08, 2016

Dapoxetine is Safe and Effective for Premature Ejaculation

A drug called dapoxetine is a safe, effective method for treating premature ejaculation (PE), according to a team of Turkish researchers.

However, acupuncture could be a viable treatment, too, they noted.

Their study, published online in April in Urologica Internationalis, compared two dose levels of dapoxetine to acupuncture.

PE is one of the most common sexual problems for men. In general terms, it occurs when a man ejaculates before he and his partner wish it to happen. The International Society for Sexual Medicine (ISSM) defines two types of PE. Men with lifelong PE ejaculate within a minute of vaginal penetration and have done so since their first sexual experience. Those with acquired PE typically ejaculate within three minutes of penetration, but have not had the condition all their lives.

The ISSM definition also notes that men with PE are not able to delay the timing of ejaculation and feel distress over their situation.

There are several approaches for treating PE, including medication, sex therapy, and topical treatments that can be applied directly on the penis.

Acupuncture has been practiced in Chinese medicine for over 2,500 years. It involves restoring the balance of energy in the body through the manipulation of tiny needles placed in the skin in certain strategic areas called acupoints. This approach has not been widely studied for treatment of PE.

To learn more, the researchers worked with 120 men with lifelong PE. On average, the participants were in their thirties and had been married for four to five years.

One of the ways experts assess premature ejaculation is by calculating the intravaginal ejaculatory latency time (IELT). Couples measure IELT themselves, using a stopwatch during intercourse.

For this study, men and their partners measured IELT before the study began and again a month later. At these times, the men also completed questionnaires designed to evaluate their ejaculatory function.

The men were randomly assigned to one of four treatment groups. One group took 60 mg of dapoxetine on demand (one to three hours before having sex); another took 30 mg of the drug. A third group had twice-weekly acupuncture sessions. The fourth received “sham” acupuncture, during which a specialist used needles, but did not penetrate the skin. The treatment period lasted for four weeks.

Men who took 60 mg of dapoxetine saw the biggest improvements, with longer IELTs and improved scores on the PE questionnaire. Men who took 30 mg of the drug had the next-best improvements, followed by the men in the acupuncture group and those in the sham group.

Common side effects with dapoxetine included nausea, dizziness, diarrhea, insomnia, and headache.

However, the men who received acupuncture or sham treatment reported no side effects.

The absence of side effects could make acupuncture a “plausible” PE treatment, even if it wasn’t as effective as dapoxetine. But more research is needed, the authors said.

“To the best of our knowledge, this is the first report to compare acupuncture and dapoxetine in the treatment of PE and we think that our results will bring a new perspective to treatment decisions,” they wrote.

It should be noted that dapoxetine is not available in the United States, nor has it been approved for use in that country.  

Resources

Urologica Internationalis

Sahin S., et al.

“A Prospective Randomized Controlled Study to Compare Acupuncture and Dapoxetine for the Treatment of Premature Ejaculation”

(Full-text. First published online: April 7, 2016)

http://www.karger.com/Article/Abstract/445253

News

Men with Penile Implants Seem Satisfied With Treatment

Aug 16, 2016

Men with Penile Implants Seem Satisfied With Treatment

Men who receive penile implants for erectile dysfunction (ED) appear to be more satisfied with their treatment compared to those who try other therapies, according to a new study published in Andrology.

Men with ED – the inability to get and keep an erection firm enough for intercourse – have a variety of treatment options available to them. This study, conducted by researchers in Turkey, compared the effectiveness of and satisfaction with three types:

·         Oral medication. Drugs called phosphodiesterase type 5 (PDE5) inhibitors are usually the first treatment urologists try with their ED patients. These medications relax smooth muscle tissue in the penis and allow more blood to flow in when a man is sexually stimulated. In this study, the drug tadalafil was used.

·         Self-injection.Sometimes, oral medications either don’t work or aren’t feasible. (For example, men who take nitrates for heart disease should not take PDE5 inhibitors.) In those cases, patients might try self-injection therapy. Men inject medication into the base of their penis shortly before they’d like to have sex. The drug then triggers an erection.

·         Penile implants (prostheses).  If the above methods don’t work out, men may decide to have a penile prosthesis implanted. The penis contains two areas of spongy tissue called the corpora cavernosa, which fill with blood and give the penis the firmness it needs for an erection. In an inflatable implant procedure, these two areas are replaced with two cylinders that can fill with a reserve of saline solution when a man presses on a special pump. (Less often, malleable rods are implanted, allowing the man to raise and lower his penis by hand as needed.)

The researchers collected data from 356 men with an average age of 52 years. All of the men had ED.

The participants were divided into four groups and followed these treatment protocols for the next twelve weeks:

·         132 men (37%) took 20 mg of tadalafil twice a week.

·         106 men (30%) took 5 mg of tadalafil once a day.

·         96 men (27%) underwent injection therapy.

·         22 men (6%) underwent implant surgery (inflatable prostheses).

The men completed questionnaires that assessed their erectile function and treatment satisfaction. The satisfaction of the men’s partners was also evaluated.

Overall, the men who had penile implants had more improvement in erectile function than the men who took tadalafil (both groups) and those who used injection therapy.

In addition, the men in the implant group – and their partners – appeared to be more satisfied with their treatment than those in the other groups.

The authors reported that in general, satisfaction rates for penile implants are above 90% for both men and their partners.

However, they added that more research is needed to confirm the results of this study.

Resources

Andrology

Kucuk, E. V., et al.

“Erectile dysfunction patients are more satisfied with penile prosthesis implantation compared with tadalafil and intracavernosal injection treatments”

(Full-text. First published: July 1, 2016)

http://onlinelibrary.wiley.com/doi/10.1111/andr.12237/full

News

Older Men May Benefit from Testosterone Treatment

Aug 03, 2016

Older Men May Benefit from Testosterone Treatment

Older men with low testosterone could see improvements in sexual symptoms with testosterone therapy, according to the results of a recent trial.

Men’s testosterone levels gradually decline as they get older. It’s a natural part of aging. But for many men, this hormonal drop leads to fatigue, weakness, and decreased muscle mass. Men might feel moody or depressed.

Their sex lives may also be affected. Men with low testosterone can have low libido and erectile dysfunction (ED).

The trial involved 470 men aged 65 or older who lived in the United States. The participants’ average age was around 71 years old. All of them were experiencing low sex drive and had low testosterone, defined as measurements below 275 ng/dL. In addition, all of the men had regular sexual partners. About 60% of the men were obese and about a third had diabetes. Over 70% of them had high blood pressure.

For the next year, roughly half the group applied a daily dose of testosterone gel to their skin. This dose was adjusted as necessary to keep testosterone levels within the range considered normal for younger men. The other half also received a gel, but it was a placebo and did not contain testosterone. None of the men knew whether they were receiving testosterone or not.

The men’s testosterone levels were checked regularly. They also filled out questionnaires to assess their sexual activities and function.

The researchers found that the men in the testosterone group had more sexual interest, more frequent intercourse, and better erectile function than the men in the placebo group.

These improvements continued through the twelve-month treatment period. Improved desire and more frequent sexual activity seemed to be linked to the degree of testosterone increase.

Still, the researchers did not find a specific threshold measurement for these improvements. In other words, they did not see that a man’s sexual interest and activity got better once his testosterone levels reached a certain measurement point.

The study was first published online in June in the Journal of Clinical Endocrinology & Metabolism.

Resources

The Journal of Clinical Endocrinology & Metabolism

Cunningham, Glenn R., et al.

“Testosterone Treatment and Sexual Function in Older Men with Low Testosterone Levels”

(Full-text. First published online: June 29, 2016)

http://press.endocrine.org/doi/pdf/10.1210/jc.2016-1645

News

No Connection Found Between Testosterone Therapy and Risk of Aggressive Prostate Cancer

Jul 19, 2016

https://www.sexhealthmatters.org/images/uploads/07-20-16_NEWS_Prostate_Cancer_Medical_Note_508544108.jpg TRT is a popular approach to treating low levels of testosterone, an important hormone for men. When a man has low testosterone, he may feel tired, weak, and depressed. He may lose interest in sex or develop erection problems.

Sometimes, men have low testosterone because of medical conditions that interfere with its production. But men can also develop low testosterone as a result of normal aging.

That’s because men’s testosterone levels naturally decline as they get older. The goal of testosterone therapy, which can be administered through gels, patches, and injections, is to bring a man’s testosterone levels back to a normal range.

Some experts have been concerned about TRT and prostate cancer risk, as testosterone can fuel the growth of prostate cancer cells.

To learn more, a group of American and Canadian researchers examined data from two Swedish databases related to prostate cancer and prescriptions, including testosterone.

They identified 38,570 cases of prostate cancer diagnosed between 2009 and 2012. They also looked at data from 192,838 men without prostate cancer.

Prescriptions for TRT were filled by 284 men with prostate cancer before their cancer diagnosis. TRT prescriptions were filled by 1,378 men who did not have prostate cancer.

The scientists found no connection between TRT and prostate cancer risk. They did discover that “favorable risk” prostate cancer (disease that is not aggressive and does not necessarily need immediate treatment) was more common among men who had had TRT. But these men may have gone to the doctor more often and had early biopsies, which could have increased the odds of finding cancer earlier.

Results related to aggressive prostate cancer were different, however. Men who had taken testosterone for a year or longer had their risk of aggressive disease cut in half. The researchers did not expect this finding and noted that more study is needed.

“Overall, our study suggests that what is best for men’s health is to keep testosterone levels balanced and within a normal range,” said lead investigator Stacy Loeb, MD, MSc of the NYU Langone Medical Center in a press release.

The findings were presented in May at the American Urological Association’s annual meeting in San Diego, California,

Resources

AUA 2016

Loeb, Stacy, MD, MSc, et al.

“Testosterone Therapy and Prostate Cancer Risk”

(Abstract presented at the annual meeting of the American Urological Association, May 9, 2016, San Diego, California)

http://www.aua2016.org/abstracts/files/presenter_LoebStacy-NewYork-NY.cfm

NYU Langone Medical Center

“Testosterone Therapy Does Not Raise Risk of Aggressive Prostate Cancer, Study Suggests”

(Press release. May 9, 2016)

http://nyulangone.org/press-releases/testosterone-therapy-does-not-raise-risk-of-aggressive-prostate-cancer-study-suggests

News

Men with ED More Likely to Have Hip Fractures, Study Reports

Jul 04, 2016

Men with ED More Likely to Have Hip Fractures, Study Reports

Men with erectile dysfunction (ED) have greater chances of getting a hip fracture than men with normal erections, according to new research out of Taiwan.

It might seem like ED and hip fracture wouldn’t have much in common. But the connection might start with coronary heart disease, which occurs when fat deposits called plaques build up on artery walls, restricting blood flow. Both ED and hip fractures are more common in people with coronary heart disease.

Using information from Taiwan’s National Health Insurance Database, scientists analyzed the medical claims records of over 23,000 men. They identified 4,636 men who were diagnosed with ED between 1996 and 2010. They also chose 18,544 men around the same age to serve as a comparison group. All of the men were age 40 and older; their average age was 58 years.

They discovered that 1.27% of the men with ED later had a hip fracture, compared to 0.75% of the men without ED. And overall, the men with ED were over three times more likely to develop a hip fracture. This likelihood increased with age.

Other medical conditions, like high cholesterol, diabetes, and osteoporosis were more common in the men with ED. About two-thirds of these men had high blood pressure. Rates of testosterone use were also higher in the ED group.

Men with ED tended to develop hip fractures in a shorter amount of time, too. Five years was the average; for men without ED, the average was almost eleven years.

Why did men with ED have a greater risk for hip fracture? The researchers weren’t entirely sure, but suggested that imbalance of hormones, such as testosterone, might be one explanation. Men with low testosterone often develop muscle weakness, which can make them more prone to falling.

Other possible explanations could involve osteoporosis, depression, vitamin D deficiency, and heart disease, the authors noted. But further research is needed.

The authors recommended that men with ED have their bone mineral density checked and be careful about falling, especially if they are over 40 years old.

The study was published online in April in PLOS One.

Resources

American Heart Association

“Coronary Artery Disease - Coronary Heart Disease”

(Updated: May 20, 2016)

http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Coronary-Artery-Disease---Coronary-Heart-Disease_UCM_436416_Article.jsp#.V3Qi_bgrIdU

PLOS One

Wu, Chieh-Hsin, at al.

“Hip Fracture in People with Erectile Dysfunction: A Nationwide Population-Based Cohort Study”

(April 14, 2016)

http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0153467

Renal and Urology News

Persaud, Natasha, et al.

“ED Patients at Higher Risk of Hip Fracture”

(April 26, 2016)

http://www.renalandurologynews.com/erectile-dysfunction-ed/ed-patients-at-higher-risk-of-hip-fracture/article/492176/

News

New Research on Adult-Onset Hypogonadism Provides “Conceptual Framework” for Healthcare Providers

Jun 21, 2016

A new literature review published today in Mayo Clinic Proceedings provides some insight into adult-onset hypogonadism (AOH), a condition in which middle-aged and older men have low levels of testosterone.

The research project is the result of a colloquium held in Washington DC last summer by the Sexual Medicine Society of North America (SMSNA). At that meeting, seventeen experts in the fields of men’s health, sexual medicine, urology, endocrinology, and methodology discussed the diagnosis and management of AOH as well as the reasons a physician might consider testosterone therapy for men with AOH.

The goal of the resulting study was to “support health care professionals in the development of a deeper understanding of AOH, particularly in how it differs from classical primary and secondary hypogonadism, and to provide a conceptual framework to guide its diagnosis, treatment, and follow-up.”

Primary hypogonadism occurs when a man’s testes do not function properly and, therefore, cannot produce adequate amounts of testosterone. Secondary hypogonadism is caused by problems in areas of the brain responsible for testosterone production.

A man’s testosterone levels naturally decline as he ages. But declines in testosterone are also associated with other conditions that are common in older men, like metabolic syndrome, diabetes, hypertension, and obesity.

Testosterone levels can also be affected by certain drugs, like anabolic steroids, opioids, tricyclic antidepressants, nicotine, and marijuana.

Men with low testosterone often experience sexual dysfunction, including low libido, erectile dysfunction, or delayed ejaculation. They may also feel fatigued, weak, and depressed.

Treatment of low testosterone sometimes includes lifestyle changes (like losing weight) and managing the comorbidities that could be contributing factors (such as keeping blood sugar under control).

Testosterone replacement therapy is currently approved by the U.S. Food and Drug Administration (FDA) for primary and secondary hypogonadism, but not adult-onset hypogonadism. In 2015, the FDA called for labeling changes on FDA-approved testosterone products as well as further research, as concerns had been raised about the therapy and cardiovascular risk.

In the study, the authors discuss research on the safety of testosterone therapy, noting that low testosterone is associated with an increased risk for heart disease.

They added that testosterone treatment does not increase a man’s risk for prostate cancer. Also, there is no evidence showing that testosterone therapy worsens an enlarged prostate or related urinary symptoms.

“Clinical evidence supports the authenticity of [adult-onset hypogonadism] and its health relevance,” the authors wrote in their conclusion.

“Importantly, improved clinical management can be expected to result from ongoing rigorous investigation of diagnostic criteria and demonstration of efficacy and safety of treatments for this syndrome,” they said.

Patients concerned about low testosterone are encouraged to see their healthcare provider for a complete check-up.

Resources

Mayo Clinic Proceedings

Khera, Mohit, MD, MBA, MPH, et al. “Adult-Onset Hypogonadism”

(Full-text. June 21, 2016) 

http://www.mayoclinicproceedings.org/article/S0025-6196(16)30143-4/fulltext

News

Surgeons Perform First Penis Transplant in the U.S.

Jun 07, 2016

Surgeons Perform First Penis Transplant in the U.S.

The operation took about 15 hours and involved over a dozen surgical specialists. But in the end, a medical team from Massachusetts General Hospital in Boston performed the first penis transplant in the United States.

The patient, 64-year-old Thomas Manning, was recovering well when the announcement was made on May 16th. His body was not rejecting the new penis, there were no signs of infection, and blood was flowing properly.

Mr. Manning had had his penis amputated because of penile cancer, which was discovered after a work accident in 2012. Left with a short stump, he had to sit down to urinate and could not perform sexually at all.

His doctors say they are “cautiously optimistic” that he will recover his sexual function eventually. However, his urinary function is expected to return to normal and the penis should look like his natural genitals.

The transplanted penis came from a deceased donor who had the same blood type and skin tone as Mr. Manning.

As a transplant recipient, Mr. Manning will need to take immunosuppression drugs for the rest of his life. These medications ensure that his body does not reject the new penis.

Surgeons Curtis L. Cetrulo, Jr., MD and Dicken S.C. Ko, MD had been studying the feasibility of a penis transplant for over three years, with assistance from urologists, nurses, social workers, psychiatrists, and other professionals at the hospital.

After completing a successful hand transplant, the team began preparing for a penis transplant. They studied the intricate connection of tissues, blood vessels, and nerves, practicing their technique on cadavers.

Genital injuries can be devastating for men, both physically and psychologically. Damage to their “manhood” can make them feel less complete.

“We are hopeful that these reconstructive techniques will allow us to alleviate the suffering and despair of those who have experienced devastating genitourinary injuries and are often so despondent they consider taking their own lives,” said Dr. Cetrulo in a press release.

In his own statement, Mr. Manning said, “Today, I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries, particularly for our service members who put their lives on the line and suffer serious damage as a result.”

He added, “In sharing this success with all of you, it’s my hope we can usher in a bright future for this type of transplantation. Thank you.”

Two other penis transplants have been performed worldwide, but only one has been successful. That patient, a 21-year-old man from South Africa, was able to impregnate his girlfriend just months after surgery.

Resources

CNN

Goldschmidt, Debra and Nadia Kounang

“Doctors perform first U.S. penis transplant”

(May 16, 2016)

http://www.cnn.com/2016/05/16/health/first-u-s-penis-transplant/

Massachusetts General Hospital

“First Genitourinary Vascularized Composite Allograft (Penile) Transplant in the Nation Performed at Massachusetts General Hospital”

(Press release. May 16, 2016)

http://www.massgeneral.org/News/pressrelease.aspx?id=1937

“MGH Genito-Urinary Vascularized Composite Allograft (Penile) Transplant FAQs”

http://www.massgeneral.org/News/assets/pdf/penile-transplant-faq-051616.pdf

“Patient Statement”

http://www.massgeneral.org/News/assets/pdf/penile-transplant-patient-statement-051616.pdf

The New York Times

Grady, Denise

“Man Receives First Penis Transplant in the United States”

(May 16, 2016)

http://www.nytimes.com/2016/05/17/health/thomas-manning-first-penis-transplant-in-us.html

News

Anatomy Could Be a Key to Orgasm

May 31, 2016

Anatomy Could Be a Key to OrgasmFor many people, reaching orgasm is one of the goals of a sexual experience. But not everyone gets there, even with the “right” amount of stimulation and excitement. Many factors can be involved, including relationship stress, depression, and side effects of medications. However, a recent study published in Clinical Anatomy suggests that a person’s physical makeup plays a role, too.

Researchers from the Mayo Clinic and the Indiana University School of Medicine reviewed medical studies to see just how anatomy affected orgasms.

In a press release, lead author Dr. Elizabeth Emhardt posed the research question: “Sexual experiences are assumed to be in your control based on your attitude: your confidence, your ability to trust, your openness. What if variations in sexual anatomy actually set the foundation for differences in sexual experience, and we aren't in control of our sexual experiences as much as we once thought?”

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Might your anatomy be one key to a satisfying orgasm? (Click to tweet)

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The scientists found that for men to achieve orgasm, two types of nervous systems need to be in balance. One is the parasympathetic nervous system (sometimes called the “rest and digest” system), which controls the body’s functions while at rest. The other is the sympathetic nervous system, from which the “fight or flight” response originates. When these two systems are not aligned, men can experience sexual problems, sure as premature ejaculation.

For women, orgasms seem to depend more on physical structures. Many women reach orgasm with stimulation of the clitoris, a small genital organ full of sensitive nerves. The clitoris moves closer to the vaginal wall during sex. But if it doesn’t get close enough, the likelihood of orgasm is reduced.  

Similarly, the size of the clitoris can be important too. Research published in 2014 found that women with a smaller clitoris had more trouble reaching orgasm.

Ultimately, people are individuals with a number of anatomical variations. And orgasms are complex. Couples may need to experiment with different sexual positions and activities to discover what works best for them. Understanding each other’s anatomy may be one place to start.

Resources

AlphaGalileo.org

“Do Differences in Anatomy Matter for Achieving Orgasm?”

(Press release. April 5, 2016)

http://www.alphagalileo.org/ViewItem.aspx?ItemId=162820&CultureCode=en

Clinical Anatomy

Emhardt, E., et al.

“Anatomic variation and orgasm: Could variations in anatomy explain differences in orgasmic success?”

(Full-text. April 4, 2016)

http://onlinelibrary.wiley.com/doi/10.1002/ca.22703/full

Diffen.com

“Parasympathetic vs. Sympathetic Nervous System”

http://www.diffen.com/difference/Parasympathetic_nervous_system_vs_Sympathetic_nervous_system

Medical Daily

Dovey, Dana

“The Big O: Physiological Reasons Why You May Have Orgasmic Dysfunction”

(April 8, 2016)

http://www.medicaldaily.com/big-o-orgasmic-dysfunction-physiological-reasons-381216

SexHealthMatters.org

“Size and Location of Clitoris May Affect Orgasm”

(November 12, 2014)

https://www.sexhealthmatters.org/news/size-and-location-of-clitoris-may-affect-orgasm

News

For Certain Men, Testosterone Therapy Might Be Good for the Heart

May 10, 2016

Testosterone replacement therapy might reduce the risk of heart attacks and strokes in older men with both low testosterone and coronary artery disease, a new study finds.

Produced by the testes, the hormone testosterone contributes much to a man’s masculinity. It’s responsible for increased his muscle mass, deeper voice, and facial hair. It’s also important for his sex drive and erections.

As men get older, their testosterone levels naturally drop. The process is gradual, but some men sense the change. They might feel fatigued and moody. Some men start to lose interest in sex.

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Testosterone therapy may benefit older men with low testosterone and coronary artery disease. (Click to tweet)

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Sometimes, doctors prescribe testosterone for these symptoms. But the practice has been controversial, with some studies showing increased risk of cardiovascular events – stroke, heart attack, and death – in men taking testosterone. Other studies have found no increased risk.

In this study, researchers from the Intermountain Medical Center Heart Institute in Salt Lake City worked with 755 men who ranged in age from 58 to 78. The men had low testosterone and severe coronary artery disease, a condition caused by atherosclerosis (hardening of the arteries). When plaque builds up in the coronary arteries, it becomes more difficult for blood to flow to the heart.

Three groups were formed. One group of men received a high dose of testosterone therapy; another was given a medium dose. The third group did not receive any testosterone.

After a year, 64 men in the non-treatment group had had a cardiovascular event, compared to 12 men in the medium-dose testosterone group and nine in the high-dose group.

After three years, cardiovascular events were experienced by 125 men who were not treated with testosterone, 38 men in the medium-dose group, and 22 men in the high-dose group.

Doctors shouldn’t be changing their patients’ treatment plans quite yet, however.  The scientists stressed that their study was observational and that more research is needed.

The findings were presented last month in Chicago at the American College of Cardiology’s 65th Annual Scientific Session.

Resources

Intermountain Healthcare

“New Study Finds Testosterone Supplementation Reduces Heart Attack and Stroke Risk in Men with Heart Disease”

(News release. April 3, 2016)

https://intermountainhealthcare.org/news/2016/04/testosterone-supplementation-reduces-heart-attack-and-stroke-risk-in-men-with-heart-disease/

UPI.com

Feller, Stephen

“Testosterone supplement reduces heart attack risk from heart disease”

(April 4, 2016)

http://www.upi.com/Health_News/2016/04/04/Testosterone-supplement-reduces-heart-attack-risk-from-heart-disease/3791459771756/

News

Operative Vaginal Delivery Could Be Linked to Sexual Problems for New Mothers

Apr 19, 2016

Operative Vaginal Delivery Could Be Linked to Sexual Problems for New MothersWomen who give birth by operative vaginal delivery are more likely to develop sexual problems after birth, a new study suggests.

Operative vaginal delivery involves the use of tools to help the birth along. An obstetrician may use forceps – a metal tool that is sometimes compared to salad tongs – to gently pull the baby’s head out of the vagina. Another option is vacuum extraction, in which a vacuum pump is used.

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Women who give birth by operative vaginal delivery more likely to develop sexual problems later. (Click to tweet)

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An obstetrician may decide to use one of these methods when the mother is exhausted from labor or having trouble pushing. Operative delivery may also be chosen when there are health concerns for the mother or baby.

It’s common for women to have sexual problems, such as low libido and painful intercourse, after giving birth. Scientists have tried to determine if certain methods of childbirth influence the types of problems a woman might have. But their findings have been mixed.  

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