Male Sexual Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Multicenter Study
Anu HaavistoSidsel MathiesenAnu SuominenPäivi M. LähteenmäkiKaspar SørensenMarianne IfversenAnders JuulMalene Mejdahl NielsenKlaus MüllerKirsi Jahnukainen
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There are many known endocrine complications after allogeneic hematopoietic stem cell transplantation (HSCT) in childhood including increased risk of biochemical hypogonadism. However, little is known about sexuality in adulthood following childhood HSCT. In this multicenter study, sexual functions and possible risk factors were assessed comprehensively in two national cohorts (Finland and Denmark) of male adult survivors of childhood HSCT. Compared to a healthy control group (n = 56), HSCT survivors (n = 97) reported less sexual fantasies, poorer orgasms, lower sexual activity with a partner and reduced satisfaction with their sex life, even in the presence of normal erectile functions and a similar frequency of autoerotic acts. Of the HSCT survivors, 35% were cohabitating/married and 66% were sexually active. Risk factors for poorer self-reported sexual functions were partner status (not cohabitating with a partner), depressive symptoms, CNS and testicular irradiation. Sexual dysfunction increased by age in the HSCT group with a pace comparable to that of the control group. However, because of the lower baseline level of sexual functions in the HSCT group, they will reach the level of clinically significant dysfunction at a younger age. Hence, male survivors of childhood HSCT should be interviewed in detail about their sexual health beyond erectile functions.Fifty-nine uremic patients (38 males and 21 females) maintained on chronic hemodialysis (CHD) served as the subjects in a study of the relationship between sexual dysfunction and serum prolactin levels (SPL). Sexual desire and activity were evaluated by a self-report sexual function rating scale (SFRS). About half the population of this study reported sexual dysfunction. Males and females reporting disturbance of sexual function had significantly higher SPL than those with normal sexual function. Bromocriptine treatment in five hyperprolactinemic patients reduced SPL to normal range and improved the sexual function. Association between sexual dysfunction and hyperprolactinemia in uremic patients is suggested.
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Sexual dysfunction in general and erectile dysfunction in particular are common problems in the overall population but also frequent symptoms of both untreated and treated depression. Erectile dysfunction and associated sexual dysfunction secondary to antidepressant therapy may occur in up to 90% of men with antidepressant-emergent sexual side effects; accurate assessment of prevalence rates depends on taking a detailed history regarding erectile dysfunction and other aspects of sexual function prior to treatment. In this review, we examine the available data on prevalence of erectile dysfunction and related sexual dysfunction in untreated depression and secondary to antidepressant medications compared with healthy populations. Possible mechanisms involved in serotonin reuptake inhibitor (SRI)-associated erectile dysfunction are examined. The assessment of SRI-associated erectile dysfunction is presented to aid in the management of this important and prevalent side effect. Treatment of antidepressant-associated erectile dysfunction can greatly increase the likelihood that patients will continue the medication that effectively treats their depression.
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Severe obesity is most effectively treated with bariatric surgery. The resulting weight loss is expected to improve a variety of obesity-related conditions, including sexual dysfunction.To analyze changes in the sexual function of women with obesity following bariatric surgery.A prospective study was conducted between April 2015 and April 2016 involving 62 women with obesity who underwent Roux-en-Y gastric bypass. The Female Sexual Function Index (FSFI) was used to evaluate sexual function. Sexual dysfunction was defined as an FSFI score below 26.55. Patients' clinical and demographic data were recorded. Sexual frequency of 12 different sexual positions was also evaluated.Sexual dysfunction prevalence and the frequency of sexual positions before and 6 months after surgery.The prevalence of sexual dysfunction decreased from 62% before surgery to 19% 6 months after the procedure. There was a 19.2% improvement in the mean overall FSFI score (P < .01). 6 months after surgery, the mean overall FSFI score had improved in all patients, with a statistically significant change being found in all 6 domains of the questionnaire (P < .05). There was an increase in the frequency of 3 of 12 sexual positions evaluated.Sexual function in women with obesity effectively improves after bariatric surgery. Favorable changes following weight loss included a significant reduction in the prevalence of sexual dysfunction and an increase in the frequency of different sexual positions during intercourse. Oliveira CFA, dos Santos PO, Oliveira RA, et al. Changes in sexual function and positions in women with severe obesity after bariatric surgery. Sex Med 2019;7:80-85.
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Erectile dysfunction is currently considered a condition with high prevalence in the general population, exerting a major impact on patients' and their sexual partners' quality of life. Available data indicate that hypertension represents a risk factor for erectile dysfunction, which is more frequent in hypertensive compared with normotensive subjects. The pathophysiologic basis of erectile dysfunction in hypertension is under thorough investigation, and several mechanisms have been proposed. Erectile dysfunction has also been related to cardiovascular risk factors and might be used as a marker of cardiovascular disease in the future. Although male sexuality has been studied rather extensively, female sexual dysfunction in hypertension is underexplored. Recently published hypertension guidelines either ignore or superficially address sexual dysfunction, underlining the need for more attention and better education of health care professionals on this issue.
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Sexual dysfunction in general and erectile dysfunction in particular are common problems in the overall population but also frequent symptoms of both untreated and treated depression. Erectile dysfunction and associated sexual dysfunction secondary to antidepressant therapy may occur in up to 90% of men with antidepressant-emergent sexual side effects; accurate assessment of prevalence rates depends on taking a detailed history regarding erectile dysfunction and other aspects of sexual function prior to treatment. In this review, we examine the available data on prevalence of erectile dysfunction and related sexual dysfunction in untreated depression and secondary to antidepressant medications compared with healthy populations. Possible mechanisms involved in serotonin reuptake inhibitor (SRI)-associated erectile dysfunction are examined. The assessment of SRI-associated erectile dysfunction is presented to aid in the management of this important and prevalent side effect. Treatment of antidepressant-associated erectile dysfunction can greatly increase the likelihood that patients will continue the medication that effectively treats their depression.
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