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Erectile Dysfunction
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Mark Johnson, Marco Falcone, Tarek M. A. Aly, Amr Abdel Raheem
ED is a common condition that can affect men of all ages. In general, the prevalence of ED increases with age; however, it is often underreported due to the nature of the condition. The prevalence of ED is estimated to reach 322 million by 2025 from 152 million in 1995 [3]. The International Consultation Committee for Sexual Medicine cites the prevalence of ED in men younger than 40 years between 1%–9%. For men 40–59 years of age, the prevalence is reported to be as low as 2%–9% and as high as 20%–30% in various studies. This may be due to differences in the study population or the definition of ED between studies. Between the ages of 60–69 years, the prevalence of ED is estimated to be between 20%–40%. The prevalence reaches 75% for men in their 70s and 80s. [1]. Further epidemiological data is provided by the Massachusetts Male Aging Study (a large prospective population-based study), which found a crude incidence of ED of 26 per 1,000 man-years. This increased to 46 per 1,000 man-years in men 60–69 years of age [4].
Sexuality and Sexual Dysfunctions
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Peggy J. Kleinplatz, Lianne A. Rosen, Maxime Charest, Alyson K. Spurgas
Because the initial academic and clinical discourse in sexology rested on tenuous footing, it was not surprising to see even the existing structures collapse upon the introduction of medical and pharmacologic solutions to sexual problems. Sexual difficulties were suddenly reconstituted as problems in sexual health to be treated by specialists in sexual medicine. Any hope for trans-disciplinary sharing of knowledge, challenging of one another’s assumptions, conceptualizations of the goals of treatment, and general contextualizing of women’s health care needs and aspirations has been lost. (For a fuller exposition of these changes over time, see Kleinplatz, 2003, 2012, 2018.)
Measuring Efficacy in Psychosexual Medicine
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
One of the earliest attempts to measure elements of efficacy in patients presenting with widespread sexual problems was published in 1996. The IPM journal published a study aiming ‘to assess the acceptability and usefulness of an outcome and satisfaction measure in sexual medicine’ (9). Postal questionnaires were sent out to clinic attenders with four questions including one asking for their view on whether their condition had improved. The satisfaction measure was stated as 89% but the response rate was only 42%. There was a comprehensive discussion with two case examples as a basis for comparing an objective successful outcome measure of only 24%, compared to the higher patient satisfaction figure. This again demonstrates that patients’ views of the ‘success’ of interventions are often different to that of clinicians and reinforces the need to consider PROMs when judging efficacy and effectiveness.
An up-to-date overview of the pharmacotherapeutic options for premature ejaculation
Published in Expert Opinion on Pharmacotherapy, 2022
Iraklis Mitsogiannis, Athanasios Dellis, Athanasios Papatsoris, Mohamad Moussa
There is still a lack of universally accepted definition of PE in the medical literature. Indeed, the International Society of Sexual Medicine (ISSM) have developed an evidence-based definition, according to which PE is categorized by the following: ‘1) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); 2) the inability to delay ejaculation on all or nearly all vaginal penetrations; 3) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy’ [22]. This definition has been adopted by the European Association of Urology Guidelines as well [23]. Meanwhile, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) further defines PE as a ‘persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes it.’ Further, it states that the symptom must have been present for at least 6 months and must be experienced on almost all or all (approximately 75–100%) occasions of sexual activity. It also states that this dysfunction ‘causes clinically significant distress in the individual and is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition’ [24].
General practitioners’ self-reported competence in the management of sexual health issues – a web-based questionnaire study from Finland
Published in Scandinavian Journal of Primary Health Care, 2021
Sanna-Mari Manninen, Katja Kero, Katariina Perkonoja, Tero Vahlberg, Päivi Polo-Kantola
According to our study, the GPs reported good competence in discussing sexual health issues with their patients. However, treating sexual problems, especially those of female patients, was reported to be more difficult. Several factors hindered bringing up sexual health issues; most frequently, these factors were reported to be the shortness of the appointment time and a lack of knowledge about and experience with sexual medicine. Regarding the GPs’ gender, some differences emerged in bringing up patients’ sexual problems. Interestingly, the male GPs more often reported good competence in discussing sexual health and treating male patients than the female GPs; however, a similar gender advantage for female GPs was found only in discussing sexual health issues, not in treating them. There were no differences between the age groups in self-reported competence in discussing sexual health or treating patients. In addition, age had only marginal importance regarding the barriers to bringing up sexual health issues. The results were predictable concerning the numbers of patients with sexual health issues: the more the GPs saw patients with sexual health issues weekly, the better their self-reported competence was in discussing issues and treating these patients. Although the GPs used several sources of education, most of them considered their education on sexual medicine to be insufficient and reported a need for continuing education.
Sexual quality of life in men and women after cancer
Published in Climacteric, 2019
Most patients also need professional help beyond the assessment visit. Some may want to utilize self-help programs, but to also schedule a follow-up visit to make sure problems are resolving. Others can benefit from male or female sexual medicine assessment and treatment of sexual problems28,29,40, including hormonal replacement therapy; oral, injectable, or surgical treatment of erectile dysfunction; treatment of genital pain that interferes with sexual pleasure; or diagnosis and treatment of genital damage such as urethral or vaginal stenosis or scarring and irritation from genital graft versus host syndrome41,42. Incorporating a new medical treatment into a couple’s sexual routine often also requires some help from an expert mental health professional with sexual communication, body image concerns, and relationship conflict17–20,39.