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Nguyen V, Dolendo I, Uloko M, Hsieh TC, Patel D. Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers. Int J Impot Res 2024; 36:186-193. [PMID: 37061617 PMCID: PMC11035123 DOI: 10.1038/s41443-023-00692-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/17/2023]
Abstract
Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. Given the multifactorial complex nature of this disorder, a thorough history and physical examination represent the most critical components of patient evaluation in the clinical setting. Treating DO/AO can be challenging due to the lack of standardized FDA-approved pharmacotherapies. There is no standardized treatment plan for DO/AO, though common treatments plans are often multidisciplinary and may include adjustment of offending medications and sex therapy. In this review, we summarize the etiology, diagnosis, and treatment of DO/AO.
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Affiliation(s)
- Vi Nguyen
- Department of Urology, University of California, San Diego, CA, USA
| | - Isabella Dolendo
- Department of Urology, University of California, San Diego, CA, USA
| | - Maria Uloko
- Department of Urology, University of California, San Diego, CA, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California, San Diego, CA, USA
| | - Darshan Patel
- Department of Urology, University of California, San Diego, CA, USA.
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2
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Szukiewicz D. Current Insights in Prolactin Signaling and Ovulatory Function. Int J Mol Sci 2024; 25:1976. [PMID: 38396659 PMCID: PMC10889014 DOI: 10.3390/ijms25041976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Prolactin (PRL) is a pleiotropic hormone released from lactotrophic cells of the anterior pituitary gland that also originates from extrapituitary sources and plays an important role in regulating lactation in mammals, as well as other actions. Acting in an endocrine and paracrine/autocrine manner, PRL regulates the hypothalamic-pituitary-ovarian axis, thus influencing the maturation of ovarian follicles and ovulation. This review provides a detailed discussion of the current knowledge on the role of PRL in the context of ovulation and ovulatory disorders, particularly with regard to hyperprolactinemia, which is one of the most common causes of infertility in women. Much attention has been given to the PRL structure and the PRL receptor (PRLR), as well as the diverse functions of PRLR signaling under normal and pathological conditions. The hormonal regulation of the menstrual cycle in connection with folliculogenesis and ovulation, as well as the current classifications of ovulation disorders, are also described. Finally, the state of knowledge regarding the importance of TIDA (tuberoinfundibular dopamine), KNDγ (kisspeptin/neurokinin B/dynorphin), and GnRH (gonadotropin-releasing hormone) neurons in PRL- and kisspeptin (KP)-dependent regulation of the hypothalamic-pituitary-gonadal (HPG) axis in women is reviewed. Based on this review, a rationale for influencing PRL signaling pathways in therapeutic activities accompanying ovulation disorders is presented.
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Affiliation(s)
- Dariusz Szukiewicz
- Department of Biophysics, Physiology & Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, 02-004 Warsaw, Poland
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3
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Maseroli E, Verde N, Cipriani S, Rastrelli G, Alfaroli C, Ravelli SA, Costeniero D, Scairati R, Minnetti M, Petraglia F, Auriemma RS, Nappi RE, Maggi M, Vignozzi L. Low prolactin level identifies hypoactive sexual desire disorder women with a reduced inhibition profile. J Endocrinol Invest 2023; 46:2481-2492. [PMID: 37204690 PMCID: PMC10632269 DOI: 10.1007/s40618-023-02101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/19/2023] [Indexed: 05/20/2023]
Abstract
PURPOSE Data on the role of prolactin (PRL) in the physiologic range in the female sexual response are scanty. We aimed at investigating the association between PRL and sexual function as assessed by the Female Sexual Function Index (FSFI). We explored the presence of a cut-off level of PRL able to identify Hypoactive Sexual Desire Disorder (HSDD). METHODS 277 pre- and post-menopausal women consulting for Female Sexual Dysfunction (FSD) and sexually active were enrolled in an observational, retrospective study. 42 women were used as no-FSD controls. A clinical, biochemical and psychosexual evaluation was performed. The main outcome measures were: FSFI, Female Sexual Distress Scale-Revised, Middlesex Hospital Questionnaire and Sexual excitation/sexual inhibition scale (SIS/SES). RESULTS Normo-PRL FSD women (n = 264) showed lower FSFI Desire score than controls (n = 42), and higher than hyper-PRL FSD women (n = 13). These differences emerged both in pre-menopausal and post-menopausal subjects. In the normo-PRL FSD group, those with PRL in the higher quintile reported higher FSFI Desire scores than those with PRL in the lowest quintile. Women with HSDD presented a lower PRL level than those without (p = 0.032). A ROC curve analysis for PRL showed an accuracy of 0.610 ± 0.044 (p = 0.014) in predicting HSDD. With a threshold of < 9.83 μg/L, sensitivity and specificity for HSDD were 63% and 56%, respectively. Subjects with PRL < 9.83 μg/L also reported lower sexual inhibition (p = 0.006) and lower cortisol levels (p = 0.003) than those with PRL > = 9.83 μg/L. CONCLUSIONS Hyper-PRL is associated with low desire; however, among normo-PRL FSD women, those with the lowest levels demonstrated a poorer desire than those with the highest levels. PRL < 9.83 μg/L predicted HSDD and a lower sexual inhibitory trait.
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Affiliation(s)
- E Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - N Verde
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
| | - S Cipriani
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - C Alfaroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - S A Ravelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - D Costeniero
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - R Scairati
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
| | - M Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - F Petraglia
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, University of Florence, Florence, Italy
| | - R S Auriemma
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile (FERTISEXCARES), Università Federico II di Napoli, Naples, Italy
| | - R E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Science, University of Pavia, Pavia, Italy
| | - M Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - L Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
- I.N.B.B. (Istituto Nazionale Biostrutture e Biosistemi), Rome, Italy.
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Komisaruk BR, Del Cerro MCR, Goldstein I. Orgasm utilizes the pain pathway: is orgasm "nonaversive pain"? Sex Med Rev 2023; 11:291-295. [PMID: 37635366 DOI: 10.1093/sxmrev/qead037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
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Blyuss KB, Kyrychko YN. Sex, ducks, and rock "n" roll: Mathematical model of sexual response. CHAOS (WOODBURY, N.Y.) 2023; 33:043106. [PMID: 37097948 DOI: 10.1063/5.0143190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
In this paper, we derive and analyze a mathematical model of a sexual response. As a starting point, we discuss two studies that proposed a connection between a sexual response cycle and a cusp catastrophe and explain why that connection is incorrect but suggests an analogy with excitable systems. This then serves as a basis for derivation of a phenomenological mathematical model of a sexual response, in which the variables represent levels of physiological and psychological arousal. Bifurcation analysis is performed to identify stability properties of the model's steady state, and numerical simulations are performed to illustrate different types of behavior that can be observed in the model. Solutions corresponding to the dynamics associated with the Masters-Johnson sexual response cycle are represented by "canard"-like trajectories that follow an unstable slow manifold before making a large excursion in the phase space. We also consider a stochastic version of the model, for which spectrum, variance, and coherence of stochastic oscillations around a deterministically stable steady state are found analytically, and confidence regions are computed. Large deviation theory is used to explore the possibility of stochastic escape from the neighborhood of the deterministically stable steady state, and the methods of an action plot and quasi-potential are employed to compute most probable escape paths. We discuss implications of the results for facilitating better quantitative understanding of the dynamics of a human sexual response and for improving clinical practice.
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Affiliation(s)
- K B Blyuss
- Department of Mathematics, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - Y N Kyrychko
- Department of Mathematics, University of Sussex, Brighton BN1 9QH, United Kingdom
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6
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Ghorai S, Khandelwal S, Das S, Rai S, Guria S, Majumder P, Dutta A. Improving the synthetic H 2 production catalyst design strategy with the neurotransmitter dopamine. Dalton Trans 2023; 52:1518-1523. [PMID: 36594514 DOI: 10.1039/d2dt03509j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The strategic incorporation of the neurotransmitter dopamine around a cobaloxime core resulted in excellent electrocatalytic (rate 8400 s-1) and photocatalytic H2 production under neutral aqueous conditions. The influence of the synthetic outer coordination sphere features continues even with a phenylene-diimino-dioxime motif-coordinated cobalt core.
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Affiliation(s)
- Santanu Ghorai
- Chemistry Department, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India.
| | - Shikha Khandelwal
- Chemistry Discipline, Indian Institute of Technology Gandhinagar, Palaj, 382355 India
| | - Srewashi Das
- Chemistry Department, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India.
| | - Surabhi Rai
- Chemistry Department, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India. .,National Centre of Excellence in CCU, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India
| | - Somnath Guria
- Chemistry Department, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India.
| | - Piyali Majumder
- National Centre of Excellence in CCU, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India
| | - Arnab Dutta
- Chemistry Department, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India. .,National Centre of Excellence in CCU, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India.,Interdisciplinary Program in Climate Studies, Indian Institute of Technology Bombay, Powai, Mumbai, 400076 India
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Xu H, Yang F. The interplay of dopamine metabolism abnormalities and mitochondrial defects in the pathogenesis of schizophrenia. Transl Psychiatry 2022; 12:464. [PMID: 36344514 PMCID: PMC9640700 DOI: 10.1038/s41398-022-02233-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Abstract
Dopamine (DA) is a major monoamine neurotransmitter in the brain and has essential roles in higher functions of the brain. Malfunctions of dopaminergic signaling have been implicated in various mental disorders such as addiction, attention deficit/hyperactivity disorder, Huntington's disease, Parkinson's disease (PD), and schizophrenia. The pathogenesis of PD and schizophrenia involves the interplay of mitochondrial defect and DA metabolism abnormalities. This article focuses on this issue in schizophrenia. It started with the introduction of metabolism, behavioral action, and physiology of DA, followed by reviewing evidence for malfunctions of dopaminergic signaling in patients with schizophrenia. Then it provided an overview of multiple facets of mitochondrial physiology before summarizing mitochondrial defects reported in clinical studies with schizophrenia patients. Finally, it discussed the interplay between DA metabolism abnormalities and mitochondrial defects and outlined some clinical studies showing effects of combination therapy of antipsychotics and antioxidants in treating patients with schizophrenia. The update and integration of these lines of information may advance our understanding of the etiology, pathogenesis, phenomenology, and treatment of schizophrenia.
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Affiliation(s)
- Haiyun Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.
- Zhejiang Provincial Clinical Research Center for Mental Illness, The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China.
- Mental Health Center, Shantou University Medical College, Shantou, China.
| | - Fan Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
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Contaldi E, Magistrelli L, Gallo S, Comi C. Striatal dopamine transporter imaging in Parkinson’s disease drug-naïve patients: focus on sexual dysfunction. Neurol Sci 2022; 43:4769-4776. [PMID: 35386018 PMCID: PMC9349118 DOI: 10.1007/s10072-022-06050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
Abstract
Introduction Dopamine is involved in sexual behavior, but dopaminergic imaging studies establishing the relationship between nigrostriatal dopaminergic degeneration and sexual dysfunction (SD) in Parkinson’s disease (PD) are lacking. Methods We retrospectively analyzed clinical and 123I-FP-CIT SPECT data of 43 drug-naïve PD patients. Based on the sexual function domain of the Non-Motor Symptoms Scale (NMSS), we identified 23 patients with sexual concerns (WSC), reporting a score ≥ 2 due to hyposexuality, and 20 patients without sexual concerns (NoSC). Dopamine transporter (DAT) uptake was assessed through semi-quantitative analysis in the most and least affected putamen (maP, laP), and most and least affected caudate (maC, laC). Total putamen-to-caudate ratio and total striatal binding ratio (tSBR) were also quantified. Results WSC and NoSC had similar demographic and disease-related characteristics. WSC displayed lower uptake values in maC (p = 0.016), maP (p = 0.004), laC (p = 0.019), laP (p = 0.009), and tSBR (p = 0.006). Pearson correlation analysis revealed, in the WSC group, moderate inverse correlations between the log-transformed SD scores and the uptake in maP (r = − 0.473, p = 0.023), maC (r = − 0.428, p = 0.042), laP (r = -0.437, p = 0.037), and tSBR (r = − 0.460, p = 0.027). After controlling in a two-way ANCOVA model for age and sex, between-group differences,between WSC and NoSC remained statistically significant only for dopaminergic denervation in maP [F(1,38) = 7.478, p = 0.009)], laP [F(1,38) = 4.684, p = 0.037)], and tSBR [F(1,38) = 5.069, p = 0.030]. Conclusion To the best of our knowledge, this is the first study reporting the relationship between the severity of SD and specific patterns of nigrostriatal dopaminergic denervation (especially involving both putamina) in newly diagnosed drug-naïve PD patients.
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Affiliation(s)
- Elena Contaldi
- Department of Translational Medicine, Movement Disorders Centre, "Maggiore Della Carità" University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy.
- PhD Program in Medical Sciences and Biotechnology, University of Piemonte Orientale, Novara, Italy.
| | - Luca Magistrelli
- Department of Translational Medicine, Movement Disorders Centre, "Maggiore Della Carità" University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
- PhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, Italy
| | - Silvia Gallo
- Department of Translational Medicine, Movement Disorders Centre, "Maggiore Della Carità" University Hospital, University of Piemonte Orientale, Corso Mazzini 18, 28100, Novara, Italy
| | - Cristoforo Comi
- Department of Translational Medicine, Neurology Unit, S. Andrea Hospital, University of Piemonte Orientale, Vercelli, Italy
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9
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Hypogonadism in Male Patients with Pituitary Adenoma and Its Related Mechanism: A Review of Literature. Brain Sci 2022; 12:brainsci12060796. [PMID: 35741681 PMCID: PMC9221259 DOI: 10.3390/brainsci12060796] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 12/04/2022] Open
Abstract
Maintaining normal gonadal axis hormone levels is important for improving the condition of male patients with pituitary adenoma. The current literature is somewhat divided on the results of evaluations of gonadal axis function in male patients with pituitary adenoma before and after treatment, and the increasing demand for better quality of life has provided motivation for this research to continue. In this article, we summarize the feasibility of using testosterone as an indicator for assessing male function and discuss the changes reported in various studies for gonadal hormones before and after treatment in male patients with pituitary adenoma. It is important for clinicians to understand the advantages of each treatment option and the effectiveness of assessing gonadal function. The rationale behind the theory that pituitary adenomas affect gonadal function and the criteria for evaluating pituitary–gonadal axis hormones should be explored in more depth.
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Battista VD, Hey-Hawkins E. Development of Prodrugs for Treatment of Parkinson's Disease: New Inorganic Scaffolds for Blood-Brain Barrier Permeation. J Pharm Sci 2022; 111:1262-1279. [PMID: 35182542 DOI: 10.1016/j.xphs.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
The treatment of Parkinson's disease (PD) has not been consistently modified for more than 60 years. L-DOPA, the blood-brain barrier permeable precursor prodrug of dopamine, is to date the only effective therapy on the market. However, it is well known that prolonged treatment with L-DOPA leads to several side effects, which may affect the patient's life expectancy (i.e., the wearing-off phenomenon, on-off fluctuations, and dyskinesia). For this reason, modifications, and supplements to L-DOPA treatment have been and are being studied, which, however, have not yet resulted in a valid alternative to the cornerstone drug. This review aims to summarize the main formulations currently in use for PD treatment, explaining advantages and disadvantages for each class. The attention will be focused on the promising prodrug concept, aimed at finding a suitable L-DOPA substitute with improved pharmacokinetic behavior. In this respect, new potential candidates which show interesting properties for the intended scope, the so-called dicarba-closo-dodecaboranes(12) (carboranes), will be discussed. Carboranes are inorganic molecular icosahedral boron-carbon clusters with 12 vertices and 20 deltahedral faces. They have been extensively studied for applications in medicine as potential pharmacophores, reagents in boron neutron capture therapy (BNCT) and radiotherapy. Here, we discuss them as inorganic scaffolds for dopamine delivery at the central nervous system (CNS) level.
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Key Words
- %F, Oral Bioavailability
- 5-HTP, L-5-Hydroxy-Tryptophan
- AADC, Aromatic L-Amino Acid Decarboxylase
- AGPs, Arabinogalactan Proteins
- AUC, Area Under the Plasma Concentration Curve
- Abbreviations
- BBB, Blood–Brain Barrier
- BNCT, Boron Neutron Capture Therapy
- CNS, Central Nervous System
- COMT, Catechol-O-Methyltransferase
- DBS, Deep Brain Stimulation
- DDC, Dopamine Decarboxylase
- DMSO, Dimethylsulfoxide
- FAD, Flavin Adenine Dinucleotide
- FDA, Food and Drug Administration
- GPCRs, G-Protein-Coupled Receptors
- HIV, Human Immunodeficiency Virus
- HSA, Human Serum Albumin
- ICT, Intramolecular Charge Transfer
- IPG, Implanted Pulse Generator
- IUPAC, International Union of Pure and Applied Chemistry
- IV, Intravenous Injection
- LDEE, L-DOPA Ethyl Ester
- LNAA, Large Neutral Amino Acid transport system
- MAO-A/B, Monoamine Oxidase-A/B
- MPO, Multiparameter Optimization
- Mw, Molecular Weight
- NMDAR, N-Methyl D-Aspartate Receptor
- P, Partition Coefficient
- PAMPA, Parallel Artificial Membrane Permeability Assay
- PD, Parkinson's Disease
- PLP, Pyridoxal Phosphate
- PNS, Peripheral Nervous System
- Parkinson's disease, Dopamine, Blood–brain barrier, Permeability, Bioavailability, L-DOPA, Prodrugs, Inorganic scaffold, Icosahedral carborane
- SAM, S-Adenosyl L-Methionine
- STN, Subthalamic Nucleus
- TBP, Tetrahydrobiopterin
- UPDRS, Unified Parkinson's Disease Rating Scale
- VTA, Ventral Tegmental Are
- hBMECs, human Brain Microvascular Endothelial Cells
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Affiliation(s)
- Veronica Di Battista
- Leipzig University, Faculty of Chemistry and Mineralogy, Institute of Inorganic Chemistry, Johannisallee 29, 04103 Leipzig, Germany
| | - Evamarie Hey-Hawkins
- Leipzig University, Faculty of Chemistry and Mineralogy, Institute of Inorganic Chemistry, Johannisallee 29, 04103 Leipzig, Germany.
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11
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Isenmann E, Schumann M, Notbohm HL, Flenker U, Zimmer P. Hormonal response after masturbation in young healthy men - a randomized controlled cross-over pilot study. Basic Clin Androl 2021; 31:32. [PMID: 34937544 PMCID: PMC8697462 DOI: 10.1186/s12610-021-00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hormones like testosterone play a crucial role in performance enhancement and muscle growth. Therefore, various attempts to increase testosterone release and testosterone concentration have been made, especially in the context of resistance training. Among practitioners, sexual activity (coitus and masturbation) a few hours before training is often discussed to result in increases of testosterone concentration and thus promote muscle growth. However, there is no evidence to support this assumption and the kinetics of the testosterone and cortisol response after sexual activity have not been adequately investigated. Therefore, the aim of this pilot-study was to examine the kinetics of hormone concentrations of total testosterone, free testosterone and cortisol and their ratios after masturbation. In a three-arm single blinded cross-over study, the effects of masturbation with visual stimulus were compared to a visual stimulus without masturbation and the natural kinetics in healthy young men. RESULTS The results showed a significant between-condition difference in free testosterone concentrations. Masturbation (p < 0.01) and a visual stimulus (p < 0.05) may seem to counteract the circadian drop of free testosterone concentrations over the day. However, no statistical change was observed in the ratios between total testosterone, free testosterone and cortisol. CONCLUSIONS It can be assumed that masturbation may have a potential effect on free testosterone concentrations but not on hormonal ratios. However, additional studies with larger sample sizes are needed to validate these findings.
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Affiliation(s)
- Eduard Isenmann
- Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany.
- Department of Fitness and Health, IST-University of Applied Sciences, Dusseldorf, Germany.
| | - Moritz Schumann
- Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
| | - Hannah L Notbohm
- Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
| | - Ulrich Flenker
- Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sports University, Cologne, Germany
| | - Philipp Zimmer
- Department of 'Performance and Health (Sports Medicine)', Institute of Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
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12
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André GI, Firman RC, Simmons LW. The effect of baculum shape and mating behavior on mating-induced prolactin release in female house mice. Behav Ecol 2021. [DOI: 10.1093/beheco/arab083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Male genitalia are subject to rapid divergent evolution, and sexual selection is believed to be responsible for this pattern of evolutionary divergence. Genital stimulation during copulation is an essential feature of sexual reproduction. In mammals, the male intromittent genitalia induces a cascade of physiological and neurological changes in females that promote pregnancy. Previous studies of the house mouse have shown that the shape of the baculum (penis bone) influences male reproductive success and responds to experimentally imposed variation in sexual selection. Here, we test the hypothesis that the baculum is subject to sexual selection due to a stimulatory function during copulation. We selected male and female house mice (Mus musculus domesticus) from families with breeding values at the extremes of baculum shape and performed two series of experimental matings following which we examined the concentration of prolactin in the blood of females either 15 (“early”) or 75 (“late”) min after ejaculation. Our results provide evidence of a mating-induced release of prolactin in the female house mouse early after ejaculation, the level of which is dependent on an interaction between the shape of the baculum and male sexual behavior. Our data thereby provide novel insight into the mechanism(s) of sexual selection acting on the mammalian baculum.
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Affiliation(s)
- Gonçalo I André
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, Australia
| | - Renée C Firman
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, Australia
| | - Leigh W Simmons
- Centre for Evolutionary Biology, School of Biological Sciences (M092), The University of Western Australia, Crawley, Australia
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13
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Mostafa T, Abdel-Hamid IA. Ejaculatory dysfunction in men with diabetes mellitus. World J Diabetes 2021; 12:954-974. [PMID: 34326948 PMCID: PMC8311479 DOI: 10.4239/wjd.v12.i7.954] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/06/2021] [Accepted: 06/15/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder that is characterized by elevated blood glucose levels due to absolute or relative insulin deficiency, in the background of β-cell dysfunction, insulin resistance, or both. Such chronic hyperglycemia is linked to long-term damage to blood vessels, nerves, and various organs. Currently, the worldwide burden of DM and its complications is in increase. Male sexual dysfunction is one of the famous complications of DM, including abnormal orgasmic/ejaculatory functions, desire/libido, and erection. Ejaculatory dysfunction encompasses several disorders related to DM and its complications, such as premature ejaculation, anejaculation (AE), delayed ejaculation, retrograde ejaculation (RE), ejaculatory pain, anesthetic ejaculation, decreased ejaculate volume, and decreased force of ejaculation. The problems linked to ejaculatory dysfunction may extend beyond the poor quality of life in diabetics as both AE and RE are alleged to alter the fertility potential of these patients. However, although both diabetes patients and their physicians are increasingly aware of diabetic ejaculatory dysfunction, this awareness still lags behind that of other diabetes complications. Therefore, all these disorders should be looked for thoroughly during the clinical evaluation of diabetic men. Besides, introducing the suitable option and/or maneuvers to treat these disorders should be tailored according to each case. This review aimed to explore the most important findings regarding ejaculatory dysfunction in diabetes from pre-clinical and clinical perspectives.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
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14
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Valente S, Marques T, Lima SQ. No evidence for prolactin's involvement in the post-ejaculatory refractory period. Commun Biol 2021; 4:10. [PMID: 33398068 PMCID: PMC7782750 DOI: 10.1038/s42003-020-01570-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/04/2020] [Indexed: 01/18/2023] Open
Abstract
In many species, ejaculation is followed by a state of decreased sexual activity, the post-ejaculatory refractory period. Several lines of evidence have suggested prolactin, a pituitary hormone released around the time of ejaculation in humans and other animals, to be a decisive player in the establishment of the refractory period. However, data supporting this hypothesis is controversial. We took advantage of two different strains of house mouse, a wild derived and a classical laboratory strain that differ substantially in their sexual performance, to investigate prolactin's involvement in sexual activity and the refractory period. First, we show that there is prolactin release during sexual behavior in male mice. Second, using a pharmacological approach, we show that acute manipulations of prolactin levels, either mimicking the natural release during sexual behavior or inhibiting its occurrence, do not affect sexual activity or shorten the refractory period, respectively. Therefore, we show compelling evidence refuting the idea that prolactin released during copulation is involved in the establishment of the refractory period, a long-standing hypothesis in the field of behavioral endocrinology.
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Affiliation(s)
- Susana Valente
- Champalimaud Research, Champalimaud Centre for the Unknown, Av. Brasilia, s/n Lisboa, Portugal
- Graduate Program in Areas of Basic and Applied Biology (GABBA), University of Porto, 4200-465, Porto, Portugal
| | - Tiago Marques
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA, 02139, USA
- McGovern Institute for Brain Research, MIT, Cambridge, MA, 02139, USA
- Center for Brains, Minds and Machines, MIT, Cambridge, MA, 02139, USA
| | - Susana Q Lima
- Champalimaud Research, Champalimaud Centre for the Unknown, Av. Brasilia, s/n Lisboa, Portugal.
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Gombert M, Ballester P, Segura A, Peiró AM. Introducing sexual dysfunction in mental care. Expert Opin Drug Saf 2020; 20:69-79. [PMID: 33191796 DOI: 10.1080/14740338.2020.1849135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: People with any psychiatric disorder tend to have difficulties in responding sexually. However,sexual dysfunction (SD) is usually under-recognized, even the tightly hormonal and neuronal common connexions through the brain-sex axis. Multiple sources of resistance to SD assessment and intervention persist. Areas covered: The present review aims to underline the feasibility to introduce SD evaluation in patients with any psychiatric disorders, evaluating the potential mutual benefits of their management. Expert opinion: Women and men living with mental disorders frequently display sexual difficulties; however, some of them consider sexuality as a relevant parameter of their quality of life. In fact, SD as a side effect is a frequent reason for stopping the intake of medication. What is more, a holistic approach integrating sexual function could foster a better understanding of mental pathologies due to a common origin of pathogenesis. This could improve care quality, in keeping with the global tendency toward the development of personalized medicine. Consistently, the integration of SD assessment is highly recommended in mental health, all the more so when a psychotropic drug is prescribed. An expected consequence would be a reconstruction of the healthcare professional's consideration for the sexuality of people experiencing mental disorders.
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Affiliation(s)
- Marie Gombert
- Department of Paediatrics, Obstetrics and Gynecology, University of Valencia , Valencia, Spain
| | - Pura Ballester
- Department of Pharmacology, Paediatrics and Organic Chemistry , Alicante, Spain.,Neuropharmacology on Pain (NED) Group, Alicante Institute for Health and Biomedical Research (ISABIAL) , Alicante, Spain
| | - Ana Segura
- Andrology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
| | - Ana M Peiró
- Department of Pharmacology, Paediatrics and Organic Chemistry , Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante - General Hospital, Alicante, Spain
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Yoshizumi M, Yonezawa A, Kimura Y, Watanabe C, Sakurada S, Mizoguchi H. Central Mechanisms of Apomorphine and m-Chlorophenylpiperazine on Synergistic Action for Ejaculation in Rats. J Sex Med 2020; 18:231-239. [PMID: 33243689 DOI: 10.1016/j.jsxm.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND We previously reported that the combination of the dopamine (DA) receptor agonist apomorphine and the 5-hydroxytryptamine (5-HT2) receptor agonist m-chlorophenylpiperazine (m-CPP) in rats potently and selectively facilitates the ejaculatory response through activation of D2-like and 5-HT2C receptors, respectively. AIM The aim of this study was to clarify the target level of the proejaculatory effects induced by combination of these agonists. METHODS For in vivo behavioral studies, apomorphine and m-CPP were given intracerebroventricularly and intrathecally alone or in combination with either drug administered systemically. Male rats were acclimated to observational cages bedded in paper towels, and the occurrence of ex copula ejaculation was assessed by evaluating the presence and weight of ejaculatory plugs dropped from the tip of the penis to the paper towels or adhered to the tip of the penis at 30 min after drug administration. For in vitro contraction studies, seminal vesicles isolated from rats were suspended in an organ bath to test contractile responses to drug combinations, and the effects of the combined drugs on the contractile response of noradrenaline were also tested. MAIN OUTCOME MEASURES The presence and weight of ejaculatory plugs produced by drug-induced ejaculation and the contractile responses of the seminal vesicle were evaluated. RESULTS Intrathecal m-CPP (10 μg), but not intracerebroventricular m-CPP, evoked the synergistic effects on ejaculation when used in combination with systemically administered apomorphine (0.1 mg/kg, subcutaneous). Moreover, the synergy between m-CPP and apomorphine was completely abolished by the intrathecal 5-HT2C receptor antagonist SB242084 (10 μg). Intrathecal or intracerebroventricular apomorphine (1-10 μg) evoked proejaculatory effects in combination with systemically administered m-CPP (0.3 mg/kg, intraperitoneal). The selective peripherally acting D2-like receptor agonist carmoxirole did not evoke ejaculation when used in combination with m-CPP. Furthermore, isolated rat seminal vesicles were completely insensitive to the combination of apomorphine and m-CPP. CONCLUSION These results indicated that the synergistic effects of the drugs on ejaculation were induced at the central level but not at peripheral sites. Our findings also suggested that the 5-HT2C receptor mediated the stimulation of the spinal ejaculatory pattern generator and was synergistically potentiated by the spinal DA receptor and that activation of the supraspinal DA receptor was also involved in mediating these synergistic effects. Yoshizumi M, Yonezawa A, Kimura Y, et al. Central Mechanisms of Apomorphine and m-Chlorophenylpiperazine on Synergistic Action for Ejaculation in Rats. J Sex Med 2021;18:231-239.
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Affiliation(s)
- Masaru Yoshizumi
- Department of Physiology and Anatomy, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
| | - Akihiko Yonezawa
- Department of Pharmaceutical Education Center, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
| | | | - Chizuko Watanabe
- Department of Physiology and Anatomy, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Shinobu Sakurada
- Department of Physiology and Anatomy, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Hirokazu Mizoguchi
- Department of Physiology and Anatomy, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
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18
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Macotela Y, Triebel J, Clapp C. Time for a New Perspective on Prolactin in Metabolism. Trends Endocrinol Metab 2020; 31:276-286. [PMID: 32044206 DOI: 10.1016/j.tem.2020.01.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/09/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022]
Abstract
The pituitary hormone prolactin (PRL) regulates a variety of functions beyond reproduction. The association between physiological (pregnancy) and pathological (prolactinoma) hyperprolactinemia and metabolic alterations led to the concept of this hormone being diabetogenic. However, large cohort clinical studies have recently shown that low circulating PRL levels are associated with metabolic disease and represent a risk factor for type 2 diabetes (T2D), whereas high PRL levels are beneficial. Moreover, PRL acts on the pancreas, liver, adipose tissue, and hypothalamus to maintain and promote metabolic homeostasis. By integrating basic and clinical evidence, we hypothesize that upregulation of PRL levels is a mechanism to maintain metabolic homeostasis and, thus, propose that the range of PRL levels considered physiological should be expanded to higher values.
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Affiliation(s)
- Yazmín Macotela
- Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Campus UNAM-Juriquilla, 76230 Querétaro, México.
| | - Jakob Triebel
- Institute for Clinical Chemistry, Laboratory Medicine, and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, Germany
| | - Carmen Clapp
- Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Campus UNAM-Juriquilla, 76230 Querétaro, México
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19
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Phillipps HR, Yip SH, Grattan DR. Patterns of prolactin secretion. Mol Cell Endocrinol 2020; 502:110679. [PMID: 31843563 DOI: 10.1016/j.mce.2019.110679] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/06/2019] [Accepted: 12/06/2019] [Indexed: 12/11/2022]
Abstract
Prolactin is pleotropic in nature affecting multiple tissues throughout the body. As a consequence of the broad range of functions, regulation of anterior pituitary prolactin secretion is complex and atypical as compared to other pituitary hormones. Many studies have provided insight into the complex hypothalamic-pituitary networks controlling prolactin secretion patterns in different species using a range of techniques. Here, we review prolactin secretion in both males and females; and consider the different patterns of prolactin secretion across the reproductive cycle in representative female mammals with short versus long luteal phases and in seasonal breeders. Additionally, we highlight changes in the pattern of secretion during pregnancy and lactation, and discuss the wide range of adaptive functions that prolactin may have in these important physiological states.
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Affiliation(s)
- Hollian R Phillipps
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand
| | - Siew H Yip
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand
| | - David R Grattan
- Centre for Neuroendocrinology and Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, 9016, New Zealand.
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20
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Wesche R, Walsh JL, Shepardson RL, Carey KB, Carey MP. The Association Between Sexual Behavior and Affect: Moderating Factors in Young Women. JOURNAL OF SEX RESEARCH 2019; 56:1058-1069. [PMID: 30507324 PMCID: PMC6546558 DOI: 10.1080/00224499.2018.1542657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sexual behavior is associated with increased positive affect and decreased negative affect. However, contextual variables such as partner type, behavior type, and condom use may moderate these associations. The goal of the present research was to examine these contextual moderators using monthly longitudinal data from a sample of young women. Female first-year college students (N = 477) completed monthly assessments of their sexual behaviors and positive and negative affect. Participants reported more negative affect in months in which they engaged in sexual behavior compared to months in which they did not. This association was moderated by partner type, such that only sexual behavior with casual partners was associated with increased negative affect. Participants reported more positive affect during months with kissing/touching only compared to months without sexual behavior; however, this association did not differ significantly from the association between oral/vaginal sex and positive affect. Condom use did not moderate the association between vaginal sex and positive or negative affect. In this sample of young women transitioning to college, engaging in sexual behavior was generally associated with negative affect; however, changes in affect depended on partner type and sexual behaviors. Findings have implications for sexual health education.
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Affiliation(s)
- Rose Wesche
- Center for AIDS Intervention Research, Medical College of Wisconsin
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, Medical College of Wisconsin
| | | | - Kate B Carey
- Center for Alcohol and Addiction Studies, Brown University; and Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Michael P Carey
- Department of Behavioral and Social Sciences, Brown University School of Public Health; Centers for Behavioral and Preventive Medicine, The Miriam Hospital; and Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University
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21
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Grabovac I, Jackson SE, Smith L. Authors' Reply to the Letter to the Editor: "Sleep and Sexual Arousal: A Complex Issue". J Sex Med 2019; 16:947-948. [PMID: 31029537 DOI: 10.1016/j.jsxm.2019.03.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Sarah E Jackson
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.
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22
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Zhao S, Wang J, Xie Q, Luo L, Zhu Z, Liu Y, Luo J, Zhao Z. Parkinson's Disease Is Associated with Risk of Sexual Dysfunction in Men but Not in Women: A Systematic Review and Meta-Analysis. J Sex Med 2019; 16:434-446. [PMID: 30773498 DOI: 10.1016/j.jsxm.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/26/2018] [Accepted: 12/26/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Mounting evidence has emerged suggesting that patients with Parkinson's disease (PD) are susceptible to sexual dysfunction (SD). AIM To better clarify the relationship between PD and SD. METHODS PubMed, Embase, Cochrane Library database, and PsychINFO database were systematically searched for pertinent studies evaluating sexual function in the patients with PD. This systematic review and meta-analysis have been registered on PROSPERO (ID: CRD42018108714; http://www.crd.york.ac.uk/PROSPERO). OUTCOMES The association between PD and SD was assessed using relative risk (RR) with 95% CI. The quality of evidence was ranked by the GRADE profiler. RESULTS 11 observational studies met the predefined criteria for inclusion, enrolling 30,150 subjects from both the PD group and healthy control group (mean age 54.6-75.1 years). Synthesis results revealed that PD was associated with an elevated risk of SD in males (7 studies; 1.79; 95% CI = 1.26-2.54, P = .001; heterogeneity: I2 = 73.2%, P < .001). However, when restricted to female subjects, the combined RR from 3 eligible studies suggested a lack of significant association between PD and SD (RR = 1.3, 95% CI = 0.64-2.61, P = .469; heterogeneity: I2 = 80.0%, P = .007). The GRADE profiler indicated the overall quality of the evidence was low in studies including males and very low in studies including females. CLINICAL IMPLICATIONS The current meta-analysis indicated that men with PD were more likely to experience SD than those without PD. In female subjects, however, PD seemed to not be associated with a high prevalence of SD compared with healthy controls. Based on these findings, patients with PD should be routinely assessed for sexual functioning, especially males. STRENGTHS & LIMITATIONS This is the first systematic review and meta-analysis of the association between PD and the risks of SD in both males and females. However, substantial heterogeneities were detected across the included studies. CONCLUSION A hazardous effect of PD for developing SD was detected in men but not in women. As a result, sexual function assessment and appropriate therapy are recommended for men with PD in clinical practice. Zhao S, Wang J, Xie Q, et al. Parkinson's Disease Is Associated with Risk of Sexual Dysfunction in Men but Not in Women: A Systematic Review and Meta-Analysis J Sex Med 2019;16:434-446.
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Affiliation(s)
- Shankun Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiamin Wang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Xie
- Department of Reproduction, Southern Medical University Affiliate Dongguan People's Hospital, Dongguan, China
| | - Lianmin Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhiguo Zhu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yangzhou Liu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jintai Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhigang Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Salais-López H, Agustín-Pavón C, Lanuza E, Martínez-García F. The maternal hormone in the male brain: Sexually dimorphic distribution of prolactin signalling in the mouse brain. PLoS One 2018; 13:e0208960. [PMID: 30571750 PMCID: PMC6301622 DOI: 10.1371/journal.pone.0208960] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/27/2018] [Indexed: 01/10/2023] Open
Abstract
Research of the central actions of prolactin is highly focused on females, but this hormone has also documented roles in male physiology and behaviour. Here, we provide the first description of the pattern of prolactin-derived signalling in the male mouse brain, employing the immunostaining of phosphorylated signal transducer and activator of transcription 5 (pSTAT5) after exogenous prolactin administration. Next, we explore possible sexually dimorphic differences by comparing pSTAT5 immunoreactivity in prolactin-supplemented males and females. We also assess the role of testosterone in the regulation of central prolactin signalling in males by comparing intact with castrated prolactin-supplemented males. Prolactin-supplemented males displayed a widespread pattern of pSTAT5 immunoreactivity, restricted to brain centres showing expression of the prolactin receptor. Immunoreactivity for pSTAT5 was present in several nuclei of the preoptic, anterior and tuberal hypothalamus, as well as in the septofimbrial nucleus or posterodorsal medial amygdala of the telencephalon. Conversely, non-supplemented control males were virtually devoid of pSTAT5-immunoreactivity, suggesting that central prolactin actions in males are limited to situations concurrent with substantial hypophyseal prolactin release (e.g. stress or mating). Furthermore, comparison of prolactin-supplemented males and females revealed a significant, female-biased sexual dimorphism, supporting the view that prolactin has a preeminent role in female physiology and behaviour. Finally, in males, castration significantly reduced pSTAT5 immunoreactivity in some structures, including the paraventricular and ventromedial hypothalamic nuclei and the septofimbrial region, thus indicating a region-specific regulatory role of testosterone over central prolactin signalling.
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Affiliation(s)
- Hugo Salais-López
- Unitat Predepartamental de Medicina, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
| | - Carmen Agustín-Pavón
- Unitat Predepartamental de Medicina, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
- Departament de Biologia Cel·lular i de Biologia Funcional, Facultat de Ciències Biològiques, Universitat de València, València, Spain
| | - Enrique Lanuza
- Departament de Biologia Cel·lular i de Biologia Funcional, Facultat de Ciències Biològiques, Universitat de València, València, Spain
| | - Fernando Martínez-García
- Unitat Predepartamental de Medicina, Facultat de Ciències de la Salut, Universitat Jaume I, Castelló de la Plana, Spain
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Dopamine: Functions, Signaling, and Association with Neurological Diseases. Cell Mol Neurobiol 2018; 39:31-59. [PMID: 30446950 DOI: 10.1007/s10571-018-0632-3] [Citation(s) in RCA: 469] [Impact Index Per Article: 78.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/02/2018] [Indexed: 02/07/2023]
Abstract
The dopaminergic system plays important roles in neuromodulation, such as motor control, motivation, reward, cognitive function, maternal, and reproductive behaviors. Dopamine is a neurotransmitter, synthesized in both central nervous system and the periphery, that exerts its actions upon binding to G protein-coupled receptors. Dopamine receptors are widely expressed in the body and function in both the peripheral and the central nervous systems. Dopaminergic signaling pathways are crucial to the maintenance of physiological processes and an unbalanced activity may lead to dysfunctions that are related to neurodegenerative diseases. Unveiling the neurobiology and the molecular mechanisms that underlie these illnesses may contribute to the development of new therapies that could promote a better quality of life for patients worldwide. In this review, we summarize the aspects of dopamine as a catecholaminergic neurotransmitter and discuss dopamine signaling pathways elicited through dopamine receptor activation in normal brain function. Furthermore, we describe the potential involvement of these signaling pathways in evoking the onset and progression of some diseases in the nervous system, such as Parkinson's, Schizophrenia, Huntington's, Attention Deficit and Hyperactivity Disorder, and Addiction. A brief description of new dopaminergic drugs recently approved and under development treatments for these ailments is also provided.
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25
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A Review of Pathophysiology and Management Options for Delayed Ejaculation. Sex Med Rev 2018; 4:167-76. [PMID: 27530382 DOI: 10.1016/j.sxmr.2015.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 09/01/2015] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Delayed ejaculation (DE) is a poorly defined disorder that entails the delay or absence of orgasm that results in personal distress. Numerous causes of DE exist, and management must be tailored to the specific etiology to maximize treatment success. Management strategies include psychological and sexual therapy, pharmacotherapy, and penile vibratory stimulation. AIM This article intends to review the pathophysiology and treatment options for DE discussed in the literature to date. METHODS A review of the literature was performed to identify and evaluate the existing data on treatment success for the various forms of DE management. MAIN OUTCOME MEASURES Each treatment option was evaluated for method of administration, data supporting its success for DE, and potential risks or side effects. RESULTS Different psychosexual therapy strategies have been described for DE but with limited data to describe efficacy. There is no medication for DE approved by the United States Food and Drug Administration. The quality of evidence supporting the off-label use of medications for DE is low. However, there are numerous medications reported in the literature suggested to treat the condition. Cabergoline and bupropion are the two most commonly used. In addition, penile vibratory stimulation has been described as an adjunct treatment option for DE. CONCLUSION There are different treatment options reported for DE, all with limited evidence supporting their efficacy. Identifying the etiology of the DE is important to appropriately target therapy. A multimodal approach combining psychosexual therapy with medications and/or penile vibratory stimulation will likely provide the best outcomes.
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Boiten HJ, Baris L, van den Bos EJ. Orgasm induced torsades de pointes in a patient with a novel mutation with long-QT syndrome type 2: a case report. Eur Heart J Case Rep 2018; 2:yty062. [PMID: 31020140 PMCID: PMC6177060 DOI: 10.1093/ehjcr/yty062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/22/2018] [Indexed: 01/08/2023]
Abstract
Introduction Congenital long-QT (LQT) syndrome can lead to torsades de pointes (TdP), which can deteriorate into ventricular fibrillation resulting in sudden death. Thus far, more than 16 genes have been linked to the LQT syndrome. We report an orgasm-induced TdP in a patient with LQT syndrome type 2 with a novel mutation in the KCNH2 gene. Case presentation A 24-year-old Caucasian woman with a medical history of depression, no medication use and no family history of sudden death, presented with recurrent syncope during sexual activity. Immediately after achieving orgasm during sexual intercourse she lost consciousness. Baseline 12-lead electrocardiogram revealed a wide based T-wave with a prolonged QTc-interval of 507 ms. During hospital admission runs of TdP were recorded. The patient was treated with magnesium, an oral beta-blocker, and an implantable cardioverter-defibrillator. Genetic testing (Sanger sequencing) revealed a novel mutation (c.361del) in the KCNH2 gene (chromosome 7q36). Discussion To date, orgasm-induced TdP as a first symptom in a patient with LQT2 has not been published previously. In studies with continuous blood sampling in healthy volunteers, large peaks in plasma epinephrine levels during orgasm were observed with fast post-orgasmic decline. However, in a large cohort study (402 patients of which 129 with LQT2), no patients experienced cardiac events during sexual activity, suggesting that these are indeed very rare. Nevertheless, the high levels of sympathetic adrenal hormones during orgasm may explain the timing of the TdP in our patient. The patient has remained free of syncope at 6 months of follow-up.
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Affiliation(s)
- Henk-Jan Boiten
- Department of Internal Medicine, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, AT Dordrecht, The Netherlands
- Department of Cardiology, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, AT Dordrecht, The Netherlands
| | - Lucia Baris
- Department of Cardiology, Erasmus Medical Center, 's Gravendijkwal 230, CE Rotterdam, The Netherlands
| | - Ewout J van den Bos
- Department of Internal Medicine, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, AT Dordrecht, The Netherlands
- Department of Cardiology, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, AT Dordrecht, The Netherlands
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Lopes RA, Coelho T, Barros A, Sousa M. Corino de Andrade disease: mechanisms and impact on reproduction. JBRA Assist Reprod 2017; 21:105-114. [PMID: 28609277 PMCID: PMC5473703 DOI: 10.5935/1518-0557.20170025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Familial amyloid polyneuropathy was first described by Corino de Andrade in 1952
in Northern Portugal. It is a fatal autosomal dominant neurodegenerative
disorder characterized by a progression of neurologic symptoms, beginning early
in the reproductive life. The Transthyretin gene mutation originates a mutated
protein that precipitates in the connective tissue as amyloid deposits. This
disease is presently named Transthyretin-related hereditary amyloidosis. We
performed an extensive review on this disease based on searches in Medical
databases and in paper references. In this review, we briefly summarize the
epidemiology and the mechanisms involved on amyloid deposition; we detailed how
to evaluate the mechanisms implicated on the development of the major signs and
symptoms associated with reproductive dysfunction; and we discuss the mechanisms
involved in secondary sexual dysfunction after psychological treatments.
Treatment of the disease is directed towards relieving specific symptoms in
association with liver transplant, and molecular and genetic therapeutics.
Although the current clinical trials indicate symptoms relief, no data on the
reproductive function was reported. Thus, preimplantation genetic diagnosis is
presently the only available technique that eradicates the disease as it avoids
the birth of new patients.
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Affiliation(s)
- Rita A Lopes
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Portugal
| | - Teresa Coelho
- Department of Neurophysiology, Research Center of Corino de Andrade (Paramyloidosis), Hospital Centre of Porto, Portugal
| | - Alberto Barros
- Centre for Reproductive Genetics Prof. Alberto Barros (CGR), Porto, Portugal.,Department of Genetics - School of Medicine, Institute of Health Research and Innovation, University of Porto
| | - Mário Sousa
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Portugal
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Abstract
Sexual dysfunction, a common side effect of antipsychotic medications, may be partly caused by dopamine antagonism and elevation of prolactin. In QUALIFY, a randomized study, aripiprazole once-monthly 400 mg (AOM 400), a dopamine D2 receptor partial agonist, showed noninferiority and subsequent superiority versus paliperidone palmitate (PP), a dopamine D2 receptor antagonist, on the Heinrichs-Carpenter Quality-of-Life Scale (QLS) in patients with schizophrenia aged 18-60 years. Sexual dysfunction (Arizona Sexual Experience Scale) and serum prolactin levels were also assessed. Odds for sexual dysfunction were lower with AOM 400 versus PP [week 28 adjusted odds ratio (95% confidence interval), 0.29 (0.14-0.61); P=0.0012] in men [0.33 (0.13-0.86); P=0.023], women [0.14 (0.03-0.62); P=0.0099], and patients aged 18-35 years [0.04 (<0.01-0.34); P=0.003]. Among patients shifting from sexual dysfunction at baseline to none at week 28, there was a trend toward greater improvement in the QLS total score. The mean (SD) prolactin concentrations decreased with AOM 400 [-150.6 (274.4) mIU/l] and increased with PP [464.7 (867.5) mIU/l] in both men and women. Six PP-treated patients experienced prolactin-related adverse events. In addition to greater improvement on QLS, patients had a lower risk for sexual dysfunction and prolactin elevation with AOM 400 versus PP in QUALIFY.
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Qin X, Ma X, Liang J, Tu D, Luo Z, Huang J, Mo C. Profiles of brain central nervous system gene expression associated with ejaculation behavior in male rats. Behav Brain Res 2017; 324:21-29. [DOI: 10.1016/j.bbr.2017.01.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/22/2017] [Accepted: 01/27/2017] [Indexed: 01/23/2023]
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Qin X, Ma X, Tu D, Luo Z, Huang J, Mo C. The effect of 8-OH-DPAT and dapoxetine on gene expression in the brain of male rats during ejaculation. Acta Pharm Sin B 2017; 7:381-389. [PMID: 28540176 PMCID: PMC5430880 DOI: 10.1016/j.apsb.2016.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The 5-HT1A receptor agonist 8-hydroxy-2-[di-n-propylamino] tetralin (8-OH-DPAT) promotes ejaculation of male rats, whereas dapoxetine delays this process. However, the gene expression profile of the brain at ejaculation following administrationof these two compounds has not been fully elucidated. In the present study, a transcriptomic BodyMap was generated by conducting mRNA-Seq on brain samples of male Sprague–Dawley rats. The study included four groups: pre-copulatory control (CK) group, ejaculation (EJ) group, 0.5 mg/kg 8-OH-DPAT-ejaculation group (DPAT), and 60 mg/kg dapoxetine-ejaculation (DAP) group. The resulting analysis generated an average of approximately 47 million sequence reads. Significant differences in the gene expression profiles of the aforementioned groups were observed in the EJ (257 genes), DPAT (349 genes) and the DAP (207 genes) compared with the control rats. The results indicate that the expression of Drd1 and Slc6a3 was significantly different after treatment with 8-OH-DPAT, whereas the expression of Drd4 was significantly different after treatment with dapoxetine. Other genes, such as Wnt9b, Cdkn1a and Fosb, exhibited significant differences in expression after the two treatments and are related to bladder cancer, renal cell carcinoma and sexual addiction. The present study reveals the basic pattern of gene expression that was activated at ejaculation in the presence of 8-OH-DPAT or dapoxetine, providing preliminary gene expression information during rat ejaculation.
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Affiliation(s)
- Xijun Qin
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Xiaojun Ma
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
- Corresponding author. Tel.: +86 13501187416; fax: +86 21 57643271.
| | - Dongping Tu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Zuliang Luo
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China
| | - Jie Huang
- Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Changming Mo
- Guangxi Branch of Institute of Medicinal Plant Development, Chinese Academy of Medical Science, Nanning 530023, China
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Rotenberg VS. Sexual Disorders Caused by Antidepressants: Considerations in the Context of Brain Hemisphere Functions. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/bf03379566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
All phases of normal sexual activity are under the control of the right hemisphere coupled with limbic structures, and depression is characterized by the functional insufficiency of this system. At the same time, those modern antidepressants that cause sexual disorders are activating the left hemisphere and determine its domination on the expense of the right one and disturb free and spontaneous emotional interrelationships, sexual behavior and pleasure. Those antidepressants that do not cause sexual dysfunction are not activating predominantly the left hemisphere structures and activate the limbic brain zones responsible for reward, reinforcement and emotional excitement.
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Prause N, Siegle GJ, Deblieck C, Wu A, Iacoboni M. EEG to Primary Rewards: Predictive Utility and Malleability by Brain Stimulation. PLoS One 2016; 11:e0165646. [PMID: 27902711 PMCID: PMC5130195 DOI: 10.1371/journal.pone.0165646] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 10/14/2016] [Indexed: 11/18/2022] Open
Abstract
Theta burst stimulation (TBS) is thought to affect reward processing mechanisms, which may increase and decrease reward sensitivity. To test the ability of TBS to modulate response to strong primary rewards, participants hypersensitive to primary rewards were recruited. Twenty men and women with at least two opposite-sex, sexual partners in the last year received two forms of TBS. Stimulations were randomized to avoid order effects and separated by 2 hours to reduce carryover. The two TBS forms have been demonstrated to inhibit (continuous) or excite (intermittent) the left dorsolateral prefrontal cortex using different pulse patterns, which links to brain areas associated with reward conditioning. After each TBS, participants completed tasks assessing their reward responsiveness to monetary and sexual rewards. Electroencephalography (EEG) was recorded. They also reported their number of orgasms in the weekend following stimulation. This signal was malleable by TBS, where excitatory TBS resulted in lower EEG alpha relative to inhibitory TBS to primary rewards. EEG responses to sexual rewards in the lab (following both forms of TBS) predicted the number of orgasms experienced over the forthcoming weekend. TBS may be useful in modifying hypersensitivity or hyposensitivity to primary rewards that predict sexual behaviors. Since TBS altered the anticipation of a sexual reward, TBS may offer a novel treatment for sexual desire problems.
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Affiliation(s)
- Nicole Prause
- Department of Psychiatry; University of California;Los Angeles, CA
- * E-mail:
| | - Greg J. Siegle
- Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA
| | - Choi Deblieck
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA
| | - Allan Wu
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA
| | - Marco Iacoboni
- Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA
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Alrashedy NA, Molina J. The ethnobotany of psychoactive plant use: a phylogenetic perspective. PeerJ 2016; 4:e2546. [PMID: 27761334 PMCID: PMC5068365 DOI: 10.7717/peerj.2546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/09/2016] [Indexed: 12/21/2022] Open
Abstract
Psychoactive plants contain chemicals that presumably evolved as allelochemicals but target certain neuronal receptors when consumed by humans, altering perception, emotion and cognition. These plants have been used since ancient times as medicines and in the context of religious rituals for their various psychoactive effects (e.g., as hallucinogens, stimulants, sedatives). The ubiquity of psychoactive plants in various cultures motivates investigation of the commonalities among these plants, in which a phylogenetic framework may be insightful. A phylogeny of culturally diverse psychoactive plant taxa was constructed with their psychotropic effects and affected neurotransmitter systems mapped on the phylogeny. The phylogenetic distribution shows multiple evolutionary origins of psychoactive families. The plant families Myristicaceae (e.g., nutmeg), Papaveraceae (opium poppy), Cactaceae (peyote), Convolvulaceae (morning glory), Solanaceae (tobacco), Lamiaceae (mints), Apocynaceae (dogbane) have a disproportionate number of psychoactive genera with various indigenous groups using geographically disparate members of these plant families for the same psychoactive effect, an example of cultural convergence. Pharmacological traits related to hallucinogenic and sedative potential are phylogenetically conserved within families. Unrelated families that exert similar psychoactive effects also modulate similar neurotransmitter systems (i.e., mechanistic convergence). However, pharmacological mechanisms for stimulant effects were varied even within families suggesting that stimulant chemicals may be more evolutionarily labile than those associated with hallucinogenic and sedative effects. Chemically similar psychoactive chemicals may also exist in phylogenetically unrelated lineages, suggesting convergent evolution or differential gene regulation of a common metabolic pathway. Our study has shown that phylogenetic analysis of traditionally used psychoactive plants suggests multiple ethnobotanical origins and widespread human dependence on these plants, motivating pharmacological investigation into their potential as modern therapeutics for various neurological disorders.
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Affiliation(s)
| | - Jeanmaire Molina
- Department of Biology, Long Island University, Brooklyn, NY, United States
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Abstract
Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically .We also highlighted specific settings where drugs could be introduced to medical practice. Electronic databases were searched from 1966 to February 2016, including PubMed MEDLINE, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google Scholar using key words; delayed ejaculation, retarded ejaculation, inhibited ejaculation, drugs, treatment, or pharmacology. To achieve the maximum sensitivity of the search strategy and to identify all studies, we combined “delayed ejaculation” as Medical Subject Headings (MeSH) terms or keywords with each of “testosterone” or “cabergoline” or “bupropion” or “amantadine” or “cyproheptadine” or “midodrine” or “imipramine” or “ephedrine” or “pseudoephedrine” or “yohimbine” or “buspirone” or “oxytocin” or “bethanechol” as MeSH terms or keywords. There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. Review of literature showed that evidence level 1 (Double blind randomized clinical trial) studies were performed with testosterone, oxytocin, buspirone or bethanechol treatment. It is concluded that successful drug treatment of DE is still in its infancy. The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care for these patients. Various drugs are available to address such problem, however their evidence of efficacy is still limited and their choice needs to be individualized to each specific case.
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Affiliation(s)
| | | | - Taymour Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
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Goodwin BC, Browne M, Rockloff M, Loxton NJ. Rash impulsivity predicts lower anticipated pleasure response and a preference for the supernormal. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Butcher MJ, Welliver RC, Sadowski D, Botchway A, Köhler TS. How is delayed ejaculation defined and treated in North America? Andrology 2016; 3:626-31. [PMID: 26013106 DOI: 10.1111/andr.12041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/27/2015] [Accepted: 03/24/2015] [Indexed: 12/31/2022]
Abstract
Delayed ejaculation (DE) is an uncommon disorder that is difficult to treat because it is poorly understood. The aim was to evaluate the current opinion and clinical management of DE by practitioners in sexual medicine. Members of the Sexual Medicine Society of North America (SMSNA) were invited by email to participate in a web-based survey. The questionnaire consisted of eight questions pertaining to DE. Questions addressed patient volume, qualification of patient bother, ranking of etiologies, perceived success, treatments used, quantification of symptom resolution, and broad characterization of practitioner type. A total of 94 respondents completed the survey with 73% of those being urologists. Fifty-nine percent of the respondents saw ≤ 2 patients a month with DE and 89% of practitioners felt that DE was moderately or severely bothersome to the patients. Etiology was felt to be from medications and psychological factors primarily. Despite treatment modality, 'seldom' success was obtained for 49% of the time and 'never' for 11%. Carbergoline was the most common selected medication for DE. Academic and private urologists reported 'never' or 'seldom' success with sexual counseling compared to other practitioners, respectively (p = 0.008 and p = 0.001). Respondents who saw ≤ 2 patients per month often reported normalization of hypogonadism 'never' or 'seldom' corrected DE (p = 0.047). Delayed ejaculation is still a poorly understood disorder with inconsistent practice patterns seen among members of the SMSNA. A better understanding of this vexing disorder is needed with efforts placed on research and practitioner education.
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Affiliation(s)
- M J Butcher
- Division of Urology, Southern Illinois University - School of Medicine, Springfield, IL, USA
| | | | - D Sadowski
- Division of Urology, Southern Illinois University - School of Medicine, Springfield, IL, USA
| | - A Botchway
- Southern Illinois University Center for Clinical Research, Springfield, IL, USA
| | - T S Köhler
- Division of Urology, Southern Illinois University - School of Medicine, Springfield, IL, USA
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Multiple Orgasms in Men-What We Know So Far. Sex Med Rev 2016; 4:136-148. [PMID: 27872023 DOI: 10.1016/j.sxmr.2015.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 01/23/2023]
Abstract
INTRODUCTION There is much popular discussion on strategies to facilitate multiple orgasms in men (ie, 100,000+ hits in Google), yet the topic has not received an objective comprehensive review in the literature. AIM To review the literature on male multiple orgasms. METHODS We searched the literature for publications on "male multiple orgasms" and factors influencing male multiple orgasms in Google, PubMed, and PsychINFO. This yielded 15 relevant publications. MAIN OUTCOME MEASURES A comprehensive overview on the topic of male multiple orgasms and factors that influence the propensity of men to experience multiple orgasms. RESULTS Few men are multiorgasmic: <10% for those in their 20s, and <7% after the age of 30. The literature suggests 2 types of male multiple orgasms: "sporadic" multiorgasms, with interorgasmic intervals of several minutes, and "condensed" multiorgasms, with bursts of 2-4 orgasms within a few seconds to 2 minutes. Multiple orgasms appear physiologically similar to the single orgasm in mono-orgasmic men. However, in a single case study, a multiorgasmic man did not experience with his first orgasm the prolactin surge that usually occurs with orgasm in mono-orgasmic men. Various factors may facilitate multiple orgasms: (1) practicing to have an orgasm without ejaculation; (2) using psychostimulant drugs; (3) having multiple and/or novel sexual partners; or (4) using sex toys to enhance tactile stimulation. However, confirmatory physiological data on any of these factors are few. In some cases, the ability to experience multiple orgasms may increase after medical procedures that reduce ejaculation (eg, prostatectomy or castration), but what factor(s) influence this phenomenon is poorly investigated. CONCLUSION Despite popular interest, the topic of male multiple orgasms has received surprisingly little scientific assessment. The role of ejaculation and physiological change during the refractory period in inhibiting multiple orgasms has barely been investigated.
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Rojas-Hernández J, Juárez J. Copulation is reactivated by bromocriptine in male rats after reaching sexual satiety with a same sexual mate. Physiol Behav 2015; 151:551-6. [PMID: 26319370 DOI: 10.1016/j.physbeh.2015.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 07/27/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
Abstract
Male sexual satiety has been associated with a decrease in dopamine levels. Spontaneous recovery of copulatory behavior begins at least 72 h after sexual satiety is reached or in the condition in which a sexually-satiated male is exposed to a new receptive female distinct from the one with which sexual satiety was reached. The aim of the present study was to explore whether dopaminergic activation by bromocriptine (BrCr) can reactivate copulatory behavior with the same sexual mate immediately after sexual satiety is reached. Male rats were divided into three groups exposed to one of the following three conditions: 1) administration of 2 mg/kgs.c. of BrCr and exposure to the same female with whom sexual satiety was previously reached; 2) administration of 0.3 mLs.c. of the vehicle solution with exposure to the same female with whom sexual satiety was reached; and, 3) exposure to a new receptive female after sexual satiety was reached. Results showed that BrCr significantly reactivated copulatory capability in sexually-satiated males with the same receptive female. In contrast, no males in the vehicle group ejaculated with the same female after reaching sexual exhaustion. Copulation was reactivated by BrCr in a way similar to that observed in untreated males exposed to a new receptive female (i.e., the Coolidge effect). The reversal of sexual satiety in the males treated with BrCr could be explained by its action on D2 family receptors, which promotes a reactivation of sexual motivation at a level sufficient to allow renewed copulation with the same female mate.
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Affiliation(s)
- Jorge Rojas-Hernández
- Laboratorio de Farmacología y Conducta, Instituto de Neurociencias, CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco CP 44130, Mexico
| | - Jorge Juárez
- Laboratorio de Farmacología y Conducta, Instituto de Neurociencias, CUCBA, Universidad de Guadalajara, Guadalajara, Jalisco CP 44130, Mexico.
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Schmid Y, Hysek CM, Preller KH, Bosch OG, Bilderbeck AC, Rogers RD, Quednow BB, Liechti ME. Effects of methylphenidate and MDMA on appraisal of erotic stimuli and intimate relationships. Eur Neuropsychopharmacol 2015; 25:17-25. [PMID: 25498417 DOI: 10.1016/j.euroneuro.2014.11.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 10/24/2014] [Accepted: 11/24/2014] [Indexed: 12/27/2022]
Abstract
Methylphenidate mainly enhances dopamine neurotransmission whereas 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") mainly enhances serotonin neurotransmission. However, both drugs also induce a weaker increase of cerebral noradrenaline exerting sympathomimetic properties. Dopaminergic psychostimulants are reported to increase sexual drive, while serotonergic drugs typically impair sexual arousal and functions. Additionally, serotonin has also been shown to modulate cognitive perception of romantic relationships. Whether methylphenidate or MDMA alter sexual arousal or cognitive appraisal of intimate relationships is not known. Thus, we evaluated effects of methylphenidate (40 mg) and MDMA (75 mg) on subjective sexual arousal by viewing erotic pictures and on perception of romantic relationships of unknown couples in a double-blind, randomized, placebo-controlled, crossover study in 30 healthy adults. Methylphenidate, but not MDMA, increased ratings of sexual arousal for explicit sexual stimuli. The participants also sought to increase the presentation time of implicit sexual stimuli by button press after methylphenidate treatment compared with placebo. Plasma levels of testosterone, estrogen, and progesterone were not associated with sexual arousal ratings. Neither MDMA nor methylphenidate altered appraisal of romantic relationships of others. The findings indicate that pharmacological stimulation of dopaminergic but not of serotonergic neurotransmission enhances sexual drive. Whether sexual perception is altered in subjects misusing methylphenidate e.g., for cognitive enhancement or as treatment for attention deficit hyperactivity disorder is of high interest and warrants further investigation.
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Affiliation(s)
- Yasmin Schmid
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Cédric M Hysek
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Oliver G Bosch
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | | | | | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias E Liechti
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
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Garcia JR, Lloyd EA, Wallen K, Fisher HE. Variation in orgasm occurrence by sexual orientation in a sample of U.S. singles. J Sex Med 2014; 11:2645-52. [PMID: 25131299 PMCID: PMC6035747 DOI: 10.1111/jsm.12669] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Despite recent advances in understanding orgasm variation, little is known about ways in which sexual orientation is associated with men's and women's orgasm occurrence. AIM To assess orgasm occurrence during sexual activity across sexual orientation categories. METHODS Data were collected by Internet questionnaire from 6,151 men and women (ages 21-65+ years) as part of a nationally representative sample of single individuals in the United States. Analyses were restricted to a subsample of 2,850 singles (1,497 men, 1,353 women) who had experienced sexual activity in the past 12 months. MAIN OUTCOME MEASURES Participants reported their sex/gender, self-identified sexual orientation (heterosexual, gay/lesbian, bisexual), and what percentage of the time they experience orgasm when having sex with a familiar partner. RESULTS Mean occurrence rate for experiencing orgasm during sexual activity with a familiar partner was 62.9% among single women and 85.1% among single men, which was significantly different (F1,2848 = 370.6, P < 0.001, η(2) = 0.12). For men, mean occurrence rate of orgasm did not vary by sexual orientation: heterosexual men 85.5%, gay men 84.7%, bisexual men 77.6% (F2,1494 = 2.67, P = 0.07, η(2) = 0.004). For women, however, mean occurrence rate of orgasm varied significantly by sexual orientation: heterosexual women 61.6%, lesbian women 74.7%, bisexual women 58.0% (F2,1350 = 10.95, P < 0.001, η(2) = 0.02). Lesbian women had a significantly higher probability of orgasm than did either heterosexual or bisexual women (P < 0.05). CONCLUSIONS Findings from this large dataset of U.S. singles suggest that women, regardless of sexual orientation, have less predictable, more varied orgasm experiences than do men and that for women, but not men, the likelihood of orgasm varies with sexual orientation. These findings demonstrate the need for further investigations into the comparative sexual experiences and sexual health outcomes of sexual minorities.
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Affiliation(s)
- Justin R. Garcia
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of Gender Studies, Indiana University, Bloomington, IN, USA
| | - Elisabeth A. Lloyd
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of History and Philosophy of Science, Indiana University, Bloomington, IN, USA
| | - Kim Wallen
- Department of Psychology and Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Helen E. Fisher
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- Department of Anthropology, Rutgers University, New Brunswick, NJ, USA
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Affiliation(s)
- Ali Ulvi Uca
- Department of Neurology; Meram Faculty of Medicine; Necmettin Erbakan University; Konya Turkey
| | - Mustafa Altaş
- Department of Neurology; Meram Faculty of Medicine; Necmettin Erbakan University; Konya Turkey
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Panos GD, Gatzioufas Z. Effect of hyperprolactinaemia on intra-ocular pressure. Acta Ophthalmol 2014; 92:e326. [PMID: 24028445 DOI: 10.1111/aos.12269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Georgios D Panos
- Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland
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Reis SLB, Abdo CHN. Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors. Clinics (Sao Paulo) 2014; 69:294-303. [PMID: 24714838 PMCID: PMC3971358 DOI: 10.6061/clinics/2014(04)11] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/10/2013] [Indexed: 01/08/2023] Open
Abstract
With advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men. The efficacy of phosphodiesterase type 5 inhibitors, together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction. For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder. We sought to evaluate the use of androgens in the treatment of a lack of libido in women, comparing two periods, i.e., before and after the advent of the phosphodiesterase type 5 inhibitors. We also analyzed the risks and benefits of androgen administration. We searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof. We selected articles written in English, Portuguese, or Spanish. After the advent of phosphodiesterase type 5 inhibitors, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder. However, the risks and benefits of testosterone administration have yet to be clarified.
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Affiliation(s)
- Sandra Léa Bonfim Reis
- Department of Pathophysiology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carmita H N Abdo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Anatomie et physiologie de la sexualité. Prog Urol 2013; 23:547-61. [DOI: 10.1016/j.purol.2012.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 11/16/2012] [Indexed: 01/08/2023]
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Abstract
We report the results of repeated ambulatory continuous 24-h IOP monitoring with a contact lens sensor in a female glaucoma patient who engaged in sexual activity during each of three monitoring sessions. Our findings show that IOP patterns seemed to decrease during the period of sexual activity.
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Leeners B, Kruger TH, Brody S, Schmidlin S, Naegeli E, Egli M. The Quality of Sexual Experience in Women Correlates with Post‐Orgasmic Prolactin Surges: Results from an Experimental Prototype Study. J Sex Med 2013; 10:1313-9. [DOI: 10.1111/jsm.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Glasper ER, Gould E. Sexual experience restores age-related decline in adult neurogenesis and hippocampal function. Hippocampus 2013; 23:303-12. [PMID: 23460298 PMCID: PMC9985342 DOI: 10.1002/hipo.22090] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 01/17/2023]
Abstract
Aging is associated with compromised hippocampal function and reduced adult neurogenesis in the dentate gyrus. As new neurons have been linked to hippocampal functions, such as cognition, age-related decline in new neuron formation may contribute to impaired hippocampal function. We investigated whether a rewarding experience known to stimulate neurogenesis in young adult rats, namely sexual experience, would restore new neuron production and hippocampal function in middle-aged rats. Sexual experience enhanced the number of newly generated neurons in the dentate gyrus with both single and repeated exposures in middle-aged rats. Following continuous long-term exposure to sexual experience, cognitive function was improved. However, when a prolonged withdrawal period was introduced between the final mating experience and behavioral testing, the improvements in cognitive function were lost despite the presence of more new neurons. Taken together, these results suggest that repeated sexual experience can stimulate adult neurogenesis and restore cognitive function in the middle-aged rat as long as the experience persists throughout the testing period. The extent to which changes in adult neurogenesis underlie those in cognition remain unknown.
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Affiliation(s)
- Erica R. Glasper
- University of Maryland, Department of Psychology, College Park, MD 20742, US
| | - Elizabeth Gould
- Princeton University, Department of Psychology and Neuroscience Institute, Princeton, NJ 08544, US,Corresponding author: Elizabeth Gould, Department of Psychology and Neuroscience, Institute, Princeton University, Princeton, NJ 08544, Telephone: 609-258-4483,
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Galdiero M, Pivonello R, Grasso LFS, Cozzolino A, Colao A. Growth hormone, prolactin, and sexuality. J Endocrinol Invest 2012; 35:782-794. [PMID: 28726215 DOI: 10.1007/bf03345805] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2012] [Indexed: 01/23/2023]
Abstract
GH and PRL, although not considered as 'classi cal' sexual hormones, could play a role in the endocrine control of sexual function both in men and women. Physiologically, PRL seems to be involved in the central control of sexual behavior and activity, by modulating mainly the effects of dopaminergic and serotoninergic systems on sexual function. Indeed, circulating PRL levels increase after orgasm and may potentially play a role in the acute regulation of further sexual arousal following orgasm both in men and women. On the other hand, either short-term or long-term PRL in crease can modulate central nervous system areas involved in the control of sexual function and, peripherally, can directly influence mechanisms of penile erection in men, and presently only as an hypothesis, mechanisms related to the sexual response of genitalia in women. Furthermore, chronic hyperprolactinemia is classically associated with hypogonadotropic hypogonadism and sexual dysfunction in both sexes. Successful treatment of chronic hyperprolactinemia generally restores normal sexual function both in men and women although this effect is not only related to relapse of gonadal function. Hypoprolactinemia is recently recognised as a possible risk factor of arteriogenic erectile dysfunction while a possible role on female sexual function is not known. The physiological role of GH on sexual function is not fully elucidated. GH is an important regulator of hypothalamus-pituitary-gonadal axis and seems to participate in the regulation of the sexual response of genitalia in men, and potentially also in women. Sexual function in men and women with GH deficiency (GHD) and GH excess, particularly in acromegaly, is scantily studied and GH- or IGF-I-dependent effects are difficult to quantify. Nevertheless, a decrease of desire and arousability both in men and women, together with an impairment of erectile function in men, have been described both in patients with GHD and acromegaly, although it is not clear whether they are dependent directly on the hormone defect or excess or they are consequence of the hypogonadism or the different clinical complications or the physical disfigurement and psychological imbalance, which are associated with the diseases, and are potentially affecting sexual function. Data on beneficial effects of GH replacement therapy and specific surgical or pharmacological approach for acromegaly are far to be fully elucidated although restoring normal GH/IGF-I levels have been associated to improvement of sexual function.
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Affiliation(s)
- M Galdiero
- Department of Molecular & Clinical Endocrinology and Oncology, "Federico II" University of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - R Pivonello
- Department of Molecular & Clinical Endocrinology and Oncology, "Federico II" University of Naples, Via S. Pansini 5, 80131, Naples, Italy.
| | - L F S Grasso
- Department of Molecular & Clinical Endocrinology and Oncology, "Federico II" University of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - A Cozzolino
- Department of Molecular & Clinical Endocrinology and Oncology, "Federico II" University of Naples, Via S. Pansini 5, 80131, Naples, Italy
| | - A Colao
- Department of Molecular & Clinical Endocrinology and Oncology, "Federico II" University of Naples, Via S. Pansini 5, 80131, Naples, Italy
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