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Zamponi V, Haxhi J, Pugliese G, Faggiano A, Mazzilli R. Diabetes technology and sexual health: which role? J Endocrinol Invest 2024; 47:1315-1321. [PMID: 37987916 PMCID: PMC11142995 DOI: 10.1007/s40618-023-02237-7] [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: 09/07/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The aim of this review is to evaluate the effects of new technology used in the management of diabetes mellitus (DM), including the use of continuous glucose monitoring (CGM) and the administration of insulin through continuous subcutaneous insulin infusion (CSII), on male and female sexual function. METHODS This narrative review was performed for all available prospective, retrospective and review articles, published up to June 2023 in PubMed. Data were extracted from the text and from the tables of the manuscript. RESULTS Sexual dysfunctions are an underestimated comorbidity of DM in both male and female. Although erectile dysfunction (ED) is recognized by the guidelines as a complication of DM, female sexual dysfunction (FSD) is poorly investigated in clinical setting. In addition to the complications of DM, the different types of therapies can also influence male and female sexual response. Furthermore, insulin therapy can be administered through multiple-daily injections (MDI) or a CSII. The new technologies in the field of DM allow better glycemic control which results in a reduction in the occurrence or aggravation of complications of DM. Despite this evidence, few data are available on the impact of new technologies on sexual dysfunctions. CONCLUSIONS The use of DM technology might affect sexual function due to the risk of a worse body image, as well as discomfort related to CSII disconnection during sexual activity. However, the use is related to an improved metabolic control, which, in the long-term associates to a reduction in all diabetes complications, including sexual function.
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Affiliation(s)
- V Zamponi
- Endocrine-Metabolic Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, via di Grottarossa, 1035-1039, Rome, Italy
| | - J Haxhi
- Endocrine-Metabolic Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, via di Grottarossa, 1035-1039, Rome, Italy
| | - G Pugliese
- Endocrine-Metabolic Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, via di Grottarossa, 1035-1039, Rome, Italy
| | - A Faggiano
- Endocrine-Metabolic Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, via di Grottarossa, 1035-1039, Rome, Italy
| | - R Mazzilli
- Endocrine-Metabolic Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant' Andrea Hospital, via di Grottarossa, 1035-1039, Rome, Italy.
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Bilen H, Dayanan R, Ciftel E, Bilen A, Ciftel S, Mercantepe F, Capoglu I. Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients? Int J Gen Med 2023; 16:5147-5156. [PMID: 37954658 PMCID: PMC10638931 DOI: 10.2147/ijgm.s441833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/28/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. The current study aims to determine whether all adult patients who have applied for their regular health check-ups due to diabetes mellitus had ever voluntarily expressed their sexual problems to a specialist and whether they were asked about the presence of sexual dysfunction. It also aims to determine how the physicians attach importance to the issue. Patients and Methods All patients aged 18-65 years with type 1 and type 2 diabetes mellitus, who applied to our hospital between the years of January 2021 and 2022, were questioned by filling out a questionnaire for the presence of sexual problems in addition to screening for chronic complications of diabetes mellitus (retinopathy, nephropathy, and neuropathy) and routine history and physical examination. Results The association between the presence of sexual problems and whether patients were questioned about the relevant issue in their previous controls and gender and age factors, educational background, presence of comorbidities, duration of marriage, and microvascular complications of diabetes mellitus were examined. In a population of 595 patients, 53.78% of the patients stated that they had sexual problems; however, 9.91% had been questioned about this issue by the physician. It was observed that 6.3% of female and 15.3% of male patients had previously consulted a doctor voluntarily due to their sexual problems. Conclusion This study presents empirical findings that shed light on the inadequacies in healthcare providers' approach to addressing sexual health concerns among individuals diagnosed with diabetes, as well as the shortcomings in patients' effective communication of these concerns.
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Affiliation(s)
- Habib Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ramazan Dayanan
- Department of Endocrinology and Metabolism, Batman Training and Research Hospital, Batman, Turkey
| | - Enver Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Arzu Bilen
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Serpil Ciftel
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Filiz Mercantepe
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
| | - Ilyas Capoglu
- Faculty of Medicine, Internal Medicine, Endocrinology and Metabolism Department, Atatürk University, Erzurum, Turkey
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Killari KN, Polimati H, Prasanth DSNBK, Singh G, Panda SP, Vedula GS, Tatipamula VB. Salazinic acid attenuates male sexual dysfunction and testicular oxidative damage in streptozotocin-induced diabetic albino rats. RSC Adv 2023; 13:12991-13005. [PMID: 37124014 PMCID: PMC10132129 DOI: 10.1039/d3ra01542d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023] Open
Abstract
Male sexual dysfunctions such as infertility and impotence are recognized as the consequences of diabetes. Salazinic acid (Sa) is a depsidone found in lichen genera of Lobaria, Parmelia, and Usnea, which has prominent free radical and α-glucosidase inhibitory actions. The present study establishes the beneficial role of salazinic acid (Sa) to combat the deleterious effects of streptozotocin-induced diabetes on the male reproductive system of rats. In a dose-dependent manner, Sa significantly restored the reproductive organs weight, sperm characteristics, and testicular histoarchitecture in diabetic rats. Further, a significant recovery of insulin, follicle-stimulating hormone, luteinizing hormone and testosterone levels in serum was recorded in Sa-treated diabetic rats. The malondialdehyde levels were significantly lowered, and the activities of glutathione, superoxide dismutase, glutathione peroxidase and catalase, markedly elevated in the blood serum, as well as testicular tissue after Sa-supplementation. Sa also suppressed the protein expression levels of tumor necrosis factor-α in serum. The high dose of Sa showed significant improvement in glycemia and testicular protection, similar to sildenafil citrate. Moreover, the docking results showed that both Sa and sildenafil have a high affinity toward the target protein, PDE5 with binding affinity values found to be -9.5 and -9.2 kcal mol-1, respectively. Molecularly, both Sa and sildenafil share similar hydrogen bonding patterns with PDE5. Hence, our study clearly showed the protective role of Sa against diabetic-induced spermatogenic dysfunction in rats, possibly by competing with cGMP to bind to the catalytic domain of PDE5 and thereby controlling the oxidative impairment of testes.
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Affiliation(s)
- Kishore Naidu Killari
- Department of Pharmaceutical Sciences, AU College of Pharmaceutical Sciences, Andhra University Visakhapatnam-530 003 India
| | - Haritha Polimati
- Department of Pharmaceutical Sciences, AU College of Pharmaceutical Sciences, Andhra University Visakhapatnam-530 003 India
| | - D S N B K Prasanth
- Department of Pharmacognosy, KVSR Siddhartha College of Pharmaceutical Sciences Vijayawada AP 520010 India
| | - Gagandeep Singh
- Section of Microbiology, Central Ayurveda Research Institute Jhansi Uttar Pradesh 284003 India
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi New Delhi India
| | - Siva Prasad Panda
- Institute Pharmacology Research Division, Institute of Pharmaceutical Research, GLA University 281406 Mathura Uttar Pradesh India
| | - Girija Sastry Vedula
- Department of Pharmaceutical Sciences, AU College of Pharmaceutical Sciences, Andhra University Visakhapatnam-530 003 India
| | - Vinay Bharadwaj Tatipamula
- Center for Molecular Biology, College of Medicine and Pharmacy, Duy Tan University Danang 550000 Vietnam
- Institute of Research and Development, Duy Tan University Da Nang 550000 Vietnam
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Lotti F, Maggi M. Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence. Andrology 2023; 11:399-416. [PMID: 36416060 DOI: 10.1111/andr.13342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diabetes mellitus is a global epidemic characterized by high morbidity and mortality. Diabetes mellitus can lead to acute and chronic systemic complications. Among them, a negative effect of diabetes mellitus on sperm quality and male/couple fertility has been suggested. However, available studies in diabetes mellitus men evaluated relatively small cohorts with discordant results. OBJECTIVES To evaluate the clinical evidences of the effects of diabetes mellitus on sperm quality and fertility outcomes. METHODS An extensive Medline search was performed identifying studies in the English language. RESULTS The prevalence of diabetes mellitus in infertile men ranges from 0.7% to 1.4%, while the prevalence of infertility in diabetes mellitus men, evaluated in a few studies, ranges from 35% to 51%. Male diabetes mellitus seems to play a negative effect on couple fecundity, while being childless or subfertile men might increase the risk of diabetes mellitus. Available cross-sectional studies investigating semen parameters and male sexual hormones in men with diabetes mellitus are heterogeneous, assessed relatively small cohorts, show often discordant results and frequently are not directly comparable to derive robust conclusions. Two meta-analyses support a negative effect of diabetes mellitus on sperm normal morphology and no effect on sperm total count, with contradictory results regarding other semen parameters. Considering only studies on type 1 diabetes mellitus men, meta-analyses support a negative effect of diabetes mellitus on sperm motility and no effect on sperm total count, with contradictory results regarding other semen parameters. The rate of children observed among type 1 diabetes mellitus men was lower than controls, especially in subjects with a longer diabetes mellitus duration. Couples with a diabetes mellitus male partner undergoing assisted reproduction techniques showed lower pregnancy rates than controls. No study evaluated the impact of diabetes mellitus treatment on semen quality and male fertility. CONCLUSIONS Overall, available data show that diabetes mellitus might impair male reproductive health and couple fertility. However, further larger and full of details studies are needed.
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Affiliation(s)
- Francesco Lotti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Andrology, Female Endocrinology, and Gender Incongruence Unit, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Endocrinology Unit, Univesity of Florence, Florence, Italy
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Defeudis G, Mazzilli R, Di Tommaso AM, Zamponi V, Carlomagno F, Tuccinardi D, Watanabe M, Faggiano A, Gianfrilli D. Effects of diet and antihyperglycemic drugs on erectile dysfunction: A systematic review. Andrology 2023; 11:282-294. [PMID: 35485604 PMCID: PMC10084359 DOI: 10.1111/andr.13192] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Erectile dysfunction is recognized as one of the complications of diabetes mellitus. To date, a wide gap of knowledge is present on the efficacy of pharmacological treatments of diabetes mellitus on erectile function, acting not only through metabolic control. Similarly, the effects of different diet regimens on erectile dysfunction are still debated. OBJECTIVES We aimed to explore the effects of diet and antihyperglycemic drugs, considering both old and novel therapeutic approaches, on erectile function. MATERIALS/METHODS We performed a systematic review, following the PRISMA guidelines. The research was conducted on studies reporting erectile dysfunction assessment in subjects with diabetes and the relationship with diet and antihyperglycemic drugs. RESULTS The Mediterranean diet was effective in most studies for the protection of erectile function. Furthermore, antihyperglycemic drugs seem to show an overall protective role on erectile function. DISCUSSION/CONCLUSION Although encouraging results are present for all classes of antihyperglycemic drugs, several studies are needed in humans, mainly on acarbose, pioglitazone, dipeptidyl-peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Rossella Mazzilli
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Alfonso Maria Di Tommaso
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Virginia Zamponi
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Francesco Carlomagno
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Dario Tuccinardi
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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Mazzilli R, Zamponi V, Mangini F, Olana S, Defeudis G, Faggiano A, Gianfrilli D. The effects of non-andrological medications on erectile dysfunction: a large single-center retrospective study. J Endocrinol Invest 2023:10.1007/s40618-023-02011-9. [PMID: 36656432 PMCID: PMC9850328 DOI: 10.1007/s40618-023-02011-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE To evaluate the association among andrological diseases at the first outpatient visit and the medications taken by patients for other comorbidities, as well as the differential impact between specific medication and relative comorbidities. METHODS This is a single-center retrospective study based on subjects who referred to the Andrology Unit with a well-defined andrological diagnosis. RESULTS A total of 3752 subjects were studied (mean age ± DS 46.2 ± 16.5 years). A total of 19 categories of andrological diseases and 110 type of medications for other comorbidities were identified. ED was the most frequent andrological pathology at the first andrological examination (28.7%), followed by infertility (12.4%). The couple of variables that were statistically significant in the univariate association analysis (p < 0.001) were: ED and (a) antihypertensives; (b) antihyperglycemics; (c) lipids-lowering; (d) psychotropics. The univariate and multivariate regression analyses confirmed the association. All the related comorbidities were also significantly associated with the univariate analysis, and all remained significantly associated with multivariate analysis. A multivariate analysis was also conducted to analyze the association between ED and the following pairs of variables "DM-antihyperglycemics", "dyslipidemia-lipids-lowering", and "hypertension-antihypertensives". In all cases, the pathology, but not the specific treatment, was significantly associated with ED. CONCLUSION ED is significantly associated with antihypertensive, antihyperglycemic, lipid-lowering, psychotropic drugs' intake. Anyway, ED appears to be more related to the diseases than to the specific therapies. The definitive cause/effect relationship should be established based on future prospective studies.
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Affiliation(s)
- R Mazzilli
- Endocrinology and Andrology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1036-1039, 00100, Rome, Italy.
| | - V Zamponi
- Endocrinology and Andrology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1036-1039, 00100, Rome, Italy
| | - F Mangini
- Endocrinology and Andrology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1036-1039, 00100, Rome, Italy
| | - S Olana
- Endocrinology and Andrology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1036-1039, 00100, Rome, Italy
| | - G Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, Rome, Italy
| | - A Faggiano
- Endocrinology and Andrology Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1036-1039, 00100, Rome, Italy
| | - D Gianfrilli
- Endocrinology and Andrology Unit, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Celik S, Bal MD, Kelleci M. Comparison of sexual functions in women with and without type 1 diabetes. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:216-221. [PMID: 36790230 PMCID: PMC9983465 DOI: 10.1590/1806-9282.20220293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 02/12/2023]
Abstract
OBJECTIVE This study aimed to investigate female sexual function in patients with type 1 diabetes by comparing female sexual function index scores between women with and without type 1 diabetes. METHODS A total of 62 women with type 1 diabetes and 69 age-matched women without diabetes but with similar backgrounds were enrolled in the patient and control groups, respectively. All participants were sexually active and had no systemic diseases other than diabetes in the patient group. RESULTS The frequency of female sexual dysfunction was significantly higher, and the mean female sexual function index score was significantly lower in women with diabetes compared to the control group (p=0.01). There was a significant relationship between sexual dysfunction and duration of diabetes, glycosylated hemoglobin test, and body mass index (p<0.05). CONCLUSION This study demonstrates that female sexual dysfunction is more common among women with type 1 diabetes than among women without type 1 diabetes. Patients with type 1 diabetes should be evaluated in terms of sexual health. Health professionals should give more attention to and provide guidance regarding sexual function in women with type 1 diabetes.
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Affiliation(s)
- Selda Celik
- University of Health Sciences, Hamidiye Faculty of Nursing - Istanbul, Turkey
| | - Meltem Demirgöz Bal
- Marmara University, Health Sciences Faculty, Midwifery Department - Istanbul, Turkey
| | - Meral Kelleci
- Cumhuriyet University, Faculty of Health Sciences, Nursing Department - Sivas, Turkey
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Galvis-Acevedo S, Rivas-Escobar D, Arias-Castillo L, García-Perdomo HA. Enfermedad cardiovascular aterosclerótica y sexualidad. UROLOGÍA COLOMBIANA 2022. [DOI: 10.1055/s-0042-1746202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ResumenLa enfermedad cardiovascular aterosclerótica es la primera causa de muerte en todo el mundo, y la principal causa de años de vida perdidos por discapacidad (AVADs) en los adultos. Sus factores de riesgo son muy prevalentes en la población, y su ocurrencia se ha asociado con disfunción sexual tanto en hombres como en mujeres, debido a que comparten un mecanismo fisiopatológico similar en el caso de la disfunción eréctil en los hombres y potencialmente en la disfunción sexual femenina. Además, los trastornos mentales asociados (principalmente ansiedad y depresión) y los efectos adversos de los medicamentos antihipertensivos y antidepresivos también contribuyen a las disfunciones sexuales. Por otro lado, los inhibidores de la fosfodiesterasa 5 (iFDE5s) han demostrado seguridad y beneficios cardiovasculares en los hombres, y en las mujeres hay evidencia creciente de su utilidad en las disfunciones sexuales. En esta revisión, se presentan las implicaciones de la enfermedad cardiovascular aterosclerótica y su tratamiento en la vida sexual de hombres y mujeres, los efectos cardiovasculares de los tratamientos de las disfunciones sexuales, y la consejería a los pacientes.
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Affiliation(s)
| | - Daniela Rivas-Escobar
- Departamento de Medicina Familiar, Escuela de Medicina, Universidad del Valle, Cali, Colombia
| | - Liliana Arias-Castillo
- Departamento de Medicina Familiar, Escuela de Medicina, Universidad del Valle, Cali, Colombia
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Obaid ZM, Amer AW, Zaky MS, Elhenawy RM, Megahed AEM, Hanafy NS, Elsaie ML. Prevalence of female sexual dysfunction among diabetic females: a cross sectional case controlled study. Postgrad Med 2022; 134:680-685. [PMID: 35838136 DOI: 10.1080/00325481.2022.2102842] [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: 10/17/2022]
Abstract
BACKGROUND Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological and reproductive functions of women. AIM OF THE WORK The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality. PATIENT AND METHODS This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls. RESULTS Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%).. Conclusion FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.
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Affiliation(s)
- Zakaria M Obaid
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Ahmed W Amer
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Mohamed S Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Raghda M Elhenawy
- Department of Dermatology, Damietta dermatology and leprosy hospital, Egypt
| | - Alaa Eldin M Megahed
- Department of Obstetrics and Gynaecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Noha S Hanafy
- Department of Dermatology, Medical Research and Clinical Studies Institute; National Research Centre, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Medical Research and Clinical Studies Institute; National Research Centre, Egypt
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Defeudis G, Di Tommaso AM, Di Rosa C, Cimadomo D, Khazrai YM, Faggiano A, Cincione RI, Napoli N, Mazzilli R. The Role of Antihyperglycemic Drugs and Diet on Erectile Function: Results from a Perspective Study on a Population with Prediabetes and Diabetes. J Clin Med 2022; 11:jcm11123382. [PMID: 35743453 PMCID: PMC9224931 DOI: 10.3390/jcm11123382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of diet and antihyperglycemic drugs on erectile dysfunction (ED) in a setting of subjects affected by diabetes mellitus (DM) or preDM. METHODS This is a prospective observational study on 163 consecutive subjects with preDM or DM. All patients have undergone a medical evaluation (age, Body Mass Index (BMI), family history of DM, duration of DM, smoking, physical activity, dyslipidemia, cardiovascular comorbidities, and testosterone and HbA1c levels) and the International Index of Erectile Function (IIEF)-5 questionnaire. RESULTS Overall, the mean age was 62.8 ± 9.3 years, and the mean BMI was 28.4 ± 4.6 kg/m2. The IIEF-5 score mean value was 14.4 ± 6.2 (range 4-25). Among all confounders investigated for their association with the IIEF-5 score, only age and the duration of DM among diabetic patients showed a significant trend. The IIEF-5 score was higher in patients using GLP-1a compared to insulin (16.7 ± 4.7 vs. 12.9 ± 6.2; p = 0.02). This association was confirmed after adjustment for age and duration of DM (p = 0.01). All other treatments were similar (14.9 ± 6.2, 14.8 ± 9.2, 15.3 ± 5.4, and 13.6 ± 6.8 for metformin, sulfonylureas (SU), dipeptidyl-peptidase-4 inhibitors (DPP-4i), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) treatment, respectively). CONCLUSIONS This prospective observational study increases attention and focus on the effect of antihyperglycemic drugs and diet on ED, above all about the role of new classes, showing a significant higher IIEF-5 mean value in patients using GLP-1a compared to patients on insulin treatment.
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Affiliation(s)
- Giuseppe Defeudis
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
- Correspondence: or
| | - Alfonso Maria Di Tommaso
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
| | - Claudia Di Rosa
- Unit of Food Science and Nutrition, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (C.D.R.); (Y.M.K.)
| | - Danilo Cimadomo
- Clinica Valle Giulia, GeneraLife IVF Center, 00197 Rome, Italy;
| | - Yeganeh Manon Khazrai
- Unit of Food Science and Nutrition, Department of Science and Technology for Humans and the Environment, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (C.D.R.); (Y.M.K.)
| | - Antongiulio Faggiano
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.); (R.M.)
| | - Raffaele Ivan Cincione
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico di Roma, 00128 Rome, Italy; (A.M.D.T.); (N.N.)
| | - Rossella Mazzilli
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.); (R.M.)
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Angulo J, Hannan JL. Cardiometabolic Diseases and Female Sexual Dysfunction: Animal Studies. J Sex Med 2022; 19:408-420. [DOI: 10.1016/j.jsxm.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/21/2023]
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Di Stasi V, Maseroli E, Vignozzi L. Female Sexual Dysfunction in Diabetes: Mechanisms, Diagnosis and Treatment. Curr Diabetes Rev 2022; 18:e171121198002. [PMID: 34789131 DOI: 10.2174/1573399818666211117123802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/09/2021] [Accepted: 09/16/2021] [Indexed: 11/22/2022]
Abstract
Female sexual dysfunction (FSD) is an underinvestigated comorbidity of diabetes mellitus, often not evaluated in diabetes clinics. Diabetic women should be encouraged to talk about this topic by their diabetologist, because these problems could be comorbid to cardio-metabolic alterations, as it happens in the male counterpart. This review summarizes evidence on sexual dysfunction characteristics in diabetic women, exploring possible underlying pathogenic mechanisms. The role of hypoglycemic drugs in this context was also evaluated. To date, no specific questionnaire has been designed for the assessment of sexual dysfunctions in diabetic female patients but the use of colour-doppler ultrasound of clitoral arteries has been highlighted as a useful tool for the assessment of cardiovascular risk in these women. Similarly, no specific guidelines are available for the treatment of FSD in the diabetic population but patients should be supported to have a healthy lifestyle and, in the absence of contraindications, can benefit from already approved treatments for FSD.
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Affiliation(s)
- Vincenza Di Stasi
- Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elisa Maseroli
- Department of Andrology, Women\'s Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero Universitaria Caffi, Florence, Italy
| | - Linda Vignozzi
- Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy; | Department of Andrology, Women\'s Endocrinology and Gender Incongruence Unit, Azienda Ospedaliero Universitaria Caffi, Florence, Italy
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13
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Interactions between erectile dysfunction, cardiovascular disease and cardiovascular drugs. Nat Rev Cardiol 2022; 19:59-74. [PMID: 34331033 DOI: 10.1038/s41569-021-00593-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 02/06/2023]
Abstract
Sexual health has a fundamental role in overall health and well-being, and a healthy and dynamic sex life can make an important contribution to a good quality of life. Sexual dysfunction, and especially erectile dysfunction (ED) in men, is highly prevalent in patients with cardiovascular disease (CVD). CVD and ED have shared risk factors and pathophysiological links, such as endothelial dysfunction, inflammation and low plasma testosterone levels. ED has been shown to be an independent and early harbinger of future CVD events, providing an important window to initiate preventive measures. Therefore, screening and diagnosing ED is essential for the primary and secondary prevention of CVD because the assessment of ED offers an easy and low-cost prognostic tool that is an alternative to other investigational cardiovascular biomarkers. Moreover, ED is a major contributing factor to the discontinuation of, or poor adherence to, cardiovascular therapy. Cardiovascular drugs have divergent effects on erectile function, with diuretics and β-blockers having the worst profiles, and renin-angiotensin-aldosterone system inhibitors and nebivolol having the best profiles. Pharmacological treatment of ED has an equivocal effect on the risk of CVD, suggesting a complex interaction between ED and drugs for CVD. In this Review, we discuss how sexual function could be incorporated into the patient history taken by physicians treating individuals with CVD, not merely as part of the diagnostic work-up but as a means to pursue tangible and essential benefits in quality of life and cardiovascular outcomes.
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14
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Facondo P, Di Lodovico E, Delbarba A, Anelli V, Pezzaioli LC, Filippini E, Cappelli C, Corona G, Ferlin A. The impact of diabetes mellitus type 1 on male fertility: Systematic review and meta-analysis. Andrology 2021; 10:426-440. [PMID: 34904793 DOI: 10.1111/andr.13140] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/16/2021] [Accepted: 12/10/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Some evidence suggests that diabetes mellitus type 1 (DM1) could affect male fertility, gonadal axis, semen parameters, and spermatogenesis because of effects of hyperglycemia and insulin deficiency. Anyhow, the exact impact of DM1 on male fertility is unclear. OBJECTIVES To review the studies evaluating paternity rate, male gonadal axis, and semen parameters in men with DM1. MATERIALS AND METHODS A review of relevant literature from January 1980 to December 2020 was performed. Only studies published in English reporting data on fatherhood (rate of children by natural fertility), hormonal and seminal parameters were included. Out of 14 retrieved articles, the eight studies evaluating semen parameters were meta-analyzed. RESULTS The rate of children (four studies) was lower than controls among men affected by DM1, especially in men with a longer duration of disease. The data of gonadal hormonal profile in DM1 men (six studies) are very heterogeneous and a neutral effect of DM1 or a condition of subclinical hypogonadism could not be concluded. Meta-analysis showed that men with DM1 (n = 380), compared with controls (n = 434), have significantly lower normal sperm morphology [-0.36% (-0.66; -0.06), p < 0.05, six studies] and sperm progressive motility [33.62% (-39.13; -28.11), p < 0.001, two studies] and a trend toward a lower seminal volume [-0.51 (-1.03; 0.02), p = 0.06, eight studies], without difference in total sperm count and concentration. Data on scrotal ultrasound and sperm DNA fragmentation are too few. No study evaluated other factors of male infertility, such as transrectal ultrasound, semen infections, sperm auto-antibodies, and retrograde ejaculation. DISCUSSION DM1 might impair male fertility and testis functions (endocrine, spermatogenesis), but definition of its actual impact needs further studies. CONCLUSION Men with DM1 should be evaluated with a complete hormonal, seminal, and ultrasound workup to better define their fertility potential and need for follow up of testis functions.
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Affiliation(s)
- Paolo Facondo
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Elena Di Lodovico
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Andrea Delbarba
- Unit of Endocrinology and Metabolism, ASST Spedali Civili, Brescia, Italy
| | - Valentina Anelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | | | - Erica Filippini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Endocrinology and Metabolism, ASST Spedali Civili, Brescia, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Endocrinology and Metabolism, ASST Spedali Civili, Brescia, Italy.,Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
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15
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Khodarahimi S, Mazraeh N, Rahimian Bougar M, Sheikhi S. Hypogonadism and Sexual functioning in males with and without Diabetes Type II. SEXOLOGIES 2021. [DOI: 10.1016/j.sexol.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Yannas D, Frizza F, Vignozzi L, Corona G, Maggi M, Rastrelli G. Erectile Dysfunction Is a Hallmark of Cardiovascular Disease: Unavoidable Matter of Fact or Opportunity to Improve Men's Health? J Clin Med 2021; 10:jcm10102221. [PMID: 34065601 PMCID: PMC8161068 DOI: 10.3390/jcm10102221] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 12/14/2022] Open
Abstract
Erectile dysfunction (ED) is an early manifestation of cardiovascular (CV) disease. For this reason, men with ED should be carefully assessed for CV risk factors in order to prevent future major adverse CV events (MACE). Traditional risk factors are not found in all subjects at high CV risk. In fact, a relevant proportion of MACE occurs in men who are apparently risk factor free. In men with ED, it is important to take into account not only traditional risk factors but also unconventional ones. Several parameters that derive from good clinical assessment of subjects with ED have proven to be valuable predictors of MACE. These include family history of cardiometabolic events, alcohol abuse, fatherhood, decreased partner’s sexual interest, severe impairment in erection during intercourse or during masturbation, impaired fasting glucose, increased triglycerides, obesity even without metabolic complications, decreased penile blood flows or impaired response to an intra-cavernosal injection test. Recognizing these risk factors may help in identifying, among subjects with ED, those who merit stricter lifestyle or pharmacological interventions to minimize their CV risk. Effective correction of risk factors in ED men considered as high risk, besides reducing CV risk, is also able to improve erectile function.
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Affiliation(s)
- Dimitri Yannas
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Francesca Frizza
- Endocrinology Unit, Medical Department, Azienda Usl Maggiore-Bellaria Hospital, 40121-40141 Bologna, Italy; (F.F.); (G.C.)
| | - Linda Vignozzi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl Maggiore-Bellaria Hospital, 40121-40141 Bologna, Italy; (F.F.); (G.C.)
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Endocrinology Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
| | - Giulia Rastrelli
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50121-50145 Florence, Italy; (D.Y.); (L.V.); (M.M.)
- Andrology, Women’s Endocrinology and Gender Incongruence Unit, Careggi Teaching Hospital, 50121-50145 Florence, Italy
- Correspondence:
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Cannarella R, Calogero AE, Condorelli RA, Greco EA, Aversa A, La Vignera S. Is there a role for glucagon-like peptide-1 receptor agonists in the treatment of male infertility? Andrology 2021; 9:1499-1503. [PMID: 33818920 PMCID: PMC8596505 DOI: 10.1111/andr.13015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/22/2023]
Abstract
Glucagon‐like peptide‐1 receptor agonists (GLP1‐RAs) are novel anti‐hyperglycemic drugs efficacious on glucose control, weight loss, and cardiovascular prevention. These drugs may also be effective in modulating testicular function. In fact, they increase serum testosterone levels in diabetic and/or obese patients with functional hypogonadism on a dysmetabolic basis. Although part of this effect can be ascribed to weight loss, some evidence suggests that there is a direct effect at the testicular level. Indeed, human Leydig, Sertoli, and germ cells express GLP1 receptors. GLP1‐RAs improve sperm metabolism, motility, and insulin secretion in vitro. Likewise, GLP1‐RAs exert positive effects on the metabolism of human Sertoli cells in vitro. Finally, GLP1 is secreted by mouse Leydig cells and this suggests the presence of a paracrine mechanism by which these cells could support the metabolism of Sertoli cells. Therefore, the widespread use of GLP1‐RAs in clinical practice may reveal an important role in the management of male infertility in obese and/or diabetic patients given the negative impact of these diseases on testicular steroidogenesis and spermatogenesis. This should suggest the design of randomized controlled studies aimed at evaluating the effects of these drugs on testicular function.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Emanuela A Greco
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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18
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Mitidieri E, Vanacore D, Turnaturi C, Sorrentino R, d’Emmanuele di Villa Bianca R. Uterine Dysfunction in Diabetic Mice: The Role of Hydrogen Sulfide. Antioxidants (Basel) 2020; 9:antiox9100917. [PMID: 32993056 PMCID: PMC7599872 DOI: 10.3390/antiox9100917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
It is well-known that the physiological uterine peristalsis, related to several phases of reproductive functions, plays a pivotal role in fertility and female reproductive health. Here, we have addressed the role of hydrogen sulfide (H2S) signaling in changes of uterine contractions driven by diabetes in non-obese diabetic (NOD) mice, a murine model of type-1 diabetes mellitus. The isolated uterus of NOD mice showed a significant reduction in spontaneous motility coupled to a generalized hypo-contractility to uterotonic agents. The levels of cyclic nucleotides, cAMP and cGMP, notoriously involved in the regulation of uterus homeostasis, were significantly elevated in NOD mouse uteri. This increase was well-correlated with the higher levels of H2S, a non-specific endogenous inhibitor of phosphodiesterases. The exposure of isolated uterus to L-cysteine (L-Cys), but not to sodium hydrogen sulfide, the exogenous source of H2S, showed a weak tocolytic effect in the uterus of NOD mice. Western blot analysis revealed a reorganization of the enzymatic expression with an upregulation of 3-mercaptopyruvate-sulfurtransferase (3-MST) coupled to a reduction in both cystathionine-β-synthase (CBS) and cystathionine-γ-lyase (CSE) expression. In conclusion, the increased levels of cyclic nucleotides dysregulate the uterus peristalsis and contractility in diabetic mice through an increase in basal H2S synthesis suggesting a role of 3-MST.
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Affiliation(s)
- Emma Mitidieri
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Domenico Vanacore
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Carlotta Turnaturi
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
| | - Raffaella Sorrentino
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples, Federico II, Via Pansini, 5, 80131 Naples, Italy
- Interdepartmental Centre for Sexual Medicine, University of Naples, Federico II, Via Pansini 5, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-678437
| | - Roberta d’Emmanuele di Villa Bianca
- Department of Pharmacy, School of Medicine, University of Naples, Federico II, Via D. Montesano, 49, 80131 Naples, Italy; (E.M.); (D.V.); (C.T.); (R.d.d.V.B.)
- Interdepartmental Centre for Sexual Medicine, University of Naples, Federico II, Via Pansini 5, 80131 Naples, Italy
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19
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Barbagallo F, Mongioì L, Cannarella R, La Vignera S, Condorelli R, Calogero A. Sexual Dysfunction in Diabetic Women: An Update on Current Knowledge. DIABETOLOGY 2020; 1:11-21. [DOI: 10.3390/diabetology1010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Diabetes mellitus (DM) is one of the most common chronic diseases worldwide and its prevalence is expected to increase in the coming years. Therefore, updated knowledge of all diabetic complications and their management is essential for the proper treatment of these patients. Sexual dysfunctions are one of the long-term complications of DM in both genders. However, female sexuality is still a taboo and sexual concerns are often overlooked, underdiagnosed, and untreated. The aim of this review is to summarize the current knowledge on the relationship between sexual function and DM in women. In particular, we evaluated the prevalence, etiology, diagnostic approaches, and current treatment options of female sexual dysfunction (FSD) in diabetic patients.
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20
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Corona G, Baldi E, Isidori AM, Paoli D, Pallotti F, De Santis L, Francavilla F, La Vignera S, Selice R, Caponecchia L, Pivonello R, Ferlin A, Foresta C, Jannini EA, Lenzi A, Maggi M, Lombardo F. SARS-CoV-2 infection, male fertility and sperm cryopreservation: a position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) (Società Italiana di Andrologia e Medicina della Sessualità). J Endocrinol Invest 2020; 43:1153-1157. [PMID: 32462316 PMCID: PMC7252417 DOI: 10.1007/s40618-020-01290-w] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/02/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The recent pandemic of severe acute respiratory syndrome (SARS) due to coronavirus (CoV) 2 (SARS-CoV-2) has raised several concerns in reproductive medicine. The aim of this review is to summarize available evidence providing an official position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) METHODS: A comprehensive Pubmed, Web of Science, Embase, Medline and Cochrane library search was performed. Due to the limited evidence and the lack of studies, it was not possible to formulate recommendations according to the Oxford 2011 Levels of Evidence criteria. RESULTS Several molecular characteristics of the SARS-CoV-2 can justify the presence of virus within the testis and possible alterations of spermatogenesis and endocrine function. Orchitis has been reported as a possible complication of SARS-CoV infection, but similar findings have not been reported for SARS-CoV-2. Alternatively, the orchitis could be the result of a vasculitis as COVID-19 has been associated with abnormalities in coagulation and the segmental vascularization of the testis could account for an orchitis-like syndrome. Finally, available data do not support the presence of SARS-CoV-2 in plasma seminal fluid of infected subjects. CONCLUSION Data derived from other SARS-CoV infections suggest that in patients recovered from COVID-19, especially for those in reproductive age, andrological consultation and evaluation of gonadal function including semen analysis should be suggested. Studies in larger cohorts of currently infected subjects are warranted to confirm (or exclude) the presence of risks for male gametes that are destined either for cryopreservation in liquid nitrogen or for assisted reproduction techniques.
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Affiliation(s)
- G. Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy
| | - E. Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - A. M. Isidori
- Department of Experimental Medicine, ʺSapienzaʺ University of Rome, Rome, Italy
| | - D. Paoli
- Department of Experimental Medicine, ʺSapienzaʺ University of Rome, Rome, Italy
| | - F. Pallotti
- Department of Experimental Medicine, ʺSapienzaʺ University of Rome, Rome, Italy
| | - L. De Santis
- IVF Unit, Gynaecological-Obstetric Department, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - F. Francavilla
- Andrology Unit, Department of Clinical Medicine, Public Health, Life and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - S. La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - R. Selice
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - L. Caponecchia
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - R. Pivonello
- 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; Staff of Unesco Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
| | - A. Ferlin
- Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia, Brescia, Italy
| | - C. Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - E. A. Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy
| | - A. Lenzi
- Department of Experimental Medicine, ʺSapienzaʺ University of Rome, Rome, Italy
| | - M. Maggi
- Endocrinology Unit, Department of Experimental Clinical and Biomedical Sciences ``Mario Serio’’, University of Florence, Florence, Italy
| | - F. Lombardo
- Department of Experimental Medicine, ʺSapienzaʺ University of Rome, Rome, Italy
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