1
|
Sultan MAH, Zin MHM, Hayati F, Zainuddin ZM, Kosai NR, Rajan R, Abidin ZAZ, Febriany DC. Improvement in Erectile Dysfunction Among Male Obese Patient, Following Bariatric Surgery in Hospital Canselor Tuanku Muhriz (HUKM). Obes Surg 2023; 33:1506-1518. [PMID: 36997694 DOI: 10.1007/s11695-023-06547-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Obesity is associated with multiple health-related complications and affects various aspects of life, including erectile dysfunction (ED). The aim of this study is to postulate that erectile dysfunction in male obese patients can be reversed following bariatric surgery. MATERIALS AND METHODS We conducted a non-randomized quasi-experimental study (prospective) between 2 groups, those who underwent surgery with the control group. In this study, the resolution of erectile dysfunction following bariatric surgery comparing with the control group was evaluated in terms of International Index of Erectile Function (IIEF) score. IIEF score is taken by delivering validated questionnaire to participants that enrolled in this study, both the control and intervention group. RESULTS A total of 25 patients were included in this study, 13 from the intervention group and 12 from the control group. From our study, we evaluated the resolution of IIEF score in both groups. We found that the resolution of erectile function is statistically significant in the intervention group compared to control group. Spearman rank correlation (rs) test was performed to identify the correlation between age and IIEF score. CONCLUSION Statistically significant improvements in erectile function were found following bariatric surgery. This is evidenced by the improvements in the IIEF score post-surgery compared to control group.
Collapse
Affiliation(s)
- Mohamed Arif Hameed Sultan
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Postal code 88400, Sabah, Malaysia.
| | - Muhamad Hud Muhamad Zin
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Postal code 88400, Sabah, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Postal code 88400, Sabah, Malaysia
| | - Zulkifli Md Zainuddin
- Department of Surgery, Hospital Canselor Tuanku Muhriz, Jalan Yaakob Latif, Postal code 88400, Cheras, Kuala Lumpur, Malaysia
| | - Nik Ritza Kosai
- Department of Surgery, Hospital Canselor Tuanku Muhriz, Jalan Yaakob Latif, Postal code 88400, Cheras, Kuala Lumpur, Malaysia
| | - Reynu Rajan
- Department of Surgery, Hospital Canselor Tuanku Muhriz, Jalan Yaakob Latif, Postal code 88400, Cheras, Kuala Lumpur, Malaysia
| | - Zainal Adwin Zainal Abidin
- Department of Surgery, Faculty of Medicine, Hospital Universiti Teknologi Mara, Postal Code 40450, Shah Alam, Selangor, Malaysia
| | - Dayang Corieza Febriany
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Postal code 88400, Sabah, Malaysia
| |
Collapse
|
2
|
Bakr AM, El-Sakka AA, El-Sakka AI. Pharmaceutical management of sexual dysfunction in men on antidepressant therapy. Expert Opin Pharmacother 2022; 23:1051-1063. [PMID: 35400255 DOI: 10.1080/14656566.2022.2064218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Sexual dysfunction (SD) and depression have a bidirectional relationship. The rising prescription of antidepressants, especially those with a serotonergic effect, is associated with increased SD. Sexual dysfunction reduces compliance and increases risk of recurrence of depressive episodes. Various strategies have been studied to manage antidepressant-induced SD. AREAS COVERED This review covers the identification of symptoms of antidepressant-induced SD, prevalence of symptoms in association with commonly used antidepressants, and the main lines of management, with a focus on pharmacological strategies. EXPERT OPINION The management of antidepressant-induced SD aims to reduce the unwanted sexual adverse effects while maintaining an acceptable control of depressive symptoms. It should implicate a multidisciplinary approach and determination of baseline sexual function and SD risk factors. In spite of several methodological issues, antidepressants can be divided into low- and high-risk categories with regard to the possibility of developing SD. In patients interested in sexual activity, it is recommended to start with low-risk antidepressants. Otherwise, encourage the patient to wait for tolerance and then switch to low-risk. In selected cases, dose reduction or a drug holiday may be applied. The adjunctive use of a PDE5i can help in a significant number of patients. Randomized controlled trials are needed to set high-level evidence-based recommendations.
Collapse
Affiliation(s)
- Ahmed M Bakr
- Department of Urology, Suez Canal University, Ismailia, Egypt
| | | | | |
Collapse
|
3
|
Randomized Placebo Controlled Trial of Sildenafil Citrate, Cognitive Behavior Sex Therapy and Integrated Treatment in Men Diagnosed With Non Organic Erectile Dysfunction. Sex Med 2021; 10:100464. [PMID: 34922302 PMCID: PMC8847802 DOI: 10.1016/j.esxm.2021.100464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction The integrated treatment combining phosphodiesterase-type 5 inhibitors (PDE5i) and Cognitive Behavior Sex Therapy (CBST) has been shown to yield promising results in the treatment of Non Organic Erectile Dysfunction (NOED) in young men. Aim The current study aimed to establish the efficacy of integrated treatment combining Sildenafil Citrate (SC) 50mg and CBST as a treatment of choice in young Pakistani men with NOED. Methods One hundred thirty-seven young men were recruited to participate in the study out of 164 men referred from sexual health clinics in Pakistan. They were randomized sequentially into 4 treatment groups namely SC = 35, CBST = 34, integrated treatment = 35, and placebo = 33. 7, 4, 6, and 4 men were dropped out of each treatment group respectively. The data of 116 men were analyzed. The on demand SC 50 mg, twice weekly 50 minutes sessions and home assignments, a combination of SC and 50 minutes sessions, and placebo were administered to firsst, second, third, and fourth group respectively for a period of 12 weeks. The follow-up assessment was done after 12 weeks of post-treatment for all groups. Main Outcome Measures The Urdu standardized versions of International Index of Erectile Functoning-5 (IIEF-5) and Depression Anxiety Stress Scale-21 (DASS-21) were the main outcome measures. Results The mixed repeated measures analysis of co-variance yielded significant impact of both CBST and integrated treatment groups in improving IIEF-5 scores at post treatment as compared to placebo. The CBST group experienced reduction in depression scores at post treatment as compared to both SC and integrated treatment. Only the integrated treatment brought reduction in anxiety scores at post treatment as compared to SC. The covariates age and NOED duration did not significantly impact the treatment outcome for all treatment groups. Clinical Implications The efficacy of integrated treatment approach for improving symptoms of NOED and associated depression and anxiety is strong clinical implication of the study. Strengths & Limitations The effectiveness of integrated treatment approach in the improvement of NOED symptoms and associated depression and anxiety scores is the main strength of the study. The improvement in depression scores is the added strength of CBST component of integrated treatment approach. The study should have included other PDE5i to compare their effects with the CBST or placebo groups. Conclusion The study concludes that the CBST and integrated treatments are treatment of choice for NOED and associated depression and anxiety in young men. Bilal A, Abbasi NH. Randomized Placebo Controlled Trial of Sildenafil Citrate, Cognitive Behavior Sex Therapy and Integrated Treatment in Men Diagnosed With Non Organic Erectile Dysfunction. Sex Med 2022;10:100464.
Collapse
|
4
|
Beecken WD, Kersting M, Kunert W, Blume G, Bacharidis N, Cohen DS, Shabeeh H, Allen MS. Thinking About Pathomechanisms and Current Treatment of Erectile Dysfunction-"The Stanley Beamish Problem." Review, Recommendations, and Proposals. Sex Med Rev 2020; 9:445-463. [PMID: 33358577 DOI: 10.1016/j.sxmr.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Up to 50% of all men over 50 years of age suffer from erectile dysfunction. Since the late 1990s erectile dysfunction has been treated mostly with phosphodiesterase 5 inhibitors (PDE5I). Over the past 20 years, numerous scientific findings on the development of erectile dysfunction have been collected, which have so far received little attention in the treatment of erectile dysfunction. OBJECTIVES The objectives of this study were to review the existing medical literature on erectile dysfunction regarding physiology, pathophysiology, and especially therapeutic options beyond treatment with PDE5I and to enable a more effective and especially sustainable treatment for erectile dysfunction. METHODS A literature review was performed by using PubMed from 1985 to 2020 regarding the physiology, pathophysiology, and treatment of erectile dysfunction. RESULTS Since the end of the 1990s an enormous amount of knowledge has been gained about the physiology/pathophysiology of erection/erectile dysfunction. Based on these findings, numerous physical, drug, and holistic therapeutic options (beyond the application of PDE5I) have been developed for the treatment of erectile dysfunction. However, these are still relatively rarely used in the therapeutic concept of erectile dysfunction today. CONCLUSION Based on scientific findings of the last 20 years, there are numerous therapeutic approaches, including lifestyle modification, specific pelvic floor exercises, shock wave treatment, and the application of different supplements. The long-term treatment of erectile dysfunction should now go beyond the purely symptomatic use of PDE5I. W-D Beecken, M Kersting, W Kunert, et al. Thinking About Pathomechanisms and Current Treatment of Erectile Dysfunction-"The Stanley Beamish Problem." Review, Recommendations, and Proposals. Sex Med Rev 2021;9:445-463.
Collapse
Affiliation(s)
- Wolf-D Beecken
- UroGate, Practice for Urology, Frankfurt, Germany; Regimen/with O Inc, San Jose, CA, USA.
| | | | | | | | | | - Deborah S Cohen
- Regimen/with O Inc, San Jose, CA, USA; Fundamental Physical Therapy & Pelvic Wellness, Poway, CA, USA
| | - Husain Shabeeh
- Regimen/with O Inc, San Jose, CA, USA; Department of Cardiology, Croydon University Hospital, London, UK
| | - Mark S Allen
- Regimen/with O Inc, San Jose, CA, USA; Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| |
Collapse
|
5
|
Zhang Z, Gao X, Zhou Y, Yu C, Pimolsettapun J, Yang L, Zhao Y. Study on the combination of brief psychodynamic psychotherapy with Viagra in the treatment of non-organic ED. Gen Psychiatr 2020; 33:e100184. [PMID: 32875271 PMCID: PMC7440693 DOI: 10.1136/gpsych-2019-100184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/23/2020] [Accepted: 06/15/2020] [Indexed: 11/23/2022] Open
Abstract
Background Erectile dysfunction (ED) has gradually become an important issue that seriously affects the quality of life of Chinese men. In addition to classic oral medications, psychotherapeutic interventions are increasingly being used in the treatment of ED. Aim This study aims to investigate the clinical efficacy of brief psychodynamic psychotherapy (BPP) plus Viagra in the treatment of non-organic ED. Methods We initiated this study via a controlled, prospective experimental design with initial optimal efficiency standard greater than 10%. On the standard, 63 patients were enrolled who were assigned to control or treatment group. The control group (including 33 cases) received Viagra treatment for 2 months, and the treatment group (including 30 cases) was cured with BPP plus Viagra. After the treatments, the clinical efficacy was assessed using the International Erectile Function Index (IIEF-5) score, the Self-rating Anxiety Scale (SAS), Sexual Satisfaction (SS) score and Erection Hardness Score (EHS). Results In the comparison of efficacy, pretreatment and post-treatment within each group, the two groups showed improvements in IIEF, SAS scores, SS, and EHS (treatment group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001; control group: PIIEF<0.001, PSAS<0.001, PSS<0.001, PEHS<0.001). Furthermore, the treatment group presented better performances in IIEF (p=0.040), SAS (p=0.006), SS scores (p=0.045) and EHS (p=0.041) than the control group. Conclusion The combination of BPP with Viagra has positive effect on the treatment of non-organic ED.
Collapse
Affiliation(s)
- Zhihang Zhang
- Sexual Medicine and Andrology Department, Long Hua Hospital, Shanghai, China
| | - Xiang Gao
- Shanghai Yizhi Institute of Applied Psychology, Shanghai, China
| | - Ying Zhou
- Shanghai Huangpu District Mental Health Center, Shanghai, China
| | - Chao Yu
- Shanghai Yizhi Institute of Applied Psychology, Shanghai, China.,Urology and Andrology Department, Longhua Hospital Affiliated to Shanghai University of TCM, Shanghai, China
| | | | - Libin Yang
- Sexual Medicine and Andrology Department, Long Hua Hospital, Shanghai, China
| | - Youkang Zhao
- Sexual Medicine and Andrology Department, Long Hua Hospital, Shanghai, China
| |
Collapse
|
6
|
Bossio JA, Basson R, Driscoll M, Correia S, Brotto LA. Mindfulness-Based Group Therapy for Men With Situational Erectile Dysfunction: A Mixed-Methods Feasibility Analysis and Pilot Study. J Sex Med 2019; 15:1478-1490. [PMID: 30297094 DOI: 10.1016/j.jsxm.2018.08.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/17/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Recent advances in sexual health research support the benefits of mindfulness-based therapy (non-judgmental present-moment awareness) for the treatment of women's sexual dysfunction. AIM To determine whether it is feasible to implement an adapted, empirically supported treatment protocol for female sexual dysfunction to the specific needs of men with situational erectile dysfunction (ED). METHODS A mixed-methods approach was taken for this feasibility pilot study. A total of 10 men (Mage = 40.3, SD = 14.01, Range = 20-67) with a diagnosis of situational ED were recruited to participate in a 4-week mindfulness-based treatment group. The group was adapted from protocols shown to be effective for women with sexual dysfunction and edited to include content specific to situational ED. Sessions were 2.25 hours in length, included daily home-practice activities, and integrated elements of psychoeducation, sex therapy, and mindfulness skills. Men completed questionnaires (International Index of Erectile Functioning, Relationship Assessment Scale, Five Facets of Mindfulness Questionnaire, a treatment expectation questionnaire) at 3 time points (prior to treatment, immediately after treatment, and 6 months after treatment). 5 men (Mage = 44.4, SD = 15.76, Range = 30-67) participated in qualitative exit interviews. MAIN OUTCOME MEASURE Findings support the feasibility of adapting a mindfulness-based group treatment for situational ED. RESULTS With respect to feasibility, the dropout rate was 10%, with 1 participant who did not complete the treatment. Comparisons between Time 1 and Time 3 self-reports suggested that this treatment protocol holds promise as a novel means of impacting erectile functioning (Cohen's d = 0.63), overall sexual satisfaction (Cohen's d = 1.02), and non-judgmental observation of one's experience (Cohen's d = 0.52). Participants' expectations for the treatment were generally positive and correlated to self-reported outcomes (r = .68-.73). Qualitative analyses revealed 6 themes: normalization, group magic, identification of effective treatment targets, increased self-efficacy, relationship factors, and treatment barriers. CLINICAL IMPLICATIONS In a shift toward a biopsychosocial framework for the treatment of men's sexual dysfunction, clinicians may consider incorporating mindfulness to address psychosocial and psychosexual components of dysfunction. STRENGTH & LIMITATIONS This is the first study-to our knowledge-to adapt mindfulness protocols for use with men's sexual dysfunction. Because this is a pilot study aimed at feasibility, the sample size is small and no control group was included, thus conclusions about efficacy and generalizability cannot be made. CONCLUSION The current study suggests that a mindfulness group therapy framework offers a feasible and potentially promising treatment avenue for men with situational ED. Bossio JA, Basson R, Driscoll M, et al. Mindfulness-based group therapy for men with situational erectile dysfunction: A mixed-methods feasibility analysis and pilot study. J Sex Med 2018;15:1478-1490.
Collapse
Affiliation(s)
- Jennifer A Bossio
- University of British Columbia, Department of Obstetrics and Gynaecology, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada; University of British Columbia, Department of Urologic Sciences, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada.
| | - Rosemary Basson
- University of British Columbia, UBC Sexual Medicine Program, Department of Psychiatry, Vancouver General Hospital Blusson Centre, Vancouver, BC, Canada
| | - Miriam Driscoll
- University of British Columbia, UBC Sexual Medicine Program, Department of Psychiatry, Vancouver General Hospital Blusson Centre, Vancouver, BC, Canada
| | - Shauna Correia
- University of British Columbia, UBC Sexual Medicine Program, Department of Psychiatry, Vancouver General Hospital Blusson Centre, Vancouver, BC, Canada
| | - Lori A Brotto
- University of British Columbia, Department of Obstetrics and Gynaecology, Gordon & Leslie Diamond Health Care Centre, Vancouver, BC, Canada; Women's Health Research Institute, Vancouver, BC, Canada
| |
Collapse
|
7
|
Elshimi E, Sakr N, Morad W, Mohamad NE, Waked I. Direct-acting antiviral drugs improve the female sexual burden associated with chronic HCV infection. Expert Rev Anti Infect Ther 2019; 17:919-926. [PMID: 31625425 DOI: 10.1080/14787210.2019.1682551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Background: The impact of patient cure by direct-acting antiviral agents (DAAs) on female sexual dysfunction (FSD) associated with HCV hasn't been studied.Aim: To study the impact of DAAs on associated FSD in patients with chronic HCV infection.Methods: In patients with chronic HCV infection who were eligible for DAAs, the self-administered female-sexual-function index (FSFI) questionnaire was completed by 300 sexually active females' patients before treatment and compared to equal number of age and socioeconomically matched controls. FSFI questionnaire results after treatment were compared to patients' baseline results.Results: The mean total score for the patients was significantly lower than that for controls (16.77 ± 1.36 versus 17.52 ± 0.99, P < 0.001). Patients after treatment with DAAs significantly scored better results than baseline results in the total score and all domains of the questionnaire and significantly less patients had FSD compared to baseline (2.7% versus 29.3% P < 0.05). Patients' mean FSFI score significantly improved after cure (18.8 ± 0.27 vs. 16.77 ± 1.36, P < 0.001).Conclusion: Hepatitis C has negative impacts on FSF and affecting all domains of FSFI. The DAAS improve the sexual burden associated with hepatitis C in patients who achieved sustained virologic response.
Collapse
Affiliation(s)
- Esam Elshimi
- Hepatology Department, National Liver Institute, Menoufia University, Shebeen Elkom, Egypt
| | - Neamat Sakr
- Hepatology Department, National Liver Institute, Menoufia University, Shebeen Elkom, Egypt
| | - Wesam Morad
- Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebeen Elkom, Egypt
| | - Noha Ezzat Mohamad
- Dermatology and Venerology Department, Faculty of Medicine, Fayoum University, Egypt
| | - Imam Waked
- Hepatology Department, National Liver Institute, Menoufia University, Shebeen Elkom, Egypt
| |
Collapse
|
8
|
Evaluation of Sexual Function in Turkish Male Individuals Who are Substance Abusers: A Descriptive Study. ADDICTIVE DISORDERS & THEIR TREATMENT 2019. [DOI: 10.1097/adt.0000000000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Zainol M, Sidi H, Kumar J, Das S, Ismail SB, Hatta MH, Baharuddin N, Ravindran A. Co-Morbid Erectile Dysfunction (ED) and Antidepressant Treatment in a Patient – A Management Challenge? Curr Drug Targets 2018; 20:182-191. [DOI: 10.2174/1389450118666170315110902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/06/2017] [Accepted: 01/18/2017] [Indexed: 11/22/2022]
Abstract
Throughout the world, antidepressants (AD) and phosphodiesterase-5 inhibitors (PDE-5i) are the commonly prescribed psychopharmacological agents for treating patients with co-morbid mental health problem and sexual dysfunction (SD). The serotonergic and noradrenergic ADs, although effective, are not without any SD adverse-effects, especially erectile dysfunction (ED). ED is a failure to obtain a satisfactory erection for rewarding sexual coitus during the phases of male’s sexual arousal. It is recognized as an important reason why non-adherence to treatment was observed in patients who were on AD. AD intervention caused remission to some of the pre- treatment psychopathology of ED. However, in many patients, AD potentially magnified the unwanted sexual sideeffects. This made the situation challenging for the mental health professional. These challenges are based on the complexity of ED, its etiology and the associated risk factors, which further add to its AD side-effect. The neuro-psychopharmacological basis for AD treatment selection was deliberated. Bio-psycho-social interventions are recommended at two pivotal stages. Firstly, a step should be taken for proper assessment (e.g. detailed history, psychosocial and laboratory investigations); and identify few modifiable risk factors for ED and associated mental health issues. Secondly, with guidance of an algorithm pathway, a practical intervention should include strategies such as dose reduction, augmentation or changing to an AD with lesser or no sexual adverse-effects. It is recommended that bupropion and mirtazepine to be prescribed when patients develop adverse sexual effects with serotonin selective reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI) and tricyclic antidepressant (TCA). Few suggestions which may be borne in mind are revising sexual scripts and improving sexual techniques, life-style modifications, psychotherapy and other nonpharmacological approaches which may be beneficial to both patients and their partners.
Collapse
Affiliation(s)
- Maszaidi Zainol
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Srijit Das
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medicine, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | | | - Najwa Baharuddin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Arun Ravindran
- Department of Psychiatry, University of Toronto, Ontario, Canada
| |
Collapse
|
10
|
Chokka PR, Hankey JR. Assessment and management of sexual dysfunction in the context of depression. Ther Adv Psychopharmacol 2018; 8:13-23. [PMID: 29344340 PMCID: PMC5761906 DOI: 10.1177/2045125317720642] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/22/2017] [Indexed: 12/19/2022] Open
Abstract
Sexual dysfunction (SD) is pervasive and underreported, and its effects on quality of life are underestimated. Due in part to its bidirectional relationship with depression, SD can be difficult to diagnose; it is also a common side effect of many antidepressants, leading to treatment noncompliance. While physicians often count on patients to spontaneously report SD, treatment is optimized when the clinician instead performs a thorough assessment of sexual functioning before and during drug therapy using a standardized questionnaire such as the Arizona Sexual Experiences Scale (ASEX). Separating the effects of the disorder from those of medications is challenging; we present a concise, evidence-based schematic to assist physicians in minimizing treatment-emergent sexual dysfunction (TESD) while treating depression. Vascular, hormonal, neurogenic, and pharmacological factors should be considered when a patient presents with SD. We also recommend that physicians obtain patient information about baseline and historical sexual functioning before prescribing a drug that may lead to SD and follow up accordingly. When the goal is to treat depression while attenuating the risk of sexual symptoms, physicians may wish to consider agomelatine, bupropion, desvenlafaxine, moclobemide, trazodone, vilazodone, and vortioxetine.
Collapse
|
11
|
Gebregeorgise DT, Belay YM, Kälvemark Sporrong S. Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists' dispensing practices. Int J Clin Pharm 2017; 40:67-73. [PMID: 29134487 DOI: 10.1007/s11096-017-0558-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 11/02/2017] [Indexed: 12/17/2022]
Abstract
Background Studies have reported misuse of sildenafil citrate for recreational purpose, not least by healthy young men. This is becoming a major concern, for medical and other reasons. Objective The aim of this study was to document the characteristics of sildenafil citrate users and to explore the dispensing practices of the medicine in selected community pharmacies in Addis Ababa, Ethiopia. Setting Data was collected in community pharmacies in Addis Ababa, Ethiopia. Method A survey, using a self-administrated questionnaire, was conducted among customers who purchased sildenafil citrate from community pharmacies. Simple descriptive statistics were used to analyse data. Also, semi-structured interviews were conducted with community pharmacists. These were analysed thematically. Main outcome measures Socio-demographic characteristics (survey), themes (interviews). Results All survey respondents (n = 197) were men, 57.9% were below 40 years old, 53.8% had never been married and 58.4% had used sildenafil citrate before. A minority (16.2%) were diagnosed with erectile dysfunction. The main reason for buying sildenafil citrate was experimentation (45.7%). Pharmacists reported that sildenafil citrate was often dispensed without a prescription. The reason for this was, according to the interviewees, competition in the market. Also, the medicine was often dispensed without adequate information or counselling. Conclusions Selling and buying sildenafil citrate without a prescription seems to be common practice in pharmacies in Addis Ababa. It is crucial to strengthen the regulatory activity to protect customers from health risks. In addition pharmacy professionals should be supported to work in accordance with professional and legal standards.
Collapse
Affiliation(s)
- Dawit Teshome Gebregeorgise
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yajeb Melesse Belay
- University of Copenhagen, Copenhagen, Denmark.,Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | |
Collapse
|
12
|
Abstract
OBJECTIVE The aim of the study was to detect sexual impairment in male hepatitis C virus patients and determine its associations. PATIENTS AND METHODS A total of 61 male hepatitis C virus patients were enrolled in this cross-sectional study. Sexual functioning was assessed using the International Index of Erectile Function. Health-related quality of life (HRQOL) was evaluated using the Greek version of the Short Form 36 Health Survey, and the presence and severity of anxiety and depression were assessed using the Greek version of the Hospital Anxiety and Depression Scale. RESULTS Noncirrhotic patients showed clinically significant dysfunction, mainly in intercourse (59.6%) and overall satisfaction (57.4%). Erectile functioning and desire were correlated with depression (r=-0.520, P=0.000 and r=-0.473, P=0.000), anxiety (r=-0.443, P=0.000 and r=-0.428, P=0.001), physical (r=0.427, P=0.001 and r=0.329, P=0.012), and mental (r=0.379, P=0.003 and r=0.432, P=0.001) HRQOL, platelet count (r=-0.357, P=0.012 and r=0.366, P=0.010), and international normalized ratio (INR) levels (r=-0.373, P=0.013 and r=-0.440, P=0.003). Erection was also correlated with albumin levels (r=0.310, P=0.032). Orgasmic functioning was associated significantly with platelet count (r=0.322, P=0.024) and INR levels (r=-0.425, P=0.004). Intercourse satisfaction was significantly related to depression (r=-0.435, P=0.001) and anxiety (r=-0.335, P=0.008) levels, physical (r=0.374, P=0.004) and mental (r=0.300, P=0.022) HRQOL, platelet count (r=0.333, P=0.020), and INR levels (r=-0.373, P=0.013), and overall satisfaction was significantly correlated with depressive (r=-0.435, P=0.001) and anxiety (r=-0.278, P=0.033) symptoms, mental HRQOL (r=0.340, P=0.010), platelet count (r=0.316, P=0.029), and INR levels (r=-0.332, P=0.030). CONCLUSION Hepatitis C is accompanied by poor sexual functioning even in the absence of cirrhosis and different correlations emerge for distinct subdomains of male sexuality.
Collapse
|
13
|
Abstract
Chronic hepatitis C virus (HCV) infection is a systematic disease that affects several aspects of patients' well-being, including physical, mental, social, and sexual quality of life. In recent years, there has been a growing body of literature focusing on HCV patients' sexual health, providing evidence of clinically significant and enduring disturbances that disrupt everyday living, but commonly evade clinicians' attention. Relevant studies are characterized by considerable methodological heterogeneity and their findings should be interpreted using a systematic and integrative approach. In this context, we performed a systematic literature review on the topic of HCV patients' sexual functioning aiming at identifying high-quality investigations reporting scientifically sound and clinically useful data. We performed a thorough search of PudMed, ScienceDirect, and GoogleScholar according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Twenty-five articles were included to the review, reporting data from over 5300 chronic HCV patients. Sexual dysfunction, predominantly in the domains of sexual desire, drive, and satisfaction, is commonly reported by HCV patients at rates ranging between 19 and 88%. The current review yielded three distinct patterns of sexual impairment, namely, precirrhotic sexual impairment, cirrhosis-induced sexual decline, and interferon-associated sexual difficulties. Our search yielded significant findings on the prevalence, the characteristics, and the determinants of HCV-associated sexual dysfunction. In addition, we detected several areas of scientific controversy and inadequate information, thus highlighting novel directions for future research.
Collapse
|
14
|
Nwakanma NC, Ofoedu JN. Depressive symptoms and marital adjustment among primary care patients with erectile dysfunction in Umuahia, Nigeria. S Afr J Psychiatr 2016; 22:979. [PMID: 30263170 PMCID: PMC6138087 DOI: 10.4102/sajpsychiatry.v22i1.979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/03/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between erectile dysfunction (ED), marital adjustment and depression. METHODS The survey was conducted among primary care patients at Federal Medical Centre, Umuahia. Subjects were 678 married, male primary care patients; aged 20-70 years (mean age = 45 years). ED was assessed by International Index of Erectile Function 5 (IIEF-5) score, the presence of clinically significant depressive symptoms was assessed with the 5-item version of the Center for Epidemiological Studies Depression Scale (CES-D), and marital adjustment was assessed with the Revised Dyadic Adjustment Scale (RDAS). RESULTS The prevalence of probable depression by CES-D and ED by IIEF-5 score was 20.9% and 26.0%, respectively. Marital distress was rampant (62.0%) among subjects with ED (p < 0.05, χ2 = 196.58). Erectile dysfunction was associated with marital adjustment (p < 0.05). Partial correlation revealed that depression affects both ED and marital adjustment, and is closely related to both variables. CONCLUSION Partner involvement and screening for depression should be emphasised in the care of patients with ED.
Collapse
Affiliation(s)
| | - John N Ofoedu
- Department of Family Medicine, Federal Medical Centre, Umuahia, Nigeria
| |
Collapse
|
15
|
Echeverri Tirado LC, Ferrer JE, Herrera AM. Aging and Erectile Dysfunction. Sex Med Rev 2016; 4:63-73. [DOI: 10.1016/j.sxmr.2015.10.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/22/2015] [Indexed: 01/23/2023]
|
16
|
Clarke MJ, Marks ADG, Lykins AD. Effect of normative masculinity on males' dysfunctional sexual beliefs, sexual attitudes, and perceptions of sexual functioning. JOURNAL OF SEX RESEARCH 2014; 52:327-337. [PMID: 24558985 DOI: 10.1080/00224499.2013.860072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Male sexual dysfunction is a prevalent and distressing condition, which may be exacerbated by the sufferer's perceptions of masculinity and normative sexual behavior. This study sought to investigate the effect of social context on males' beliefs regarding sexual behavior. The research examined the effect of male role modeling and masculine cues on males' dysfunctional sexual beliefs, sexual attitudes, and self-perceptions of sexual functioning. A sample of 140 male participants, with a mean age of 29 years, was exposed to pictorial and verbal cues that presented different versions of male behavior across three conditions. Results indicated that males exposed to models and cues of traditional masculinity showed significantly increased levels of dysfunctional sexual beliefs and traditional sexual attitudes relative to males exposed to models of modern masculinity. Results also indicated that males exposed to traditional masculine stimuli reported lower levels of sexual inhibition due to fear of performance failure than males exposed to models of modern masculinity. The potential role of social context is discussed in the development and maintenance of male sexual dysfunction and its implications for treatment.
Collapse
Affiliation(s)
- Michael J Clarke
- a School of Behavioural, Cognitive, and Social Sciences , University of New England
| | | | | |
Collapse
|
17
|
Berry MD, Berry PD. Integrative Approaches to the Treatment of Erectile Dysfunction. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0012-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
18
|
Berry MD, Berry PD. Contemporary Treatment of Sexual Dysfunction: Reexamining the Biopsychosocial Model. J Sex Med 2013; 10:2627-43. [DOI: 10.1111/jsm.12273] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
19
|
Lee CP, Jiang JR, Chen Y, Chu CL, Hsu SC, Chen CL, Chen CY. The "Aging Males' Symptoms" (AMS) Scale assesses depression and anxiety. Aging Male 2013; 16:97-101. [PMID: 23826982 DOI: 10.3109/13685538.2013.807428] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Emotional distress may be associated with severe aging symptoms. This study aimed to investigate aging symptoms in male psychiatric outpatients and their relationship with anxiety and depression. METHOD About 176 male psychiatric outpatients aged 40-80 years were enrolled into this single-center cross-sectional study, and completed self-reported questionnaires including "Aging Males' Symptoms" (AMS) scale and the Hospital Anxiety and Depression Scale (HADS). RESULT Age was correlated with less anxiety (r = -0.23), less psychological (r = -0.16) and more sexual symptoms (r = 0.31). After controlling demographic variables, the partial correlation coefficients of HADS and AMS scores ranged from 0.30 to 0.73. Four groups were defined by HADS: control (C; n = 103), depression (D; n = 18), anxiety (A; n = 26) and mixed anxiety and depression (M; n = 29). The M group had the most severe aging symptoms, and the C group the least. The A group had more psychological and less sexual symptoms than the D group. "Impaired sexual potency" was the only aging symptom in males not significantly different among the four groups. CONCLUSIONS Anxiety and depression was associated with more severe aging symptoms in male psychiatric outpatients. Sexual dysfunction could be regarded as the core manifestation to differentiate aging symptoms from syndromal emotional distress.
Collapse
Affiliation(s)
- Chin-Pang Lee
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | | | | | | | | | | | | |
Collapse
|