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Giraldi A, Nappi RE, Palacios S, Reisman Y, Jannini EA. From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples. Sex Med Rev 2024; 12:346-354. [PMID: 38515320 DOI: 10.1093/sxmrev/qeae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/12/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Midlife men and women are facing frequent sexual problems that affect not only individuals' sexual health but also the sexual health of aging couples. OBJECTIVES To review the main sexual life challenges faced by midlife couples, to present the concepts of couplepause and doublepause as 2 new paradigms to address the sexual health needs of aging couples, and to discuss key aspects in couple-focused care. METHODS An online meeting attended by 5 European experts in sexual health was carried out in June 2023 to discuss the topic. The conversation centered on their clinical experience and expert opinion. Additionally, the indexed literature was reviewed to endorse and complement the expert opinions obtained in the aforementioned meeting. RESULTS Midlife men and women face physical, psychological, and sociocultural changes that affect their sexual activity. These changes may be experienced differently between genders. Both members of a couple may experience age-related changes concurrently or in an unsynchronized manner affecting their sexual health. Communication, sharing expectations, defining sexual dynamics, and couple goals are determinant for the sexual health of a midlife couple. Couplepause and doublepause are 2 new complementary paradigms that effectively address the sexual health needs of aging couples as a unit, considering physical, psychological, cultural, social, and dyadic-related factors. Couple-centered strategies should promote open communication about couple intimacy issues, understanding the diverse expectations according to gender and orientation, communication styles, and goals. The following are identified as crucial aspects to promote couple-focused care: education and training of health care professionals, the provision of information to aging couples, physician involvement in addressing sexual problems, the need for collaboration across medical specialties, and the development of effective tools and strategies. CONCLUSIONS The sexual problems of aging couples should be managed following couple-centered strategies that effectively address their sexual health needs as a couple.
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Affiliation(s)
- Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 27100, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, 27100, Italy
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Zhuang W, Sun N, Gu C, Liu S, Zheng Y, Wang H, Tong X, Song J. A literature review on Epimedium, a medicinal plant with promising slow aging properties. Heliyon 2023; 9:e21226. [PMID: 38027566 PMCID: PMC10665689 DOI: 10.1016/j.heliyon.2023.e21226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/18/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Ethnopharmacological relevance Aging is related to many factors, such as genes, oxidative damage, metabolic abnormalities, immune regulation and sex hormones. This article reviews the pharmacological mechanism of Epimedium on slow aging from six aspects: gene regulation, antioxidant, the regulation of metabolism, the modulation of the immune system, the regulation of sex hormone, and clinical efficacy.Aim of the studyThrough literature review, to discover the potential pharmacological mechanism of Epimedium for slow aging. Materials and methods We reviewed the literature on the applications of Epimedium in multiple systems and the potential underlying mechanisms with systematic and comprehensive illustrations. The review includes the following aspects: gene regulation, antioxidant, the regulation of metabolism, the modulation of the immune system, the regulation of sex hormone, clinical efficacy and safety. Results The slow aging active components of Epimedium may be flavonoids, such as Epimedins A, B, C and icariin The slow aging effect of Epimedium may be related to gene regulation, antioxidant, the regulation of metabolism, the modulation of the immune system, and the regulation of sex hormone. No severe adverse reaction has been reported. Conclusions Epimedium has potential slow aging effect and been widely used in the clinic for aging-related diseases in the real world in China; however, large-scale studies are still needed.
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Affiliation(s)
- Wei Zhuang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, National Gerontic Disease Clinical Research Center, Beijing 100053, China
| | - Nan Sun
- Department of Pharmacy, Beijing Mentougou District Hospital,Beijing, China
| | - Chengjuan Gu
- Department of Endocrinology, Shenzhen Hospital of Guangzhou University of Chinese Medicine(Futian),Shenzhen, China
| | - Shimeng Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yujiao Zheng
- Graduate School, Beijing University of Chinese Medicine, China, Beijing, China
| | - Han Wang
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Xiaolin Tong
- Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, China
| | - Juexian Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Fu K, Zhang D, Metcalf BR, Bennell KL, Zhang Y, Oo WM, Deveza LA, Robbins SR, Zhang C, Arden N, Hunter DJ. Sexual activity satisfaction in symptomatic hip osteoarthritis patients: A cross-sectional, national web-based study. Int J Rheum Dis 2023; 26:1067-1075. [PMID: 37057763 PMCID: PMC10947282 DOI: 10.1111/1756-185x.14697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 04/15/2023]
Abstract
AIM Despite high-interest rates in sex in people with hip osteoarthritis (OA), clinicians tend not to address sexual issues, especially in older adults. The objective of this study is to evaluate sexual activity and factors associated with sexual activity satisfaction in people with symptomatic hip OA. METHODS A cross-sectional study was conducted among 252 participants with symptomatic hip OA in Australia. Quality of sex life was assessed using the online composite of sexual activities and positions questionnaires. A Poisson model with robust variance was used to calculate the prevalence ratio (PR). Factors that showed a univariate association with sexual satisfaction were then included in a multivariable model. PR with corresponding 95% confidence intervals (CI) are reported. RESULTS Among the 282 participants registered on the study website, 252 met the inclusion criteria, and 60.3% (152/252) completed the sexual activity questionnaires. Hip OA interfered with sexual activity in 70.0% of the participants. High confidence in completing sexual activity (PR: 0.53, 95% CI: 0.36 to 0.77) was associated with an increased prevalence ratio of sexual satisfaction. High anxiety, depression or stress during sexual activity (PR: 1.33, 95% CI: 1.10 to 1.60) was associated with an increased prevalence ratio of sexual dissatisfaction after adjusting for hip pain level and perceived partner's orgasm. CONCLUSION Although a large proportion of people with hip OA remain sexually active, a substantial proportion of persons are dissatisfied with their sexual activity. Hip OA interfered with sexual activity in most participants. Psychological factors were found to be associated with sexual activity satisfaction.
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Affiliation(s)
- Kai Fu
- Department of Orthopedic SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
| | - Di Zhang
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
- Institute of Endemic Diseases and Key Laboratory of Trace Elements and Endemic Diseases, National Health Commission of the People's Republic of China, School of Public HealthXi'an Jiaotong University Health Science CenterXi'anShaanxiChina
| | - Ben R. Metcalf
- Centre for Health, Exercise and Sports Medicine, Department of PhysiotherapyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Kim L. Bennell
- Centre for Health, Exercise and Sports Medicine, Department of PhysiotherapyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Yuqing Zhang
- Division of Rheumatology, Allergy, and ImmunologyMassachusetts General Hospital, Harvard School of MedicineBostonMassachusettsUSA
| | - Win Min Oo
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
| | - Leticia A. Deveza
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
| | - Sarah R. Robbins
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
| | - Changqing Zhang
- Department of Orthopedic SurgeryShanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Nigel Arden
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research CentreUniversity of OxfordOxfordUK
| | - David J. Hunter
- Sydney Musculoskeletal HealthKolling Institute of Medical Research, The University of SydneySydneyNew South WalesAustralia
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Fatherhood Is Associated with Increased Infidelity and Moderates the Link between Relationship Satisfaction and Infidelity. PSYCH 2020. [DOI: 10.3390/psych2040027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Relationship satisfaction has been identified as an important factor in terms of extradyadic sexual involvement. However, in men, fatherhood might be associated with infidelity by leading to changes in relationship satisfaction and the social life of parents. To date, no study has focused on the association of fatherhood and infidelity, nor the influence of fatherhood on the association between relationship satisfaction and infidelity. Methods: Using a cross-sectional design, 137 fathers and 116 non-fathers were assessed regarding relationship satisfaction, infidelity, and potential confounds. Results: Significantly more fathers reported having been unfaithful in the current relationship than non-fathers (30.7% vs. 17.2%). Fathers also reported longer relationship duration, higher relationship satisfaction, and lower neuroticism than non-fathers. Furthermore, fatherhood moderated the association between relationship satisfaction and infidelity insofar that only in non-fathers reduced relationship satisfaction was associated with infidelity. Conclusions: The results suggest that fatherhood increases the risk of engaging in extradyadic sexual activities and moderates the link between relationship satisfaction and infidelity. However, results need to be interpreted with caution due to the cross-sectional study design and the lack of information about the specific time point of the infidelity incident(s).
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Rusiecki L, Zdrojowy R, Gebala J, Rabijewski M, Sobieszczańska M, Smoliński R, Pilecki W, Dziubek W, Janocha A, Womperski M, Kałka D. Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality. Asian J Androl 2020; 22:526-531. [PMID: 31929194 PMCID: PMC7523618 DOI: 10.4103/aja.aja_131_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.
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Affiliation(s)
- Lesław Rusiecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Romuald Zdrojowy
- Department and Clinic of Urology, Wroclaw Medical University, Wroclaw 50-556, Poland
| | - Jana Gebala
- Cardiosexology Students' Scientific Club, Wrocław Medical University, Wrocław 50-368, Poland
| | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw 01-004, Poland
| | | | - Ryszard Smoliński
- Consultant Sexologist, Clinical Hospital Wrocław Medical University, Wrocław 50-556, Poland
| | - Witold Pilecki
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
| | - Wioletta Dziubek
- Department of Physiotherapy, University School of Physical Education, Wroclaw 51-612, Poland
| | - Anna Janocha
- Department of Physiology, Wroclaw Medical University, Wroclaw 50-368, Poland
| | | | - Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland.,Centre for Men's Health, Wroclaw 53-151, Poland
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Parish SJ, Hahn SR, Goldstein SW, Giraldi A, Kingsberg SA, Larkin L, Minkin MJ, Brown V, Christiansen K, Hartzell-Cushanick R, Kelly-Jones A, Rullo J, Sadovsky R, Faubion SS. The International Society for the Study of Women's Sexual Health Process of Care for the Identification of Sexual Concerns and Problems in Women. Mayo Clin Proc 2019; 94:842-856. [PMID: 30954288 DOI: 10.1016/j.mayocp.2019.01.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/10/2018] [Accepted: 01/16/2019] [Indexed: 12/20/2022]
Abstract
Sexual problems are common in women of all ages. Despite their frequency and impact, female sexual dysfunctions (FSDs) are often unrecognized and untreated in clinical settings. In response, the International Society for the Study of Women's Sexual Health convened a multidisciplinary, international expert panel to develop a process of care (POC) that outlines recommendations for identification of sexual problems in women. This POC describes core and advanced competencies in FSD for clinicians who are not sexual medicine specialists and serve as caregivers of women and, therefore, is useful for clinicians with any level of competence in sexual medicine. The POC begins with the expectation of universal screening for sexual concerns, proceeds with a 4-step model (eliciting the story, naming/reframing attention to the problem, empathic witnessing of the patient's distress and the problem's impact, and referral or assessment and treatment) that accommodates all levels of engagement, and delineates a process for referral when patients' needs exceed clinician expertise. Distressing problems related to desire, arousal, and orgasm affect 12% of women across the lifespan. Low desire is the most common sexual problem, but sexual pain and other less common disorders of arousal and orgasm are also seen in clinical practice. Screening is best initiated by a ubiquity statement that assures the patient that sexual concerns are common and can be revealed. Patient-centered communication skills facilitate and optimize the discussion. The goal of the POC is to provide guidance to clinicians regarding screening, education, management, and referral for women with sexual problems.
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Affiliation(s)
- Sharon J Parish
- Department of Medicine and Department of Psychiatry, Weill Cornell Medical College, New York, NY.
| | - Steven R Hahn
- Department of OB/GYN, Albert Einstein College of Medicine, Bronx, NY
| | | | - Annamaria Giraldi
- Department of Clinical Medicine and Department of Family and Community Medicine, Sexological Clinic, Psychiatric Center Copenhagen, University of Copenhagen, Denmark
| | - Sheryl A Kingsberg
- Department of OB/GYN, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, OH
| | - Lisa Larkin
- Lisa Larkin MD and Associates, Cincinnati, OH
| | - Mary Jane Minkin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT
| | | | | | | | | | - Jordan Rullo
- Department of Psychology and Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Richard Sadovsky
- Department of Family Medicine, SUNY-Downstate Medical Center, Brooklyn, NY
| | - Stephanie S Faubion
- Center for Women's Health and Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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Brennan-Ing M, Seidel L, Ansell P, Raik BL, Greenberg D, Nicastri C, Breznay J, Karpiak SE, Adelman RD. Addressing sexual health in geriatrics education. GERONTOLOGY & GERIATRICS EDUCATION 2018; 39:249-263. [PMID: 28614012 DOI: 10.1080/02701960.2017.1340885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Adults remain sexually active well into later life, but few report discussing sexual health with a physician after age 50. The authors explored how geriatrics education might better address sexual health in the context of a psychosocial conference for geriatrics fellows, program directors, and faculty comprising an informational plenary, which included a skills-building presentation on taking sexual histories, and a program director/faculty roundtable. Although informed about older adult sexual health, knowledge scores of geriatrics fellows increased following the plenary. Fellows reported inconsistent sexual history taking with older adults and noted patient differences in age and gender as barriers. The roundtable discussion highlighted several barriers to inclusion of sexual health content in geriatrics curricula including competing competencies, lack of educational materials, and discomfort with this topic on the part of faculty. Implications of these findings for geriatrics training and education programs and suggestions for improving this domain of geriatrics education are discussed.
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Affiliation(s)
- Mark Brennan-Ing
- a ACRIA , Center on HIV and Aging , New York , New York USA
- b New York University Rory Meyers College of Nursing , New York , New York USA
| | - Liz Seidel
- a ACRIA , Center on HIV and Aging , New York , New York USA
| | - Pam Ansell
- c Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York USA
| | - Barrie L Raik
- c Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York USA
| | - Debra Greenberg
- d Division of Geriatrics , Montefiore Medical Center , Bronx , New York USA
| | - Catherine Nicastri
- e Department of Medicine , Stony Brook School of Medicine , Stony Brook , New York USA
| | - Jennifer Breznay
- f Division of Geriatrics , Maimonides Medical Center , Brooklyn , New York USA
| | - Stephen E Karpiak
- a ACRIA , Center on HIV and Aging , New York , New York USA
- b New York University Rory Meyers College of Nursing , New York , New York USA
| | - Ronald D Adelman
- c Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York USA
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Bueno Robles LS. Desarrollo investigativo en salud sexual de mujeres con cáncer de mama: una revisión integrativa. AVANCES EN ENFERMERÍA 2016. [DOI: 10.15446/av.enferm.v34n1.57616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p>Objetivo: Caracterizar la producción científica relacionada con la salud sexual en mujeres con cáncer de mama.Metodología: Revisión integrativa. Se realizó una búsqueda en las bases de datos Scopus, Medline, LILACS y SciELO, así comobúsquedas secundarias en revistas científicas. Se encontraron 85artículos organizados y caracterizados por año, idioma y continente; edad promedio y tipos de tratamiento; metodología, perspectiva, enfoque, diseño, perspectiva disciplinar y tendenciatemática.Resultados: La temática reportó mayor producción de conocimiento en los últimos 10 años. La tendencia de investigación se orienta hacia tres categorías: Salud sexual y cáncer de mama; Salud sexual en la mujer y tratamientosdel cáncer de mama; y Salud sexual y relaciones de pareja.Conclusiones: La salud sexual en mujeres con cáncer de mamaes un aspecto importante en la calidad de vida, que continuamente se ve alterada como resultado de la enfermedad y los efectos adversos de los tratamientos. Esta condición no sólo aqueja a la persona enferma, sino también a su pareja, por lo que se requiere del desarrollo de líneas de acción que permitan dar una atención integral a las mujeres con esta enfermedad.</p>
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