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Transcranial Photobiomodulation Therapy for Sexual Dysfunction Associated with Depression or Induced by Antidepressant Medications. PHOTONICS 2022. [DOI: 10.3390/photonics9050330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sexual dysfunction (SD) is frequently encountered in patients suffering from depression. There is a bidirectional relationship between various types of SD and depression, so the presence or treatment of one condition may exacerbate or improve the other condition. The most frequent sexual problem in untreated depressed patients is declining sexual desire, while in treated depressed patients it is difficulties with erection/ejaculation and with orgasm. Numerous classes of neuropsychiatric medications, commonly used in depressed patients—such as antidepressant, antipsychotic, alpha sympathetic, and opioid drugs—may cause SD. Photobiomodulation (PBM) therapy, also called low-level light/laser therapy, is a novel neuromodulation technique for neuropsychiatric conditions, such as depression. Transcranial PBM (tPBM) targets the cellular metabolism—through the mitochondrial respiratory enzyme, cytochrome c oxidase—and has numerous cellular and physiological beneficial effects on the central nervous system. This paper represents a comprehensive review of the application of tPBM to SD, coexisting with depression or induced by antidepressant medications.
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Reis SLB, Abdo CHN. Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors. Clinics (Sao Paulo) 2014; 69:294-303. [PMID: 24714838 PMCID: PMC3971358 DOI: 10.6061/clinics/2014(04)11] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/10/2013] [Indexed: 01/08/2023] Open
Abstract
With advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men. The efficacy of phosphodiesterase type 5 inhibitors, together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction. For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder. We sought to evaluate the use of androgens in the treatment of a lack of libido in women, comparing two periods, i.e., before and after the advent of the phosphodiesterase type 5 inhibitors. We also analyzed the risks and benefits of androgen administration. We searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof. We selected articles written in English, Portuguese, or Spanish. After the advent of phosphodiesterase type 5 inhibitors, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder. However, the risks and benefits of testosterone administration have yet to be clarified.
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Affiliation(s)
- Sandra Léa Bonfim Reis
- Department of Pathophysiology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carmita H N Abdo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Leeners B, Kruger TH, Brody S, Schmidlin S, Naegeli E, Egli M. The Quality of Sexual Experience in Women Correlates with Post‐Orgasmic Prolactin Surges: Results from an Experimental Prototype Study. J Sex Med 2013; 10:1313-9. [DOI: 10.1111/jsm.12097] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Woodis CB, McLendon AN, Muzyk AJ. Testosterone Supplementation for Hypoactive Sexual Desire Disorder in Women. Pharmacotherapy 2012; 32:38-53. [DOI: 10.1002/phar.1004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- C. Brock Woodis
- The Department of Pharmacy Practice; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
- The Department of Community and Family Medicine; Duke University Medical Center; Durham North Carolina
| | - Amber N. McLendon
- The Department of Pharmacy Practice; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
- The Glenaire Continuing Care Retirement Community; Cary North Carolina
| | - Andrew J. Muzyk
- The Department of Pharmacy Practice; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
- The Department of Pharmacy; Duke University Hospital; Durham North Carolina
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Abstract
The comorbid conditions erectile dysfunction (ED) and depression are highly prevalent in men. Multiple regression analysis to control for all other predictors of ED indicate that men with high depression scores are nearly twice as likely to report ED than nondepressed men. Depression continues to be among the most common comorbid problems in men with ED, both in the community and in clinical samples. This article reviews the current knowledge about the relationship between ED and depression, the effect of treatments for depression on ED, ways to improve screening for depression, and treatment of ED in patients with this comorbidity.
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Affiliation(s)
- Michael A Perelman
- Human Sexuality Program, Payne Whitney Clinic, The New York Presbyterian Hospital, New York, NY, USA.
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Andersson KE, Abdel-Hamid IA. Therapeutic targets for premature ejaculation. Maturitas 2011; 70:26-33. [PMID: 21816550 DOI: 10.1016/j.maturitas.2011.06.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 06/17/2011] [Accepted: 06/20/2011] [Indexed: 12/31/2022]
Abstract
Premature ejaculation (PE) is the most common male sexual complaint, and may exert a profound negative impact on the man's life and partnership. Using currently available treatment alternatives (e.g., selective serotonin uptake inhibitor, agents acting locally on the penis), PE can be treated in most, but not all patients. However, since long term success rates have been disappointing, and the only approved treatment so far is the short-acting selective serotonin re-uptake inhibitor dapoxetine, there is currently an intensive search for new treatment modalities. Selection of the most promising therapeutic targets from a host of current and potential candidates depends heavily on their roles in the pathophysiology of PE. Possible central nervous targets that will be discussed are serotonin transporters, and CNS receptors for 5-HT(IA) and 5-HT(1B), dopamine, oxytocin, opioids, neurokinin-1, and glutamate. Putative peripheral targets include α(1)-adrenoceptors, phosphodiestrase enzymes, Rho kinases, purinergic (P2X) receptors, and penile sensory nerves. It is clear that exploiting the full therapeutic potential of these targets will require additional basic and clinical research.
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Affiliation(s)
- Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston Salem, NC 27157, USA.
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Palacios S. Hypoactive Sexual Desire Disorder and Current Pharmacotherapeutic Options in Women. WOMENS HEALTH 2011; 7:95-107. [DOI: 10.2217/whe.10.81] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hypoactive Sexual Desire Disorder (HSDD) is the most common female sexual dysfunction. The diagnosis of HSDD requires the existence of personal distress or interpersonal difficulties associated with low sexual desire, that cannot be explained by any other psychiatric affection and that is not exclusively due to a disease or substance. HSDD can have a serious effect on emotional wellbeing and interpersonal relationships, and it occurs in premenopausal and postmenopausal women. The Decreased Sexual Desire Screener is a shortened diagnostic method designed to help doctors who are not specialized in female sexual dysfunction to diagnose acquired HSDD in women. There is evidence that treatment with androgens or with estrogens is effective in HSDD; however, important unanswered questions still exist. Presently, new therapeutic strategies to combat HSDD are being researched, including novel methods of testosterone provision and drugs that act upon the CNS.
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Affiliation(s)
- Santiago Palacios
- Palacios Institute of Woman's Health, Antonio Acuña, 9, 28009, Madrid, Spain, Tel.: +34 915 780 517, Fax: +34 914 319 951,
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[Hypoactive sexual desire disorder, HSDD]. ACTA ACUST UNITED AC 2010; 39:28-31. [PMID: 21186133 DOI: 10.1016/j.gyobfe.2010.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 09/25/2010] [Indexed: 01/23/2023]
Abstract
Hypoactive Sexual Desire Disorder (HSDD) is the most common Female Sexual Dysfunction (FSD) affecting adult women of any age, including postmenopausal women. HSDD may have significant effects on the relationships and emotional balance of women and constitutes the most common form of FSD observed in clinical practice. HSDD is characterised by a deficiency or lack of sexual fantasies and desire for sexual activity, causing serious distress or interpersonal difficulties, and it is not exclusively caused by the effects of another psychiatric disorder, pathology or substance (such as medication). HSDD pathophysiology is not yet well understood, but it is thought to involve an imbalance between factors controlling inhibition and excitation of sexual desire in the brain. Many physicians are reluctant to discuss sexual desire problems with their patients for various reasons, such as insufficient knowledge of the field, an absence of efficient treatments and time constraints. Even though current treatment options are limited, a better understanding of the physiopathology behind HSDD may help develop new therapies.
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Clayton AH. The pathophysiology of hypoactive sexual desire disorder in women. Int J Gynaecol Obstet 2010; 110:7-11. [DOI: 10.1016/j.ijgo.2010.02.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 02/23/2010] [Accepted: 03/16/2010] [Indexed: 01/23/2023]
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Abdel-Hamid IA, Jannini EA, Andersson KE. Premature ejaculation: focus on therapeutic targets. Expert Opin Ther Targets 2009; 13:175-93. [DOI: 10.1517/14728220802663549] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Vallender EJ, Priddy CM, Hakim S, Yang H, Chen GL, Miller GM. Functional variation in the 3′ untranslated region of the serotonin transporter in human and rhesus macaque. GENES BRAIN AND BEHAVIOR 2008; 7:690-7. [DOI: 10.1111/j.1601-183x.2008.00407.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Increasing numbers of patients are on psychiatric drugs, especially antidepressants. When patients complain of sexual dysfunction, it is important that the clinician take a careful history concerning psychopharmacologic agents. It is possible that simple interventions may maintain the desired effect of the psychiatric drugs while also eliminating sexual side effects caused by these agents.
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Abstract
INTRODUCTION Although several conceptual frameworks for female sexual dysfunction (FSD) have been advanced, there still is considerable disagreement over what constitutes a normal vs. abnormal response. Sexual dysfunction is a disturbance in sexual functioning involving one or multiple phases of the sexual response cycle or pain associated with sexual activity, while a sexual disorder includes both dysfunction and marked distress. AIM Review the literature regarding the epidemiology and neurobiology of FSD. METHODS Review of the literature. RESULTS While a wide range of epidemiologic studies has been published, it is still difficult to determine the scope of FSD and sexual disorders in the general population. It is becoming clear that good sexual health is associated with good physical and mental health as well as compatible relationships with one's sexual partner. Central nervous system (CNS) control of the sexual response is a relatively new area of scientific exploration. CONCLUSIONS We are improving our understanding of the contributions of the CNS neuroendocrine and neurotransmitter systems that modulate sexual behavior.
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Affiliation(s)
- Anita H Clayton
- Department of Psychiatry & Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22903, USA.
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Perelman MA. GUEST EDITORIAL: Female Sexual Dysfunction and the Central Nervous System. J Sex Med 2007; 4 Suppl 4:257-9. [DOI: 10.1111/j.1743-6109.2007.00608.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Sexual dysfunction is a serious medical and social symptom that occurs in 10%-52% in men and 25%-63% in women. Numerous central and peripheral neural circuits control sexual activity. Impairment of one or more of these functional circuits may have a significant impact on personal, social and biological relationships. Although several aspects of sexual motivation and performance are known, a complete picture of the various factors that control human sexual activity is still unknown. The available drugs and treatments have limited efficacy, unpleasant side effects and contraindications in certain disease conditions. A variety of botanicals are known to have a potential effect on the sexual functions, supporting older claims and offering newer hopes. This review, while evaluating various factors that control sexual function, identifies a variety of botanicals that may be potentially useful in treating sexual dysfunction.
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Affiliation(s)
- Binu Tharakan
- Plummer Movement Disorders Center, Department of Neurology, Scott and White Clinic and the Texas A&M University System, Health Science Center College of Medicine, Temple, Texas 76508, USA
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López-Sosa C, Tévar RR. The Human Sexual System in the Context of the Health Sciences. SEXUALITY AND DISABILITY 2005. [DOI: 10.1007/s11195-005-6729-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Salonia A, Nappi RE, Pontillo M, Daverio R, Smeraldi A, Briganti A, Fabbri F, Zanni G, Rigatti P, Montorsi F. Menstrual cycle-related changes in plasma oxytocin are relevant to normal sexual function in healthy women. Horm Behav 2005; 47:164-9. [PMID: 15664019 DOI: 10.1016/j.yhbeh.2004.10.002] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2004] [Revised: 07/26/2004] [Accepted: 10/11/2004] [Indexed: 12/14/2022]
Abstract
Circulating levels of the neuro-hypophysial nonapeptide oxytocin increase during sexual arousal and orgasm in both men and women. A few studies have evaluated the effect of the menstrual cycle on plasma oxytocin in normally cycling, sexually active, healthy fertile women using or not using contraceptive pills. In 20 ovulating women and 10 women taking an oral contraceptive (group 1 and group 2, respectively), sexual function, hormonal profile, and plasma oxytocin (OT) were evaluated throughout the menstrual cycle. In group 1, plasma OT was significantly lower during the luteal phase in comparison with both the follicular and ovulatory phases. Plasma oxytocin was significantly correlated with the lubrication domain of the Female Sexual Function Index (FSFI) during the luteal phase and showed a trend towards statistical significance during the follicular phase. In group 2, plasma OT did not show any significant fluctuation throughout the menstrual cycle, even though a significant correlation was evident with both the arousal and the lubrication domain of the FSFI during the assumption of the contraceptive pill. These findings suggest that plasma OT fluctuates throughout the menstrual cycle in normally cycling healthy fertile women with adequate sexual activity but not taking any oral contraceptive pill. Moreover, plasma OT levels significantly relates to the genital lubrication in both women taking and not taking oral contraceptive pill apparently confirming its role in peripheral activation of sexual function.
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Affiliation(s)
- Andrea Salonia
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.
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Segraves RT, Clayton A, Croft H, Wolf A, Warnock J. Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. J Clin Psychopharmacol 2004; 24:339-42. [PMID: 15118489 DOI: 10.1097/01.jcp.0000125686.20338.c1] [Citation(s) in RCA: 147] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Premenopausal women meeting operational criteria for idiopathic, acquired, global hypoactive sexual desire disorder were studied in a randomized, double-blind, placebo-controlled, multiple-site escalating dose 112-day trial of bupropion sustained release. Outcome was measured by investigator-rating and self-administered questionnaires. All measures indicated greater sexual responsiveness in women receiving bupropion. The Changes in Sexual Functioning Questionnaire indicated that bupropion had significant effects on increasing measures of sexual arousal, orgasm completion, and sexual satisfaction.
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Affiliation(s)
- Robert Taylor Segraves
- Department of Psychiatry, Case Western Reserve University and Metro-Health Medical System, 2500 MetroHealth Drive, Cleveland, OH 44109-1998, USA.
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Abstract
Sexual dysfunction caused by psychotropic medications has become an increasingly important clinical topic. Only recently have we acknowledged the extent to which many psychotropic medications, especially antidepressants and antipsychotics, cause sexual side effects. Prevalence rates of sexual side effects are extraordinarily difficult to estimate due to a variety of factors, such as the effect of the disorder being treated, comorbid disorders and baseline sexual dysfunction. Among the antidepressants, those with strong serotonergic properties have the highest rate of sexual side effects. Among the antipsychotics, those with greater D(2) blockade leading to increased prolactin levels are probably associated with more sexual dysfunction. Treatment approaches have been poorly developed for both antidepressants and antipsychotics. Antidotes for antidepressant-induced sexual dysfunction include bupropion, buspirone and sildenafil.
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Affiliation(s)
- Michael Gitlin
- Department of Psychiatry, UCLA School of Medicine, 300 UCLA Medical Plaza, Suite 2200, Los Angeles, CA 90095, USA.
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