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Macleod A, Busija L, McCabe M. Mapping the Perceived Sexuality of Heterosexual Men and Women in Mid- and Later Life: A Mixed-Methods Study. Sex Med 2019; 8:84-99. [PMID: 31706848 PMCID: PMC7042162 DOI: 10.1016/j.esxm.2019.10.001] [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: 07/22/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 12/04/2022] Open
Abstract
Introduction There is currently limited research that examines the meaning of sexuality at midlife and later life. Aim This study investigates how heterosexual men and women in mid- and later life perceive their sexuality and the factors that influence it. Methods Group concept mapping was used to produce a conceptual map of the experience of sexuality for heterosexual adults ages 45 years and above. Group concept mapping data were collected using 6 open-ended survey questions that asked about sexuality, intimacy, and desire. Thematic analysis was used to examine how participants perceived their sexuality to have changed as they aged. Thematic analysis data were collected using a single open-ended survey question. Main Outcome Measure Statements generated from 6 of the open-ended survey questions were rated by participants using a 5-point Likert scale for how important participants felt that each statement was to themselves personally. Participants responses to the seventh open-ended survey question were examined using thematic analysis to understand whether participants felt that their sexual experiences had changed over time and, if so, how they had changed. Results Eight themes were identified across the different phases of group concept mapping. These were, in order of importance, partner compatibility, intimacy and pleasure, determinants of sexual desire, sexual expression, determinants of sexual expression, barriers to intimacy, sexual urges, and barriers to sexual expression. Seven areas of change were identified in terms of perceived changes to sexuality with age. These included changes to perspective, relationship dynamics, environment, behavior, body/function, sexual interest/desire, and sexual enjoyment. Conclusion The results highlight the prioritization of interrelationship dynamics in mid- and later life sexuality over sexual functioning and sexual urges. These findings may facilitate the development of new perspectives on how sexuality is experienced in the later years and provide new avenues for intervention in situations where sexual problems arise. Macleod A, Busija L, McCabe M. Mapping the Perceived Sexuality of Heterosexual Men and Women in Mid- and Later Life: A Mixed-Methods Study. Sex Med 2019; 8:84–99.
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Affiliation(s)
- Ashley Macleod
- Swinburne University of Technology, Hawthorn, Victoria, Australia.
| | - Lucy Busija
- Monash University, Melbourne, Victoria, Australia
| | - Marita McCabe
- Swinburne University of Technology, Hawthorn, Victoria, Australia
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Clifford C, McCauley M. Male psychosexual therapy in the UK military. J ROY ARMY MED CORPS 2019; 165:94-97. [PMID: 30679182 DOI: 10.1136/jramc-2018-001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/03/2022]
Abstract
Military personnel can experience psychosexual difficulties for a variety of reasons. Problems can arise because of psychological trauma, physical injury, consequences arising from pharmacological and surgical complications and social or emotional concerns relating to intrapersonal and interpersonal relationship dynamics. Such individuals might seek to minimise or avoid resolving their pertinent difficulties, while others can experience cultural, personal or organisational barriers to accessing professional help. This paper offers an overview of the development of a national specialist psychosexual therapy service (PST), commenting specifically on the service delivery for male military personnel. It will also consider factors which may support progress in treatment and reflect upon the importance of considering psychosexual functioning in relationships as part of the broader service-life context, which is especially relevant to military personnel.
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Affiliation(s)
- Clair Clifford
- Centre for Innovative Research Across the Life Course, Coventry University, Coventry, UK .,Defence Clinical Psychology Service, UK Ministry of Defence, Lichfield, UK
| | - M McCauley
- Defence Clinical Psychology Service, UK Ministry of Defence, Lichfield, UK.,Trinity College Dublin, University College Dublin, Dublin, Ireland
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Bronner G, Korczyn AD. The Role of Sex Therapy in the Management of Patients with Parkinson's Disease. Mov Disord Clin Pract 2017; 5:6-13. [PMID: 30363420 DOI: 10.1002/mdc3.12561] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Patients with Parkinson disease (PD) and their partners report deterioration in their sexual life. Sexual dysfunction (SD), an important and often ignored aspect, is common in PD. Motor and nonmotor symptoms are involved in limiting pleasure and disturbing function. Sexual dissatisfaction is more common in men that in women. Frequently, both patients and partners have SD associated with PD, and both need suitable treatment. These issues need to be evaluated by neurologists or PD nurses and by specialized sex therapists. The objectives of this study were to describe the complexity and multidimensional nature of sexual problems in PD, enable practitioners to assess and treat sexual difficulties of their patients, and increase awareness of the role of sex therapy in the therapeutic process of PD. Methods Based on clinical experience of over 30 years in movement disorder clinics and a review of the literature, the authors suggest practical approaches, including an "Open Sexual Communication" module, prescribing medications, and/or referring to specialists. Results and Discussion The longitudinal nature of treating neurologic patients puts physicians in an important position to introduce sexual issues and to assess and plan the interventions and follow-up needed to ensure that sexual difficulties are resolved. The management of hypersexuality requires a thoughtful distinction between lack of opportunities for sexual expression, limited ability to perform, and true hypersexuality. Sex therapists have a major role in the assessment and treatment of the multiple factors that may underlie sexual dissatisfaction in PD, differentiating between hypersexual behaviors and other sexual preoccupation behaviors, and training the professional team.
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Affiliation(s)
- Gila Bronner
- Department of Urology Sexual Medicine Center Sheba Medical Center Tel-Hashomer Israel.,Department of Neurology Movement Disorders Institute Sheba Medical Center Tel-Hashomer Israel
| | - Amos D Korczyn
- Division of Neurology Tel-Aviv Medical Center Tel Aviv Israel.,Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
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Jannini EA, Ciocca G, Limoncin E, Mollaioli D, Di Sante S, Gianfrilli D, Lombardo F, Lenzi A. Premature ejaculation: old story, new insights. Fertil Steril 2015; 104:1061-73. [DOI: 10.1016/j.fertnstert.2015.08.035] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 01/26/2023]
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Boddi V, Castellini G, Casale H, Rastrelli G, Boni L, Corona G, Maggi M. An integrated approach with vardenafil orodispersible tablet and cognitive behavioral sex therapy for treatment of erectile dysfunction: a randomized controlled pilot study. Andrology 2015; 3:909-18. [DOI: 10.1111/andr.12079] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/05/2015] [Accepted: 06/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- V. Boddi
- Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - G. Castellini
- Psychiatry Unit; Department of Neurological and Psychiatric Sciences; University of Florence; Florence Italy
| | - H. Casale
- Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - G. Rastrelli
- Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - L. Boni
- Oncology Department; Careggi Hospital; Florence Italy
| | - G. Corona
- Endocrinology Unit; Maggiore-Bellaria Hospital; Bologna Italy
| | - M. Maggi
- Andrology Unit; Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
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Gleser H. Sex, women and the menopause: are specialist trainee doctors up for it? A survey of views and attitudes of specialist trainee doctors in Community Sexual & Reproductive Health and Obstetrics & Gynaecology around sexuality and sexual healthcare in the (peri)menopause. Post Reprod Health 2015; 21:26-33. [PMID: 25725451 DOI: 10.1177/2053369115574448] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Sexual health, function and pleasure can contribute significantly towards the wellbeing of (peri-)menopausal women. Healthcare professionals specialising in women's health should therefore be able to provide 'sex-positive' menopause care, which proactively addresses any sexual issues and assesses the need for contraception and prevention of sexually transmitted infections. A survey was used to investigate the views and attitudes of specialist trainee doctors in Community Sexual & Reproductive Health (cSRH) and Obstetrics & Gynaecology towards sexual health in the (peri)menopause as they play a key role in promoting the sexual wellbeing of their patients. The results showed that both study groups had positive attitudes towards sexuality and sexual healthcare of mid-life and older women. However, cSRH trainees had significantly more confidence in dealing with psychosexual problems and perceived significantly less barriers to deliver comprehensive menopausal care within the mostly community-based Sexual & Reproductive Healthcare settings they are working in compared to their mainly hospital-based gynaecological colleagues. Profiting from seemingly better training in the topic cSRH trainees also noticed considerably less embarrassment from their patients when addressing sexual issues. Nonetheless, training needs were identified in both trainee groups.
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Affiliation(s)
- Heike Gleser
- Community Sexual & Reproductive Health, Conifer Sexual & Reproductive Healthcare Services (City Healthcare Partnership CIC), Wilberforce Health Centre, UK
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Hucker A, McCabe MP. Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems. JOURNAL OF SEX RESEARCH 2014; 52:627-639. [PMID: 24742343 DOI: 10.1080/00224499.2014.888388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.
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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]
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Hucker A, McCabe MP. An online, mindfulness-based, cognitive-behavioral therapy for female sexual difficulties: impact on relationship functioning. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:561-576. [PMID: 24308322 DOI: 10.1080/0092623x.2013.796578] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article presents the evaluation of an online treatment for female sexual difficulties as it relates to relationship functioning. Pursuing Pleasure was an online, mindfulness-based, cognitive behavioral therapy for female sexual difficulties. In Study 1, 26 women completed treatment and changes were compared with a waitlist control group (n = 31). In Study 2, 16 women from the control group then completed treatment. The authors did not use a control group in Study 2. Results demonstrated that both treatment groups observed significant improvements in sexual intimacy and communication, and emotional intimacy improved significantly in the Study 1 treatment group. Most improvements were maintained at follow-up.
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Affiliation(s)
- Alice Hucker
- a Centre for Mental Health and Wellbeing , Deakin University , Melbourne , Australia
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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]
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Ciocca G, Limoncin E, Mollaioli D, Gravina GL, Di Sante S, Carosa E, Lenzi A, Jannini EA. Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation. Arab J Urol 2013; 11:305-12. [PMID: 26558097 PMCID: PMC4443008 DOI: 10.1016/j.aju.2013.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy. METHODS We list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012. RESULTS The cognitive feedback from PE can lead to a 'performance anxiety', which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE. CONCLUSIONS A holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist.
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Affiliation(s)
- Giacomo Ciocca
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Erika Limoncin
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Daniele Mollaioli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Giovanni Luca Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Stefania Di Sante
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Eleonora Carosa
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Andrea Lenzi
- Department of Medical Pathophysiology, University of Rome ‘La Sapienza’, Rome, Italy
| | - Emmanuele A. Jannini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
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Hucker A, McCabe MP. A qualitative evaluation of online chat groups for women completing a psychological intervention for female sexual dysfunction. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:58-68. [PMID: 23768099 DOI: 10.1080/0092623x.2012.675020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Because of the embarrassment that can surround female sexual dysfunctions, online interventions offer an anonymous and private treatment alternative. Recently, an online cognitive-behavioral treatment for female sexual dysfunctions was evaluated. Although significant improvements were observed in sexual functioning, the treatment was primarily a behavioral intervention because of difficulties with engaging participants in cognitive therapy over e-mail. To address this limitation, the use of chat groups was incorporated into a new online treatment for female sexual dysfunctions-the PursuingPleasure program. Thirty-eight women participated in the PursuingPleasure chat groups. The goals of the chat groups were to address and overcome challenges as women progressed through PursuingPleasure and to create a social support network where group therapy processes could be used. The chat groups aimed to address misunderstandings, monitor changes, and receive feedback. A qualitative analysis of the chat groups revealed that they helped to facilitate the cognitive-affective aspects of the program, as well as fulfill their other intended functions. This study demonstrates how the use of chat groups in the online treatment of female sexual dysfunctions is a useful addition to Internet-based treatment. Feedback suggests that the chat groups were one of the most helpful aspects of the program, although a small group of women reported finding the groups unhelpful.
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Affiliation(s)
- Alice Hucker
- a School of Psychology , Deakin University , Melbourne , Australia
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Berry MD. Historical revolutions in sex therapy: a critical examination of men's sexual dysfunctions and their treatment. JOURNAL OF SEX & MARITAL THERAPY 2013; 39:21-39. [PMID: 23152967 DOI: 10.1080/0092623x.2011.611218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
History, recent and ancient, presents innumerable methods intended to ensure or restore male sexual performance. Although these methods have regularly claimed to be "revolutionary," they have often been remarkably similar, and of questionably efficacy. This article provides a critical account of key historical trends in the treatment of male sexual dysfunctions in order to contextualize and critique the current treatment field. The author uses historical analysis to contextualize contemporary sex therapy techniques, arguing that even clinically verified contemporary revolutions, such as the advent of Viagra and similar drugs, may not present broadly efficacious standalone cures. Using critical historical analysis to illustrate the limitations of single-method treatments, the article argues for the value of comprehensive, biopsychosocial therapy methods. A common tendency--to seek a 'magic bullet' solution to sexual dysfunctions--is apparent throughout history, the author argues. While Viagra differs biomedically from historical treatments, it may appeal to the same logic, raising the question of whether it constitutes a truly revolutionary development in treatment. The article concludes with a set of recommendations regarding the implementation of biopsychosocial practice in sex therapy.
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Affiliation(s)
- Michael D Berry
- Department of Psychology, University College London, London, England.
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Jannini EA, Limoncin E, Ciocca G, Buehler S, Krychman M. Ethical Aspects of Sexual Medicine. Internet, Vibrators, and Other Sex Aids: Toys or Therapeutic Instruments? J Sex Med 2012. [DOI: 10.1111/jsm.12018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Berry MD. The History and Evolution of Sex Therapy and its Relationship to Psychoanalysis. INTERNATIONAL JOURNAL OF APPLIED PSYCHOANALYTIC STUDIES 2012. [DOI: 10.1002/aps.1315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael D. Berry
- Psychoanalysis Unit,Department of Psychology; University College London; Gower Street; London; WC1E 6BT; UK
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Hucker A, McCabe MP. Manualized Treatment Programs for FSD: Research Challenges and Recommendations. J Sex Med 2012; 9:350-60. [DOI: 10.1111/j.1743-6109.2011.02573.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Jones LM, McCabe MP. The Effectiveness of an Internet‐Based Psychological Treatment Program for Female Sexual Dysfunction. J Sex Med 2011; 8:2781-92. [DOI: 10.1111/j.1743-6109.2011.02381.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Nappi RE, Martini E, Terreno E, Albani F, Santamaria V, Tonani S, Chiovato L, Polatti F. Management of hypoactive sexual desire disorder in women: current and emerging therapies. Int J Womens Health 2010; 2:167-75. [PMID: 21072309 PMCID: PMC2971736 DOI: 10.2147/ijwh.s7578] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Indexed: 01/23/2023] Open
Abstract
Hypoactive sexual desire disorder (HSDD) is a common multifactorial condition which is characterized by a decrease in sexual desire that causes marked personal distress and/or interpersonal difficulty. The general idea that HSDD is a sexual dysfunction difficult to treat is due to the large number of potential causes and contributing factors. Indeed, a balanced approach comprising both biological and psycho-relational factors is mandatory for accurate diagnosis and tailored management in clinical practice. There are currently no approved pharmacological treatments for premenopausal women with HSDD, while transdermal testosterone is approved in Europe for postmenopausal women who experience HSDD as a result of a bilateral oophorectomy. Even though the role of sex hormones in modulating the sexual response during the entire reproductive life span of women is crucial, a better understanding of the neurobiological basis of sexual desire supports the idea that selective psychoactive agents may be proposed as nonhormonal treatments to restore the balance between excitatory and inhibitory stimuli leading to a normal sexual response cycle. We conclude that the ideal clinical approach to HSDD remains to be established in term of efficacy and safety, and further research is needed to develop specific hormonal and nonhormonal pharmacotherapies for individualized care in women.
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Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Ellis Martini
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Erica Terreno
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Francesca Albani
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Valentina Santamaria
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Silvia Tonani
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Luca Chiovato
- Gynecological Endocrinology and Menopause Unit, Department of Internal Medicine and Endocrinology, IRCCS Maugeri Foundation; University of Pavia, Italy
| | - Franco Polatti
- Research Center for Reproductive Medicine, Section of Obstetrics and Gynecology, Department of Morphological, Eidological and Clinical Sciences
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