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1.
Bratisl Lek Listy ; 120(12): 941-944, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31855055

RESUMEN

OBJECTIVES: Erectile dysfunction (ED) is characterised as the inability to achieve or maintain an erection to complete sexual intercourse. ED may be considered as an early complication of diabetes mellitus (DM). The aim of this study was to assess the effect of registered food supplement, natural polyphenolic extract from the French maritime pine bark, Pycnogenol (PYC) on erectile function and lipid profile in ED patients. METHODS: 53 patients with ED were divided into two groups (32 with DM, 21 non-DM) in randomised, blinded and placebo-controlled study. During 3-month intervention with PYC or placebo and one month after the end of the intervention patients were investigated for ED with validated questionnaire International Index of Erectile Function-5 (IIEF-5); lipid profile, glycaemia was analysed in each group. RESULTS: In a randomised, blinded and placebo-controlled study, we found that natural polyphenolic extract, Pycnogenol improved erectile function in DM group by 45 % compared to the NDM group, where the improvement was also significant, but only by 22 %. Total cholesterol, LDL-cholesterol and glucose level was lowered by PYC in patients with DM. Glucose level was not affected by PYC in non-DM. Placebo showed no effect on monitored parameters in both groups. CONCLUSION: Administration of Pycnogenol leads in improvement of erectile function in patients with ED and diabetes (DM group) by 45 %, in NDM group by 22 %, in lowering of total-, LDL-cholesterol by 20 % and 21 % and glycaemia by 22 % in DM (Tab. 2, Fig. 2, Ref. 19).


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Disfunción Eréctil/tratamiento farmacológico , Erección Peniana/efectos de los fármacos , Polifenoles/farmacología , Adulto , Complicaciones de la Diabetes , Método Doble Ciego , Disfunción Eréctil/complicaciones , Humanos , Lípidos , Masculino , Persona de Mediana Edad , Polifenoles/administración & dosificación , Conducta Sexual/efectos de los fármacos , Encuestas y Cuestionarios , Resultado del Tratamiento
2.
Crim Behav Ment Health ; 29(4): 227-238, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31478289

RESUMEN

BACKGROUND: Sexual behaviour towards another person who does not or cannot consent to it causes serious harm to its victims. Understandable tendencies towards isolating or shaming the offenders, however, may actually increase risks of recidivism and further such harms. AIM: The study aims to consider evidence for the effectiveness of interventions for sex offenders, mainly in a U.K. context, across four areas: criminal justice system programmes, medication, interventions for sex offenders with personality disorder and a community-based model for the reintegration-Circles of Support and Accountability, and identify key evidence gaps. METHODS: We searched for reviews in the following four strands of work-psychosocial programmes, medication, personality focused therapies, and Circles of Support and Accountability-and identified gaps in knowledge. FINDINGS: Randomised controlled trials in this field are rare but have been achieved. Findings from more naturalistic outcome studies of sex offender treatment programmes are disappointing, but recidivism rates among released sex offender prisoners are low, regardless. Medication relying on substantial physiological change raises substantial ethical concerns. Not all sex offenders have a mental disorder but up to half have been diagnosed with a personality disorder, which may need specific treatment. Evidence is growing that lay work such as Circles of Support and Accountability is a valuable adjunct to other interventions. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH: In this field, where tensions between attributions swing between "madness" and "badness," there is growing evidence for optimism that complexity of history and presentation can be met through cooperation between the many disciplines, integrative strategies, and wider community engagement. The need now is for large, prospective controlled trials of interventions, with long periods of follow-up. Perhaps, the most exciting developments have come from the wider public. More research into the qualities of these volunteers might inform public education and health strategies supporting wider safety.


Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Antipsicóticos/uso terapéutico , Criminales/psicología , Libido/efectos de los fármacos , Trastornos Mentales/tratamiento farmacológico , Grupos de Autoayuda , Delitos Sexuales/prevención & control , Conducta Sexual/efectos de los fármacos , Responsabilidad Social , Apoyo Social , Adulto , Antagonistas de Andrógenos/efectos adversos , Antipsicóticos/efectos adversos , Femenino , Humanos , Masculino , Trastornos Mentales/etiología , Prisioneros , Reincidencia/prevención & control , Delitos Sexuales/psicología
3.
Artículo en Inglés | MEDLINE | ID: mdl-31314740

RESUMEN

Background We investigated the effects of a polyherbal formulation prepared from the extracts of Mondia whitei (Periplocaceae), Dracaena arborea (Dracaenaceae), and Bridelia ferruginea (Euphorbiaceae) (MDB) on the sexual behavior of normal rats (NR) and prediabetic rats (PR). Methods Male Wistar rats were administered with drinking fructose solution (21%) or tap water for 16 weeks. After induction of prediabetic status, NR (n = 30) and PR (n = 30) were randomly distributed into 10 groups of six animals each and orally treated with distilled water (10 mL/kg), sildenafil citrate (5 mg/kg), or MDB (50, 100, or 500 mg/kg) for 21 days. Sexual behavior parameters per series (S) of ejaculation were evaluated on days 1, 7, 14, and 21. Results Drinking fructose solution (21%) induced prediabetic status in rats, characterized by a significant (p < 0.01) increase in glycemia by 43.41% compared with the control group. MDB improved sexual performances of NR and PR by increasing the mount frequency (MF) and the intromission frequency (IF) as well as the number of rats capable of ejaculating. For instance, the MF and the IF were significantly increased in animals administered with MDB for 7 (50 mg/kg, S1 and S2), 14 (100 mg/kg, S3), or 21 days (100 or 500 mg/kg, S2). This increase was more pronounced on days 7 and 14 in NR and PR treated with sildenafil citrate or MDB extracts, respectively. Conclusions The mixture of MDB improved sexual activity in NR and PR. This result may further justify the traditional use of these plants as sexual performance enhancers.


Asunto(s)
Apocynaceae/química , Dracaena/química , Euphorbiaceae/química , Extractos Vegetales/farmacología , Estado Prediabético/tratamiento farmacológico , Conducta Sexual Animal/efectos de los fármacos , Conducta Sexual/efectos de los fármacos , Animales , Eyaculación/efectos de los fármacos , Masculino , Ratas , Ratas Wistar
4.
Psychiatry Res ; 276: 142-150, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31082749

RESUMEN

BACKGROUND: While methadone maintenance therapy (MMT) in patients with opioid use disorder (OUD) decreases the risk of substance use relapses and criminal and risky sexual behavior, a major disadvantage is its negative impact on sexual function. In the present study we tested whether, compared to placebo, ginseng extract ameliorates methadone-related sexual dysfunction among female and male patients with OUD and receiving MMT. METHOD: A total of 74 patients (26 females: mean age: M = 39.0 years; 48 males; mean age: 40.64 years) took part in a double-blind, randomized and placebo-controlled study. Female and male patients were separately randomly assigned either to the ginseng or to a placebo condition. At the beginning of the study and four weeks later, patients completed questionnaires on sexual function. RESULTS: Irrespective of gender, sexual function improved over time, but more so in the ginseng condition than in the placebo condition. CONCLUSIONS: Ginseng appears to counteract the sexual dysfunction resulting from methadone use in both female and male patients with OUD and undergoing MMT.


Asunto(s)
Tratamiento de Sustitución de Opiáceos/efectos adversos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Panax , Extractos Vegetales/uso terapéutico , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Metadona/uso terapéutico , Persona de Mediana Edad , Conducta Sexual/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/inducido químicamente
6.
Biomed Pharmacother ; 111: 1029-1035, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30841416

RESUMEN

Sexual dysfunction is a side effect of the antidepressant drug paroxetine. Anogeissus leiocarpus is a medicinal plant with a wide range of biological activities which include antioxidant and antiulcer properties. With these in mind, we investigated the effect of Anogeissus leiocarpus stem bark extract on paroxetine-induced sexual dysfunction in male Wistar rats. Forty-two adult male Wistar rats were divided into seven experimental groups: normal control, PAR (10 mg/kg), PAR + sildenafil (5 mg/kg), ALE (50 and 100 mg/kg) and PAR + ALE (50 and 100 mg/kg). The experiment lasted for 21 days, after which the rats were subjected to sexual behavioral test. Various biochemical assays (phosphodiesterase-5, arginase, acetylcholinesterase, nitric oxide and MDA) were carried out on the penile tissue homogenate. From our findings, paroxetine significantly altered sexual behavior in male rats and increased phosphodiesterase-5, arginase and acetylcholinesterase activities with a concomitant decrease in nitric oxide level. Furthermore, paroxetine altered antioxidant status which revealed by increased MDA level and reduced thiol level. However, treatment with Anogeissus leiocarpus stem bark extract reversed the altered sexual behavior in male rats and boosted antioxidant status. In addition, administration of Anogeissus leiocarpus stem bark extract resulted in a significant attenuation of phosphodiesterase-5, arginase and acetylcholinesterase activities in paroxetine-induced rats. In view of the aforementioned findings, Anogeissus leiocarpus could be considered a promising natural agent in erectile dysfunction management.


Asunto(s)
Antioxidantes/metabolismo , Óxido Nítrico/metabolismo , Paroxetina/farmacología , Extractos Vegetales/farmacología , Plantas Medicinales/química , Conducta Sexual/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Animales , Arginasa/metabolismo , Combretaceae/química , Fosfodiesterasas de Nucleótidos Cíclicos Tipo 5/metabolismo , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/metabolismo , Masculino , Malondialdehído/metabolismo , Pene/efectos de los fármacos , Pene/metabolismo , Ratas , Ratas Wistar , Disfunciones Sexuales Fisiológicas/metabolismo , Citrato de Sildenafil/farmacología
7.
Int J Impot Res ; 31(2): 71-73, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30837720

RESUMEN

Sildenafil has had a dramatic influence on the field of sexual medicine over the past 20 years. Not only have phosphodiesterase-5 (PDE5) inhibitors improved the treatment of erectile dysfunction (ED), they have indirectly contributed to the treatment of male factor infertility. A review of the literature between 1998 - 2018 was performed using PubMed with regards to sildenafil and male infertility. Numerous studies have demonstrated sildenafil's safety and efficacy for treating ED. Sildenafil does not alter semen parameters, and, in fact, may positively affect semen parameters. Sildenafil is helpful for treating ED caused by the psychological stress of infertility treatments. Sildenafil has improved the treatment of ED and may have a benefit on semen parameters. This has aided in the management of male factor infertility, and has contributed to hundreds of thousands of pregnancies that would have been more difficult, as it was before its advent.


Asunto(s)
Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/psicología , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Citrato de Sildenafil/uso terapéutico , Humanos , Infertilidad Masculina/tratamiento farmacológico , Masculino , Conducta Sexual/efectos de los fármacos , Motilidad Espermática/efectos de los fármacos
8.
Biomed Res Int ; 2019: 3726957, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30834263

RESUMEN

Objectives: To evaluate the impact on metabolism, bleeding, and sexual function of Nexplanon, a subdermal implant. Study Design: We recruited women (n=101) receiving the Nexplanon implant at two university centers in Italy between 2011 and 2016 into this prospective, observational, multicenter research trial. Participants completed the Interview for Ratings of Sexual Function (IRSF) and the Female Sexual Function Index (FSFI) questionnaires before and 3 and 6 months after the implant was inserted. In addition, all blood parameters were assessed at these visits. All women were given a menstrual diary card and a pictorial blood assessment chart to record daily any vaginal bleeding. Results: The studied metabolic parameters remained in the normal range, showing no alarming modifications: minimal statistical reductions (in aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, and activated partial thromboplastin time) and increases (in glucose and prothrombin activity) were observed. Changes in IRSF score over 6 months showed a significant increase in pleasure, personal initiative, orgasm, intensity of orgasm, and satisfaction, and a significant decrease in anxiety and discomfort. Mean Body Mass Index decreased, and the weekly frequency of sexual intercourse increased. Conclusions: Nexplanon showed not only a lower metabolic and bleeding impact, but also important positive effects on sexual function. It expands the range of possibilities for women, 38 and couples, in the modern concepts of sexual and reproductive wellbeing.


Asunto(s)
Desogestrel/administración & dosificación , Orgasmo/efectos de los fármacos , Conducta Sexual/efectos de los fármacos , Hemorragia Uterina/tratamiento farmacológico , Adulto , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Índice de Masa Corporal , Colesterol/sangre , Coito , Anticonceptivos Femeninos , Femenino , Humanos , Italia/epidemiología , Menstruación/efectos de los fármacos , Tiempo de Tromboplastina Parcial , Satisfacción Personal , Encuestas y Cuestionarios , Triglicéridos/sangre , Hemorragia Uterina/sangre , Hemorragia Uterina/fisiopatología , Adulto Joven
9.
BMC Urol ; 19(1): 7, 2019 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-30665388

RESUMEN

BACKGROUND: Overactive bladder (OAB) can frequently exert a negative effect on female sexual function. Mirabegron, a ß3 receptor agonist, improves OAB symptoms, but there are very few information about its role on female sexual dysfunction (FSD). Aim of the study was to assess the impact of Mirabegron on FSD in women affected by OAB. METHODS: Fifty sexually active women suffering from idiopathic OAB were included in the study. Patients were assessed by means of a urogynecologic physical examination and were asked to complete the 3-day voiding diary, the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), the Female Sexual Function Index (FSFI) questionnaire and VAS, before and 12 weeks after treatment with Mirabegron. In addition, at the same time points, patients underwent uroflowmetry with the measurement of post- void residual volume (PVR). RESULTS: At baseline all patients were affected by OAB symptoms, with 49/50 patients (98%) presenting with FSD. At 12- weeks follow- up, OAB symptoms improved significantly in all patients, with 59.5% of subjects achieving a complete urinary continence. FSFI Total Score significantly improved in 42/50 patients (84%) from 18.9 ± 4.3 to 21.8 ± 4.5 (p < 0.0001). Sixteen cases (32%) presented with no FSD. Also mean ± SD scores of ICIQ-SF and VAS significantly improved (from 17.1 ± 5 to 7.9 ± 4.8 and from 3.9 ± 1.2 to 6.9 ± 1.2 respectively, p < 0.000). CONCLUSIONS: Mirabegron not only is able to control urinary symptoms in women with OAB, but also induces a significant improvement in their sexual life.


Asunto(s)
Acetanilidas/uso terapéutico , Agonistas de Receptores Adrenérgicos beta 3/uso terapéutico , Conducta Sexual/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Tiazoles/uso terapéutico , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Acetanilidas/farmacología , Agonistas de Receptores Adrenérgicos beta 3/farmacología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Italia/epidemiología , Persona de Mediana Edad , Estudios Prospectivos , Conducta Sexual/fisiología , Disfunciones Sexuales Fisiológicas/diagnóstico , Disfunciones Sexuales Fisiológicas/epidemiología , Encuestas y Cuestionarios , Tiazoles/farmacología , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/epidemiología
10.
Pediatrics ; 143(2)2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30647089

RESUMEN

BACKGROUND: Timely contraceptive initiation is increasingly common, yet population trends by method and among subgroups with increased risk of unintended pregnancy are not well described. The impact of timing and type of contraceptive initiation on risk of unwanted pregnancy is unknown. METHODS: We used nationally representative cross-sectional data from 4 cycles of the National Survey of Family Growth, 2002-2015. We calculated outcomes from self-reported dates of sexual debut, contraceptive initiation, and unwanted pregnancy. We compared trends in timely contraceptive initiation (within 1 month of sexual debut) by method and by race and/or ethnicity and income. Using multivariable regression, we identified predictors of delayed contraceptive initiation. We compared the risk of unwanted pregnancy for delayed versus timely contraceptive initiation. RESULTS: We analyzed responses from 26 359 women with sexual debuts in 1970-2014. One in 5 overall and 1 in 4 African American, Hispanic, or low-income respondents reported delayed contraceptive initiation, which was associated with unwanted pregnancy within 3 months of sexual debut (adjusted risk ratio 3.7 versus timely contraceptive initiation; 99.9% confidence interval: 2.3-5.9; P < .001). Timely contraceptive initiation with less effective versus effective methods was not associated with unwanted pregnancy within 3 months. CONCLUSIONS: Delayed contraceptive initiation is more common among African American, Hispanic, and low-income women and is strongly associated with short-term risk of unwanted pregnancy. Pediatricians play a key role in making timely contraception available to adolescents at or before sexual debut. More research is needed to understand the importance of early contraceptive methods on pregnancy risk.


Asunto(s)
Condones/tendencias , Anticoncepción/tendencias , Anticonceptivos/administración & dosificación , Resultado del Embarazo/epidemiología , Conducta Sexual , Adolescente , Adulto , Anticoncepción/métodos , Estudios Transversales , Femenino , Humanos , Masculino , Embarazo , Autoinforme , Conducta Sexual/efectos de los fármacos , Encuestas y Cuestionarios , Factores de Tiempo , Estados Unidos/epidemiología , Adulto Joven
11.
J Ethnopharmacol ; 231: 453-463, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30545804

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Piper auritum Kunth is employed as an aphrodisiac in the traditional medicine, but corroborative evidence for such effect is scarce. AIM OF THE STUDY: The pro-sexual effect of an aqueous extract of P. auritum and its possible mechanisms were analyzed in two paradigms of male sexual function. MATERIAL AND METHODS: Effects of an aqueous extract of P. auritum (PA, single administration) were investigated in the fictive ejaculation, and copulatory behavior paradigms in sexually sluggish male rats. WAY 100635 (antagonist of 5-HT1A receptors), atosiban (antagonist of oxytocinergic receptors), L-NAME (inhibitor of the nitric oxide synthase) and baclofen (antagonist of GABAB receptors) were used as pre-treatments in order to investigate the role of different neurotransmitter systems in PA actions. Chemical profile of PA was determined by Gases Chromatography and Ultra Performance Chromatography-Electrospray Ionization-Masses Spectrometry (UPLC-ESI-MS). RESULTS: In males with retarded ejaculation, PA stimulated ejaculatory behavior and recovered electromyographic activity of pelvic musculature participating in seminal emission and ejaculation. All pre-treatments blocked stimulating effects of PA on the fictive ejaculation; additionally WAY 100635 interfered with PA actions on ejaculatory behavior. Safrol, apigenin dimethylether, myristicin, vaccihein A, sakuranin and sakuranetin flavonoids, were main constituents of PA, with possible participation in its pro-sexual effects. CONCLUSIONS: Pro-sexual effects of P. auritum elicited at level of ejaculation were mediated by several neurotransmitter systems, among which serotonin and its 5-HT1A receptors play an important role. Present findings support P. auritum reputation as an aphrodisiac, with potential use in delayed ejaculation disorder.


Asunto(s)
Afrodisíacos/farmacología , Piper , Extractos Vegetales/farmacología , Conducta Sexual/efectos de los fármacos , Animales , Afrodisíacos/química , Conducta Animal/efectos de los fármacos , Eyaculación/efectos de los fármacos , Femenino , Masculino , Fitoquímicos/análisis , Fitoquímicos/farmacología , Piper/química , Piperazinas/farmacología , Extractos Vegetales/química , Hojas de la Planta/química , Piridinas/farmacología , Ratas Wistar , Receptor de Serotonina 5-HT1A/fisiología , Antagonistas del Receptor de Serotonina 5-HT1/farmacología
12.
AIDS Behav ; 23(1): 161-174, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30088199

RESUMEN

Alcohol use is a key risk factor for HIV infection among MSM, in part because intoxication may interfere with the use of prevention methods like condoms. However, few studies have examined whether this is due to alcohol's pharmacological or expectancy effects or explored the specific aspects of sexual decision-making that may be affected. In this study, high-risk, heavy drinking MSM (N = 121) were randomly assigned to receive either (1) alcohol beverages, (2) placebo beverages, or (3) control beverages, before navigating a video-based sexual risk scenario that assessed several aspects of sexual decision-making. Results showed that condom use intentions and negotiation behaviors were lower among alcohol and placebo participants compared with controls, but that few significant differences emerged between the alcohol and placebo groups. These findings contrast with similar past studies, and suggest that alcohol's expectancy effects may play a role in sexual decision-making.


Asunto(s)
Intoxicación Alcohólica/psicología , Depresores del Sistema Nervioso Central/farmacología , Condones , Etanol/farmacología , Infecciones por VIH/prevención & control , Intención , Negociación , Conducta Sexual/efectos de los fármacos , Minorías Sexuales y de Género , Adulto , Consumo de Bebidas Alcohólicas , Causalidad , Toma de Decisiones , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Asunción de Riesgos , Sexo Seguro , Conducta Sexual/psicología , Sexo Inseguro , Adulto Joven
13.
Acta Derm Venereol ; 99(1): 12-17, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30206635

RESUMEN

Treatment of male androgenetic alopecia with 5α-reductase inhibitors is efficacious. However, the risk of adverse sexual effects remains controversial. This systematic review and meta-analysis investigated the risk of adverse sexual effects due to treatment of androgenetic alopecia in male patients with finasteride, 1 mg/day, or dutasteride, 0.5 mg/day. Fifteen randomized double-blinded placebo-controlled trials (4,495 subjects) were meta-analysed. Use of 5α-reductase inhibitors carried a 1.57-fold risk of sexual dysfunction (95% confidence interval (95% CI) 1.19-2.08). The relative risk was 1.66 (95% CI 1.20-2.30) for finasteride and 1.37 (95% CI 0.81-2.32) for dutasteride. Both drugs were associated with an increased risk, although the increase was not statistically significant for dutasteride. As studies into dutasteride were limited, further trials are required. It is important that physicians are aware of, and assess, the possibility of sexual dysfunction in patients treated with 5α-reductase inhibitors.


Asunto(s)
Inhibidores de 5-alfa-Reductasa/efectos adversos , Alopecia/tratamiento farmacológico , Dutasterida/efectos adversos , Finasterida/efectos adversos , Disfunciones Sexuales Fisiológicas/inducido químicamente , Inhibidores de 5-alfa-Reductasa/administración & dosificación , Administración Oral , Dutasterida/administración & dosificación , Eyaculación/efectos de los fármacos , Disfunción Eréctil/inducido químicamente , Disfunción Eréctil/fisiopatología , Finasterida/administración & dosificación , Humanos , Libido/efectos de los fármacos , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Factores de Riesgo , Conducta Sexual/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/diagnóstico , Disfunciones Sexuales Fisiológicas/fisiopatología
14.
J Clin Endocrinol Metab ; 104(4): 1160-1170, 2019 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-30388241

RESUMEN

CONTEXT: In 46,XY disorders of sexual development (DSD) patients, several factors may affect psychosexual development, leading to gender identity discrepancy and gender change later in life. Prenatal sexual steroid exposure and external genital virilization are considered to influence human psychosexual development, but their roles not completely understood yet. DESIGN: A total of 144 individuals (18 to 60 years of age) with a clinical/molecular diagnosis of 46,XY DSD from a single tertiary center were enrolled. Psychosexual outcomes (gender role, gender identity, and sexual orientation) were assessed using questionnaires and psychological test. The Sinnecker score was used for genital virilization measurement. Prenatal androgen exposure was estimated according to 46,XY DSD etiology. RESULTS: We found a positive association between prenatal androgen exposure and male psychosexual outcomes. Alternatively, prenatal estrogen exposure, age of gonadectomy, and the degree of external genital virilization did not influence any psychosexual outcome. There were 19% (n = 27) with gender change, which was associated with prenatal androgen exposure (P < 0.001) but not with the external genital virilization. The median age of gender change was 15 years, but most of the patients reported the desire for gender change earlier. CONCLUSIONS: Prenatal androgen exposure influenced psychosexual development in 46,XY DSD favoring male psychosexuality in all psychosexual outcomes, whereas the degree of external genital virilization did not influence these outcomes. The organizational effect of sexual steroids on psychosexuality at puberty appears to be weak in comparison with the prenatal effects. Prenatal androgen exposure also influenced female-to-male gender change frequency. All 46,XY DSD conditions with prenatal androgen exposure must be followed for gender issues in their management.


Asunto(s)
Andrógenos/administración & dosificación , Trastorno del Desarrollo Sexual 46,XY/psicología , Identidad de Género , Efectos Tardíos de la Exposición Prenatal/psicología , Procedimientos de Reasignación de Sexo/estadística & datos numéricos , Adolescente , Adulto , Trastorno del Desarrollo Sexual 46,XY/etiología , Trastorno del Desarrollo Sexual 46,XY/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Estudios Retrospectivos , Conducta Sexual/efectos de los fármacos , Conducta Sexual/psicología , Desarrollo Sexual/efectos de los fármacos , Virilismo/psicología , Adulto Joven
15.
Low Urin Tract Symptoms ; 11(2): O11-O15, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29057583

RESUMEN

OBJECTIVE: This study assessed the effectiveness and safety of a medical device containing purified bovine colostrum (Monurelle Biogel; Zambon, Bresso, Italy) in improving vulvovaginal atrophy (VVA), sexual function, urinary symptoms, and quality of life (QoL) in postmenopausal women. METHODS: In all, 172 postmenopausal women with VVA were included in the study. All women were treated with vaginal Monurelle Biogel daily for 12 weeks. Patients underwent clinical examinations, completed a 3-day voiding diary, and had VVA graded using the Vaginal Health Index (VHI) at baseline and 12 weeks. Patients also completed the Female Sexual Function Index (FSFI), overactive bladder questionnaire (OAB-Q), and the Urogenital Distress Inventory (UDI-6), among others. RESULTS: After 12 weeks, there were significant increases in mean (± SD) VHI (12.53 ± 3.67 vs. 19.31 ± 3.49; P < .0001), the number of patients engaging in regular sexual activity 102 (59.3%) vs. 144 (83.7%), and in the total FSFI score (21.64 ± 2.99 vs. 28.16 ± 1.93; P < .0001) compared with baseline. In addition, there were significant reductions in the mean number of 24-hour voids (9.57 ± 2.12 vs. 7.13 ± 1.22; P < .0001), urgent micturition episodes per 24 hours (1.75 ± 0.76 vs. 1.14 ± 0.87; P = .001), nocturia episodes (1.58 ± 0.85 vs. 0.97 ± 1.18; P = .0002), and urinary incontinence episodes per 24 hours (0.74 ± 0.59 vs. 0.28 ± 0.52; P = .003). Finally, after 12 weeks treatment, there were significant differences in UDI-6 (7.85 ± 0.81 vs. 5.56 ± 1.40), OAB-Q symptom (53.60 ± 12.57 vs. 22.08 ± 9.63), and OAB-Q health-related QoL (21.75 ± 8.51 vs. 69.34 ± 14.59) scores compared with baseline (P < .0001 for all). The Patient Impression of Global Improvement scale revealed global improvement in 143 women (83.14%). CONCLUSIONS: Monurelle Biogel is an effective treatment for VVA in postmenopausal women, improving sexual life, urinary symptoms, and QoL.


Asunto(s)
Calostro , Conducta Sexual/efectos de los fármacos , Vejiga Urinaria Hiperactiva/prevención & control , Vagina/patología , Vulva/patología , Administración Intravaginal , Animales , Atrofia , Bovinos , Femenino , Geles , Humanos , Persona de Mediana Edad , Posmenopausia , Calidad de Vida , Estudios Retrospectivos , Resultado del Tratamiento , Vagina/efectos de los fármacos , Vulva/efectos de los fármacos
16.
Life Sci ; 218: 253-264, 2019 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-30586564

RESUMEN

AIMS: Bisphenol A (BPA), an endocrine disruptor used in industrial applications, has been detected in both placenta and milk. We studied the effects of BPA exposure during pregnancy and lactation on body composition, palatable food intake, biochemical, hormonal and behavioral profiles of young and adult Wistar rat offspring. MAIN METHODS: Female rats were divided into: control, BPA10 (10 µg/kg/day) and BPA50 (50 µg/kg/day). BPA was administered by gavage to dams from gestation until the end of lactation. Euthanasia occurred at weaning [postnatal day (PN) 21] or adulthood (PN180). KEY FINDINGS: At weaning, BPA10 female pups had higher plasma cholesterol and triacylglycerol. BPA10 male pups showed lower plasma T3. BPA10 pups of both sexes had higher plasma progesterone, testosterone and estradiol. At adulthood, females of both BPA groups had lower food intake and higher insulinemia, whereas males had lower visceral fat, lower progesterone and testosterone concentrations. BPA10 females and males had lower T4 levels, while only males showed lower estradiol. BPA50 females showed lower fat mass, higher lean mass and lower corticosteronemia, while males had lower food intake. In the feeding study, BPA10 males ate more fat at 30 min, while BPA10 females and males ingested less fat after 12 h. BPA10 females showed hyperactivity while both groups showed less exploration. SIGNIFICANCE: Maternal exposure to BPA during gestation and lactation, even at low doses, induces life-long changes in the regulation of metabolic homeostasis of the progeny, affects sex steroids and thyroid hormones levels, compromises behavior, but does not lead to obesity or dyslipidemia.


Asunto(s)
Compuestos de Bencidrilo/toxicidad , Hormonas Esteroides Gonadales/metabolismo , Exposición Materna/efectos adversos , Fenoles/toxicidad , Conducta Sexual/efectos de los fármacos , Hormonas Tiroideas/metabolismo , Contaminantes Ocupacionales del Aire/toxicidad , Animales , Animales Recién Nacidos , Femenino , Masculino , Ratas , Ratas Wistar
17.
Brain ; 142(1): 146-162, 2019 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-30590514

RESUMEN

Patients with Parkinson's disease may develop impulse control disorders under dopaminergic treatments. Impulse control disorders include a wide spectrum of behaviours, such as hypersexuality, pathological gambling or compulsive shopping. Yet, the neural systems engaged in specific impulse control disorders remain poorly characterized. Here, using model-based functional MRI, we aimed to determine the brain systems involved during delay-discounting of erotic rewards in hypersexual patients with Parkinson's disease (PD+HS), patients with Parkinson's disease without hypersexuality (PD - HS) and controls. Patients with Parkinson's disease were evaluated ON and OFF levodopa (counterbalanced). Participants had to decide between two options: (i) wait for 1.5 s to briefly view an erotic image; or (ii) wait longer to see the erotic image for a longer period of time. At the time of decision-making, we investigated which brain regions were engaged with the subjective valuation of the delayed erotic reward. At the time of the rewarded outcome, we searched for the brain regions responding more robustly after waiting longer to view the erotic image. PD+HS patients showed reduced discounting of erotic delayed rewards, compared to both patients with Parkinson's disease and controls, suggesting that they accepted waiting longer to view erotic images for a longer period of time. Thus, when using erotic stimuli that motivate PD+HS, these patients were less impulsive for the immediate reward. At the brain system level, this effect was paralleled by the fact that PD+HS, as compared to controls and PD - HS, showed a negative correlation between subjective value of the delayed reward and activity of medial prefrontal cortex and ventral striatum. Consistent with the incentive salience hypothesis combining learned cue-reward associations with current relevant physiological state, dopaminergic treatment in PD+HS boosted excessive 'wanting' of rewards and heightened activity in the anterior medial prefrontal cortex and the posterior cingulate cortex, as reflected by higher correlation with subjective value of the option associated to the delayed reward when ON medication as compared to the OFF medication state. At the time of outcome, the anterior medial prefrontal/rostral anterior cingulate cortex showed an interaction between group (PD+HS versus PD - HS) and medication (ON versus OFF), suggesting that dopaminergic treatment boosted activity of this brain region in PD+HS when viewing erotic images after waiting for longer periods of time. Our findings point to reduced delay discounting of erotic rewards in PD+HS, both at the behavioural and brain system levels, and abnormal reinforcing effect of levodopa when PD+HS patients are confronted with erotic stimuli.10.1093/brain/awy298_video1awy298media15983845074001.


Asunto(s)
Descuento por Demora , Trastornos Disruptivos, del Control de Impulso y de la Conducta/psicología , Agonistas de Dopamina/efectos adversos , Enfermedad de Parkinson/psicología , Conducta Sexual/efectos de los fármacos , Estudios de Casos y Controles , Trastornos Disruptivos, del Control de Impulso y de la Conducta/inducido químicamente , Trastornos Disruptivos, del Control de Impulso y de la Conducta/complicaciones , Giro del Cíngulo/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuroimagen , Enfermedad de Parkinson/complicaciones , Corteza Prefrontal/fisiopatología , Estriado Ventral/fisiopatología
18.
Int J Drug Policy ; 61: 31-37, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30388567

RESUMEN

BACKGROUND: Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore. METHODS: We conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18-39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, transcribed, coded, and analysed using thematic analysis. RESULTS: Participants reported that it was common to encounter chemsex among GBMSM in Singapore as it could be easily accessed or initiated using social networking phone apps. Enhancement and prolongation of sexual experiences, fear of rejection from sexual partners and peers, and its use as a means of coping with societal rejection were three main reasons cited for engaging in chemsex. The impact of punitive drug laws on disclosure and stigmatisation of GBMSM who use drugs were reported to be key barriers towards addressing chemsex. Participants suggested using gay-specific commercial venues as avenues for awareness and educational campaigns, and social media to reach out to younger GBMSM. CONCLUSIONS: This study highlights the complexities behind chemsex use among GBMSM in Singapore, and the range of individual to institutional factors to be addressed. We recommend that community-based organisations and policy-makers find ways to destigmatise discussion of chemsex and provide safe spaces to seek help for drug use.


Asunto(s)
Homosexualidad Masculina/psicología , Conducta Sexual/efectos de los fármacos , Conducta Sexual/psicología , Parejas Sexuales/psicología , Minorías Sexuales y de Género/psicología , Adolescente , Adulto , Reducción del Daño , Conocimientos, Actitudes y Práctica en Salud , Humanos , Entrevista Psicológica , Masculino , Motivación , Investigación Cualitativa , Asunción de Riesgos , Enfermedades de Transmisión Sexual/etiología , Enfermedades de Transmisión Sexual/psicología , Singapur , Trastornos Relacionados con Sustancias , Sexo Inseguro/efectos de los fármacos , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
19.
Am J Addict ; 27(8): 618-624, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30328218

RESUMEN

BACKGROUND AND OBJECTIVES: Prescription opioid misuse is an established problem in the United States. Less information is known regarding the clinical and cognitive characteristics of prescription opioid misusers, specifically in a college age population. This study sought to characterize individuals who misuse prescription opioids and the differences between current, past and non-misusers. METHODS: A 156-item survey was administered to over 9,449 university students at a large, public Midwestern university. Survey questions obtained demographic information, self-reported grade point average, sexual behavior, mental health characteristics, and substance use. Participants also completed assessments that asked questions regarding impulsivity, mental health, substance use, and other impulsive behaviors including gambling and sexual activity. 3,522 students completed the survey and were included in the analysis. RESULTS: Of this group, 2.2% reported misusing prescription opioids in the last 12 months and another 5.3% reported misusing prescription opioids previously but not in the past year. This study found prescription opioid misusers to be more likely to live off campus, have a lower GPA, and exhibit increased impulsivity. Prescription opioid misusers were also more likely to report earlier age of sexual activity and were less likely to use barrier protection during sexual activity. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This study identifies a number of risk factors for those misusing prescription opioids that can be used to develop and refine prescription opioid misuse screening tools for university health centers. It also identifies a number of concurring behaviors that can simultaneously be addressed when prescription opioid misusers are identified. (Am J Addict 2018;XX:1-7).


Asunto(s)
Analgésicos Opioides/farmacología , Conducta Adictiva , Cognición/efectos de los fármacos , Mal Uso de Medicamentos de Venta con Receta , Estudiantes/psicología , Conducta Adictiva/prevención & control , Conducta Adictiva/psicología , Consumidores de Drogas/psicología , Femenino , Humanos , Masculino , Evaluación de Necesidades , Mal Uso de Medicamentos de Venta con Receta/efectos adversos , Mal Uso de Medicamentos de Venta con Receta/prevención & control , Mal Uso de Medicamentos de Venta con Receta/psicología , Problema de Conducta/psicología , Medición de Riesgo/métodos , Factores de Riesgo , Conducta Sexual/efectos de los fármacos , Encuestas y Cuestionarios , Estados Unidos , Universidades , Adulto Joven
20.
JCI Insight ; 3(20)2018 10 18.
Artículo en Inglés | MEDLINE | ID: mdl-30333302

RESUMEN

BACKGROUND: Resting brain connectivity is a crucial component of human behavior demonstrated by disruptions in psychosexual and emotional disorders. Kisspeptin, a recently identified critical reproductive hormone, can alter activity in certain brain structures but its effects on resting brain connectivity and networks in humans remain elusive. METHODS: We determined the effects of kisspeptin on resting brain connectivity (using functional neuroimaging) and behavior (using psychometric analyses) in healthy men, in a randomized double-blinded 2-way placebo-controlled study. RESULTS: Kisspeptin's modulation of the default mode network (DMN) correlated with increased limbic activity in response to sexual stimuli (globus pallidus r = 0.500, P = 0.005; cingulate r = 0.475, P = 0.009). Furthermore, kisspeptin's DMN modulation was greater in men with less reward drive (r = -0.489, P = 0.008) and predicted reduced sexual aversion (r = -0.499, P = 0.006), providing key functional significance. Kisspeptin also enhanced key mood connections including between the amygdala-cingulate, hippocampus-cingulate, and hippocampus-globus pallidus (all P < 0.05). Consistent with this, kisspeptin's enhancement of hippocampus-globus pallidus connectivity predicted increased responses to negative stimuli in limbic structures (including the thalamus and cingulate [all P < 0.01]). CONCLUSION: Taken together, our data demonstrate a previously unknown role for kisspeptin in the modulation of functional brain connectivity and networks, integrating these with reproductive hormones and behaviors. Our findings that kisspeptin modulates resting brain connectivity to enhance sexual and emotional processing and decrease sexual aversion, provide foundation for kisspeptin-based therapies for associated disorders of body and mind. FUNDING: NIHR, MRC, and Wellcome Trust.


Asunto(s)
Emociones/efectos de los fármacos , Kisspeptinas/administración & dosificación , Conducta Sexual/efectos de los fármacos , Administración Intravenosa , Adulto , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de los fármacos , Encéfalo/fisiología , Conectoma , Estudios Cruzados , Método Doble Ciego , Emociones/fisiología , Femenino , Voluntarios Sanos , Humanos , Masculino , Trastornos Mentales/tratamiento farmacológico , Red Nerviosa/efectos de los fármacos , Red Nerviosa/fisiología , Placebos/administración & dosificación , Psicometría , Descanso/fisiología , Conducta Sexual/fisiología , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Adulto Joven
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