pinecone/core-2020-05-10-deduplication huggingface dataset:
Perspectives on Sexual Health and Function of Recent Male Combat Veterans of Iraq and Afghanistan

AbstractBackgroundU.S. veterans of recent wars in Iraq and Afghanistan may be at greater risk for sexual dysfunction due to injuries, mental health conditions, medications used to treat those conditions, and psychosocial factors.ObjectiveTo explore the perceptions of recent Veterans about sexual health and dysfunction, contributing factors, its impact and solutions.DesignQualitative study.ParticipantsEight men who screened positive for sexual dysfunction at initial presentation to a postdeployment clinic at a Veterans Affairs medical centerApproachPatients who screened positive for sexual dysfunction and indicated an interest in participating were contacted and scheduled for an in‐person private interview with a researcher. Interviews were semistructured, utilizing open‐ended and follow‐up probe questions to elicit the individual's perspective about sexual dysfunction and its cause, impact and solutions. Interviews were recorded, transcribed and analyzed for themes.Key ResultsThese heterosexual men discussed a range of sexual dysfunction in their activities including lack of desire, erectile dysfunction, delayed orgasm, premature ejaculation, and distraction. They also discussed the importance of setting or context and changes over time to their sexual health and function. The men shared their ideas about contributory factors, including normal aging, medication side effects, injury and a possible role for combat deployment more generally. Reported solutions for sexual dysfunction included medications, herbal remedies, and new positions and approaches to sexual activity. Participants reported discussing sexual dysfunction with their health‐care providers and what was helpful. Finally, the men expressed in their own words the significant impact of sexual dysfunction on their self‐perception, their partners, and their relationships.ConclusionsSexual dysfunction in recent combat veterans can have important negative effects on their health and relationships. Our findings elucidate perceived contributory factors and preferred solutions, which can be applied by health‐care providers to improve the management of sexual dysfunction in these patients. Helmer DA, Beaulieu G, Powers C, Houlette C, Latini D, and Kauth M. Perspectives on sexual health and function of recent male combat veterans of Iraq and Afghanistan. Sex Med 2015;3:137–146
Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

AbstractIntroductionLittle is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis.AimTo compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns.MethodsAn opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33).Main Outcome MeasuresThe Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis.ResultsMen with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success.ConclusionMen with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. Veale D, Miles S, Read J, Troglia A, Wylie K, and Muir G. Sexual functioning and behavior of men with body dysmorphic disorder concerning penis size compared with men anxious about penis size and with controls: A cohort study. Sex Med 2015;3:147–155
Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review

AbstractIntroductionPremature ejaculation (PE) is defined by short ejaculatory latency and inability to delay ejaculation causing distress. Management may involve behavioral and/or pharmacological approaches.AimTo systematically review the randomized controlled trial (RCT) evidence for behavioral therapies in the management of PE.MethodsNine databases including MEDLINE were searched up to August 2014. Included RCTs compared behavioral therapy against waitlist control or another therapy, or behavioral plus drug therapy against drug treatment alone. [Correction added on 10 September 2015, after first online publication: Search period has been amended from August 2013 to August 2014.]Main Outcome MeasureIntravaginal ejaculatory latency time (IELT), sexual satisfaction, ejaculatory control, and anxiety and adverse effects.ResultsTen RCTs (521 participants) were included. Overall risk of bias was unclear. All studies assessed physical techniques, including squeeze and stop‐start, sensate focus, stimulation device, and pelvic floor rehabilitation. Only one RCT included a psychotherapeutic approach (combined with stop‐start and drug treatment). Four trials compared behavioral therapies against waitlist control, of which two (involving squeeze, stop‐start, and sensate focus) reported IELT differences of 7–9 minutes, whereas two (web‐based sensate focus, stimulation device) reported no difference in ejaculatory latency posttreatment. For other outcomes (sexual satisfaction, desire, and self‐confidence), some waitlist comparisons significantly favored behavioral therapy, whereas others were not significant. Three trials favored combined behavioral and drug treatment over drug treatment alone, with small but significant differences in IELT (0.5–1 minute) and significantly better results on other outcomes (sexual satisfaction, ejaculatory control, and anxiety). Direct comparisons of behavioral therapy vs. drug treatment gave mixed results, mostly either favoring drug treatment or showing no significant difference. No adverse effects were reported, though safety data were limited.ConclusionsThere is limited evidence that physical behavioral techniques for PE improve IELT and other outcomes over waitlist and that behavioral therapies combined with drug treatments give better outcomes than drug treatments alone. Further RCTs are required to assess psychotherapeutic approaches to PE. Cooper K, Martyn‐St James M, Kaltenthaler E, Dickinson K, Cantrell A, Wylie K, Frodsham L, and Hood C. Behavioral therapies for management of premature ejaculation: A systematic review. Sex Med 2015;3:174–188
Female Sexual Health Training for Oncology Providers: New Applications

AbstractIntroductionSexual health care remains an unmet need for women with cancer. Many barriers are described, such as provider discomfort and lack of training; however, there is little evidence‐based guidance regarding how to effectively address these obstacles.AimThis pilot study was performed to determine whether brief, targeted sexual health training for oncology providers results in improved provider comfort level and frequency of addressing female cancer‐related sexual issues.MethodsA brief (30–45 minute), targeted sexual health training program focused on improving comfort level, knowledge and communication skills when addressing breast cancer–related sexual issues was developed by the primary author. Using a pretest‐posttest format, this educational program was provided to oncology providers (physicians and nurses/other allied health) from a suburban health‐care system. Surveys based on 5‐point Likert scales were provided before and 3–6 month post training.Main Outcome MeasuresPrimary endpoints were changes in mean Likert scores for provider comfort level and self‐reported frequency of addressing sexual issues. A secondary endpoint was change in mean Likert scores for perception of access to sexual health resources/referrals.ResultsEligible respondents included 8 oncologists, 4 surgeons, and 62 nurses/other allied health. For total respondents, comparison of mean Likert scores for survey 1 (n = 71) and survey 2 (n = 36) demonstrated statistically significant increases for all parameters queried, including provider comfort level with bringing up (Pre mean Likert score = 3.4, Post = 4.3, P < 0.0001) and coordinating care (Pre = 3.5, Post = 4.6, P < 0.0001), and frequency of addressing sexual issues for both diagnosis/treatment and surveillance phase (Pre = 2.4, Post = 3.3, P ≤ 0.0052).ConclusionBrief, targeted sexual health training for oncology providers positively correlated with improved provider comfort level and frequency of addressing female cancer‐related sexual issues. Wang LY, Pierdomenico A, Lefkowitz A, and Brandt R. Female sexual health training for oncology providers: New applications. Sex Med 2015;3:189–197
Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

AbstractIntroductionThe question of whether removal of sensory receptors in the prepuce by circumcision affects sensitivity and/or sexual pleasure is often debated.AimsTo examine histological correlates relevant to penile sensitivity and sexual pleasure.MethodsSystematic review of the scientific literature on penile structures that might affect sensitivity and sexual sensation. Articles were included if they contained original data on human male penile histology or anatomy. Individual articles, including reference lists, were evaluated. They were then considered in relation to physiological data from articles retrieved by a previous systematic review.ResultsWe retrieved 41 publications on penile structure. Considered in the light of 12 reporting physiological measurements, our evaluation finds that sexual response is unlikely to involve Meissner's corpuscles, whose density in the prepuce diminishes at the time of life when male sexual activity is increasing. Free nerve endings also show no correlation with sexual response. Because tactile sensitivity of the glans decreases with sexual arousal, it is unrelated to sexual sensation. Thermal sensitivity seems part of the reward mechanism of intercourse. Vibrational sensitivity is not related to circumcision status. Observations that penile sexual sensation is higher post circumcision are consistent with greater access of genital corpuscles to sexual stimuli after removal of the prepuce. This is based on the distribution of these corpuscles (which are located in the glans) and, in uncircumcised men, the position of the retracted prepuce during intercourse, rather than any change in the number of genital corpuscles. The scientific literature suggests that any sexual effect of circumcised men may depend solely on exposure of the glans and not on the absence of the prepuce.ConclusionBased on histological findings and correlates of sexual function, loss of the prepuce by circumcision would appear to have no adverse effect on sexual pleasure. Our evaluation supports overall findings from physiological measurements and survey data. Cox G, Krieger JN, and Morris BJ. Histological correlates of penile sexual sensation: Does circumcision make a difference? Sex Med 2015;3:76–85
Italian Validation of Homophobia Scale (HS)

AbstractIntroductionThe Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self‐reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition.AimThe aim of this study was to validate the HS in the Italian context.MethodsAn Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back into the English language. A psychologist and sexologist checked the translated items from a clinical point of view. We recruited 100 subjects aged18–65 for the Italian validation of the HS. The Pearson coefficient and Cronbach's α coefficient were performed to test the test–retest reliability and internal consistency.Main Outcome MeasuresA sociodemographic questionnaire including the main information as age, geographic distribution, partnership status, education, religious orientation, and sex orientation was administrated together with the translated version of HS.ResultsThe analysis of the internal consistency showed an overall Cronbach's α coefficient of 0.92. In the four domains, the Cronbach's α coefficient was 0.90 in behavior/negative affect, 0.94 in affect/behavioral aggression, and 0.92 in negative cognition, whereas in the total score was 0.86. The test–retest reliability showed the following results: the HS total score was r = 0.93 (P < 0.0001), behavior/negative affect was r = 0.79 (P < 0.0001), affect/behavioral aggression was r = 0.81 (P < 0.0001), and negative cognition was r = 0.75 (P < 0.0001).ConclusionsThe Italian validation of the HS revealed the use of this self‐report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior. Ciocca G, Capuano N, Tuziak B, Mollaioli D, Limoncin E, Valsecchi D, Carosa E, Gravina GL, Gianfrilli D, Lenzi A, and Jannini EA. Italian validation of Homophobia Scale (HS). Sex Med 2015;3:213–218
The Clinician's Toolbox: Assessing the Sexual Impacts of Cancer on Adolescents and Young Adults with Cancer (AYAC)

AbstractIntroductionAdolescents and young adults aged 15-39 years who have been diagnosed with cancer (AYAC) have unique medical and psychosocial needs. Following their cancer treatments, AYAC must learn to manage the sometimes irreversible general side effects of cancer treatments including side effects that impact their sexuality. These side effects include but are not limited to: infertility, altered body/physical appearance, and sexual dysfunction. Such effects may hinder AYAC efforts to date and experiment sexually, limiting sexual maturation and confidence, as well as the formation or maintenance of meaningful couple and sexual relationships. It is clear that we need to tailor our clinical approaches to ensure that we assess the unique needs and concerns faced by AYAC.AimsBased on consistent study findings substantiating the distinctive needs of AYAC, the main objective of this article is to present the core clinical components involved in assessing sexuality among AYAC.MethodsThe clinical recommendations are based on the authors and experts' clinical experiences coupled with a thorough examination of the literature related to AYAC sexuality.Main Outcome MeasuresThis article first describes the three components (clinical interview, review of chart notes, and self‐report questionnaires) of a sexuality assessment and the seven core domains that highlight target areas of focus.ResultsA detailed outline of each of the core domains of assessment (socio‐demographics; medical history; fertility and sexually transmitted infection; sexual functioning; sexual coping style; body and self‐image; and sexual history and dating/couple experience) is presented. A “toolbox” table containing useful resources for clinicians (e.g., questionnaires and red flags) and direct resources for AYAC patients are included.ConclusionCancer can have a significant impact on numerous domains of AYAC sexuality. The assessment of and attention to the impact of sexuality on AYAC is crucial in order to provide effective and comprehensive quality patient cancer care. Aubin S and Perez S. The clinician's toolbox: assessing the sexual impacts of cancer on adolescents and young adults with cancer (AYAC). Sex Med 2015;3:198–212
Comparison of the Effects of Testosterone Gels, Injections, and Pellets on Serum Hormones, Erythrocytosis, Lipids, and Prostate‐Specific Antigen

AbstractIntroductionNumerous testosterone (T) formulations are available, each with differing effects on serum parameters.AimThe aim of this study was to compare the long‐term effects of topical, injectable, and implantable pellet T formulations in hypogonadal men.MethodsRetrospective review of hypogonadal men treated with a single T formulation was performed: 47 men on T gels, 57 on injectable T, and 74 on T pellets were identified. Total T (TT), calculated free T (FT), estradiol (E), hemoglobin (Hgb), hematocrit (Hct), prostate‐specific antigen (PSA), total cholesterol (Tchol), triglycerides (TG), low‐density lipoprotein (LDL), and high‐density lipoprotein (HDL) cholesterol were evaluated at baseline and every 3–6 months for 3 years. Serum parameters were compared using a mixed model linear regression for repeated measures.Main Outcome MeasuresEffects of topical, injectable, and pellet T formulations on serum hormone levels, Hgb, Hct, lipid parameters and PSA.ResultsMen in the injectable T group were younger (42.5 ± 12.3 years) than in the gel (54.1 ± 9.8 years) or pellet groups (53.8 ± 13.0 years), and baseline FT, Hgb, and Hct were higher in the injectable T group than in gel or pellet groups. Increases in TT and FT were observed throughout follow‐up in all groups. Increases in E were observed at in all T groups and throughout follow‐up in injectable and gel groups. No PSA increases were observed. Erythrocytosis (Hct > 50%) was more common with injectable T (66.7%) than with T gels (12.8%) or pellets (35.1%, P < 0.0001). Transient changes in cholesterol, TG, and LDL were observed, and no significant changes were seen in HDL for any group.ConclusionsAll T formulations increase serum T and FT. More significant increases in E occur with injectable T and T gels. Changes in Hgb and Hct are most significant with injectable T, and effects on lipids are variable and inconsistent. Selection of T formulations must account for individual patient preferences and the effects of each formulation. Pastuszak AW, Gomez LP, Scovell JM, Khera M, Lamb DJ, and Lipshultz LI. Comparison of the effects of testosterone gels, injections, and pellets on serum hormones, erythrocytosis, lipids, and prostate‐specific antigen. Sex Med 2015;3:165–173
The Female Sexual Function Index (FSFI): Translation, Validation, and Cross‐Cultural Adaptation of an Urdu Version “FSFI–U”

AbstractIntroductionFemale sexual dysfunction (FSD) is a common problem, and many self‐report questionnaires are available for its evaluation. Pakistani women with sexual problems feel shy to consult with their physician. A validated self‐report questionnaire, in the local language with modest expressions is required for these women.AimThe aim of this study was to translate, cross‐culturally adapt, and perform a psychometric validation of an Urdu translation of the Female Sexual Function Index (FSFI).MethodsThe FSFI was translated in Urdu, and its precision was ascertained through reverse translation. It was pretested on 22 bilingual women and refined again to reach at a reliable Urdu version of the questionnaire FSFI‐U. One hundred sixteen bilingual women, in a stable sexual relationship over the previous 6 months were finally asked to fill out the FSFI and FSFI‐U. Their sexual function was then clinically evaluated and responses were compared with the clinical assessment as well as with each other.Main Outcome MeasuresThe responses were analyzed through descriptive statistics for reliability, face validity, agreement between the responses to the original English version and to the FSFI‐U, and also for test–retest consistency. The data were analyzed statistically using Cronbach's alpha analysis, Intraclass correlation coefficients, Pearson correlation, and Student's t‐test.ResultsFSFI was found to be easily understandable and capable of adequately evaluating and measuring various aspects of female sexual function. A high degree of internal consistency was demonstrated on Cronbach's alpha analysis. Cronbach's α coefficient for various domains was sufficiently high ranging from 0.84 to 0.97. The clinical assessment of the presence and severity of FSD also matched with the self‐report questionnaire. Similarly, various domains of FSFI had high degree of correlation in the Urdu version of FSFI (P < 0.001).ConclusionThe Urdu translation version of FSFI is valid and reliable for use in the literate population of Pakistan. Rehman KU, Asif Mahmood M, Sheikh SS, Sultan T, Khan MA. The Female Sexual Function Index (FSFI): Translation, Validation, and Cross‐Cultural Adaptation of an Urdu Version “FSFI–U”. Sex Med 2015;3:244–250
A Longitudinal Study of Predictors of Sexual Dysfunction in Men on Active Surveillance for Prostate Cancer

AbstractAimThe aim of this study was to examine the relationship between sexual dysfunction, repeat biopsies and other demographic and clinical factors in men on active surveillance (AS).MethodsPatient‐reported outcomes (PROs) measures were administered at enrollment and every 6 months to assess quality of life (QOL), psychosocial and urological health outcomes. Using mixed‐effects models, we examined the impact of repeat biopsies, total number of cores taken, anxiety, age, and comorbidity on sexual function over the first 24 months of enrolling in AS.Main Outcome MeasuresPROs included the Expanded Prostate Cancer Index Composite‐26 (EPIC‐26) Sexual Function (SF) subscale, the American Urological Association‐Symptom Index (AUA‐SI), and the Memorial Anxiety Scale for Prostate Cancer (MAX‐PC).ResultsAt enrollment (n = 195), mean age was 66.5 ± 6.8 with a mean EPIC‐26 SF score of 61.4 ± 30.4. EPIC‐26 SF scores steadily decreased to 53.9 ± 30.7 at 24 months (P < 0.01). MAX‐PC scores also progressively decreased over time (P = 0.03). Factors associated with lower EPIC‐26 scores over time included age, unemployed status, diabetes, coronary artery disease, and hypertension (all P < 0.05). Higher prostate‐specific antigen (PSA) was associated with a more rapid decline in EPIC‐26 SF over time (P = 0.03). In multivariable analysis, age, diabetes, and PSA × time interaction remained significant predictors of diminished sexual function. Anxiety, number of biopsies, and total cores taken did not predict sexual dysfunction or change over time in our cohort.ConclusionsMen on AS experienced a gradual decline in sexual function during the first 24 months of enrollment. Older age, PSA × time, and diabetes were all independent predictors of diminished sexual function over time. Anxiety, AUA‐SI, the number of cores and the number of biopsies were not predictors of reduced sexual function in men in AS. Pearce SM, Wang CHE, Victorson DE, Helfand BT, Novakovic KR, Brendler CB, and Albaugh JA. A longitudinal study of predictors of sexual dysfunction in men on active surveillance for prostate cancer. Sex Med 2015;3:156–164