Search Results (610)

Background and Objectives: Chronic mental disorders may negatively affect sexual functioning and dyadic adjustment. This study aimed to investigate the associations between alexithymia, sexual dysfunctions, and dyadic adjustment in patients with obsessive–compulsive disorder (OCD) and to compare these variables with those of healthy controls. Materials and Methods: This case–control study included 72 patients with OCD and 82 sociodemographically matched healthy controls. All participants completed the Toronto Alexithymia Scale (TAS-20), Arizona Sexual Experiences Scale (ASEX), Yale–Brown Obsessive Compulsive Scale (YBOCS), and Dyadic Adjustment Scale (DAS). Group comparisons were conducted using independent t-tests, Mann–Whitney U tests, and chi-square tests, while correlations were examined using Pearson’s analysis. Results: Patients with OCD had significantly higher TAS-20 scores (60.97 ± 11.15 vs. 43.18 ± 8.86, p < 0.001) and ASEX total scores (18.33 ± 4.93 vs. 13.76 ± 3.55, p < 0.001), alongside lower DAS scores (total and all subscales, p < 0.001) than controls. Within the OCD group, TAS-20 scores correlated positively with the total ASEX score (r = 0.366, p = 0.002) and negatively with the total DAS score (r = −0.339, p = 0.004) and subscales (all p < 0.05). Conclusions: Patients with OCD exhibit elevated alexithymia, greater sexual dysfunction, and reduced dyadic adjustment compared with healthy controls. Furthermore, alexithymia in patients with OCD is associated with impaired sexual functioning and dyadic adjustment. Assessing alexithymic traits and addressing them in treatment may improve social and familial functioning in this population. Full article

Chronic stress (CS) is known to induce testicular oxidative stress and apoptosis. Fruit of Momordica charantia (FMC) has antioxidant capacity to protect tissue damage, but its effect on sexual activity and testicular damage caused by CS has never been documented. This study aimed to investigate the impact of FMC extract against testicular damage and sexual dysfunction in chronic unpredictable stress (CUS) rats. Rats were divided into four groups and pretreated with vehicle or FMC (40 and 80 mg/kg) before CUS induction for 56 days. Sexual behaviors, serum hormones, and sperm quality were analyzed. Testes were collected to determine daily sperm production (DSP), malondialdehyde (MDA) level, and expressions of cleaved apoptotic proteins. Testicular DNA fragmentation, as revealed by TUNEL and morphometric analysis, was observed. FMC improved sexual activity, increased testosterone levels, and sperm count with improvements in DSP, testicular morphometrics, and MDA levels. Moreover, TUNEL-positive cells and expression of caspase 3 in the testis were decreased in FMC rats. FMC has antioxidant potential and could protect against male sexual dysfunction and testicular damage caused by stress-related apoptosis. It is a potential extract to be developed as a supplement in preventing CS-male subfertility. However, future studies about the optimal dose and clinical trials are required. Full article

Background: Endocrine therapy (ET) with or without ovarian function suppression (OFS) is a cornerstone treatment for estrogen receptor-positive (ER+) breast cancer (BC) in premenopausal women, but its impact on quality of life (QoL) and sexual health remains a concern. Methods: We conducted a multicenter, prospective, observational study including premenopausal women (≤50 years) diagnosed with stage I–III ER+ BC and treated in private healthcare facilities in Brazil between 2013 and 2023. Patients received ET alone (ET-only) or combined with OFS (OFS-ET). QoL was assessed at baseline and 3, 6, 9, 12, and 24 months using the EORTC QLQ-BR23. Sexual functioning and sexual enjoyment were prespecified primary outcomes. Logistic regression identified factors associated with OFS use, and Fisher’s exact test was applied for categorical comparisons at 24 months. Results: Among 363 patients (80% ET-only, 20% ET + OFS), younger age, advanced stage, and chemotherapy were independently associated with OFS use. Both groups reported early declines in sexual functioning and enjoyment. By 24 months, ET-only patients had returned to baseline, whereas OFS patients remained below baseline. At the item level, no significant differences were observed in sexual desire (51.5% vs. 42.0%; p = 0.33) or enjoyment (26.0% vs. 13.5%; p = 0.20). Lack of sexual activity was more frequent in the OFS group (60.6% vs. 41.2%; p = 0.05). Body image was significantly more impaired with OFS, with a higher proportion of patients reporting feeling less attractive (38.2% vs. 19.9%; p = 0.04) and less feminine (26.5% vs. 11.7%; p = 0.05). Conclusions: ET impairs sexual health in young BC survivors, particularly when combined with OFS. These findings underscore the need for routine sexual health assessments and supportive interventions in survivorship care. Full article

Background and objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that affects not only physical health but also psychological well-being. While the emotional and social burden of AD is well documented, there is still limited research on how AD affects sexual health. The study aimed to evaluate quality of life (QoL), mental health, and risk factors for impaired sexual life, as well as their relationships. Materials and Methods: A total of 201 participants (96 patients with AD and 105 healthy controls) were enrolled in the study. Socio-demographic and clinical data were obtained using a specifically developed questionnaire. In addition, participants completed validated scales, including the DLQI, HADS, FSFI, IIEF-5, and SRSLQ. AD severity was assessed using the SCORAD questionnaire. Results: Our study found that patients with AD had statistically significantly higher mean anxiety (6.8 ± 3.6 vs. 5.0 ± 3.2; p < 0.001), depression (5.2 ± 3.4 vs. 3.9 ± 2.9, p < 0.01), and skin-related sexual dysfunction scores (15.0 ± 4.5 vs. 4.4 ± 4.7, p < 0.001), as well as QoL scores (12.3 ± 6.1 vs. 1.8 ± 3.1, p < 0.001), than healthy controls. Female AD patients reported higher values of depression and anxiety compared to male patients (5.9 ± 3.1 vs. 4.4 ± 3.5, p = 0.03, 7.6 ± 2.9 vs. 6.0 ± 4.1, p = 0.03, respectively) and lower FSFI scores compared to healthy women (24.8 ± 8.0 vs. 31.3 ± 3.0, p < 0.001). Deterioration in sexual health, assessed by the SRSLQ score, was strongly correlated with QoL impairment (R = 0.5, p < 0.001), anxiety (R = 0.51, p < 0.001), and depression (R = 0.5, p < 0.001). Finally, we found that sex life negatively correlates with AD severity (p=0.001), involvement of a genital area (p = 0.005), intensity of pruritus (r = 0.284, p = 0.005), and insomnia (r = 0.366, p < 0.001). Conclusions: AD significantly affects patients’ quality of life, including their sex life. Many factors associated with the disease also contribute to the deterioration of patients’ sexual health. Routine assessment of sexual life in dermatological practice, using validated tools, could facilitate early identification and support for affected patients. Significance: This study highlights the often-overlooked impact of atopic dermatitis on patients’ sexual health. Our findings demonstrate that sexual function is significantly impaired in individuals with atopic dermatitis—particularly among women—and that such dysfunction is closely associated with disease-related symptoms. These results have important implications for improving the quality of care provided to individuals affected by the condition. Full article

Background/Objectives: Erectile dysfunction (ED) is a prevalent and multifactorial condition influenced by psychological and sleep-related factors. This study aimed to evaluate the independent and combined associations of insomnia and benzodiazepine use with the risk of ED. Methods: An analytical cross-sectional study was conducted in adult men with and without ED. Logistic regression was used to estimate crude and adjusted odds ratios (ORs). Effect modification was assessed through stratified analyses. Additionally, an in silico analysis of 17 active compounds was performed using SwissADME and Molinspiration to explore physicochemical properties. Results: Insomnia (adjusted OR 2.05; 95% CI 1.13–3.74; p = 0.019) and benzodiazepine use (adjusted OR 2.14; 95% CI 1.10–4.15; p = 0.025) were each independently associated with ED. In contrast, antidepressant use was not significantly associated with ED in the sample analyzed. Participants with both insomnia and benzodiazepine use had a markedly higher risk (adjusted OR 3.96; 95% CI 1.51–10.40; p = 0.005). The joint association of insomnia and benzodiazepine use was consistent with the combined effect expected from their individual associations. The in silico analysis showed an overlapping profile, suggesting benzodiazepine properties may underline their link to ED, supporting the results of the cross-sectional study. Conclusions: Both insomnia and benzodiazepine use independently increased the odds of ED. Their co-occurrence was linked to a substantially higher likelihood of ED, highlighting the clinical importance of assessing both conditions concurrently in patients with sexual dysfunction. Full article

Introduction: Prostate cancer is one of the most common neoplasia in men, and its clinical evolution is highly influenced by psycho-emotional factors, especially in elderly patients. Comorbidities, the perception of one’s identity and its impact on life quality become relevant variables in the therapeutic decision. Sexual dysfunction after treatment along with decreased libido, erectile dysfunction and ejaculatory dysfunction are significant problems in patients with prostate cancer. Case presentation: The present study presents the oncological evolution of an elderly patient with a dual diagnosis, prostate adenocarcinoma and lung squamous cell carcinoma, who faced a significant amount of medical and psychological challenges. Reluctance to hormone therapy was closely linked to the fear of sexual dysfunction, a very common reaction in elderly men concerned with maintaining autonomy and intimacy. The peculiarity of the case consists in the interaction between the evolution of the disease, the therapeutic decisions and the psychological impact on the patient. Discussion: Androgen deprivation therapy negatively influences multiple aspects of sexual function, significantly impairing the life quality of patients diagnosed with prostate cancer. In this context, therapy through acceptance and commitment is the appropriate one, its main purpose being to change the patient’s relationship with suffering—from struggle and rejection to active acceptance and value of the present. The intervention of the psychologist or the psychotherapist is essential in decision-making counseling, using coping techniques, the clarification of personal values and the involvement of the family in the decision-making process. Oncological psychology helps the patient redefine their life goals and priorities, not just to choose a treatment. Conclusions: Sexuality and psychological health are deeply affected by prostate cancer. Psychological flexibility and emotional support can mitigate this negative impact. The integration of therapy through acceptance and commitment in the rehabilitation after treatment increases effectiveness and patient satisfaction. Full article

Background: Female Sexual dysfunction (FSD) is a common but under-recognized outcome of rectal and anal cancer treatment. While survival has improved, sexual health remains insufficiently addressed in survivorship care, warranting a multidisciplinary perspective. Methods: A narrative review of studies published between 2000 and 2025 was conducted, including clinical trials, cohort studies, and guideline documents addressing female sexual dysfunction after anorectal cancer treatment. Articles that were not pertinent to the research topic, outdated, or methodologically inadequate were excluded from the analysis. Results: Over 60% of female survivors experience FSD, including decreased libido, vaginal dryness, dyspareunia, and arousal difficulties. Causes include hormonal deficiency, nerve injury, and radiation fibrosis, compounded by psychological distress, altered body image, stoma-related stigma, and communication issues. The FSFI is commonly applied but lacks specificity for this population. Geographic disparities persist, with greater stigma and limited care access in low- and middle-income countries. Emerging therapies, such as immunotherapy, may mitigate FSD risk, though evidence is scarce. Conclusions: FSD after anorectal cancer is highly prevalent and significantly impacts quality of life, yet remains under-assessed in follow-up care. Multidisciplinary, culturally sensitive strategies integrating screening, psychosexual support, and tailored rehabilitation are urgently needed. Future research should address sexual outcomes more systematically, particularly in novel treatment contexts. Full article

Background/Objectives: Sexuality is a frequently overlooked but clinically significant dimension in patients with obsessive–compulsive disorder (OCD). Beyond comorbid anxiety and depressive symptoms, OCD can substantially affect sexual functioning and include obsessions and compulsions relating to sexual content. This review aims to synthesize current evidence on sexual dysfunction in OCD and the role of sexuality in OCD symptom dimensions, as well as associated neurobiological, cognitive, and clinical outcomes. Methods: We conducted a review of the literature including studies published in the last 20 years using the PubMed and Cochrane databases. Our search strategy used the terms “sexual AND (Obsessive-compulsive disorder OR OCD)”, retrieving a total of 582 articles. After a screening and eligibility assessment based on predefined inclusion and exclusion criteria, 200 studies were included. Additional papers were retrieved through citation tracking. Results: Sexual dysfunction is highly prevalent in OCD patients, particularly among women, ranging from low desire and arousal to anorgasmia and pain during intercourse. Sexual obsessions affect a large proportion of OCD patients and are associated with an early onset, male sex, greater symptom severity, poorer insight, and suicidality. These obsessions often co-occur with aggressive or religious themes. Neuroimaging studies indicate distinct patterns of brain activation in patients with sexual obsessions. Treatment with SSRIs and CBT is often less effective in this subgroup, suggesting the need for targeted interventions. Conclusions: Sexuality-related symptoms in OCD patients constitute a distinct and clinically relevant domain that affects functioning, prognosis, and treatment response. Recognizing and addressing these symptoms is essential for the holistic and effective care of patients with OCD. Full article

Background: Selective serotonin reuptake inhibitors (SSRIs) are one of the most frequently used medication classes in psychiatry, with many approved and off-label uses. One common side effect of SSRIs is sexual dysfunction, leading to the off-label use of SSRIs to manage inappropriate sexual behaviors in psychiatric settings. However, no official guidelines exist for this off-label use of SSRIs, so a review of this use is warranted. Methods: This review was conducted using the PubMed and Google Scholar databases. Grey literature was considered for inclusion in this review, but only one report by the United Kingdom’s Care Quality Commission was included. Peer-reviewed references discussing the theoretical mechanisms of SSRI-induced sexual dysfunction, case reports/studies examining the off-label use of SSRIs, and reviews discussing relevant disorders like post-SSRI sexual dysfunction (PSSD) were included in this review. Results: The literature proposes that SSRIs act through a variety of serotonin receptors such as 5-HT_1A, 5-HT_2A, and 5-HT_2C to inhibit dopaminergic tone in the mesolimbic and spinal pathways to cause sexual dysfunction. Discussion: SSRIs are frequently considered for off-label use in managing inappropriate sexual behavior, particularly in geriatric patients with dementia, given their superior safety profile compared to antipsychotics in that population. However, the risk and treatment options for PSSD are unclear, which poses a risk for patients taking SRRIs, as it can be a severe and enduring condition. High-quality clinical trials are needed, as the majority of the literature on the topic consists of case reports or theoretical papers. Full article

Background and Objectives: This study compares laparoscopic and robotic surgical techniques for rectal cancer, focusing on oncologic outcomes, mesocolic excision quality, lymph node yield, and postoperative sexual and urinary function, while also exploring patient satisfaction and recovery trajectories through clinical outcomes and validated questionnaires. Materials and Methods: A retrospective analysis was conducted on 100 patients who underwent rectal cancer surgery between 2017 and 2021 at our tertiary center—53 underwent laparoscopic and 47 robotic surgery. Demographic data, tumor characteristics, and surgical details (procedure type, lymph node yield, morbidity, and mortality) were collected, and postoperative outcomes, including local recurrence, metastasis, need for reoperation, urinary incontinence, and sexual dysfunction, were compared. Functional outcomes were evaluated using the LARS questionnaire, Wexner score, IPSS, IIEF, and FSFI. Results: No significant differences were found in age, BMI, tumor size, or ASA scores between groups. Robotic surgery was associated with shorter hospital stays (p < 0.001), no conversions to open surgery (vs. 28.3% in laparoscopy), and zero cases of positive circumferential margins (vs. 35.8% in laparoscopy; p < 0.001). Lymphatic and perineural invasion rates were similar. Tumor recurrence occurred in four robotic and six laparoscopic cases, and factors significantly associated with recurrence included pathological stage, hospital stay, and adjuvant treatment. Robotic surgery showed improved urinary and sexual function, with lower Wexner, IPSS, and FSFI scores. Conclusions: Robotic surgery is a safe, effective, and patient-friendly alternative to laparoscopy, offering better preservation of continence and sexual function, reduced conversion rates, and shorter hospitalization, and should be considered the preferred approach in appropriately selected rectal cancer patients. Full article

Background: Female sexual dysfunction (FSD) is an underrecognized issue in women with systemic sclerosis (SSc), influenced by physical and psychological factors. Data on FSD in reproductive-age SSc patients, especially those with diffuse cutaneous SSc (dcSSc), remain limited. Objectives: This study aimed to determine the prevalence of FSD and identify its associated factors among reproductive-age women with SSc. Methods: A cross-sectional study (May 2019–March 2020) included sexually active women with SSc aged 18–45. Patients with surgical amenorrhea, prior radiation, hormonal contraceptive use within 12 weeks, or pregnancy were excluded. Sexual function was assessed using the Female Sexual Function Index (FSFI). Results: Among 27 women of reproductive age, 66.7% had the dcSSc subset. The mean age was 39.4 ± 5.2 years (range: 22–45 years), with a mean disease duration of 9.9 ± 7.9 years. FSD was identified in 51.9% of patients (95%CI: 31.9–71.3), with a higher prevalence in the dcSSc subset (71.4%) compared to limited cutaneous SSc (28.6%). Patients with FSD were more likely to be older at disease onset, exhibit telangiectasia, and have longer exposure to cyclophosphamide (CYC), although these findings were not statistically significant. Women with FSD showed significantly lower FSFI scores in arousal, lubrication, orgasm, sexual satisfaction, and total sexual function (p < 0.01 for all). Conclusions: FSD is highly prevalent among SSc women of reproductive age, particularly in those with dcSSc. Disease severity, older age at onset, and prolonged CYC treatment may contribute to the risk of FSD. Early recognition and management of sexual health issues are essential in this patient population. Full article

Lichen sclerosus (LS) is a chronic, relapsing skin disease that predominantly affects the perineal and genital regions, although extragenital manifestations can occur. Despite its significant impact on patients’ quality of life, particularly affecting sexual and urinary function, LS remains underdiagnosed. Multiple factors, including genetic predisposition, hormonal changes, immunological abnormalities, trauma, and urine irritation, contribute to its development and persistence. This review aims to clarify the complex pathophysiology of LS by exploring three main mechanisms: autoimmune dysregulation, sclerotic tissue formation, and oxidative stress. Autoimmune dysregulation involves T-cell infiltration and the roles of miR-155 and extracellular matrix protein 1 dysfunction, leading to chronic inflammation. miR-155 contributes to sclerotic tissue formation alongside galectin-7, promoting fibroblast proliferation and collagen synthesis. Oxidative stress results in tissue damage, autoimmunity, chronic inflammation, and an increased risk of carcinogenesis. Understanding these mechanisms is crucial for developing targeted therapies and improving LS management. Further research is needed to unravel the genetic basis, immune responses, and interactions between key mediators, ultimately advancing innovative therapeutic strategies and precision medicine in LS. Full article

Involuntary urinary leakage due to stress urinary incontinence in women represents a widespread health condition that reduces quality of life. Background: Treatment with tension-free vaginal tape (TVT) remains the most used procedure, although its impact on quality of life, specifically regarding sexual function effects, has not been thoroughly investigated. The aim of our study is to achieve a broader understanding of the full range of outcomes after surgery, emotional well-being, and sexual function. Materials and Methods: The present prospective cohort study was conducted between 15 July 2023 and 15 June 2024 in the Emergency County Clinical Hospital Targu Mures, Department of Obstetrics and Gynecology. This is an investigation of TVT surgery and its impact on urinary incontinence, conducted by evaluating bladder dysfunction and sexual function before and after surgical intervention, as well as considering physical and psychological outcomes using specific questionnaires. Results: There was a 91.7% objective cure rate for incontinence, while urinary symptoms, sexual function, and emotional health significantly improved, urine leakage associated with strong urgency (p = 0.0002), urine leakage associated with coughing, sneezing, or laughing (p ≤ 0.0001), and patient sexual activity and emotional health also improved after surgery (p ≤ 0.0001). Furthermore, colorectal symptoms improved. Conclusions: This study emphasizes that for the best recovery of sexual and emotional health post-surgery, complete symptom removal is a requirement. Additionally, the significance of combined questionnaires in assessing treatment efficacy is highlighted. A larger sample size of patients and a longer follow-up are required before recommending this procedure as a standard treatment. Full article

Background/Objectives: This study aims to evaluate the quality of life (QoL) and oncological outcomes in premenopausal women diagnosed with hormone receptor-positive breast cancer who are receiving either bilateral oophorectomy (BO) or gonadotropin-releasing hormone agonist (GnRH) therapy. Both methods serve to inhibit ovarian function, which is essential for the management of estrogen-dependent tumors; however, their effects on QoL have yet to be fully clarified. Methods: Data were analyzed from the Mayo Clinic Breast Disease Registry, focusing on women under 55 diagnosed with estrogen receptor-positive breast cancer who received either BO or GnRH within one year of diagnosis. QoL was assessed using the Patient-Reported Outcomes Measurement Information System Global-10 (PROMIS-10) at baseline and annually for five years. Results: A total of 181 patients were enrolled in the study; 40 into the BO group and 141 to the GnRH group. Both groups exhibited similar levels of sexual dysfunction after a one-year period; however, the BO group stated a higher frequency of hot flashes. PROMIS-10 scores improved in both mental and physical health over time, with no significant differences between the groups. Within the BO group, one recurrence was observed, in contrast to the GnRH group, which had six events. Nonetheless, the difference in recurrence rates did not reach statistical significance. Conclusions: The long-term QoL and oncologic outcomes for premenopausal women with hormone receptor-positive breast cancer were similar for BO and GnRH therapy. These findings emphasize the need for individualized treatment decisions, considering patient preferences and side effects. Full article