Post-Stroke Sexual Disorders and Its Real-Life Experience within Couples in Brazzaville

Background: Post-stroke sequelae can have repercussions on the sexual life and relational life of patients and their partners. Objectives: To determine the frequencies of sexual disorders after a first stroke event;to identify the factors associated with sexual disorders;to explore the real-life experience of sexual disorders within couples. Methods: It was an analytical cross-sectional study, conducted on patients followed up for a first stroke and their partners. It was carried out at public and private hospitals in Brazzaville, Congo, during the period of patient follow-up, from May to September 2019 (5 months). The Female Sexual Function Index, International Index of Erectile Function 5 and interviews were used to describe sexual aspects. The real-life experience of couples was explored using standardized and pre-established questionnaires. Results: Of the 36 patients who had taken up again sexual intercourse after stroke, 29 (80.6%) were men. Among the post-stroke sexual disorders, erectile dysfunction (53.2%) and ejaculatory dysfunction (40.4%) were the most frequent in men. Decrease of sexual desire was predominant in women (100%). Factors associated with erectile dysfunction were sleep disorder (p = 0.007) and mean sleep duration per night (p = 0.01). Lack of verbal and non-verbal communication of sexual problems and psychological effects was noted in 77.8% of patients and 60% of their partners. The most frequent psychological effects were: in patients, frustration (52.8%), attitude of person decreased (50%) and sadness (41.7%);in partners, attitude of carer (86.7%). Conclusion: Post-stroke sexual disorders are frequent in our context. Sleep disorders and mean sleep duration per night, psychological factors seem to have a negative impact on the sexual life and relational life of stroke patients and their partners. It is important to improve the sex management of couples.

Premature ejaculation： current and future treatments

Premature ejaculation （PE） is recognized to be the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition nor a medication approved by the Food and Drug Administration （FDA）. Despite these shortcomings, physicians continue to diagnose their patients with PE according to major guidelines and treat them with either behavioral therapies or off-label medications. This review focuses on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.

Current therapeutic strategies for premature ejaculation and future perspectives

Premature ejaculation （PE） is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used ＇off-label＇, some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE.

Male infertility:A scoping review of prevalence,causes and treatments

Male factor infertility has now become a major health disorder,affecting human reproduction and developing worldwide as a serious medical and social issue.It causes trauma,emotional instability,and mental stress in the affected couples.In nearly half of the analyzed cases,male-associated factors are the major contributors.The present review outlines a wide range of factors responsible for male infertility.We performed an in-depth literature review of the global index of infertility by using data from World Health Organization’s website,Elsevier’s,PubMed and Scopus databases as well as journals.The quality and quantity of semen,male hormonal imbalance,genetic deterioration,and reactive oxygen species are the fundamental causes of male factor infertility.In addition,air quality,water quality,noise pollution,lifestyle changes,improper diet consumption,malnutrition,exposure to chemicals and toxins,smoking habits,drug abuses,major diseases,and medications are also contributors to infertility issues that can temporarily or permanently influence male reproductive system.We also reviewed the prevalence of male infertility in different countries.

Erectile Dysfunction (ED) within Hospital Facilities in Cotonou

Introduction: Erectile dysfunction (ED) is defined as the persistent inability to achieve the necessary degree of erection for sexual activity. It is a common disease which can significantly affect the quality of life of sufferer and their partners. The purpose of this study is to give an overview of the magnitude of this medical condition in Benin society. Material and Method: It was a multicenter cross-sectional descriptive and analytical study conducted over a period of one month from 1st to 30th June 2015. A questionnaire was prepared for this purpose. Outcomes: The average age in this series is 48.32 with extremes ranging from 18 to 95 years. These patients were predominantly public servants. All our patients (100% of the study population) responded to the single question of John. B. Mckinlay. The global ED prevalence was 52.6%. The multivariate analysis helped to identify a correlation with several factors associated with ED. These factors included: age, occupation, lifestyle, etc. 41.91% of patients with ED and/or other sexual disorders declared “not at all acceptable” to continue living with these disorders. The patients benefitted from different treatments including IPDE-5 and traditional treatment in respectively 32.8% and 40.1% of cases. Conclusion: ED is a condition in its own which has an impact on the patients’ quality of life. Its discovery may lead to the diagnosis of cardiovascular, hormonal or neurological diseases.

Drug flibanserin–in hypoactive sexual desire disorder

Hypoactive sexual desire disorder(HSDD)is a widely known type of female sexual dysfunction that could also cause emotional distress and relationship problems.Flibanserin,a benzimidazole,was being studied as a treatment for premenopausal women with hypoactive sexual desire disorder because there was no accurate drug therapy available at the time(HSDD).The US Food and Drug Administration(FDA)approved Flibanserin in 2015 for the treatment of generalised acquired HSDD in premenopausal women.It has a high affinity for postsynaptic 5-HT-1A receptors(agonist)and 5-HT-2A receptors(antagonist),and it tends to work by increasing dopamine and noradrenaline levels in the brain while decreasing serotonin levels.This review was to assess Flibanserin efficacy and safety and it is found the drug Flibanserin benefits did not outweigh the risks in premenopausal and postmenopausal women.

Gonadal Steroid Hormones Levels in a Bitch with True Bilateral Hermaphroditism

Intersexualism occurs in all species of maxnmals and the pathogenesis of abnormal development of the gonads is still unclear. Thus, the aim of this report is to describe the hormonal and histopathological findings from a case of bilateral true hermaphroditism in a mixed-breed bitch due to the few case reports published involving hormonal levels in dogs with intersexuality. Serum was obtained from the animal before surgery and was submitted to hormone measurements. Progesterone and testosterone were evaluated by radioimnunoassay and estrogen by ELISA （immune-enzymatic assay）. The values of progesterone, testosterone and estrogen concentrations were 2.26 ng/mL, 0.05 ng/mL and 9.7 pg/mL, respectively. The proportion of ovarian tissue found in the ovotestes after histopathological examination was higher in relation to seminiferous tubules, which may explain the low level of serum testosterone. Low concentration of serum testosterone may have contributed to the partial virilization of external genitalia, since the animal only had clitoral hypertrophy. Estrogen and progesterone levels found were compatible with the initial stage of estrus （preovulatory LH （luteinizing hormone） surge）, which shows that ovarian follicles found in the bilateral ovotestes contributed to the occurrence of the estrous cycle before surgery. Quantitation of serum hormones may also shed light on the cause of disturbances in sex differentiation in canine species. More studies are needed to elucidate the real cause of intersex in dogs.

Eurycoma Longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies

Eurycoma longifolia(EL) has been well recognized as a booster of male sexual health. Over the past few decades, numerous in vivo animal studies and human clinical trials have been conducted across the globe to explore the promising role of EL in managing various male sexual disorders, which include erectile dysfunction, male infertility, low libido, and downregulated testosterone levels. The aim of the present review is to analyze and summarize the literature on human clinical trials which revealed the clinical significance and therapeutic feasibility of EL in improving male sexual health. This systematic review is focused on the following databases: Medline, Wiley Online Library, Bio Med Central, Hindawi, Web of Knowledge, Pub Med Central and Google Scholar, using search terms such as "Eurycoma longifolia", "EL", "Tongkat Ali", "male sexual health", "sexual infertility", "erectile dysfunction", "male libido", and "testosterone levels". Notably, only human clinical studies published between 2000 and 2014 were selected and thoroughly reviewed for relevant citations. Out of 150 articles, 11 met the inclusion criteria. The majority of articles included were randomized placebo-controlled trials, multiple cohort studies, or pilot trials. All these studies demonstrated considerable effects of EL on male sexual health disorders. Among them, 7 studies revealed remarkable association between the use of EL and the efficacy in the treatment of male sexual disorders, and remaining 4 studies failed to demonstrate sufficient effects on male sexual health. In summary, there is convincing evidence for the prominence of EL in improving the male sexual health. The review also substantiates the use of current methodology in the development of novel and more rationale natural herbal medicines for the management of male sexual disorders.

Sexual health in Polish elderly men with coronary artery disease:importance, expectations,and reality

Deterioration in overall health,hormonal disturbances,and erectile dysfunction(ED)contributes to limitations in sexual activity in the elderly,which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients.We aimed to analyze the occurrence of ED in elderly men,their perception of the relevance of good sexual function,and their expectations of physicians.A cross-sectional study encompassed 731 patients with coronary artery disease(CAD)subjected to cardiac rehabilitation.Demographic data and data on modifiable risk factors and patient expectations were collected.ED was assessed using the IIEF-5 questionnaire.Relationships among the risk factors for ED,occurrence of ED,and patient expectations,as well as the changes in the indicators between 2012 and 2016,were analyzed.The mean age of men was 70.7±5.1 years.The prevalence of ED was 93.0%.The IIEF-5 score was significantly associated with age,tobacco smoking,exercise tolerance,time to diagnosis of CAD,and treatment with calcium channel blockers and diuretics.Patients declared that sexual activity was overall important(47.9%)or very important(25.6%).Three hundred and sixty(49.3%)patients expected their physician to show interest in their sexual health,but the topic was addressed in only 12.5%.Over the past few years,we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients’expectations of physicians to show interest in their sexual health.Patients’expectations of discussing and receiving treatment for ED remain an unmet medical need.