Yohimbine in the treatment of orgasmic dysfunction

Aim： To study the effect of yohimbine in the treatment of men with orgasmic dysfunction. Methods： A 20-mg dose of yohimbine was first given to 29 men with orgasmic dysfunction of different aetiology in the clinic. Patients were then allowed to increase the dose at home （titration） under more favourable circumstances. The outcome and side effects were subsequently assessed. Results： The patients were classified into three groups of orgasmic dysfunction： primary complete （13）, primary incomplete （8） and secondary （8）. Nocturnal emissions were present in 75%, 40% and 50% of patients in the above groups, respectively （overall average 62%）. The men presented because of fertility problems （52%） or because they wanted to experience the pleasure of orgasm （48%）. Of the 29 patients who completed the treatment, 16 managed to reach orgasm and were able to ejaculate either during masturbation or sexual intercourse. A further three achieved orgasm, but only with the additional stimulation of a vibrator. A history of preceding nocturnal emissions was present in 69% of the men in whom orgasm was induced but only 50% who failed treatment. Of the patients, two have subsequently fathered children （one set of twins） and another 3 men were also cured. Side effects were not sufficient to cause the men to cease treatment. Conclusion： Yohimbine is a useful treatment option in orgasmic dysfunction.

A Case of Male Anorgasmia with Cerebral Infarction

Objective: The deficit of male orgasm is an unusual clinical condition. This is a case report on secondary male anorgasmia with cerebral infarction. Material and Method: The patient was a 55-year-old man who had suffered from male anorgasmia, acquired type. The patient had a normal erectile response, but ejaculated without any sensation of orgasm. The patient underwent an evaluation by a psychiatrist and an urologist trained in sexual medicine. Result: The results of physical, psychological, and laboratory examination were normal. Brain MRI revealed cerebral infarction at bilateral parietal lobes and frontal lobes. Conclusion: There is a possibility that these brain regions are related to male orgasmic dysfunction.

Impact of androgen deprivation therapy on sexua function

Many patients with prostate cancer for whom androgen deprivation therapy （ADT） is indicated are young and desire to remain sexually active. In such patients, the side effects of androgen therapy on sexual function can be a source of serious reduction in overall quality of life. Providing the appropriate treatment options in this patient population is therefore essential. Nevertheless, treating such patients is challenging and an understanding of the underlying mechanisms of sexual physiology and pathophysiology is crucial to optimal patient care. In this paper, we reviewed what was known regarding the effects of ADT on sexual function in animal models and we also provided a detailed review on the effects of ADT on sexual health in humans and its treatment.

The cavernoso-anal reflex： response of the anal sphincters to cavernosus muscles＇ stimulation

Aim： To prove the hypothesis that cavernosus muscles＇ contraction during coitus affects the reflex contraction of anal sphincters. Methods： Electromyographic response of external and internal anal sphincters to ischiocavernosus and bulbocavernosus muscle stimulation was studied in 17 healthy volunteers （10 men, 7 women, mean aged 38.3 ± 11.6 years）. The test was repeated after individual anesthetization of anal sphincters and the two cavernosus muscles,and after using saline instead of lidocaine. Results： Upon stimulation of each of the two cavernosus muscles,external and internal anal sphincters recorded increased electromyographic activity. Anal sphincters did not respond to stimulation of the anesthetized cavernosus muscles nor did anesthetized anal sphincters respond to cavernosus muscles＇ stimulation. Saline infiltration did not affect anal sphincteric response to cavernosal muscles＇ stimulation.Conclusion： Cavernosus muscles＇ contraction is suggested to evoke anal sphincteric contraction, which seems to be a reflex and mediated through the ＂cavernoso-anal reflex＂. Anal sphincteric contraction during coitus presumably acts to close the anal canal to thwart flatus or fecal leak.

A Double-Blind, Placebo-Controlled Study of the Effectiveness of Mate Endurance TM Dietary Supplement on Sexual Satisfaction, Ejaculatory Control, and Distress in Men with Premature Ejaculation

Background: To assess the efficacy of the dietary supplement Mate Endurance on sexual satisfaction, ejaculatory control, and sexually related personal distress in patients with premature ejaculation. Methods: In a double-blind, randomized, placebo-controlled study, 68 patients between 21 and 60 years old with premature ejaculation were randomized to receive either Mate Endurance or placebo treatment for three months. The patients were provided a questionnaire at the start of the study and again three months post commencement of the study. The questionnaires were comprised of the Index of Premature Ejaculation (IPE) and the PE Diagnostic Tool (PEDT). Results: Participants in the treatment group experienced a significant improvement in symptoms often associated with premature ejaculation versus those in the placebo group. The treatment was widely used with limited adverse effects. Conclusions: The results of the study demonstrate the effectiveness of the dietary supplement Mate Endurance in improving symptoms associated with premature ejaculation, including general sexual satisfaction and distress associated with sexual encounters.

Modifications of sexual activity during uncomplicated pregnancy: A prospective investigation of Spanish women

Introduction: Pregnancy is a time of profound changes in a woman’s life. These changes can influence her sexual behaviour and the relationship with her partner. The purpose of this article is to study sexual behaviour modification before and during pregnancy in a cohort of healthy Spanish pregnant women. Methods: This is a prospective cohort study in which 111 pregnant women took part. They completed a questionnaire about their sexual habits before pregnancy and at 20, 30 and 38 weeks (frequency of intercourse and orgasm, satisfaction with their relationships and pain or discomfort). Results: Intercourse frequency decreased progressively during pregnancy at all times studied relative to pre-regnancy periods, to a significant degree (p < 0.0001), accompanied by a reduction in sexual satisfaction. The incidence of orgasm was lightly modified, except in the weeks before parturition in which it underwent a notable decrease (p < 0.0001) with an increase in the rate of hypoorgasmia/ anorgasmia from 19% pre-pregnancy to 43% at 38th week. Conclusions: The longitudinal monitoring of this cohort permits the conclusion that during pregnancy, sexual behaviour undergoes a general decline with respect to prepregnancy levels. The differences vary depending on the sexual parameter considered, with intercourse frequency being the most affected variable in contrast to dyspareunia, which is the least affected.

The cavernoso-anal reflex:response of the anal sphincters to cavernosus muscles'stimulation

Aim:To prove the hypothesis that cavernosus muscles'contraction during coitus affects the reflex contraction of anal sphincters.Methods:Electromyographic response of external and internal anal sphincters to ischiocavernosus and bulbocavernosus muscle stimulation was studied in 17 healthy volunteers(10 men.7 women,mean aged 38.3± 11.6 years).The test was repeated after individual anesthetization of anal sphincters and the two cavernosus muscles, and after using saline instead of lidocaine.Results:Upon stimulation of each of the two cavernosus muscles, external and internal anal sphincters recorded increased electromyographic activity.Anal sphincters did not respond to stimulation of the anesthetized cavernosus muscles nor did anesthetized anal sphincters respond to cavernosus muscles'stilnulation.Saline infiltration did not affect anal sphincteric response to cavernosal muscles'stimulation. Conclusion:Cavernosus muscles'contraction is suggested to evoke anal sphincteric contraction,which seems to be a reflex and mediated through the'cavernoso-anal reflex'.Anal sphincteric contraction during coitus presumably acts to close the anal canal to thwart flatus or fecal leak.