Penile hypersensitivity plays an important role in premature ejaculation (PE), but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction (ED), PE with an intravaginal ejaculation latency time ≤1 min and >1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, Premature Ejaculation Diagnostic Tool (PEDT) score, and the 5-item version of the International Index of Erectile Function (IIEF-5) score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus (median amplitude: 4.92 vs 3.65 μ m, P = 0.02) and the right penile shaft (median amplitude: 3.87 vs 3.30 μ m, P = 0.03), while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group (12 vs 14, P < 0.001). The IIEF-5 and PEDT scores were negatively correlated (r = -0.29, P < 0.001). Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score (20 vs 21, P = 0.02). Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.
Adolescent ; Adult ; Ejaculation ; Erectile Dysfunction/physiopathology* ; Humans ; Male ; Middle Aged ; Orgasm ; Penis/physiology* ; Physical Stimulation ; Pleasure ; Premature Ejaculation/physiopathology* ; Prospective Studies ; Sensory Thresholds ; Sexual Dysfunctions, Psychological ; Sexuality ; Surveys and Questionnaires ; Temperature ; Vibration ; Young Adult

Diabetes mellitus is a common problem, and female sexual dysfunction is one of its complications in diabetic women. Recent studies show that the major risk factors of sexual dysfunction in diabetic women are diabetes-induced vascular disease, neuropathy, endocrine abnormalities and psychological problems and so on. This article outlines the advances in the recent studies of female sexual dysfunction in diabetic women.
Diabetes Mellitus ; physiopathology ; psychology ; Diabetic Angiopathies ; physiopathology ; psychology ; Diabetic Neuropathies ; physiopathology ; psychology ; Female ; Humans ; Sexual Dysfunction, Physiological ; etiology ; Sexual Dysfunctions, Psychological ; etiology

Female sexual dysfunction (FSD) is an age-related progressive disease and may affect up to half of adult women, but it has failed to receive due attention for a long time. Hypertension is a common and frequently encountered disease, and female sexual dysfunction is closely related to hypertension and antihypertensive drugs. Hypertension-related atherosclerosis, endothelial disorder and antihypertensive drugs are important risk factors for female sexual function. This article reviews the mechanisms of hypertension-induced FSD and advances in their studies.
Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; Prevalence ; Risk Factors ; Sexual Dysfunctions, Psychological ; epidemiology ; etiology

OBJECTIVETo study the changes of hypothalamus metabolism in patients with psychogenic erectile dysfunction (ED) so as to get some clues to the possible pathogenic factors and pathophysiological mechanism of the problem.

METHODSSix cases of psychogenic ED and 4 normal volunteers were studied by positron emission tomography (PET) for the characteristics of hypothalamus glucose metabolism. Following audiovisual sexual stimulation, the concentration of fluorine-18-fluorodeoxyglucose (18 F-FDG) was determined and the ratio of the left (right) hypothalamus count to the cerebrum count was calculated.

RESULTSAudiovisual sexual stimulation significantly increased 18F-FDG in the volunteers (left: 1.026 +/- 0.115 vs 2.400 +/- 0.210; right: 1.003 +/- 0.187 vs 2.389 +0.196, P < 0.05) as compared with the psychogenic ED patients (left: 2.781 +/- 0.156 vs 2.769 +/- 0.223; right: 2.809 +/- 0.129 vs 2.793 +/- 0.217, P > 0.05).

CONCLUSIONPsychogenic ED may not be simply a functional disease; the hypothalamus may be involved in the pathophysiology of the problem.

Acoustic Stimulation ; Adult ; Audiovisual Aids ; Fluorodeoxyglucose F18 ; pharmacokinetics ; Humans ; Hypothalamus ; diagnostic imaging ; metabolism ; physiopathology ; Male ; Photic Stimulation ; Sexual Dysfunctions, Psychological ; diagnostic imaging ; metabolism ; physiopathology ; Tomography, Emission-Computed

AIMTo study the effect of yohimbine in the treatment of men with orgasmic dysfunction.

METHODSA 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.

RESULTSThe 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.

CONCLUSIONYohimbine is a useful treatment option in orgasmic dysfunction.

Adrenergic alpha-Antagonists ; therapeutic use ; Adult ; Aged ; Dose-Response Relationship, Drug ; Ejaculation ; drug effects ; physiology ; Humans ; Male ; Middle Aged ; Sexual Dysfunctions, Psychological ; drug therapy ; physiopathology ; Treatment Outcome ; Yohimbine ; therapeutic use

OBJECTIVETo study the changes of the hippocampus metabolites with MRS to provide some clues for exploring the possible underlying unrecognised factors and pathophysiological mechanisms of psychogenic erectile dysfunction (ED).

METHODSFifteen cases of psychogenic erectile dysfunction and 15 normal volunteers (the control) were studied by a clinical 1. 5T MRI/MRS system. Proton multi-voxel spectroscopy imaging (1H-MRSI) was obtained from both sides of the hippocampus region. N-acetylaspartate (NAA), creatine and phosphocreatine (Cr) and choline-containing compounds (Cho) were determined and the ratios of NAA/Cr and Cho/Cr were calculated respectively.

RESULTSThe NAA/Cr ratio was significantly lower in the ED patients than in the control (P < 0.05). There was no significant difference in the Cho/Cr ratio between the two groups (P > 0.05).

CONCLUSIONPsychogenic erectile dysfunction may not be simply a functional disease. The hippocampus may be involved in the pathophysiology of psychogenic ED. The disease may have some previously unrecognised underlying aetiological factors and pathophysiological mechanisms.

Adult ; Aspartic Acid ; analogs & derivatives ; analysis ; Case-Control Studies ; Creatine ; analysis ; Erectile Dysfunction ; metabolism ; physiopathology ; Hippocampus ; chemistry ; physiopathology ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Phosphocreatine ; analysis ; Sexual Dysfunctions, Psychological ; metabolism ; physiopathology

OBJECTIVE: To demonstrate the functional neuroanatomy associated with sexual arousal visually evoked in depressed males who have underlying sexual dysfunction using Blood Oxygenation Level Dependent-based fMRI. MATERIALS AND METHODS: Ten healthy volunteers (age range 21-55: mean 32.5 years), and 10 depressed subjects (age range 23-51: mean 34.4 years, mean Beck Depression Inventory score of 39.6+/-5.9, mean Hamilton Rating Scale Depression (HAMD) -17 score of 33.5+/-6.0) with sexual arousal dysfunction viewed erotic and neutral video films during functional magnetic resonance imaging (fMRI) with 1.5 T MR scanner (GE Signa Horizon). The fMRI data were obtained from 7 oblique planes using gradient-echo EPI (flip angle/TR/TE= 90 degrees/6000 ms/50 ms). The visual stimulation paradigm began with 60 sec of black screen, 150 sec of neutral stimulation with a documentary video film, 30 sec of black screen, 150 sec of sexual stimulation with an erotic video film followed by 30 sec of black screen. The brain activation maps and their quantification were analyzed by SPM99 program. RESULTS: There was a significant difference of brain activation between two groups during visual sexual stimulation. In depressed subjects, the level of activation during the visually evoked sexual arousal was significantly less than that of healthy volunteers, especially in the cerebrocortical areas of the hypothalamus, thalamus, caudate nucleus, and inferior and superior temporal gyri. On the other hand, the cerebral activation patterns during the neutral condition in both groups showed no significant differences (p < 0.01). CONCLUSION: This study is the first demonstration of the functional neuroanatomy of the brain associated with sexual dysfunction in depressed patients using fMRI. In order to validate our physiological neuroscience results, further studies that would include patients with other disorders and sexual dysfunction, and depressed patients without sexual dysfunction and their treatment response are needed.
Adult ; *Brain Mapping ; Cerebrovascular Circulation ; Depressive Disorder/complications/*physiopathology ; *Erotica ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Oxygen/blood ; *Photic Stimulation ; Sexual Dysfunctions, Psychological/*physiopathology ; Support, Non-U.S. Gov't

Sexual dysfunction is a highly prevalent problem among patients with chronic renal failure, which affects patients in the quality of life. However, it has not received enough attention. The genesis of sexual dysfunction is multifactorial, including physiological, psychological and organic factors. This review summarized the incidence, main manifestation, evaluation, risk factors and treatments associated with sexual dysfunction in patient of the chronic renal failure.
Female ; Humans ; Kidney Failure, Chronic ; complications ; physiopathology ; psychology ; Male ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Sexual Dysfunctions, Psychological ; etiology ; therapy

Female sexual dysfunction (FSD) is a significant age-related, progressive, and highly prevalent problem that affects a substantial number of women on their quality of life. However, it hasn't received enough attention. In this review, the local regulation mechanism and the aetiological factors are associated with FSD are discussed. With the increased research, an improved awareness and understanding of the pathophysiological machanism of FSD may, in the future, enable us to address it more appropriately and develop suitable treatment.
Age Factors ; Female ; Humans ; Prevalence ; Sexual Dysfunctions, Psychological ; epidemiology ; etiology ; physiopathology

The cause of premature ejaculation (PE) has been thought to be psychological in the majority of patients but we investigated penile hypersensitivity for an organic basis of PE. For another organic basis of PE, we have suggested hyperexcitability of the ejaculation center. SS-cream is a topical agent containing 9 oriental herbs for treating PE. Clinically SS-cream has been effective in the treatment of PE. Therefore, in order to implicate the organic basis of PE and realize the effect of SS-cream on PE, we investigated the somatosensory evoked potential (SEP) in patients with PE(16 cases) and the effects of SS-cream on SEP for treating PE. The latencies and amplitudes of the evoked responses were measured by two different places in stimuli, one was on the penile shaft with ring electrode and the other on the glans penis with a surface electrode. The latency of SEP stimulated at the glans penis was significantly longer than that stimulated at the penile shaft (p< 0.05). The latency stimulated at the glans penis after applying SS-cream was significantly longer than before applying SS-cream (p< 0.05), which was near the level of a normal potent man. But the latency stimulated at the penile shaft has no significant difference between before and after the application of SS-cream (P > 0.05). The amplitudes of the evoked responses stimulated at the glans penis were significantly higher than those stimulated at penile shaft (p< 0.05). And both these amplitudes were significantly reduced with the application of SS-cream (p< 0.05). With these result, we can suggest that the patients with PE have glans penile hyperexcitability and it provides further implications for an organic basis of PE, SEP stimulated at the glans penis can be a very useful method to evaluate PE, along with SEP stimulated a penile shaft and SS-cream prolongs the sensory conduction and reduces the penile hyperexcitability of the patient with PE.
Adult ; Drugs, Chinese Herbal/*therapeutic use ; Ejaculation/*drug effects ; Evoked Potentials, Somatosensory/*drug effects ; Human ; Male ; Middle Age ; Sexual Dysfunctions, Psychological/*drug therapy/physiopathology