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Female sexual dysfunction in patients treated with antidepressant-comparison between escitalopram and fluoxetine

Sidi H, Asmidar D, Hod R, Guan NC

J Sex Med, 2012 May;9(5):1392-9.
PMID: 21477024 DOI: 10.1111/j.1743-6109.2011.02256.x

Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD).

Matched MeSH terms: Sexual Dysfunction, Physiological/chemically induced*; Sexual Dysfunction, Physiological/epidemiology
The Female Sexual Function Index (FSFI): validation of the Malay version

Sidi H, Abdullah N, Puteh SE, Midin M

J Sex Med, 2007 Nov;4(6):1642-54.
PMID: 17608666

Female sexual dysfunction (FSD) is a prevalent sexual health problem that has been inadequately investigated in Malaysia, a nation with a conservative multiethnic society.

Matched MeSH terms: Sexual Dysfunction, Physiological/diagnosis*
The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women

Sidi H, Puteh SE, Abdullah N, Midin M

J Sex Med, 2007 Mar;4(2):311-21.
PMID: 17040486

Female sexual dysfunction (FSD) is a prevalent sexual health problem that does not spare the women in Malaysia, a nation with a conservative multiethnic society.

Matched MeSH terms: Sexual Dysfunction, Physiological/diagnosis; Sexual Dysfunction, Physiological/epidemiology*
The menopausal experience among indigenous women of Sarawak, Malaysia

Syed Alwi SA, Lee PY, Awi I, Mallik PS, Md Haizal MN

Climacteric, 2009 Dec;12(6):548-56.
PMID: 19905907 DOI: 10.3109/13697130902919519

OBJECTIVES:
To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia.

METHODS:
A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause.

RESULTS:
The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual).

CONCLUSIONS:
The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.

Matched MeSH terms: Sexual Dysfunction, Physiological/epidemiology
Men's health: sexual dysfunction, physical, and psychological health--is there a link?

Tan HM, Tong SF, Ho CC

J Sex Med, 2012 Mar;9(3):663-71.
PMID: 22188573 DOI: 10.1111/j.1743-6109.2011.02582.x

INTRODUCTION: Sexual dysfunction in men, such as erectile dysfunction, hypogonadism, and premature ejaculation, generates considerable attention. Its association with physical and psychological health is an issue which should be addressed seriously.
AIM: A review of the literature pertaining to the correlation between sexual dysfunction and physical and psychological health.
METHODS: PubMed search for relevant publications on the association between sexual dysfunction in men and physical and psychological health.
MAIN OUTCOME MEASURE: Clinical and epidemiological evidence that demonstrates the association between sexual dysfunction in men and physical and psychological health.
RESULTS: Sexual dysfunction, i.e., erectile dysfunction, hypogonadism, and premature ejaculation, has been shown to be associated with physical and psychological health. There is a strong correlation between sexual dysfunction and cardiovascular disease, metabolic syndrome, quality of life, and depression.
CONCLUSION: The association between men's sexual dysfunction and physical and psychological health is real and proven. Therefore, it should not be taken lightly but instead treated as a life-threatening medical problem.

Matched MeSH terms: Sexual Dysfunction, Physiological/physiopathology*; Sexual Dysfunction, Physiological/psychology*
Psychological problems among university students in an area of rapid socio-cultural change

Teoh JI

Aust N Z J Psychiatry, 1974 Jun;8(2):109-20.
PMID: 4528692 DOI: 10.3109/00048677409159785

A twelve-month study of all university students with psychological problems and symptoms, referred by the Student Health Physicians of the University of Malaya, Kuala Lumpur was conducted. A total of 308 students were seen and treated. The following results were elicited:
1) The proportion of student breakdown among the different ethnic groups was in proportion with the total student population.
2) There was no significant difference in diagnosis among students of urban-rural origins or from the different faculties.
3) The majority of students were seen during the first term from the first and second year courses.
4) Fifty-six percent of students suffered from symptoms prior to their admission to the university.
5 ) Differences in language stream, especially from the Malay-medium schools, did not increase the rates of breakdown because of attenuating factors to reduce the stress among Malay students.
6) Chinese students had significantly more severe acculturation gap differences from their parents than Malay students. They also significantly came from more well-off homes, of a higher social class and from urban regions as compared to the Malay students.
7) Fifty-one percent were diagnosed as suffering from a neurosis and 13.3% from a schizophrenic psychosis. The neurotics had a much lower failure rate than the schizophrenic students.
8) Personality and family problems were significantly higher among Chinese than Malay students. On the whole, there were more personality and family problems among urban-based students of both ethnic groups.

Matched MeSH terms: Sexual Dysfunction, Physiological/epidemiology
Eurycoma Longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies

Thu HE, Mohamed IN, Hussain Z, Jayusman PA, Shuid AN

Chin J Nat Med, 2017 Jan;15(1):71-80.
PMID: 28259255 DOI: 10.1016/S1875-5364(17)30010-9

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, BioMed Central, Hindawi, Web of Knowledge, PubMed 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.

Matched MeSH terms: Sexual Dysfunction, Physiological/prevention & control*
Fulltext Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings

Tong SF, Low WY, Ismail SB, Trevena L, Wilcock S

Transl Androl Urol, 2013 Dec;2(4):281-90.
PMID: 26816741 DOI: 10.3978/j.issn.2223-4683.2013.09.14

BACKGROUND: Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men.
METHODS: This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated.
RESULTS: 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010).
CONCLUSIONS: Whilst sexual health inquiry should be initiated in an appropriate context, 'perceived receptivity' to sexual health inquiry significantly affected doctors' intention in initiating sexual health inquiry to their male patients. Malaysian men's health may be substantially improved by strategies that assist doctors to identify patient 'receptivity'.

Matched MeSH terms: Sexual Dysfunction, Physiological
Effect of quercetin on cadmium chloride-induced impairments in sexual behaviour and steroidogenesis in male Wistar rats

Ujah GA, Nna VU, Agah MI, Omue LO, Leku CB, Osim EE

Andrologia, 2018 Mar;50(2).
PMID: 28703286 DOI: 10.1111/and.12866

Cadmium chloride (CdCl2 ) has been reported to cause reproductive toxicity in male rats, mainly through oxidative stress. This study examined its effect on sexual behaviour, as one of the mechanisms of reproductive dysfunction, as well as the possible ameliorative effect of quercetin (QE) on same. Thirty male Wistar rats (10 weeks old), weighing 270-300 g, were used for this study. They were either orally administered 2% DMSO, CdCl2 (5 mg/kg b.w.), QE (20 mg/kg b.w.) or CdCl2 +QE, once daily for 4 weeks, before sexual behavioural studies. The 5th group received CdCl2 for 4 weeks and allowed 4-week recovery period, before sexual behavioural test. Rats were sacrificed after sexual behavioural studies. The blood, testis and penis were collected for biochemical assays. Cadmium increased mount, intromission and ejaculatory latencies, but reduced their frequencies, compared to control. Serum nitric oxide increased, while penile cyclic guanosine monophosphate reduced in the CdCl2 -exposed rats, compared to control. CdCl2 increased testicular cholesterol, but reduced 3β-hydroxysteroid dehydrogenase (3β-HSD) and 17β-HSD activities, and testosterone concentration. QE better attenuated these negative changes compared to withdrawal of CdCl2 treatment. In conclusion, CdCl2 suppressed steroidogenesis, penile erection and sexual behaviour, with poor reversal following withdrawal, while QE attenuated these effects.

Matched MeSH terms: Sexual Dysfunction, Physiological/blood; Sexual Dysfunction, Physiological/chemically induced; Sexual Dysfunction, Physiological/drug therapy*
Psychological aspects of vasectomy in Malaysia

Wolfers H, Subbiah N, Ariffin Bin Mazurka

Soc Biol, 1973 Sep;20(3):315-22.
PMID: 4763761
Matched MeSH terms: Sexual Dysfunction, Physiological/etiology
The prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments: a meta-analysis study

Yee A, Loh HS, Hisham Hashim HM, Ng CG

J Sex Med, 2014 Jan;11(1):22-32.
PMID: 24344738 DOI: 10.1111/jsm.12352

INTRODUCTION: For many years, methadone has been recognized as an effective maintenance treatment for opioid dependence. However, of the many adverse events reported, sexual dysfunction is one of the most common side effects.
AIM: We conducted a meta-analysis to evaluate the prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments.
METHODS: Relevant studies published from inception until December 2012 were identified by searching PubMed, OVID, and Embase. Studies were selected using prior defined criteria. Heterogeneity, publication bias, and odds ratio were assessed thoroughly.
MAIN OUTCOME MEASURES: To examine the prevalence and odds ratio of sexual dysfunctions among the methadone and buprenorphine groups.
RESULTS: A total of 1,570 participants from 16 eligible studies were identified in this meta-analysis. The studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval [CI], 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (OR = 4.01, 95% CI, 1.52-10.55, P = 0.0049).
CONCLUSIONS: Evidence showed that the prevalence of sexual dysfunction was higher among the users of methadone compared with buprenorphine. Patients with sexual difficulty while on methadone treatment were advised to switch to buprenorphine.

Matched MeSH terms: Sexual Dysfunction, Physiological/chemically induced; Sexual Dysfunction, Physiological/epidemiology*
Fulltext Clinical factors associated with sexual dysfunction among men in methadone maintenance treatment and buprenorphine maintenance treatment: a meta-analysis study

Yee A, Loh HS, Hisham Hashim HM, Ng CG

Int J Impot Res, 2014 Sep-Oct;26(5):161-6.
PMID: 24990199 DOI: 10.1038/ijir.2014.18

Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52-10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.

Matched MeSH terms: Sexual Dysfunction, Physiological/chemically induced*
Plasma Testosterone and Sexual Function in Southeast Asian Men Receiving Methadone and Buprenorphine Maintenance Treatment

Yee A, Loh HS, Danaee M, Riahi S, Ng CG, Sulaiman AH

J Sex Med, 2018 02;15(2):159-166.
PMID: 29275046 DOI: 10.1016/j.jsxm.2017.12.004

BACKGROUND: Methadone has been recognized as an effective maintenance treatment for opioid dependence. However, its use is associated with several complications, including sexual dysfunction in men.
AIM: To assess plasma testosterone and sexual function in Southeast Asian men on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT).
METHODS: 76 sexually active men on MMT (mean age = 43.30 ± 10.32 years) and 31 men on BMT (mean age = 41.87 ± 9.76 years) from a Southeast Asian community were evaluated using plasma total testosterone (TT) and prolactin levels, body mass index, social demographics, substance use measures, and depression severity scale.
OUTCOMES: Prevalence and associated factors of TT level lower than the reference range in men on MMT or BMT.
RESULTS: More than 1 third of men (40.8%, n = 31) on MMT had TT levels lower than the reference range, whereas 1 fourth of men (22.6%, n = 7) on BMT did. At univariate analysis, MMT vs BMT (β = 0.298, adjusted R2 = 0.08, P = .02) and body mass index (β = -0.23, adjusted R2 = 0.12, P = .02) were associated with changes in TT after stepwise regression. There were no significant associations with age; Opiate Treatment Index Q scores for alcohol, heroin, stimulant, tobacco, or cannabis use and social functioning domain; education levels; hepatitis C status; and severity of depression. Prolactin level did not differ between the MMT and BMT groups.
CLINICAL IMPLICATIONS: The sex hormonal assay should be used regularly to check men on MMT.
STRENGTHS AND LIMITATIONS: This is the first study conducted in the Southeast Asian community. Our study was limited by the lack of a healthy group as the reference for serum levels of testosterone and prolactin.
CONCLUSIONS: The findings showed that plasma testosterone levels are lower in MMT than in BMT users. Hence, men who are receiving MMT should be screened for hypogonadism routinely in the clinical setting. Yee A, Loh HS, Danaee M, et al. Plasma Testosterone and Sexual Function in Southeast Asian Men Receiving Methadone and Buprenorphine Maintenance Treatment. J Sex Med 2018;15:159-166.

Matched MeSH terms: Sexual Dysfunction, Physiological/epidemiology
Fulltext Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial of Bupropion as Treatment for Methadone-Emergent Sexual Dysfunction in Men

Yee A, Loh HS, Ong TA, Ng CG, Sulaiman AH

Am J Mens Health, 2018 Sep;12(5):1705-1718.
PMID: 29973132 DOI: 10.1177/1557988318784152

Methadone is largely recognized as an effective treatment for opiate-dependent patients; however, it causes reduced brain dopaminergic action resulting in significant sexual dysfunction. Bupropion is a dopamine reuptake inhibitor which can potentially improve erectile function among male patients on methadone (MMT). This is a phase II, randomized, double-blind, parallel-group, placebo-controlled trial, involving 80 MMT male patients (73.4%) with mean age of 42.83 years ±9.68. These MMT male patients were randomly assigned into two groups to receive bupropion and placebo, respectively. The primary efficacy outcome measure was the difference between the two groups in end-point mean improvement scores using the measurement of Clinical Global Impression Scale adapted for Sexual Function (CGI-SF) at baseline (week 0) and at weeks 2, 4, and 6. Malay version of the sexual desire inventory-2 (SDI-2-BM) and Malay version of International Index of Erectile Function 15 (Mal-IIEF-15) domain scores were evaluated as secondary parameters. Improvement of the end-point mean from baseline were seen across the scores of SDI-2-BM (mean difference = 11.77 ± 2.90, 95% confidence interval (CI) [3.89, 19.54], p < .001) and Mal-IIEF-15 (mean difference = 8.37 ± 2.71, 95% CI [15.75, 0.99], p = .02), and the total plasma testosterone level (mean difference = 4.03, 95% CI [0.90, 7.15], p = .01). A categorical improvement of "much/very much improved" (CGI-SF score = 2) was reported by 58.3% ( n = 21/36) of bupropion SR-assigned versus 27.7% ( n = 10/36) placebo-assigned patient. Bupropion was well tolerated with no serious adverse events reported other than insomnia (17.7%). Six weeks of bupropion SR treatment reported significant improvement in key aspects of sexual function among male opiate-dependent patients on methadone maintenance treatment with emergent sexual dysfunction.

Matched MeSH terms: Sexual Dysfunction, Physiological/chemically induced*; Sexual Dysfunction, Physiological/drug therapy*
Female sexual dysfunction post radical cystectomy and urinary diversion

Zahran MH, Fahmy O, El-Hefnawy AS, Ali-El-Dein B

Climacteric, 2016 Dec;19(6):546-550.
PMID: 27649461

OBJECTIVES: To evaluate the impact of radical cystectomy and urinary diversion on female sexual function.
MATERIALS AND METHODS: A Medline search was conducted according to the PRISMA statement for all English full-text articles published between 1980 and 2016 and assessing female sexual function post radical cystectomy and urinary diversion. Eligible studies were subjected to critical analysis and revision. The primary outcomes were the reporting methods for female sexual dysfunction (FSD), manifestations of FSD, and factors associated with FSD, postoperative recoverability of FSD, and awareness level regarding FSD.
RESULTS: From the resulting 117 articles, 11 studies were finally included in our systematic review, with a total of 361 women. Loss of sexual desire and orgasm disorders were the most frequently reported (49% and 39%). Dyspareunia and vaginal lubrication disorders were reported in 25% and 9.5%, respectively. The incidence of sexual dysfunction was 10% in 30 patients receiving genital- or nerve-sparing cystectomy vs. 59% receiving conventional cystectomy.
CONCLUSION: Although female sexual function is an important predictor of health-related quality of life post radical cystectomy and urinary diversion, the available literature is not enough to provide proper information for surgeons and patients.

Matched MeSH terms: Sexual Dysfunction, Physiological/epidemiology*

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