Practical Clinical Andrology

This open access book offers a valuable resource for understanding the correct pathways in the context of sexual disorders, couple reproduction, gender identity dysphoria, conditions for which patients commonly ask for consultation and treatment. Based on clinical evidence, international guidelines and experts experience, practical clinical management strategies are presented for each condition. Each clinical care pathway is based on updated algorithm, level of evidence, photos and video-clips that describes the clinical presentations and the best practice management through diagnostic tools and medical or surgical treatment. Leading experts from the most important center of excellence in the field of sexual medicine joined to cover the field of andrology in its entirety, each of them dealing with a single topic from the top of their recognized experience and providing a complete and update textbook that will help urologists and other physicians in their daily clinical practice. This book is thought to be a practical and valuable reference for urologists, gynecologists, endocrinologists, psychiatrics and psychologists, and residents who are not specialty trained in andrology. It is designed for both young fellows training in different specialties and coming into contact with andrological issues for the first time and also more experienced clinicians and surgeons requiring updated guidelines and clear advice on the most controversial issues. This book will represent an invaluable quick consulting tool, updated in its scientific contents and rich in tables, images and video-clips

Practical Clinical Andrology

This open access book offers a valuable resource for understanding the correct pathways in the context of sexual disorders, couple reproduction, gender identity dysphoria, conditions for which patients commonly ask for consultation and treatment. Based on clinical evidence, international guidelines and experts experience, practical clinical management strategies are presented for each condition. Each clinical care pathway is based on updated algorithm, level of evidence, photos and video-clips that describes the clinical presentations and the best practice management through diagnostic tools and medical or surgical treatment. Leading experts from the most important center of excellence in the field of sexual medicine joined to cover the field of andrology in its entirety, each of them dealing with a single topic from the top of their recognized experience and providing a complete and update textbook that will help urologists and other physicians in their daily clinical practice. This book is thought to be a practical and valuable reference for urologists, gynecologists, endocrinologists, psychiatrics and psychologists, and residents who are not specialty trained in andrology. It is designed for both young fellows training in different specialties and coming into contact with andrological issues for the first time and also more experienced clinicians and surgeons requiring updated guidelines and clear advice on the most controversial issues. This book will represent an invaluable quick consulting tool, updated in its scientific contents and rich in tables, images and video-clips

Sex, aggression and pair-bond : a study on the serotonergic regulation of female sexual function in the marmoset monkey

Women diagnosed with a sexual dysfunction often suffer from marked distress and interpersonal difficulty that arise from unwanted, persistent or recurrent low sexual desire (hypoactive sexual desire disorder, HSDD). An imbalance of excitatory and inhibitory neurotransmitters has been proposed to underlie certain forms of HSDD. Serotonin (5-HT) is a key neurotransmitter involved in female sexual inhibition. Animal studies that apply 5-HT receptor subtype specific ligands permit mechanistic examination of 5-HT mediated effects on sexual behavior. The aim of this thesis was to investigate the serotonergic regulation of female sexual behavior in the common marmoset (Callithrix jacchus), a nonhuman primate that is characterized by a pairmate social setting comparable to humans. The experimental agents employed in the study were (1) flibanserin, a 5-HT1A agonist, 5-HT2A antagonist and putative pharmacotherapeutic treatment for HSDD in women, and (2) 8-OH-DPAT, a prototype 5-HT1A agonist. Neuroendocrine, PET imaging and genetic experiments were conducted to explore hormonal, brain activity and gene expression patterns that underlie female sexual behavior. While flibanserin, administered daily to the female for several weeks, enhanced the male pairmate’s sexual interest and increased pro-social interactions between pairmates, 8-OH-DPAT reduced female sexual receptivity and increased aggressive interactions between pairmates. HPA responses to restraint stress were enhanced after both flibanserin and 8-OH-DPAT. Furthermore, 8-OH-DPAT treated females showed reduced glucose uptake to the medial occipital cortex that correlated with sexual rejection behavior, while gene transcription of the serotonin transporter in the dorsal raphé nucleus, and of oxytocin in the medial preoptic area of the hypothalamus, was increased. Gene cluster analysis of microarray data indicated brain region-specific alterations in neural development, neurotransmission and energy production after 8-OH-DPAT. The results presented in this thesis demonstrate that pair-bond quality between partners and sexual behavior are closely linked and suggest that oxytocin may be the pivot of serotonergic regulation of female sexual behavior, pair-bond and pharmacotherapy of HSDD.Boehringer Ingelheim; Reseach Facilities Improvement Program, National Institutes of Health, U.S.A.; Netherlands Organization for Scientific Research (NWO); Royal Netherlands Academy of Arts and Sciences (KNAW

The Varieties of Spiritual States Triggered by Sex: A Systematic Review of the Empirical Literature

This systematic review integrates the empirical evidence of spiritual experiences triggered by sexual activity, including studies by 10 authors. Despite venerable sexual meditative traditions of embodied spiritual practices, such as Hindu Tantra, Vajrayana Buddhism, and Taoism, empirical studies of sexual spiritual experiences are in their infancy. This review presents the range of sexual altered states experiences identified to date and how they qualify as spiritual experiences phenomenologically and in terms of their lifechanging effects. Seventeen distinct sexual-spiritual states have been identified across authors, with 4 others identified at significant levels in qualitative studies by individual authors. As an emergent area of scholarly interest, research on this topic remains scattered across disciplines and is characterized by small studies, many advanced by doctoral students conducting dissertation research. This article integrates the empirical research and situates it in a larger, diverse theoretical, historical, and anecdotal literature, to critically assess consensus on the topic. Deliberate practices, adventitious conditions, human physiology, and other dynamics that conduce to sexual spiritual experiences are discussed

Nerve growth factor: its role in male fertility as an ovulation inducer

The studies presented in this thesis were designed to elucidate whether the abundance of ovulation-inducing factor/nerve growth factor (OIF/NGF) in alpaca semen can be used as a biomarker to predict male fertility. The neurotrophin, OIF/NGF has been identified in camelid, cattle and human semen. It is only in camelids, however, that an ovulation-inducing role for OIF/NGF has been described. The information gathered from several studies clearly demonstrate that this protein is the stimulus responsible for initiating the ovulatory cascade in camelids. In addition, intramuscular administration of OIF/NGF resulted in a dose-dependent response in terms of ovulation rate, corpus luteum (CL) lifespan, luteinizing hormone (LH) and progesterone secretion. I hypothesized that the quantity of OIF/NGF differs among male alpacas and this abundance arbitrates ovulation and pregnancy rates as well as CL formation and function. To substantiate this hypothesis, the following questions were answered: 1) can OIF/NGF in alpaca semen be quantified using a radioimmunoassay; 2) does the concentration and total abundance of OIF/NGF in alpaca semen vary within and among male ejaculates; 3) what is the glandular source of OIF/NGF that contributes to the male ejaculate; 4) is OIF/NGF concentration or abundance related to parameters associated with male fertility; 5) can OIF/NGF concentration or total abundance in the ejaculate discriminate fertile and subfertile males using both retrospective and prospective approaches; and 6) can power Doppler ultrasonography be used to assess the luteotrophic effect of OIF/NGF in tissue vasculature of the developing CL? I discovered that the source and the amount of OIF/NGF varies among species. In llamas, OIF/NGF is produced by both the corpus and disseminate portions of the prostate gland. In rats, OIF/NGF was detected in testis interstitial cells and in the lumen of the coagulating gland (anterior prostate). Ovulation-inducing factor/NGF secretion by the ampullae and vesicular glands contributed to its presence in bull (cattle and bison) ejaculates. In elk and white tail deer, OIF/NGF was detected in the ampullae and prostate glands, respectively. To gain an understanding of the abundance of OIF/NGF in ejaculates and changes in its concentration within and among males, OIF/NGF levels in semen were quantified using the radioimmunoassay. The assay developed exhibited parallel displacement curves among recombinant NGF, OIF/NGF purified from llama seminal plasma, llama and bull (cattle) seminal plasma. Ovulation-inducing factor/NGF comprised a greater percentage of the total protein found in camelid ejaculates than in cattle. Ovulation-inducing factor/NGF concentration correlated positively with sperm concentration and negatively with pH and semen volume, while total abundance of OIF/NGF was related to total prostate area and OIF/NGF concentration. Although a correlation was found between sperm concentration, neither OIF/NGF concentration nor total abundance was associated with higher ovulation, pregnancy or live birth rates. A clear association of the quantity of OIF/NGF in the male ejaculate at breeding and CL form and function was not evident. The measurement of CL vasculature by power Doppler ultrasonography, however, was able to determine nonpregnancy in alpacas earlier than the assessment of changes in CL diameter. In summary, my results did not support the hypothesis that the measurement of OIF/NGF concentration or total abundance in alpaca semen can be used to predict fertility in male alpacas

The Varieties of Spiritual States Triggered by Sex: A Systematic Review of the Empirical Literature

This systematic review integrates the empirical evidence of spiritual experiences triggered by sexual activity, including studies by 10 authors. Despite venerable sexual meditative traditions of embodied spiritual practices, such as Hindu Tantra, Vajrayana Buddhism, and Taoism, empirical studies of sexual spiritual experiences are in their infancy. This review presents the range of sexual altered states experiences identified to date and how they qualify as spiritual experiences phenomenologically and in terms of their lifechanging effects. Seventeen distinct sexual-spiritual states have been identified across authors, with 4 others identified at significant levels in qualitative studies by individual authors. As an emergent area of scholarly interest, research on this topic remains scattered across disciplines and is characterized by small studies, many advanced by doctoral students conducting dissertation research. This article integrates the empirical research and situates it in a larger, diverse theoretical, historical, and anecdotal literature, to critically assess consensus on the topic. Deliberate practices, adventitious conditions, human physiology, and other dynamics that conduce to sexual spiritual experiences are discussed

Male Reproductive Health

Male reproductive health is an important area affecting men's overall health and well-being. Infertility is a worldwide problem that affects approximately 15% of married couples. Half of these cases can be traced to male partners. Infertile men are at an elevated risk of cancer development later in life, primarily genitourinary malignancies such as testicular and prostate cancer. This book will focus on male reproductive health, from the aspects of semen quality, male infertility, testicular cancer, and prostate cancer, and their detection, diagnosis, treatment, and prevention