Thyroid hormone receptors and ligand, tissue distribution and sexual behavior

The thyroid hormones (THs) triiodothyronine (T3) and tetraiodothyronine, or thyroxine (T4), not only dramatically impact on development and differentiation, but also on the sexual and reproductive function. There is large body of literature, in fact, on the effects of THs on the reproductive function in both humans (Poppe and Velkeniers, 2004; Wajner et al., 2009) and animals (Hapon et al., 2010; Nelson et al., 2011). For a long time the gonads were thought to be unresponsive to THs, but TH receptors (TR) were discovered in rat (Jannini et al., 1990; Palmero et al., 1988) and then in human testis (Jannini et al., 2000). In women, the association of menstrual disturbance with thyroid disease was described as early as 1840 by von Basedow, but the discovery of TRs in the ovary was carried out at the end of last century (Wakim et al., 1994b). Therefore, the link between thyroid and reproductive function was well established. Since then, research has shown that thyroid dysfunction is associated with an adverse effect on fertility, both in men (Wagner et al., 2009) and women (Dittrich et al., 2011). There is also evidence that THs can affect the sex steroid hormone axis (Bagamasbad and Denver, 2011), consequently sexual hormones and the pituitary gland can mediate the action of THs on the reproductive physiology. While the effects of THs on fertility have been widely studied, little is known about their influence on sexual function. In the last few years, an increasing number of evidences have shown the influence of THs on male sexual function, particularly on ejaculation control as well on desire and erectile function (Carani et al., 2005; Corona et al., 2012b; Di Sante et al., 2016). The female sexual function and the relationship with thyroid function is still less studied. Furthermore, studies conducted on animals have shown the presence of TRs in the male (Carosa et al., 2010) and female genitalia (Rodriguez-Castelan et al., 2017). Moreover, knockout mice for TRs showed alterations in sexual behavior (Dellovade et al., 2000). The purpose of this review is to summarize and discuss the available data on the influence of THs on male and female sexual function to understand the molecular mechanisms of the influence of the thyroid gland on sexual behavior and function

The andrologist from medicine of reproduction to sexual medicine: the Italian experience

The main andrological areas of interest, male reproductive and - more recently sexual dysfunctions are most appropriately viewed as symptoms of the couple with medical, psychological and behavioural components that cannot be treated in a mechanical, purely medicinal manner (sexual medicine). The patient and his sexual partner must be active participants in a full continuum of care (medical sexology), the new challenge for the renewed and enriched field of andrology. In this field, the cooperation between basic researchers (such as geneticists, neurophysiologists, pharmacologists, ethologists) and a wide group of clinicians (such as endocrinologists, psychologists and psycho-sexologlsts, psychiatrists, urologists and gynaecologists) is of paramount importance for the andrologist at the dawn of the new field of medical sexology, which will be full of scientific gratification in the years to come

Relationship between hyperuricemia with deposition and sexual dysfunction in males and females

Purpose The association between gout, the most common crystal arthropathy, and sexual dysfunctions has often been investigated by studies in the last decades. Despite the presence of shared risk factors and comorbidities and the possible effects on sexual health of long-term gout complications, awareness of this association is severely lacking and the pathogenetic mechanisms have only partially been identified. In the present review, we aimed to investigate the current evidence regarding the potential mechanisms linking sexual dysfunctions and gout. Methods A comprehensive literature search within PubMed was performed to provide a summary of currently available evidence regarding the association between gout and sexual dysfunctions. Results Gout and sexual dysfunctions share several risk factors, including diabesity, chronic kidney disease, hypertension, metabolic syndrome, and peripheral vascular disease. Gout flares triggered by intense inflammatory responses feature severe pain and disability, resulting in worse sexual function, and some, but not all, treatments can also impair sexual health. Long-term gout complications can result in persistent pain and disability due to joint deformity, fractures, or nerve compression, with negative bearing on sexual function. The presence of low-grade inflammation impairs both sex steroids synthesis and endothelial function, further advancing sexual dysfunctions. The psychological burden of gout is another issue negatively affecting sexual health. Conclusions According to currently available evidence, several biological and psychological mechanisms link sexual dysfunctions and gout. Addressing risk factors and providing adequate treatment could potentially have beneficial effects on both conditions. Appropriate clinical evaluation and multidisciplinary approach are recommended to improve patient care

The sentiment analysis of tweets as a new tool to measure public perception of male erectile and ejaculatory dysfunctions

Twitter is a social network based on "tweets," short messages of up to 280 characters. Social media has been investigated in health care research to ascertain positive or negative feelings associated with several conditions but never in sexual medicin

Diabetes in the Time of COVID-19: A Twitter-Based Sentiment Analysis

Since December 31, 2019 and as of May 31, 2020, 6 028 135 cases of coronavirus disease 2019 (COVID-19) have been reported, including 368 944 deaths.1 A Chinese longitudinal study showed that the COVID-19 outbreak had a significant psychological impact on the general population, with symptoms comparable to those of post-traumatic stress disease.2 Diabetes represents a fully-fledged risk factor for poorer prognosis of COVID-19

Short-term effects of focal muscle vibration on motor recovery after acute stroke: a pilot randomized sham-controlled study

Repetitive focal muscle vibration (rMV) is known to promote neural plasticity and long-lasting motor recovery in chronic stroke patients. Those structural and functional changes within the motor network underlying motor recovery occur in the very first hours after stroke. Nonetheless, to our knowledge, no rMV-based studies have been carried out in acute stroke patients so far, and the clinical benefit of rMV in this phase of stroke is yet to be determined. The aim of this randomized double-blind sham-controlled study is to investigate the short-term effect of rMV on motor recovery in acute stroke patients. Out of 22 acute stroke patients, 10 were treated with the rMV (vibration group–VG), while 12 underwent the sham treatment (control group–CG). Both treatments were carried out for 3 consecutive days, starting within 72 h of stroke onset; each daily session consisted of three 10-min treatments (for each treated limb), interspersed with a 1-min interval. rMV was delivered using a specific device (Cro®System, NEMOCO srl, Italy). The transducer was applied perpendicular to the target muscle's belly, near its distal tendon insertion, generating a 0.2–0.5 mm peak-to-peak sinusoidal displacement at a frequency of 100 Hz. All participants also underwent a daily standard rehabilitation program. The study protocol underwent local ethics committee approval (ClinicalTrial.gov NCT03697525) and written informed consent was obtained from all of the participants. With regard to the different pre-treatment clinical statuses, VG patients showed significant clinical improvement with respect to CG-treated patients among the NIHSS (p < 0.001), Fugl-Meyer (p = 0.001), and Motricity Index (p < 0.001) scores. In addition, when the upper and lower limb scales scores were compared between the two groups, VG patients were found to have a better clinical improvement at all the clinical end points. This study provides the first evidence that rMV is able to improve the motor outcome in a cohort of acute stroke patients, regardless of the pretreatment clinical status. Being a safe and well-tolerated intervention, which is easy to perform at the bedside, rMV may represent a valid complementary non-pharmacological therapy to promote motor recovery in acute stroke patients

The psychosexual profile of sexual assistants: an internet-based explorative study

Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution

Type V phosphodiesterase inhibitor treatments for erectile dysfunction increase testosterone levels.

OBJECTIVE Lack of sexual activity due to erectile dysfunction (ED) decreases testosterone (T) levels through a central effect on the hypothalamic-pituitary axis. In this paper we studied the effect of different type V phosphodiesterase (PDE5) inhibitor treatments for ED on the reversibility of this endocrine pattern. DESIGN Open-label, retrospective study. PATIENTS Seventy-four consecutive patients were treated on demand with sildenafil (Sild) (50 mg) and tadalafil (Tad) 20 mg. MEASUREMENTS The success in sexual intercourse was recorded and total (tT) and free testosterone (fT) levels were studied before and after 3 months of treatment. RESULTS Basal level of tT and fT were at the bottom of the normal range and LH levels were at the top of the high normal range. After treatments, this endocrine pattern was reversed in both groups. However, the T increase in Sild-treated patients was significantly lower than in those treated with Tad (4.7 +/- 2.7 vs. 5.1 +/- 0.9, P < 0.001). fT levels followed a directly proportional pattern, while the inverse was found when LH production was studied. The intercourse rate reflected this effect: in fact, the Sild group showed a 4.9 +/- 2.9/month full sexual intercourse rate while in the Tad group a significantly higher rate of sexual intercourse was found (6.9 +/- 4.6/month, P = 0.04). However, drug consumption was comparable between the groups (Sild 4.9 +/- 2.9 vs. Tad 4.4 +/- 2.8 pills/month, P = 0.72). CONCLUSIONS As it is unlikely that the two drugs have a different direct effect on the pituitary-testis axis, this effect is probably due to the higher frequency of full sexual intercourse in the Tad-treated group, because of the drug's longer half-life

Klinefelter syndrome: cardiovascular abnormalities and metabolic disorders

Klinefelter syndrome (KS) is one of the most common genetic causes of male infertility. This condition is associated with much comorbidity and with a lower life expectancy. The aim of this review is to explore more in depth cardiovascular and metabolic disorders associated to KS. KS patients have an increased risk of cerebrovascular disease (standardized mortality ratio, SMR, 2.2; 95% confidence interval, CI, 1.6-3.0), but it is not clear whether the cause of the death is of thrombotic or hemorrhagic nature. Cardiovascular congenital anomalies (SMR, 7.3; 95% CI, 2.4-17.1) and the development of thrombosis or leg ulcers (SMR, 7.9; 95% CI, 2.9-17.2) are also more frequent in these subjects. Moreover, cardiovascular abnormalities may be at least partially reversed by testosterone replacement therapy (TRT). KS patients have also an increased probability of endocrine and/or metabolic disease, especially obesity, metabolic syndrome and type 2 diabetes mellitus. The effects of TRT on these abnormalities are not entirely clear