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

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

Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm

Introduction. The physiology and anatomy of female sexual function are poorly understood. The differences in sexual function among women may be partly attributed to anatomical factors. Aim. The purpose of this study was to use ultrasonography to evaluate the anatomical variability of the urethrovaginal space in women with and without vaginal orgasm. Methods. Twenty healthy, neurologically intact volunteers were recruited from a population of women who were a part of a previous published study. All women underwent a complete urodynamic evaluation and those with clinical and urodynamic urinary incontinence, idiopathic detrusor overactivity, or micturition disorders, as well as postmenopausal women and those with sexual dysfunction were excluded. The reported experience of vaginal orgasm was investigated. Main Outcome Measure. The urethrovaginal space thickness as measured by ultrasound was chosen as the indicator of urogenital anatomical variability. Designated evaluators carried out the measurements in a blinded fashion. Results. The urethrovaginal space and distal, middle, and proximal urethrovaginal segments were thinner in women without vaginal orgasm. A direct correlation between the presence of vaginal orgasm and the thickness of urethrovaginal space was found. Women with a thicker urethrovaginal space were more likely to experience vaginal orgasm (r = 0.884; P = 0.015). A direct and significant correlation between the thickness of each urethrovaginal segment and the presence of vaginal orgasm was found, with the best correlation observed for the distal segment (r = 0.863; P < 0.0001). Interobserver agreement between the designated evaluators was excellent (r = 0.87; P < 0.001). Conclusions. The measurement of the space within the anterior vaginal wall by ultrasonography is a simple tool to explore anatomical variability of the human clitoris-urethrovaginal complex, also known as the G-spot, which can be correlated to the ability to experience the vaginally activated orgasm

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

Orgasm is preserved regardless of ejaculatory dysfunction with selective α1A-blocker administration

We evaluated whether ejaculatory dysfunction induced with a selective α1A-blocker influenced orgasm. Fifteen healthy male volunteers took silodosin or a placebo in a randomized, double-blind crossover design. We investigated the ejaculatory volume before and after administration of the agents. After each ejaculation, participants self-reported the answers to an original questionnaire, which was about discomfort on ejaculation, orgasm and satisfaction with the discomforting ejaculation. All participants on silodosin had a complete lack of seminal emission and expulsion. All participants felt orgasm in spite of a complete lack of seminal emission. Of the 15, 12 (80%) who had a somewhat uncomfortable feeling during orgasm were dissatisfied with this feeling, although 9 of the 12 reported that its degree was mild. Orgasm is preserved regardless of the loss of seminal emission with silodosin administration. Although most participants reported mild discomfort during orgasm, they were greatly dissatisfied with the loss of seminal emission

Is acupuncture a therapeutic option for premature ejaculation?

In the past, premature ejaculation (PE) has been considered a psychogenic condition, treated with psychotherapy. Our growing understanding of PE pathophysiology has increased the scientific community's interest in a symptom that is seen across many sexual pathologies. Is it possible to approach PE with traditional medicine approaches, such as acupuncture

Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause

At midlife and beyond, both men and women face organic changes that can affect sexual functioning. For women, ovarian exhaustion causes estrogen deficiency, leading to genitourinary syndrome of menopause, which may include vaginal dryness, irritation/itching, inadequate lubrication, and dyspareunia. Hypoactive sexual desire disorder also can result from biopsychosocial factors. For men, erectile dysfunction prevalence increases with age, and some men develop testosterone deficiency