Recent advances in the treatment of premature ejaculation

Premature ejaculation (PE) is the most common sexual problem affecting men. It can affect men at all ages and has a serious impact on the quality of life for men and their partners. Currently there are no pharmaceutical agents approved for use in the UK, and so all drugs used for this condition are off label. Behavioral therapy has been used to treat PE, but the results are not durable once therapy has been concluded. Several topical therapies have been used including severance-secret (SS) cream, lignocaine spray, lidocaine-prilocaine cream and lidocaine-prilocaine spray (TEMPE). There has been recent interest in the selective serotonin reuptake inhibitors (SSRIs) for the treatment of PE, due to the fact that one of their common side effects is delayed ejaculation. Currently used SSRIs have several non-sexual side effects and long half lives, therefore there has been interest in developing a short acting, efficacious SSRI that can be used on-demand for PE. Dapoxetine has been recently evaluated for the treatment of PE by several groups, and results so far appear promising

Caring for transgender people: looking beyond the hype.

This special issue of Sexual Health presents a collection of articles that addresses issues facing transgender individuals that are particularly challenging. Issues covered range from sexual health education in schools, the need for accurate epidemiological measurements, the perils of inaccurate diagnostic labels of transgender children, legal issues, the disproportionately high prevalence of HIV and sexually transmissible infections (STIs), and the role of primary care. We need to think critically, constructively and compassionately about transgender people. Particularly, we must look beyond the hype and objectively consider the evidence, without forgetting the people who are trying to cope with feelings that may be causing them great distress

The perspectives of psychosexual therapists towards using play therapy techniques in sex and relationship therapy: A qualitative study

Play therapy is an intervention traditionally used with children that is beginning to be used with adults. One area of use is within the psychosexual context; however, there is an absence of empirical research in this area. This qualitative study explored therapists’ perspectives on using play therapy techniques in psychosexual therapy. The 16 participants were either qualified or trainee psychosexual therapists. Data were collected through focus group interviews and analysed thematically. Four interlinking themes were identified: (1) playfulness already used but not recognised as play therapy; (2) delivery and receiving of play techniques; (3) attachment; and (4) well-being and social skills. Overall, participants believed there were benefits to using play therapy in the psychosexual context but that the therapeutic environment should be conducive to its use. Recommendations for practice include views about whether or not play therapy can be further developed and refined for use within the psychosexual context

British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice

BACKGROUND: Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. AIM: To review the available literature on TD and provide evidence-based statements for UK clinical practice. METHODS: Evidence was derived from Medline, EMBASE, and Cochrane searches on hypogonadism, testosterone (T) therapy, and cardiovascular safety from May 2005 to May 2015. Further searches continued until May 2017. OUTCOMES: To provide a guideline on diagnosing and managing TD, with levels of evidence and grades of recommendation, based on a critical review of the literature and consensus of the British Society of Sexual Medicine panel. RESULTS: 25 statements are provided, relating to 5 key areas: screening, diagnosis, initiating T therapy, benefits and risks of T therapy, and follow-up. 7 statements are supported by level 1, 8 by level 2, 5 by level 3, and 5 by level 4 evidence. CLINICAL IMPLICATIONS: To help guide UK practitioners on effectively diagnosing and managing primary and age-related TD. STRENGTHS AND LIMITATIONS: A large amount of literature was carefully sourced and reviewed, presenting the best evidence available at the time. However, some statements provided are based on poor-quality evidence. This is a rapidly evolving area of research and recommendations are subject to change. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions and take personal values and preferences and individual circumstances into account. Many issues remain controversial, but in the meantime, clinicians need to manage patient needs and clinical expectations armed with the best clinical evidence and the multidisciplinary expert opinion available. CONCLUSION: Improving the diagnosis and management of TD in adult men should provide somatic, sexual, and psychological benefits and subsequent improvements in quality of life. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. J Sex Med 2017;14:1504-1523

Sex education and the influence on sexual wellbeing

AbstractObjectiveTo identify any links between knowledge about sexual matters sex education and sexual wellbeing.Material & MethodsA global survey was undertaken of 26,032 participants across 26 counties.Results49% of people who have received formal sex education were highly satisfied with their sex lives, compared with just 40% of those who have not. Similarly, 49% of women and 48% of men do not think that they received enough advice and information to get the best from their relationships especially about the emotional aspects.ConclusionsPeople who have enough information to enjoy their sex life to the full are significantly more likely to be satisfied with many aspects of their sex life

A Global Survey of Sexual Behaviours

Objective: To identify the variety of sexual behaviours undertaken by adults across the world. Materials and methods: A global survey was undertaken using the internet to access 26,032 participants across 26 countries that completed a set of questions on line. Results: Three in five people agreed that sex was important to them with nearly one in three strongly agreeing with the statement. Sex was important for both men and women and remains important as people grow older. Sixty nine percent of respondents agreed that sex is fun and that they enjoyed sex. Two thirds agreed that "a good sex life is a vital part of life" of which a third strongly agreed. In addition 56% of non-sexually active individuals agreed with the statement. Two thirds agreed that "sex is beneficial for your health and well being" of which a third strongly agree. Fifty three percent of non-sexually active people agreed as well. Conclusion: Sex is important for people and contributes to their overall global well being.