Journal of Sexual Medicine and Reproductive Health

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Rapid-Onset Gender Dysphoria - A Topic for Debate

Several publications from specialized units report changes in the demands of children with gender dysphoria.

María Fernández Rodríguez¹*, Guerra-Mora P², and Martínez-Menéndez N³


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Are Male Enhancement Ultraceuticals Sold Online Safe, Natural and Compliant with their Label Claim?

Attention to ultraceuticals has become extremely prevalent. A large surge of male enhancement ultraceuticals hashit the U.S. market through online retail stores such as eBay, Amazon, GNC, and Alibaba that consist of unverified therapeutic label claims. The issue at hand is the increase in the production, marketing and sale of adulterated products from these online retail stores that falsify the safety, efficacy, and therapeutic claims on their websites. These products are further provoked to continue their false claims due to the absence of strict regulatory laws to govern label claims, manufacturing, and marketing in U.S. and global markets. The online retail stores that sponsor and advertise the sales of these ultraceuticals neglect the literature that show many of the products were discovered to be counterfeit, mislabeled, or adulterated with active pharmaceutical ingredients (API). Ultimately, regulatory authorities should instill regulations in order to monitor, examine, and test the ultraceutical market and the research community should draw public attention to the possible effects of these products on consumers.

Nadine Amine, Cindy Zheng, Harshvir Kaur, Jessica Sweeney, Mark Mikail, and Mohamed Ismail Nounou*


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The Psychosocial Impact of Disorders of Sexual Development

Disorders of Sexual Development (DSD) consist of ‘congenital conditions with atypical development of chromosomal, gonadal, or anatomic sex’. They cause significant psychological impact upon patients and their families. A search of MEDLINE, EMBASE and Clinical trials USA and Australia was conducted using MESH terms ‘disorders of sexual development,’ ‘psychology’ and ‘quality of life.’ Four themes emerged from the literature search; psychological support and treatment for parents and patients, the need for holistic management, quality of life assessment and identification of sociocultural factors that impact psychological health in DSD patients. Educating medical and paramedical staff is crucial to ensure adequate early assessment, diagnosis, counselling, and where appropriate management. Caution should be exercised in early genital surgery to ease parental distress; rather this should be a team-based decision at an appropriate age where the individual can be involved in the consent process. Psychological input should be specialised to the individual and more readily accessible.

Kavita Ravendran¹,²* and Rebecca Deans¹,²


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Biomechanical Comparison of the Relationship between Variable Rear Tip Extender & Inflatable Penile Implant Cylinder Lengths with X-Ray Imaging: A Cadaveric Pilot Study

Objective: Here we present our findings assessing the biomechanical properties of IPPs with differing lengths of RTEs.

Materials and Methods: This is a biomechanical study of the interaction of penile implant cylinders and RTE as assessed by column compression and modified cantilever deflection. X-Ray (XR) photography was also used to identify the precise location of kink formation after failure. The IPPs were surgically placed into two fresh cadavers via a penoscrotal technique by a single large volume implanter. A biomechanical evaluation of the properties of the IPP and RTE inside the fibroelastic tunica albuginea was assessed in unblinded testing and analyses were based on industry standard methods for assessment.

Results: In the 20 and 24 cm phallus respectively, the maximum load before kink was shown to be highest with no RTEs. This is to say device failure was at lower force when more RTE were present versus when no RTE were present. We also see in the shorter phallus there is a higher overall resistance to kink formation, even with increasing RTE lengths. Results from the horizontal studies were mixed and no direct conclusions can be drawn.

Conclusions: Column load testing to the maximum load before kink formation increases sequentially with decreasing RTE. This suggests no RTE will translate to a higher load tolerance for patients when we consider the physiologic act of intromission. Our data also suggest that even with more RTE, shorter phalluses can resist higher loads. Surgeons should use this as a guide to maximize cylinder lengths when performing IPP surgery. Further research will be required to validate these findings.

Jared J. Wallen¹*, SriGita K. Madaraju², Enrique V. Barrera³, Liehui Ge³, Angelina Hou⁴, Alexander W. Pastuszak⁵, Rafael E. Carrion⁶, Paul E. Perito⁷, and Tariq S. Hakky⁴


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Dynamics of Sexual Activity of Men and Women of Different Ages, Undergoing Cerebral Stroke

Introduction: The issues of sexual activity of representatives of different sexes who have suffered a stroke are poorly covered in the literature. However, this problem has a distinct clinical significance.

Objective: Determination of the prevalence and clinical variability of sexual disorders in people of different sex and age at different times – before and after cerebral stroke, and the need to take into account sexual history in predicting the consequences of stroke and in treatment and rehabilitation measures

Materials and Methods: In the process of a targeted survey of 111 patients (58 men and 53 women) of different ages, conducted in the acute period of stroke, their sexual activity was studied in the pre – stroke period, and then in 77 of these patients-after 3-24 months. Sexual partners of the respondents were involved in the survey. The obtained data were compared with age, stroke background pathology, and stroke variant, severity of neurological defect, cognitive and emotional disorders, and results of neuroimaging studies.

Results: The decrease in sexual activity before stroke is of clear importance along with age in the development of background pathology for stroke, the formation of the consequences of stroke in cognitive and emotional functions. At the age of 55 years the most severe functional consequences of stroke were formed in 8.3% of persons who had normal sexual relations before stroke and in 27.6% in the absence of such (p=0.09). The negative dynamics of sexual activity after stroke is associated with the presence and severity of neurological deficits, especially among women, and the presence of cerebral atrophic changes, more often in men.

Conclusion: The initial quality of intimate relationships largely determines the clinical features of stroke and its consequences, and the negative dynamics of sexual activity after stroke is associated with different causal factors in different sexes, and this must be taken into account in the process of rehabilitation treatment.

Myakotnykh VS* and Ostapchuk ES


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Evidence for Androgenic Influences on Self-Rated Health

Background: According to most studies, males self-report being physically and mentally healthier than females. The present study sought to determine if androgens might influence health.

Methods: Self-reports of physical and mental health were obtained from college students in Malaysia (N = 2,058) and the United States (N = 2,511). Androgen exposure was assessed based on five self-reported measures that were then factor analyzed. A clear two-factor solution resulted from the analysis: muscularity, physical strength, and athletic ability loaded onto a muscular coordination factor, while adult height and 2D:4D finger length measure loaded onto a bone growth factor.

Results: As hypothesized, for males and females in both countries, self-rated physical and mental health were both positively correlated to a significant degree with the muscular coordination androgen factor. The only significant correlation between self-rated health and the bone growth androgen factor was negative among the Malaysian sample.

Conclusions: Androgenic influences on muscular coordination appear to coincidentally alter self-rated physical and mental health. This conclusion conflicts with proposals that men and women would provide the same self-ratings of health if it were not for sex role training and discrimination.

Lee Ellis¹* and Anthony W. Hoskin²


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Impact of COVID-19 infection on male smoker

Background: COVID-19, a mutated virulent virus of severe acute respiratory syndrome (SARS), was declared a global pandemic by the World Health Organization, with nearly 545,226,550 confirmed cases and 6,334,728 deaths. Furthermore, this mutated COVID-19 targets the lungs’ major respiratory organs and other vital organs (heart and kidney). The mutated virus of COVID-19 primarily targets crucial human organs, and those who smoke are particularly vulnerable.

Main Body: It is estimated that 30-40% of people worldwide smoke. Compared to nonsmokers, smokers exposed to the COVID-19 virus have a lower rate of recovery from this lethal virus. ACE2 is a type of angiotensin-renin converting enzyme group 2 that affects spermatogenesis and steroidogenesis by increasing or decreasing. As a result of SARS-virulent CoV-2’s capability, ACE2 was altered, and entry into the lungs/testis caused orchitis formation in the testis. A few COVID-19-infected males aged 30-35 are said to have reported microbial itching in their private parts along with decreased testosterone levels, and testicular histopathological confirmation was suggested. Because SARS-CoV-2 affects the testis, it may impact male fertility. For proof, we need to research with many participants to prevent COVID-19 mutation from causing germ cell mutation in offspring.

Conclusion: The current review primarily concerns whether this COVID-19 of SARS CoV-2 affects human male smoker fertility by impairing testicular spermatogenesis

Parameswari Ranganathan¹*, Babujanarthanam Ranganathan¹, Ganeshamoorthy², and Sridharan TB³


Latest Articles

Rapid-Onset Gender Dysphoria - A Topic for Debate

María Fernández Rodríguez¹*, Guerra-Mora P², and Martínez-Menéndez N³

Pages: 11

Are Male Enhancement Ultraceuticals Sold Online Safe, Natural and Compliant with their Label Claim?

Nadine Amine, Cindy Zheng, Harshvir Kaur, Jessica Sweeney, Mark Mikail, and Mohamed Ismail Nounou*

Pages: 11

The Psychosocial Impact of Disorders of Sexual Development

Kavita Ravendran¹,²* and Rebecca Deans¹,²

Pages: 11

Biomechanical Comparison of the Relationship between Variable Rear Tip Extender & Inflatable Penile Implant Cylinder Lengths with X-Ray Imaging: A Cadaveric Pilot Study

Jared J. Wallen¹*, SriGita K. Madaraju², Enrique V. Barrera³, Liehui Ge³, Angelina Hou⁴, Alexander W. Pastuszak⁵, Rafael E. Carrion⁶, Paul E. Perito⁷, and Tariq S. Hakky⁴

Pages: 11

Dynamics of Sexual Activity of Men and Women of Different Ages, Undergoing Cerebral Stroke

Myakotnykh VS* and Ostapchuk ES

Pages: 11

Evidence for Androgenic Influences on Self-Rated Health

Lee Ellis¹* and Anthony W. Hoskin²

Pages: 11

Impact of COVID-19 infection on male smoker

Parameswari Ranganathan¹*, Babujanarthanam Ranganathan¹, Ganeshamoorthy², and Sridharan TB³

Pages: 11

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Seth J. Worley, MD, FHRS, FACC

Director, Interventional Implant Program MedStar Heart & Vascular Institute, Washington, DC, USA

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