As expected, there were no significant associations between SCS and avoidance sexual goals for either partner. There were also no significant associations between USC and approach or avoidance sexual goals for either partner. We also ran all analyses reported above with age and relationship duration controlled. With two exception, all of the effects remain significant. The exceptions were that the association between men’s SCS and approach goals and the association between women with FSIAD’s Table 3. Associations between sexual communal strength and unmitigated sexual communion and sexual well-being. W’s sexual desire P’s sexual desire W’s sexual satisfaction P’s sexual satisfaction W’s sexual distress P’s sexual distress b (SE) t b (SE) t b (SE) t b (SE) t b (SE) t b (SE) t W’s SCS 3.73 (1.81) 2.06⇤ 2.13 (1.59) 1.34 3.68 (1.08) 3.41⇤⇤⇤ 3.29 (1.25) 2.64⇤⇤ 1.61 (2.01) .80 -2.99 (2.15) -1.39 P’s SCS -3.95 (2.11) -1.87 5.63 (1.85) 3.04⇤ 2.05 (1.25) 1.63 2.72 (1.45) 1.87 .45 (2.34) .19 -5.33 (2.47) -2.16⇤ W’s USC -.11 (1.51) -.07 -2.07 (1.32) -1.57 -1.17 (.89) -1.31 .11 (1.03) .11 .02 (1.67) .02 -.11 (1.82) -.06 P’s USC -.42 (1.60) -.26 1.75 (1.40) 1.25 -.90 (.95) -.95 -1.20 (1.10) -1.09 2.91 (1.77) 1.64 5.08 (1.89) 2.69⇤⇤ Note. W = women; P = partner; SE = standard error; SCS = sexual communal strength; USC = unmitigated sexual communion. ⇤ p < .05. ⇤⇤ p < .01. ⇤⇤⇤ p < .001. https://doi.org/10.1371/journal.pone.0219768.t003 PLOS ONE | https://doi.org/10.1371/journal.pone.0219768 July 17, 2019 10 / 20 SCS; sexual communal strength ੑతڞಉྗʢύʔτφʔͷੑతχʔζΛຬͨ͢ʣ USC; unmitigated sexual communion ʢύʔτφʔͷχʔζΛ༏ઌͯࣗ͠ͷχʔζΛഉআʣ
for the different stroking velocities between men and women. Overall, eroticism and two-point discrimination did not correlate with any of the measurements of sexual desire or per- formance (Table 1). Partial correlations controlled for tion did not co desire or perfor for neuroticism eroticism and m DISCUSSION The present mediate erotic study,22 an inv eroticism and st ratings correspo stimulate CT a points were use results suggest t performance (as in men and wo more erotic tha the stimulated fi in the way repo differentiation— CT touch proce Figure 2. Mean ratings (VAS) of perceived eroticism for the
analy and social only) were the perceiv correlated social agre Table 1]. I nificance b Further and women sitivity and r(corr) = − p(corr) = . Fig. 1 Odor sensitivity related to the perceived pleasantness of sexual ᄿ֮ײडੑ͕ߴ͍ࢀՃऀɺੑత׆ಈͷշײ͕ΑΓߴ͍
Table 2) Discus The pred behavio ence of o participa of sexua et al., 20 ple with Our focu confoun sexual interactions and vice versa, respectively ᄿ֮ײͷߴ͍ঁੑɺੑަதʹΦϧΨεϜͷස͕ߴ͍
in each toms and nt among n the cul- n in Bra- person in question- ollowing s/usually/ quate for e consid- ED,” and men with prevalence of erectile dysfunction (ED) in community-based populations random sample of approximately 600 men aged 40 to 70 years
was the initial attempt at first-line that PDE5i therapy was continue “clinically indicated.” Given the va for ED, it would be valuable to k the drugs, dosage and dosing reg the run-in phase and following s One significant limitation o patients taking nitrates. Nitrates symptoms in cardiac patients, and hydralazine combination therapy Figure 2: Left panel: Atherosclerotic resulting in poor arterial inflow an cavernosal tissue. Right panel: Impr a zotarolimus-eluting peripheral sten permission from Rogers et al.14 Curr Treat Options Cardiovasc Med. 2012;14(2):193–202. Arterial blood supply to the penis
Kim et al Figure 2: Left panel: Atherosclerotic narrowing in the internal pudendal artery resulting in poor arterial inflow and ED with suboptimal filling of penile cavernosal tissue. Right panel: Improved arterial inflow after implantation of a zotarolimus-eluting peripheral stent system. This figure is reproduced with 14 Left panel: Atherosclerotic narrowing in the internal pudendal artery resulting in poor arterial inflow and ED with suboptimal filling of penile cavernosal tissue. Right panel: Improved arterial inflow after implantation of a zotarolimus-eluting peripheral stent system. ED͕Χςʔςϧ࣏ྍͰվળ͢Δ߹͋Δ
Tadalafil25 mg 200 mg Udenafil 100 mg Mirodenafil 25 mg Sildenafil Vardenafil 20 mg Tadalafil20 mg Vardenafil 10 mg Lodenaf il 80 mg Udenafil 100 mg Tadalafil10 mg Tadalafil5 mg Tadalafil2 mg Avanafil 100 mg Avanafil 200 mg Mirodenafil 50 mg Sildenafil 10 mg Vardenafil 5 mg 50 mg Avanafil 80 60 40 20 0 Efficacy against placebo (%) orest plot of overall efficacy (from 82 trials, 47 626 patients) for phosphodiesterase 5 inhibitors at different dosages. Data are shown as me E U R O P E A N U R O L O G Y X X X ( 2 0 1 5 ) X X X – X X X overall efficacy for PDE 5 inhibitors at different dosages. 82 trials, 47 626 patients
Ն1 severity category (based on the E tional Index of Erectile Function [IIEF]), Self-Esteem and Relationship questionnaire (SEA UROLOGY 68 (Suppl 3A): 26–37, 2006. ຄىػೳͷվળ͕େ͖͍΄Ͳɺੑతؔɺࣗ৴ɺࣗଚ৺ɺશൠతͳؔੑ ͕Α͘ͳΔ ࣗଚ৺͓Αͼؔੑ࣭ථ (Self-Esteem and Relationship Questionnaire: SEAR) είΞ
and faction, and reduced pain during inter- , provided that the woman is still o have sex with that partner. In this considered that this finding emphas tance of a holistic approach to the t [30]. Such a strategy may need to in appropriate hormonal treatment of w of partner satisfaction during intercourse in men treated with sildenafil versus men treated J Sex Med 2006;3(suppl 3):258. Rates of partner satisfaction during intercourse in men treated with sildenafil versus men treated with placebo.
703–708 Among 96 respondents who experienced a morning erection with tadalafil, 52% (58% in the 45–54 year old age group, 64% in the 55–64 year old age group and ported morning erections after taking sildenafil. Consid- ering the short action duration, sildenafil would not be very effective in producing morning erection after being Table 2. Sentiments upon regaining a morning erection. First mention Second mention Age (years) Total 45–54 55–64 ≥ 65 Total 45–54 55–64 ≥ 65 Number of respondants 97 27 25 45 9 27 25 45 Question n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) Like being reborn 15 (15) 4 (15) 3 (12) 8 (18) 10 (10) 0 (0) 2 (8) 8 (18) More confidence as a man 50 (52) 17 (63) 12 (48) 21(47) 21 (22) 3 (11) 5 (20) 13 (29) More positive in every matter 6 (6) 0 (0) 4 (16) 2 (4) 13 (13) 8 (30) 4 (16) 1 (2) Less dispirited/dejected 7 (7) 1 (4) 2 (8) 4 (9) 11 (11) 3 (11) 1 (4) 7 (16) More intimate with partner 4 (4) 0 (0) 2 (8) 2 (4) 9 (9) 2 (7) 4 (16) 3 (7) Like being healthier 12 (12) 5 (19) 2 (8) 5 (11) 17 (18) 5 (19) 5 (20) 7 (16) Happy 3 (3) 0 (0) 0 (0) 3 (7) 11 (11) 3 (11) 4 (16) 4 (9) ேཱͪ lੜ·ΕมΘͬͨΑ͏ͩʂz zஉͱͯ͠ͷࣗ৴͕࣋ͯΔʂz
for Screening The Institute of Medicine (IOM) number of studies, particularly pla ised trials, assessing the risks an replacement therapy in older men ally diagnosed with hypogonadism one levels than young adult male symptoms of ageing and hypogona the IOM has recommended that Aging and other research agencies acy trials, and, if clinically signific ted, conduct long-term studies to (45). At present, there is no basis replacement therapy in older men, matic androgen deficiency (3,4). Testosterone levels needed for vary among individuals. Some me Int J Clin Pract. 2006 Sep;60(9):1087-92. Testosterone therapy improved response to sildenafil, a PDE5 inhibitor.
Explain therapy options • Take relevant histories • Educate patient and partner regarding the e ects of therapy • Communicate with both patient and partner Patient • Visit doctor regularly • Provide a history • Adapt sexual activities • dopt a healthy lifestyle • Use relaxation techniques to alleviate stress • Take medication • Participate in education programmes • Communicate with partner and physician • Take part in activities as a couple Partner • Engage with therapy • Accompany partner to the clinic • Provide an individual history • Help with treatment selection and counselling • Participate in education programmes • Assist at home with healthy lifestyle and medication • Adapt sexual activities • Communicate with partner and physician • Take part in activities as a couple Nat Rev Urol. 2016;13(3):168–177
Explain therapy options • Take relevant histories • Educate patient and partner regarding the e ects of therapy • Communicate with both patient and partner Patient • Visit doctor regularly • Provide a history • Adapt sexual activities • dopt a healthy lifestyle • Use relaxation techniques to alleviate stress • Take medication • Participate in education programmes • Communicate with partner and physician • Take part in activities as a couple Partner • Engage with therapy • Accompany partner to the clinic • Provide an individual history • Help with treatment selection and counselling • Participate in education programmes • Assist at home with healthy lifestyle and medication • Adapt sexual activities • Communicate with partner and physician • Take part in activities as a couple Nat Rev Urol. 2016;13(3):168–177
of testosterone versus comparator on satisfying sexual events, by menopausal status Data are change in number of satisfactory sexual events per month. Grey square indicates the weight of the study. Black diamond represents the mean difference per study and white diamond the mean difference overall. Horizontal lines depict the 95% CI. Vertical dotted line shows overall mean difference. Weight (%) Mean difference (95% CI) Comparator Patients (n) Surgical menopausal women Braunstein et al (2005)17 Buster et al (2005)18 Davis et al (2006)28 Davis et al (2008)8 Simon et al (2005)54 Subtotal (I2=34·6%, p=0·191) Estimated prediction interval Natural menopausal women Davis et al (2008)8 Panay et al (2010)50 Shifren et al (2006)53 Unpublished trial 20020057 Subtotal (I2=44·1%, p=0·147) Estimated prediction interval Overall (I2=58·1%, p=0·014) Estimated prediction interval 119 255 39 69 273 755 196 142 269 186 793 1548 Mean (SD) Testosterone Patients (n) 110 258 37 65 276 746 189 130 270 355 944 1690 Mean (SD) 0·23 (1·31) 0·73 (3·99) 0·28 (0·94) 1·48 (3·57) 0·98 (4·13) ·· 0·49 (2·94) 0·53 (3·10) 0·54 (3·44) 0·83 (3·55) ·· ·· 0·51 (1·47) 1·56 (4·66) 0·77 (0·91) 2·51 (5·08) 2·13 (3·99) ·· 1·97 (3·71) 1·69 (3·88) 1·92 (4·27) 1·30 (4·15) ·· ·· 0·28 (–0·08 to 0·64) 0·83 (0·08 to 1·58) 0·49 (0·07 to 0·91) 1·03 (–0·46 to 2·52) 1·15 (0·47 to 1·83) 0·60 (0·27 to 0·92) 0·60 (–0·26 to 1·46) 1·48 (0·81 to 2·15) 1·16 (0·32 to 2·00) 1·38 (0·72 to 2·04) 0·47 (–0·20 to 1·14) 1·12 (0·65 to 1·59) 1·12 (–0·59 to 2·83) 0·85 (0·52 to 1·18) 0·85 (–0·10 to 1·80) 16·70 10·00 15·67 3·92 11·04 57·34 11·18 8·84 11·42 11·22 42·66 100·00 –4 2 0 –2 4 Favours comparator Favours testosterone Effect of testosterone versus comparator on satisfying sexual events, by menopausal status
sexual desire, by menopausal status Figure 3: Effect of testosterone versus comparator on sexual desire, by menopausal status Data are change in sexual desire score per month. Grey square indicates the weight of the study. Black diamond represents the standardised mean difference per study and white diamond represents the overall standardised mean difference. Horizontal lines depict the 95% CI. Vertical dotted line shows overall standardised mean difference. Weight (%) Standardised mean difference (95% CI) Comparator Patients (n) Surgical menopausal women Braunstein et al (2005)17 Buster et al (2005)18 Davis et al (2006)23 El-Hage et al (2007)28 Floter et al (2002)30 Shifren et al (2000)52 Simon et al (2005)54 Subtotal (I2=0·0%, p=0·841) Estimated prediction interval Natural menopausal women de Paula et al (2007)25 Panay et al (2010)50 Penteado et al (2008)51 Shifren et al (2006)53 Unpublished trial 20020057 Subtotal (I2=90·4%, p<0·0001) Estimated prediction interval Surgical and natural menopausal women Davis et al (2008)8 Huang et al (2014)38 Lobo et al (2003)45 Subtotal (I2=18·7%, p=0·292) Estimated prediction interval Overall (I2=71·8%, p<0·0001) Estimated prediction interval 119 257 39 18 44 65 269 811 21 142 24 264 183 634 249 13 109 371 1816 Mean (SD) Testosterone Patients (n) 110 252 37 18 44 65 269 795 21 130 27 270 352 800 232 12 107 351 1946 Mean (SD) 8·40 (24) 6·21 (19·9) 5·98 (25) 0·18 (2·17) 3·80 (8·77) 3·55 (2·12) 6·90 (18·7) ·· 1·00 (0·4) 4·56 (15·7) 7·24 (3·64) 4·00 (15·4) 5·45 (16·4) ·· 6·65 (15·5) 0·13 (1·67) 0·30 (1·4) ·· ·· 13·70 (22) 11·40 (19·5) 16·40 (22) 1·41 (2·08) 4·00 (4·91) 4·08 (2·12) 11·90 (18·4) ·· 2·60 (0·5) 12·20 (20·5) 9·04 (2·7) 9·79 (19·4) 10·10 (17·6) ·· 13·60 (20) –0·65 (4·15) 0·80 (1·6) ·· ·· 0·23 (–0·03 to 0·49) 0·26 (0·09 to 0·44) 0·44 (–0·01 to 0·90) 0·58 (–0·09 to 1·25) 0·03 (–0·39 to 0·45) 0·25 (–0·10 to 0·60) 0·27 (0·10 to 0·44) 0·26 (0·16 to 0·36) 0·26 (0·13 to 0·39) 3·53 (2·55 to 4·52) 0·42 (0·18 to 0·66) 0·57 (0·01 to 1·13) 0·33 (0·16 to 0·50) 0·27 (0·09 to 0·45) 0·71 (0·30 to 1·11) 0·71 (–0·76 to 2·17) 0·39 (0·21 to 0·57) –0·25 (–1·04 to 0·54) 0·33 (0·06 to 0·60) 0·34 (0·16 to 0·52) 0·34 (–1·17 to 1·85) 0·36 (0·22 to 0·50) 0·36 (–0·12 to 0·84) 8·02 9·51 5·04 3·09 5·52 6·59 9·59 47·36 1·67 8·36 3·92 9·57 9·43 32·96 9·41 2·40 7·87 19·68 100·00 –4 2 0 –2 4 Favours comparator Favours testosterone
sexual desire scores comparing of PDE5is and placebo. Scores are based on the questionnaire applied in each study. Abbreviations: PDE5i, phosphodiesterase type 5 L. Gao et al. / International Journal of Gynecology and Obstetrics xxx (2015) xxx–xxx Int J Gynaecol Obstet. 2016;133(2): PDE5iɺঁੑͷੑػೳোͷޮՌతͳ࣏ྍ๏ͱͳΔՄೳੑ ݚڀશͯTJMEFOBpM
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