Background: Although common repeat number polymorphisms in 3 hormone-related genes (AR, CYP19A1, and ESR2) have been implicated in the variations in several sexually dimorphic phenotypes, their contributions to the variations in gender identity (GI) and sexual orientation (SO) remain to be clarified.
Aim: To clarify the possible association between the repeat number polymorphisms and gender phenotype variations in the general population.
Methods: We used paper-based questionnaires to select 80 individuals with atypical gender phenotypes (the case group) and 114 control individuals (the control group) from 736 university students. The case group was further divided into two subgroups: one consisted of individuals with low GI scores (the atypical GI subgroup), and the other consisted of individuals with non-heterosexual orientation (the atypical SO subgroup). Repeat numbers of the longer and shorter alleles in each participant (Alleles 1 and 2) were examined through microsatellite analysis. Repeat numbers of AR in females were adjusted for the X chromosome inactivation status.
Outcomes: We examined the statistical differences in the repeat numbers between the case and control groups, and between each subgroup and the control group.
Results: The overall differences between the case and control groups and between each subgroup and the control group were small. However, the repeat numbers of AR in males of the case group were larger than those of the control group (P = 0.049), and the repeat numbers of ESR2 Allele 1 were larger in males of the atypical GI subgroup than in those of the control group (P = 0.046). In addition, females in the atypical SO subgroup had smaller repeat numbers of CYP19A1 Allele 2 than control females (P = 0.011).
Clinical implications: These results indicate the complex genetic basis of gender phenotype variations.
Strengths & limitations: This is the first study that addresses the possible association between common polymorphisms in hormone-related genes and gender phenotypes in the general population. Given the small number of our subjects and the modest differences in the repeat numbers between the case and control groups, our results await further validation.
Conclusion: The results indicate that the contribution of repeat number polymorphisms of the 3 genes to gender phenotype variations in the general population is small, although the repeat numbers of AR and ESR2 are potentially associated with atypical gender phenotypes in males.
[This corrects the article DOI: 10.1093/sexmed/qfaf024.].
Background: Sexual distress is a critical element in diagnosing sexual dysfunction. Recent research using a cross-sectional design has supported the adequacy of a transdiagnostic approach for its understanding.
Aim: This exploratory study aimed to investigate the mediating role of repetitive negative thinking between difficulties in emotional regulation and sexual and psychological distress in a community sample.
Methods: We used a quantitative longitudinal design with measures including a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale-Short Form, the Persistent and Intrusive Negative Thoughts Scale, the Sexual Distress Scale-Revised, and the Kessler Psychological Distress Scale.
Outcomes: Data were collected from 64 partnered individuals (85.9% women; age: M = 31.20, SD = 6.46).
Results: Correlational analysis across time revealed significant associations among difficulties in emotion regulation (T1 r = 0.37, T2 r = 0.32), repetitive negative thinking (T1 r = 0.30, T2 r = 0.27), psychological distress (T1 r = 0.37, T2 r = 0.55), and sexual distress (all at P < .01). The total effect of difficulties in emotion regulation on sexual distress was found to be positive (β = 0.20, P = .008) after controlling for frequency of sexual activity (r = -0.25, P < .05). Longitudinal mediation analysis indicated a significant negative indirect effect from difficulties in emotion regulation on sexual distress via repetitive negative thinking (β = -0.04, 95% CI [-0.008, -0.001]), suggesting a buffering effect over time on sexual distress.
Clinical implications: These results highlight the significance of recognizing difficulties in emotion regulation and repetitive negative thinking as coping strategies when examining sexual distress, emphasizing the need to explore the putative efficacy of therapeutic interventions focused on addressing these cognitive processes to decrease adverse sexual-related outcomes.
Strengths and limitations: These findings highlight the importance of acknowledging difficulties in emotion regulation and repetitive negative thinking as coping strategies in the study of sexual distress. However, the small sample size and the predominance of women participants limit generalizability. Further research with clinical samples and more diverse populations is needed to better understand the relevance of these aspects in assessment and therapy.
Conclusions: The findings imply that repetitive negative thinking may have potentially adaptive effects, indicating a nuanced role in coping strategies within the context of the study.
Introduction: Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a condition of persistent or recurrent, unwanted or intrusive sensation of genital arousal that is usually associated with a distressing feeling and has a great impact on patients' daily life. Pelvic floor physical therapy is one of the effective conservative treatment options that deserves increased attention.
Aims: This case report aims to provide a comprehensive pelvic floor physical therapy evaluation and treatment plans for a patient with PGAD/GPD that resulted in a complete resolution of symptoms.
Methods: The patient is a 63-year-old female who suffered from persistent and uncontrolled sexual arousal over 3 months. Despite her efforts, the symptoms gradually worsened and never completely resolved, resulting in significant distress and despair. Her examination findings include myofascial restrictions on superficial pelvic floor structures, hypertonic pelvic floor muscles with trigger points, radiating pain along with genitofemoral nerve innervated areas, and lack of pelvic floor muscle strength and coordination. Physical therapy treatment plan included patient education, manual therapy, muscle strengthening exercises, and home exercise programs.
Results: The patient's symptoms were completely resolved after a total of four pelvic floor physical therapy sessions. Home exercise program was able to maintain satisfactory treatment outcomes 3 months post treatment. No complaints were reported at the 6-month and 1-year follow-ups.
Conclusion: Genitofemoral nerve pathology may be a potential etiology for PGAD/GPD. Pelvic floor physical therapy can an effective medical treatment for PGAD/GPD originating from the pelvic and perineum region. A comprehensive pelvic floor examination and an evidence-based treatment plan will be able to improve symptoms and potentially resolve them completely.
Background: Erectile dysfunction (ED) is a significant health issue affecting the global male population, with a complex and multifaceted etiology. High-fat diet (HFD) is known to impair endothelial function and promote the development of ED. Hinokiflavone (HINO), a naturally occurring biflavonoid, has garnered attention for its notable antioxidant and anti-inflammatory activities, suggesting its potential therapeutic role in treating ED.
Aim: This study aims to investigate the therapeutic effects and underlying mechanisms of HINO in HFD-induced ED.
Methods: Network pharmacology and molecular dynamics simulation were employed to predict relevant targets and analyze their binding kinetics. Rat corpus cavernosum endothelial cells (RCCECs) were treated with palmitic acid in vitro to induce metabolic dysfunction. The ED model was established in vivo by feeding male rats an HFD (60 kcal% fat).
Outcomes: The primary outcomes were the target genes and pathways associated with HINO and the evaluation of its therapeutic potential in HFD-induced ED.
Results: Bioinformatics analyses identified the epidermal growth factor receptor (EGFR) and protein kinase B (Akt) as key molecular targets of HINO. Treatment with HINO promoted RCCEC proliferation, enhanced antioxidant activities, and increased nitric oxide production. The administration of HINO ameliorated erectile dysfunction, improved serum lipid profiles, and reduced oxidative stress in HFD-fed rats. The protective effects of HINO against endothelial dysfunction and impaired cell viability were mediated through modulation of the EGFR/PI3K/Akt/eNOS signaling pathway.
Clinical translation: The results provide a strong rationale for further investigation of HINO as a novel therapeutic agent for ED, with promising implications for future clinical applications.
Strengths and limitations: In this study, we found that HINO could mitigate HFD-induced ED. Limitations of the study include that the alternative mechanisms of HINO were not fully explored in these settings.
Conclusions: Our findings underscore the pharmacological properties of HINO in the management of ED, particularly through the modulation of critical targets such as EGFR.
Background: There is a dearth of data on the impact of residency on resident sexual health. What exists utilizes the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF), which primarily assess function and often refer to sexual activity as penetrative sexual intercourse. This presents a limited view on sexual activity and sexuality.
Aim: The objective of this study was to evaluate the effect of obstetrics and gynecology (OBGYN) residency on resident sexual satisfaction using the gender and relationship neutral New Sexual Satisfaction Scale (NSSS).
Methods: Between July 2022 and August 2023, 137 current US OBGYN residents were recruited and completed questionnaires at three timepoints (baseline, 6 months, and 12 months) assessing their demographic data, city and level of training, work hours, gender identity, sexual orientation, relationship status, and the NSSS.
Outcomes: We hypothesized that OBGYN residents in later years of residency would report lower sexual satisfaction than post graduate year one residents (PGY-1 s) and that sexual satisfaction would decrease later in OBGYN residency due to the cumulative effect of work stress.
Results: There was a significant increase in NSSS total scores from baseline (M = 67.5) to 12 month follow-up (M = 72.1) in all residents. However, when the sample was stratified by year of residency, postgraduate year one residents (PGY-1 s) had a decrease in their NSSS total and subscale scores over time as compared to postgraduate year two residents and above who had an overall increase in their NSSS total and subscale scores over time.
Clinical implications: This data presents evidence to support initiatives by OBGYN residency programs to support sexual health and resilience training and opens avenues for further research into sexual satisfaction in other medical subspecialities.
Strengths & limitations: Strengths include utilizing a validated, gender neutral survey. Limitations include small sample size and opt-in study design.
Conclusion: The increase in sexual satisfaction in later years of OBGYN residency may be due to increased resilience over the course of residency. However, the unique stress of the transition from medical school to residency may be highlighted in the decrease in sexual satisfaction scores over time demonstrated in the PGY-1 s.
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