Long-Term Effects on Sexual Function of Five Antihypertensive Drugs and Nutritional Hygienic Treatment in Hypertensive Men and Women: Treatment of Mild Hypertension Study (TOMHS)

Sexual dysfunctions have commonly been reported as the resulting side effects of many drugs. To understand the impact of a single drug, the mechanism of action of the most commonly prescribed drugs and the physiological mechanisms of sexual function have to be taken into dual consideration. Psychotropic drugs (Antidepressants, Antipsychotics and Antiepileptic) in particular result in both short and long-term effects on sexual function. Antihypertensive drugs have also produced evidence certifying their role in determining sexual dysfunction. Patients affected with sexual dysfunction are often aged and assume several drugs and, while Iatrogenic sexual dysfunction is prevalent in men, urological drugs are not the only drugs to be held accountable. Many different drugs acting on different sites and with several mechanisms of action can induce sexual dysfunction. The drug classes involved are widely diffused and frequently assumed in combination therapies.

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Glycyrrhizic acid: the assessment of a no effect level

Human & Experimental Toxicology ◽

10.1191/096032700682694251 ◽

2000 ◽

Vol 19 (8) ◽

pp. 434-439 ◽

Cited By ~ 39

Author(s):

C E M van Gelderen ◽

J A Bijlsma ◽

W van Dokkum ◽

T J F Savelkoull

Keyword(s):

Body Weight ◽

Pilot Study ◽

Glycyrrhizic Acid ◽

Mild Hypertension ◽

Daily Intake ◽

Long Term Effects ◽

Healthy Female ◽

The Usa ◽

Effect Level

Because from earlier experiments in rats and a pilot study in humans a no effect level of glycyrrhizic acid could not be established, a second experiment was performed in healthy volunteers. The experiment was performed in females only, because the effects were most marked in females in the pilot study. Doses of 0, 1, 2 and 4 mg glycyrrhizic acid/kg body weight were administered orally for 8 weeks to 39 healthy female volunteers aged 19-40 years. The experimentlasted 12 weeks including an adaptation and a “wash-out” period.Ano-effectlevel of2 mg/kgis proposed from the results ofthis study, from which an acceptable daily intake (ADI) of 0.2 mg/kg body weight can be extrapolated with a safety factor of 10. This means consumption of 12 mg glycyrrhizic acid/day for a person with a body weight of 60 kg. This would be equal to 6 g licorice a day, assuming that licorice contains 0.2% of glycyrrhizic acid. The proposed ADI is below the limit advised by the Dutch Nutrition Council of 200 mg glycyrrhizic acid/day. This reflects the relatively mild acute toxicity of glycyrrhizic acid, which is also emphasised by the “generally recognised as safe” (GRAS) status of glycyrrhizic acid in the USA in 1983. However, the long-term effects of a mild chronic intoxication (causing, for example, a mild hypertension), although not immediately lethal, justify special attention to the amount of glycyrrhizic acid used daily.

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Long-term effects of spinal cord injury on sexual function in men: implications for neuroplasticity

Spinal Cord ◽

10.1038/sj.sc.3101978 ◽

2006 ◽

Vol 45 (5) ◽

pp. 338-348 ◽

Cited By ~ 54

Author(s):

K D Anderson ◽

J F Borisoff ◽

R D Johnson ◽

S A Stiens ◽

S L Elliott

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Sexual Function ◽

Long Term Effects ◽

Cord Injury

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Feasibility of a sexual health program for women receiving pelvic radiation therapy for gynecologic and lower GI cancers.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.7_suppl.135 ◽

2018 ◽

Vol 36 (7_suppl) ◽

pp. 135-135

Author(s):

Lorraine C. Drapek

Keyword(s):

Sexual Health ◽

Sexual Function ◽

Health Survey ◽

Current Evidence ◽

Health Clinic ◽

Long Term Effects ◽

Pelvic Radiation ◽

Vaginal Stenosis ◽

Vaginal Dilators

135 Background: Long term effects of pelvic radiation for women include vaginal stenosis, leading to distress regarding sexual function. The NCCN guidelines recommend asking patients about sexual function at frequent intervals. NCCN recommends the use of vaginal dilators for women who have had pelvic radiation. Vaginal dilators have been widely recommended to minimize these long term effects. However, current evidence demonstrates poor adherence (less than 50%) of vaginal dilator use. Methods: A sexual health clinic was implemented at the radiation oncology department of a large academic medical center. This initiative consisted of three visits with a nurse practitioner over a twelve week period. The first visit was completed prior to the start of radiation, consisted of sexual history, completion of the PROMIS sexual health survey, and education regarding vaginal stenosis. The importance of the use of vaginal dilators following the completion of radiation was emphasized.. The second visit occurred at the completion of radiation and consisted of the PROMIS sexual health survey, and reinforcement of the use of vaginal dilators. Patients were instructed to begin use of vaginal dilators two weeks later. Each patient was given a set of four vaginal dilators, and a vaginal dilator diary. The third visit was completed six to eight weeks post treatment and consisted of completion of the PROMIS sexual health survey, review of the vaginal dilator diary, discussion of patient progress, and reinforcement of education. Results: From August 2016 to September 2017, 38 patients were approached and all completed the first visit (100%). Twenty-three patients completed the second visit (61%). Thirteen patients have completed all three visits (35%). At the end of three visits 11 (85%) of 13 patients were using vaginal dilators, and three had become sexually active. Conclusions: This program demonstrates a high enrollment and completion rate, as well as an important survivorship issue for women undergoing pelvic radiation. The reinforcement of long term effects of radiation enabled patients to understand the importance of using vaginal dilators in to maintain vaginal health and maintain sexual function.

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