Radical scavenging activity of fruit extracts Tribulus Terrestris with natural antioxidant Ascorbic acid: A comparative study

The main aim of this work was to analyze through a systematic review the ability of Tribulusterrestris to promote the increase of hormonal levels as a mechanism for the relief of menopausal symptoms. The criteria used for the selection were: studies involving menopausal women and use of Tribulusterrestris as a treatment for sexual dysfunction and / or other menopausal symptoms. The survey of literature shows that women who used Tribulusterrestris had drastic improvement in symptoms such as vaginal lubrication, sensation in the genitals during intercourse and other constructive activities. In this study, we have found a significant increase in bioavailable testosterone after the use of the plant extracts which has great potential in the treatment of sexual intercourse and unique symptoms of menopause.

The Attitudes, Perspectives, and Barriers Among Primary Care Physicians Towards Addressing Sexual Health of Perimenopausal-Aged Women

Background/Objective: Menopause is the natural cessation of menstruation that typically occurs in women between ages 45 and 50. Menopause can lead to numerous issues regarding sexual health such as vulvovaginal atrophy, low desire, issues with vaginal lubrication, and an inability to achieve climax. Despite these issues, very few physicians initiate conversations about sexual health. Female patients generally feel uncomfortable bringing up the topic without first being asked by their physicians, so it is imperative to assess the reasons why physicians rarely discuss the topic. Methods: Sixteen semi-structured interviews were conducted with family medicine physician faculty and residents regarding barriers to discussing sexual health with their patients. Interviews were transcribed, reviewed, and coded for common themes. Generalizable categories were identified from these themes. Results: Patient embarrassment and cultural/religious norms were the most stated barriers to discussing sexual health. Adherence to norms and the lack of sexual education among patients were the most stated potential reasons for these barriers. The use of standardized questions and increasing efforts to directly discuss sexual dysfunction were the most stated potential solutions to these barriers. Better medical education regarding female sexual health and developing routines to ask about sexual health were the most stated strategies to help family medicine physicians to better serve this population. Conclusion and Potential Impact: This study established, from a family medicine perspective, the barriers and respective potential solutions towards improving the sexual health of women of menopausal age. Patients with suboptimal sexual health can affect other aspects of their health. If barriers to discussing this topic with patients can be reduced, more sexual dysfunction diagnoses can be made, and family medicine physicians can better guide and treat patients to resolve these issues and improve overall quality of life.

Transcriptome profiling of lncRNA and co-expression network in the vaginal epithelial tissue of women with lubrication disorders

Background Vaginal lubrication is a crucial physiological response that occurs at the beginning of sexual arousal. However, research on lubrication disorders (LD) is still in its infancy, and the role of long non-coding RNAs (lncRNAs) in LD remains unclear. This study aimed to explore the function of lncRNAs in the pathogenesis of vaginal LD. Methods The expression profiles of LD and normal control (NC) lncRNAs were examined using next-generation sequencing (NGS), and eight selected differentially expressed lncRNAs were verified by quantitative real-time PCR. We conducted GO annotation and KEGG pathway enrichment analyses to determine the principal functions of significantly deregulated genes. LncRNA-mRNA co-expression and protein-protein interaction (PPI) networks were constructed and the lncRNA transcription factors (TFs) were predicted. Results From the results, we identified 181,631 lncRNAs and 145,224 mRNAs in vaginal epithelial tissue. Subsequently, our preliminary judgment revealed a total of 499 up-regulated and 337 down-regulated lncRNAs in LD. The top three enriched GO items of the dysregulated lncRNAs included the following significant terms: “contractile fiber part,” “actin filament-based process,” and “contractile fiber”. The most enriched pathways were “cell-extracellular matrix interactions,” “muscle contraction,” “cell-cell communication,” and “cGMP-PKG signaling pathway”. Our results also showed that the lncRNA-mRNA co-expression network was a powerful platform for predicting lncRNA functions. We determined the three hub genes, ADCY5, CXCL12, and NMU, using PPI network construction and analysis. A total of 231 TFs were predicted with RHOXF1, SNAI2, ZNF354C and TBX15 were suspected to be involved in the mechanism of LD. Conclusion In this study, we constructed the lncRNA-mRNA co-expression network, predicted the lncRNA TFs, and comprehensively analyzed lncRNA expression profiles in LD, providing a basis for future studies on LD clinical biomarkers and therapeutic targets. Further research is also needed to fully determine lncRNA’s role in LD development.

Pelvic Radiation Therapy Induced Vaginal Stenosis: A Review of Current Modalities and Recent Treatment Advances

Radiation-induced vaginal stenosis (VS) is a common side effect of pelvic radiotherapy (RT). RT-induced VS may have various negative effects on women’s quality of life, in particular dyspareunia, decreased vaginal lubrication and difficulties in sexual intercourse. This narrative review provides the aspects of RT-induced VS pathogenesis, incidence, evaluation and associated risk factors. Available treatment modalities are discussed in the article, putting the focus on preliminary, although promising, experience in the use of hyaluronic acid and laser therapy in cancer survivors after pelvic RT.

Hydrogen Gas: A Novel Type of Antioxidant in Modulating Sexual Organs Homeostasis

Sex is a science of cutting edge but bathed in mystery. Coitus or sexual intercourse, which is at the core of sexual activities, requires healthy and functioning vessels to supply the pelvic region, thus contributing to clitoris erection and vaginal lubrication in female and penile erection in male. It is well known that nitric oxide (NO) is the main gas mediator of penile and clitoris erection. In addition, the lightest and diffusible gas molecule hydrogen (H2) has been shown to improve erectile dysfunction (ED), testis injuries, sperm motility in male, preserve ovarian function, protect against uterine inflammation, preeclampsia, and breast cancer in female. Mechanistically, H2 has strong abilities to attenuate excessive oxidative stress by selectively reducing cytotoxic oxygen radicals, modulate immunity and inflammation, and inhibit injuries-induced cell death. Therefore, H2 is a novel bioactive gas molecule involved in modulating sexual organs homeostasis.

Relationship of the type of breastfeeding in the sexual function of women

Objective: to relate the type of breastfeeding in the women’s sexual function. Method: a cross-sectional study conducted with 150 women in the postpartum period registered in the Family Health Strategy of a large Brazilian municipality. Two instruments were used: one for characterizing sociodemographic, obstetric and breastfeeding variables, and the Female Sexual Function Index for the sexual function. Descriptive data analysis was performed, comparing the variables of interest using the Analysis of Variance, Brown-Forsythe and Tukey tests. Results: there was statistical significance between the groups that practiced different types of breastfeeding in the vaginal lubrication domain (p = 0.015), with the mothers in mixed or partial breastfeeding presenting a higher score for this domain (3.8). Conclusion: there is a difference in the female sexual function between different types of breastfeeding. Women who presented better vaginal lubrication belonged to the mixed breastfeeding group.

Hypertension and reproductive dysfunction: a possible role of inflammation and inflammation-associated lymphangiogenesis in gonads

Hypertension is one of the most prevalent diseases that leads to end organ damage especially affecting the heart, kidney, brain, and eyes. Numerous studies have evaluated the association between hypertension and impaired sexual health, in both men and women. The detrimental effects of hypertension in men includes erectile dysfunction, decrease in semen volume, sperm count and motility, and abnormal sperm morphology. Similarly, hypertensive females exhibit decreased vaginal lubrication, reduced orgasm, and several complications in pregnancy leading to fetal and maternal morbidity and mortality. The adverse effect of hypertension on male and female fertility is attributed to hormonal imbalance and changes in the gonadal vasculature. However, mechanistic studies investigating the impact of hypertension on gonads in more detail on a molecular basis remain scarce. Hence, the aim of the current review is to address and summarize the effects of hypertension on reproductive health, and highlight the importance of research on the effects of hypertension on gonadal inflammation and lymphatics.

Penile-scrotal flap vaginoplasty versus inverted penile skin flap expanded with spatulated urethra: A multidisciplinary single-centre analysis

This study is aimed to compare outcomes of penile-scrotal flap vaginoplasty to inverted penile skin flap expanded with spatulated urethra as a singlecentre experience. Data regarding vaginoplasty performed between May 2003 and January 2014 were reviewed. Subjects were divided into two groups according to the surgical technique performed: perineal- scrotal flap vaginoplasty (Group A), and inverted penile skin flap expanded with spatulated urethra vaginoplasty (Group B). All patients underwent to psychological analysis before surgery. Functional follow-up was based on a modified validated Female Sexual Function Index. Overall, 67 patients with a mean (SD) age of 34 (±9.38) years underwent to surgery. 41 patients were included into the Group A and 26 into the Group B. Mean operative time among Groups A and B was 316 (±101.65) and 594 (±89.06) minutes, respectively (p<0.0001). Longer postoperative hospitalization was shown in Group B (14 days ± 4,51) than in Group A (10 days ± 2,49); (p<0.0001). Group B patients showed a higher anemization rate requiring blood transfusion (p=0.00014) as well as compressive neuropathy (p=0.038). In addition to this, necrosis of the skin flap was reported in 8 patients of Group B (p<0.0001). Comprehensive functional follow-up data was included; spontaneous vaginal lubrication was not reported in 82.4% of Group A vs 12.5% cases of Group B (p=0.0085). When compared to penile-scrotal flap vaginoplasty, inverted penile skin flap expanded with spatulated urethra technique shows an increased risk of complications with comparable satisfaction rates whereas a higher spontaneous vaginal lubrication is reported. Sexological support is of utmost importance in this setting.

Differences of Sexual Function: A Study in Two Menopause Groups

Menopause is a period where the reproductive cycle has stopped in women and is characterized by a permanent menstrual cessation, due to a decrease in the function of reproductive organs such as the ovaries as a sex steroid hormone (estrogen and progesterone) which plays an important role in the reproductive cycle. The decrease in hormones during menopause causes problems in sexual function such as decreased interest in sexual relations due to vaginal lubrication problems, this can be overcome by doing light physical exercise. Light exercise or physical activity when entering menopause is known to have a positive effect on the quality of life of menopause, including on sexual function. The purpose of this study was to determine differences in sexual function between menopausal women who exercise or do physical activity and who do not exercise. This research method is a conceptual study or literature study from previous research relating to exercise and sexual function at menopause. The results of the study showed that menopausal women who routinely exercise or physical activity, their sexual function is better than those that are not, it is known that menopausal women feel very satisfied with their sexual lives and have no problems during intercourse with their partners. Menopausal women have to exercise regularly, besides consuming healthy foods with balanced nutrition, because the more frequent and regular exercise, the sexual life of menoapause women will be much better.