Michael H Berger1, Marisa Messore2, Alexander W Pastuszak3, Ranjith Ramasamy4. 1. Department of Urology, University of Miami-Miller School of Medicine, Miami, FL, USA. 2. Center for Women's Sexual Health and Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA. 3. Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA; Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. 4. Department of Urology, University of Miami-Miller School of Medicine, Miami, FL, USA. Electronic address: Ramasamy@miami.edu.
Abstract
INTRODUCTION: The relation between infertility and sexual dysfunction can be reciprocal. Causes of sexual dysfunction that affect fertility include erectile dysfunction, Peyronie's disease (abnormal penile curvature), low libido, ejaculatory disorders in men, and genito-pelvic pain/penetration disorder (GPPPD) and low sexual desire in women. AIM: To review the association between infertility and sexual dysfunction and discuss current management strategies to address sexual disorders in couples with infertility. METHODS: Peer-reviewed publications from PubMed published from 1980 through February 2016 were identified that related to sexual dysfunction and infertility in men and women. MAIN OUTCOME MEASURES: Pathophysiology and management approach of erectile dysfunction, Peyronie's disease, low libido, ejaculatory disorders in men, and GPPPD and low sexual desire in women and how each etiology contributes to sexual dysfunction and infertility in the couple. RESULTS: Treating the infertile couple with sexual dysfunction involves addressing underlying conditions such as psychogenic erectile dysfunction, low testosterone, Peyronie's disease in men, and GPPPD and low sexual desire in women. Psychogenic erectile dysfunction can be successfully treated with phosphodiesterase inhibitors. Low testosterone is often identified in men with infertility, but testosterone therapy is contraindicated in men attempting conception. Men with Peyronie's disease have a new treatment option to address their penile curvature-collagenase Clostridium histolyticum injection directly into the penile plaque. GPPPD is a broad disorder that includes vulvodynia and vaginismus and can be treated with topical lubricants and moisturizers. We must address psychosocial factors in women with low sexual desire. Flibanserin and transdermal testosterone (off-label) are novel therapies for women with low sexual desire. CONCLUSION: Sexual dysfunction in a couple with infertility is a complex issue. Management of infertility and sexual dysfunction should involve appropriate medical therapy and addressing the psychosocial concerns of the couple.
INTRODUCTION: The relation between infertility and sexual dysfunction can be reciprocal. Causes of sexual dysfunction that affect fertility include erectile dysfunction, Peyronie's disease (abnormal penile curvature), low libido, ejaculatory disorders in men, and genito-pelvic pain/penetration disorder (GPPPD) and low sexual desire in women. AIM: To review the association between infertility and sexual dysfunction and discuss current management strategies to address sexual disorders in couples with infertility. METHODS: Peer-reviewed publications from PubMed published from 1980 through February 2016 were identified that related to sexual dysfunction and infertility in men and women. MAIN OUTCOME MEASURES: Pathophysiology and management approach of erectile dysfunction, Peyronie's disease, low libido, ejaculatory disorders in men, and GPPPD and low sexual desire in women and how each etiology contributes to sexual dysfunction and infertility in the couple. RESULTS: Treating the infertile couple with sexual dysfunction involves addressing underlying conditions such as psychogenic erectile dysfunction, low testosterone, Peyronie's disease in men, and GPPPD and low sexual desire in women. Psychogenic erectile dysfunction can be successfully treated with phosphodiesterase inhibitors. Low testosterone is often identified in men with infertility, but testosterone therapy is contraindicated in men attempting conception. Men with Peyronie's disease have a new treatment option to address their penile curvature-collagenase Clostridium histolyticum injection directly into the penile plaque. GPPPD is a broad disorder that includes vulvodynia and vaginismus and can be treated with topical lubricants and moisturizers. We must address psychosocial factors in women with low sexual desire. Flibanserin and transdermal testosterone (off-label) are novel therapies for women with low sexual desire. CONCLUSION:Sexual dysfunction in a couple with infertility is a complex issue. Management of infertility and sexual dysfunction should involve appropriate medical therapy and addressing the psychosocial concerns of the couple.
Authors: Maria do Carmo B de Souza; Marcia C G Gusmão; Roberto A Antunes; Marcelo M de Souza; Ana L S Rito; Paloma Lira; Ana C A Mancebo; Maria A Tamm; Tatiana R Panaino; Maria J Bahia Journal: JBRA Assist Reprod Date: 2018-03-01
Authors: Edouard G Mills; Lisa Yang; Ali Abbara; Waljit S Dhillo; Alexander N Comninos Journal: Front Endocrinol (Lausanne) Date: 2022-06-09 Impact factor: 6.055