Gene/Protein Disease Symptom Drug Enzyme Compound
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Our objective was to determine the prevalence of sexual dysfunction among new heterosexual attendees at a central London genitourinary medicine (GUM) clinic. We carried out a cross-sectional study in which patients completed a self-administered questionnaire-the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) and participated in a brief interview during which additional information was sought regarding the patient's sexual history. An overall transformed score of >5 on the GRISS was defined as indicative of overall sexual dysfunction and a score of >5 on any of the subscales as indicative of a specific sexual dysfunction. Twenty-five (24%) men and 10 (9%) women had a GRISS score in keeping with overall sexual dysfunction, the prevalence being significantly lower in women (P=0.01, chi2=6.56, 1df). Sixty-three men (59%) and 63 (60%) women produced scores indicative of significant abnormality on at least one subscale, including, in men: erectile dysfunction 20 (19%), premature ejaculation 23 (22%), and in women: vaginismus 26 (25%) and anorgasmia 23 (22%). Neither an abnormal overall or subscale score on the GRISS was associated with a current STD on KC60 diagnosis or a history of sexual assault for either men or women. There is a substantial prevalence of sexual dysfunction in new heterosexual attendees at our clinic, the service implications of which need to be addressed.
Int J STD AIDS 1997 May
PMID:Prevalence of sexual dysfunction in heterosexual patients attending a central London genitourinary medicine clinic. 917 51

A postal questionnaire survey, enquiring about the provision of psychosexual services, was sent to each GUM clinic in the UK. Of the 246 questionnaires distributed, replies were received from 166 directors responsible for 171 (69.5%) clinics. Of the 140 (84%) who supported the provision of a sexual dysfunction service, 59 (42%) currently provided such a service. Doctors and psychologists were the health care professionals most commonly involved in sexual dysfunction services for patients who were referred both internally and from external sources such as general practice and diabetic clinics. Patients with a variety of dysfunctions were being treated with a broad range of therapies, a reflection probably of the multidisciplinary nature of the team providing the service. However, it appears that junior doctors are not being trained in this field at present.
Int J STD AIDS 1997 Jun
PMID:The provision of psychosexual services by genitourinary medicine physicians in the United Kingdom. 917 53

Sexual functioning is often neglected in the care of HIV-infected patients. Little information exists about the relationship between hormonal factors, psychological factors, medication, HIV disease stage and sexual functioning among persons with HIV disease. In this study, 50 HIV+ men completed the Derogatis Sexual Functioning Inventory (DSFI), and had serum hormonal assays drawn (testosterone, thyroid function test, leuteinizing hormone, prolactin and oestradiol). Although all the subjects reported some degree of sexual dysfunction, persons with symptomatic HIV/AIDS reported more negative mood, lower sexual satisfaction scores and worse body image than persons with asymptomatic HIV. Persons with asymptomatic HIV also tended to have normal testosterone levels compared with persons with symptomatic HIV/AIDS. No relationship was found between medications and low testosterone, although numbers were small. These results suggest that sexual dysfunction is prevalent among persons with HIV disease, is more common as patients become symptomatic and progress to AIDS and that both physiological (low testosterone) and psychological issues play a role.
Int J STD AIDS 1998 Nov
PMID:Sexual functioning in ambulatory men with HIV/AIDS. 986 80

Over 85% of clinical directors of genitourinary (GU) clinics in Britain support the provision of services for patients with sexual dysfunction in their clinics. However only 41% of those who support this provision are able to at present. The major barriers are a lack of resources and a lack of suitable training options for both medical and nursing staff. The Medical Society for the Study of Venereal Diseases (MSSVD) Special Interest Group (SIG) will be running a series of national meetings later this year in order to overcome the latter of these. Those clinics who are providing a service are offering a wider range of treatments than in 1997. As previously noted the services are still predominantly consultant and/or nurse led with junior medical staff having minimal involvement.
Int J STD AIDS 2001 Jun
PMID:The provision of sexual dysfunction services by genitourinary medicine physicians in the UK, 1999. 1136 22

In the current era of effective antiretroviral therapy, sexual dysfunction is being increasingly recognized in HIV-positive individuals. This article reviews the literature about the causes, treatments available and any issues specific to the HIV-positive individual.
Int J STD AIDS 2002 Sep
PMID:Medical management of sexual difficulties in HIV-positive individuals. 1259 Jul 98

Our objective was to determine the relationship between highly active antiretroviral therapy (HAART), serum total oestradiol and sexual dysfunction in HIV-infected men. Sexual difficulties were recorded prospectively in a cohort of HIV-negative (or unknown status) gay/bisexual men (MSM) and a cohort of HIV-infected men. The HIV-infected men were divided into those on and not on HAART and by sexuality. Serum total oestradiol and testosterone levels were evaluated where possible. One hundred HIV-negative MSM and 73 HIV-infected men (88% MSM) were analysed. Low libido and erectile dysfunction (ED) were reported in the control group in 2% and 10% respectively. This compared to a prevalence of 26% for both problems in HIV-infected MSM not taking HAART. In those MSM on HAART reduced libido was noted in 48% and ED in 25%. In the group of men taking HAART the mean oestradiol level was 228 pmol/L and was significantly above normal limits. Low libido and ED are more commonly reported in HIV-infected men compared to gay men of negative or unknown status. HAART is associated with a higher prevalence of lack of sexual desire and raised serum oestradiol levels.
Int J STD AIDS 2004 Apr
PMID:Antiretroviral therapy is associated with sexual dysfunction and with increased serum oestradiol levels in men. 1507 15

Premature ejaculation is a common male sexual dysfunction. Treatment modalities as recommended by the British Association of Sexual Health and HIV include behavioural therapy, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and local anaesthetic creams. We audited the clinical cohort from our dedicated sexual dysfunction clinic to determine the success of prescribed treatment and co-existing prostatitis/male pelvic pain, erectile dysfunction, phosphodiesterase-5 (PDE5) inhibitor use and anxiety. The use of SSRIs was successful in the treatment of premature ejaculation with or without the use of local anaesthetic cream. Co-existing prostatitis/male pelvic pain, erectile dysfunction, PDE5 inhibitor use and anxiety were high.
Int J STD AIDS 2005 Oct
PMID:Pharmacological treatment for premature ejaculation. 1621 22

We present the British Association of Sexual Health and HIV (BASHH) special interest group in sexual dysfunction recommendations for the management of retarded ejaculation. The recommendations outline the physiology, prevalence, definitions, aetiological factors and patient assessment for this sexual problem. We suggest treatment strategies, recommendations for management and an auditable outcome.
Int J STD AIDS 2006 Jan
PMID:Recommendations for the management of retarded ejaculation: BASHH Special Interest Group for Sexual Dysfunction. 1640 71

Women form an increasing proportion of HIV-infected individuals in the developed world. Early data suggest that women with HIV are at particular risk of developing sexual problems. The aim of this study was to describe our anecdotal experience of HIV-infected women and to ascertain their sexual dysfunction, and also to conduct a national survey to evaluate what sexual dysfunction services are provided for women in other UK HIV centres. Retrospective analysis of clinic notes of women attending our HIV clinic and letter surveys of HIV centres in the UK were carried out. About half our cohort reported that they had sexual problems or were not satisfied with sex over the preceding 12 months. Contextual issues seemed to be the commonest cause of these problems. Sixty percent of HIV physicians in the UK rarely/never ask their female HIV patients about sexual functioning. Sexual dysfunction is probably common in HIV-infected women. Most physicians seeing women with HIV in the UK do not ask about sexual functioning. 'Physician coaching' could help to redress this situation, so that at the least the sexual problems could be brought up in discussion.
Int J STD AIDS 2006 Oct
PMID:HIV-associated female sexual dysfunction - clinical experience and literature review. 1705 42

A postal survey was sent out to all members of the British Association for Sexual Health and HIV (BASHH) in September 2005 asking what their educational needs were in the sexual dysfunction (SD) area of their practice. Of a total of 912 members, 340 replied. Two hundred and eighty-seven respondents (87%) expressed an interest in attending masterclasses and indicated the area(s) of SD that should be covered at these events.
Int J STD AIDS 2006 Nov
PMID:Is there demand for a masterclass on sexual dysfunction? 1706 74


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