A cross-sectional study was carried out with 288 male blood donors, aged between 40 and 60 years old, with the aim of comparing the prevalence of erectile dysfunction (ED) as defined by the International Index of Erectile Function (IIEF) and that resulting from the simple questioning of the presence of ED. Socio-demographic, clinical, and behavioral factors that are associated with the presence of ED were considered. Erectile dysfunction prevalence in the IIEF was 31.9%, while self-reported ED prevalence was 3.1%. The factors associated to ED, as reported by the IIEF were: professional inactivity, suspected depression and/or anxiety, reduced sexual desired, and self-reported ED.

Background There are only a few studies about the prevalence and correlates of premature ejaculation (PE) among men who have sex with men (MSM). Aim (1) To estimate PE prevalence according to 3 assessment methods: self-reported time from penetration to ejaculation (ejaculation latency time [ELT]); Premature Ejaculation Diagnostic Tool (PEDT); and a direct question about the self-perception of ejaculation as being normal, too early (premature), or retarded. (2) To assess the agreement of the 3 assessment methods and identify factors associated with PE according to each method and their combination. Methods We evaluated data from 226 MSM who participated in a cross-sectional study about sexual behavior among men living in the metropolitan region of São Paulo, Brazil. They responded anonymously to an online survey between May 2019 and March 2020. We calculated the agreement of the 3 assessment methods and their association with other characteristics using logistic regression models. Outcomes Outcomes included the prevalence of PE according to the assessment methods and the association measures (PE vs sociodemographic characteristics and sexual behavior). Results The prevalence of PE among MSM was 21.2% (95% CI, 16.1%-27.1%) according to the PEDT, 17.3% (95% CI, 12.6%-22.8%) per self-report, and 6.2% (95% CI, 3.4%-10.2%) by estimated ELT ≤2 minutes. The agreement among the 3 assessments was fair (kappa, 0.31; 95% CI, 0.25-0.37; P < .001). Association with PE varied by assessment method: obesity and shorter time for ejaculation with anal sex vs masturbation were associated with PE according to the PEDT and ELT but not self-evaluation. Perception about ideal time to ejaculate ≤5 minutes increased the chance of PE based on ELT. Higher chances of self-reported PE were associated with trying to hold back ejaculation, and lower chances were associated with higher frequencies of masturbation. Clinical Implications Combining tools to investigate PE allows the identification of characteristics associated with this condition and may result in improvement in the care of MSM. Strengths and Limitations This anonymous online survey provided the privacy necessary for participants to respond freely about sensitive questions, with a low risk of social adequacy bias. However, as it was a secondary analysis of a larger study, it could not evaluate comorbidities (eg, erectile dysfunction, prostatitis, depression) and the use of condoms. Conclusion The prevalence of PE among MSM is high and varies according to the instrument used for the assessment, and the agreement among the 3 assessments was only fair.

O período da gestação constitui uma fase de grandes alterações emocionais, fisiológicas e sociais e tem repercussão na expressão da sexualidade da mulher e do casal. A sexualidade é um comportamento que se expressa por sentimentos, pensamentos, estímulos, intimidade e prazeres e, no período da gestação,essas características devem ser ainda mais valorizadas para que o casal possa manter-se em harmonia. Trata-se de um artigo de revisão da literatura, tendo como objetivo avaliar a resposta sexual e o comportamento sexual de mulheres no período gestacional. É relevante também identificar possíveis influências e interferências na manifestação desse comportamento e resposta sexual, como crenças, mitos e a própria relação conjugal. Verificou-se através dos estudos que as modificações fisiológicas, emocionais e comportamentais interferem no desejo, excitação e satisfação sexual, no entanto, se houver diálogo,  afetividade, intimidade emocional e sexual na relação conjugal, essas alterações podem ser melhor superadas nessa fase. Na literatura foi demonstrado que há uma diminuição no desejo e na excitação no primeiro e terceiro trimestres da gestação e que há aumento de desejo e frequência sexual no segundo trimestre devido às alterações fisiológicas inibidoras terem se normalizado e por conta do aumento da autoestima, valorização do corpo e variações hormonais que favorecem esse período. Identificou-se que crenças, mitos e tabus também têm sua parcela nas alterações de desejo e frequência sexual e, de modo geral, o que se evidenciou foi o medo de machucar o feto e/ou a grávida. Estímulos que transpassam os órgãos sexuais se mostraram de grande valia, se tornando necessário explorar novas formas de sentir prazer e adaptar posições sexuais.

Background: Patients may remain dissatisfied after penile prosthesis implantation for the treatment of erectile dysfunction. Studies showing the results of standardized protocols for preoperative psychological evaluation are lacking. Purpose: To estimate the rate of patients considered psychologically unfit for penile prosthesis implantation and to compare their characteristics with those considered fit after the implementation of a standardized psychological profile evaluation protocol for men with erectile dysfunction. Methods: Cross-sectional evaluation of men referred for penile prosthesis implantation by their urologists, based on organic causes for the erectile dysfunction, including a semi-structured (sexual and relational anamnesis of the patient and their partner, information about expectations about the results of the penile prosthesis implantation and possible complications) and a structured instrument including validated tools for the evaluation of depression and/or anxiety symptoms. These were the Self Reporting Questionnaire (SRQ-20), the 36-Item Short-Form Health Survey for quality of life, and the Five-Factor Model (FFM) for behavioral tendencies. After at least 3 interviews, the psychology team rated the patients as fit or unfit for surgery. Unfit patients were those with any of a set of warning signals indicating risk for dissatisfaction even after penile implantation. Main outcome measure: The prevalence of patients considered "unfit for surgery." Results: The quality of life scores were good, but 27.6% of patients (95% confidence interval, CI: 16.7e40.9%) were unfit for surgery. Being unfit was associated with obesity (P ¼ .027), anxiety and/or depression symptoms (P < .001) and high levels of neuroticism (P ¼ .001). Conclusion: The preoperative evaluation protocol combining standardized and validated tools shows that more than one-quarter of patients with a medical indication for penile prosthesis implantation were not in good psychological conditions for the surgery. The development of psychological evaluation protocols can help identify patients in need of adequate care before penile implantation. M de Mello Ferreira dos Reis, EA Corrêa Barros, M Pollone, et al. Preoperative Psychological Evaluation for Patients Referred for Penile Prosthesis Implantation. Sex Med 2020; XX:XXXeXXX.

Perceptions about penis size among supposedly healthy 40 to 60-year-old Brazilian men: a cross-sectional pilot study Percepções ABSTRACTCONTEXT AND OBJECTIVE: Many men seek medical treatments complaining that their penises are too small (short) when in fact they are not (they are not cases of micropenis). The objective of the present study was to evaluate men's satisfaction with their own bodies and sex life and the prevalence of erectile dysfunction, among men who were not seeking medical or psychological advice. DESIGN AND SETTING: Cross-sectional study in a private, philanthropic hospital in São Paulo, Brazil. METHODS:In this study, 300 male blood donors aged between 40 and 60 years old answered a questionnaire, in privacy, about their sex life and their satisfaction with their own bodies. They were also screened for erectile dysfunction by means of the International Index of Erectile Function questionnaire. RESULTS: Seven men (2.3%) reported that they were dissatisfied with their penis size (they thought that it was small), and among these, one was found to have mild erectile dysfunction. However, none of them had sought medical attention. Among these seven, only two had normal body mass index; the other five were overweight (three) or obese (two