Differences in the Gut Microbiome of Women With and Without Hypoactive Sexual Desire Disorder: Case Control Study

Li, Guanjian; Li, Weiran; Song, Bing; Wang, Chao; Shen, Qunshan; Li, Bo; Tang, Dongdong; Xu, Chuan; Geng, Hao; Gao, Yang; Wang, Guanxiong; Wu, Huan; Zhang, Zhiguo; Xu, Xiaofeng; Zhou, Ping; Wei, Zhaolian; He, Xiaojin; Cao, Yunxia

doi:10.2196/25342

Cited by 9 publications

(2 citation statements)

References 37 publications

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“…Importantly, finasteride withdrawal can also affect the gut microbiota composition in PFS patients [ 11 ] and its experimental model [ 8 ]. Therefore, because (i) sexual dysfunction may be related to alterations in gut microbiota [ 67 , 68 , 69 , 70 ] and (ii) the existence of the well-described gut-brain axis [ 9 , 10 ], observations here obtained may provide an important background to explore, with this experimental model, the protective effect of ALLO on psychiatric and andrological dysfunctions, laying the groundwork for possible therapy in PFS patients.…”

Section: Discussionmentioning

confidence: 99%

Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

et al. 2022

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The treatment with finasteride (i.e., an inhibitor of 5α-reductase) may be associated with different side effects (i.e., depression, anxiety, cognitive impairment and sexual dysfunction) inducing the so-called post finasteride syndrome (PFS). Moreover, previous observations in PFS patients and an experimental model showed alterations in gut microbiota populations, suggesting an inflammatory environment. To confirm this hypothesis, we have explored the effect of chronic treatment with finasteride (i.e., for 20 days) and its withdrawal (i.e., for 1 month) on the levels of steroids, neurotransmitters, pro-inflammatory cytokines and gut permeability markers in the colon of adult male rat. The obtained data demonstrate that the levels of allopregnanolone (ALLO) decreased after finasteride treatment and after its withdrawal. Following the drug suspension, the decrease in ALLO levels correlates with an increase in IL-1β and TNF-α, serotonin and a decrease in dopamine. Importantly, ALLO treatment is able to counteract some of these alterations. The relation between ALLO and GABA-A receptors and/or pregnenolone (ALLO precursor) could be crucial in their mode of action. These observations provide an important background to explore further the protective effect of ALLO in the PFS experimental model and the possibility of its translation into clinical therapy.

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Section: Discussionmentioning

confidence: 99%

Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

et al. 2022

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“…The gut microbiome might also help maintain structural integrity 103 , preserve anatomical function 103 and modulate intestinal permeability 104 , which can influence sexual health. Gut microbial dysbiosis, or an imbalanced microbiome, has been associated with anatomical abnormalities in the anus (anal sphincter hypertonicity, inflammation, anal pain and anal fistulas 103,105 ) and sexual dysfunction 106,107 , which is likely multifactorial but could be due to metabolite dysregulation 102 as well as anatomical dysfunction from pelvic cross-organ sensitization increasing inflammatory-related intestinal permeability 104 .…”

Section: Gut Microbiome and Raimentioning

confidence: 99%

Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus

Dickstein,

Edwards,

Rowan

et al. 2024

Nat Rev Gastroenterol Hepatol

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The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI -encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable. Sections Key points• Receptive anal intercourse (RAI) is common worldwide.• Pleasurable RAI occurs through stimulation of the perianal or anal nerves and prostate or paraurethral glands, inducing vasodilation, erectile tissue engorgement, anopelvic tissue sensitization, and anal sphincter and pelvic muscular contractions.• Patients with a stoma and anorectal stump should be counselled on hygiene and dilator use to minimize infections, maintain anorectal patency, and prevent a permanent stoma, promoting RAI restoration.• Antidiarrhoeals, anti-flatulence medications, fibre supplements, lower residue diet to control regularity, avoiding spicy foods, timing meals, and defecation prior to RAI can help control symptoms and relieve distress.• Survivors of anal, rectal, and colon cancer and patients with gastrointestinal disease should be counselled on problematic RAI due to anal sphincter, neurovasculature, and prostate or paraurethral gland damage resulting in arousal dysfunction, anodyspareunia or orgasm dysfunctions.• Management strategies, including anal dilators for anodyspareunia, anal vibrators for arousal disorders, pelvic floor strengthening for anorgasmia and psychological interventions for decreased desire, should be discussed with patients.Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author selfarchiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Internet-Based Epidemiology

Richiardi,

Pizzi,

Paolotti

et al. 2023

Handbook of Epidemiology

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Differences in the Gut Microbiome of Women With and Without Hypoactive Sexual Desire Disorder: Case Control Study

Cited by 9 publications

References 37 publications

Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

Gut Inflammation Induced by Finasteride Withdrawal: Therapeutic Effect of Allopregnanolone in Adult Male Rats

Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus

Internet-Based Epidemiology

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