Journey into the Realm of Requests for Help Presented to Sexual Medicine Specialists: Introducing Male Sexual Distress

Abstract

Introduction The recent availability of noninvasive pharmacological remedies for male sexual function triggered an exponential increase in the number of men requesting help in the sexuality area. Aim The Italian Society of Andrology explored requests for help, not included in formerly established clinical categories of sexual medicine. Methods A central board of 67 andrologists identified new areas of requests for help, instrumental for a web-based questionnaire, forwarded to 912 members of the Italian Society of Andrology. Results were submitted to an independent consensus development panel. Main Outcome Measures A questionnaire response rate of 30.8% was considered acceptable according to standard response rates of medical specialist samples. Results The Central Board interaction identified two new domains of requests for help: sexual distress and unconventional requests for pro-erectile medications. Web-based questionnaire results suggested that such domains account for 29% and 9% respectively of all requests for help already presented by male patients at sexual medicine clinics. The Independent Consensus Development Panel issued a final consensus document; herewith, the statement defining male sexual distress: A non-transitory condition and/or feeling of inadequacy such as to impair “sexual health” (WHO working definition). Inadequacy can originate both from physiological modifications of male sexual functions, and from diseases, dysfunctions, dysfunctional symptoms and dysmorphisms, both of andrological and non-andrological origin, which do not relate to “erectile dysfunction” (NIH Consensus Development Panel definition), but that might also induce erectile dysfunction. Sexual Distress can lead to a request for help which needs to be acknowledged. Conclusion The Italian Society of Andrology identified two new areas of requests for help concerning male sexual issues: sexual distress and unconventional requests for pro-erectile medications. These domains, which do not represent new diseases, nonetheless induce the sufferers to seek help and, accordingly, need to be acknowledged.

Recreational Use of Phosphodiesterase Type 5 Inhibitors by Healthy Young Men

“…In line with Pescatori et al. [11], there is a risk among these young men of not being properly acknowledged by the medical community and directing themselves towards persistent, or recurrent, sexual distress, or drug‐abuse.…”

“…In recent years, the use of PDE5i has become more popular among men without ED to improve their sexual performance. This recreational use has been reported by different authors, especially in young men [7–11]. The purpose of our study was to evaluate the recreational use of PDE5i in a population of men between 18 and 30 years of age through a self‐reported anonymous questionnaire.…”

A pilot study to evaluate the effects of vardenafil on sexual distress in men with obesity

“…In such cases, the subjects, not satisfied with the size of their burred penis, or suffering from poor ejaculatory control despite normal erectile functions, may develop a feeling of sexual inadequacy, possibly leading to erectile difficulties. 3 To our knowledge, this is the first study investigating such aspects in healthy obese male subjects. We found that SD in men with obesity is a common and underestimated condition, affecting 40% of subjects investigated by SDEQ-M questionnaire, in the absence of ED or PE.…”

“…2 According to the most recent data in literature, SD may be defined as a reduction/absence of 'sexual health,' which results in a feeling of inadequacy, causing a negative impact on sexual responses, not included in the definition of classical ED or in that of 'unconventional requests.' 3 Inadequacy can originate both from physiological modifications of male sexual functions, or from diseases, that is, dysfunctions, dysfunctional symptoms and dysmorphisms derived from andrological and non-andrological origin, which do not relate to ED (National Institutes of Health Consensus Development Panel definition), but that might also induce ED. Along with requests for situational ED, there are a variety of conditions that do not constitute a classical ED, but may be related with 'inadequate sexual health,' such as the new taxonomy of subclinical ED.…”

Growing Up and Seeking Guidance

“…Sexual distress was associated with depression and inversely associated with better communication of sexual needs. This manuscript goes well beyond reporting the simple prevalence of a sexual dysfunction and sets a new standard for epidemiologic studies in sexual medicine [10–15].…”