Late‐stage clinical development in lower urogenital targets: sexual dysfunction

Azam, Usman

doi:10.1038/sj.bjp.0706638

Cited by 10 publications

(4 citation statements)

References 67 publications

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“…Treatment should include pelvic floor exercises and training, psychology, cognitive therapy, pharmacotherapy and reconstructive or restorative surgery. [97][98][99]…”

Section: Management Of Fsd In Fgmmentioning

confidence: 99%

Female sexual dysfunction in female genital mutilation

Elneil

2016

Trop Doct

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Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring. To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and, on occasion, reconstructive surgery. In many cases the situation is complicated by symptoms of chronic pelvic pain, which can make treatment increasingly difficult as this issue needs a defined multidisciplinary approach for its effective management in its own right.The problems suffered by women with FGM are wholly preventable, as the practice need not happen. The current global momentum to address the social, cultural, economic and medical issues of FGM is being supported by communities, governments, non-governmental agencies (NGOs) and healthcare providers. It is only by working together that the practice can be abolished and women and girls may be free from this practice and its associated consequences.

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“…Treatment should include pelvic floor exercises and training, psychology, cognitive therapy, pharmacotherapy and reconstructive or restorative surgery. [97][98][99]…”

Section: Management Of Fsd In Fgmmentioning

confidence: 99%

Female sexual dysfunction in female genital mutilation

Elneil

2016

Trop Doct

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“…83 Although specific data on these candidate drugs are not available by now, the Pfizer drug (UK 390957; Pfizer Inc., New York, USA) has been described as a rapid-acting serotonin modulator as well as a shortacting SSRI. 84 Novel topical agents Prilocaine-Lidocaine spray. The topical eutectic mixture for PE (Plethora Solutions Holdings PLC, London, UK) is a metered-dose spray of lidocaine and prilocaine under development.…”

Section: On-demand Therapy Of Ssrismentioning

confidence: 99%

Current therapeutic strategies for premature ejaculation and future perspectives

Xin¹,

Zhu²,

Yuan³

et al. 2011

Asian J Androl

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Premature ejaculation (PE) is a common sexual disorder in men that is mediated by disturbances in the peripheral and central nervous systems. Although all pharmaceutical treatments for PE are currently used 'off-label', some novel oral agents and some newer methods of drug administration now provide important relief to PE patients. However, the aetiology of this condition has still not been unified, primarily because of the lack of a standard animal model for basic research and the absence of a widely accepted definition and assessment tool for evidence-based clinical studies in patients with PE. In this review, we focus on the current therapeutic strategies and future treatment perspectives for PE. Ejaculation is a tightly coordinated activity with different ejaculatory organs and a spinal reflex initiated by genital and/or brain stimulation through the peripheral sensory receptors and regions, afferent pathways, the central nervous system ejaculatory centre of the brain (namely, sensory and motor areas located in the para-ventricular nucleus of the hypothalamus and the medial preoptic area). The spinal ejaculatory centre, located at the T 12 -L 1-2 spinal cord level (paragigantocellular), and its efferent pathway modulate the function of the ejaculatory organs. Ejaculation is also mediated by a complex interaction of central serotonergic and dopaminergic neurons with the secondary involvement of cholinergic, adrenergic, oxytocinergic and GABAergic neurons.Ejaculation consists of two main phases, the emission phase and the expulsion phase. The emissions include seminal fluid and secretions of the prostate and bulbourethral glands. In this phase, the contraction of accessory ejaculatory organs induces the accumulation of semen in the posterior urethra. Expansion of the posterior urethra creates a feeling of emission and sensory information that is transmitted to the spine via dorsal nerve sensory pathway and along the spinal cord up to the brain ejaculatory centre during the sexual arousal phase. The expulsion phase consists of the highly regular rhythmic contraction of striated muscles and the relaxation of smooth muscles in the ejaculatory ducts. The ejaculated semen can be divided into a number of components by serial biochemical analysis. 1 These include secretions from the seminal vesicles, prostate and bulbourethral (Cowper's) glands and spermatozoa.

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“…Pfizer and Bristol‐Myers Squibb also have patented agents under development [56]. Although specific data about these compounds are not available at the time of this writing, the Pfizer medication (UK 390957, Pfizer Inc., New York, NY, USA) has been described as a rapid‐acting serotonin modulator, i.e., a short‐acting SSRI [95]. The Bristol‐Myers Squibb drug, BMS‐505130, is a potent and selective SSRI with a short half‐life with potential advantages in the treatment of PE because of the relatively rapid fall in plasma concentrations [96].…”

Section: New Directionsmentioning

confidence: 99%

Premature Ejaculation: Current Medical Treatment and New Directions (CME)

Sadeghi‐Nejad¹,

Watson²

2008

The Journal of Sexual Medicine

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Introduction Premature ejaculation (PE) is the most common form of male sexual dysfunction. Until very recently, scientific investigation of PE has been hampered by a lack of standardized definitions and objective, validated questionnaires. Small numbers of randomized controlled studies evaluating various treatment options have also added to the challenges facing the clinicians who manage PE. Aim This article provides a summary of some of the more relevant the peer-reviewed literature pertaining to the medical therapy of premature ejaculation. Methods A retrospective review of peer reviewed publications relevant to the field of premature ejaculation and related medical therapies. Main Outcome Measures Review of safety and efficacy of various medical therapies for premature ejaculation. Results Selective serotonin release inhibitors have been the most promising agents to date. The on-demand “PRN” use of these agents is more convenient, but its efficacy is less well established. Chronic use of this class of medications has been associated with minor, but bothersome side effects. More recently, concern over the risk of an increased suicide rate in young men upon initiation of SSRIs has dampened enthusiasm. Recent experience with the use of Tramadol raises the hope that this might prove to be an agent as effective as SSRIs with less worrisome risk of side-effects. New trials on novel formulations of topical solutions are currently underway in the United States. Conclusions Interest in medical therapy for PE is rapidly increasing and reflected in a disproportionate number of publications in this field in the past few years. Clinical research in this field is hampered by the complexity, variability among different men and cultures, and subjectivity of PE. Reliable, appropriately controlled and assessed studies are generally lacking and carefully devised, methodically conducted research is much needed.

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Late‐stage clinical development in lower urogenital targets: sexual dysfunction

Cited by 10 publications

References 67 publications

Female sexual dysfunction in female genital mutilation

Female sexual dysfunction in female genital mutilation

Current therapeutic strategies for premature ejaculation and future perspectives

Premature Ejaculation: Current Medical Treatment and New Directions (CME)

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