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The availability of PDE5 inhibitors has significantly altered the way in which erectile dysfunction (ED) is treated. Some major issues have emerged since the advent of PDE5 inhibitor use for ED, especially in relation to recreational use in young, healthy men and the role of confidence in erectile ability.
Counterfeit medicines sold online are a global scourge. Although erectile dysfunction drugs are well known to be heavily counterfeited, illicit vendors are rapidly expanding to other drugs and devices in the sexual health arena. International multidisciplinary cooperation is needed to address key patient safety concerns resulting from such markets.
Finding effective treatment for chronic vulvar pain—vulvodynia—is a challenge. Although two new studies answer critical questions regarding treatment effectiveness for two interventions, both studies found that approximately 40% of women still experience pain during sex (dyspareunia) despite treatment. Is this as good as it gets for these women?
Reasons why men discontinue a medication that successfully addresses their erectile dysfunction have been investigated often. A recent study adds few new reasons for discontinuation, but does report which medical conditions result in men discontinuing due to PDE5 inhibitors not being able to restore their erectile function.
Georgiadis et al. provide a comprehensive description of the available animal and human literature on sexual reward and sexual incentive motivation, highlighting the major points of convergence and divergence across species. They discuss a neural concept of human sexual behavioural control and suggest novel testable hypotheses for future sex research.
In this Review, Kayes and colleagues discuss the aetiology, diagnosis and treatment options for congenital micropenis, acquired micropenis and penile dysmorphic disorder, including both nonsurgical and surgical techniques. They evaluate the role of phalloplasty and penile replacement surgery including transplantation, in this challenging clinical area.
Owing to the expansive nervous components participating in the ejaculation reflex, that multiple neurotransmitters are involved is unsurprising. In this Review, the authors focus on the endocrine control of the ejaculatory reflex and suggest that widely available endocrine therapies might be effective in treating sexual disorders such as premature ejaculation.
Men with erectile dysfunction (ED) that is unresponsive to available oral pharmacotherapy with PDE5 inhibitors represent a significant subgroup of patients with the disorder. Such patients might in the near future benefit from regenerative medicine options that restore tissue integrity and signalling in penis-projecting neurons, penile smooth muscle cells and endothelial cells. In this comprehensive Review, the authors discuss the current cutting-edge research in regenerative medicine for ED and consider the therapeutic potential of these techniques for the future.
Sexual medicine represents one of the newest medical specialties—indeed it has only recently been recognized as a specialty in its own right. Although research in sexual medicine is at the cutting edge of some of the newest techniques, obstacles remain. Here, Cellek and Giraldi discuss the challenges faced by sexual medicine as a field, including funding difficulties, taboos and female sexual dysfunction.
