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Lifestyle modifications and pharmacological approaches to improve sexual function and satisfaction in men with spinal cord injury: a narrative review.
Spinal Cord ( IF 2.1 ) Pub Date : 2019-12-19 , DOI: 10.1038/s41393-019-0404-z Chloe A R Lim 1 , Tom E Nightingale 1, 2 , Stacy Elliott 1, 3, 4 , Andrei V Krassioukov 1, 2, 5
Spinal Cord ( IF 2.1 ) Pub Date : 2019-12-19 , DOI: 10.1038/s41393-019-0404-z Chloe A R Lim 1 , Tom E Nightingale 1, 2 , Stacy Elliott 1, 3, 4 , Andrei V Krassioukov 1, 2, 5
Affiliation
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STUDY DESIGN
A narrative review describing various components of sexual dysfunction in men with spinal cord injury (SCI), as well as addressing potential therapeutic approaches.
OBJECTIVES
Restoration of sexual function is considered one of the most important health priorities for individuals with SCI. The purpose of this review is to provide information regarding the factors that are less appreciated when considering changes to sexual function in men with SCI. We also propose therapeutic approaches, with a focus on lifestyle modifications, which have been shown to improve sexual function.
METHODS
A literature search was performed and limited evidence for therapeutic approaches in individuals with SCI was supplemented by consistent findings from the able-bodied population.
RESULTS
We evaluated the less addressed factors known to contribute to sexual dysfunction in men with SCI, including hormonal influences (i.e., testosterone deficiency, thyroid hormone, and cortisol), psychological factors (i.e., pain, fatigue, depression, and body image), and secondary SCI complications (i.e., urinary tract infection, pressure sores, and autonomic dysreflexia). To address these factors beyond standard medical treatments for sexual dysfunction, options include physical activity/exercise, diet, and specific medications for symptom relief (i.e., testosterone replacement therapy and selective serotonin reuptake inhibitors for depression).
CONCLUSIONS
Physical activity's potential application, efficacy across multiple aspects of sexuality, and the lack of side effects, suggests that long-term exercise is a viable solution to directly or indirectly improve sexual function in males with SCI. Diet and supplemental medications may further promote body composition changes, which more broadly affect sexuality.
中文翻译：
改善脊髓损伤男性性功能和满意度的生活方式改变和药理学方法：叙述性回顾。
研究设计 描述脊髓损伤 (SCI) 男性性功能障碍的各种组成部分的叙述性综述，以及潜在的治疗方法。目标 恢复性功能被认为是 SCI 患者最重要的健康优先事项之一。本综述的目的是提供有关在考虑 SCI 男性性功能变化时不太被重视的因素的信息。我们还提出了治疗方法，重点是生活方式的改变，这些方法已被证明可以改善性功能。方法 进行了文献检索，并通过来自健全人群的一致发现补充了 SCI 患者治疗方法的有限证据。结果 我们评估了已知导致 SCI 男性性功能障碍的较少处理因素，包括激素影响（即睾酮缺乏、甲状腺激素和皮质醇）、心理因素（即疼痛、疲劳、抑郁和身体形象）、和继发性 SCI 并发症（即尿路感染、压疮和自主神经反射障碍）。为了解决性功能障碍标准药物治疗之外的这些因素，选择包括体育活动/锻炼、饮食和缓解症状的特定药物（即睾酮替代疗法和抑郁症的选择性血清素再摄取抑制剂）。结论 体育活动的潜在应用、性行为多个方面的功效以及没有副作用，表明长期运动是直接或间接改善 SCI 男性性功能的可行解决方案。饮食和补充药物可能会进一步促进身体成分的变化，从而更广泛地影响性行为。
更新日期：2019-12-20
中文翻译：
改善脊髓损伤男性性功能和满意度的生活方式改变和药理学方法：叙述性回顾。
研究设计 描述脊髓损伤 (SCI) 男性性功能障碍的各种组成部分的叙述性综述，以及潜在的治疗方法。目标 恢复性功能被认为是 SCI 患者最重要的健康优先事项之一。本综述的目的是提供有关在考虑 SCI 男性性功能变化时不太被重视的因素的信息。我们还提出了治疗方法，重点是生活方式的改变，这些方法已被证明可以改善性功能。方法 进行了文献检索，并通过来自健全人群的一致发现补充了 SCI 患者治疗方法的有限证据。结果 我们评估了已知导致 SCI 男性性功能障碍的较少处理因素，包括激素影响（即睾酮缺乏、甲状腺激素和皮质醇）、心理因素（即疼痛、疲劳、抑郁和身体形象）、和继发性 SCI 并发症（即尿路感染、压疮和自主神经反射障碍）。为了解决性功能障碍标准药物治疗之外的这些因素，选择包括体育活动/锻炼、饮食和缓解症状的特定药物（即睾酮替代疗法和抑郁症的选择性血清素再摄取抑制剂）。结论 体育活动的潜在应用、性行为多个方面的功效以及没有副作用，表明长期运动是直接或间接改善 SCI 男性性功能的可行解决方案。饮食和补充药物可能会进一步促进身体成分的变化，从而更广泛地影响性行为。
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