Recent debates have evolved regarding the classification/conceptualization of compulsive sexual behavior disorder (CSBD). Conclusions regarding an agreed upon CSBD model are hindered by reliance on the latent disease model. Competing biological-based frameworks are moving forward to replace latent disease classification more broadly but have been met with limited success. We suggest that CSBD researchers move towards developing dimensional, transtheoretical, process-based models. We further suggest additional research, particularly mixed methods and longitudinal studies. Finally, we request that federal funding bodies take a more active role in supporting CSBD research.

Although compulsive sexual behavior disorder (CSBD) is a relatively common disorder with an estimated prevalence of at least 3%, clinicians currently have limited evidence and no FDA-approved drugs to guide their treatment of this condition. N-acetylcysteine (NAC), an amino acid that seems to restore extracellular levels of glutamate in the nucleus accumbens, has previously demonstrated efficacy in treating multiple psychiatric disorders, including substance use disorders and putative behavioral addictions. However, no study has assessed the use of NAC (or any other glutamatergic agent, for that matter) in the treatment of CSBD. Here, we present data from a case series of 8 male patients with CSBD treated with NAC in routine clinical practice in a specialty outpatient clinic. Of these 8 patients, all of whom had previously been treated for CSBD with medications, therapy, or both, 5 had marked clinical improvement (>35% improvement on a modified version of Yale-Brown Obsessive Compulsive Scale) on NAC, and 3 showed minimal or no improvement (<15%). These findings suggest that NAC may be a potentially promising, well-tolerated treatment option for patients with CSBD, including those who have failed more traditional therapies.

UNASSIGNED: Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological, and reproductive functions of women.
UNASSIGNED: The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality.
UNASSIGNED: This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls.
UNASSIGNED: Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type 1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%).
UNASSIGNED: FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.

There is a paucity of research on psychosexual outcomes after neo-vaginoplasty in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. We compared anatomical and psychosexual outcomes between women with MRKH syndrome who had undergone vaginoplasty and age-matched, sexually active, childless women. Outcomes were assessed using the female sexual function index (FSFI), World Health Organization Disability Assessment Schedule (WHODAS 2.0), General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire (PHQ-9) tools. Although mean vaginal length was shorter in women with MRKH syndrome than controls (8.6 ± 1.8 cm vs 9.3 ± 2.6 cm), FSFI scores were comparable in both groups (27.8 ± 1.4 vs. 27.3 ± 4.1). Women with MRKH syndrome reported fewer depressive symptoms, and WHODAS 2.0 scores were comparable in both groups (8.9 ± 2.4 vs. 7.8 ± 6.7). Therefore, psychosexual outcomes for women who had undergone neo-vaginoplasty for MRKH syndrome were not different from those of the general population.

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The gut microbiome is receiving considerable attention as a potentially modifiable risk factor and therapeutic target for numerous mental and neurological diseases.
This study aimed to explore and assess the difference in the composition of gut microbes and fecal metabolites between women with hypoactive sexual desire disorder (HSDD) and healthy controls.
We employed an online recruitment method to enroll \"hard-to-reach\" HSDD populations. After a stringent diagnostic and exclusion process based on DSM-IV criteria, fecal samples collected from 24 women with HSDD and 22 age-matched, healthy controls underwent microbiome analysis using 16S ribosomal RNA gene sequencing and metabolome analysis using untargeted liquid chromatography-mass spectrometry.
We found a decreased abundance of Ruminococcaceae and increased abundance of Bifidobacterium and Lactobacillus among women with HSDD. Fecal samples from women with HSDD showed significantly altered metabolic signatures compared with healthy controls. The abundance of Bifidobacterium, Lactobacillus, and several fecal metabolites correlated negatively with the sexual desire score, while the number of Ruminococcaceae correlated positively with the sexual desire score in all subjects.
Our analysis of fecal samples from women with HSDD and healthy controls identified significantly different gut microbes and metabolic signatures. These preliminary findings could be useful for developing strategies to adjust the level of human sexual desire by modifying gut microbiota.
Chinese Clinical Trial Registry ChiCTR1800020321; http://www.chictr.org.cn/showproj.aspx?proj=34267.

UNASSIGNED: This study aimed to identify the unmet sexual health needs of the patients with diabetes seen in a tertiary healthcare facility in Nigeria.
UNASSIGNED: Case-control study design and random sampling method were utilized to recruit type 2 diabetic cases from the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. Female Sexual Function Index (FSFI) and International Index for Erectile Function (IIEF) were used to assess sexual function.
UNASSIGNED: There were 330 subjects with the mean age of 54.9 years. Among females, the FSFI score was lower among cases compared with controls (18.8 vs. 23.1, P < 0.05). Except for sexual interest, mean scores for all other domains of sexual function were also lower among cases (P < 0.05). Among males, there was no significant difference in overall mean IIEF score comparing cases and controls (40.0 vs. 41.7, P > 0.05). However, mean scores for desire and satisfaction was lower among cases compared with controls (P < 0.05). Older age, unmarried status, presence and duration of hypertension were associated with sexual dysfunction among females. The use of supplements was associated with sexual dysfunction among males (P < 0.05).
UNASSIGNED: Sexual dysfunction is common among diabetics with variation in affected domains in both genders in the study setting. These unmet sexual health needs focus to be addressed.

The paper describes three case reports of changes in sexual behavior patterns in male patients who use stimulants (amphetamine and mephedrone). Two of them demonstrate that the consumption of stimulants may lead to hypersexuality and excessive masturbation. Case report three shows that mephedrone use results in such typical stimulant-related subjective effects as the intensification of sensory experiences and sexual arousal. It leads to the loss of interest in sex without mephedrone. In light of the popularity of sex under the influence of drugs, clinicians should be aware of this phenomenon, since it is associated with high-risk sexual behavior. The description of clinical cases on the link between sex and drugs expands our knowledge in this area, leading to more effective treatment interventions.

Patients with rosacea have a higher incidence of depression, embarrassment, social phobia, stress, subjective disease perception and decreased quality of life. Sexual dysfunction is one of the main factors contributing to impaired life quality. The aim of this study is to evaluate the presence of sexual dysfunction in women with rosacea. A prospective case-control study was planned to investigate female sexual dysfunction in patients utilizing the Female Sexual Function Index (FSFI). A total of 85 patients with rosacea and 80 healthy control subjects were included in the study. The total FSFI scores were significantly lower in the rosacea group than in the control group (26.6 vs. 27.6, p < 0.001, respectively). According to the total FSFI scores, 49.4% of the rosacea patients had sexual dysfunction compared with 30.0% of the healthy controls (p = 0.011). The total FSFI scores were negatively correlated with the values of the Dermatologic Life Quality Index (DLQI) (r: -0.251, p = 0.001), disease duration (r: -0.416, p < 0.001), age (r: -0.632, p < 0.001) and body mass index (r: -0.329, p < 0.001). Sexual dysfunction in female rosacea patients was demonstrated in this study. We believe that the recognition of sexual dysfunction in women with rosacea will provide improvements in the life quality of such patients.

The present paper is describing a case of persistent genital arousal disorder that developed to a 55-year-old woman, shortly after the initiation of zolpidem. Persistent genital arousal disorder (PGAD) is a clinical entity that appears with a relatively low frequency in women, and is characterized by persistent or recurrent, unwanted and bothersome feelings of genital arousal, which often do not resolve with orgasm and are not associated with sexual desire (sexual interest, thoughts or fantasies). Women who experience PGAD often have feelings of shame, guilt and distress. Although its exact etiology remains unclear, various etiological factors have been proposed, central or peripheral, which may be psychological, vascular, dietary, pharmacological or neurological. Additionally, its presence has been associated to restless legs syndrome and overactive bladder syndrome. Likewise, multiple therapeutic interventions have been proposed and tried in patients with PGAD, either pharmacological (SSRIs, SNRIs, antiandrogens, benzodiazepines, antipsychotics, anticonvulsive agents) or other (ECT, physiotherapy, psychotherapy, nerve stimulation). Zolpidem is a nonbenzodiazepine indirect GABA A receptor agonist, which has lately been used as a therapeutic agent for PGAD in some cases. Nevertheless, in our patient, receiving zolpidem for insomnia seemed to be timely connected to the onset of PGAD symptomatology. The aim of the present paper is to highlight the need for more research into the possible factors that may contribute to PGAD.