Treating Male Sexual Dysfunction: Which Treatment Comes First?
New Research: Breast Cancer Development in Transsexuals
The question of "which should be first?" in treating male sexual problems was recently discussed by experts in the October 7, 2013 online edition of the Journal of Sexual Medicine.
The discussions addressed the following:
• use of testosterone and/or phosphodiesterase type 5 inhibitors (PDE5s) to treat hypogonadal men with erectile dysfunction (ED)
• treatment of premature ejaculation (PE)
• the roles of counseling and psychotherapy in MSD treatment
Dr. Andrea M. Isidori and Dr. Andrea Lenzi, both of the “Sapienza” University of Rome, covered the first topic, noting that treatment for hypogonadal men with ED depends on the diagnosis itself and the age of the patient.
Younger men might start with testosterone therapy and then add an PDE5 if necessary. Older men might benefit from the reverse: PDE5 first, then testosterone if needed.
Dr. Antonio Aversa, also of the “Sapienza” University of Rome, joined Dr. Lenzi in the discussion of PE. They suggested that clinicians consider both physical and psychological factors before making treatment decisions.
Finally, Dr. Stanley E. Althof of Case Western Reserve University School of Medicine in Florida, USA discussed pharmacotherapy vs. psychotherapy for treating sexual problems. He explained that sometimes a combination treatment is warranted.
Dr. Emmanuele A. Jannini of the University of L’Aquila, who led the discussion, concluded, "Intuition, experience, and available evidence should guide the choice of which treatment to use first. This decision is highly critical in influencing the therapeutic outcome as well as the patient’s and couple’s adherence.”
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2014 Membership Renewal
What is the incidence of breast cancer in transsexuals undergoing cross-sex hormone treatment? Our latest research summary examines this question.
"Breast Cancer Development in Transsexual Subjects Receiving Cross-Sex Hormone Treatment" by Louis J. Gooren MD, PhD; Michael A.A. van Trotsenburg MD, PhD; Erik J. Giltay MD PhD; and Paul J. van Diest MD, PhD was published in the Journal of Sexual Medicine in September.
The researchers examined data from male-to-female and female-to-male populations in the Netherlands. They found that cross-sex hormone treatment did not appear to increase the risk of breast cancer in either group. Incidence rates were similar to those of male breast cancers.
Please click here for more details on this study.
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