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The aim of this study is to perform a bibliometric and demographic analysis of the 10 most productive researchers over the past 7 years in relation to the selection of key topics in andrology. We conducted a bibliometric analysis in December 2023, using Scopus Researcher Discovery. Seven major andrological topics were identified: erectile dysfunction (T1), premature ejaculation (T2), male infertility (T3), Peyronie’s disease (T4), male hypogonadism (T5), priapism (T6), and low sexual desire (T7). A total of 10 researchers per topic were identified (51 unique authors). Most were urologists (65%) or endocrinologists (23%). Most authors belonged to centers in the USA (35.7%) and Italy (32.9%). The majority of authors were male (77.1%) and over 40 years old (83.3% of authors of known age). The mean (standard deviation (SD)) H-index of the 10 top researchers was 42.6 (24.6), ranging from 6 to 119. Male infertility was the topic with the most articles (1110) written by the top 10 researchers and the most cited (20,585). Erectile dysfunction was the second topic for articles (678) and third for citations after male hypogonadism (6046 vs. 11,384). The mean (SD) impact factor of the journals in which the andrological articles were published varied from 3.5 (0.53) for premature ejaculation to 5.33 (1.85) for hypogonadism.

INTRODUCTION Many elements of life can affect sexual health; thus, healthcare professionals require good knowledge of sexual medicine to encounter patients with these issues. We aimed to study final-year medical and midwifery students' self-reported knowledge of factors associated with sexuality and their knowledge of how to evaluate and treat/counsel patients with sexual problems. In addition, educational interests regarding sexual medicine were assessed. METHODS In a cross-sectional study, a web-based questionnaire was distributed to finalyear medical (n=233) and midwifery (n=131) students graduating between December 2018 and May 2019 in Finland. RESULTS Both student groups self-reported insufficient knowledge of how to consider sexuality in mentally ill patients, how to encounter victims of domestic violence/sexual abuse, and how multiculturalism affects sexuality. In addition, compared to the midwifery students, the medical students were more likely to self-report insufficient knowledge of the basics of sexual pleasure and treating the lack of it (p<0.001), including how to treat sexual problems due to relationship problems (p<0.001) or chronic diseases (p=0.015). Although several educational areas of interest arose, both student groups had two mutual most desirable educational interests: 1) reasons for dyspareunia and its treatment, n=117/233 (50.2%) for medical students, and n=60/131 (45.8%) for midwifery students; and 2) lack of sexual desire and its treatment, n=100/233 (42.9%) for medical students, and n=55/131 (42.0%) for midwifery students. CONCLUSIONS In both student groups, the self-reported knowledge of sexual medicine was insufficient. Thus, more education on sexual medicine should be included in the curricula of medical and midwifery education. [ABSTRACT FROM AUTHOR]

Background: While female urologists are known to publish at less frequency than their male peers, The Journal of Sexual Medicine was reported to have among the highest growth in female authorship from 2002 to 2020 in urology journals. Aim: We sought to assess the frequency of female authorship in sexual medicine journals worldwide and the factors that affect this, including the blinded/unblinded review process. Methods: Eleven sexual medicine journals were assessed for geographic location, peer review method, and SCImago Journal Rank citation index (a metric of citation frequency and prestige). Journals were grouped into top, middle, and bottom quartiles based on metric score. Web of Science was used to access the publications' first, second, last, and corresponding authors from the past 5 years. An internet search or Gender-API.com was used to determine the gender identities of authors. Univariate and multivariable logistic regression models were performed. Outcomes: Outcomes included the likelihood of female authorship (first, second, last, and corresponding) based on journal location and ranking, the clustering of female authors, the journal's peer review process, and the frequency of female editorial board members. Results: Overall, 8938 publications were identified. Women represented 30.7%, 31.3%, 21.3%, and 18.7% of the first, second, last, and corresponding authors, respectively; gender was unable to be assessed for 2.6%, 17.2%, 7.3%, and 2.7%. On univariate analysis, journals from North America, in the top quartile, and with a double-blind review process were more likely to have female authors (P <.001). On multivariate analysis, articles were more likely to have a female first author if they had a double-blind peer review process (odds ratio [OR], 1.20; 95% CI, 1.02-1.40), a female second author (OR, 2.54; 95% CI, 2.26-2.85), or a female corresponding author (OR, 7.80; 95% CI, 6.69-9.10). Clinical Implications: Gender-concordant mentoring and universal double-blind manuscript review processes may minimize the impact of gender bias and increase female authorship rates, in turn producing more diverse research. Strengths and Limitations: This is the first study assessing female authorship in sexual medicine journals. Limitations include not assessing every author listed on articles and being unable to determine gender identities for some authors. Conclusion: Female authorship rates are higher than reported rates of practicing female urologists but still lower than their male peers. Female authors were more likely to be published in journals with double-blind peer review processes and when publishing with additional female authors. [ABSTRACT FROM AUTHOR]

Rafael Mathias Pitta,1 Luana de Lima Queiroga,1 Andressa Cristina Sposato Louzada,1 Raphael Mendes Ritti-Dias,2 Oskar Grau Kaufmann,1 Nelson Wolosker1 1Postgrad Program Health Science, Instituto Israelita de Ensino & Pesquisa, São Paulo, SP, Brazil; 2Postgrad Program Rehabilitation Science, Universidade Nove Julho, São Paulo, SP, BrazilCorrespondence: Rafael Mathias Pitta, Instituto Israelita de Ensino & Pesquisa, Rua Arapá, 131 – ap44, São Paulo, SP, 04363060, Brazil, Tel +5511989193674, Email Prof.rafaelpitta@gmail.comBackground: Erectile dysfunction (ED) is a multifactorial medical disorder often neglected in clinical practice between elderly men, defined as the inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual intercourse and a common clinical entity among men and associated with impaired quality of life and cardiovascular diseases in elderly men. The aim of this study is to evaluate the association between ED and clinical, demographic and behavioral parameters in elderly men.Methods: A total of 2436 males aged 60 years and over who participated in the health screening between January 2008 and December 2018 were included in this study. Laboratory exams, clinical and behavior profiles were analyzed. Logistic regression models were used.Results: Men with ED were older (65.87± 5.49 vs. 63.85± 4.05 years old. p< 0.001), higher prevalence of physical inactivity (23.8 vs. 19%, p = 0.039) and had a higher body mass index (BMI; 28.36± 4.06 vs. 27.72± 3.89 kg/m2. p< 0.001) than men without ED. The multivariate model shown that hypertension (p = 0.001), diabetes mellitus (p< 0.001), lower urinary tract symptoms (LUTS), depressive symptoms (p< 0.001) and age (p< 0.001), were strongly associated with ED.Conclusion: The main risk factors associated with ED in elderly men were hypertension, diabetes mellitus, LUTS, depressive symptoms and age.Keywords: age, elderly, erectile dysfunction, obesity, sexual medicine, ED

Abstract Background No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task. Methods We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH. Results A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH. Conclusion Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH.

Background: Although the use of the Web has brought major advances in every step of the research process, this also comes with several methodological challenges. Aim: The article presents the European Society for Sexual Medicine's position statements on key methodological concerns relative to Web-based research in sexual medicine. Methods: The authors conducted a systematic scoping review of articles using Web-based research methods in sexual medicine. For the creation of the statements, the authors processed the data from the methodology of the studies and formulated the final statements reaching 100% agreement in the group. Outcomes: European Society for Sexual Medicine statements were provided on the following domains: definition of the population of interest, selection of the population of interest, data collection quality, response rate, self-reported questionnaire, consent, and legal obligations. Results: Researchers should justify the relevance of the Internet population to the population of interest; should clearly describe how they identified study participants; should select and employ specific measures to avoid hoax; should explicitly describe the process of calculation of response and completion rates as well as the relative implications; should validate traditional sexual health questionnaires for online and, if possible, multilingual use; should not ignore consent in Web-based research; and need to be knowledgeable of the technical measures and legal obligations to protect anonymity. Implications: Researchers are advised to include trained computer scientists in their group, have a good understanding of their legal obligations as to collecting, storing and disseminating personal data, and design their studies by taking into account the challenges of Web-based research. Strengths and limitations: The heterogeneity of the included studies and methodological low quality of most of them was a limitation, which also shows the importance of this study and the need for guidelines regarding Web-based research. Conclusion: Large uncontrolled samples could be a threat to the quality of the studies and increase bias if researchers are not mindful of the methodological challenges they would need to account for. [ABSTRACT FROM AUTHOR]

Professionals who work in clinical sexology intervene in situations related to mental health, such as sexual dysfunctions and marital conflicts, often with vulnerable populations, e.g., people with chronic illnesses or trans people. In this work, we wanted to understand the perceptions these professionals have about using Internet interventions and how they perceive—based on their COVID-related experience and the reflections it brought about non-face-to-face interventions—the use of online interventions. During the first lockdown due to COVID-19 in Portugal, we used an online survey and collected answers from 39 Portuguese sexual health professionals to open questions about the use of Internet interventions. The data were analyzed following the summative content analysis procedures. Our results showed that sexual health professionals had several difficulties in clinical practice during the lockdown period, such as the perception that sexuality moved to the backseat in people's lives. Even so, they stated that Internet interventions have several advantages, such as easy accessibility and excellent promotion of social justice. However, disadvantages were also pointed out. The current study allowed us to understand clinicians' perception of the impact of the pandemic on sexual healthcare access and brought recommendations for good practice of sexual medicine with e-health. [ABSTRACT FROM AUTHOR]

This has been the case not only regarding ED but also surrounding other male sexual dysfunctions (eg, premature ejaculation[5]) and women's sexual health.[6] Last but not least, pharma have played a major role in supporting national and international scientific societies in the area of sexual medicine. Keywords: industry; sponsor; research; sexual medicine EN industry sponsor research sexual medicine 422 425 4 06/15/23 20230401 NES 230401 Introduction The debate around the role of pharmaceutical industries (hereinafter "pharma") in the field of sexual medicine over the course of my (A.S.) nearly 30 years of clinical and translational research on this amazing topic has been harsh and sometimes unproductive. Google Scholar Crossref Search ADS PubMed WorldCat 2 Salonia A, Rigatti P, Montorsi F. Sildenafil in erectile dysfunction: a critical review. In the specific and relatively narrow context of sexual medicine, pharma have played a primary role throughout the last 50 years, with an incredible peak in the late 1990s and early 21st century in (1) the discovery, development, and implementation of drugs for the treatment of erectile dysfunction (ED) that have drastically revolutionized the field; (2) the way that we treat patients; (3) our way of approaching medicine; and (4) the way in which research, at least clinical research, has been conducted from 1998 onward. [Extracted from the article]

Background Patients are increasingly looking to social media platforms for medical information. Aim In this study we aimed to evaluate the quality of information regarding premature ejaculation (PE) on TikTok. Methods The term "premature ejaculation" was searched on TikTok on a single day in May 2022. Videos were sorted by 3 reviewers as reliable or unreliable based on the accuracy of video content. Relevant user metrics were collected for each video, including the numbers of likes, shares, and followers, and the video length, source of upload, and speaker type. The quality of information was objectified with 2 validated tools, with mean scores obtained from the 3 reviewers, the Patient Education Materials Assessment Tool (PEMAT) and the 5-point modified DISCERN instrument. Outcomes Outcomes were video reliability categorization, video and user metrics as described above, and video quality as quantified by PEMAT and DISCERN scores. Results Eight videos were categorized as reliable and 32 videos were categorized as unreliable. The mean number of "likes" per video was higher in the reliable than in the unreliable group (1238 vs 126, P  < .018). Accounts posting reliable videos had higher mean numbers of followers than those posting unreliable videos (55 050 vs 12 042, P  = .025). The majority of unreliable videos (75%) vs reliable videos (12.5%) were posted by self-identified patients or individual users, whereas 62.5% of reliable videos vs versus 6.3% of unreliable videos were posted by individual physicians or physician groups. Few videos overall mentioned PE definition, indications for PE treatment, types of treatment, or value of psychological intervention (12.5%, 15%, 22.5%, and 5.0% of videos, respectively). Video length and number of shares did not differ between groups. Reliable videos had higher PEMAT (73.0 vs 45.1, P  < .001) and DISCERN (2.7 vs 0, P  < .001.) scores. Clinical implications There exists a critical need for enhanced quality of medical information on social media platforms in hopes of encouraging patients with impaired sexual function to seek appropriate medical care. Strength and limitations Strengths of this study include the objective use of validated quality assessment tools and a focus on TikTok as an emerging social media platform. Limitations include large numbers of excluded videos. Conclusion The quality of available information regarding PE on TikTok is low, with a significant percentage of videos on this topic fraught with inaccuracies. Given TikTok's prominence as a social media platform primarily geared toward younger audiences, we emphasize the need for improvement in the quality of information available regarding PE and its management. [ABSTRACT FROM AUTHOR]

IntroductionIn the USA, transgender women are among the most vulnerable to HIV. In particular, transgender women of colour face high rates of infection and low uptake of important HIV prevention tools, including pre-exposure prophylaxis (PrEP). This paper describes the design, sampling methods, data collection and analyses of the TURNNT ('Trying to Understand Relationships, Networks and Neighbourhoods among Transgender women of colour') study. In collaboration with communities of transgender women of colour, TURNNT aims to explore the complex social and environmental (ie, neighbourhood) structures that affect HIV prevention and other aspects of health in order to identify avenues for intervention.Methods and analysesTURNNT is a prospective cohort study, which will recruit 300 transgender women of colour (150 Black/African American, 100 Latina and 50 Asian/Pacific Islander participants) in New York City. There will be three waves of data collection separated by 6 months. At each wave, participants will provide information on their relationships, social and sexual networks, and neighbourhoods. Global position system technology will be used to generate individual daily path areas in order to estimate neighbourhood-level exposures. Multivariate analyses will be conducted to assess cross-sectional and longitudinal, independent and synergistic associations of personal relationships (notably individual social capital), social and sexual networks, and neighbourhood factors (notably neighbourhood-level social cohesion) with PrEP uptake and discontinuation.Ethics and disseminationThe TURNNT protocol was approved by the Columbia University Institutional Review Board (reference no. AAAS8164). This study will provide novel insights into the relationship, network and neighbourhood factors that influence HIV prevention behaviours among transgender women of colour and facilitate exploration of this population's health and well-being more broadly. Through community-based dissemination events and consultation with policy makers, this foundational work will be used to guide the development and implementation of future interventions with and for transgender women of colour.

Background: No study appraised the knowledge gaps and factors impacting men's sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task. Methods: We searched PubMed and Web of Science (WoS) electronic databases for original articles on men's SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men's experiences of and access to SRH. Results: A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men's SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH. Conclusion: Men's SRH is not sufficiently prioritized. We observed five 'paradoxes': strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men's involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men's involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These 'mismatches' suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men's SRH. [ABSTRACT FROM AUTHOR]

Introduction: Sexual health is an important aspect of quality of life, yet both healthcare professionals and patients might hesitate to bring up the topic during appointments. Our study investigated obstetrician‐gynecologists' (OB/GYNs') self‐reported competences in discussing and treating sexual problems, as well as the barriers to bringing up the subject. An additional aim was to evaluate the need for continuing education in sexual medicine. Material and methods: A web‐based questionnaire was sent to the members of The Finnish Society of Obstetrics and Gynecology (n = 1212). The survey was completed by 328 respondents (275 specialists and 53 OB/GYN residents). Their background information (gender, age, education, occupational status, daily number of patients, and daily number of patients with sexual health issues) was assessed. The questionnaire included four fields: (A) self‐reported competence in discussing and treating patients with sexual problems (three questions), (B) the barriers to bringing up sexual problems with patients (nine questions), (C) the source of education in sexual medicine (two questions), and (D) the need for education in sexual medicine (two questions). Results: Most of the OB/GYNs self‐reported their competence to be good in discussing sexual problems, but poor in treating patients' sexual problems. The male OB/GYNs reported better competence than did the females. Several barriers were identified—most frequently, "shortness of the appointment time" (76%), "lack of knowledge about sexual medicine" (75%), and "lack of experience with sexual medicine" (74%). Older OB/GYNs and male OB/GYNs reported fewer barriers. The majority of the respondents considered their previous education in sexual medicine to be insufficient, especially in medical school (95%), but also in residency (83%), and they reported a need for additional education. Conclusions: Our study indicated several barriers that hindered OB/GYNs from assessing sexual problems during appointments. Although OB/GYNs reported a good competence in discussing sexual problems, they reported a poor competence in treating them. Their previous education in sexual medicine was rated as insufficient, and continuing education was desired. The information provided by our study can be used for improving and organizing education in sexual medicine, which is crucial for diminishing the barriers to discussing and treating sexual problems. [ABSTRACT FROM AUTHOR]

Aim: A course on sexual anamnesis based on peer teaching was developed, piloted, and evaluated at the medical school of the University of Würzburg. The course is part of the expansion of the communication curriculum and in order to close existing gaps in medical education. An implementation of the course in the curriculum is meant to give all students the opportunity to acquire professional skills in this area. Method: The course consists of knowledge transfer, interactive exercises, role plays with structured feedback, and an exchange with practitioners. A standardized online evaluation of the course took place in regard to teaching quality, subjective learning success, and acceptance. The voluntary course was conducted online in the summer semester of 2021 and in person in the winter semester of 2021/22. A total of 68 students participated. The training of the tutors was realized in cooperation with the "Deutsche Aidshilfe" (DAH). Results: The course was successfully conducted online and in person. A total of 60 students participated in the evaluation. More than 80% of the students rated the course as structured. They assessed an adequate mix of knowledge transfer and practical exercises. More than half of the students reported that they were more confident in performing sexual anamnesis after they participated in the course. There was an open exchange among the students. More than 90% of the students found the peer teaching by the tutors helpful. Conclusion: The implementation of the course closes a relevant gap of the curriculum in Würzburg. Sexual anamnesis will be a regular part of the curriculum starting in the winter semester 2022/23. The concept can also be transferred to other universities. [ABSTRACT FROM AUTHOR]

Introduction: Gender medicine is an innovative medical approach that studies how some biological variables are influenced by the male or female sex and gender. This issue is under debate because it characterizes the impact of tailored or individual medicine. In this scenario, the aim of this study is to study the correlation between heavy metal exposure and pathologies of neurodevelopment, according to the sex of newborns. In particular, this is an observational study under the name of the Neurosviluppo Project, involving 217 motherchild couples. Material and methods: The correlation with phenotype small for gestational age and congenital malformations were studied, but above all we focused on the pattern of placental permeability to heavy metals. Results: Our results are specifically related to foetal medicine and investigate the impact of foetal sex in transplacental metal exposure. Our results did not show any significant differences related to foetal sex in terms of congenital malformations or the other variables taken into consideration. However, because these conclusions are the first related to the gender medicine in transplacental foetal medicine, they could be a marked background for further studies. Conclusions: Considering the lack of data in literature regarding foetal sexual medicine and transplacental exposure, these study results are pioneering in terms of sexual foetal medicine. Possibly in the future, studies regarding the correlation between foetal sex and obstetrics outcomes will be performed. [ABSTRACT FROM AUTHOR]

There is overwhelming evidence to suggest that male gender is at a higher risk of developing more severe Covid‐19 disease and thus having poorer clinical outcomes. However, the relationship between testosterone (T) and Covid‐19 remains unclear with both protective and deleterious effects on different aspects of the disease suggested. Here, we review the current epidemiological and biological evidence on the role of testosterone in the process of SARS‐CoV‐2 infection and in mediating Covid‐19 severity, its potential to serve as a biomarker for risk stratification and discuss the possibility of T supplementation as a treatment or preventative therapy for Covid‐19. [ABSTRACT FROM AUTHOR]

Objectives: Physicians and midwives meet patients with sexual health issues regularly; however, they may have limited sexual medicine education. The study's aim was to evaluate the self-reported competence of medical and midwifery students to bring up sexual health issues with their patients and to assess the barriers that hinder these discussions. The need for additional education was also evaluated.Study Design: A web-based questionnaire was sent to the last-year medical and midwifery students graduating between December 2018 and May 2019 in Finland. In total, 233 medical students and 131 midwifery students participated in the study. Three fields were evaluated: the self-reported competence in discussing sexual health issues and treating patients with these issues, the barriers to bringing up sexual problems, and the need for education in sexual medicine.Results: The students self-reported better competence in discussing sexual health issues than in treating patients' sexual problems. For the medical students, the most important barriers hindering bringing up sexual health issues were lack of i) time (89.2 %), ii) experience with sexual medicine (88.1 %), and iii) knowledge (82.1 %). For the midwifery students, the most important barriers were i) lack of experience with sexual medicine (73.3 %), ii) fear of failing to respond to patients' sexual health issues (64.9 %), and iii) lack of knowledge (62.5 %). A higher percentage of the midwifery students (96.2 %) reported an interest in sexual medicine education compared to the medical students (55.4 %) (OR 13.89, 95 % CI 5.32-35.71, P <.001). Majority (76.5 %) of the medical students and almost half (45.0 %) of the midwifery students reported receiving too little sexual medicine education (OR 7.30, 95 % CI 4.00-13.33, P <.001).Conclusions: Both student groups reported several barriers hindering bringing up sexual health issues with their patients and expressed a need for more education, particularly the medical students. [ABSTRACT FROM AUTHOR]

• The Finnish obstetrician-gynecologists in this web-based survey considered that treating sexual problems is important. • Fewer than half of the obstetrician-gynecologists routinely inquired about sexual problems. • Around half of them assessed sexual life satisfaction. • Especially female obstetrician-gynecologists reported that diagnosing sexual problems is difficult. • Routine assessment of sexual problems by obstetrician-gynecologists is yet to be implemented. Female sexual problems are common but are not routinely assessed in obstetrician-gynecologist appointments. Therefore, we evaluated obstetrician-gynecologists' attitudes and practice patterns regarding their patients' sexual problems. A web-based questionnaire was used to collect information from each respondent on gender, age, education, occupational status, and the total number of patients treated per day and sexual issues dealt with per day. This study covered three fields of interest: 1) attitudes toward sexual problems, 2) practice patterns in sexual history-taking, and 3) practice patterns in the treatment of sexual problems. Of the 328 respondents, 299 provided eligible responses (specialists, 83 %, n = 249; residents, 17 %, n = 50). Almost all obstetrician-gynecologists (95 %) considered treating sexual problems as an important health care practice, but only 45 % and 53 % asked about sexual problems and sexual life satisfaction during general medical history-taking, respectively. Most obstetrician-gynecologists (86 %) used open conversation to assess sexual history. Half (52 %) of them reported that diagnosing female sexual problems is difficult, with the female obstetrician-gynecologists (54 %) more likely to report difficulty than the male obstetrician-gynecologists (29 %). Of the obstetrician-gynecologists, 15 % prescribed medications, whereas 58 % prescribed other treatments. A third (34 %) received distinct instructions from their organization for referring patients to continued care. Although almost all obstetrician-gynecologists reported that treating sexual problems is an important health care issue, fewer than half routinely inquired about sexual problems. The practice patterns regarding sexual problems were disorganized. Our results show a need for additional clinical practice guidelines and education in sexual medicine. [ABSTRACT FROM AUTHOR]

Introduction: The Biopsychosocial model (BPS) represents a comprehensive paradigm of consolidated practices. Although it has been outlined as the gold standard in sexology, its implementation is often challenging. The sex-positive approach is a ground-breaking movement that is gaining popularity all over and is focused on the recognition of different sexual expressions as valid, consensual, healthy, and meaningful. However, a pragmatic implementation of this approach is still missing. Methods: A critical review was conducted based on bibliographic research on Medline, PubMed, EBSCO, Cochrane Library, Scopus and Web of Science on relevant articles published from January 2011 to July 2021. Results: A total of 116 papers were included in the following review, indicating an increasing body of research about BPS and sex-positive frameworks during the last 10 years. One of the main limitations in the BPS is the scarce attention paid to socio-cultural factors involved in sexual expressions, such as the role of negative attitudes towards sexuality that may affect health care professionals' work. An application of the sex-positive approach to the BPS model may bring greater attention to the needs, values and desires of the individual, as well as allow a new knowledge and understanding of sexuality within a broader spectrum, including diversities and pleasures. Conclusions: The sex-positive approach represents a viable path that entails the willingness of health care professionals to get involved actively; criticize their personal attitudes, beliefs, and knowledge about sex and work hard to improve their practice in sexology. Policy Implications: A discussion of the possible fruitful integration between the BPS and the sex-positive approach is presented, highlighting practical applications in research, clinical practice, training and sex education and giving possible directions for future studies and policies. [ABSTRACT FROM AUTHOR]

Over the past 30 years, functional magnetic resonance imaging (fMRI) has emerged as a powerful tool to non-invasively study the activity and function of the human brain. But along with the potential of fMRI to shed light on neurological, psychiatric, and psychological processes, there are methodological challenges and criticisms. We herein provide an fMRI primer designed for a diverse audience, from the neuroimaging novice to the experienced user. This primer is structured as follows: Part 1: Overview: "What is fMRI and what can it tell us?." Part 2: Basic fMRI principles: MR physics, the BOLD signal, and components of a typical scan session. Part 3: Basic fMRI experimental design: why timing is critical, and common sources of noise in the signal. Part 4: Basic fMRI analysis methods: software, the 3 stages of data analysis (preprocessing, individual, and group level), and a survey of advanced topics and methods including connectivity, machine learning, and assessing statistical significance. Part 5: Criticism, crises, and opportunities related to power of studies, computing requirements, logistical, and interpretational challenges, and methodological debate (assessing causality, circular correlations, and open science best practices). fMRI has primarily been used in clinical research to elucidate the brain correlates of sexual behavior. The translational potential of the method into clinical practice has not yet been realizedfMRI has primarily been used in clinical research to elucidate the brain correlates of sexual behavior. The translational potential of the method into clinical practice has not yet been realized fMRI is a useful and powerful tool for understanding the brain basis of human sexuality. However, it is also expensive, requires extensive methods expertise, and lacks the precision needed to be immediately translatable to clinical practice. The recency of the method, need for basic research, technical limitations, as well as inherent variability in individuals brain activity also impact the pace at which fMRI for sexual medicine can move from the scanner to the clinic. This primer provides the novice an understanding of the appropriate uses and limitations of fMRI, and for the experienced user, a concise update on current issues and methodological advances. Mills-Finnerty C, Frangos E, Allen K, et al. Functional Magnetic Resonance Imaging Studies in Sexual Medicine: A Primer. J Sex Med 2022;19:1073–1089. [ABSTRACT FROM AUTHOR]

Introduction: The question of whether sexual intercourse can harm athletic performance is a long-debated topic since first sport competitions were invented. Therefore, due to the lack of solid evidence, we aimed to evaluate the effects of sexual intercourse on muscle training performance.Materials and Methods: Physically and sexually active, 50 men (age=29.3±1.14 years) were enrolled in the study. Participants completed three weight training sessions and all sessions were at the same time of the day. The maximum weight was adjusted in the first session. In the second and third sessions, they performed five repetitions of the squat with their maximum weight for each set with a total of five sets after participating in and abstaining from sexual intercourse the night before, respectively. The duration of sexual intercourse was measured with a stopwatch.Results: The mean duration of sex was measured to be 13.8±3.61 min. Furthermore, the mean lifted weight before sex was calculated to be 109.4±11.41 kg and the mean lifted weight after sex was calculated to be 107±11.05 kg. According to obtained data, sexual intercourse has a significant detrimental effect on maximum weight in squat training (p=0001).Conclusion: Results demonstrate that sexual intercourse within 24 hours before exercise have detrimental effect on lower extremity muscle force, which suggests that restricting sexual activity before a short-term activity may be necessary. [ABSTRACT FROM AUTHOR]

Background: In England, voluntary sector specialist (VSS) services are central to supporting victim-survivors of sexual violence (SV). However, empirical evidence is lacking about the scope, range and effectiveness of VSS provision for SV in England., Objectives: To undertake national surveys to map SV VSS service provision and describe arrangements for funding and commissioning., Design: Cross-sectional surveys., Setting: VSS services for SV and commissioners from multiple organisations across England (January-June 2021)., Methods: Senior staff working in VSS services and commissioners from multiple organisations were surveyed electronically. Surveys explored SV service commissioning, funding and delivery, partnerships between organisations, perceived unmet need for services, and views about facilitators and challenges. Data were analysed descriptively to characterise VSS service provision for SV and commissioning across England., Results: 54 responses were received from VSS providers and 34 from commissioners. Data demonstrated a complex and evolving funding and commissioning landscape in which providers typically secured funding from multiple sources, impacting consistency and scope of service provision. It was common for multiple organisations to co-commission services, demonstrating trends towards larger contracts that may disadvantage smaller specialist providers. Numerous examples of partnership working between organisations were identified, although developing partnerships was noted as challenging, particularly between VSS organisations. There was clear evidence of unmet need for services, with some groups of victim-survivors such as those from black and minority ethnic groups, often underserved by specialist services. However, there was also evidence of innovative service development and commissioning approaches to meet the needs of victim-survivors who face challenges accessing services., Conclusions: This study provides novel insights into SV service provision and commissioning in England, including unmet needs among victim-survivors., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Background: Male factor infertility can affect spermatogenesis, sexual desire, and thus the quality of life of couples. The present study was conducted to investigate the relationship between spermogram parameters, and the score of sexual desire in infertile men., Methods: This cross-sectional study was conducted on 315 infertile men referred to the Avicenna Infertility Center of Tehran (March 2022 to March 2023). The participants were selected based on the results of previous spermogram and hormonal tests recorded in their medical records. Eligible men completed the demographic information questionnaire and Hurlbert Index of Sexual Desire. A multivariable linear regression model was used to adjust the effect of variables on Hurlbert's score., Results: There was no significant relationship among sperm parameters (count, morphology, motility, vitality, concentration and DNA Fragmentation Index) and with sexual desire of infertile men. Education level, age of men and their partners, the duration of the marriage and duration of infertility did not have a statistically significant effect on sexual desire. However, economic status had an inverse effect on men's sexual desire, with regression coefficients of 7.37 and 7.78 for medium and low socioeconomic levels compared with high (p<0.05)., Conclusion: Male sexual desire is primarily influenced by social factors rather than organic ones. Further multicentre prospective studies are recommended for more accurate results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Adolescence and young adulthood are critical life stages with varied healthcare needs. Adolescents and young adults (AYAs) are often confronted with challenges in their sexual and reproductive health (SRH) and rights. Uptake of SRH services among AYAs groups remains limited, especially in resource-limited settings. This could be partly attributed to the existing services not catering for the preferences of AYAs. However, there is no systematic evaluation of research to explore the preferences of AYAs for SRH services in Africa. Therefore, the objective of this systematic review is to assess AYAs's preferences for SRH in Africa., Methods and Analysis: The systematic review will follow the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Stated preference studies in the area of SRH services conducted among AYAs will be included. We will search MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Global Health and Google Scholar databases. Two independent researchers will screen the articles, and any disagreement will be handled through discussion with the broader research team. The quality of the included papers will be assessed and reported. The preferences for attributes, the most important and least important attributes and preference heterogeneity will be reported. In addition, the preference research gap across African regions and SRH services among AYAs will be reported., Ethics and Dissemination: Ethical approval is not required for this protocol. The systematic review findings will be published in a peer-reviewed journal and presented at conferences., Prospero Registration Number: CRD42023386944., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The Austrian Society for the Promotion of Sexual Medicine and Sexual Health (Österreichische Gesellschaft zur Förderung der Sexualmedizin und der Sexuellen Gesundheit [ÖGFSSG]) was founded in 2014. This foundation looked back upon the increasing efforts to develop this field of academic knowledge since the middle of the 19th century, in which Viennese medicine played an important role. This article highlights key Viennese players who had a particular interest in sexual medicine from a urological perspective around 1900. They worked in the wider area of several disciplines, striving for specialization in the environment of a rapidly growing metropolis with multiple cultural influences. The scholars presented here as a collection of sources contributed to the upswing in sexual medicine through their work by venturing into an area in which no medical or other discipline had previously been able to claim sovereignty of interpretation., (© 2024. The Author(s).)

Background: Sexual Medicine Society of North America (SMSNA) fellowships offer variable experience in sexual health domains: erectile dysfunction, Peyronie's disease, male infertility, male hypogonadism (low testosterone), reconstruction (including male incontinence), benign prostatic hyperplasia, gender affirmation surgery, sexual mental health, and female sexual dysfunction., Aim: To evaluate baseline and postbootcamp understanding and trust in these domains., Methods: In 2023, 28 of 31 urologists currently enrolled in SMSNA-endorsed fellowships participated in a 3.5-day training bootcamp in Minneapolis, Minnesota. Participants were asked to complete pre- and postbootcamp surveys. The bootcamp curriculum offered American Urological Association guidelines and case-based lectures, hands-on clinical training with cadavers (penile surgery) and models (collagenase training), and interaction with industry., Outcomes: Changes in knowledge, independence, and trust in performing the procedures, as well as billing issues and feedback for future bootcamps., Results: Prebootcamp surveys revealed vastly varied residency experience. Reported time with an expert faculty member was greatest for benign prostatic hyperplasia and least for female sexual dysfunction, gender affirmation surgery, and low testosterone. The lowest prebootcamp confidence in performing surgery independently was for penile grafting procedures and elevating the neurovascular bundle. Postbootcamp results revealed several areas of significant improvement in confidence (P ≤ .03): intralesional injections for Peyronie's disease, manual modeling, penile plication, penile grafting procedures, and elevating the neurovascular bundle. There was a trend for improved confidence with the insertion of inflatable (P = .05) and semirigid (P = .08) penile prostheses. Nonsignificant improvement occurred in artificial urinary sphincter surgery (P = .12). Participants graded the bootcamp very highly and requested that next year's bootcamp have more content on female sexual dysfunction, male incontinence, and low testosterone, as well as more hands-on skills sessions and case-based lecture formats., Clinical Implications: Offering a bootcamp with hands-on instruction could significantly improve urologists' knowledge and confidence., Strengths and Limitations: As the main strength, this study was the first specialized bootcamp for urologists in the subject of men's health, taking into account hands-on and cadaver laboratories, as well as highlighting industrial and pharmaceutical products. The small sample size was the major limitation., Conclusions: Current SMSNA fellows present with varied levels of experience and confidence across sexual health domains. Notable confidence improvements were seen with topics that combined didactic lectures with hands-on trainings., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: This study aims to describe patterns of beliefs about contraceptive-induced infertility and assess their relationship with current contraceptive use, including whether these relationships vary by parity and residence., Design: We use data from Performance Monitoring for Action Ethiopia, a nationally representative, cross-sectional survey of 7491 women, aged 15-49, to assess agreement with the statement 'If I use family planning, I may have trouble getting pregnant next time I want to.' We used multilevel hierarchical models to identify the association between agreement and use of a hormonal method of contraception among 3882 sexually active, fecund women who wish to prevent pregnancy. We include interaction terms for parity and residence., Results: 4 in 10 women disagreed (42.3%) and 2 in 10 strongly disagreed (20.7%) with the statement. Relative to women who strongly disagreed, women who disagreed and women who agreed had significantly lower odds of using a hormonal method of contraception (adjusted OR (aOR) 0.65, 95% CI 0.44 to 0.97 and 0.46, 95% CI 0.46, 95% CI 0.30 to 0.70). The effect of agreeing with the statement was strongest among high parity women (aOR 0.54, 95% CI 0.30 to 0.95). Greater agreement with the statement at the community-level use was associated with a reduction in the odds of using hormonal contraception but only among rural women., Conclusions: Efforts to address concerns around contraceptive-induced fertility impairment through the provision of comprehensive counselling and through community education or mass media campaigns are necessary, particularly among high-parity women and in rural communities. Interventions should acknowledge the possibility of delayed return to fertility for specific methods and attempt to address the root causes of concerns., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Introduction: Sexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan Africa, these services are significantly underused, with 9 out of 10 survivors not seeking care due to a range of psychological, cultural, economic and logistical factors. Thus, there is a strong need for research to improve health service utilisation for survivors of sexual violence., Methods and Analysis: The proposed study seeks to address the underutilization of health services for female survivors of sexual violence using a discrete choice experiment (DCE). The study will be conducted in the greater Masaka region of southwestern Uganda and target adult female survivors of sexual violence. We will first undertake qualitative interviews with 56 survivors of sexual violence to identify the key attributes and levels of the DCE. In order to ensure a sufficiently powered sample, 312 women who meet inclusion criteria will be interviewed. Our primary analysis will employ a mixed (random parameters) logit model. We will also model the role of individual-specific characteristics through latent class models., Ethics and Dissemination: The study protocol was reviewed and approved by the following ethics review boards in Uganda and the USA: the Uganda Virus Research Institute (UVRI), the Uganda National Council for Science and Technology (HS2364ES), Washington University in St Louis and the University of Michigan. Our methods conform to established guidelines for the protection of human subjects involved in research. Our dissemination plan targets a broad audience, ranging from policymakers and government agencies to healthcare providers, academic communities and survivors themselves., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Professionals who work in clinical sexology intervene in situations related to mental health, such as sexual dysfunctions and marital conflicts, often with vulnerable populations, e.g., people with chronic illnesses or trans people. In this work, we wanted to understand the perceptions these professionals have about using Internet interventions and how they perceive—based on their COVID-related experience and the reflections it brought about non-face-to-face interventions—the use of online interventions. During the first lockdown due to COVID-19 in Portugal, we used an online survey and collected answers from 39 Portuguese sexual health professionals to open questions about the use of Internet interventions. The data were analyzed following the summative content analysis procedures. Our results showed that sexual health professionals had several difficulties in clinical practice during the lockdown period, such as the perception that sexuality moved to the backseat in people’s lives. Even so, they stated that Internet interventions have several advantages, such as easy accessibility and excellent promotion of social justice. However, disadvantages were also pointed out. The current study allowed us to understand clinicians’ perception of the impact of the pandemic on sexual healthcare access and brought recommendations for good practice of sexual medicine with e-health.

Objectives: Many chronic diseases and their medications may induce sexual problems. This study aimed to evaluate whether general practitioners (GPs) raise sexual health issues during appointments with patients who have chronic diseases.Study Design: A web-based questionnaire was distributed to a random sample of 1,000 GPs in Finland.Main Outcome Measures: The study aim was to determine GPs' self-reported inquiry into sexual problems with patients who have chronic diseases and GPs' awareness of medications inducing sexual problems.Results: Only 16.2% of the GPs inquired about sexual health issues, typically during appointments dealing with reproductive organs. A majority (66.9%) considered sexual problems to be side-effects of medications, but only 17.9% followed up about them. Compared to male GPs, female GPs were more likely to inquire about gynecologic patients' sexual issues (OR 1.77, 95% CI 1.05-2.99), but less likely to ask about them with urologic (OR 0.56, 95% CI 0.35-0.91) and neurologic patients (OR 0.35, 95% CI 0.17-0.72). The GPs aged 40-49 and 50-65 were more likely than those aged 27-39 to inquire about sexual health issues among patients with cardiovascular (OR 2.87, 95% CI 1.11-7.44, OR 2.89, 95% CI 1.16-7.19) and neurologic (OR 4.63, 95% CI 1.45-14.82, OR 5.68, 95% CI 1.87-17.23) diseases.Conclusions: GPs seldom inquire about sexual problems with patients who have chronic diseases or after prescribing medications for these conditions, which may lead to underdiagnosis and undertreatment of sexual problems. [ABSTRACT FROM AUTHOR]

In ancient Greece, many textbooks were written in order to provide comprehensive, pioneering, and ingenious guides on the philosophy and medical aspects of sexual behaviour. Unfortunately, only fragments of these texts have survived among the treatises from Greek and Roman antiquity. The aim of this study is to examine these texts and understand the triad of the female prostitution-hygiene-medicine in ancient Greek populations. We conduct a thorough study of ancient texts, using PubMed, Google Scholar, and medical libraries of Athens, Greece. Prostitution in ancient Greece symbolized both lust and sexual freedom of women, while at the same time it could signal the relationship of female potency to control men. Most prostitutes served men in need of medical and psychological services. They also addressed issues like physical violence, sexually transmitted infections, post-traumatic stress, and unplanned pregnancies. The contribution of female prostitution in ancient Greece, demonstrates the polysemous development of terms such as sexual pleasure , lust , and eroticism in the medico-philosophical texts of that era.

Introduction Sexual dysfunction is a quite common side effect of antidepressant treatment. Sexual side effects may affect the person’s adherence to treatment, quality of life, and relations. Premature ejaculation is rarely seen as an adverse effect of antidepressant drugs. Objectives We aimed to present a clinical case of a 53-year-old man who developed painful ejaculation with the use of venlafaxine. Methods We made a narrative literature search in Pubmed and Google scholar with the terms of painful ejaculation induced by venlafaxine and antidepressant treatment. Results A 53-year-old man was admitted to the psychiatric outpatient unit with symptoms of anhedonia, decreased sleep, decreased self-esteem for the last month. The patient was diagnosed with depression and he started to take 37,5 mg venlafaxine per day. After one month, when venlafaxine dose was increased to 75mg and the patient started to complain of painful ejaculation. The pain continued from the beginning to the end of the ejaculation. The pain increased more when the venlafaxine dose increased to 150mg per day. The patient was consulted at the urology clinic. The urological examination, laboratory tests (direct microscopic examination of the urethral discharge and urethral culture), and serum prostate-specific antigen levels were normal. No pathology was found in uroflowmetry and ultrasonography of the urinary system. The dose of venlafaxine decreased and the patient started to take 20 mg of fluoxetine per day. His symptoms disappeared after venlafaxine was discontinued. Conclusions To literature, this is the second presentation of painful ejaculation observed during the use of venlafaxine. Disclosure No significant relationships.

Introduction Development of gender identity is a complicated process. During this process it is thought that many factors play a role. Gender dysphoria is a condition where there is a mismatch between the assigned gender at birth and gender identity. Although scarce, literature shows that compared to cisgender individuals, transgender and gender-diverse individuals have higher rates of autism, other neurodevelopmental and psychiatric diagnoses. Objectives To describe posible relations and overlap between gender dysphoria and neurodevelopmental disorders. Methods Literature search in Pubmed and other similar platforms. Articles considered relevant under this theme were included. Results Autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) can compromise health and may be more prevalent amongst individuals with gender dysphoria (GD). Symptoms such as attention difficulties, deficits in communication and social skills, obsessional interests, and stereotyped behaviour can significantly impact assessment of GD and the appropriate clinical care. With some overlapping symptoms, the potential for misdiagnosis is possible. Data about prevalence of this conditions in transgender community is of low quality, but ASD is more prevalent, ranging from 6-26%. Conclusions Studies demosntrate that neurodevelopmental disorders and other psychiatric conditions are more common in transgender and gender-diverse individuals. It is important that future studies focus on exploring the mental health outcomes of neurodevelopmental-trans individuals. Disclosure No significant relationships.

Outside of Europe, Egypt has a longstanding tradition to train doctors in clinical andrology directly after the medical school; hence, andrology is considered as an independent specialization. Keywords: EAA; clinical andrologist; clinical andrology examination; education; andrology schools; ultrasound; genetics; testis; reproduction; sexual medicine; sexology EN EAA clinical andrologist clinical andrology examination education andrology schools ultrasound genetics testis reproduction sexual medicine sexology 97 99 3 11/29/22 20221003 NES 221003 Andrology is a relatively new field encompassing several scientific and clinical backgrounds dealing with male and couple's sexual and reproductive health. The establishment of clinical training programs for physicians who wish to become (sub)specialists in Andrology obtaining the certificate of Clinical Andrologist as a mark of excellence represents one of the principal missions of the EAA. [Extracted from the article]

Despite physicians frequently caring for patients with sexual health issues, only 50% of United States medical schools require formal education in sexual medicine, and there are currently no guidelines pertaining to this with research which found that medical trainees are ill-equipped to provide sexual healthcare. This study aims to identify areas to improve sexual health training in order to increase physician confidence and competence in evaluating and training patients with sexual health problems. A prospective survey was sent via REDCap to medical students (n = 190, 68.6%), residents (n = 75, 27.1%), and fellows (n = 11, 3.9%) via a known listserv. Participants (N = 276, ∼15% response rate) were asked to provide demographic information, whether they received sexual health training during medical school and rate their confidence in addressing patients' sexual health concerns. Medical students and residents currently do not receive sufficient education on sexual health and medicine, particularly in fields outside of OB-GYN and Urology, leaving them underqualified and less confident than needed for adequate patient care. 65.6% of trainees reported receiving formal sexual health education, while 13.9% received informal education, and 20.6% received no education during medical school. Although trainees desire to understand a patients' sexual health (P <.001), only residents in a relevant field (Urology, OB-GYN) felt confident in their ability to assist patients with a sexual health issue (P =.013). All other trainees lacked confidence in attending to sexual health concerns (P <.001), regardless of training level (P >.1). More efforts should be made to integrate sexual health education into medical school curriculum. The strength of this study includes specific evaluation of medical student and resident confidence level with 15 individual sexual health topics. The limitations include that the demographic was regionally confined to the Midwest of the United States and women were more strongly represented among medical students. Due to the lack of standardized education, medical trainees (except for Urology and OB-GYN residents) feel unprepared to treat patients with sexual health issues, and medical schools should make sexual health education mandatory. Beebe S, Payne N, Posid T, et al. The Lack of Sexual Health Education in Medical Training Leaves Students and Residents Feeling Unprepared. J Sex Med 2021;18:1998–2004. [ABSTRACT FROM AUTHOR]