Sexual and reproductive health in neurological disorders: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)
Why this work is in the frame
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Bibliographic record
Abstract
INTRODUCTION: Neurological disorders impact both the central and peripheral nervous systems, often leading to sexual dysfunction (SD). These conditions affect not only genital function but also sensory and motor abilities, pain perception, bladder and bowel control, mood, and hormonal balance. Despite the significance of sexual health for overall quality of life, SD in individuals with neurological conditions remains an under addressed issue. OBJECTIVES: This review aims to provide an overview of SD in individuals with neurological disorders, examining underlying neurophysiological mechanisms, the impact of various neurological conditions, and available treatment strategies. The goal is to offer clinically relevant recommendations to healthcare professionals managing SD in these patients. METHODS: A panel of experts reviewed and synthesized the literature on SD in neurological disorders, with an emphasis on randomized controlled trials and high-quality evidence. The review covers central and peripheral neural control of sexual function, SD associated with specific neurological disorders, and diagnostic and treatment approaches. RESULTS: Sexual dysfunction in neurological disorders varies by condition. For example, erectile dysfunction (ED) and anejaculation are common in spinal cord injury, while Parkinson's disease may be associated with hypersexuality and orgasmic disorders. Brain injuries such as traumatic brain injury, stroke, and neurodegenerative diseases can reduce libido and satisfaction, and multiple sclerosis is associated with ED and reduced genital arousal. Pharmacological and nonpharmacological interventions, including phosphodiesterase-5 inhibitors, vibratory stimulation, hormonal therapy, pelvic floor therapy, and assistive devices, demonstrate variable efficacy depending on the neurological condition. A multidisciplinary approach, including medical, psychological, and rehabilitative interventions, is crucial for optimizing sexual health in these patients. CONCLUSION: Sexual dysfunction is a prevalent consequence of neurological disorders. Proper assessment, should include a sexual history and neurological examination with specific attention to genital sensation and reflex testing. Effective management requires a holistic, multidisciplinary approach. Addressing sexual health should be a core component of neurological rehabilitation to enhance patients' quality of life.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it