43
17
th
Congress of the European Society for Sexual Medicine
Workshops
e
To learn how to diagnose the most important endocrine
diseases involved in the pathogenesis of male and
female sexual dysfunction
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To learn how the correction of the endocrine problem
might improve male and female sexual function
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To learn the possible outcomes of combinations
between endocrine therapy and traditional therapies
used for the treatments of male and female sexual
dysfunction
Summary of contents
Tips and tricks for the everyday clinical practice
Hormone alterations can be involved in determining sexual
dysfunction both in men and women, or they can be the
consequence of sexual problems, often with a bidirectional
interconnection. In particular, the most frequently reported
endocrinopathies in men are hypogonadism, hyperprolacti-
nemia and hypothyroidism whereas hyperthyroidism is less
often associated with sexual dysfunction. Testosterone has
a pivotal role in regulating several aspects of the male se-
xual response, and its deficiency is probably the underlying
cause for a consistent portion of male sexual dysfunctions.
Despite this evidence, the widespread screening for hypog-
onadism in subjects with sexual dysfunction, and the role
of testosterone supplementation as a possible treatment,
still remains questionable. The association between severe
hyperprolactinemia and male reduced sexual desire is well
known. Conversely, the role of prolactin in the pathogenesis
of erectile dysfunction is still conflicting. Obesity and type
2 diabetes mellitus (T2DM) are common metabolic disorders.
Male subjects with sexual dysfunction represent a popula-
tion overloaded with these conditions, which contributes to
increasing the overall high cardiovascular risk as well to the
increased prevalence of hypogonadism. On the contrary,
evidence regarding the association between metabolic di-
seases and female sexual dysfunction are less conclusive,
although most studies documented a higher prevalence of
female sexual dysfunction in diabetic women as compared
to non-diabetic ones. Female sexual function appears to be
more related to psychosociological issues than to the orga-
nic consequence of diabetes. Chronic hyperprolactinemia
is classically associated with hypogonadotropic hypogona-
dism and sexual dysfunction also in females and its suc-
cessful treatment generally normalizes sexual function. In
addition, in females, menopause with a progressive decline
of sex steroid hormones as well as the aging process asso-
ciated with many psychological stressors, modulate vulne-
rability for sexual symptoms (hypoactive sexual desire, re-
duced arousal and lubrication, dyspareunia, orgasmic
dysfunction and lack of satisfaction). Among all these symp
toms the most common one is decreased libido.
WS-05
WORKSHOP
11:00–12:00
Auditorium 12
Title: Infertility and sexuality
Experts: Ates Kadıoglu, Turkey, Natalio Cruz Navarro,
Spain, Johannes Bitzer, Switzerland
Chair: Natalio Cruz Navarro, Spain
Audience:
Workshop designed for physician and psychologist
who deal with sexuality or infertility. Content divided in
2 section according to gender of the patients. The influence
of both sexuality and infertility on the patient and each other
will be addressed.
Aim:
Although a bidirectional link is accepted to exit between
infertility and sexual dysfunction, only 5% of the infertility
cases are caused by sexual dysfunction. While erectile dys-
function and inability to ejaculate are infertility causes of
male origin, vaginismus is only infertility reason originating
from female sexual dysfunction (FSD). However both infer-
tility treatment and the disease itself have a great negative
impact on the sexual life of infertile couples. The causality
relationship of infertility and SD is hypothesized to be de-
pending on the loss of sexual spontaneity, direct linkage of
sex into pregnancy without entertainment, decreased self-
esteem and body image of the individuals. In addition the
inter-relationship problems and the possible negative influ-
ence of hormonal treatment aggravates the sexual dysfunc
tion problem. The aim of this workshop is to increase the
urologists’ awareness about this cause-effect relation and
furthermore prepare our colleagues for the diagnosis and
prevention of this disease.
Learning objectives
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The awareness of the bidirectional link of sexual
dysfunction and infertility
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Assessment and prevention of possible risk factors
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Investigating both male and female aspects of this
phenomena
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Diagnosis and management of sexual dysfunction
in infertile couples
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Update the literature knowledge of the attendees
about the subject
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Application of the obtained skill set to their
clinical practice
Summary of contents
Moderator: Ates Kadıoglu, Turkey
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Male infertility and sexual dysfunction (prevalence,
diagnosis, treatment) / Natalio Cruz Navarro, 25 min
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Female infertility and sexual dysfunction (prevalence,
diagnosis, treatment) / Johannes Bitzer, 25 min
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Questions-Answers, 10 min
