Author Interviews, Sexual Health, Urology / 18.05.2017
Flibanserin- Addyi -Improved Sexual Health in Women With Hypoactive Sexual Desire Disorder
MedicalResearch.com Interview with:
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Dr. Krychman[/caption]
Dr. Michael Krychman, MD
Executive Director: The Southern California Center for Sexual Health and Survivorship,
Medical Director: Sexual Medicine at Hoag Hospital Newport Beach CA
Clinical faculty member
University of Southern California
Los Angeles, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This post hoc analysis pooled data from three 24-week, double-blind, placebo-controlled studies (VIOLET, DAISY, and BEGONIA) of flibanserin in premenopausal women with acquired, generalized HSDD5-7. Patients who received flibanserin 100 mg once daily at bedtime (qhs) or placebo were included in the analysis. The Female Sexual Function Index (FSFI) consists of 19 items across 6 domains. Scores range from 2 to 36. Higher scores indicate better sexual functioning. Scores under 26 indicate sexual dysfunction. Analysis of covariance was used to evaluate changes from the first week to week 24 in the FSFI domain and total scores were compared for flibanserin 100 mg qhs versus placebo. For patients who discontinued study participation prior to week 24, the last postbaseline observation was carried forward (LOCF).
Results found that treatment with flibanserin 100 mg qhs produced statistically significant improvement, relative to placebo, on all domains of the FSFI (desire, arousal, lubrication, orgasm, satisfaction and pain) in premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD).
Dr. Krychman[/caption]
Dr. Michael Krychman, MD
Executive Director: The Southern California Center for Sexual Health and Survivorship,
Medical Director: Sexual Medicine at Hoag Hospital Newport Beach CA
Clinical faculty member
University of Southern California
Los Angeles, CA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This post hoc analysis pooled data from three 24-week, double-blind, placebo-controlled studies (VIOLET, DAISY, and BEGONIA) of flibanserin in premenopausal women with acquired, generalized HSDD5-7. Patients who received flibanserin 100 mg once daily at bedtime (qhs) or placebo were included in the analysis. The Female Sexual Function Index (FSFI) consists of 19 items across 6 domains. Scores range from 2 to 36. Higher scores indicate better sexual functioning. Scores under 26 indicate sexual dysfunction. Analysis of covariance was used to evaluate changes from the first week to week 24 in the FSFI domain and total scores were compared for flibanserin 100 mg qhs versus placebo. For patients who discontinued study participation prior to week 24, the last postbaseline observation was carried forward (LOCF).
Results found that treatment with flibanserin 100 mg qhs produced statistically significant improvement, relative to placebo, on all domains of the FSFI (desire, arousal, lubrication, orgasm, satisfaction and pain) in premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD).
Prof. Phil Reed[/caption]
Professor Phil Reed
Department of Psychology
Swansea University
Swansea,U.K
MedicalResearch.com: What is the background for this study? How common is the problem of incontinence in women?
Dr. Reed: Incontinence is an enormous and under-discussed issue for women’s health – it affects around 25% of adult females, and this can rise to 50-60% after childbirth or in those over 60 years old. This condition is affected by many other factors – such as smoking and obesity – and it can be very common for individuals who are living in poor economic circumstances. Many women with continence problems also show signs of depression and anxiety – perhaps not surprisingly – and these factors can reduce their motivation to engage with physiotherapy treatment for incontinence. This is a great pity, because physiotherapy is a very effective treatment for this problem, and it can be safer (and cheaper) than surgery. So finding ways to support women as they undertake physiotherapy is really important for them and to publically health services.
Dr. James M. Smith[/caption]
Dr. James M. Smith Ph.D
Laboratory Branch, Division of HIV/AIDS Prevention
Centers for Disease Control and Prevention
Atlanta, Georgia
MedicalResearch.com: What is the background for this study?
Dr. Smith: Our laboratory has been developing a macaque model for testing drug release, safety and efficacy of intravaginal rings (IVR) for preexposure prophylaxis (PrEP) against HIV for several years. The initial studies involved both matrix rings, where the drug is dispersed in the silicone matrix of the device, and reservoir rings, which are essentially a polymer tube filled with drug. In collaboration with the Oak Crest Institute of Science and Auritec Pharmaceuticals, Inc., we began testing a new type of intravaginal ring, the pod-IVR. In this innovative design the ring itself is a scaffold that contains compressed polymer-coated drug tablets, or pods, within the ring. Each pod is separate, allowing for a customizable release rate for each drug by varying the number and diameter of the drug release ports for each individual pod. The macaque pod-IVR can accommodate up to six pods whereas the human pod-IVR can accommodate up to 10 pods. The IVR design was developed to allow the delivery of drug combinations and for simple, cost-effective manufacturing.
Dr. Reshma Jagsi[/caption]
Reshma Jagsi, MD, DPhil
Department of Radiation Oncology, University of Michigan
Ann Arbor, MI 48109
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Jagsi: There has recently been considerable media attention to certain egregious individual cases of sexual harassment, but it has been less clear whether these cases were isolated and uncommon incidents or whether they are indicative of situations more commonly experienced by academic medical faculty. An excellent survey study had previously documented that 52% of female faculty in 1995 had experienced harassment, but many of those women had attended medical school when women were only a small minority of the medical students (let alone faculty). More recent estimates of faculty experiences are necessary to guide ongoing policies to promote gender equity in an era when nearly half of all medical students are women.
We found that in a modern sample of academic medical faculty, 30% of women and 4% of men had experienced harassment in their careers.
Dr. Charu Kaushic[/caption]
Charu Kaushic. PhD.
Professor
OHTN Applied HIV Research Chair
Department of Pathology and Mol. Medicine
McMaster Immunology Research Center,
McMaster University
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kaushic: Female sex hormones, estradiol and progesterone have been shown to regulate immune responses in many experimental and clinical studies. We and others have shown previously that these hormones also regulate susceptibility to and outcome of sexually transmitted infections (STIs), including Chlamydia, HSV-2, SIV and HIV-1. Most studies show that progesterone generally increases susceptibility while estradiol generally confers protection against STIs. This has recently gained much more widespread attention because of the controversy surrounding use of injectable hormonal contraceptives in geographical areas where there is high prevalence of HIV-1. The most frequently used injectable contraceptive uses a progestin-based formulation which has been correlated with 2-fold increase in HIV acquisition and transmission in epidemiological studies. Oral contraceptives that contain a combination of estradiol and progesterone do not show similar correlation with increased infection. This is currently a very important women’s health issue, which is being carefully monitored by many public health agencies, including WHO. Many researchers are focusing efforts in understanding how sex hormones can increase or decrease susceptibility of women to STIs.
We have published in this area for more than a decade, including a series of papers showing that in a mouse model, the outcome of genital herpes (HSV-2) infection can depend on which hormone we treat the mice with. A few years ago, we showed for the first time that mice that received an HSV-2 vaccine under the influence of estradiol were much better protected and showed less disease pathology (Bhavanam et al, Vaccine 2008). These results were reproduced a year later by another group, using an actual HSV-2 vaccine formulation. Since then, we have been working to understand at a cellular level, the underlying mechanism of estradiol-mediated enhanced protection. In this PLOS Pathogens paper, we report for the first time a cellular mechanism by which estradiol was seen to enhance immune protection against HSV-2 infection in mice.
The main findings are that estradiol primes dendritic cells in the vaginal tract to induce enhanced anti-viral T cell responses. Dendritic cells are key immune cells that decide what type of immune responses will be mounted against an infection. Under the influence of estradiol, the dendritic cells in the vaginal tract of mice induced Th17 cells which in turn helped enhance anti-viral T cell responses (Th1), resulting in better protection against genital HSV-2. This regulation of anti-viral immunity was seen only in the reproductive tract.
Dr. Lee Ellis[/caption]
MedicalResearch.com Interview with:
Lee Ellis PhD
Department of Anthropology
University of Malaya
Kuala Lumpur Malaysia
Medical Research: What is the background for this study? What are the main findings?
Dr. Ellis: Sexual orientation appears to be highly influenced by prenatal neurohormonal factors (as opposed to social experiences throughout life). However, the specifics continue to elude scientific comprehension. Over the past two decades, researchers began to explore the possibility that a putative measure of prenatal testosterone exposure, called the 2D:4D finger length ratio, might be predictive of variations in sexual orientation. The results have been mixed. In the present study, colleagues and I obtained multiple measures of prenatal testosterone exposure (including a 2D:4D measure) from large samples of college students in two countries and factor analyzed these measures. Analyses revealed two apparent prenatal testosterone exposure variables, one largely pertaining to bone growth (that included our 2D:4D measure), and the other mainly pertaining to muscular growth and coordination. It was this second factor, not the first one, that appeared to be mainly responsible for variations in sexual orientation.
Ms. Gemberling[/caption]
MedicalResearch.com Interview with:
Tess M. Gemberling, M.A.
Social Psychology Ph.D. Student
Co-Principal Investigator
University of Alabama
Medical Research: What is the background for this study?
Response: Many stereotypes of BDSM (bondage and discipline [B&D], dominance and submission [D/s], sadomasochism [SM],) that can be seen on websites similar to