{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:07:14Z","timestamp":1790143634085,"version":"4.0.1"},"reference-count":150,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health, \u201cRicerca Corrente\u201d"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sexual dysfunction in neurological disorders varies by condition. For example, erectile dysfunction (ED) and anejaculation are common in spinal cord injury, while Parkinson\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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\u2019 quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sxmrev\/qeaf030","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T07:49:25Z","timestamp":1749800965000},"page":"456-470","source":"Crossref","is-referenced-by-count":15,"title":["Sexual and reproductive health in neurological disorders: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)"],"prefix":"10.1093","volume":"13","author":[{"given":"Stacy","family":"Elliott","sequence":"first","affiliation":[{"name":"BC Center for Sexual Medicine and Sexual Health Rehabilitation Service, Vancouver Coastal Health Authority , Vancouver, BC ,","place":["Canada"]},{"name":"Departments of Psychiatry and Urologic Sciences, Faculty of Medicine, University of British Columbia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika","family":"Birkh\u00e4user","sequence":"additional","affiliation":[{"name":"Department of Neuro-Urology, Balgrist University Hospital, University of Z\u00fcrich , Z\u00fcrich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederique","family":"Courtois","sequence":"additional","affiliation":[{"name":"Department of Sexology, Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al , Montreal, QC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"G\u00fcl","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Selcuk University , Konya ,","place":["Turkey"]},{"name":"Department of Andrology, School of Medicine, Selcuk University , Konya ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Desai Sethi Urology Institute, University of Miami \u2013 Miller School of Medicine , Miami, FL ,","place":["United States"]},{"name":"The Miami Project to Cure Paralysis, University of Miami \u2013 Miller School of Medicine , Miami, FL ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotte","family":"Kiekens","sequence":"additional","affiliation":[{"name":"IRCCS Galeazzi-Sant\u2019Ambrogio Hospital , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Wayne","family":"New","sequence":"additional","affiliation":[{"name":"Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health , Melbourne, VIC ,","place":["Australia"]},{"name":"Rehabilitation and Aged Care Service, Monash Health , Melbourne, VIC ,","place":["Australia"]},{"name":"Department of Epidemiology and Preventative Medicine, School of Public Health & Preventative Medicine, Monash University , Prahran, VIC ,","place":["Australia"]},{"name":"Epworth-Monash Rehabilitation Medicine Unit, Monash University , Melbourne, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana A","family":"Ohl","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Michigan , Ann Arbor, MI ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"Fode","sequence":"additional","affiliation":[{"name":"Department of Urology, Copenhagen University Hospital - 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