{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:11:14Z","timestamp":1790392274903,"version":"4.1.0"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on sexual function in patients with adrenal insufficiency are scarce and largely controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate sexual dysfunction in patients with primary and secondary adrenal insufficiency and the effects of switching to once\u2010daily dual\u2010release hydrocortisone on sexual function in outcome assessors blinded, randomized, multicenter, active comparator clinical trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Eighty\u2010nine adrenal insufficiency patients on conventional, multiple daily doses of glucocorticoid replacement, enrolled in the Dual RElease hydrocortisone versus conventionAl glucocorticoid replaceMent in hypocortisolism (DREAM) trial, were randomly assigned to continue their therapy or to switch to an equivalent dose of dual\u2010release hydrocortisone. Sixty\u2010three patients (34 women) consented to sex steroid measurements and questionnaires completion for quality of life (Addison's disease\u2010specific quality\u2010of\u2010life questionnaire) and sexual function evaluation (female sexual function index for women, International Index of Erectile Function\u2010Erectile Function for men) at baseline and 24\u00a0weeks after randomization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, sexual dysfunction was observed in 41% of women and 59% of men with adrenal insufficiency. In both sexes, no associations were found between sexual function and hormone levels, whereas Addison's disease\u2010specific quality\u2010of\u2010life questionnaire total and fatigue domain scores positively correlated with total female sexual function index and International Index of Erectile Function\u2010Erectile Function scores. At 24\u00a0weeks, there was no significant difference either in sexual function or sex steroid levels between study groups. In the dual\u2010release hydrocortisone group, the variation in the female sexual function index desire domain score was positively associated with the change in Addison's disease\u2010specific quality\u2010of\u2010life questionnaire's symptom domain score (<jats:italic>\u03c1<\/jats:italic>\u00a0=\u00a00.478, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Sexual dysfunction is common in adrenal insufficiency patients and is likely explained by multiple factors. dual\u2010release hydrocortisone treatment is not directly associated with sexual function improvement, but an indirect effect mediated by quality\u2010of\u2010life amelioration cannot be excluded.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13635","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T09:13:06Z","timestamp":1711617186000},"page":"302-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Exploring sexual function in adrenal insufficiency: findings from the Dual RElease hydrocortisone versus conventionAl glucocorticoid replaceMent therapy in hypocortisolism (DREAM) trial"],"prefix":"10.1111","volume":"13","author":[{"given":"Valeria","family":"Hasenmajer","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"De Alcubierre","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"},{"name":"Inserm U1052, CNRS UMR5286 Cancer Research Center of Lyon Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Minnetti","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Bonaventura","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Pofi","sequence":"additional","affiliation":[{"name":"Oxford Centre for Diabetes Endocrinology and Metabolism NIHR Oxford Biomedical Research Centre Churchill Hospital University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Simeoli","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia Sezione di Endocrinologia, Universit\u00e0 Federico II di Napoli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Tomaselli","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Sciarra","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Bottillo","sequence":"additional","affiliation":[{"name":"Laboratory of Cutaneous Physiopathology and Integrated Centre for Metabolomics Research San Gallicano Dermatological Institute \u2010 IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Angelini","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Anna","family":"Venneri","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-039X","authenticated-orcid":false,"given":"Emmanuele A.","family":"Jannini","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine Endocrinology and Medical Sexology (ENDOSEX) University of Rome Tor Vergata  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2682-8266","authenticated-orcid":false,"given":"Daniele","family":"Gianfrilli","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-1348","authenticated-orcid":false,"given":"Rosario","family":"Pivonello","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Chirurgia Sezione di Endocrinologia, Universit\u00e0 Federico II di Napoli  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-5417","authenticated-orcid":false,"given":"Andrea M.","family":"Isidori","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine \u201cSapienza\u201d University of Rome  Rome Italy"},{"name":"Centre for Rare Diseases (Endo\u2010ERN accredited) Policlinico Umberto I  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00136\u20107"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath\u20102021\u2010207895"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006\u20100076"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab096"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(14)70142\u20101"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201016\u20100969"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574\u2010020\u20100341\u20100"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30398\u20104"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201008\u20100880"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201022\u20100454"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743\u20106109.2009.01412.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep32550"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12111"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)01349\u20106"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360556"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011\u20100414"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201008\u20100578"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms231911952"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab140"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010\u20100445"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10132767"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009\u20100672"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004\u20101802"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743\u20106109.2012.02673.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011\u20101926"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE\u201014\u20101114"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sxmr.2017.03.006"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/009262300278597"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/00926230590475206"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(97)00238-0"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/bmc.5344"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011\u20101901"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.34296\/01021018"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2006.0052"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12590"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sxmr.2016.03.002"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743\u20106109.2010.01871.x"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.3"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743\u20106109.2010.01778.x"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2015.12.034"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618\u2010023\u201002015\u20105"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2020.1745632"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3494"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618\u2010022\u201001859\u20107"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ucl.2021.06.009"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008\u2010682X.126386"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909303411401"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.5.8494"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007\u20101134"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.85.12.7022"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002\u2010020769"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2022.01.515"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014\u20102260"},{"key":"e_1_2_10_55_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2019\u201001603"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1530\/EC\u201013\u20100023"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618\u2010023\u201002091\u20107"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ijir.3901410"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12220"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0202076"}],"container-title":["Andrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/andr.13635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T10:09:59Z","timestamp":1739354999000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/andr.13635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":59,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/andr.13635"],"URL":"https:\/\/doi.org\/10.1111\/andr.13635","archive":["Portico"],"relation":{},"ISSN":["2047-2919","2047-2927"],"issn-type":[{"value":"2047-2919","type":"print"},{"value":"2047-2927","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]},"assertion":[{"value":"2024-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}