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Selective androgen receptor modulators (SARMs) are a class of androgen receptor ligands that bind androgen receptors and display tissue selective activation of androgenic signaling. SARMs have selective anabolic effects on muscle and bone, and were originally synthesized for treatment of muscle wasting conditions, osteoporosis, breast cancer. To date, no SARM has been clinically approved and little is known about the beneficial effects and other adverse effects on users. We examined the adverse effects and potential benefits of SARMs amongst users. We performed an internet survey assessing the demographics of users via a 32-question survey. Using reddit as a platform, we distributed the survey through various subreddits that included potential SARMs users. Out of the 520 responses, 343 participants admitted having used SARMs. Most were males (98.5%), between the ages of 18-29 (72.3%). More than 90% of users acquired SARMs via the internet and did not consult with a physician. More than half of SARMs users experienced side effects including mood swings, decreased testicular size, and acne. More than 90% of men reported increased muscle mass and were satisfied with their SARMs usage. Despite having seemingly positive effects, more than 50% of SARMs users report significant adverse effects. Chi square was the main method of statistical analysis. Future studies should focus on comprehensive reproductive evaluation of men using SARMs.

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Penile concerns include erectile dysfunction (ED) and Peyronie disease (PD). Restorative therapies including Stem Cell Therapy (SCT) and Platelet Rich Plasma (PRP) injections are proposed to treat these concerns. SCT encompasses the harvesting and injection of mesenchymal stem cells or stromal vascular fractions from various tissue sources. PRP is derived autologously from a patient's plasma and is then injected into the penile tissue. These therapies repair damaged penile tissue and promote both new cellular and vascular growth, as demonstrated in basic science studies. Human trials on SCT and PRP for both ED and PD and have yielded promising results with few side effects. While encouraging, small cohort size and lack of blinding or placebo control limit these studies' external validity. Recently, the first double-blinded randomized controlled trial on PRP for ED was published, providing significant evidence of efficacy. With the rapid commercial availability of SCT and PRP for ED and PD, it is imperative to perform more randomized and placebo-controlled trials with standardized procedures and preparations to evaluate efficacy and safety. This narrative review will summarize the available literature on these penile restorative therapies to date.

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Peyronie's disease results in curvature of the penis which may cause difficulty with penetrative intercourse. The diagnosis of Peyronie's disease is easily obtained through history and physical examination alone, but the severity of erectile dysfunction relies on patient history and use of validated questionnaires. However, erectile dysfunction questionnaires were not validated in the Peyronie's disease population and may not be a reliable assessment. Penile Doppler ultrasound is a noninvasive tool that assesses vascular function. We hypothesized that penile Doppler ultrasound will be discordant with International Index of Erectile Function (IIEF) results in men with Peyronie's disease and erectile dysfunction. In this cross-sectional study, we reviewed a prospectively collected database of men with Peyronie's disease. In total, 108 men had questionnaire and ultrasound data. Of them, 87 had erectile dysfunction based on IIEF-EF or IIEF-5 (SHIM). However, 48 (55%) of those men had normal vascular parameters. Interestingly, among a subgroup of 33 men with severe erectile dysfunction on IIEF-EF or IIEF-5, 20 (61%) had normal vascular parameters. Our study demonstrates significant discordance between questionnaires and penile Doppler ultrasound. Therefore, ultrasound may be a useful tool in the workup of men with Peyronie's disease and erectile dysfunction.

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To characterise trends and interest in selective androgen receptor modulators (SARMs). SARMs are androgen receptor ligands that bind androgen receptors selectively. SARMs have anabolic effects on muscle and bone and were originally synthesised for treatment of muscle wasting conditions, osteoporosis and breast cancer. To date, no SARM has been clinically approved and little is known about their beneficial effects and other adverse effects on users. We examined Google Trend searches of SARMs. Using Google Trends, we analysed how interest in SARMs has evolved over the last 15 years and compared it to trends in testosterone. Comparing 'TRT', 'SARMs' and 'Low Testosterone' together, we see low search interest in SARMs compared to TRT until February 2018, when the interest in both SARMs and TRT terms appear to be the same. Since February 2018, search interest for SARMs has surpassed search interest for both 'TRT' and 'Low Testosterone'. Trends for SARMs demonstrate a continuous increase over the years which has to date surpassed interest for both 'TRT' and 'low testosterone'. The rising interest in SARMs is concerning as the adverse effects of its usage, including its potential effects on fertility, have not been explored. Further investigation is necessary.

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INTRODUCTION: Several studies have investigated the association between erectile dysfunction (ED), its treatment, and female sexual dysfunction, but the impact of males blaming their female partners for their ED remains unknown. AIMS: To investigate whether women who are blamed by their male partners for their ED experience worse overall sexual function and satisfaction. METHODS: We performed a global, cross-sectional web-based survey to investigate female perceptions of ED. We distributed the 30-item survey via email, Reddit, Amazon Mechanical Turk, and Facebook. Women 18 years of age or older were eligible to participate and answered questions based on a 5-point Likert scale. Women were grouped by ages 18-29, 30-39, and 40 and older. MAIN OUTCOME MEASURES: The survey collected data that included general demographics and questions regarding experiencing male blame for ED and its relationship with each subject's sexual health and wellness. RESULTS: A total of 13,617 females participated in the survey. Of the women surveyed, 79% have experienced their partner losing their erection during sexual activity and approximately 1 out of 7 women (14.7%) had experienced being blamed by their partner for loss of their erection. Women who were blamed for their partner's ED were more likely to end the sexual encounter, were less sexually satisfied, and were more likely to end relationships due to their partner's ED. CONCLUSION: Approximately 1 out of 7 women have experienced male blame for their partner's ED which is associated with negative impacts on female mental health, sexual satisfaction and the success of the overall partnership. Because of its widespread impact on female wellness, male blame should be considered during evaluation of female sexual history and men must be educated on the significant impact their reactions during intimacy have on their female partners and their relationships as a whole. Dubin JM, Wyant WA, Balaji NC, et al. Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?. Sex Med 2021;9:100352.