Diabetes mellitus-induced erectile dysfunction (DMED) is a common complication of diabetes and is often associated with impaired nitric oxide (NO) signaling and increased oxidative stress. Angiotensin (1-7) (Ang (1-7)) has been reported to exert protective effects in cardiovascular and metabolic disorders; however, its role and underlying mechanisms in DMED remain incompletely understood. This study investigated whether Ang (1-7) improves erectile function in DMED through regulation of the caveolin-1 (Cav-1)/endothelial nitric oxide synthase (eNOS) signaling pathway.

Background/Objectives: Diabetes mellitus-induced erectile dysfunction (DMED) is characterized by severe endothelial and smooth-muscle dysfunction and reduced responsiveness to conventional therapy. Guanxinning tablet (GXN), a traditional Chinese medicine compound containing Salvia miltiorrhiza (Danshen) and Ligusticum stratum (Chuanxiong), has vascular-protective and anti-oxidative properties, but its effect on DMED remains unclear. This study evaluated whether GXN improves erectile function in a streptozotocin (STZ)-induced type 1 diabetic rat model and explored the possible involvement of PI3K/Akt/FOXO1 signaling. Methods: STZ-induced diabetic rats with ED were treated with GXN. Artery pressure (AP) and intracavernous pressure (ICP) were measured to evaluate erectile dysfunction. Western blots, immunohistochemistry, immunofluorescence, biochemical assays, TUNEL staining, RNA-seq, and in vitro HCMEC assays were performed to evaluate erectile effector cell function, oxidative stress, fibrosis, apoptosis, and PI3K/Akt/FOXO1-associated changes. Results: GXN improved erectile function in DMED rats and was associated with improved endothelial and smooth-muscle-related markers, reduced oxidative stress, attenuated fibrosis, and decreased apoptosis. RNA-seq and protein validation suggested that GXN treatment was associated with activation of PI3K/Akt/FOXO1-related signaling. In HCMECs, LY294002 (a PI3K inhibitor) partially reversed the GXN-associated improvement in cell viability and apoptosis-related markers. Conclusions: GXN ameliorated erectile dysfunction and tissue injury in STZ-induced type 1 diabetic rats, which were associated with PI3K/Akt/FOXO1 signaling. These findings support the potential of GXN as a traditional Chinese medicine compound for treating DMED.

Bisphenols, phthalates, and other plastic-associated compounds are endocrine-disrupting chemicals (EDCs), common environmental contaminants that can disrupt hormonal homeostasis. Human exposure to such chemicals occurs mainly through food packaging, consumer goods, medical devices, and the environment, starting right from early development stages up to adulthood. These chemicals might cause damage to male reproductive systems as a result of being anti-androgens and estrogenic chemicals. However, the proper development of the male reproductive system requires well-regulated hormonal signaling pathways; hence, exposure to such compounds during the developmental stages poses a great risk. Environmental exposure to plastics during fetal development may influence the development of the testes, reduce the function of the Leydig cells, disrupt steroidogenesis, and produce epigenetic modifications, as documented through studies. This has been shown to increase the risk of developing reproductive disorders and reduce the production of testosterone. Therefore, one of the pathophysiological links between endocrine disruptor exposure and ED might be testosterone deficiency. Apart from disrupting testosterone production, the plastic-sourced EDCs could influence various physiological processes associated with erectile performance, such as those related to vasculature, inflammation, metabolism, and endocrinology. In this review, a comprehensive overview of the scientific data on the effect of plastic-based EDCs on testosterone regulation and male reproductive health has been provided. The role of developmental programming, endocrine disruption, oxidative stress, epigenetics, and vascular dysfunction has been explored in detail. Moreover, the possible involvement of micro- and nanoplastics has also been reviewed. From the data that is currently available, there seems to be a physiologically plausible association between plastic-based contaminants, testosterone dysregulation, and adverse reproductive outcomes.

The use of glucagon-like peptide-1 receptor agonists (GLP1-RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) resulted in weight loss and long-term cardiovascular (CV) and renal safety preservation. Their role in male sexual hormones and behavior is still not sufficiently investigated. This paper aims at summarizing the effects of GLP1-RA and SGLT2i on obesity-associated hypogonadism and sexual dysfunctions. Both GLP1-RA and SGLT2i resulted in an improvement of body composition and metabolic profile, supporting erectile function amelioration. Only GLP1-RA showed a weight loss dependent increase in total and calculated free testosterone with lower effects on gonadotropin levels, while for SGLT2i, the data are contradictory. Finally, the use of testosterone replacement therapy showed better results as compared to GLP1-RA when orgasm and sexual satisfaction domains were investigated. In conclusion considering the beneficial effects of GLP1-RA on long-term CV mortality and morbidity, compared to the substantially neutral effects derived from the use of testosterone replacement therapy, we support the use of this class of medications for improving sexual dysfunction and its underlying CV problems in overweight and obese patients with erectile dysfunction.

To compare rates of depression, anxiety, stress, and sexual dysfunction between men and women with infertility.

Background/Objectives: Penile rehabilitation (PR) techniques are claimed to counteract chronic degenerative processes of cavernous tissue, such as penile hypoxia, neurovascular damage, and cavernous fibrosis. The objective of this umbrella review is to synthesize findings from existing meta-analyses to evaluate the efficacy of traditional and emerging PR strategies, providing an evidence-based roadmap for clinical management after surgery for prostate cancer. Methods: Conducted in accordance with PRIOR guidelines, a comprehensive literature search of PubMed, the Cochrane Library, and Scopus was performed through April 2026. The review included primarily systematic reviews and meta-analyses investigating pharmacological, physical, surgical, and regenerative interventions for post-prostatectomy erectile dysfunction (ED). Methodological quality was independently assessed using standardized tools. Results: PDE5 inhibitors (PDE5-is) significantly improve erectile function during active treatment, yet evidence supporting their role in promoting spontaneous, "unassisted" recovery remains limited. Vacuum erectile devices demonstrate high efficacy for assisted intercourse but show minimal impact on returning to baseline function compared to placebo. Penile prosthesis (PP) implantation maintains robust efficacy with exceptionally high satisfaction rates (83-85%), proving independent of prior pelvic surgery. Although early-phase trials suggest clinical potential for regenerative therapies like low-intensity extracorporeal shockwave therapy, platelet-rich plasma, and stem cell interventions, the evidence is currently undermined by substantial heterogeneity in study protocols and concerns regarding methodological quality. Conclusions: PR following radical prostatectomy remains a complex challenge characterized by poor evidence. While PDE5-Is are established first-line therapy for assisted function, PP remains the most reliable definitive treatment for refractory ED cases. Regenerative approaches show promise but remain investigational until standardized protocols and large-scale trials are established.