Polyendocrine metabolic ovarian syndrome (PMOS) affects around one out of 8 women globally. PMOS often involves insulin resistance and excess fat around internal organs in the abdomen. This can happen even if a woman is not obese. Insulin is a hormone that helps the body process and store blood sugar. When the body does not respond well to insulin, levels can rise. This imbalance can disrupt the systems that control sex hormones and the ovaries.

People make decisions about nearly everything throughout the day. What to eat for breakfast, what to wear, which train to take to work, what to make for dinner, which show to watch, and so on. Sometimes, though, other things are competing for attention. Cognitive and emotional processes are involved in decision-making, which can be influenced by prior experiences and the situation at hand.

As artificial intelligence becomes increasingly integrated into research and scientific publishing, ISSM has introduced a new Artificial Intelligence (AI) Policy for Authors and Peer Reviewers, providing clear guidance for the responsible use of AI across The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access.

The policy is centered around three core principles: authorship, accountability, and disclosure. AI systems cannot be listed as authors, human authors remain fully responsible for the accuracy, originality, and integrity of their work, and substantive uses of AI must be transparently disclosed.

For authors, AI tools may support aspects of manuscript preparation, including drafting text, refining figures, literature discovery, and improving organization. However, authors must retain intellectual control, independently verify AI-assisted content and references, and never use AI to fabricate or manipulate research data or findings.

The policy also establishes important safeguards for peer review. Reviewers may not upload manuscripts, abstracts, reviews, or other confidential material into public AI tools. Only appropriately secured tools that guarantee data isolation may be used, with permitted AI use disclosed during the review process.

The introduction of the policy comes as the Editors-in-Chief of the three ISSM Journals continue the conversation around AI and its implications for scientific publishing. In the new Journal of Sexual Medicine editorial “The evolving landscape of AI in publishing,” Annamaria Giraldi, MD, PhD; Landon Trost, MD; and Giovanni Corona, MD, PhD discuss both the opportunities and challenges presented by these rapidly developing technologies.

The editorial considers how AI may support research, scientific communication, and peer review while also addressing concerns surrounding inaccurate or fabricated information, bias, confidentiality, intellectual property, and research integrity.

Together, the ISSM AI policy and the new editorial provide practical guidance and broader perspective on how AI can support scientific publishing while maintaining human responsibility, transparency, and academic integrity.

View the ISSM Artificial Intelligence (AI) Policy for Authors and Peer Reviewers

Read the editorial: The evolving landscape of AI in publishing

Check out a short video on this topic.

The International Society for Sexual Medicine (ISSM) and Movember have published a new online toolkit to help healthcare professionals address sexual health with prostate cancer patients and their partners before, during, and after treatment.

Based on the Guidelines for Sexual Health Care for Prostate Cancer Patients, the toolkit brings together practical clinical tools, consultation videos, patient resources, and educational materials in one place. It is designed to help clinicians translate guideline recommendations into everyday care.

Practical resources for clinical care and education

The toolkit is organized around five ways to use its resources:

• Use in clinical practice: Access the full Guidelines and supporting resources, a one-page Guidelines summary, and the 5A’s Clinical Checklist for Prostate Cancer Care.
• Watch consultation examples: See how clinicians use the 5A’s framework in discussions before radical prostatectomy, radiation therapy with androgen deprivation therapy (ADT), or ADT, and in sexual rehabilitation after radical prostatectomy.
• Share with patients: Explore True North resources for patients and partners on sexual health, treatment side effects, recovery, intimacy, and relationships.
• Teach or train colleagues: Download ready-to-use slide sets introducing the Guidelines and the 5A’s framework for presentations and educational activities.
• Learn from experts: Watch short expert Q&A videos addressing key questions about sexual health after prostate cancer treatment.

A framework for the conversation

The 5A’s Clinical Checklist offers a practical structure: Ask, Assess, Advise, agree on an Action Plan, and Arrange Follow-Up. It helps clinicians identify concerns, agree realistic next steps with patients, and plan follow-up or referral.

Clinicians can start with the one-page checklist, watch a consultation example relevant to their practice, and identify resources to share with patients and partners. The toolkit also offers filters by topic and intended audience to help users find relevant materials.

Explore the toolkit

ISSM invites healthcare professionals involved in prostate cancer care to explore the toolkit and use its resources to support sexual health conversations throughout the care journey.

Explore the ISSM & Movember Toolkit →

Background

Anabolic-androgenic steroids (AAS) are manufactured testosterone medications intended for use in testosterone-deficient men and to stimulate muscle growth in certain cases. However, AAS are often associated with athletes and bodybuilders because some may misuse them to enhance their physical appearance and performance. Around 6% of non-athletes with normal testosterone levels may also use AAS at least once in their lifetime.

Previous research has linked  AAS use to reduced natural testosterone production, continuing for years after withdrawing from use. Former AAS users have also reported symptoms associated with testosterone deficiency, such as erectile dysfunction (ED).

Study Objective

• Researchers investigated long-term  ED medication prescription filling among men who used or had used AAS within the previous 15 years.

Methods

• Data were collected from Anti-Doping Denmark’s national control program for public fitness centers between 2006 and 2018.
  • Information is included from 1,189 AAS users and 50,490 controls.
  • The average age was around 27.
• For this study, researchers identified the presence of ED through ED medication prescriptions n filled at a pharmacy, based on data from the Danish National Prescription Register.
  • Secondary outcomes included the cumulative number of prescriptions filled during the follow-up period.
• The follow-up period was an average of 11 years, depending on how long the men’s records were with the doping program.

Key Results/Analysis

• Men who used AAS were more likely to fill at least one ED medication prescription than the controls.
  • 24% of AAS users filled at least one ED medication prescription
  • 8% of controls filled at least one ED medication prescription
• Men who used AAS also filled more r ED medication prescriptions over the entire study period than the controls.
  • Average of 72 ED medication prescriptions for each AAS user.
  • Average of 36 ED medication prescriptions for each control.
• These results are in line with previous research that links AAS use to long-term testosterone deficiency.

Limitations

• This study identified differences in ED treatment between the cohorts but could not establish that AAS use caused those differences.
  • Although AAS users filled more ED medication prescriptions, researchers could not determine whether AAS use was the reason.
    • Patient history information, such as smoking, alcohol use, weight, presence of diabetes, etc., was not included.
• Researchers also could not determine whether the medications were actually used, only that the prescriptions were filled.

Key Takeaways

• AAS have been linked to testosterone deficiency and ED through mechanisms that slow testosterone production.
• Men with a history of AAS use were more likely to fill ED medication prescriptions during long-term follow-up compared with controls.
• AAS users also filled a greater number of ED medication prescriptions over the study period.
• Future research should include medical history variables and ED diagnoses to further clarify this correlation.

Resources

• Handelsman, D. J. (2021). Androgen misuse and abuse. Endocrine Reviews, 42(4), 457–501. Oxford Academic. https://doi.org/10.1210/endrev/bnab001 
• Levinsen, A. K. G., Tolver, A., Kjaer, T. K., Thygesen, L. C., Wohlfahrt, J., Rosthøj, S., Tolstrup, L. K., Hansen, M. N., Oerlemans, S., Miaskowski, C., Christiansen, P., Christensen, P., Johansen, C., Zachariae, R., Saltbæk, L., & Dalton, S. O. (2026). A structural equation modeling framework for estimating symptom burden based on symptom clusters in cancer survivors. Scientific Reports, 16(1). https://doi.org/10.1038/s41598-026-55933-8
• Middelboe, M., Heerfordt, I. M., Windfenld-Mathiasen, J., Dalhoff, K. P., Andersen, J. T., & Horwitz, H. (2026). Anabolic-androgenic steroid use and erectile dysfunction. The Journal of Sexual Medicine, 23(8). Oxford Academic. https://doi.org/10.1093/jsxmed/qdag223
• Rasmussen, J. J., Selmer, C., Østergren, P. B., Pedersen, K. B., Schou, M., Gustafsson, F., Faber, J., Juul, A., & Kistorp, C. (2016). Former abusers of anabolic androgenic steroids exhibit decreased testosterone levels and hypogonadal symptoms years after cessation: A case-control study. PLOS ONE, 11(8), e0161208. PLOS. https://doi.org/10.1371/journal.pone.0161208