RESUMO
Importance: Sexuality- and gender-diverse (SGD) young people experience substantial health disparities relative to cisgender heterosexual peers. Little is known about SGD adolescents younger than 15 years. Objective: To describe SGD prevalence and associated factors in a population-representative cohort of younger adolescents in Australia. Design, Setting, and Participants: This prospective cohort study was part of the Future Proofing Study, with enrollment of year 8 students at 134 Australian secondary schools from 2019 to 2021 and annual follow-ups for 5 years. Data were analyzed from June 20, 2023, to June 6, 2024. Main Outcome and Measures: Outcomes of interest were baseline self-reported gender and sexuality identities, individual characteristics, and mental health and disability diagnoses, as well as school characteristics. Results: Among 6388 participants, median (IQR) age was 13.9 (13.6-15.8), with a range of 10.7 to 17.5 years. Most participants attended school in a major city (76.0%), were born in Australia (91.4%), and spoke English at home (93.7%). Approximately half (3122 participants; 48.9% [95% CI, 45.2%-59.0%]) identified as female or girls, and 46.5% (2973 participants; 95% CI, 39.8%-53.4%) identified as male or boys. The overall proportion of transgender identity was 3.3% (95% CI, 2.7%-3.9%), with 23 participants (0.4%) identifying as transgender boys, 10 participants (0.2%) identifying as transgender girls, 117 participants (1.8%) identifying as transgender nonbinary, and 59 participants (0.9%) identifying as another transgender identity. The overall proportion of sexuality diversity was 12.0% (95% CI, 10.4%-13.8%). The proportion of cisgender participants who were sexuality-diverse (13.0% [95% CI, 11.4%-14.8%] of girls and 4.7% [95% CI, 3.7%-5.9%] of boys) was lower than the proportion among gender-diverse participants, which ranged from 30.0% (95% CI, 9.3%-64.1%) of transgender girls to 91.5% (95% CI, 81.3%-96.4%) of those with another diverse gender identity. Gender diversity and sexuality diversity were strongly associated (odds ratio [OR], 66.24; 95% CI, 38.23-114.80), and both were negatively associated with age (gender diversity: OR per 1-year older, 0.61; 95% CI, 0.49-0.76; sexuality diversity: OR per 1-year older, 0.78; 95% CI, 0.65-0.93) and positively with mental health diagnosis (gender diversity: OR, 2.41; 95% CI, 1.79-3.24; sexuality diversity: OR, 2.50; 95% CI, 2.10-2.98), and disability diagnosis (gender diversity: OR, 2.39; 95% CI, 1.68-3.40; sexuality diversity: OR, 1.96; 95% CI, 1.64-2.36). While there were significant associations between individual and school characteristics and responses to gender and sexuality identity items, patterns of association differed, with no consistent association with economic disadvantage. Conclusions and Relevance: This cohort study of young adolescents found higher rates of SGD than among samples of older adolescents. The significant associations with younger age, poorer mental health, and disability underscored the urgent need for inclusive programs to promote a safe and welcoming environment in schools, health care settings, and communities.
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Minorias Sexuais e de Gênero , Humanos , Adolescente , Masculino , Feminino , Austrália/epidemiologia , Estudos Prospectivos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Sexualidade/estatística & dados numéricos , Sexualidade/psicologia , Criança , PrevalênciaRESUMO
BACKGROUND: Side effects of breast cancer treatment (BCT) impact patients' general and sexual wellbeing. Sexuality related complaints are reported by 70% of breast cancer survivors mainly due to the genitourinary syndrome of menopause (GSM). In clinical care, sexual side effects are often un(der)detected because physicians as well as patients experience barriers to discuss sexuality-related issues. MATERIALS AND METHODS: We composed an online survey ourselves using known definitions about sexuality and menopause and known factors for not discussing sexuality. We used multiple-choice questions with a Likert scale to optimize interpretation of the statements. 64 practitioners completed the survey. With this online survey, we examined physicians' knowledge of -and attitude towards- sexual wellbeing and detection and treatment of GSM in breast cancer survivors (BCS). RESULTS: Vaginal dryness and dyspareunia were the symptoms most associated with menopause (n = 63/64 (98 %) and n = 56/64 (87 %)) and sexuality (n = 63/64 (98 %) and n = 61/64 (95 %)). These 2 complaints were also the most discussed symptoms of menopause (vaginal dryness n = 51/64 (80 %) and dyspareunia n = 45/64 (70 %)). The main reason to not discuss these issues were absence of reporting GSM (n = 40/64 (62 %)) and absence of a direct cause to discuss GSM (n = 35/64 (55 %). 64 % (n = 41/64) of practitioners don't feel sufficiently educated to discuss and treat GSM. They proposed vaginal estrogens to treat GSM as first or second line respectively in 12 % (n = 8/64) and 46 % (n = 30/64) of symptomatic BCS. DISCUSSION: Although sexuality related complaints are common in BCS, 64% of all participating physicians feel they are not adequately trained to handle them. More attention towards training of physicians is needed to discuss GSM related complaints also when they are not spontaneously reported by a patient and with clear guidance towards the medical treatment of GSM in BCS.
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Neoplasias da Mama , Dispareunia , Menopausa , Sexualidade , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , Menopausa/psicologia , Inquéritos e Questionários , Dispareunia/etiologia , Dispareunia/psicologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Sobreviventes de Câncer/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Doenças Vaginais/terapia , Doenças Vaginais/psicologia , Doenças Vaginais/etiologiaRESUMO
OBJECTIVE: To evaluate the effectiveness of a sexual rehabilitation program, SEXHAB, in improving sexual functioning, reducing sexual distress, and enhancing marital satisfaction for women after gynecological cancer treatment. METHODS: This is a randomized controlled trial that included 150 women newly diagnosed with gynecological cancer from three public hospitals in Hong Kong. Participants were randomly assigned to the intervention group (n = 78) to receive the SEXHAB or to an attention control group (n = 72) to receive attention. The SEXHAB comprises four individual- or couple-based sessions with three major components: information provision, cognitive-behavioral therapy and counseling using motivational interviewing skills. The outcomes were measured at baseline (T0), upon completion of the program (T1) and 12-month post-treatment (T2). Semi-structured interviews were also conducted with the SEXHAB group participants to explore their experiences with and opinions toward the program. RESULTS: At both follow-ups, there were no statistically significant differences between groups in improving sexual functioning, sexual distress and marital satisfaction. Nevertheless, participants in the SEXHAB group reported their partners having significantly greater sexual interest at T1 (76% vs. 52%, rate ratio: 1.46, 95% CI: 1.07 to 1.99, p = 0.024) and T2 (74% vs. 48%, rate ratio: 1.55, 95% CI: 1.11 to 2.10, p = 0.014). From the qualitative interviews, the interviewees who resumed sexual activity reported positive experiences in rebuilding sexuality and intimacy. CONCLUSIONS: Despite the quantitative results are negative, the qualitative findings suggest potential benefits of the SEXHAB for women resuming sexual activities after treatment for gynecological cancer. Further studies with longer intervention period and follow-ups are needed to confirm the intervention effects.
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Terapia Cognitivo-Comportamental , Neoplasias dos Genitais Femininos , Humanos , Feminino , Neoplasias dos Genitais Femininos/psicologia , Neoplasias dos Genitais Femininos/reabilitação , Pessoa de Meia-Idade , Adulto , Terapia Cognitivo-Comportamental/métodos , Hong Kong , Comportamento Sexual/psicologia , Sexualidade/psicologia , Aconselhamento/métodos , Entrevista Motivacional/métodos , Disfunções Sexuais Psicogênicas/psicologia , Disfunções Sexuais Psicogênicas/reabilitaçãoRESUMO
INTRODUCTION: Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI. METHODS: A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence. RESULTS: A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations. CONCLUSION: The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI.
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Lesões Encefálicas Traumáticas , Humanos , Lesões Encefálicas Traumáticas/reabilitação , Lesões Encefálicas Traumáticas/psicologia , Adulto , Feminino , Masculino , Comportamento Sexual , Relações Interpessoais , Sexualidade , Guias de Prática Clínica como AssuntoRESUMO
One might think that the representation of the ageing body in film has evolved over the years, reflecting certain cultural and societal changes, as well as advances in the understanding of ageing. However, regardless of gender, older people are more likely than any other group to appear in film as comic antidotes to ageing, cultivating stereotypes of physical, cognitive and even sexual inefficiency.
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Envelhecimento , Filmes Cinematográficos , Sexualidade , Humanos , Envelhecimento/fisiologia , Envelhecimento/psicologia , Idoso , Feminino , MasculinoRESUMO
Sexo também é saúde! Você sabia que as pessoas da terceira idade também têm sexualidade e podem contrair e transmitir doenças durante as relações sexuais? Neste Dezembro Vermelho o Ativa Idade conversou com o professor Marco Antônio dos Santos, sociólogo, educador em saúde e assessor da área técnica da saúde da população negra da Secretaria Municipal da Saúde, quem nos explica sobre a importância do uso de preservativo e ajuda a quebrar alguns tabus em relação a estes temas. Acompanhe e envie este vídeo para o seu / sua colega que, mesmo acima dos 60, precisa relembrar algumas dicas importantes em relação a isso.
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Sexualidade , Serviços de Saúde para IdososRESUMO
BACKGROUND AND OBJECTIVES: English and Welsh laws require "contemporaneous" consent to sexual relations, often precluding "non-capacituos" people living with advanced dementia from these human interactions. RESEARCH DESIGN AND METHODS: The views of people living with dementia, carers, professionals, and over-55s were explored on implications of current laws on sexuality in dementia. Thirty-five participants from England were recruited through purposive selective sampling. Audio-taped semistructured interviews were transcribed and thematically analyzed with each stakeholder group coded separately. RESULTS: Common themes across stakeholders were (i) law reform needed due to their hammer-like effect ignoring the individual; (ii) dissonant theme of needing the law for protection; (iii) negative impact of denied intimacy on individuals and partners; (iv) support for Advance Decisions on Intimacy with caveats; (v) less support for involvement of Court of Protection and Powers of Attorney; (vi) call for review of capacity concept with support for an assent model. People living with dementia described shame and stigma associated with policing of their sexuality and perception of being singled out for protection and intrusion into their lives. For informal carers (mostly wives), the theme of "what about me" emerged, demonstrating that for the long-term partnered, this is a couple's issue. DISCUSSION AND IMPLICATIONS: Practical implications of this study include need to address ageism and ableism; human rights education for society and professionals; starting point of presumed capacity for sexual relations with consensus on how and when this should be rebutted; and care homes' certification requirements should incorporate assessment of the relationship health of their residents.
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Cuidadores , Demência , Sexualidade , Humanos , Demência/psicologia , Feminino , Masculino , Idoso , Inglaterra , Sexualidade/psicologia , Pessoa de Meia-Idade , Cuidadores/psicologia , Idoso de 80 Anos ou mais , Pesquisa Qualitativa , País de GalesRESUMO
BACKGROUND: The integration of gender and sexuality awareness in health care is increasingly recognized as vital for patient outcomes. Despite this, there is a notable lack of comprehensive data on the current state of physicians' training and perceptions in these areas, leading to a gap in targeted educational interventions and optimal health care delivery. OBJECTIVE: The study's aim was to explore the experiences and perceptions of attending and resident physicians regarding the inclusion of gender and sexuality content in medical school curricula and professional practice in Israel. METHODS: This cross-sectional survey targeted a diverse group of physicians across various specializations and experience levels. Distributed through Israeli Medical Associations and professional networks, it included sections on experiences with gender and sexuality content, perceptions of knowledge, the impact of medical school curricula on professional capabilities, and views on integrating gender medicine in medical education. Descriptive and correlational analyses, along with gender-based and medical status-based comparisons, were used, complemented, and enhanced by qualitative analysis of participants' replies. RESULTS: The survey, encompassing 189 respondents, revealed low-to-moderate exposure to gender and sexuality content in medical school curricula, with a similar perception of preparedness. A need for more comprehensive training was widely recognized. The majority valued training in these areas for enhancing professional capabilities, identifying 10 essential gender-related knowledge areas. The preference for integrating gender medicine throughout medical education was significant. Gender-based analysis indicated variations in exposure and perceptions. CONCLUSIONS: The study highlights a crucial need for the inclusion of gender and sexuality awareness in medical education and practice. It suggests the necessity for curriculum development, targeted training programs, policy advocacy, mentorship initiatives, and research to evaluate the effectiveness of these interventions. The findings serve as a foundation for future directions in medical education, aiming for a more inclusive, aware, and prepared medical workforce.
Assuntos
Currículo , Educação Médica , Sexualidade , Humanos , Estudos Transversais , Feminino , Masculino , Sexualidade/psicologia , Adulto , Israel , Inquéritos e Questionários , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Conscientização , Conhecimentos, Atitudes e Prática em SaúdeRESUMO
People over 65 years of age will constitute the majority of the world's population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.
Las personas mayores de 65 años constituirán la mayoría de la población mundial en corto plazo, pero en condiciones de vida precarias. Esto quiere decir que vivirán más años en peor condición de vulnerabilidad y fragilidad. Las sociedades y modelos de desarrollo no estarían preparados, generando altos costos personales, familiares y colectivos. En Chile la fragilidad sería altamente prevalente en esta población, impactando el desarrollo pleno de su vida. La sexualidad es uno de los aspectos que son invisibilizados y poco estudiados. Este trabajo realiza una aproximación crítica, a partir de la revisión y análisis de antecedentes de contexto, políticas públicas y legislación vigentes en Chile. En estos aspectos se evidencia atomización y orientación biomédica de las políticas públicas, colaborando en la comprensión de la relación fragilidad y sexualidad en personas mayores. Además, se revelan tareas de formación e investigación pendientes para la generación de políticas públicas para una vida activa y saludable.
Assuntos
Política Pública , Sexualidade , Chile , Humanos , Idoso , Direitos HumanosRESUMO
The aim of the study is to create a Polish version of the sexuality attitudes and beliefs survey (SABS), to assess its cultural adaptation and psychometric properties and to utilize it to enable a cross-sectional study of the sexual attitudes and beliefs among Poland's nursing and midwifery students. Non-random network sampling and the adapted SABS v. PL scale were employed for the latter purpose. A total of 570 nursing and midwifery students from two Polish universities completed the questionnaire. Cronbach's alpha coefficient was utilized to measure the internal consistency of the SABS scale, while exploratory factor analysis (EFA) was employed to determine its construct validity. The factors that most affect respondents' sexual attitudes and beliefs were identified through a stepwise multiple regression method and through an econometric model. An exploratory factor analysis of the SABS v. PL scale revealed an adequate fit and confirmed the 4-factor model. The Cronbach's alpha coefficient for SABS v. PL amounted to: α = 0.66. The study's student population had a mean SABS score of 41.65 ± 5.63, while the mean SABS item score varied between 2.55 ± 1.27 and 4.35 ± 1.07. The study's results show that the SABS v. PL questionnaire is a valid and reliable instrument. The work revealed that Polish nursing and midwifery students have attitudes and beliefs which negatively impact their ability to evaluate a person's sexual health concerns and provide relevant health counselling.
Assuntos
Tocologia , Psicometria , Estudantes de Enfermagem , Humanos , Estudantes de Enfermagem/psicologia , Polônia , Feminino , Inquéritos e Questionários , Masculino , Adulto , Tocologia/educação , Psicometria/métodos , Adulto Jovem , Estudos Transversais , Sexualidade/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Análise Fatorial , Reprodutibilidade dos TestesRESUMO
AIMS: We aimed to ascertain the content validity of an instrument to assess health and social care professionals' knowledge and attitudes towards later-life intimacy and sexuality (HSCP-KALLIS). BACKGROUND: For older adults, intimacy and sexuality are important in maintaining their quality of life and well-being. However, addressing these needs remains challenging for health and social care professionals, particularly for nursing staff providing 24-h direct care to older people with dementia or those identified as lesbian, gay, bisexual, transgender, intersex or queer/questioning individuals. Existing instruments assessing knowledge and attitudes towards later-life intimacy and sexuality are dated and fail to adequately address dementia and sexual diversity. DESIGN: A two-round modified Delphi study was conducted. METHODS: Initially, 79 knowledge and attitude items were generated through an integrative review. Panellists rated each item's clarity and importance using online questionnaires. The content validity index for the individual and overall items was calculated. The panellists' written feedback-along with their knowledge level of later-life intimacy and sexuality-was obtained. RESULTS: Panellists included health and social care professionals (n = 9); healthcare-related educators (n = 2); researchers specialising in later-life intimacy, sexuality, dementia care and sexual diversity support (n = 7); and family carers of older people with dementia (n = 2). The instrument was revised based on the feedback received. The components of dementia, LGBTIQ+ and the provision of sex worker services in healthcare settings were highlighted by the panellists. Notably, 46 knowledge and 40 attitude items fulfilled the consensus criteria for clarity and importance. CONCLUSIONS: Acceptable content validity was established for the knowledge and attitude items. Further research is required to establish the psychometric properties of the HSCP-KALLIS. This instrument has implications for clinical practice-specifically, in nursing care-by addressing issues to improve awareness regarding later-life intimacy and sexuality in healthcare settings. IMPLICATIONS FOR PRACTICE: The HSCP-KALLIS has the potential to inform the educational needs regarding knowledge and attitudes towards later-life intimacy and sexuality for health and social care professionals, specifically nursing staff. The findings of the HSCP-KALLIS can be used for the development of competencies for later-life intimacy and sexuality, establishing policies and guidelines to support older adults' intimacy and sexuality needs in health care settings.
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Técnica Delphi , Conhecimentos, Atitudes e Prática em Saúde , Sexualidade , Humanos , Feminino , Masculino , Sexualidade/psicologia , Inquéritos e Questionários , Idoso , Pessoa de Meia-Idade , Pessoal de Saúde/psicologia , Atitude do Pessoal de Saúde , Adulto , Demência/enfermagem , Demência/psicologia , Qualidade de Vida/psicologiaRESUMO
This study investigated the correlations between social workers' levels of religiosity and their professional attitudes toward discussing sexual health. The focus was particularly on the potential mediating role of their attitudes to heteronormative beliefs. A random sample of 150 social workers from Israel (Jewish [63.3 percent], Palestinian-Arab [36 percent], and those who self-identified as "other" [0.7 percent]) completed a self-administered questionnaire. The findings revealed significant correlations among professional attitudes toward discussing sexual health, attitudes toward heteronormativity, and degree of religiosity. Social workers with higher levels of religiosity exhibited higher levels of heteronormative beliefs, which, in turn, influenced their professional attitudes toward discussing sexual health. Furthermore, the findings highlight the importance of challenging heteronormative perspectives for all social welfare service users. Social work must establish culturally sensitive training to challenge the hegemony of heteronormative perspectives while connecting to religious and conservative values and perceptions.
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Atitude do Pessoal de Saúde , Assistentes Sociais , Humanos , Assistentes Sociais/psicologia , Feminino , Masculino , Israel , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Sexualidade/psicologia , Religião , Serviço Social , Saúde SexualRESUMO
Despite ongoing medical advancements in infertility treatment, the significant impact of sexuality on this journey often goes unaddressed. The present research aims to examine sexual conversations during ART visits, including who initiate the conversation and their content.This quali-quantitative study delves into analyzed video-recorded ART visits to explore how "sex" conversations are broached during healthcare interactions. Our findings reveal a strikingly low proportion of utterances related to sexuality, accounting for only 1.3% of the total 14,372 utterances analyzed. Sex utterances were mainly introduced by physicians (72%), while regarding those introduced by the couple, 64% were reported by men. From the qualitative analysis on the utterances emerged three distinct levels of communication about sex: explicit, almost explicit, and implicit. While physicians and males exhibit an almost balanced distribution across the 3 levels, female patients primarily respond to explicit and almost explicit communication initiated by physicians. The low percentage of sexual utterances underscores the rarity of these conversations during ART interactions, despite the clinical field where sexual health should deserve a crucial attention. Opening the door to conversations about sexuality could help to create a safe and supportive space for patients to talk about sex, with a potential impact on well-being and quality of care during the ART process.
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Comunicação , Relações Médico-Paciente , Técnicas de Reprodução Assistida , Humanos , Feminino , Masculino , Técnicas de Reprodução Assistida/psicologia , Adulto , Sexualidade/psicologia , Pesquisa Qualitativa , Comportamento Sexual/psicologiaRESUMO
BACKGROUND: The present study examines the relationship between stereotypical beliefs about people with intellectual disabilities, desire for social distance, and general knowledge about human sexuality with attitudes towards the sexuality of adults with mild intellectual disabilities. METHOD: Two hundred fifty participants from staff, family and community samples completed an online set of questionnaires. RESULTS: Higher agreement with stereotypical beliefs and lower sexual knowledge were associated with less normalising and more paternalistic attitudes towards the sexuality of adults with mild intellectual disabilities. Higher agreement with stereotypical beliefs was also associated with more negative attitudes. On the other hand, willingness to interact with these adults was associated with more normalising and less paternalistic attitudes. CONCLUSIONS: Interventions that aim to support adults with intellectual disabilities in relation to their sexuality should also address the perceptions of their support network towards them as individuals with disabilities, as well as their knowledge about sexuality.
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Conhecimentos, Atitudes e Prática em Saúde , Deficiência Intelectual , Distância Psicológica , Sexualidade , Estereotipagem , Humanos , Masculino , Deficiência Intelectual/psicologia , Feminino , Adulto , Pessoa de Meia-Idade , Sexualidade/psicologia , Adulto Jovem , Idoso , AdolescenteRESUMO
Sexuality and sexual intimacy are important aspects of cancer survivorship. In head and neck cancer (HNC), concerns around sexual health, sexuality and sexual intimacy are infrequently raised or addressed in standard HNC consultations, either before embarking on treatment or during survivorship. The changing demographic of HNC patients, largely due to the increasing proportion of patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC), has driven renewed interest in some specific survivorship issues, including sexual behaviours and lifestyles, which may account for both the primary mode of HPV transmission and the younger and less comorbid population affected by this disease. While HNC survivors may have many complex needs in the short and longer term, some patients may prioritise preserving sexual function above other more HNC-specific issues, such as swallowing and xerostomia. Beyond HPVOPSCC, there is evidence to suggest that impairment of sexual health is a pervasive survivorship issue across all HNC cancer types, and this narrative review article highlights publications reporting quantitative assessments of sexual health outcomes in HNC patients. There are also limited studies evaluating whether current sexual health models of care are adequate for HNC patients or whether new or adapted models are needed. Future research will also need to define the impact of our treatments on the sexuality and sexual intimacy concerns of specific HNC cohorts with more granularity to enhance pre- and post-treatment counselling.
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Neoplasias de Cabeça e Pescoço , Saúde Sexual , Sexualidade , Humanos , Neoplasias de Cabeça e Pescoço/psicologia , Neoplasias de Cabeça e Pescoço/complicações , Sexualidade/psicologia , Comportamento Sexual/psicologia , Masculino , FemininoRESUMO
RATIONALE: Sexuality is a central aspect of being human that encompasses many facets. Cannabis, a widely used psychoactive substance, has been associated with various effects on sexuality. The relationship between cannabis and sexuality is complex and multifaceted, involving physiological, psychological, and social factors. OBJECTIVES: This review aims to provide an overview of the current literature on the effects of cannabis on several sexual functions, including sexual desire, arousal, orgasm, and sexual satisfaction. It also discusses the potential mechanisms underlying these effects, as well as the impact of dose and frequency of use. RESULTS: This review has revealed a complex relationship between cannabis dosage and its influence on sexuality. It appears that the frequency of cannabis use in humans has been associated with the frequency of sexual activities. Individuals who use cannabis more frequently tend to report higher levels of sexual activity. Moreover, there is a notable gender difference in how cannabis affects sexuality. In addition, we found lower doses of cannabis to be linked to heightened sexual desire and enjoyment, whereas higher doses may lead to a decrease in sexual desire and performance. CONCLUSIONS: Overall, the association between cannabis and sexuality is complex and warrants further research to better understand the psychological and neurological mechanisms that underlie the effect of cannabis on these sexuality functions and its implications for sexual health. To advance in this endeavor, a crucial step is establishing a precise measurement of dosage in human studies.
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Cannabis , Comportamento Sexual , Sexualidade , Humanos , Sexualidade/efeitos dos fármacos , Sexualidade/psicologia , Comportamento Sexual/efeitos dos fármacos , Comportamento Sexual/psicologia , Orgasmo/efeitos dos fármacos , Libido/efeitos dos fármacos , Relação Dose-Resposta a Droga , Masculino , Feminino , Excitação SexualRESUMO
Beta-endorphin is secreted from the hypothalamus and pituitary in both mother and newborn. The placenta produces numerous pituitary hormones from the third month of pregnancy, one of which is ßE. It has been suggested that ßE has a role in the appetitive and precopulatory phase of sexual behavior in animals. An increase in endorphin levels during sexual activity in humans may contribute to attachment and bonding between partners, but contradictory reports in the literature question the association between sexuality and ßE levels. The level of ßE also increases during pregnancy, rises in early labor, peaks in late labor, and drops in the postpartum period. This fluctuation provides natural analgesia, raises the pain threshold, decreases the sensation of pain, or suppresses pain, and decreases fear levels during labor and birth. Beta-endorphin also protects the fetus from hypoxia during labor and birth and potential neural damage by aiding blood flow to the brain under hypoxic conditions. It has been suggested that a variety of pharmacologic and nonpharmacologic complementary therapies, when used in pregnancy, labor, and birth, activate the opioid receptors in the CNS and alter the sensation of pain during labor and birth, affect the mother-child attachment and affect sexual function. These studies report contradictory results that will be discussed in this chapter.
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beta-Endorfina , Animais , Feminino , Humanos , Gravidez , beta-Endorfina/metabolismo , Endorfinas/metabolismo , Reprodução/fisiologia , Comportamento Sexual/fisiologia , Sexualidade/fisiologiaAssuntos
Ansiedade , Depressão , Prostatectomia , Sexualidade , Incontinência Urinária , Humanos , Masculino , Prostatectomia/métodos , Prostatectomia/efeitos adversos , Depressão/etiologia , Ansiedade/etiologia , Incontinência Urinária/psicologia , Incontinência Urinária/etiologia , Sexualidade/psicologia , Neoplasias da Próstata/cirurgia , Neoplasias da Próstata/psicologiaRESUMO
PURPOSE: To evaluate the initial impact of a combined oral contraceptive (COC) containing norgestimate (NGM) on female sexuality and on circulating androgen levels in users. MATERIALS AND METHODS: Six months modification in the McCoy Female Sexuality Questionnaire (MFSQ) and testosterone (T) and dehydroepiandrosterone sulphate (DHEAS) serum levels in women starting a monophasic pill containing ethinyl-estradiol (EE) 35 µg and NGM 0.250 mg. RESULTS: The study was completed by 36 subjects. There was a significant increase in MFSQ during treatment (p < 0.0001) (and its domains with the exclusion of vaginal lubrication domain) with concomitant decreases in T (-4.45%, p < 0.0001) and DHEAS (-19.41%, p < 0.0001) serum levels. CONCLUSIONS: Contraception with EE/NGM was associated with a short term non-deteriorating effect on sexuality despite the evident decrease in androgen levels. Female sexuality during COC use is a complex topic and is not only linked with changes in serum androgen levels.
EE/NGM treatment has a short term non-deteriorating effect on sexuality despite the evident decrease in androgen serum levels.