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1.
Support Care Cancer ; 29(8): 4311-4318, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33411047

RESUMO

PURPOSE: Women's sexual health and wellbeing with cervical or vaginal cancer may be largely affected by complications from external beam radiotherapy (EBRT) and utero-vaginal brachytherapy (BT), of which vaginal stenosis is the main complication. The objective of this study was to assess the impact of support by a nurse sexologist on sexuality, vaginal side-effects, and the quality of clinical follow-up in patients treated with brachytherapy for cervical or vaginal cancer. METHODS: We performed a retrospective study of the sexuality of women treated for cervical or vaginal cancer. Data from patients with cervical or vaginal cancer who underwent brachytherapy between 2013 and 2017 were collected at Institut Universitaire de Cancer de Toulouse-Oncopôle (IUCT-Oncopôle). Patients were divided into two groups: group A (intervention group) received support from a nurse sexologist and group B (control group) did not. The chi-square test and a logistic multivariate model were used for data analysis. RESULTS: A total of 156 patients were included in this study, including 57.7% who were followed by a nurse sexologist. We observed low compliance in using vaginal dilators after brachytherapy and/or radiotherapy over time regardless of the group, and patients' sexual activity was inadequately addressed. Information regarding the resumption of sexuality 2 months after treatment was missing in 1.1% of patients in group A and in 36.4% of patients in group B. Multivariate analysis showed that patients in group A had a lower risk of developing vaginal stenosis with OR crude = 0.5 (95% CI = 0.25-0.92) and OR adj. = 0.5 (95% CI = 0.26-1.09) compared with those in group B. CONCLUSION: This retrospective study highlights the lack of information collected by physicians during follow-up concerning the sexuality of patients with cervical or vaginal cancer treated by EBRT and BT. The support offered by nurse sexologists in improving patients' sexual activity and reducing their physical side-effects such as vaginal stenosis is likely to be beneficial. A prospective study is currently being conducted to validate the present findings.


Assuntos
Braquiterapia/efeitos adversos , Sistemas de Apoio Psicossocial , Comportamento Sexual/psicologia , Sexualidade/estatística & dados numéricos , Neoplasias do Colo do Útero/radioterapia , Neoplasias Vaginais/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/radioterapia , Constrição Patológica/epidemiologia , Constrição Patológica/etiologia , Dilatação , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Cooperação do Paciente , Estudos Prospectivos , Estudos Retrospectivos , Sexologia/métodos
2.
Support Care Cancer ; 26(8): 2889-2899, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29541884

RESUMO

PURPOSE: To assess sexual health and needs for sexology care of cancer patients during chemotherapy. METHODS: We performed a 4-month cross-sectional study in cancer patients treated by chemotherapy in the digestive cancer department of a regional university hospital. Patients were asked to fill out a self-administered questionnaire about their sexual health, Sexual Quality of Life Questionnaire for Male (SQoL-M) or Female (SQoL-F), and their needs for sexology care. RESULTS: The study sample was composed of 47 men and 31 women. Tumor locations were 36 colorectal (46%), 23 pancreatic (30%), and 19 other digestive cancers (24%). SQoL scores were lower in women (p < .001), in pancreatic and colorectal tumors (p = .041 and p = .033, respectively) compared to other digestive cancers, and in less-educated patients (p = .023). During chemotherapy, 40% of sexually active patients had less frequent sexual intercourse than before diagnosis, and 33% had completely stopped sexual activity. Sexuality care was desired by 44% of respondents. Among them, 83% favored a consultation with a medical sexologist and 63% with a psycho-sexologist, 54% wanted couple therapy, and 31% considered support groups. Patients with colorectal cancer had more frequent sexual intercourse without penetration at the time of survey (p = .036) and more often wanted couple therapy than patients with pancreatic cancer (p = .048). CONCLUSIONS: This study is the first determination of sexual health and sexual quality of life in digestive cancers. Targets for interventions during chemotherapy for digestive cancers include populations with lower sexual quality of life: women, pancreatic sites, patients with sexual troubles during chemotherapy, and less-educated patients.


Assuntos
Neoplasias Gastrointestinais/psicologia , Qualidade de Vida/psicologia , Sexologia/métodos , Saúde Sexual/normas , Estudos Transversais , Feminino , França , Neoplasias Gastrointestinais/tratamento farmacológico , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
3.
J Sex Marital Ther ; 43(8): 760-773, 2017 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-27911184

RESUMO

Few studies explore the clinicians' knowledge, attitudes, and practices regarding sexuality, despite their role in the sexual-health socialization process. This study focuses on Portuguese sexologists engaged in clinical practice. It aims to characterize sexologists' sex education and training and their clinical practices, including diagnostic and therapeutic approaches. This research followed the methodology of an European survey on sexology as a profession (Euro-Sexo). From the 91 respondents who completed questionnaires, 51 (56%) were active in clinical practice. Results indicate that the Portuguese clinical sexologist is significantly older, predominantly male, has had training in sexology, performs more scientific research, and is more engaged in teaching activities when compared to nonclinical working sexologists. This article describes the main sexual problems presented by patients to Portuguese clinical sexologists and highlights differences in the professional groups and approaches toward treating these problems by medical doctors and nonmedical professionals. Results reinforce the idea that there are intra-European differences in the educational background of sexologists and reveal important variations in Portuguese sexologists' education, training, and clinical practice. The representations and practices of the sexologists in Portugal, as in other European countries, are embedded in cultural scenarios and sexual cultures, with implications for the clinical practice.


Assuntos
Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Relações Médico-Paciente , Educação Sexual/métodos , Sexologia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Médico , Portugal
5.
J Sex Med ; 7(4 Pt 2): 1627-56, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20388162

RESUMO

INTRODUCTION: Endocrine disorders may adversely affect men's sexual function. AIM: To provide recommendations based on best evidence for diagnosis and treatment of endocrine-related male sexual dysfunctions. METHODS: The Endocrine Aspects of Male Sexual Dysfunctions Committee, including 11 members from eight countries and four continents, collaborated with the Endocrine subcommittee of the Standards Committee of the International Society for Sexual Medicine. Medical literature was reviewed in detail, followed by extensive internal committee discussion over 2 years, then public presentation and discussion with the other experts before finalizing the report. MAIN OUTCOME MEASURE: Recommendations based on grading of evidence-base medical literature and interactive discussion. RESULTS: From animal studies, it is derived that testosterone modulates mechanisms involved in erectile machinery, including expression of enzymes that both initiate and terminate erection. In addition, testosterone is essential for sexual motivation. Whether these findings could be extrapolated to human erections is unclear. Testosterone plays a broad role in men's overall health. Recent studies have established strong associations between low testosterone and metabolic and cardiovascular imbalances. In some studies, low testosterone decreased longevity; however, longitudinal studies do not support the predictive value of low testosterone for further cardiovascular events. The article proposes a standardized process for diagnosis and treatment of endocrine-related male sexual dysfunctions, updating the knowledge on testosterone and prostate safety. There is no compelling evidence that testosterone treatment causes prostate cancer or its progression in men without severe testosterone deficiency (TD). The possible roles of prolactin and thyroid hormones are also examined. CONCLUSIONS: Men with erectile dysfunction, hypoactive sexual desire and retarded ejaculation, as well as those with visceral obesity and metabolic diseases, should be screened for TD and treated. Prospective interventional studies are required before screening for TD in more conditions, including cardiovascular diseases, and considering correction as preventive medicine as much data suggests.


Assuntos
Doenças do Sistema Endócrino , Disfunção Erétil , Testosterona , Algoritmos , Doenças Cardiovasculares/etiologia , Monitoramento de Medicamentos , Doenças do Sistema Endócrino/complicações , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/terapia , Disfunção Erétil/diagnóstico , Disfunção Erétil/etiologia , Disfunção Erétil/terapia , Medicina Baseada em Evidências , Humanos , Masculino , Programas de Rastreamento , Medicina/métodos , Medicina/normas , Síndrome Metabólica/complicações , Obesidade Abdominal/complicações , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Medição de Risco , Segurança , Sexologia/métodos , Sexologia/normas , Testosterona/deficiência , Testosterona/uso terapêutico , Urologia/métodos , Urologia/normas
6.
J Sex Med ; 7(4 Pt 2): 1657-67, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20388163

RESUMO

INTRODUCTION: Penile trauma is common with standard management options. Gender reassignment techniques are rapidly changing and penile augmentation remains a controversial topic. Consequently, there is need for a state-of-the-art information in this area. AIM: This study aims to develop an evidence-based state-of-the-art consensus report on the management of penile trauma, gender, reassignment and penile augmentation. METHODS: The study provides state-of-the-art knowledge regarding the prevalence, etiology, medical and surgical management of penile trauma, gender reassignment and penile augmentation, representing the opinion of leading experts developed in a consensus process over a 2-year period. MAIN OUTCOME MEASURES: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. CONCLUSIONS: Penile fracture should be managed surgically. Information should be readily available to patients to help them decide the surgical technique desired for gender reassignment and to justify any form of penile augmentation.


Assuntos
Implante Peniano , Pênis , Transexualidade/cirurgia , Amputação Traumática/diagnóstico , Amputação Traumática/cirurgia , Medicina Baseada em Evidências , Prova Pericial , Feminino , Humanos , Masculino , Medicina/métodos , Medicina/normas , Seleção de Pacientes , Implante Peniano/métodos , Implante Peniano/normas , Pênis/lesões , Pênis/cirurgia , Guias de Prática Clínica como Assunto , Prevalência , Reimplante/métodos , Ruptura , Sexologia/métodos , Sexologia/normas , Transexualidade/diagnóstico , Transexualidade/epidemiologia , Urologia/métodos , Urologia/normas , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/terapia
7.
J Sex Med ; 7(4 Pt 2): 1668-86, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20388164

RESUMO

INTRODUCTION: Ejaculatory/orgasmic disorders are common male sexual dysfunctions, and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. AIM: To provide recommendations and guidelines concerning current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men. METHODS: An international consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 25 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge of disorders of orgasm and ejaculation represent the opinion of seven experts from seven countries developed in a process over a 2-year period. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS: Premature ejaculation management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin re-uptake inhibitor [SSRI] and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. Behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Retrograde ejaculation is managed by education, patient reassurance, pharmacotherapy, or bladder neck reconstruction. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic atiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. CONCLUSIONS: Additional research is required to further the understanding of the disorders of ejaculation and orgasm.


Assuntos
Ejaculação , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Algoritmos , Anestésicos Locais/uso terapêutico , Terapia Comportamental , Ejaculação/fisiologia , Humanos , Masculino , Medicina/métodos , Medicina/normas , Visita a Consultório Médico , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Prevalência , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Sexologia/métodos , Sexologia/normas , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/epidemiologia , Disfunções Sexuais Psicogênicas/etiologia , Urologia/métodos , Urologia/normas
8.
J Sex Med ; 7(4 Pt 2): 1608-26, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20388161

RESUMO

INTRODUCTION: Erectile dysfunction (ED) is common and considered to be predominantly of vascular origin. AIM: To evaluate the link between ED and coronary artery disease (CAD) and provide a consensus report regarding evaluation and management. METHODS: A committee of eight experts from six countries was convened to review the worldwide literature concerning ED and CAD and provide a guideline for management. MAIN OUTCOME MEASURE: Expert opinion was based on grading the evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. RESULTS: ED and CAD frequently coexist. Between 50-70% of men with CAD have ED. ED can arise before CAD is symptomatic with a time window of 3-5 years. ED and CAD share the same risk factors, and endothelial dysfunction is the common denominator. Treating ED in cardiac patients is safe, provided that their risks are properly evaluated. CONCLUSION: ED is a marker for silent CAD that needs to be excluded. Men with CAD frequently have ED that can be treated safely following guidelines.


Assuntos
Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/terapia , Disfunção Erétil/diagnóstico , Disfunção Erétil/terapia , Comorbidade , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/epidemiologia , Complicações do Diabetes/complicações , Disfunção Erétil/complicações , Disfunção Erétil/epidemiologia , Medicina Baseada em Evidências , Humanos , Hiperlipidemias/complicações , Hipertensão/complicações , Estilo de Vida , Masculino , Medicina/métodos , Medicina/normas , Síndrome Metabólica/complicações , Obesidade/complicações , Guias de Prática Clínica como Assunto , Medição de Risco , Fatores de Risco , Sexologia/métodos , Sexologia/normas , Fumar/efeitos adversos , Urologia/métodos , Urologia/normas
9.
J Sex Marital Ther ; 36(3): 282-94, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20432127

RESUMO

The purpose of this study was to determine whether participation in a short and well-structured psychosexual therapy was effective for people with a broad range of physical impairments and chronic diseases. Data were collected from 37 men and 10 women (between 30 and 70 years of age). The results demonstrated that psychosexual therapy has a positive effect on several areas of sexual well-being: less relational stress and sexual stress and an increase in sexual satisfaction, sexual esteem, sexual interaction competence, and a higher frequency in sexual contact. Although based on a relatively small sample, these findings clearly indicate that people with physical impairments can benefit from psychosexual therapy.


Assuntos
Pessoas com Deficiência/psicologia , Psicoterapia/métodos , Sexologia/métodos , Comportamento Sexual/psicologia , Adulto , Idoso , Doença Crônica/psicologia , Atenção à Saúde , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Avaliação de Programas e Projetos de Saúde , Autoimagem
10.
Rev Med Suisse ; 6(241): 625-7, 2010 Mar 24.
Artigo em Francês | MEDLINE | ID: mdl-20408365

RESUMO

Psychoanalysis and sexology are both int-rested in human sexuality but they do not share the same approach. Sexual medicine and sexotherapy aim to o-jectify sexuality and to treat sexual disorders whereas psychoanalysis is more interested in the discovery and the understanding of the subjective experienceoof sexuality. In psych-analysis, change arises rather from acceptance than modification. Evidence based medicine shows that the efficacy of sex therapy is limited and recommends the use of integrative approaches. Psychoanalysis is a necessary complement to sexology because of the links it forges between functional sexuality and psychosexuality, a sexuality with a psychological and emotional dimension, related to an individual's personal history and his identity.


Assuntos
Psicanálise , Sexologia/métodos , Disfunções Sexuais Psicogênicas/terapia , Humanos , Personalidade , Relações Médico-Paciente
11.
Psychol Bull ; 135(5): 794-821, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19702384

RESUMO

Evolutionary psychologists explore the adaptive function of traits and behaviors that characterize modern Homo sapiens. However, evolutionary psychologists have yet to incorporate the phylogenetic relationship between modern Homo sapiens and humans' hominid and pongid relatives (both living and extinct) into their theorizing. By considering the specific timing of evolutionary events and the role of evolutionary constraint, researchers using the phylogenetic approach can generate new predictions regarding mating phenomena and derive new explanations for existing evolutionary psychological findings. Especially useful is the concept of the adaptive workaround-an adaptation that manages the maladaptive elements of a pre-existing evolutionary constraint. The current review organizes 7 features of human mating into their phylogenetic context and presents evidence that 2 adaptive workarounds played a critical role as Homo sapiens's mating psychology evolved. These adaptive workarounds function in part to mute or refocus the effects of older, previously evolved adaptations and highlight the layered nature of humans' mating psychology.


Assuntos
Evolução Biológica , Genética Comportamental/métodos , Filogenia , Psicologia/métodos , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Adaptação Biológica/genética , Adaptação Biológica/fisiologia , Adaptação Psicológica/fisiologia , Humanos , Sexologia/métodos
12.
J Sex Res ; 56(4-5): 475-510, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30793956

RESUMO

Sexual scientists must choose from among myriad methodological and analytical approaches when investigating their research questions. How can scholars learn whether sexualities are discrete or continuous? How is sexuality constructed? And to what extent are sexuality-related groups similar to or different from one another? Though commonplace, quantitative attempts at addressing these research questions require users to possess an increasingly deep repertoire of statistical knowledge and programming skills. Recently developed open-source software offers powerful yet accessible capacity to researchers wishing to perform strong quantitative tests. Taking advantage of these new statistical opportunities will require sexual scientists to become familiar with new analyses, including taxometric analysis, tests of measurement variability and differential item functioning, and equivalence testing. In the current article, I discuss each of these analyses, providing conceptual and historical overviews. I also address common misunderstandings for each analysis that may discourage researchers from implementing them. Finally, I describe current best practices when using each analysis, providing reproducible coding examples and interpretations along the way, in an attempt to reduce barriers to the uptake of these analyses. By aspiring to explore these new statistical frontiers in sexual science, sexuality researchers will be better positioned to test their substantive theories of interest.


Assuntos
Sexologia , Estatística como Assunto , Humanos , Sexologia/métodos
13.
ScientificWorldJournal ; 8: 883-95, 2008 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-18836654

RESUMO

The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 "e 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the inverted exclamation mark section signsexological examination inverted exclamation mark ). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the inverted exclamation mark section signorgasm course for anorgasmic women inverted exclamation mark ; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 < NNT < 1.12, NNH > 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.


Assuntos
Saúde Holística , Sexologia/métodos , Disfunções Sexuais Psicogênicas/terapia , Doenças da Vulva/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medicina Clínica , Terapias Complementares , Feminino , Humanos , Masturbação , Pessoa de Meia-Idade , Psicoterapia Breve , Psicoterapia de Grupo , Estudos Retrospectivos , Tato , Vibração/uso terapêutico
14.
ScientificWorldJournal ; 6: 2066-79, 2006 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-17370003

RESUMO

Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm) are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions released by the technique, i.e., regression to earlier traumas from childhood sexual abuse. This review discusses the theory behind vaginal acupressure, ethical aspects, and presentation of a case story. This procedure helped the patient to become present in her pelvis and to integrate old traumas with painful emotions. Holistic gynecology and sexology can help the patient to identify and let go of negative feelings, beliefs, and attitudes related to sex, gender, sexual organs, body, and soul at large. Shame, guilt, helplessness, fear, disgust, anxiety, anger, hatred, and other strong feelings are almost always an important part of a sexual or functional problem as these feelings are "held" by the tissue of the pelvis and sexual organs. Acupressure through the vagina/pelvic massage must be done with great care by an experienced physician, with a third person present, after obtaining consent and the necessary trust of the patient. It must be followed by conversational therapy and further holistic existential processing.


Assuntos
Acupressão/métodos , Medicina Clínica/métodos , Saúde Holística , Sexologia/métodos , Vagina , Acupressão/psicologia , Acupressão/tendências , Adulto , Criança , Abuso Sexual na Infância/psicologia , Medicina Clínica/tendências , Feminino , Humanos , Massagem/métodos , Massagem/psicologia , Massagem/tendências , Pelve/fisiologia , Vagina/fisiologia
15.
ScientificWorldJournal ; 6: 2100-16, 2006 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-17370006

RESUMO

This is a pilot study of 20 female patients with a long history of sexual problems (mean is 8.92 years) who received vaginal acupressure (VA) with a quantitative and qualitative evaluation: 56% experienced help and none reported setbacks, 89% rated the treatment to be of high quality, and 89% rated it as valuable. After the treatment, most reported their problems to be less serious and their general quality of life improved. Only 17% reported minor or temporary side effects. VA was found statistically and clinically significant (p < 0.05, improvement more than 0.5 step on a 5-point Likert scale) to help patients with chronic genital pains, pain or discomfort during sexual intercourse, lack of desire or orgasm, and subjective sexual insufficiency, and all patients taken as one group (about 1 step up a 5-point Likert scale). Self-evaluated physical and mental health was significantly improved for the total group; the relationship with partner, the subjective sexual ability, and the quality of life that were measured with QOL1 and QOL5 questionnaires were all significantly improved. VA or Hippocratic pelvic massage is technically a simple procedure corresponding to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings provoked followed by processing and integration of these feelings, but ethical aspects are complicated. Acupressure through the vagina/pelvic massage must be done according to the highest ethical standard with great care, after obtaining consent and the necessary trust of the patient within the framework of the local laws. It must be followed by conversational therapy and further holistic existential processing.


Assuntos
Acupressão/métodos , Medicina Clínica/métodos , Saúde Holística , Pelve , Vagina , Acupressão/psicologia , Adulto , Medicina Clínica/tendências , Feminino , Humanos , Massagem/métodos , Massagem/psicologia , Massagem/tendências , Terapias Mente-Corpo/métodos , Terapias Mente-Corpo/psicologia , Terapias Mente-Corpo/tendências , Pelve/fisiologia , Projetos Piloto , Sexologia/métodos , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Vagina/fisiologia
16.
Urologe A ; 45(8): 953-4, 956-9, 2006 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-16830127

RESUMO

Sexual medicine is a subdiscipline of clinical medicine that deals with human sexuality and disorders. Sexuality eludes a unilateral definition. As a biologically, psychologically, and socially determined experience dimension of the human being, its individual form depends on biological factors and developments in the person's life. Moreover, sexuality exhibits different dimensions--lust, reproduction, and relationship--that are indeed closely interrelated. For this reason, directing therapy at only one of these dimensions is not adequate. All human beings are programmed toward fulfillment of elementary biopsychosocial needs such as acceptance, closeness, warmth, and security. If these basic needs are shortchanged in terms of fulfillment, all sorts of restrictions in the quality of life ensue, even to the point of resultant disorders of sexual function. Treatment then approaches the roots when it does not center on the sexual dysfunction but rather on the underlying frustrated relationship of the partners. Syndyastic sexual therapy is an important treatment method in sexual medicine.


Assuntos
Relações Interpessoais , Psicologia , Sexologia/métodos , Sexologia/tendências , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Sexualidade , Alemanha , Humanos , Disfunções Sexuais Fisiológicas/psicologia
17.
Urologe A ; 45(8): 960-6, 2006 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-16819602

RESUMO

Salutogenesis means a paradigmatic change in medicine. While pathogenesis restricts itself to finding out what makes a man ill, salutogenesis tries to find out what keeps him or her healthy. The human being is seen as a biological, psychological, and social creature. There are many studies which show the importance of social relationships and the satisfaction of basic psychosocial needs as protection against psychological or psychosomatic disorders. The psychosocial basic needs for acceptance, intimacy, and security can be best fulfilled by sexual communication with the partner. Therefore a salutogenic approach to sexual medicine focuses mainly on the fulfillment of these needs and not only on the treatment of a sexual dysfunction. Unnecessarily frustrating experiences can thus be avoided, especially when the sexual possibilities of one or both partners are restricted by an illness or its medical treatment. A case report shows how sexual communication and sex therapy can help to cope with a tumor disease.


Assuntos
Atenção à Saúde/tendências , Relações Interpessoais , Psicologia , Sexologia/métodos , Sexologia/tendências , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Alemanha , Humanos , Disfunções Sexuais Fisiológicas/psicologia , Sexualidade
18.
J Sex Res ; 52(4): 396-411, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25897568

RESUMO

With few exceptions, much of sexual science builds upon data from opportunistic nonprobability samples of limited generalizability. Although probability-based studies are considered the gold standard in terms of generalizability, they are costly to apply to many of the hard-to-reach populations of interest to sexologists. The present article discusses recent conclusions by sampling experts that have relevance to sexual science that advocates for nonprobability methods. In this regard, we provide an overview of Internet sampling as a useful, cost-efficient, nonprobability sampling method of value to sex researchers conducting modeling work or clinical trials. We also argue that probability-based sampling methods may be more readily applied in sex research with hard-to-reach populations than is typically thought. In this context, we provide three case studies that utilize qualitative and quantitative techniques directed at reducing limitations in applying probability-based sampling to hard-to-reach populations: indigenous Peruvians, African American youth, and urban men who have sex with men (MSM). Recommendations are made with regard to presampling studies, adaptive and disproportionate sampling methods, and strategies that may be utilized in evaluating nonprobability and probability-based sampling methods.


Assuntos
Projetos de Pesquisa Epidemiológica , Estudos Epidemiológicos , Internet , Seleção de Pacientes , Projetos de Pesquisa/normas , Sexologia/métodos , Humanos , Estudos de Amostragem
19.
ScientificWorldJournal ; 4: 571-80, 2004 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-15311333

RESUMO

Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient"s sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often "held" by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus) or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a written therapeutic contract with the patient is highly recommended and a strict ethical code is necessary to avoid malpractice. As about one woman in three suffers from sexual problems, many of which seemingly can be efficiently alleviated by the simple holistic techniques of "holding and processing", it is very important that the holistic physician is also trained to work in the sexual sphere in order to be able to support his patients fully.


Assuntos
Medicina Clínica , Saúde Holística , Manejo da Dor , Dor/psicologia , Sexologia/métodos , Tato , Doenças da Vulva/psicologia , Doenças da Vulva/terapia , Terapias Complementares , Feminino , Humanos
20.
Semergen ; 40 Suppl 3: 22-7, 2014 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-25953038

RESUMO

Strategies, recommendations and techniques proposed by sex therapy for intervention on premature ejaculation, have represented for nearly four decades the most effective model of intervention in this sexual dysfunction, which currently is complemented by the efficacy of dapoxetine drug treatment. Clinical experience and recent studies support that combined intervention offers the best therapeutic results. In addition in sex therapy, etiologic diagnosis is obtained from the analysis of the interrelationship of the couple. Diagnostic and therapeutic intervention has to be always centered in the relationship, so the techniques and resources must be applied with the expectation of being implemented in the sexual interaction. It will therefore be the relationship that receive treatment, even if medication is used for one of the members of the couple. On the other hand, this model of intervention can be implemented by a professional with training, although not necessarily a specialist.


Assuntos
Benzilaminas/uso terapêutico , Naftalenos/uso terapêutico , Ejaculação Precoce/terapia , Parceiros Sexuais/psicologia , Terapia Combinada , Feminino , Humanos , Masculino , Ejaculação Precoce/diagnóstico , Ejaculação Precoce/etiologia , Sexologia/métodos , Comportamento Sexual/psicologia
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