Disfunção sexual em mulheres com câncer do colo do útero submetidas à radioterapia: análise de conceito / Disfunción sexual en mujeres con cáncer de cuello uterino sometidas a radioterapia: análisis de concepto / Sexual dysfunction in women with cervical cancer undergoing radiotherapy: concept analysis

Resumo Objetivo analisar o conceito de disfunção sexual em mulheres com câncer do colo do útero submetidas a tratamento radioterápico. Método estudo de análise de conceito fundamentado no referencial metodológico proposto por Walker e Avant, o qual é composto por oito etapas: seleção do conceito; determinação dos objetivos da análise conceitual; identificação dos possíveis usos do conceito; determinação dos atributos críticos ou essenciais; construção de um caso modelo; construção de casos adicionais; identificação dos antecedentes e consequentes do conceito; e definição das referências empíricas. Resultados a amostra final resultou em 11 artigos, que identificaram 4 atributos críticos, 18 antecedentes e 07 consequentes do conceito, os quais permitiram a construção de uma definição conceitual e elaboração de um caso-modelo, com a finalidade de exemplificar o contexto social no qual o conceito encontra-se inserido. Conclusão e implicações para prática alterações na estrutura corporal, déficit de conhecimento, diminuição da frequência das relações sexuais, dispareunia e indiferença do parceiro são alguns dos principais antecedentes e consequentes da disfunção sexual na população estudada. Entretanto, esses fatores ainda são pouco conhecidos, o que limita a realização de ações de promoção, prevenção e reabilitação sexual, sobretudo no campo da enfermagem.

Resumen Objetivo analizar el concepto de disfunción sexual en mujeres con cáncer de cuello uterino sometidas a tratamiento radioterápico. Método estudio de análisis de concepto basado en el marco metodológico de Walker y Avant, compuesto por ocho etapas: selección del concepto; determinación de los objetivos del análisis conceptual; identificación de posibles usos del concepto; determinación de atributos críticos o esenciales; construcción de un caso modelo; construcción de casos adicionales; identificación de antecedentes y consecuentes del concepto; y definición de referencias empíricas. Resultados La muestra final resultó en 11 artículos: 04 críticos, 18 antecedentes y 07 consecuentes del concepto, lo que permitió la construcción de una definición conceptual y la elaboración de un caso modelo con el fin de ejemplificar el contexto social en que se inserta el concepto. Conclusión e implicaciones para la práctica Cambios en la estructura corporal, déficit de conocimiento, disminución de la frecuencia de las relaciones sexuales, dispareunia y la indiferencia de la pareja son algunos de los principales antecedentes y consecuentes de la disfunción sexual en la población estudiada. Sin embargo, estos factores aún son poco conocidos, lo que limita la realización de acciones de promoción, prevención y rehabilitación sexual, especialmente en el campo de la enfermería.

Abstract Objective to analyze the concept of sexual dysfunction in women with cervical cancer undergoing radiotherapy. Method a concept analysis study based on the methodological framework proposed by Walker and Avant, which consists of eight stages: concept selection; determination of the objectives of the conceptual analysis; identification of possible uses of the concept; determination of critical or essential attributes; construction of a model case; construction of additional cases; identification of the antecedents and consequences of the concept; and definition of empirical references. Results the final sample resulted in 11 articles, which identified 4 critical attributes, 18 antecedents and 07 consequences of the concept, which allowed the construction of a conceptual definition and the elaboration of a model case in order to exemplify the social context in which the concept is inserted. Conclusion and implications for practice changes in body structure, lack of knowledge, decreased frequency of sexual intercourse, dyspareunia, and partner's indifference are some of the main antecedents and consequences of sexual dysfunction in the studied population. However, these factors are still little known, which limits the performance of actions of promotion, prevention and sexual rehabilitation, especially in the field of nursing.

Critical analysis of methods for assessing genitourinary syndrome of menopause used in clinical trials.

OBJECTIVE: The aim of the study was to determine the most used methods for assessing genitourinary syndrome of menopause by the latest studies on the subject, and to critically assess their differences and comparability. METHODS: A narrative review of the literature was conducted, employing the terms genitourinary syndrome, vaginal atrophy, urogenital atrophy, and atrophic vaginitis, to analyze methods used to assess treatment efficacy. Only controlled randomized clinical trials assessing improvement of genitourinary syndrome of menopause, conducted in the last 5 years, and considering all types of treatment, were selected. RESULTS: Of the 37 studies included, 24 combined both objective and subjective methods thereby ensuring reproducibility and efficacy of symptom relief of the treatment analyzed. The vaginal maturation index was the most used objective method, followed by vaginal pH. One study used histological and immunohistochemistry tests. Regarding subjective methods, the "Most bothering Symptom" and other questionnaires as the Female Sexual Function Index for sex life, the Verbal Rating Scale, among others, were used. CONCLUSIONS: Despite the heterogeneity observed, particularly for subjective assessment of symptoms, there was a tendency to standardize methods and to use an objective method together with a subjective, which seems to be fundamental to guarantee reproducibility and comparability of results of each treatment analyzed. Histological and immunohistochemistry tests may be an option as an objective method in further studies, to better assess thickness, vascularization, among other parameters.

The effect of vaginal erbium laser treatment on sexual function and vaginal health in women with a history of breast cancer and symptoms of the genitourinary syndrome of menopause: a prospective study.

OBJECTIVES: To assess the effects of vaginal erbium laser treatment on the vaginal health and sexual function of postmenopausal women with a history of breast cancer. METHODS: An open, prospective, therapeutic intervention study was conducted with 24 postmenopausal women with a history of breast cancer and vaginal dryness, and/or dyspareunia, who had not used vaginal hormone therapy for at least 6 months. The women were treated using a 2,940-nm Erbium: YAG laser (Etherea-MX, Athena, São Carlos, São Paulo, Brazil), with 90 and 360 scanning scopes, between August, 2017 and October, 2017 in a private clinic in a city of southeastern Brazil. Vaginal erbium laser treatment was performed at three sessions with a 30-day interval between each session. Sexual function was assessed before and 1 month after treatment using the Short Personal Experiences Questionnaire. Questions related to genitourinary symptoms were also applied. Vaginal health was assessed before each laser session using the Vaginal Health Index Score. RESULTS: Mean age was 53.7 years. Vaginal health improved, as shown by an increased overall score (P < 0.001). The effect size was large between pretreatment and post-treatment scores for vaginal elasticity, fluid volume, epithelial integrity, and moisture. The effect size was also significant for the overall sexual function score and for the score in the dyspareunia domain between pretreatment and 1 month after the final treatment session. CONCLUSION: Vaginal erbium laser may represent a novel therapeutic option for improving vaginal health and sexual function in postmenopausal women with a history of breast cancer.

Lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis.

OBJECTIVES: To assess the prevalence and interrelationship between lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis (MS). METHODS: In a cross-sectional study, we evaluated 41 men (mean age 41.1±9.9 years) with MS from February 2011 to March 2013, who were invited to participate irrespective of the presence of lower urinary tract symptoms or sexual dysfunction. Neurological impairment was assessed with the Expanded Disability Status Scale; lower urinary tract symptoms were evaluated with the International Continence Society male short-form questionnaire, and sexual dysfunction was evaluated with the International Index of Erectile Function. All patients underwent transabdominal urinary tract sonography and urine culture. RESULTS: The mean disease duration was 10.5±7.3 years. Neurological evaluation showed a median Expanded Disability Status Scale score of 3 [2-6]. The median International Continence Society male short-form questionnaire score was 17 [10-25]. The median International Index of Erectile Function score was 29 [15-46]. Twenty-nine patients (74.4%) had sexual dysfunction as defined by an International Index of Erectile Function score <45. Voiding dysfunction and sexual dysfunction increased with the degree of neurological impairment (r=0.02 [0.02 to 0.36] p=0.03 and r=-0.41 [-0.65 to -0.11] p=0.008, respectively). Lower urinary tract symptoms and sexual dysfunction also displayed a significant correlation (r=-0.31 [-0.56 to -0.01] p=0.04). CONCLUSIONS: Most male patients with MS have lower urinary tract symptoms and sexual dysfunction. The severity of the neurological disease is a predictive factor for the occurrence of voiding and sexual dysfunctions.

Intervenções de enfermagem para incontinência urinária e disfunção sexual após prostatectomia radical / Intervenciones de enfermería para incontinencia urinaria y disfunción sexual después de prostatectomía radical / Nursing interventions for urinary incontinence and sexual dysfunction after radical prostatectomy

Resumo Objetivo: Investigar, na literatura, intervenções de enfermagem para promover continência urinária e adaptação à disfunção sexual após prostatectomia radical. Métodos: Revisão integrativa da literatura nas bases de dados PubMed, Web of Science, Scopus, CINAHL, e LILACS, utilizando os descritores "cuidados de enfermagem", "incontinência urinária", "disfunção erétil", e "prostatectomia" e as palavras chaves "enf*", "impotência sexual masculina" e "prostatectomia radical". Resultados: Dezoito publicações foram incluídas, entre essas, oito descreviam intervenções para a incontinência urinária, cinco para disfunção sexual e cinco para ambas as complicações. Foram encontradas três estratégias para implementação das intervenções, 16 intervenções para incontinência e 12 para disfunção sexual. Conclusão: Nas estratégias para implementação das intervenções, notou-se a importância de que o enfermeiro utilize diferentes recursos para assistir os pacientes. Para a incontinência urinária, o foco das intervenções variou entre educativo, comportamental e físico. Para disfunção sexual, observou-se um predomínio de ações psicoeducativas aos pacientes e, quando possível, ao parceiro sexual.

Resumen Objetivo: Investigar, en la literatura, intervenciones de enfermería para promover continencia urinaria y adaptación a la disfunción sexual después de prostatectomía radical. Métodos: Revisión integrativa de la literatura en las bases de datos PubMed, Web of Science, Scopus, CINAHL, y LILACS, utilizando los descriptores "cuidados de enfermería", "incontinencia urinaria", "disfunción eréctil", y "prostatectomía" y las palabras claves "enf *", "impotencia sexual masculina" y "prostatectomía radical". Resultados: Dieciocho publicaciones fueron incluidas; entre ellas, ocho describían intervenciones para la incontinencia urinaria, cinco para disfunción sexual y cinco para ambas complicaciones. Se encontraron tres estrategias para la implementación de intervenciones, 16 intervenciones para incontinencia y 12 para disfunción sexual. Conclusão: En las estrategias para la implementación de las intervenciones, se notó la importancia de que el enfermero utilice diferentes recursos para asistir a los pacientes. Para la incontinencia urinaria, el foco de las intervenciones varió entre educativo, conductual y físico. Para la disfunción sexual, se observó un predominio de acciones psicoeducativas junto a los pacientes y, siempre que posible, junto al compañero sexual.

Abstract Objective: Investigate, in the literature, nursing interventions to promote urinary continence and adapt to sexual dysfunction after radical prostatectomy. Methods: Integrative literature review in the databases PubMed, Web of Science, Scopus, CINAHL, and LILACS, using the descriptors "nursing care", "urinary incontinence", "erectile dysfunction", and "prostatectomy", and the keywords "nurse", "male sexual impotence" and "radical prostatectomy". Results: Eighteen publications were included, eight of which described interventions for urinary incontinence, five for sexual dysfunction and five for both complications. Three intervention strategies were found: 16 interventions for incontinence and 12 for sexual dysfunction. Conclusion: In the implementation strategies of interventions, the importance of nurses using different resources to attend to patients was observed. For urinary incontinence, the focus of interventions varied among educational, behavioral and physical. For sexual dysfunction, a predominance of psychoeducational actions was observed, involving the patients and, when possible the sexual partners.

Lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis

OBJECTIVES: To assess the prevalence and interrelationship between lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis (MS). METHODS: In a cross-sectional study, we evaluated 41 men (mean age 41.1±9.9 years) with MS from February 2011 to March 2013, who were invited to participate irrespective of the presence of lower urinary tract symptoms or sexual dysfunction. Neurological impairment was assessed with the Expanded Disability Status Scale; lower urinary tract symptoms were evaluated with the International Continence Society male short-form questionnaire, and sexual dysfunction was evaluated with the International Index of Erectile Function. All patients underwent transabdominal urinary tract sonography and urine culture. RESULTS: The mean disease duration was 10.5±7.3 years. Neurological evaluation showed a median Expanded Disability Status Scale score of 3 [2-6]. The median International Continence Society male short-form questionnaire score was 17 [10-25]. The median International Index of Erectile Function score was 29 [15-46]. Twenty-nine patients (74.4%) had sexual dysfunction as defined by an International Index of Erectile Function score <45. Voiding dysfunction and sexual dysfunction increased with the degree of neurological impairment (r=0.02 [0.02 to 0.36] p=0.03 and r=-0.41 [-0.65 to -0.11] p=0.008, respectively). Lower urinary tract symptoms and sexual dysfunction also displayed a significant correlation (r=-0.31 [-0.56 to -0.01] p=0.04). CONCLUSIONS: Most male patients with MS have lower urinary tract symptoms and sexual dysfunction. The severity of the neurological disease is a predictive factor for the occurrence of voiding and sexual dysfunctions.

Translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese.

INTRODUCTION: Sexual dysfunction is common in patients with psychotic illness. This article describes the translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese. METHODS: The translation and cross-cultural adaptation followed the guidelines for adapting self-report instruments proposed by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Briefly, ISPOR steps include: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing and finalization, before proofreading and final version. The original authors authorized the translation and participated in the study. RESULTS: There was good agreement between translations and between the back-translation and the original English version of the SFQ. The final version was prepared with certificated evaluators in the original language and in Portuguese. Few changes were necessary to the new version in Portuguese. CONCLUSION: The translated and adapted Brazilian Portuguese version of the SFQ is reliable and semantically equivalent to the original version. Studies on psychotropic-related sexual dysfunction may now test the validity of the instrument and can investigate sexual dysfunction in Portuguese-speaking patients.

Sexual dysfunction in females with depression: a cross-sectional study.

INTRODUCTION: Female sexual dysfunction (FSD) in depression albeit common is strikingly understudied. The condition, if addressed properly, can be readily cured, improving the quality of life of the patient. METHODS: A consecutive sample of drug-naïve married female patients with depression was assessed. Depression was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and sexual dysfunction, the Female Sexual Function Index (FSFI). RESULTS: Sexual dysfunction was found in 90% of the patients in our study. Patients with medical comorbidities showed a significant decrease in the desire subset of the FSFI (Mann-Whitney U=11.0, p=0.009), however there was no significant association with other subsets. Patients who expressed passive death wishes had higher scores on all indicators of sexual function and a significantly higher score in the orgasm subset of the FSFI (Mann-Whitney U=11.0, p=0.009). CONCLUSION: The study showed a high prevalence of FSD in depressed females regardless of type and severity of depression. Depression with medical comorbidities was associated with a significant decrease in desire. Patients who expressed passive death wishes showed improved sexual function and significantly better orgasm.

Sexual dysfunction in females with depression: a cross-sectional study / Disfunção sexual em mulheres com depressão: um estudo transversal

Abstract Introduction Female sexual dysfunction (FSD) in depression albeit common is strikingly understudied. The condition, if addressed properly, can be readily cured, improving the quality of life of the patient. Methods A consecutive sample of drug-naïve married female patients with depression was assessed. Depression was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D), and sexual dysfunction, the Female Sexual Function Index (FSFI). Results Sexual dysfunction was found in 90% of the patients in our study. Patients with medical comorbidities showed a significant decrease in the desire subset of the FSFI (Mann-Whitney U=11.0, p=0.009), however there was no significant association with other subsets. Patients who expressed passive death wishes had higher scores on all indicators of sexual function and a significantly higher score in the orgasm subset of the FSFI (Mann-Whitney U=11.0, p=0.009). Conclusion The study showed a high prevalence of FSD in depressed females regardless of type and severity of depression. Depression with medical comorbidities was associated with a significant decrease in desire. Patients who expressed passive death wishes showed improved sexual function and significantly better orgasm.

Resumo Introdução Disfunção sexual feminina (DSF) na depressão, apesar de comum, é pouco estudada. Se tratada adequadamente, a condição pode ser prontamente curada, aumentando a qualidade de vida da paciente. Métodos Foi avaliada uma amostra consecutiva de mulheres casadas, virgens de tratamento, com depressão. A depressão foi diagnosticada utilizando a Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). A gravidade da depressão foi avaliada utilizando a Escala de Avaliação de Depressão de Hamilton (HAM-D), e a disfunção sexual, com o Índice da Função Sexual Feminina (Female Sexual Function Index, FSFI). Resultados Foi observada disfunção sexual em 90% das pacientes do estudo. As pacientes com comorbidades médicas mostraram uma diminuição significativa no subdomínio desejo da FSFI (Mann-Whitney U=11,0, p=0,009), porém não houve associação significativa com os outros subdomínios. Pacientes que expressaram desejos passivos de morte apresentaram escores mais altos em todos os indicadores de função sexual e um escore significativamente mais alto no subdomínio orgasmo da FSFI (Mann-Whitney U=11,0, p=0,009). Conclusão O estudo revelou uma alta prevalência de DSF em mulheres deprimidas, independentemente do tipo e da severidade da depressão. A depressão com comorbidades médicas foi associada a uma diminuição significativa do desejo. Pacientes que expressaram desejos passivos de morte mostraram função sexual melhor e orgasmo significativamente melhor.

Translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese / Tradução e adaptação transcultural do Questionário de Função Sexual (SFQ) para o português do Brasil

Abstract Introduction Sexual dysfunction is common in patients with psychotic illness. This article describes the translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese. Methods The translation and cross-cultural adaptation followed the guidelines for adapting self-report instruments proposed by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Briefly, ISPOR steps include: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing and finalization, before proofreading and final version. The original authors authorized the translation and participated in the study. Results There was good agreement between translations and between the back-translation and the original English version of the SFQ. The final version was prepared with certificated evaluators in the original language and in Portuguese. Few changes were necessary to the new version in Portuguese. Conclusion The translated and adapted Brazilian Portuguese version of the SFQ is reliable and semantically equivalent to the original version. Studies on psychotropic-related sexual dysfunction may now test the validity of the instrument and can investigate sexual dysfunction in Portuguese-speaking patients.

Resumo Introdução A disfunção sexual é comum em pacientes com doença psicótica. Este artigo descreve a tradução e adaptação transcultural do Questionário de Função Sexual (SFQ) para o português do Brasil. Métodos A tradução e a adaptação transcultural seguiram as diretrizes para a adaptação de instrumentos de autorrelato propostas pela Força-Tarefa da Sociedade Internacional de Pesquisa Farmacológica e de Resultados (International Society for Pharmacoeconomics and Outcomes Research, ISPOR). As etapas da ISPOR incluem: preparação, primeiras traduções, reconciliação, retrotradução, revisão da retrotradução, harmonização, interrogatório cognitivo, revisão do interrogatório cognitivo e finalização, antes da revisão e versão final. Os autores originais autorizaram a tradução e participaram do estudo. Resultados Houve boa concordância entre as traduções e entre a retrotradução e a versão original em inglês do SFQ. A versão final foi preparada com avaliadores certificados na língua original e em português. Poucas mudanças foram necessárias para a nova versão em português. Conclusão A versão brasileira traduzida e adaptada do SFQ é confiável e semanticamente equivalente à versão original. Estudos sobre disfunção sexual relacionada a psicotrópicos podem agora testar a validade do instrumento e investigar a disfunção sexual em pacientes brasileiros.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study / Análise da função sexual de pacientes com dermatomiosite e polimiosite através de questionários autoaplicados: um estudo transversal

Abstract Introduction: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). Objective: To assess sexual function in female patients with DM/PM. Patients and methods: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. Results: The mean age of patients was comparable to controls (32.7 ± 5.3 vs. 31.7 ± 6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. Conclusions: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Resumo Introdução: Até o presente momento, não há descrições na literatura da avaliação ginecológica e da função sexual em pacientes do sexo feminino com dermatomiosite (DM) e polimiosite (PM). Objetivos: Avaliar a função sexual em pacientes do sexo feminino com DM/PM. Casuística e métodos: Estudo transversal unicêntrico em que 23 pacientes (16 DM e sete PM), entre 18 e 40 anos, foram comparadas com 23 mulheres saudáveis, com a mesma faixa etária. As características sobre a função sexual foram obtidas por meio da aplicação dos questionários Female Sexual Quotient (FSQ) e Female Sexual Function Index (FSFI) validados para a língua portuguesa do Brasil. Resultados: A média de idade das pacientes foi comparável à dos controles (32,7 ± 5,3 vs. 31,7 ± 6,7 anos), assim como a distribuição de etnia e da classe socioeconômica. Quanto às características ginecológicas, pacientes e controles saudáveis não apresentaram diferenças em relação à idade na menarca e às porcentagens de dismenorreia, menorragia, síndrome pré-menstrual, dor no meio do ciclo, secreção mucocervical e corrimento vaginal. O escore de pontuação do FSQ, assim como todos os domínios do questionário do FSFI (desejo, excitação, lubrificação, orgasmo e satisfação), estavam significantemente diminuídos nas pacientes comparativamente com os controles, 60,9% das pacientes apresentavam algum grau de disfunção sexual. Conclusões: Este foi o primeiro estudo que identificou disfunção sexual nas pacientes com DM/PM. Assim, uma abordagem multidisciplinar é essencial para pacientes com miopatias inflamatórias idiopáticas para fornecer medidas de prevenção e cuidados para sua vida sexual e propiciar uma melhor qualidade de vida das pacientes e de seus parceiros.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study.

INTRODUCTION: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). OBJECTIVE: To assess sexual function in female patients with DM/PM. PATIENTS AND METHODS: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. RESULTS: The mean age of patients was comparable to controls (32.7±5.3 vs. 31.7±6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. CONCLUSIONS: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Metabolic syndrome and sexual function in postmenopausal women.

OBJECTIVE: The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. SUBJECTS AND METHODS: This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant's sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. RESULTS: The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). CONCLUSION: We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Depression, sexuality and fibromyalgia syndrome: clinical findings and correlation to hematological parameters.

OBJECTIVE: To investigate sexuality and depression in women with FM compared with controls and to correlate the findings with hematological parameters. METHODS: 33 women with FM and 19 healthy women were included and evaluated with the following instruments: Female Sexual Function Index, Beck Inventory, Visual Analogue Scale, medical history and laboratory exams. RESULTS: The prevalence of sexual dysfunction (P = 0.007) and depression (P < 0.001) were higher in the study group than in the control group; they were positively correlated (P = 0.023). The study group showed lower serum concentrations of testosterone, free T4, antinuclear factor, and lower blood hemoglobin and hematocrit. CONCLUSIONS: FM was associated with high scores of sexual dysfunction and depression, and there were correlations with hematological parameters. We suggest the involvement of immune-inflammatory mediators and FM, which need further investigation to understand their role in FM syndrome and its comorbidities.

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Influence of Dyslipidemia on the Quality of Sexual Life in Women in the Menacme using a Combined Oral Contraceptive / Influência da dislipidemia na qualidade de vida sexual de mulheres na menacme usando contraceptivos orais combinados

ABSTRACT Purpose: Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs) . Methods: A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results: After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions: The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.

RESUMO Objetivo: Disfunção sexual feminina é uma condição complexa acomete as mulheres, e a relação entre a função sexual e a dislipidemia é muito pouco estudada. Este estudo objetivou avaliar esta relação em mulheres na menacme que fazem uso de contraceptivos orais combinados (COCs). Métodos: Um total de 49 mulheres saudáveis com vida sexual ativa receberam pílulas anticoncepcionais contendo etinilestradiol 30 mcg (EE30) associado a levonorgestrel 150 mcg (LNG150). As mulheres foram divididas em dois grupos, de acordo com o perfil lipídico. Dislipidemia foi definida como nível de lipoproteína de alta densidade (HDL) < 50 mg/dL, ou nível de lipoproteína de baixa densidade (LDL) > 130 mg/dL. A função sexual feminina foi avaliada utilizando o questionário de Índice de Função Sexual Feminina (IFSF). O IFSF e os parâmetros lipídicos e lipoproteicos foram obtidos no início e após o sexto ciclo do estudo. Resultados: Após seis ciclos de uso dos COCs, as mulheres com LDL > 130 mg/dL, tiveram redução dos níveis de colesterol total e colesterol LDL de 14,7% e 22,1% respectivamente. Nas mulheres com níveis HDL < 50 mg/dL no momento basal, o nível de HDL aumentou 15,5% ao final do estudo. Os domínios de excitação, orgasmo e os escores totais do IFSF aumentaram significativamente nas mulheres com e sem dislipidemia. Os domínios de desejo e satisfação aumentaram no final do período de tratamento exclusivamente no grupo sem dislipidemia. Conclusões: A formulação EE30/LNG150 aumentou a função sexual das mulheres, sendo positivamente correlata somente com os níveis de colesterol HDL. Estes achados demonstram baixa correlação entre a função sexual e as alterações no metabolismo lipídico e lipoproteico.

Depression, sexuality and fibromyalgia syndrome: clinical findings and correlation to hematological parameters / Depressão e sexualidade na síndrome fibromiálgica: achados clínicos e correlação com parâmetros hematológicos

ABSTRACT Fibromyalgia (FM) is characterized by chronic pain and comorbidities. Objective To investigate sexuality and depression in women with FM compared with controls and to correlate the findings with hematological parameters. Methods 33 women with FM and 19 healthy women were included and evaluated with the following instruments: Female Sexual Function Index, Beck Inventory, Visual Analogue Scale, medical history and laboratory exams. Results The prevalence of sexual dysfunction (P = 0.007) and depression (P < 0.001) were higher in the study group than in the control group; they were positively correlated (P = 0.023). The study group showed lower serum concentrations of testosterone, free T4, antinuclear factor, and lower blood hemoglobin and hematocrit. Conclusions FM was associated with high scores of sexual dysfunction and depression, and there were correlations with hematological parameters. We suggest the involvement of immune-inflammatory mediators and FM, which need further investigation to understand their role in FM syndrome and its comorbidities.

RESUMO Fibromialgia (FS) é caracterizada por dor e comorbidades. Objetivo investigar depressão e sexualidade em mulheres com FS comparadas a controles, e correlacionar os achados com parâmetros hematológicos. Métodos 33 mulheres com FS e 19 controles saudáveis foram incluídas e avaliadas através dos seguintes instrumentos: Índice de Função Feminina Sexual, Inventário de Beck, escala visual analógica, história médica e exames laboratoriais. Resultados A prevalência de disfunção sexual (P = 0,007) e depressão (P < 0,001) foram maiores no grupo de estudo do que nos controles; também houve correlação positiva (P = 0,023). O grupo de estudo apresentou menor concentração sérica de testosterona, T4 livre, fator antinuclear e menos concentração de hemoglobina e hematócrito. Conclusões A FS associou-se com altos índices de disfunção sexual e depressão, e houve correlação com os parâmetros hematológicos estudados. Sugere-se o envolvimento de mediadores imuno-inflamatórios na FS, que necessita de maior investigação para a compreensão dos mecanismos tanto na FS e quanto em suas comorbidades.

Análise das propriedades psicométricas dos instrumentos "The Interstitial Cystitis Symptom Index and Problem Index" e "Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale" e da qualidade de vida de pacientes com cistite intersticial / Analysis of psychometric properties of the instruments "The Interstitial Cystitis Symptom Index and Problem Index" and "Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale" and quality of life of patients with interstitial cystitis

Objetivou-se avaliar a confiabilidade e validade convergente entre os questionários "The Interstitial Cystitis Symptom Index and Problem Index" (The O'Leary-Sant) e "Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale"; verificar quais são as disfunções sexuais em pacientes com CI, identificar suas possíveis causas, verificar os instrumentos de avaliação de qualidade de vida, disfunção sexual e grau da doença e identificar os tratamentos recomendados para esse problema, além de traduzir, adaptar para a cultura brasileira e analisar a confiabilidade e a validade convergente da "Bladder Symptom Impact Scale ¿ BSI-6" utilizada em pacientes com cistite intersticial. Essa tese é composta por dois tipos de estudo: um estudo metodológico de tradução e adaptação cultural, seguindo as etapas metodológicas de tradução, síntese, retrotradução, comitê de especialistas e pré-teste, bem como, análise de confiabilidade de teste-reteste, consistência interna e validade de constructo convergente que envolveu os questionários The O'Leary-Sant, PUF e BSI-6. O segundo tipo de estudo foi uma revisão integrativa da literatura que incluiu 19 publicações relacionadas a disfunção sexual em mulheres com cistite intersticial, mediante pesquisa realizada nas bases de dados: PubMed, Embase, CINAHL e PEDro. As fases de tradução, síntese das traduções e retrotradução da Bladder Symptom Impact Scale ¿ BSI-6, que avalia a qualidade de vida em pessoas com cistite intersticial, foram finalizadas satisfatoriamente e a avaliação das versões síntese pelo comitê de especialistas resultou em algumas alterações, assegurando as equivalências entre a versão original e traduzida. Devido à necessidade de modificações em decorrência da baixa escolaridade da população, o instrumento foi pré-testado duas vezes no total de 35 sujeitos com sintomas de cistite intersticial. O instrumento, após as alterações, demonstrou ser de fácil compreensão e rápido preenchimento. A confiabilidade foi avaliada por meio da consistência interna medida pelo alfa de Cronbach, com resultado geral de: 0,92 e a validade de constructo convergente foi medida por meio da correlação com o The O'Leary-Sant e medida pelo coeficiente de correlação de Spearman e se mostrou alta. A confiabilidade de teste-reteste para os questionários "The O'Leary-Sant" e "PUF" apresentou valores superiores a 0,80, sugerindo excelente confiabilidade. A consistência interna se mostrou boa para ambos, apresentando valores superiores a 0,70. A correlação entre os dois questionários expressa pelo coeficiente de correlação de Spearman se mostrou elevada. Os estudos analisados na revisão integrativa da literatura apontaram a dispareunia e vulvodinia como os principais problemas sexuais de mulheres com CI. As principais causas desses problemas são hipertonia da musculatura do assoalho pélvico e história prévia de abuso sexual. Concluiu-se que, os questionários "The Interstitial Cystitis Symptom Index and Problem Index" e "Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale" se mostraram confiáveis e válidos para serem aplicados em pacientes com CI, auxiliando o seu diagnóstico; que a aplicação de uma meticulosa metodologia permitiu a produção de uma versão da Bladder Symptom Impact Scale ¿ BSI-6, em português, fiel à original, confiável e válida que poderá ser utilizada para a avaliar a qualidade de vida de pessoas com cistite intersticial e, por fim, os estudos mostram que mulheres com CI e que possuem disfunção sexual devem ser tratadas por uma equipe multiprofissional a fim de melhorar os sintomas da doença e, consequentemente, a qualidade de vida, assim sendo, os instrumentos para diagnóstico e avaliação da qualidade de vida traduzidos e validados poderão ser úteis para esse fim. (AU)

This study aimed to assess the reliability and convergent validity of the questionnaires "The Interstitial Cystitis Symptom Index and Problem Index" (The O'Leary-Sant) and "Pelvic Pain and Urgency / Frequency (PUF) Patient Symptom Scale"; check what are the sexual dysfunctions in patients with IC, identify possible causes, check the instruments for assessing quality of life, sexual dysfunction and degree of the disease and identify the recommended treatments for this problem, as well as to translate, adapt to the Brazilian culture and analyze the reliability and convergent validity of the "Bladder Symptom Impact Scale - BSI-6" used in patients with interstitial cystitis. This thesis is composed of two types of studies: a methodological study of translation and cultural adaptation, following the methodological steps of translation, synthesis, back translation, expert committee and pre-test and test-retest reliability analysis, consistency internal and convergent construct validity involving the questionnaires The O'Leary-Sant, PUF and BSI-6. The second type of study is an integrative literature review that included 19 publications related to sexual dysfunction in women with interstitial cystitis, by research conducted in the databases PubMed, Embase, CINAHL and PEDro. The phases of translation, synthesis of translations and back translation of Bladder Symptom Impact Scale - BSI-6, which evaluates the quality of life in people with interstitial cystitis, were completed satisfactorily and the evaluation of versions synthesis by the expert committee resulted in some changes, ensuring the equivalence between the original and translated version. Due to the need for changes due to the low educational level of the population, the instrument was pre-tested twice in the total of 35 subjects with symptoms of interstitial cystitis. The instrument, after the changes proved to be easy to understand and quick filling. Reliability was assessed by internal consistency measured by Cronbach's alpha, with the overall result of: 0.92 and convergent construct validity was measured by correlating with The O'Leary-Sant and measured by the correlation coefficient Spearman and showed high. The test-retest reliability for the questionnaire "The O'Leary-Sant" and "PUF" presented values greater than 0.80, suggesting excellent reliability. The internal consistency proved to be good for both, with values above 0.70. The correlation between the two questionnaires expressed by the Spearman correlation coefficient showed high. The studies that analyzed the integrative literature review showed dyspareunia and vulvodynia as the main sexual problems in women with IC. The main causes of these problems are hypertonia of the pelvic floor muscles and a history of sexual abuse. It was concluded that questionnaires "The Interstitial Cystitis Symptom Index and Problem Index" and "Pelvic Pain and Urgency / Frequency (PUF) Patient Symptom Scale" proved to be reliable and valid to be used in patients with IC, supporting the diagnosis; that the application of a meticulous methodology enabled the production of a version of the Bladder Symptom Impact Scale - BSI-6 in Portuguese, faithful to the original, and proved to be reliable and valid and can be used to assess the quality of life of people with interstitial cystitis and finally, studies show that women who have sexual dysfunction should be treated by a multidisciplinary team in order to ameliorate the symptoms of the disease and, consequently, the quality of life, therefore, the tools for diagnosis and assessment of quality of life translated and validated may be useful for this purpose.(AU)

Orientação para a atividade sexual após infarto agudo do miocárdio: estamos negligenciando? / Counseling on sexual activity after acute myocardial infarction: are we overlooking it?

A ocorrência de infarto agudo do miocárdio (IAM) causa mudanças consideráveis na vida do paciente, que se defronta com desafios físicos e psicológicos. Destaca-se a importante redução da atividade sexual, fator influenciador da qualidade de vida. É, portanto, importante que os profissionais da saúde estejam capacitados a orientar os pacientes na retomada da atividade sexual após o IAM e como realizar tal atividade de forma segura. Este trabalho tem por objetivo enfatizar a necessidade, ainda negligenciada, de os profissionais de saúde realizarem tal orientação de forma adequada, contribuindo assim para a qualidade de vida do paciente.

Acute myocardial infarction (AMI) causes significant changes in the life of patients, who face physical and psychological challenges.These include reduction in sexual activity, a factor that influences the quality of life. It is therefore important that health professionals be able to advise patients on the resumption of sexual activity after AMI and how to do that safely. This study is designed to emphasize the neglected need for healthcare professionals to perform such guidance properly, thus contributing to the quality of life of the patient.

Influence of Dyslipidemia on the Quality of Sexual Life in Women in the Menacme using a Combined Oral Contraceptive.

Purpose Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs). Methods A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.