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1.
Curr Urol Rep ; 22(2): 9, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33420894

RESUMO

PURPOSE OF REVIEW: The goal of this review article is to evaluate sexual dysfunction among men who have sex with men (MSM). RECENT FINDINGS: Men who have sex with men are commonly affected by sexual dysfunction. Often sexual dysfunction in MSM will significantly impact their psychological well-being perhaps even more than their heterosexual counterparts. Despite the frequency and high impact of sexual dysfunction in MSM, access to appropriate care may be limited. It is important for urologists, especially sexual medicine clinicians, to be aware of and comfortable with differences in sexual practices of MSM. Penile pathology in this patient population will negatively affect their quality of life and well-being. Therefore, it is important to properly assess and treat these patients.


Assuntos
Comportamento Sexual , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Minorias Sexuais e de Gênero , Humanos , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/psicologia , Doenças do Pênis/terapia , Pênis/anatomia & histologia , Pênis/lesões , Qualidade de Vida , Ruptura , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/psicologia , Disfunções Sexuais Psicogênicas/terapia , Minorias Sexuais e de Gênero/psicologia
2.
J Ethnopharmacol ; 264: 113400, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-32971161

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional manuscripts refer to plants such as Apium graveolens L. Fruit (celery seed), which could be used to improve sexual function among women. Since that time, local herbal shops in Iran continue to provide this herb as a natural aphrodisiac product. AIM OF THE STUDY: This study aimed to evaluate the efficacy and safety of celery seed for the treatment of female sexual dysfunction. METHODS AND MATERIALS: In this parallel, randomized, double-blinded clinical trial, 80 women were assigned to receive either 500 mg of celery seed or placebo 3 times a day for a period of 6 weeks (n = 40 per group). The female sexual function index (FSFI) questionnaire was used to evaluate women's sexual function before and after treatment. RESULTS: At the end of the sixth week, an improvement in the total FSFI score was significantly greater in celery seed-treated women than those receiving the placebo (P < 0.001). Increased total FSFI score is mainly contributed by improvement in the sexual desire (p < 0.001), arousal (p < 0.001), lubrication (p < 0.001), and pain (p = 0.033) domains at the endpoint of study. No serious side effects were noticed in both groups during the study period. CONCLUSION: It seems that celery seed improved sexual function in women and could be used as a safe, well-tolerated, and effective herbal medicine in women with sexual dysfunction.


Assuntos
Apium , Frutas , Extratos Vegetais/administração & dosagem , Sementes , Disfunções Sexuais Fisiológicas/dietoterapia , Disfunções Sexuais Fisiológicas/etnologia , Adolescente , Adulto , Método Duplo-Cego , Feminino , Humanos , Irã (Geográfico)/etnologia , Extratos Vegetais/isolamento & purificação , Disfunções Sexuais Fisiológicas/diagnóstico , Resultado do Tratamento , Adulto Jovem
3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(12): 1187-1193, 2020 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-33353275

RESUMO

Objective: To analyze and compare the efficacy of robotic, laparoscopic and open dorsal mesh rectopexy in the treatment of severe rectal prolapse. Methods: A retrospective cohort study was performed. Patients who had a full-thickness rectum pulled out of the anus before surgery and the length was greater than 8 cm, and underwent transabdominal dorsal mesh rectopexy were enrolled in the study. Those who had urinary or sexual dysfunction before surgery, could not perform sexual function scores due to lack of a fixed sexual partner or sexual activity after surgery, underwent laparotomy again during the perioperative period, were transferred to laparotomy during robotic or laparoscopic surgery, or had no complete information, were excluded. A total of 61 patients with severe rectal prolapse in the First Affiliated Hospital of Zhengzhou University from 2014 to 2018 were enrolled and divided into robotic group (20 cases), laparoscopic group (20 cases) and open group (21 cases) according to the operative procedure based on patients' will. Perioperative parameters were compared among the 3 groups. The International Prostatic Symptoms Score Scale (IPSS, higher score indicates more severe urinary dysfunction), the International Index of Erectile Function questionnaire (IIEF-15, lower score indicates more severe male sexual dysfunction) and the Female Sexual Function Index (FSFI-19, lower score indicates more severe female sexual dysfunction) were used to evaluate and compare the urinary and sexual function before and after operation. Results: There were no significant differences in baseline data among the 3 groups (all P>0.05). In the robotic, laparoscopic and open groups respectively, the operative time was (176.3±13.8) minutes, (160.2±12.1) minutes and (134.2±12.1) minutes; intraoperative blood loss was (58.5±18.9) ml, (67.9±15.7) ml and (114.2±8.4) ml; the first time to ambulation was (19.9±6.8) hours, (24.0±8.9) hours and (37.7±11.4) hours; the first time to gas passage was (31.8±6.8) hours, (35.7±8.9) hours and (49.2±11.2) hours; the hospitalization time was (11.0±1.4) days, (11.4±1.4) days and (13.3±2.1) days; whose differences among 3 groups were all significant (all P<0.001). While no significant differences in morbidity of complication and recurrence among 3 groups were observed (all P>0.05). In the robotic, laparoscopic and open groups respectively, the preoperative IPSS score was (4.2±1.7), (4.4±1.3), and (4.7±1.8); the IPSS score at postoperative 3-month was (8.5±2.5), (9.9±1.7), and (12.2±3.1); IPSS score at postoperative 12-month was (4.3±1.6), (5.8±1.3), and (6.3±1.5), respectively. Compared to preoperative score, postoperative IPSS score increased obviously, then decreased gradually (P<0.001). Preoperative male IIEE score was (22.8±1.8), (22.1±2.1), and (22.6±1.5). In the robotic, laparoscopic and open groups respectively, male IIEE score at postoperative 6-month was (19.6±2.1), (17.1±2.1), and (15.0±2.1); male IIEE score at postoperative 12-month was (22.4±1.6), (19.9±1.5), (17.9±1.8), respectively. Preoperative female FSFI score was (26.4±3.4), (26.6±3.2), and (26.6±3.0); female FSFI score at postoperative 6-month was (21.5±3.3), (18.9±2.9), (17.0±2.6); female FSFI score at postoperative 12-month was (26.1±2.7), (22.7±3.2), and (21.2±2.3), respectively. Postoperative male IIEE score and female FSFI score decreased significantly and then increased gradually with time, whose differences were all significant (all P<0.05). Postoperative IPSS, IIEE, and FSFI scores in the robotic group were superior to those in the laparoscopic and open groups (all P<0.05). Conclusion: Robotic surgery is safe and effective in the treatment of severe rectal prolapse, and is more advantageous in preserving urinary function and sexual function.


Assuntos
Laparoscopia , Laparotomia , Prolapso Retal , Procedimentos Cirúrgicos Robóticos , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparotomia/efeitos adversos , Masculino , Prolapso Retal/complicações , Prolapso Retal/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Telas Cirúrgicas , Resultado do Tratamento , Transtornos Urinários/diagnóstico , Transtornos Urinários/etiologia
4.
Dtsch Arztebl Int ; 117(39): 653-658, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-33357346

RESUMO

BACKGROUND: The 11th edition of the International Statistical Classification of Diseases (ICD-11) is due to come into force in 2022. The goal of the present partial evaluation of the GeSiD study findings is to provide the first ever estimate of the prevalence of different types of sexual dysfunction in Germany as defined by the diagnostic guidelines that are soon to take effect. METHODS: The representative GeSiD study was carried out in 4955 men and women who belonged to a doubly stratified random sample of data from residence registration offices across Germany. The participation rate was 30.2%. Various types of sexual dysfunction were ascertained for the first time by means of a screening instrument based on the new ICD-11 guidelines. RESULTS: The reported prevalence of one or more sexual problems, including mild distress, in the previous 12 months was 33.4% in men (95% confidence interval [31.0; 35.9]) and 45.7% in women [43.0; 48.4]. Some 80.4% of men and 72.1% of women stated that they had had at least one sexual contact in the past year. Sexual dysfunction causing marked distress, as per the ICD-11 guidelines, was reported by 13.3% [11.6; 15.1] of the sexually active men (most commonly, erectile dysfunction in 6.6% and early ejaculation in 4.5%), and by 17.5% [15.6; 19.6] of the sexually active women (most commonly, hypoactive sexual desire in 6.9% and orgasmic dysfunction in 5.8%). Orgasmic dysfunction was approximately twice as common in women as delayed ejaculation was in men. The prevalence of erectile dysfunction increased with age, while that of early ejaculation decreased. Women felt particularly impaired by pain associated with sexual activity. CONCLUSION: The findings of this study indicate the importance of sexual dysfunction as an obstacle to sexual health. The study provides the first prevalence estimates for the new ICD-11 guidelines and simultaneously offers a screening instrument for sexual dysfunction that can be used economically in routine practice.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Adolescente , Adulto , Idoso , Feminino , Alemanha/epidemiologia , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Prevalência , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto Jovem
5.
Tech Vasc Interv Radiol ; 23(3): 100693, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33308525

RESUMO

Many interventions to treat men with benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS) are associated with sexual side effects or complications, such as hematospermia, erectile dysfunction, or ejaculatory dysfunction. As loss of sexual function can significantly impact quality of life, an optimal treatment for BPH associated LUTS would be one without any sexual dysfunction side effects. Prostatic artery embolization is a minimally invasive treatment for men with BPH associated LUTS. The aim of this paper is to review the effects of prostatic artery embolization on sexual function and compare the sexual side effect profile to the other available BPH procedures.


Assuntos
Embolização Terapêutica/efeitos adversos , Sintomas do Trato Urinário Inferior/terapia , Próstata/irrigação sanguínea , Hiperplasia Prostática/terapia , Radiografia Intervencionista/efeitos adversos , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico por imagem , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/fisiopatologia , Medição de Risco , Fatores de Risco , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/psicologia , Resultado do Tratamento
6.
Obstet Gynecol ; 136(4): 792-801, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925609

RESUMO

OBJECTIVE: To assess whether resting genital hiatus, perineal body, and total vaginal length measured intraoperatively at the conclusion of surgery are associated with prolapse recurrence 2 years after native tissue pelvic organ prolapse reconstruction. METHODS: This ancillary analysis of the OPTIMAL (Operations and Pelvic Muscle Training in the Management of Apical Support Loss) trial included women who had an immediate postoperative pelvic organ prolapse quantification (POP-Q) examination and 2-year follow-up. Primary outcome was bothersome bulge symptoms. Secondary outcomes were anatomic failure, surgical failure (either anatomic failure or bothersome bulge symptoms), and sexual function. Descriptive statistics assessed relationships between postprocedure POP-Q measures and these four outcomes. Multivariable models were fit to the data to control for baseline differences in bivariate comparisons. Receiver operating characteristic curves were generated to identify an optimal genital hiatus cut point associated with bothersome bulge, and this threshold was explored. RESULTS: This analysis included 368 participants. Bivariate analyses identified age, body mass index, vaginal deliveries, baseline genital hiatus, perineal body, and advanced POP-Q stage (3 or higher vs 2) as clinically relevant variables to include in multivariable models. After adjusting for these variables, the association between immediate postoperative genital hiatus and bothersome bulge (adjusted odds ratio [aOR] 1.4; 95% CI 0.9-2.1) was not significant at the P<.05 level; however, immediate postoperative genital hiatus was associated with anatomic (aOR 1.6; 95% CI 1.1-2.3) and surgical failure (aOR 1.5; 95% CI 1.0-2.1). Immediate postoperative genital hiatus of 3.5 cm was the selected cutoff (area under the curve 0.58, 95% CI 0.50-0.66 from the bothersome bulge model). Women with genital hiatus 3.5 cm or greater were more likely to have anatomic and surgical failures at 2 years. No POP-Q measures were correlated with 2-year sexual function. CONCLUSION: A larger immediate postoperative genital hiatus measurement of 3.5 cm or greater is not associated with bothersome bulge symptoms or sexual dysfunction but is associated with anatomic and surgical failures 2 years after native tissue vaginal reconstructive surgery.


Assuntos
Procedimentos Cirúrgicos em Ginecologia , Prolapso de Órgão Pélvico , Complicações Pós-Operatórias/diagnóstico , Procedimentos Cirúrgicos Reconstrutivos , Risco Ajustado/métodos , Disfunções Sexuais Fisiológicas , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/diagnóstico , Prolapso de Órgão Pélvico/fisiopatologia , Prolapso de Órgão Pélvico/cirurgia , Prognóstico , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Recidiva , Índice de Gravidade de Doença , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Avaliação de Sintomas/métodos
7.
Lancet Diabetes Endocrinol ; 8(8): 693-702, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32707117

RESUMO

BACKGROUND: Although clinicians often measure the serum concentration of androgens in premenopausal women presenting with sexual dysfunction, with some women given testosterone or dehydroepiandrosterone as treatment if their concentrations are low, whether androgens are determinants of sexual function in women of reproductive age is uncertain. We aimed to clarify the associations between androgens and sexual function in a community-based sample of non-health-care-seeking women. METHODS: This is a substudy of the Grollo-Ruzzene cross-sectional study, which recruited women aged 18-39 years from eastern states in Australia (QLD, NSW, VIC). After providing consent, women completed an online survey that included the Profile of Female Secual Function (PFSF) questionnaire, and those who were who were not pregnant, breastfeeding, or using systemic steroids were asked to provide a blood sample. At sampling, women were asked the dates of their last menstrual bleed. Serum androgens was measured by liquid chromatography and tandem mass spectrometry and sex hormone binding globulin (SHBG) by immunoassay. Associations between androgens and domains of sexual function, assessed by the PFSF, were examined in participants with regular menstrual cycles. After univariable linear regression (model 1), age, BMI, stage of menstrual cycle, and smoking status were added to the model (model 2), and then parity, partner status, and psychotropic medication use (model 3). FINDINGS: Of 6986 women who completed the online survey (surveys completed between Nov 11, 2016, and July 21, 2017), 3698 were eligible and 761 (20·6%) provided blood samples by Sept 30, 2017. Of those who provided a blood sample, 588 (77·3%) had regular menstrual cycles and were included in the analysis. Adjusting for age, BMI, cycle stage, smoking, parity, partner status, and psychoactive medication, sexual desire was positively associated with serum dehydroepiandrosterone (ß-coefficient 3·39, 95% CI 0·65 to 6·03) and androstenedione (4·81, 0·16 to 9·12), and negatively with SHBG (-5.74, -9.54 to -1·90), each model explaining less than 4% of the variation in desire. Testosterone (6·00, 1·29 to 10·94) and androstenedione (6·05, 0·70 to 11·51) were significantly associated with orgasm, with the final models explaining less than 1% of the variation in orgasm. Significant associations were found between androstenedione (7·32, 0·93 to 13·08) and dehydroepiandrosterone (4·44, 0·86 to 7·95) and pleasure, and between testosterone and sexual self-image 5·87 (1·27 to 10·61), with inclusion of parity, partners status, and psychotropic drug use increasing the proportion of variation explained by each model to approximately 10%. There were no statistically significant associations between 11-oxygenated steroids and any PFSF domain, or between arousal or responsiveness and any hormone. No associations were seen between 11-oxygenated steroids and any sexual domain, or between arousal or responsiveness and any hormone. INTERPRETATION: Associations between androgens and sexual function in premenopausal women are small, and their measurement offers no diagnostic use in this context. Further research to determine whether 11-ketoandrostenedione or 11-ketotestosterone are of clinical significance is warranted. FUNDING: The Grollo-Ruzzene Foundation.


Assuntos
Androgênios/sangue , Pré-Menopausa/sangue , Comportamento Sexual/fisiologia , Adolescente , Adulto , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Disfunções Sexuais Fisiológicas/sangue , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto Jovem
8.
Obstet Gynecol ; 136(1): 174-186, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32541291

RESUMO

Female sexual dysfunction is associated with personal distress and includes female sexual interest and arousal disorder (including former hypoactive sexual desire disorder), female orgasmic disorder, genitopelvic pain and penetration disorder, and substance- or medication-induced sexual dysfunction. These disorders are remarkably common among women, with an estimated prevalence of 20-40%. It is our responsibility as obstetrician-gynecologists to identify risk factors and screen for female sexual dysfunction. Appropriate screening allows for further exploration into sexual function and dysfunction and, ultimately, determination of associated distress. Treatment often involves addressing the underlying issue through therapy or medical management. For female sexual interest and arousal disorder, treatment generally includes cognitive behavioral therapy, often with a mindfulness focus, and consideration of pharmaceutical management. Female orgasmic disorder is treated with education and awareness, as well as therapy. Evaluation for underlying etiology is particularly critical for genitopelvic pain and penetration disorder to allow treatment of an underlying condition. Finally, substance- or medication-induced sexual dysfunction is best managed by cessation of the implicated substance and consideration of adjunctive therapy if dysfunction is related to antidepressants. Female sexual dysfunction is often overlooked in clinical practice; however, there are effective medical and psychological options for management.


Assuntos
Disfunções Sexuais Fisiológicas , Feminino , Ginecologia , Humanos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia
9.
Ann Vasc Surg ; 67: 346-353, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32247063

RESUMO

BACKGROUND: The aim of this study is to evaluate vascular surgeons' knowledge and appreciation of ejaculatory dysfunction after open aortic aneurysm repair and the knowledge of possible nerve-preserving techniques. METHODS: A Dutch national survey was conducted on sexual counseling in the case of open aortic surgery. For this purpose, a designed questionnaire based on a review of the literature in the field and on other surveys aiming to analyze care for sexual health by medical specialists was used. RESULTS: The response rate was almost 60%. All responders were familiar with the occurrence of postoperative neurogenic complications. Sixty percent preoperatively informs their patients, but only one-third inquires whether such complications have occurred postoperatively. Most respondents estimated the incidence of postoperative neurogenic complications due to dissection of the periaortic tissues between 5% and 25%. Almost 75% take nerve anatomy into consideration when exposing the abdominal aorta, but only 29% mention the correct structures, and only 37% mention possible correct nerve-sparing techniques. CONCLUSIONS: Dutch vascular surgeons are well aware of the occurrence of postoperative sexual disorders after infrarenal aortic reconstruction. A gap in knowledge of pathophysiology and anatomy exists. Furthermore, a significant part of vascular surgeons seems to lack skills in sexual counseling. Therefore, more education should be offered during vascular surgical training. WHAT THIS ARTICLE ADDS: This article addresses iatrogenic neurogenic complications affecting sexual health following open aortic surgery. It opens the discussion on possible gaps in modern training of vascular surgeons and on sexual health in relation to postoperative quality of life and shared decision-making.


Assuntos
Aorta Abdominal/cirurgia , Doenças da Aorta/cirurgia , Atitude do Pessoal de Saúde , Ejaculação , Conhecimentos, Atitudes e Prática em Saúde , Doença Iatrogênica , Disfunções Sexuais Fisiológicas/etiologia , Cirurgiões/psicologia , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Países Baixos , Qualidade de Vida , Medição de Risco , Fatores de Risco , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/prevenção & controle , Resultado do Tratamento
10.
Fertil Steril ; 113(1): 13-15, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32033716

RESUMO

Post-orgasmic illness syndrome is a rare disorder causing a debilitating cluster of flu-like and allergic type symptoms that occur within seconds, minutes or hours after ejaculation. Symptoms occur after intercourse, masturbation or spontaneous ejaculation and last from 2 to 7 days. The condition is chronic and follows a primary pattern occurring in adolescence and a secondary acquired pattern with onset later in life. The true incidence is unknown as the condition is likely under-reported and under-diagnosed. The pattern of symptoms suggests an allergic or auto-immune etiology; however, the exact pathophysiology is unknown and there is no effective treatment. Men suffering from post-orgasmic illness syndrome describe emotional trauma and significant impairment of their quality of life.


Assuntos
Orgasmo/fisiologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/imunologia , Antialérgicos/uso terapêutico , Humanos , Masculino , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/terapia , Síndrome
11.
Fertil Steril ; 113(1): 21-50, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32033719

RESUMO

Post-finasteride syndrome (PFS) is a constellation of serious adverse side effects manifested in clinical symptoms that develop and persist in patients during and/or after discontinuing finasteride treatment in men with pattern hair loss (androgenetic alopecia) or benign prostatic hyperplasia. These serious adverse side effects include persistent or irreversible sexual, neurological, physical and mental side effects. To date, there are no evidence-based effective treatments for PFS. Although increasing number of men report persistent side effects, the medical community has yet to recognize this syndrome nor are there any specific measures to address this serious and debilitating symptoms. Here we evaluate the scientific and clinical evidence in the contemporary medical literature to address the very fundamental question: Is PFS a real clinical condition caused by finasteride use or are the reported symptoms only incidentally associated with but not caused by finasteride use? One key indisputable clinical evidence noted in all reported studies with finasteride and dutasteride was that use of these drugs is associated with development of sexual dysfunction, which may persist in a subset of men, irrespective of age, drug dose or duration of study. Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies. It is important to note that many clinical studies suffer from incomplete or inadequate assessment of adverse events and often limited or inaccurate data reporting regarding harm. Based on the existing body of evidence in the contemporary clinical literature, the author believes that finasteride and dutasteride induce a constellation of persistent sexual, neurological and physical adverse side effects, in a subset of men. These constellations of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. Indeed, delineating the pathophysiological mechanisms underlying PFS will be of paramount importance to the understanding of this syndrome and to development of potential novel therapeutic modalities.


Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Finasterida/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/diagnóstico , Suspensão de Tratamento/tendências , Alopecia/tratamento farmacológico , Alopecia/fisiopatologia , Ensaios Clínicos como Assunto/métodos , Humanos , Masculino , Estudos Observacionais como Assunto/métodos , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/fisiopatologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Síndrome
12.
Fertil Steril ; 113(2): 426-434, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32106994

RESUMO

OBJECTIVE: To document the prevalence of female sexual dysfunctions (FSDs) and factors associated with FSDs and sexually related personal distress in premenopausal women. DESIGN: Community-based cross-sectional study. SETTING: Eastern states of Australia. PARTICIPANTS: Women aged 18-39 years. INTERVENTIONS(S): Not applicable. MAIN OUTCOME MEASURE(S): Women were classified as having sexually related personal distress if they had a Female Sexual Distress Scale-Revised score of ≥11, and as having an FSD if they had a low Profile of Female Sexual Function desire, arousal, orgasmic function, responsiveness, or sexual self-image domain score plus sexually related personal distress. Sociodemographic factors associated with an FSD were examined by means of multivariable logistic regression. RESULT(S): The prevalence of sexually related personal distress was 50.2%. Sexually related personal distress without dysfunction affected 29.6%, and 20.6% had at least one FSD. The proportions of women with self-image, arousal, desire, orgasm, and responsiveness dysfunction were 11.1%, 9%, 8%, 7.9%, and 3.4% respectively. Sexual self-image dysfunction was associated with being overweight, obese, living together, not married, married, breastfeeding, and taking a psychotropic medication. Psychotropic medication was significantly associated with all FSDs. Independent risk factors for nonspecific sexually related personal distress included psychotropic medication., sexual inactivity, and infertility treatment. CONCLUSION(S): That one-half of young Australian women have sexually related personal distress and one in five women have at least an FSD, with sexual self-image predominating, is concerning. The high prevalence of distress signals the importance of health professionals being adequately prepared to discuss sexual health concerns.


Assuntos
Comportamento Sexual , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Fatores Etários , Austrália/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Adulto Jovem
13.
Curr Vasc Pharmacol ; 18(2): 117-124, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31057114

RESUMO

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic, non communicable, multisystem disease that has reached epidemic proportions. Chronic exposure to hyperglycaemia affects the microvasculature, eventually leading to diabetic nephropathy, retinopathy and neuropathy with high impact on the quality of life and overall life expectancy. Sexual dysfunction is an often-overlooked microvascular complication of T2DM, with a complex pathogenesis originating from endothelial dysfunction. OBJECTIVE: The purpose of this review is to present current definitions, epidemiological data and risk factors for diabetic retinopathy, nephropathy, neuropathy and sexual dysfunction. We also describe the clinical and laboratory evaluation that is mandatory for the diagnosis of these conditions. METHODS: A comprehensive review of the literature was performed to identify data from clinical studies for the prevalence, risk factors and diagnostic methods of microvascular complications of T2DM. RESULTS: Diabetic nephropathy and retinopathy affect approximately 25% of patients with T2DM; diabetic neuropathy is encountered in almost 50% of the diabetic population, while the prevalence of erectile dysfunction ranges from 35-90% in diabetic men. The duration of T2DM along with glycemic, blood pressure and lipid control are common risk factors for the development of these complications. Criteria for the diagnosis of these conditions are well established, but exclusion of other causes is mandatory. CONCLUSION: Early detection of microvascular complications associated with T2DM is important, as early intervention leads to better outcomes. However, this requires awareness of their definition, prevalence and diagnostic modalities.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Angiopatias Diabéticas/epidemiologia , Nefropatias Diabéticas/epidemiologia , Neuropatias Diabéticas/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/fisiopatologia , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/fisiopatologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/fisiopatologia , Diagnóstico Precoce , Feminino , Humanos , Masculino , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia
14.
Asian J Androl ; 22(1): 94-99, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31134919

RESUMO

Multiple measurements of nocturnal penile tumescence and rigidity (NPTR) are widely accepted as a method to differentiate psychogenic erectile dysfunction (ED) from organic ED. However, direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan. Here, we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights, particularly when abnormal first-night measurements are recorded in a laboratory setting. We retrospectively reviewed 105 patients with a complaint of ED, who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), for two consecutive nights, during the period from November 2015 to May 2016. NPTR parameters were collected and analyzed. We found that more effective nocturnal erections were detected during the second night than during the first night (P <0.001). Twenty percent of all patients had no effective erection during the first night, but exhibited at least one effective erection during the second night. The negative predictive value of NPTR measurement during the first night was 43.2%; this was significantly lower than that on the second night (84.2%; P = 0.003). Most NPTR parameters were better on the second night than on the first night. The first-night effect might be greater among patients younger than 40 years of age. In conclusion, two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect; moreover, these measurements more accurately reflect erectile capacity, especially when the first-night record is abnormal in a laboratory setting.


Assuntos
Técnicas de Diagnóstico Urológico , Disfunção Erétil/diagnóstico , Ereção Peniana , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Sono , Adulto , Diagnóstico Diferencial , Disfunção Erétil/etiologia , Humanos , Masculino , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Psicogênicas/complicações , Adulto Jovem
15.
Support Care Cancer ; 28(8): 3889-3896, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31845008

RESUMO

PURPOSE: Sexual difficulties and vulvovaginal changes are common for women undergoing, and following, cancer treatments. These changes have significant impacts on quality of life and significant relationships. The current study aimed to (1) evaluate women's interest and attendance in a group-based educational workshop to address changes in vulvovaginal health and sexuality after cancer, and (2) describe participant characteristics and presenting concerns. METHODS: Two hundred eighteen women with a history of cancer expressed interest in receiving information about the workshop and completed phone screening. Interested women (n = 156) completed an online questionnaire package examining vulvovaginal health and sexual function prior to attending the workshop. RESULTS: Approximately 75% of the women who completed screening attended the workshop. Clinically significant sexual distress was reported by 91% of participants, and 97% of sexually active participants exceeded the threshold for sexual dysfunction (per FSFI). Women within 1-2 years of diagnosis tended to report less sexual distress, less severe vulvovaginal symptoms, and less impact from these symptoms compared to women farther out from diagnosis. While the majority of women reported vaginal dryness and pain during intercourse, only a minority reported engaging in health promotion strategies sufficient to expect symptom improvement. CONCLUSIONS: The current study suggests that group-based educational workshops for vulvovaginal and sexual concerns are utilized by patients and should be offered to women well into disease survivorship. Workshops targeting vulvovaginal symptoms and sexual concerns may be a cost-effective method of reducing sexual distress and improving patients' sexual function and quality of life.


Assuntos
Promoção da Saúde/métodos , Comportamento de Busca de Informação , Neoplasias/fisiopatologia , Educação de Pacientes como Assunto/métodos , Disfunções Sexuais Fisiológicas/terapia , Saúde Sexual , Adulto , Idoso , Idoso de 80 Anos ou mais , Coito/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias/psicologia , Neoplasias/reabilitação , Qualidade de Vida , Comportamento Sexual , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/psicologia , Sexualidade , Inquéritos e Questionários , Vagina/fisiopatologia , Vulva/fisiopatologia , Adulto Jovem
16.
Rev. Fac. Cienc. Méd. Univ. Cuenca ; 38(1): 53-63, 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1100686

RESUMO

Objetivo: determinar la prevalencia y caracterizar la disfunción sexual masculina en el personal docente y administrativo de la Unidad Académica de Salud y Bienestar de la Universidad Católica de Cuenca en el 2019. Metodología: estudio cuantitativo, observacional y transversal. Se encuestaron a 114 varones que cumplieron los criterios de inclusión. El análisis se realizó mediante estadística descriptiva, para variables cuantitativas se empleó media y desviación estándar y para las cualitativas frecuencias y porcentajes. Resultados: la prevalencia de disfunciones sexuales masculinas fue de 75.4%. Un 60.5% tuvieron edades entre 20 a 39 años, 60.5% estaban casados, 87.2% religión católica, 67.4% eran docentes. Según trastornos del deseo, el 27.9% presentó hiperactividad masculina, el 18.6% fobia y un 9.3% hipoactividad; según los trastornos de excitación, el 53.5% presentó disfunción eréctil, siendo un 93.5% leve. El trastorno orgásmico y la dispareunia masculina se presentó en el 30.2% y el 29.1% respectivamente. Conclusiones: la prevalencia de disfunciones sexuales fue elevada en comparación con la bibliografía consultada


Objective: to determine the prevalence and characterize male sexual dysfunction in the teaching and administrative staff of the Academic Unit of Health and Welfare of the Catholic University of Cuenca in 2019. Methodology: It is a quantitative, observational and cross-sectional study. A total of 114 men who met the inclusion criteria were surveyed. The analysis was performed using descriptive statistics; mean and standard deviation were used for quantitative variables, and frequencies and percentages for the qualitative variables. Results: the prevalence of male sexual dysfunctions was 75.4%. The 60.5% were between 20 and 39 years old, 60.5% were married, 87.2% were Catholic, and 67.4% were teachers. According to desire disorders, 27.9% presented male hyperactivity, 18.6% phobia and 9.3% hypoactivity; according to arousal disorders, 53.5% presented erectile dysfunction, 93.5% being mild. Orgasmic disorder and male dyspareunia occurred in 30.2% and 29.1% respectively. Conclusions: the prevalence of sexual dysfunctions was high compared to the literature consulted


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/psicologia , Fatores Sociológicos , Disfunção Erétil/complicações , Ejaculação Precoce/classificação
17.
Epilepsy Behav ; 100(Pt A): 106495, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31577987

RESUMO

Sexual dysfunction is a common comorbidity in people with epilepsy (PWE) that adversely affects their quality of life. Nearly one-half of men and women with epilepsy have sexual dysfunction, but in the majority, this often goes unnoticed. The wide variation in the reported prevalence of sexual dysfunction in PWE is due to the significant heterogeneity among the studies with regard to patient population, type and severity of epilepsy, number and type of antiseizure drugs (ASDs) used, and the tools used for assessing sexual dysfunction. Generally, patients with uncontrolled epilepsy, longer duration of epilepsy, focal epilepsy, higher seizure frequency, and those receiving enzyme-inducing and multiple ASDs are more likely to have sexual dysfunction. Women generally have dysfunction in the domains of desire, while males usually have arousal disorders such as erectile dysfunction and premature ejaculation. There is limited evidence to indicate that sexual function improves in patients rendered seizure-free following epilepsy surgery. Multiple mechanisms including direct effects of epilepsy, effects of ASDs, and psychosocial factors contribute to sexual dysfunction in epilepsy. Circumstantial evidence indicates that seizures and interictal epileptiform discharges can directly affect the hypothalamic-pituitary axis as well as production of gonadal steroids. Enzyme-inducing ASDs cause sexual dysfunction by affecting the metabolism of gonadal steroids. Limited data suggest that newer ASDs including oxcarbazepine, lamotrigine, and levetiracetam cause no or minimal sexual dysfunction. Depression and anxiety significantly contribute to sexual dysfunction in PWE. A multipronged and multidisciplinary approach is essential for optimizing the sexual functions. Every effort should be made to identify and treat reversible causes including changing to nonenzyme-inducing ASDs and to provide symptomatic relief. Large, prospective studies are required to improve our understanding on prevalence and mechanisms of sexual dysfunction in PWE.


Assuntos
Epilepsia/complicações , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Adulto , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Epilepsia/fisiopatologia , Epilepsia/psicologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia
18.
J Clin Endocrinol Metab ; 104(10): 4660-4666, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31498871

RESUMO

This Position Statement has been endorsed by the International Menopause Society, The Endocrine Society, The European Menopause and Andropause Society, The International Society for Sexual Medicine, The International Society for the Study of Women's Sexual Health, The North American Menopause Society, The Federacion Latinoamericana de Sociedades de Climaterio y Menopausia, The Royal College of Obstetricians and Gynecologists, The International Society of Endocrinology, The Endocrine Society of Australia, and The Royal Australian and New Zealand College of Obstetricians and Gynecologists.


Assuntos
Androgênios/uso terapêutico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Testosterona/uso terapêutico , Feminino , Humanos , Uso Off-Label , Pós-Menopausa , Pré-Menopausa , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/metabolismo , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/metabolismo , Testosterona/metabolismo
19.
Trends psychiatry psychother. (Impr.) ; 41(3): 247-253, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1043531

RESUMO

Abstract Introduction Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. Methods The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. Results The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. Conclusion The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.


Resumo Introdução A disfunção sexual é comum em indivíduos com doenças psiquiátricas e sob o uso de medicações como antidepressivos e antipsicóticos. Várias escalas foram desenvolvidas para avaliar a função sexual desses doentes. A Arizona Sexual Scale (ASEX) é uma escala de cinco itens de avaliação que quantifica desejo sexual, excitação, lubrificação vaginal/ereção peniana, capacidade para atingir o orgasmo e satisfação com o orgasmo. Este artigo descreve o processo de tradução e adaptação transcultural da escala ASEX para a língua portuguesa, com o objetivo de contribuir para a avaliação da função sexual dos doentes medicados com fármacos psicotrópicos nos vários países onde se utiliza essa língua. Métodos A tradução e a adaptação transcultural seguiram de forma detalhada os passos recomendados pelo grupo de trabalho da International Society for Pharmacoeconomics and Outcomes Research (ISPOR), nomeadamente: preparação, tradução inicial, reconciliação, retroversão, revisão da retroversão, harmonização, teste cognitivo, revisão do teste cognitivo, finalização, leitura final e versão final. Resultados O processo foi completado com sucesso, e não foram observadas diferenças grandes entre as fases de tradução, reconciliação e retroversão, tendo sido feitos apenas pequenos ajustes. Conclusão A tradução da escala ASEX foi bem-sucedida, seguindo orientações internacionais de referência. A aplicação dessas orientações é a garantia de uma versão em língua portuguesa que é qualitativa e semanticamente equivalente à versão original da escala. A existência desta nova versão da escala permitirá estudos que avaliem a função sexual dos doentes em países nos quais se fale a língua portuguesa. Estudos futuros poderão atestar a validade da escala para essas populações.


Assuntos
Humanos , Masculino , Feminino , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Traduções , Disfunções Sexuais Psicogênicas/diagnóstico , Transtornos Mentais/psicologia , Orgasmo/fisiologia , Satisfação Pessoal , Nível de Alerta/fisiologia , Portugal , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Fisiológicas/induzido quimicamente , Vagina/fisiologia , Ereção Peniana/psicologia , Arizona , Comparação Transcultural , Inquéritos e Questionários , Disfunções Sexuais Psicogênicas/induzido quimicamente , Libido/fisiologia , Transtornos Mentais/tratamento farmacológico
20.
Trends Psychiatry Psychother ; 41(3): 247-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390459

RESUMO

INTRODUCTION: Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. METHODS: The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. RESULTS: The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. CONCLUSION: The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.


Assuntos
Transtornos Mentais/psicologia , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Traduções , Arizona , Nível de Alerta/fisiologia , Comparação Transcultural , Feminino , Humanos , Libido/fisiologia , Masculino , Transtornos Mentais/tratamento farmacológico , Orgasmo/fisiologia , Ereção Peniana/psicologia , Satisfação Pessoal , Portugal , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/induzido quimicamente , Inquéritos e Questionários , Vagina/fisiologia
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