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1.
Obstet Gynecol ; 136(5): 922-931, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030874

RESUMO

OBJECTIVE: We aimed to systematically review the literature to describe sexual activity and function before and after prolapse surgery. DATA SOURCES: We searched MEDLINE, EMBASE, and ClinicalTrials.gov databases from inception to April 2018. METHODS OF STUDY SELECTION: Prospective, comparative studies of reconstructive pelvic organ prolapse (POP) surgeries that reported sexual function outcomes were included. Studies were extracted for population characteristics, sexual function outcomes, and methodologic quality. Data collected included baseline and postoperative sexual activity, dyspareunia, and validated sexual function questionnaire scores. Change in validated scores were used to categorize overall sexual function as improved, unchanged, or worsened after surgery. TABULATION, INTEGRATION, AND RESULTS: The search revealed 3,124 abstracts and identified 74 articles representing 67 original studies. The overall quality of evidence was moderate to high. Studies reporting postoperative results found higher rates of sexual activity than studies reporting preoperative sexual activity in all POP surgeries except sacrospinous suspension, transvaginal mesh, and sacrocolpopexy. The prevalence of dyspareunia decreased after all prolapse surgery types. The risk of de novo dyspareunia ranged from 0% to 9% for all POP surgeries except posterior repair, which lacked sufficient data. Overall sexual function based on PISQ-12 (Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12) scores improved for mixed native tissue repairs, anterior repairs, uterosacral suspensions, sacrospinous suspensions, and sacrocolpopexy; scores were similar for posterior repairs, transvaginal mesh, and biologic grafts. Sexual function did not worsen after any POP surgeries. CONCLUSION: Sexual function improves or remains unchanged after all types of reconstructive POP surgeries and does not worsen for any surgery type. Prevalence of total dyspareunia was lower after all POP surgery types, and de novo dyspareunia was low ranging 0-9%. This information can help surgeons counsel patients preoperatively. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019124308.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Prolapso de Órgão Pélvico/cirurgia , Complicações Pós-Operatórias/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Prospectivos , Disfunções Sexuais Fisiológicas/etiologia , Telas Cirúrgicas/efeitos adversos
2.
Maturitas ; 140: 41-48, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972634

RESUMO

OBJECTIVE: To determine the prevalence and severity of menopausal symptoms and their related risk factors among middle-aged Korean women according to their reproductive stages. METHODS: This cross-sectional study included 3039 Korean women, aged 45-65 years, who attended their routine health checkup. Their scores from the Menopause Rating Scale (MRS) were compared and participants were categorized into four groups according to stage of menopause: premenopause, early menopause (≤2 years from their last menstruation), mid-menopause (2-8 years), and late menopause (>8 years). RESULTS: The mean age of the participants was 52.81 ± 5.39 years, and 98.5 % of them reported one or more symptoms included in the MRS. The most common symptom was physical/mental exhaustion, experienced by 86.7 % of participants. The prevalence of moderate to severe symptoms, including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort, increased in the early menopausal period. This increased in the late menopausal period compared with its prevalence at premenopause. The prevalence of moderate to severe psychological symptoms, heart discomfort, and sleep problems followed a U-shaped trend after menopause: high at early menopause, low at mid-menopause, and high again at late menopause. A low level of physical exercise was an independent risk factor for a high total MRS score; however, the menopausal stages, age, and weight were also variously associated with menopausal symptoms. CONCLUSIONS: Several menopausal symptoms remain severe, or are aggravated, until the late menopausal period among Korean women. More attention is warranted to manage these symptoms in postmenopausal women.


Assuntos
Menopausa , Idoso , Estudos Transversais , Fadiga/epidemiologia , Feminino , Fogachos/epidemiologia , Humanos , Artropatias/epidemiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Doenças Musculares/epidemiologia , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Disfunções Sexuais Fisiológicas/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Doenças Vaginais/epidemiologia
4.
Crit Rev Oncol Hematol ; 153: 103064, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32712517

RESUMO

Androgen deprivation therapy (ADT) is a common treatment for men with systemic prostate cancer. However, ADT leads to sexual dysfunction, causing >80 % of couples to cease sexual activity completely. Here, we use a biopsychosocial framework to review factors that may influence the ability of patients on ADT to remain sexually active. We address sexual factors prior to ADT, neurobiological factors, intermittent ADT, sex aids, exercise, sleep, partner factors, masculinity, non-penetrative intimacy, depressive symptoms, and access to counselling or patient education programs. We make suggestions for future research in order to extend our understanding in this field with the goal of improving evidence-based treatment protocols and practice. Importantly, we suggest that clinicians should discuss options for sexual intimacy after ADT with both patients and their partners, as sexual inactivity is not inevitable for most, and strategies are available for helping maintain sexual intimacy.


Assuntos
Neoplasias da Próstata , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Antagonistas de Androgênios/uso terapêutico , Humanos , Masculino , Qualidade de Vida , Comportamento Sexual , Parceiros Sexuais
5.
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
6.
BMC Womens Health ; 20(1): 73, 2020 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-32299459

RESUMO

BACKGROUND: This study aims to evaluate: 1) the prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 Diabetes Mellitus (DM) and the control group; 2) the correlation between duration of DM, HbA1C levels and sexual life quality; 3) the relationship between different methods of insulin administration and sexual life quality; 4) the correlation between FSD and diabetes complications. METHODS: We selected 33 women with type 1 DM and 39 healthy women as controls. Each participant underwent a detailed medical history and physical examination and completed the 6-item Female Sexual Function Index questionnaire (FSFI-6). In patients affected by type 1 DM, the different methods of insulin administration (Multi Drug Injection - MDI or Continuous Subcutaneous Insulin Infusion - CSII) and the presence of DM complications were also investigated. RESULTS: The prevalence of FSD (total score ≤ 19) was significantly higher in the type 1 DM group than in the control group (12/33, 36.4% and 2/39, 5.2%, respectively; p = 0.010). No statistically significant differences were found regarding FSD according to the presence of complications, method of insulin administration or previous pregnancies. CONCLUSIONS: This study underlined that FSD is higher in women affected by type 1 DM than in healthy controls. This could be due to the diabetic neuropathy/angiopathy and the type of insulin administration. Therefore, it is important to investigate FSD in diabetic women, as well as erectile dysfunction in diabetic men.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Estudos de Casos e Controles , Diabetes Mellitus Tipo 1/epidemiologia , Feminino , Humanos , Obesidade/complicações , Prevalência , Qualidade de Vida , Comportamento Sexual , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários
7.
World Neurosurg ; 139: e474-e479, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311559

RESUMO

OBJECTIVE: Sexual function is an important factor contributing to quality of life. Adult spinal deformity (ASD) patients may have sexual limitations due to lumbar spinal stiffness that may be affected by long-segment fusion. METHODS: This study utilized a multicenter, prospectively defined, consecutive cohort of ASD patients. The primary outcome in this study was the Lumbar Stiffness Disability Index (LSDI) question 10: "Choose the statement that best describes the effect of low back stiffness on your ability to engage in sexual intercourse". RESULTS: In total, 368 patients were included in this study, including 76 men and 292 women, of which 80.7% (n = 293) underwent 9 or more level fusion and 74.4% (n = 270) had pelvic fixation. Baseline LSDI sexual function scores averaged 1.7 (SD 1.3), which improved to 1.3 (SD 1.2) at 2-year follow-up (P = 0.0008). After adjusting for confounding factors, worse LSDI sexual function score was strongly associated with worse Oswestry Disability Index, Scoliosis Research Society-22r total, and SF-36 Physical Component Summary and Mental Component Summary scores at both baseline and 2-year follow-up (p<0.05 for all comparisons). Predictors of poorer baseline sexual function included older age, increased SVA, and increased back pain (p<0.05 for all comparisons). Predictors of improvement in sexual function at 2-year follow-up included sagittal vertical axis improvement (P = 0.0032) and decreased postoperative back pain (P < 0.0001). CONCLUSIONS: This study found that sexual dysfunction scores due to lumbar stiffness significantly improved after surgery for ASD. Additionally, lumbar stiffness-related sexual dysfunction is strongly related to overall outcome measured by Oswestry Disability Index and Scoliosis Research Society-22r total score, highlighting the importance of sexual health on overall outcome in ASD patients.


Assuntos
Região Lombossacral , Complicações Pós-Operatórias/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/etiologia , Fusão Vertebral/métodos , Coluna Vertebral/anormalidades , Coluna Vertebral/cirurgia , Adulto , Idoso , Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Estudos de Coortes , Coito , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Escoliose/cirurgia , Resultado do Tratamento
9.
BMC Neurol ; 20(1): 41, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005182

RESUMO

BACKGROUND: Epilepsy and multiple sclerosis (MS) are two neurological diseases known to greatly influence a patient's life. The primary aim of this study was to describe the prevalence of sexual dysfunction in patients with epilepsy and MS and investigate whether there is an association between disease, sexual function, and physical and mental health. A secondary aim was to investigate whether there is a difference in sexual function between patients with MS and epilepsy. METHODS: A total of 414 patients were included in this descriptive cross-sectional study. Three patient report questionnaires were used for measurements: the Changes in Sexual Function Questionnaire (CSFQ) cut-off score; the Short Form 36 Health Survey (SF-36) divided into the Physical Component Summary (PCS) and Mental Component Summary (MCS), and the Life Satisfaction-11 (LiSat-11). RESULTS: Patients with MS constituted 62% (n = 258) of the participants and patients with epilepsy 38% (n = 156). The prevalence of sexual dysfunction was 68% in women and 77% in men. No differences were found between patients with MS and epilepsy (p = 0.184), except for the CSFQ desire domain, as patients with epilepsy more often had a desire problem (p = 0.029). On the SF-36, patients with MS scored significantly worse on the PCS (p = 0.000). Patients with epilepsy scored significantly worse on the MCS (p = 0.002). No significant differences were found on the LiSat-11. Regression analysis with CSFQ as the dependent variable showed an association with the PCS in men and an association with both PCS and MCS in women. CONCLUSIONS: In this study, the cohort of patients with MS and epilepsy had negatively affected sexual function. The only significant difference between patients with MS and epilepsy in sexual function measured by the CSFQ-14, was found in the frequency of desire, in which a larger number of patients with epilepsy reported sexual dysfunction. In the studied cohort, sexual function in women is associated with both physical and mental health, and in men with physical health. These results should be considered when caring for patients with epilepsy and MS.


Assuntos
Epilepsia/complicações , Esclerose Múltipla/complicações , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto Jovem
10.
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
11.
J Sex Med ; 17(4): 665-677, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32089483

RESUMO

BACKGROUND: Unhealthy lifestyle and aging negatively impact sexuality; consequently, the prevalence of sexual problems increases sharply in middle-aged adults, but the determinants of low sexual desire and sexual dysfunction are not fully elucidated. AIMS: To investigate the association of cardiometabolic profile, free testosterone plasma levels, body composition, physical fitness, and S-Klotho plasma levels with sexual desire and sexual function in middle-aged sedentary adults. METHODS: Seventy-four (39 women) sedentary middle-aged adults (45-65 years old) were recruited for the present cross-sectional study. OUTCOMES: The blood samples were collected in the morning (12 h of fasting) to determine cardiometabolic biomarkers and free testosterone and S-Klotho plasma levels. The cardiometabolic risk score was calculated based on the International Diabetes Federation's clinical criteria, quantitative insulin sensitivity check index, and homeostatic model assessment of insulin resistance index. A dual-energy X-ray absorptiometry scanner was used to determine the lean mass index (LMI) and the fat mass index. Maximal oxygen uptake was determined by a maximum treadmill test using indirect calorimetry. Muscular strength was measured with knee extensor isokinetic dynamometry (60° s-1). Sexual desire was assessed with the Sexual Desire Inventory 2. Sexual function was assessed with the Massachusetts General Hospital-Sexual Functioning Questionnaire. RESULTS: After age adjustment, free testosterone plasma levels were associated with solitary sexual desire in women (R2 = 0.193, ß = 0.342, P = .044). The LMI was associated with solitary sexual desire in men (R2 = 0.258, ß = 0.445, P = .024) and sexual function in women (R2 = 0.470, ß = -0.607, P < .001). S-Klotho plasma levels were associated with solitary sexual desire and sexual function in men (R2 = 0.412, ß = 0.817, P = .001; R2 = 0.193, ß = -0.659, P = .021, respectively) and with dyadic sexual desire and sexual function in women (R2 = 0.270, ß = 0.508, P = .020; R2 = 0.467, ß = -0.676, P < .001, respectively). CLINICAL IMPLICATIONS: S-Klotho plasma levels may represent a potential new biomarker for sexual desire and sexual function. Lean body mass development may benefit sexual desire and sexual function. STRENGTHS AND LIMITATIONS: Strengths include the analysis of novel and diverse biomarkers of health for sexual desire and sexual function. Limitations include the cross-sectional design and a relatively small sample size; thus, results should be interpreted cautiously and in the study population context. CONCLUSION: S-Klotho plasma levels were strongly associated with dyadic sexual desire, solitary sexual desire, and sexual function in sedentary middle-aged adults. The LMI was also positively associated with solitary sexual desire and sexual function in men and women, respectively. Dote-Montero M, De-la-O A, Castillo MJ, et al. Predictors of Sexual Desire and Sexual Function in Sedentary Middle-Aged Adults: The Role of Lean Mass Index and S-Klotho Plasma Levels. The FIT-AGEING Study. J Sex Med 2020;17:665-677.


Assuntos
Envelhecimento/fisiologia , Libido/fisiologia , Comportamento Sexual/fisiologia , Sexualidade/fisiologia , Idoso , Biomarcadores/sangue , Estudos Transversais , Feminino , Glucuronidase/sangue , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários , Testosterona/sangue
12.
J Sex Med ; 17(4): 771-783, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32063471

RESUMO

BACKGROUND: Genital pain (GP) is a common symptom in women of reproductive age. The prevalence of GP is difficult to gauge as it has been underreported by both patients and clinicians and neglected in clinical studies despite wide recognition of the adverse effects to women's health. AIM: The purpose of the present study was 3-fold: (i) to explore the self-reported presence and perception of GP and its association with sexual functioning, sexual distress, emotions, psychopathology, and quality of life (QoL); (ii) to explore if, controlling for the pain effect, women with Female Sexual Function Index (FSFI) scores indicating sexual dysfunction also reported worse outcomes regarding sexual distress, emotions, psychological health, and QoL than GP women with higher FSFI scores; and (iii) to evaluate the effects of GP duration, comparing women with GP with shorter (<6 months) duration of symptoms with women with longer (≥6 months) duration of symptom of GP on sexual functioning, distress, emotions, psychopathology and QoL. METHODS: A total of 1,034 women (age ranges between 18 and 40 years) from the Italian general population completed a web survey on sexual health. OUTCOMES: 6 self-report questionnaires exploring different biopsychosocial factors were assessed: the FSFI, the Female Sexual Distress Scale, the Positive and Negative Affect Schedule, the Short Form McGill Pain Questionnaire adapted for GP, the Short Form 36, and the Symptom Check List-90-Revised. RESULTS: Women who reported GP (n = 319) indicated generally lower sexual function than women without GP (n = 648; P = .036). They reported a higher level of sexual distress (P < .001), more negative emotions related to sexual experiences (P = .001), lower scores in all QoL domains (P < .001), and higher levels of psychopathological symptoms (P < .001). Controlling for pain effects, women whose FSFI scores indicated sexual dysfunction (n = 150) reported higher rates of sexual distress than women whose FSFI scores indicated normal sexual function (n = 169; P < .001). The scores also indicated fewer positive (P < .001) and more negative emotions (P < .001) related to sexuality, lower QoL (P < .001) and significantly higher psychological burden (P < .001). Moreover, women experiencing GP for ≥6 months reported significantly lower means on the FSFI total score (P < .05; especially in the desire, satisfaction, and pain domains), distress (P < .001), and emotions (P < .05) than women experiencing GP duration <6 months. No significant differences were found on the QoL and the psychopathological symptoms. CLINICAL IMPLICATIONS: GP is significantly pervasive, but a high percentage of sexual problems and related emotional suffering is overlooked. Raising awareness about this issue is critical, both among clinicians and the general public. STRENGTHS & LIMITATIONS: The present study highlighted important characteristics of GP from a community sample; the results indicate problems related to pain experiences and their repercussions on sexual, psychological, affective health, and QoL. Major limitations are related to the use of self-report measures via a web-based study. CONCLUSION: The results provide evidence of a lack of awareness regarding pain experiences as they relate to sexual functioning in women; clinicians would be advised to more fully investigate sexual functioning and psychosocial variables associated with GP during routine consultation beginning with the first onset of the symptoms. Nimbi FM, Rossi V, Tripodi F, et al. Genital Pain and Sexual Functioning: Effects on Sexual Experience, Psychological Health, and Quality of Life. J Sex Med 2020; 17:771-783.


Assuntos
Dor/epidemiologia , Qualidade de Vida , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/epidemiologia , Adolescente , Adulto , Emoções , Feminino , Humanos , Saúde Mental , Medição da Dor , Prevalência , Autorrelato , Sexualidade , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
13.
Reprod Biol Endocrinol ; 18(1): 10, 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066450

RESUMO

Sexual health is strictly related with general health in both genders. In presence of a sexual dysfunction, the expert in sexual medicine aims to discover the specific weight of the physical and psychological factors can cause or con-cause the sexual problem. At the same time, a sexual dysfunction can represent a marker of the future development of a Non-communicable diseases (NCDss) as cardiovascular or metabolic diseases.In the evaluation phase, the sexual health specialist must focus on these aspects, focusing especially on the risk and protective factors that could impact on both male and female sexuality.This article presents a review of researches concerning healthy and unhealthy lifestyles and their contribute in the development of sexual quality of life in a gender-dependent manner.Among the unhealthy lifestyle, obesity contributes mostly to the development of sexual dysfunctions, due to its negative impact on cardiovascular and metabolic function. Tobacco smoking, alcohol - substance abuse and chronic stress lead to the development of sexual dysfunction in a med-long term.In order to guarantee a satisfying sexual quality of life, sexual health specialists have the responsibility to guide the patient through the adoption of healthy lifestyles, such as avoiding drugs, smoke and excessive alcohol, practicing a regular physical activity, following a balanced diet and use stress-management strategies, even before proposing both pharmaco- and/or psychotherapies.


Assuntos
Exercício Físico/fisiologia , Estilo de Vida , Medicina Reprodutiva/métodos , Disfunções Sexuais Fisiológicas/fisiopatologia , Sexualidade/fisiologia , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Obesidade/fisiopatologia , Comportamento Sexual/fisiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Fumar/epidemiologia , Fumar/fisiopatologia
14.
Asian Pac J Cancer Prev ; 21(2): 349-354, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32102510

RESUMO

Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.
.


Assuntos
Qualidade de Vida , Autorrelato , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Neoplasias do Colo do Útero/terapia , Adulto , Terapia Combinada , Feminino , Seguimentos , Humanos , Incidência , Índia/epidemiologia , Masculino , Prognóstico , Estudos Prospectivos , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/psicologia
15.
PLoS One ; 15(1): e0226404, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929541

RESUMO

OBJECTIVES: The study's main objective was to describe the prevalence and severity of female sexual dysfunction (FSD) amongst a group of Ghanaian women in the outpatient setting of the predominantly rural Volta region of Ghana. Additionally we determine the predictors of FSD severity and care seeking behaviors of women with the condition. STUDY DESIGN AND SETTING: This was a cross sectional study conducted in the outpatient setting of the Ho Teaching Hospital in the rural-savannah, agro-ecological zone of Volta Region, Ghana. METHODS AND PROCEDURES: FSD was assessed using the Female Sexual Function Index (FSFI) questionnaire. FSD was defined with a cutoff of ≤23 so as not to under-estimate the prevalence in this conservative setting. FSFI score >23 was designated "no FSD". We further categorized women with FSD as having mild (FSFI Total score 18-23), moderate (FSFI Total score <18 to >10) or severe (FSFI Total score ≤10) FSD. Due to sample size restrictions, we combined the moderate and severe FSD groups in our analyses and defined "moderate/severe FSD" as an FSFI Total score < 18. Participants with FSD were further asked to indicate whether or not they sought help for their conditions, the reasons they sought help, and the types of help they sought. We used p<0.05 to determine statistical significance for all analyses and logistic regression models were used to determine crude and age-adjusted effect estimates. RESULTS: FSD Prevalence: Out of 407 women approached, 300 (83.8%) agreed and consented to participate in the study. The prevalence of FSD was 48.3% (n = 145). Compared to those without FSD, over a third of the FSD women resided in rural settings (37.90% vs 20.60%; p = 0.001) and tended to be multiparous, with a significantly greater proportion having at least three children (31.70% vs 18.10%; p = 0.033). FSD Severity: Over a quarter of the sample (27.6%, n = 40) met the cut-off for moderate to severe FSD. In age-adjusted models, lubrication disorder was associated with 45 times the odds of moderate/severe FSD (age-adj. OR: 45.38, 95% CI: 8.37, 246.00; p<0.001), pain with 17times the odds (age-adj. OR: 17.18, 95% CI: 4.50, 65.50; p<0.001) and satisfaction almost 5times the odds (age-adj. OR: 4.69, 95% CI: 1.09, 20.2; p = 0.04). Compared to those with 1-3 children, nulliparous women had 3.5 times higher odds of moderate/severe sexual dysfunction as well (age-adj. OR:3.51, 95% CI:1.37,8.98; p = 0.009). FSD-related Health Seeking Behaviors: Statistically significant predictors of FSD-related care seeking included having FSD of pain disorder (age-adj. OR: 5.91, 95% CI:1.29, 27.15; p = 0.02), having ≥4 children (age-adj. OR: 6.29, 95%CI: 1.53, 25.76; p = 0.01). Of those who sought help, seven in 10 sought formal help from a healthcare provider, with General Practitioners preferred over Gynecologist. About one in 3 (31.3%) who did not seek help indicated that they did not know their sexual dysfunction was a medical condition, over a quarter (28.9%) "thought it was normal" to have FSD, and interestingly, 14.1% did not think a medical provider would be able to provide them with assistance. CONCLUSIONS: Sexual dysfunctions are prevalent yet taboo subjects in many countries, including Ghana. Awareness raising and efforts to feminize the physician workforce are necessary to meet the healthcare needs of vulnerable members of Ghanaian society.


Assuntos
Comportamento de Busca de Ajuda , Disfunções Sexuais Fisiológicas/psicologia , Adolescente , Adulto , Estudos Transversais , Emoções , Feminino , Gana/epidemiologia , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Índice de Gravidade de Doença , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/patologia , Adulto Jovem
16.
Asian J Surg ; 43(9): 891-901, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31926817

RESUMO

Lateral lymph node metastasis in rectal cancer was first reported in the 1950s, since then, there has been an on-going debate about the value of lateral lymph node dissection (LLND) in the management of rectal cancer. We carried out a systematic review and meta-analysis to evaluate the value of LLND for the patients with rectal cancer. To collect clinical studies for the comparison of LLND and non-LLND in patients with rectal cancer, PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar databases were searched from inception to 2019.A total of 26 studies, including 6865 patients were enrolled. Data processing and statistical analyses were performed using Stata V.15.0 software and Review Manager 5.3 software. Outcome measures included the 5-year survival rate, recurrence rate, perioperative outcomes, urinary function, and male sexual function. Regarding efficacy, our meta-analysis results showed no difference in 5-year disease-free survival rate and local recurrences between the two groups, the Hazard Ratio (HR) and 95% confidence interval (CI) was1.07 and 0.89 to 1.28 (P = 0.496),and the Odds Ratio(OR) and 95% CI were 0.90 and 0.76 to 1.06 (P = 0.208), respectively. Concerning safety, the incidence of urinary dysfunction and male sexual dysfunction was significantly increased in the LLND group (OR = 2.14, 95%CI = 1.21-3.79, P = 0.009), and (OR = 4.19, 95%CI = 1.55-11.33, P = 0.005), respectively. In conclusion, LLND did not improve the long-term prognosis of patients with rectal cancer, and was associated with increased urinary dysfunction and male sexual dysfunction.


Assuntos
Excisão de Linfonodo/efeitos adversos , Excisão de Linfonodo/métodos , Metástase Linfática/terapia , Neoplasias Retais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Prognóstico , Neoplasias Retais/patologia , Segurança , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Resultado do Tratamento , Transtornos Urinários/epidemiologia , Transtornos Urinários/etiologia
17.
Neurosciences (Riyadh) ; 25(1): 55-60, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31982896

RESUMO

OBJECTIVE: To measure the prevalence of sexual dysfunction in psychiatric outpatients treated with fluoxetine, paroxetine, venlafaxine or mirtazapine. METHODS: This is a retrospective cross-sectional study conducted in Sultan Qaboos University Hospital, Muscat, Oman. All patients above 18 years of age, attending psychiatric clinic and taking fluoxetine, paroxetiene, venlafaxine or mirtazapine for various indications were invited to participate in the study. A data collection sheet was designed to document the patients` demographic features, psychiatric diagnosis, type, dose and duration of antidepressant treatment. Sexual side effects` part of Toronto Side Effect Scale (TSES) was used to assess the presence of sexual dysfunction RESULTS: A total of 137 patients (Male: 51%, Female: 49%) were included in the study. The mean age for the participants was 38 years (range: 19-72 years).The number of patients for each antidepressant was as follows: paroxetine (52 patients), fluoxetine (36), mirtazapine (36 patients) and venlafaxine (17 patients). The average duration of the antidepressant use was 3.9 years. The overall prevalence of sexual dysfunction was 39%. Paroxetine was the most common antidepressant associated with sexual dysfunction especially for decreased libido (59.6%) and delayed ejaculation (34.4%). In contrary, mirtazapine was the lowest among antidepressants to cause sexual dysfunction. CONCLUSION: Sexual dysfunction is common among patients treated with antidepressants particularly selective serotonin reuptake inhibitors (SSRIs). Addressing this side effects early in treatment can improve compliance to treatment and prevent relapse.


Assuntos
Antidepressivos/efeitos adversos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/epidemiologia , Centros de Atenção Terciária/tendências , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Omã/epidemiologia , Pacientes Ambulatoriais/psicologia , Prevalência , Estudos Retrospectivos , Inibidores de Captação de Serotonina/efeitos adversos , Disfunções Sexuais Fisiológicas/psicologia , Adulto Jovem
18.
J Sex Med ; 17(3): 470-476, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31937517

RESUMO

INTRODUCTION: Although antidepressants are well known to cause sexual side effects in adults, the long-term effects of antidepressant use during development on adult sexual function is unknown. AIM: To explore differences in sexual desire and sexual behavior between adults who did vs did not use antidepressants during childhood or adolescence. METHODS: An online survey of 610 young adults (66% women) assessed childhood and current mental health and use of antidepressants and other psychiatric medications before the age of 16 years and currently, partnered and solitary sexual desire, and frequency of masturbation and partnered sexual activity. Antidepressants were coded into either selective serotonin reuptake inhibitors (SSRIs) or non-SSRI antidepressants. MAIN OUTCOME MEASURE: Scores on the Sexual Desire Inventory, and self-reported frequency of masturbation and partnered sexual activity. RESULTS: For women, childhood SSRI use was associated with significantly lower solitary sexual desire, desire for an attractive other, and frequency of masturbation. This was true even when controlling for childhood mental health concerns, current mental health, and current antidepressant use. However, there was no effect of childhood SSRI use on women's partnered sexual desire or partnered sexual activity. There was no significant effect of childhood antidepressant use on men's sexual desire or masturbation. However, in men, childhood use of non-SSRI antidepressants was associated with significantly higher frequency of partnered sexual activity. Childhood use of non-SSRI antidepressants, or nonantidepressant psychiatric medication, was not associated with adult sexual desire or behavior in either women or men. CLINICAL IMPLICATIONS: It is possible that SSRI use during childhood interrupts the normal development of sexual reward systems, which may be a risk factor for sexual desire dysfunction in adult women. STRENGTHS & LIMITATIONS: Strengths include a large sample, use of attention checks and validated measures, and careful assessment of childhood mental health history; however, generalizability is limited by a predominantly white, young adult sample. These data are cross-sectional, and therefore, causal explanations for the association between childhood SSRI use and adult sexual well-being should be considered preliminary, warranting replication. CONCLUSION: These findings point to a critical need for well-controlled, prospective research on possible long-term effects of antidepressant use, particularly SSRI use, on the development of adult sexual well-being. Lorenz TK. Antidepressant Use During Development May Impair Women's Sexual Desire in Adulthood. J Sex Med 2020;17:470-476.


Assuntos
Antidepressivos/uso terapêutico , Libido/efeitos dos fármacos , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Masturbação/epidemiologia , Saúde Mental , Fatores de Risco , Autorrelato , Inibidores de Captação de Serotonina/efeitos adversos , Parceiros Sexuais , Inquéritos e Questionários , Adulto Jovem
19.
J Sex Marital Ther ; 46(2): 170-176, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31433270

RESUMO

Women with diabetes are at increased risk of sexual problems. However, this problem is underreported; hence, the need for this study. This was a cross sectional case-controlled study. Seventy-five consenting females with type 2 diabetes mellitus (T2DM) were enrolled from the Diabetes Clinic of the Federal Medical Center, Umuahia, while 75 persons, which included hospital workers and female companions of subjects, were recruited as a control group. Sexual dysfunction in both groups was diagnosed and characterized using the female sexual function index (FSFI). Data obtained from this study was presented as Mean ± SD and analyzed using SPSS 17 software. The mean age of the T2DM group and control were 44.5 years and 38.9 years, respectively. The mean total female sexual score was 22.10 ± 6.66 in the T2DM subjects, while in the control subjects it was 22.43 ± 5.29. This was not statistically significant. The FSFI scores in the desire, lubrication, and orgasm domains were all lower in the diabetic women and this was statistically significant (p < 0.05). The domains of pain and arousal were also lower in the diabetic women, although this was not statistically significant (p > 0.05). The proportion of diabetic females who reported problems in the arousal, lubrication, orgasm, and pain domains was higher (40.0, 36.4, 32.7, 29.1) than the controls (27.9, 16.2, 14.7, 19.1; p < 0.05). The prevalence of female sexual dysfunction in our study was high. Similarly, the FSFI score was low in women with diabetes when compared with controls. The domains of arousal, pain, orgasm, and satisfaction were the most affected in subjects with DM. Age, marital status, body mass index, fasting blood sugar, and hypertension were predictive of sexual dysfunction in the diabetic women.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Psicogênicas/complicações , Centros de Atenção Terciária
20.
Dermatology ; 236(1): 37-45, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31434072

RESUMO

BACKGROUND: Hidradenitis suppurativa (HS) has a high impact on quality of life. However, sexual health has scarcely been investigated. OBJECTIVE: To describe the frequency of sexual dysfunction (SD) in women and erectile dysfunction (ED) in men with HS and to explore potential risk factors. PATIENTS AND METHODS: We conducted a cross-sectional study using a crowd-sourced online questionnaire spread by the Spanish hidradenitis suppurativa patients' association (ASENDHI). RESULTS: In total, 393 participants answered the questionnaire. SD was found in 51% (95% CI 45-57%) of women and ED in 60% (95% CI 49-70%) of men. Factors related to SD were education status, patient's global assessment for disease activity, numeric rating scale for pain and unpleasant odour and the absence of a stable relationship. Factors related to ED were increasing age, the presence of active lesions in the genital area and the number of areas affected by active lesions. CONCLUSIONS: There is a high prevalence of SD and ED in HS patients. Being in a stable relationship has been a protective factor of SD in women. The results suggest that sexual impairment in HS patients is due, at least in part, to disease activity, symptoms and active lesions.


Assuntos
Hidradenite Supurativa/diagnóstico , Hidradenite Supurativa/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Estudos Transversais , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Feminino , Hidradenite Supurativa/psicologia , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
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