Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.360
Filtrar
1.
FP Essent ; 503: 28-33, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33856181

RESUMO

Human sexual function is complex and multidimensional, with physiologic and psychological components. The common sexual dysfunctions in men have significant overlap. Low sexual desire in men includes a lack of interest in thinking about sex or in being sexual, alone or with a partner. Sexual health counseling often is helpful. Physicians should prescribe supplemental testosterone only if it is clearly indicated. (Sexual dysfunction is an off-label use of testosterone.) Supplementation is not beneficial for men with a normal total testosterone level. Erectile dysfunction (ED) is the consistent or recurrent inability to attain or maintain a penile erection sufficient for sexual satisfaction. The cause typically is multifactorial. The oral phosphodiesterase type 5 inhibitors are the first-line pharmacotherapies for most patients with ED. Their use is contraindicated in patients taking nitrates. Peyronie disease is an acquired penile abnormality that causes curvature or other deformities of the erect penis. Premature ejaculation is defined as a lack of ejaculatory control that is associated with distress. All pharmacotherapies for premature ejaculation are used off label. First-line treatment options include daily selective serotonin reuptake inhibitors (eg, paroxetine), on-demand clomipramine, and topical penile anesthetics. Psychotherapeutic and physical therapies also have been shown to be effective.


Assuntos
Disfunção Erétil , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Ejaculação , Disfunção Erétil/tratamento farmacológico , Humanos , Masculino , Saúde do Homem , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Testosterona
2.
J Womens Health (Larchmt) ; 30(4): 474-491, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33797277

RESUMO

Background: The Global Consensus Position Statement on the Use of Testosterone Therapy for Women (Global Position Statement) recommended testosterone therapy for postmenopausal women with hypoactive sexual desire disorder (HSDD). Aim: To provide a clinical practice guideline for the use of testosterone including identification of patients, laboratory testing, dosing, post-treatment monitoring, and follow-up care in women with HSDD. Methods: The International Society for the Study of Women's Sexual Health appointed a multidisciplinary panel of experts who performed a literature review of original research, meta-analyses, review papers, and consensus guidelines regarding testosterone use in women. Consensus was reached using a modified Delphi method. Outcomes: A clinically useful guideline following a biopsychosocial assessment and treatment approach for the safe and efficacious use of testosterone in women with HSDD was developed including measurement, indications, formulations, prescribing, dosing, monitoring, and follow-up. Results: Although the Global Position Statement endorses testosterone therapy for only postmenopausal women, limited data also support the use in late reproductive age premenopausal women, consistent with the International Society for the Study of Women's Sexual Health Process of Care for the Management of HSDD. Systemic transdermal testosterone is recommended for women with HSDD not primarily related to modifiable factors or comorbidities such as relationship or mental health problems. Current available research supports a moderate therapeutic benefit. Safety data show no serious adverse events with physiologic testosterone use, but long-term safety has not been established. Before initiation of therapy, clinicians should provide an informed consent. Shared decision-making involves a comprehensive discussion of off-label use, as well as benefits and risks. A total testosterone level should not be used to diagnose HSDD, but as a baseline for monitoring. Government-approved transdermal male formulations can be used cautiously with dosing appropriate for women. Patients should be assessed for signs of androgen excess and total testosterone levels monitored to maintain concentrations in the physiologic premenopausal range. Compounded products cannot be recommended because of the lack of efficacy and safety data. Clinical Implications: This clinical practice guideline provides standards for safely prescribing testosterone to women with HSDD, including identification of appropriate patients, dosing, and monitoring. Strengths & Limitations: This evidence-based guideline builds on a recently published comprehensive meta-analysis and the Global Position Statement endorsed by numerous societies. The limitation is that testosterone therapy is not approved for women by most regulatory agencies, thereby making prescribing and proper dosing challenging. Conclusion: Despite substantial evidence regarding safety, efficacy, and clinical use, access to testosterone therapy for the treatment of HSDD in women remains a significant unmet need.


Assuntos
Disfunções Sexuais Psicogênicas , Saúde Sexual , Testosterona , Feminino , Humanos , Libido , Masculino , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Saúde da Mulher
3.
J Sex Med ; 18(5): 990-995, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33903043

RESUMO

BACKGROUND: The Sexual Interest and Desire Inventory-Female (SIDI-F) is a clinician-administered scale that allows for a comprehensive assessment of symptoms related to Hypoactive Sexual Desire Dysfunction (HSDD). As self-report questionnaires may facilitate less socially desirable responding and as time and resources are scarce in many clinical and research settings, a self-report version was developed (Sexual Interest and Desire Inventory- Female Self-Report; SIDI-F-SR). AIM: To assess the psychometric properties of the SIDI-F-SR and to investigate the agreement between the SIDI-F and SIDI-F-SR. METHODS: A total of 170 women (Mage = 37, SD = 11, range = 20-69) with HSDD answered the SIDI-F, administered by a clinical psychologist via telephone, first, followed by the SIDI-F-SR, delivered as an Internet-based questionnaire. A subset of 19 women answered the SIDI-F-SR twice over a period of 14 weeks. OUTCOMES: Convergent validity of the SIDI-F-SR was assessed via correlations with the desire subscale of the Female Sexual Function Index and the Female Sexual Distress Scale Revised. Internal consistency and test-retest reliability as well as intraclass correlation and predictors of absolute agreement between SIDI-F and SIDI-F-SR were examined. RESULTS: Test-retest-reliability was good (r = 0.74). Convergent validity was low but comparable between SIDI-F and SIDI-F-SR. Internal consistency of the SIDI-F-SR was acceptable (α = 0.76) and comparable to the SIDI-F (α = 0.74). When corrections for the restriction of range were applied, internal consistency of the SIDI-F-SR increased to 0.91. There was high agreement between SIDI-F and SIDI-F-SR (ICC = 0.86). On average, women scored about one point higher (indicated more desire) in the self-report vs the clinician-administered scale. CLINICAL IMPLICATIONS: The SIDI-F-SR can be used in settings where time and resources are limited. Whether the clinical cutoff point for the SIDI-F is adequate for the SIDI-F-SR has yet to be determined. STRENGTHS AND LIMITATIONS: Large sample of diverse women with HSDD. Lack of control groups (ie, healthy controls, women with other sexual dysfunctions). CONCLUSION: The SIDI-F-SR showed promising psychometric properties in a sample of women with HSDD. Velten J, Hirschfeld G, Meyers M, et al. Psychometric Properties of a Self-Report Version of the Sexual Interest and Desire Inventory-Female (SIDI-F-SR). J Sex Med 2021;18:990-995.


Assuntos
Disfunções Sexuais Psicogênicas , Feminino , Humanos , Libido , Psicometria , Reprodutibilidade dos Testes , Autorrelato , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários
4.
BMC Womens Health ; 21(1): 63, 2021 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33573647

RESUMO

BACKGROUND: The Female Sexual Function Index (FSFI) is a commonly used scale for the assessment of female sexual function. Our aim was to develop and validate a Spanish short version of the FSFI. METHODS: A parallel exploratory, sequential mixed-methods approach was used, involving 2 sites. The process consisted of 2 steps: (1) cognitive and content validation of the previously translated FSFI in the Spanish population, both through a focus group; and item selection based on the difficulty and discrimination parameters using item response theory (IRT), thereby obtaining a short version of the scale (sFSFI-sv); (2) assessment of test-retest reliability (intraclass correlation coefficient, ICC) of the sFSFI-sv. The presence or absence of a sexual disorder variable based on clinical interview was used on the Receiver Operating Characteristic (ROC) to establish the cut off point whose Area Under the Curve (AUC) based on sensibility and specificity was maximum. RESULTS: Specific modifications of the FSFI were made according to the focus group results. 114 women were included for IRT analysis. The initial IRT model pointed to the exclusion of items 1, 2, 5, 11, 18, and 19 (S-χ2 p < 0.001). Items 3, 9, 11, and 14 showed the best discrimination and difficulty parameters. On the basis of the IRT and focus group results, items 1, 3, 9, 12, 16, and 17 were included in the final sFSFI-sv. sFSFI-sv showed good reliability (ICC 0.91) in a group of 93 women. A total score ≤ 18 could indicate a higher risk of sexual disorder (sensitivity: 81.0%, specificity: 73.3%). CONCLUSION: A focus group and the IRT analysis allowed the development of a 6-item Spanish version of the FSFI, which showed good reliability in a group of Spanish women.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários
5.
Expert Opin Drug Saf ; 20(1): 69-79, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33191796

RESUMO

Introduction: People with any psychiatric disorder tend to have difficulties in responding sexually. However,sexual dysfunction (SD) is usually under-recognized, even the tightly hormonal and neuronal common connexions through the brain-sex axis. Multiple sources of resistance to SD assessment and intervention persist. Areas covered: The present review aims to underline the feasibility to introduce SD evaluation in patients with any psychiatric disorders, evaluating the potential mutual benefits of their management. Expert opinion: Women and men living with mental disorders frequently display sexual difficulties; however, some of them consider sexuality as a relevant parameter of their quality of life. In fact, SD as a side effect is a frequent reason for stopping the intake of medication. What is more, a holistic approach integrating sexual function could foster a better understanding of mental pathologies due to a common origin of pathogenesis. This could improve care quality, in keeping with the global tendency toward the development of personalized medicine. Consistently, the integration of SD assessment is highly recommended in mental health, all the more so when a psychotropic drug is prescribed. An expected consequence would be a reconstruction of the healthcare professional's consideration for the sexuality of people experiencing mental disorders.


Assuntos
Transtornos Mentais/complicações , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Feminino , Humanos , Masculino , Transtornos Mentais/tratamento farmacológico , Medicina de Precisão , Psicotrópicos/administração & dosagem , Psicotrópicos/efeitos adversos , Qualidade de Vida , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico
6.
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
7.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 46(7): 441-447, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-201251

RESUMO

OBJETIVO: Diseñar y validar el cuestionario de Función Sexual del Hombre, FSH, en lengua española, siguiendo los criterios del Manual Diagnóstico y Estadístico de los Trastornos Mentales, DSM-5, para el diagnóstico de las disfunciones sexuales. MATERIAL Y MÉTODOS: Estudio transversal y multicéntrico, realizado en 163 hombres (18-70 años) que autocumplimentaron un test (cuestionario FSH preliminar), respondiendo después una anamnesis estructurada sobre función sexual del hombre (AFSH). Cuatro semanas más tarde autocumplimentaron un retest, igual al test pero con una pregunta suplementaria sobre posible influencia de acontecimientos recientes. RESULTADOS: Consistencia interna: α de Cronbach test 0,840; AFSH 0,835; retest 0,855. Fiabilidad test-retest: puntuaciones medias del test 33,13±6,566; retest 33,11±6,791; t de Student 0,122, no significativa (p = 0,903); correlación puntuaciones totales test-retest (coeficiente correlación intraclase) 0,979, correlación significativa (p < 0,01); correlaciones puntuaciones totales test-AFSH (coeficiente correlación intraclase) 0,966, correlación significativa (p < 0,01). Concordancia: entre preguntas del test-AFSH (índice Kappa) mínima 0,749; máxima 0,934; entre preguntas del test-retest 0,724; 0,844. Validez de contenidos mediante consenso de expertos. Validez de criterio: especificidad>90% para todos los ítems/dominios, sensibilidad>80% salvo ítem 4 (76%). Validez de constructo: mediante análisis factorial, agrupación de ítems en 4 componentes (explican el 75% de varianza); elevada correlación entre «deseo sexual» y «confianza en la erección». CONCLUSIONES: El cuestionario FSH es fiable, estable y válido, siendo su especificidad y sensibilidad altas. Evalúa la respuesta sexual del hombre describiendo aspectos de interés: ansiedad anticipatoria, iniciativa, confianza para comunicar preferencias, acontecimientos que puedan influir. Puede detectar disfunción sexual en la pareja


OBJECTIVE: The objective of this work was to design and validate a questionnaire on Male Sexual Function (MSF) in the Spanish language, following the criteria contemplated in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, for the diagnosis of sexual dysfunctions. MATERIAL AND METHODS: A cross-sectional and multicentre study was conducted on 163 men (18-70 years) who self-completed a test (MSF questionnaire). They then answered questions on the Structured History of Male Sexual Function (AMSF). Four weeks later they completed a re-test, which was the same, but including a supplementary question about the possible influence of recent events. RESULTS: Internal consistency: Cronbach's α test 0.840, AMSF 0.835, retest 0.855. Test-retest reliability: mean test scores 33.13±6.566, retest 33.11±6.791; Student t 0.122, not significant (P=.903); correlation total test-retest scores (intraclass correlation coefficient) 0.979, significant correlation (P<.01); total correlations test-AMSF scores (intraclass correlation coefficient) 0.966, significant correlation (P<.01). Concordance: between questions of the AMSF test (Kappa index) minimum 0.749, maximum 0.934; between test-retest questions: 0.724, 0.844. Content validity using expert consensus. Criteria validity: specificity>90% for all items / domains, sensitivity>80% except item 4 (76%). Content validity: using factor analysis, grouping of items into 4 components (explain 75% variance); high correlation between "sexual desire" and "confidence in erection". CONCLUSIONS: The MSF questionnaire is reliable, stable and valid, with high specificity and sensitivity. It evaluates the sexual response of the male, describing aspects of interest: anticipatory anxiety, initiative, confidence to communicate preferences, events that may influence. Can detect sexual dysfunction in the couple


Assuntos
Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Fisiológicas/diagnóstico , Inquéritos e Questionários , Disfunção Erétil/diagnóstico , Comportamento Sexual/fisiologia , Sensibilidade e Especificidade , Estudos Transversais
8.
Sci Rep ; 10(1): 12138, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32699257

RESUMO

The generally negative impact of obesity on female sexuality is well-established. The possible association between bariatric surgery, weight loss, and female sexuality is much less described. The aim of the study was to analyse the possible association between bariatric surgery and female sexual function. It was a cross-sectional study of 623 patients who underwent bariatric surgery between 1999 and 2017. Patients were recruited on the basis of medical records from the Military Institute of Medicine in Warsaw. Patients were invited to complete a questionnaire which consisted of self-designed demographic questions and Female Sexual Function Index (FSFI). The total FSFI score, as well as each subdomain, improved significantly after surgery. The prevalence of low score (< 26.55) was significantly lower after the surgery in comparison to the status prior to the procedure (36.3% vs. 57.5%; p < .001). There were no differences regarding the number of sexually active patients before and after the surgery (75.3% vs. 76.1%; p < .63). There were observed statistically significant, positive correlations between BMI decrease and each subdomain of the FSFI score as well as the total score. Weight loss surgery seems to decrease the risk of sexual dysfunction presence and the advantages are associated with the total BMI loss.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Obesidade Mórbida/cirurgia , Disfunções Sexuais Psicogênicas/etiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/diagnóstico , Estatísticas não Paramétricas , Inquéritos e Questionários
9.
Reprod Health ; 17(1): 110, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650800

RESUMO

BACKGROUND: Patients with multiple sclerosis (MS) especially those with younger age experience an alteration in physiological and emotional lifestyle that can affect intimacy and sexuality. The aim of this study was to determine demographic and disease related determinants of intimacy and sexuality in young women with MS. METHODS: This was a cross sectional study carried out in Tehran, Iran. A convenience sample of young women aged ≤35 years old with MS attending to outpatient clinics in a teaching hospital affiliated to Tehran University of Medical Sciences was entered into the study. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) was used to evaluate how the disease influences sexual function and satisfaction in these patients. Multivariable analysis using hierarchical method was performed to identify variables that are associated with intimacy and sexuality. RESULTS: In total 117 young women with confirmed diagnosis of MS were included in the study. Participants mean was 25.7 (SD = 8.07) years. A multivariable hierarchical regression analysis was performed using demographic variables entered in step one, relevant neurological variables in step two, and psychological variables in step three. Furthermore, we loaded antidepressant use in the last step. Overall, the seven variables accounted for 39% of total variance observed for the MSISQ score (P < 0.001). At step one the demographic variables accounted for 13% of the variance in the MSISQ score (P < 0.001). At step two the inclusion of relevant neurological variables increased the R2 significantly and explained 27% of variance for the MSISQ (P < 0.001). However in the third step the inclusion of psychological factors increased R2 significantly (adjusted R2 increased to 0.39, P < 0.001). CONCLUSIONS: The findings indicated that psychological, disease-related and demographic factors (education and employment status) contributed to intimacy and sexuality in young women with multiple sclerosis. Appropriate interventions, especially psychological interventions, appear to be essential immediately following a definite MS diagnosis in young women.


Assuntos
Esclerose Múltipla/complicações , Satisfação Pessoal , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Esclerose Múltipla/epidemiologia , Esclerose Múltipla/psicologia , Psicometria , Reprodutibilidade dos Testes , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/fisiopatologia , Fatores Socioeconômicos , Inquéritos e Questionários
10.
Am J Surg ; 220(5): 1258-1263, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32680624

RESUMO

INTRODUCTION: Rectal cancer treatment can lead to sexual dysfunction. METHODS: We designed a retrospective survey-based study to quantify rates of sexual dysfunction in rectal cancer survivors. Patients that underwent surgery for rectal cancer between 2005 and 2016 at our institution were identified, and the following were distributed: Quality of Life measure for oncology (QoL-30), Female Sexual Function Index (FSFI), and International Index of Erectile Function (IIEF). RESULTS: Survey response rate was 21%, 17 females and 30 males (n = 47). 50% of males recalled a physician asking about sexual function during or after treatments, compared to 18% of females (p = 0.034). More than 50% of those surveyed wished one of their physicians had discussed the possibility of sexual dysfunction. In men, the QoL-30 significantly correlated with IIEF orgasmic function (r = 0.50, p = 0.004) and IIEF overall satisfaction (r = 0.60, p < 0.001). CONCLUSIONS: Our findings demonstrate that rectal cancer patients experience posttreatment sexual dysfunction, desire discussion with their physicians on this topic, and that there are gender differences in how providers approach counseling regarding posttreatment sexual dysfunction.


Assuntos
Complicações Pós-Operatórias , Protectomia , Neoplasias Retais/cirurgia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Adulto , Idoso , Feminino , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Qualidade de Vida , Estudos Retrospectivos , Fatores Sexuais , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/epidemiologia , Resultado do Tratamento
11.
J Womens Health (Larchmt) ; 29(8): 1101-1112, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32460605

RESUMO

Hypoactive sexual desire disorder (HSDD) in women is defined as the persistent or recurrent absence of sexual thoughts or fantasies and/or lack of desire for sexual activity that is associated with marked personal distress and/or interpersonal difficulties, and cannot be better attributed to another primary disorder, medication, or general medical condition. Notably, HSDD shares some similarity with depression, as its etiology can be explained using a biopsychosocial model that includes biological, psychological, and sociocultural factors, as well as interpersonal influences. Due to its high prevalence and negative impact on the overall health and well-being of women, primary care health professionals and women's health practitioners need to be actively aware of HSDD, particularly because patients may be reluctant or unwilling to initiate a discussion about their sexual concerns during routine visits. HSDD is well established as a valid and treatable clinical entity. Even for those inexperienced in treating sexual problems, there are simple and validated screening tools such as the Decreased Sexual Desire Screener that can help identify HSDD and a need for further evaluation and treatment. There have been few established pharmacologic treatments for HSDD. Flibanserin was the first drug approved for the treatment of HSDD by the U.S. Food and Drug Administration (FDA). Bremelanotide, a novel melanocortin receptor agonist, was recently approved by the FDA for the treatment of acquired, generalized HSDD in premenopausal women. Increased awareness and recognition of HSDD as a medical condition should provide an incentive for further clinical development of effective treatments for HSDD.


Assuntos
Libido , Guias de Prática Clínica como Assunto , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/terapia , Adolescente , Adulto , Idoso , Benzimidazóis/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Motivação , Pré-Menopausa , Prevalência , Disfunções Sexuais Psicogênicas/etiologia
12.
Hum Psychopharmacol ; 35(3): e2730, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32236977

RESUMO

BACKGROUND: Approximately 40% of women and 30% of men describe sexual dysfunction, although recognition in medical settings is suboptimal, due to problems in reporting and eliciting concerns relating to sexual function and satisfaction. Screening questionnaires may help to support this aspect of clinical practice. The Arizona sexual experiences scale (ASEX) includes items that quantify sex drive, arousal, vaginal lubrication or penile erection, ability to reach orgasm, and satisfaction from orgasm. METHOD: We investigated the validity and other psychometric properties of the ASEX, and the findings from the populations in which it has been employed, by searching MEDLINE, EMBASE, and Google Scholar using the terms, Arizona sexual experiences scale, Arizona Sexual Experience Questionnaire, and ASEX. We eliminated duplications, letters, and papers not available in English, and grouped the remaining papers into the categories of psychometric, epidemiological, and outcome-based studies. RESULTS: After elimination of letters and duplicates, papers not in English, and preclinical and irrelevant studies, 104 papers were analyzed. The ASEX has excellent internal consistency, scale reliability and strong test-retest reliability. Analyses of variance reveal significant differences in total ASEX scores between patients and controls and between females and males. ASEX appears to be useful in a range of clinical situations including patients with primary sexual dysfunction, specific psychiatric disorders, specific physical illnesses, and treatment emergent sexual dysfunction. DISCUSSION: The ASEX appears to be a reliable instrument for identifying and quantifying sexual dysfunction across a range of populations in various clinical settings. Little is known about its utility in patients with anxiety disorders or relationships between ASEX scores and biological parameters.


Assuntos
Valor Preditivo dos Testes , Comportamento Sexual , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários/estatística & dados numéricos , Humanos , Psicometria , Reprodutibilidade dos Testes , Fatores Sexuais
13.
J Sex Med ; 17(6): 1144-1155, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32198102

RESUMO

BACKGROUND: About 50% of women who report orgasmic difficulty (OD) during partnered sex are distressed by their condition, yet why some women are distressed and others are not is unclear. AIM: To determine whether sexual distress is related to women's perceived causes of their OD during partnered sex. METHODS: We established homogenous subgroups of women based on their attributions for OD during partnered sex, and these groups were validated by comparing them on variables relevant to sexual response. We then predicted OD-related distress from subgroup memberships as well as from a number of sociodemographic, control, and empirically supported sexual response variables. RESULTS: 3 distinct OD subgroups emerged: type 1-high psychological-high somatic reasons; type 2-partner-related reasons; and type 3-moderate psychological-low somatic reasons. These groups also differed on independent parameters related to sexual frequency and arousal. Subgroup membership, along with age, sexual relationship satisfaction, and frequency of partnered sex predicted sexual distress related to OD. CLINICAL IMPLICATION: Particular perceptions regarding the causes for OD help predict women's sexual distress, and such factors might be considered in identifying sexual issues and managing them within the context of a sexual relationship. STRENGTHS & LIMITATIONS: A large sample size drawn from a multinational population powered the study, while the cross-sectional nature of the sample could not rule out bidirectional associations between predictor covariates (including OD subgroup) and the outcome measure (sexual distress). CONCLUSION: Type 1 membership (high levels of psychological and somatic attributions) predicted greater levels of OD-related distress than type 2 (partner-related attributions) or type 3 (moderate psychological and low somatic attributions) membership, with type 1 women having a greater likelihood of internalizing (accepting responsibility/blame for) OD attributions. Hevesi K, Miklós E, Horváth Z, et al. Typologies of Women With Orgasmic Difficulty and Their Relationship to Sexual Distress. J Sex Med 2020;17:1144-1155.


Assuntos
Orgasmo , Disfunções Sexuais Psicogênicas , Estudos Transversais , Feminino , Humanos , Comportamento Sexual , Disfunções Sexuais Psicogênicas/diagnóstico , Parceiros Sexuais , Inquéritos e Questionários
14.
J Abnorm Psychol ; 129(3): 266-278, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32027146

RESUMO

Despite controversies about the diagnosis, the World Health Organization recently elected to include compulsive sexual behavior disorder in the 11th edition of the International Classification of Diseases. Both recent and remote works have suggested that various cultural factors such as personal religiousness and morality can influence both the experience and expression of compulsive sexual behaviors. Because prior works have indicated that pornography use is likely to be the most common expression of compulsive sexual behavior, the present work sought to examine whether moral incongruence about pornography use may account for a substantive part of self-reports of compulsive sexual behavior. In 2 studies involving 4 samples, the present work tested the hypothesis that moral incongruence would positively predict self-reported compulsivity in pornography use. In Study 1, across 3 samples (Sample 1, N = 467; Sample 2, N = 739; Sample 3, N = 1,461), including 2 matched to U.S. nationally representative norms (Samples 2 and 3), results indicated that moral incongruence was a substantive and robust predictor of self-reported compulsivity. In Study 2 (baseline N = 850), parallel process latent growth curve analyses over the course of 1 year revealed that the trajectories of pornography use, self-reported compulsivity, and moral disapproval of such use covaried together over time. Collectively, these results underscore the contention that personal morality may influence individuals' self-perceptions of their sexual behaviors, which, in turn, may complicate efforts to accurately diagnose compulsive sexual behavior disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Comportamento Compulsivo/diagnóstico , Princípios Morais , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Adolescente , Adulto , Comportamento Compulsivo/psicologia , Estudos Transversais , Autoavaliação Diagnóstica , Literatura Erótica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/psicologia , Normas Sociais , Adulto Jovem
15.
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
16.
J Womens Health (Larchmt) ; 29(6): 806-814, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32096691

RESUMO

Screening, diagnosis, and management of hypoactive sexual desire disorder (HSDD) and research into the condition have been challenging due to its biopsychosocial complexity and lack of consensus on relevant measures. Although physician interviews yield much clinically valid information, self-reported questionnaires appear more acceptable to patients and physicians. Consequently, validated patient-reported outcome (PRO) tools are essential for evaluation and management of HSDD, including any therapeutic intervention. The US Food and Drug Administration (FDA) has issued guidance on the use of appropriate endpoints and associated measures for female sexual dysfunction, including HSDD. Although many of the available measures were not designed specifically for HSDD assessment, as per FDA guidelines, most clinical studies have used individual domains or items from established tools, such as the Female Sexual Function Index-desire domain and Item 13 of the revised Female Sexual Distress Scale. For clinical practice, several professional societies recommend the Decreased Sexual Desire Screener and/or a sexual history as tools to diagnose HSDD. This review discusses frequently used PRO tools as well as the newly developed and validated Elements of Desire Questionnaire, which may be appropriate for clinical trials or clinical practice.


Assuntos
Programas de Rastreamento , Medidas de Resultados Relatados pelo Paciente , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Feminino , Humanos , Inquéritos e Questionários
17.
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
18.
J Sex Med ; 17(1): 17-25, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31735616

RESUMO

INTRODUCTION: Over the past 20 years, the Female Sexual Function Index (FSFI) has been considered the gold standard for the measurement of sexual function in women, with over 1,000 published manuscripts citing the article. Despite the measure's widespread usage and excellent psychometric properties, there has been some confusion over how to best implement and score the measure and interpret corresponding findings. AIM: The aim of the current article is to provide guidance, drawing from 20 years of use, on how to best implement the FSFI in research settings and interpret results based on the validation studies that have been conducted to date. METHODS: The overview of scoring and interpretation procedures found in this article is drawn from a review of the published literature on the psychometric properties of the FSFI. MAIN OUTCOME MEASURE: The measure of interest for the present review is the FSFI. RESULTS: This review article provides information about implementing, scoring, and interpreting the full-scale FSFI. Domain-level scoring and interpretation procedures are also discussed across the 5 domains of the FSFI: arousal, satisfaction, desire, pain, and lubrication. Additionally, guidance is provided for evaluating translated versions of the FSFI and using the measure to examine sexual function in culturally diverse populations. CLINICAL IMPLICATIONS: Guidance on appropriately scoring and interpretating the FSFI has the potential to strengthen our empirical understanding of sexual function, and consequently, to guide theory-driven treatment development and clinical practice. STRENGTH & LIMITATIONS: The present review provides applied guidance for the appropriate use of the FSFI specifically, but does not cover other common measures of sexual function or adaptations of the original measure. CONCLUSION: It is our hope that the guidance found in this review will ultimately lead to more rigorous and appropriate usage of the FSFI in research settings. Meston CM, Freihart BK, Handy AB, et al. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med 2020;17:17-25.


Assuntos
Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e Questionários , Feminino , Humanos , Satisfação Pessoal , Psicometria
19.
Rev. int. androl. (Internet) ; 17(4): 130-137, oct.-dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-189270

RESUMO

INTRODUCTION: The links between body weight and sexuality, notably sexual dysfunction (SD), are intricate and not yet fully understood. A more individual-focused evaluation of sexual difficulties, as recently provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), contributes to improve precision in SD diagnosis and has the potential to advance our knowledge on the association between body weight and SD. OBJECTIVES: To identify gender differences in sexual behaviors and SD among Portuguese men and women within different classes of body mass index (BMI); and to explore the association between BMI and SD by using the new DSM-5 criteria. MATERIAL AND METHODS: Face-to-face interviews followed by self-completed questionnaires of primary healthcare users in Portugal (n=323). Data on sociodemographic variables, BMI, sexual behaviors and SD were collected. DSM-5 criteria were used to assess sexual dysfunction. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) for men and women, respectively, were used for comparison purposes. RESULTS: Overweight and obese women reported less sexual partners, less satisfaction with sexual frequency and rated sexual life as less important. These differences were not found among men. Normal weight men and women had a higher score of IIEF and FSFI, respectively, than those overweight and obese. No significant effects of BMI scale on SD following DMS-5 were detected. CONCLUSIONS: Women's sexual function is more impacted by BMI than men's. Individual-orientated approaches, as proposed in DSM-5, may allow a better understanding on the relation between body size and sexuality in both genders


INTRODUCCIÓN: La relación entre el peso corporal y la sexualidad, en particular la disfunción sexual (DS), es compleja y aún no se entiende por completo. Una evaluación de las dificultades sexuales más centrada en el individuo, como la recientemente proporcionada por el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5), contribuye a mejorar la precisión en el diagnóstico de la DS y tiene el potencial para avanzar en el conocimiento sobre la asociación entre el peso corporal y la DS. OBJETIVO: Identificar diferencias de género en conductas sexuales y DS entre varones y mujeres portuguesas con diferentes clases de índice de masa corporal (IMC), y explorar la asociación entre IMC y DS utilizando los nuevos criterios del DSM-5. MATERIAL Y MÉTODOS: Entrevistas cara a cara con usuarios de atención primaria de salud en Portugal (n=323), seguidas de cuestionarios autocompletados. Se recogieron datos sobre variables sociodemográficas, IMC, conductas sexuales y DS. Los criterios del DSM-5 se utilizaron para evaluar la DS. El Índice Internacional de Función Eréctil (IIEF) y el Índice de Función Sexual Femenina (IFSF) se utilizaron con fines comparativos, para varones y mujeres, respectivamente. RESULTADOS: Las mujeres con sobrepeso y obesidad comunicaron menos parejas sexuales, menor satisfacción con la frecuencia sexual y calificaron la vida sexual como menos importante. Estas diferencias no se encontraron entre los varones. Los varones y mujeres de peso normal tuvieron una puntuación más alta de IIEF y IFSF, respectivamente, que los varones y las mujeres con sobrepeso y obesidad. No se detectaron efectos importantes de la escala del IMC en la DS según el DSM-5. CONCLUSIÓN: La función sexual de las mujeres está más afectada por el IMC que la de los varones. Los enfoques orientados al individuo, como se propone en el DSM-5, pueden permitir una mejor comprensión de la relación entre el peso corporal y la sexualidad en ambos sexos


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Índice de Massa Corporal , Manual Diagnóstico e Estatístico de Transtornos Mentais , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Fatores Sexuais
20.
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
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...