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1.
Med Clin North Am ; 103(4): 681-698, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078200

RESUMO

Female sexual dysfunction can drastically diminish quality of life for many women. It is estimated that in the United States 40% of women have sexual complaints. These conditions are frequently underdiagnosed and undertreated. Terminology and classification systems of female sexual dysfunction can be confusing and complicated, which hampers the process of clinical diagnosis, making accurate diagnosis difficult. There are few treatment options available for female sexual dysfunctions, however, some interventions may be of benefit and are described. Additional treatments are in development. The development of clear clinical categories and diagnostic guidelines for female sexual dysfunction are of utmost importance and can be of great benefit for clinical and public health uses and disease-related research.


Assuntos
Qualidade de Vida , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Saúde da Mulher , Feminino , Humanos , Comportamento Sexual , Disfunções Sexuais Fisiológicas/classificação , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/classificação , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/terapia , Estados Unidos
2.
Mayo Clin Proc ; 94(5): 842-856, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954288

RESUMO

Sexual problems are common in women of all ages. Despite their frequency and impact, female sexual dysfunctions (FSDs) are often unrecognized and untreated in clinical settings. In response, the International Society for the Study of Women's Sexual Health convened a multidisciplinary, international expert panel to develop a process of care (POC) that outlines recommendations for identification of sexual problems in women. This POC describes core and advanced competencies in FSD for clinicians who are not sexual medicine specialists and serve as caregivers of women and, therefore, is useful for clinicians with any level of competence in sexual medicine. The POC begins with the expectation of universal screening for sexual concerns, proceeds with a 4-step model (eliciting the story, naming/reframing attention to the problem, empathic witnessing of the patient's distress and the problem's impact, and referral or assessment and treatment) that accommodates all levels of engagement, and delineates a process for referral when patients' needs exceed clinician expertise. Distressing problems related to desire, arousal, and orgasm affect 12% of women across the lifespan. Low desire is the most common sexual problem, but sexual pain and other less common disorders of arousal and orgasm are also seen in clinical practice. Screening is best initiated by a ubiquity statement that assures the patient that sexual concerns are common and can be revealed. Patient-centered communication skills facilitate and optimize the discussion. The goal of the POC is to provide guidance to clinicians regarding screening, education, management, and referral for women with sexual problems.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Saúde Sexual/normas , Saúde da Mulher/normas , Competência Clínica , Empatia , Feminino , Humanos , Assistência Centrada no Paciente/métodos , Relações Médico-Paciente , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/normas , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/terapia , Sociedades Médicas
3.
J Sex Marital Ther ; 45(7): 574-584, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30912475

RESUMO

Infertility and its consequences can have effects on various aspects of a couple's life and also in their marital relationships. This study aimed to investigate the effect of cognitive behavioral therapy (CBT) on sexual function in infertile women. The participants included 52 infertile women randomly assigned to intervention and control groups. A group-based, six-session sexual counseling using a CBT approach was also performed for the intervention group. Sexual functions of the participants in both groups were then assessed via the Female Sexual Function Index (FSFI) at three points in time. The findings revealed no statistically significant difference in the baseline FSFI mean scores of both groups. A significant difference was also reported for FSFI mean scores in the intervention group (29.35 ± 2.71) in comparison with those in the control group (25.84 ± 2.52) (p < 0.001) one month after intervention, with an effect size of 0.32. The mean scores of all the sexual-function domains, including sexual desire (p < 0.001), arousal (p < 0.001), lubrication (p < 0.001), orgasm (p < 0.001), satisfaction (p < 0.001), and pain (p < 0.001), among the participants in the intervention group had also significantly increased following CBT implementation. The results of this study could be used to promote sexual health in infertile women.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Infertilidade Feminina/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/terapia , Cônjuges/psicologia , Adulto , Feminino , Humanos , Infertilidade Feminina/terapia , Casamento , Satisfação Pessoal , Disfunções Sexuais Fisiológicas/terapia , Adulto Jovem
4.
Int J Gynecol Cancer ; 29(3): 630-634, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30765487

RESUMO

Sexual dysfunction in female cancer patients remains under-diagnosed and under-treated. As sexual dysfunction is becoming an increasingly common side effect of cancer treatments, it is imperative for healthcare providers and especially gynecologic oncologists to include a comprehensive evaluation of sexual health as a routine part of the workup of such patients. Although most oncologists are not experienced in treating sexual dysfunctions, simple tools can be incorporated into clinical practice to improve the management of these conditions. In this review, we propose a practical approach to selecting proper treatment for sexual dysfunctions in female cancer patients. This includes three main steps: knowledge, diagnosis, and sexual counseling. Knowledge can be acquired through a specific updating about sexual issues in female cancers, and with a medical training in female sexual dysfunctions. Diagnosis requires a comprehensive history and physical examination. Sexual counseling is one of the most important interventions to consider and, in some cases, it may be the only intervention needed to help cancer patients tolerate their symptoms. Sexual counseling should be addressed by oncologists; however, select patients should be referred for qualified psychological or sexological interventions where appropriate. Finally, a multidisciplinary team approach may be the best way to address this challenging issue.


Assuntos
Neoplasias dos Genitais Femininos/fisiopatologia , Neoplasias dos Genitais Femininos/psicologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Feminino , Neoplasias dos Genitais Femininos/terapia , Humanos , Comportamento Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia
6.
Praxis (Bern 1994) ; 108(1): 23-30, 2019 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30621544

RESUMO

Sexual Dysfunction in Primary Health Care Abstract. In primary health care, sexual dysfunctions are usually only insufficiently recorded. At the same time, these disorders are relatively common and often remain untreated. This study investigated sexual dysfunction and how it is influenced by lifestyle in patients in a general practitioner's practice (HP). METHODS: A sample of HP patients was asked about their sexuality, psychosocial situation and lifestyle, using validated questionnaires. RESULTS: The sample consisted of 30 women and 37 men. Of these, about two thirds have never spoken to a physician about their sex life and more than four fifths have never been asked about it by a phyisican. In 75 % of the sample there was no evidence of sexual dysfunction. Men with questionnaire values indicating sexual dysfunction showed significantly higher psychological stress than those with inconspicuous values. CONCLUSION: Despite an inconspicuous anamnesis regarding risk factors of sexual dysfunction, about a quarter of the sample found evidence of sexual dysfunction. An inconspicuous anamnesis in the areas of alcohol/tobacco consumption and depression does not make a targeted questioning about sexual dysfunction superfluous. Particularly for men, acute psychological stress should be a sufficient reason to address the topic of sexuality and to deepen it if necessary.


Assuntos
Atenção Primária à Saúde , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Feminino , Humanos , Masculino , Comportamento Sexual , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Sexualidade , Inquéritos e Questionários
7.
J R Army Med Corps ; 165(2): 94-97, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30679182

RESUMO

Military personnel can experience psychosexual difficulties for a variety of reasons. Problems can arise because of psychological trauma, physical injury, consequences arising from pharmacological and surgical complications and social or emotional concerns relating to intrapersonal and interpersonal relationship dynamics. Such individuals might seek to minimise or avoid resolving their pertinent difficulties, while others can experience cultural, personal or organisational barriers to accessing professional help. This paper offers an overview of the development of a national specialist psychosexual therapy service (PST), commenting specifically on the service delivery for male military personnel. It will also consider factors which may support progress in treatment and reflect upon the importance of considering psychosexual functioning in relationships as part of the broader service-life context, which is especially relevant to military personnel.


Assuntos
Medicina Militar , Psicologia Militar , Disfunções Sexuais Psicogênicas/terapia , Genitália Masculina/lesões , Humanos , Masculino , Medicina Militar/métodos , Medicina Militar/organização & administração , Militares , Trauma Psicológico/terapia , Psicologia Militar/métodos , Psicologia Militar/organização & administração , Reino Unido
8.
J Pediatr Adolesc Gynecol ; 32(2): 186-188, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30513343

RESUMO

BACKGROUND: After several visits with unrelated complaints, a 16-year-old female patient disclosed symptoms of unwanted genital arousal and was diagnosed with persistent genital arousal disorder (PGAD). CASE: A 16-year-old female patient with history of depression, sexual abuse, and dysmenorrhea insistently requested etonogestrel rod removal. At 2 visits after implant removal, the patient disclosed the reason for her insistence: PGAD symptoms developed after implant insertion, although they worsened with removal. Chart review revealed selective serotonin reuptake inhibitor discontinuation before symptom onset. Normalization of sexual arousal occurred with counseling, selective serotonin reuptake inhibitor treatment, and hormonal contraception. SUMMARY AND CONCLUSION: This case highlights the importance of clinician recognition of PGAD symptoms, which adolescents might not openly disclose. Clinicians must nonjudgmentally collect medication history and sexual history, including sexual arousal and satisfaction, to make this diagnosis.


Assuntos
Depressão/tratamento farmacológico , Inibidores de Captação de Serotonina/administração & dosagem , Disfunções Sexuais Psicogênicas/diagnóstico , Adolescente , Anticoncepcionais Orais Hormonais/uso terapêutico , Diagnóstico Diferencial , Feminino , Genitália , Humanos , Inibidores de Captação de Serotonina/efeitos adversos , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
10.
Lasers Surg Med ; 51(2): 127-135, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30221776

RESUMO

OBJECTIVES: Transcranial photobiomodulation (t-PBM) consists of the delivery of near-infrared (NIR) or red light to the scalp designed to penetrate to subjacent cortical areas of the brain. NIR t-PBM has recently emerged as a potential therapy for brain disorders. This study assessed the efficacy of repeated sessions of NIR t-PBM on sexual dysfunction. METHODS: We performed a secondary analysis of a double-blind clinical trial on t-PBM for major depressive disorder (MDD). Twenty individuals received NIR t-PBM (n = 9) or sham therapy (n = 11) twice a week for 8 weeks. Sexual desire, arousal, and orgasm were assessed using the Systematic Assessment for Treatment-Emergent Effects-Specific Inquiry (SAFTEE-SI). RESULTS: The mean improvement in sexual function (decrease in SAFTEE sex total score) in subjects receiving t-PBM in NIR-mode was significantly greater than in subjects receiving sham-mode in the whole sample (NIR [n = 9] -2.55 ± 1.88 vs. sham [n = 11] -0.45 ± 1.21; z = 2.548, P = 0.011]) and in the completers (NIR [n = 5] -3.4 ± 1.95 vs. sham [n = 7] -0.14 ± 1.21; z = 2.576, P = 0.010]). CONCLUSION: This exploratory study with a small sample size indicates that repeated sessions of NIR t-PBM may be associated with therapeutic effects on sexual dysfunction. The latter appeared unrelated to the antidepressant effect of t-PBM in our cohort. Lasers Surg. Med. 51:127-135, 2019. © 2018 Wiley Periodicals, Inc.


Assuntos
Encéfalo/efeitos da radiação , Transtorno Depressivo Maior/terapia , Raios Infravermelhos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Disfunções Sexuais Psicogênicas/terapia , Adolescente , Adulto , Idoso , Método Duplo-Cego , Humanos , Pessoa de Meia-Idade
11.
J Marital Fam Ther ; 45(2): 275-295, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30009425

RESUMO

The ability to conceptualize and treat sexual problems has been widely accepted as a crucial skill to master the MFT training. However, clients' sexual relationships are often ignored by clinicians because of a lack of experience or training, or personal discomfort. In this content analysis, we review sex and sex therapy research within MFT and family studies journals since the turn of the century. Of the 13,919 articles published within the 15 journals, 137 focused on sexuality or sex therapy. The articles were divided into five themes: sexual and relational health, sexual diversity, treatment and contributors of sexual dysfunction, sex therapy practices, and sexual education and development. Implications for clinical practices, sex therapy integration, and future research are discussed.


Assuntos
Bibliometria , Pesquisa Biomédica/estatística & dados numéricos , Terapia Familiar/estatística & dados numéricos , Terapia Conjugal/estatística & dados numéricos , Comportamento Sexual , Disfunções Sexuais Psicogênicas/terapia , Terapia Familiar/educação , Humanos , Terapia Conjugal/educação
12.
J Sex Marital Ther ; 45(1): 21-30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29757100

RESUMO

The aim of the study was to determine the effect of sexual counseling based on the BETTER model of female sexual health in infertile women with sexual dysfunction. This is an experimental, prospective study carried out in an infertility clinic. The study included 70 women with primary infertility, of whom 35 were in the experimental group and 35 were in the control group. The Female Sexual Function Scale and the Golombok-Rust Sexual Satisfaction Scale were administered at the initial assessment and the final assessment. Two sessions of sexual counseling were given to the experimental group based on the BETTER model. A routine follow-up of the control group was performed. After the counseling, there was a statistically significant improvement in the mean scores for Female Sexual Function Scale and the total scores for the Golombok-Rust Sexual Satisfaction Scale and its subscales in the experimental group compared to the control group. The women who had been infertile for six years and more had less improvement in sexual dysfunction and sexual dissatisfaction. The sexual counseling given in accordance with the BETTER model was found to be effective in improvement of sexual function and sexual satisfaction in the women with one to two years of infertility.


Assuntos
Infertilidade Feminina/psicologia , Aconselhamento Sexual/métodos , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Adaptação Psicológica , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Estudos Prospectivos , Fatores de Risco , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia
13.
Sex Med Rev ; 7(2): 251-258, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30301704

RESUMO

INTRODUCTION: Care-seeking for sexual dysfunction is limited by embarrassment, efficacy/safety concerns, and cost. Nutritional supplements (NSs) are low-cost but unproven. AIM: To provide hypotheses on whether effective NS combinations for sexual dysfunction can be created following known pharmacology principles and tested with sufficient rigor in Internet-based "exo-clinical" trials (XCTs). METHODS: PubMed and Google searches were conducted to review the feasibility of XCTs of NS combinations for sexual dysfunction. Findings were synthesized into recommendations for XCTs to treat the most common sexual problems. MAIN OUTCOME MEASURE: The hierarchy of references used for making recommendations was controlled clinical trials over uncontrolled trials. The frequency of sexual dysfunction was determined in population-representative national surveys. RESULTS: XCTs of cognitive behavioral therapy show conclusive efficacy for anxiety and depression. 5 small XCTs showed efficacy for female sexual dysfunction and erectile dysfunction (ED), and 2 XCTs of NS for other medical problems substantiated feasibility. To test the feasibility of XCTs for the most common forms of sexual dysfunction-ED, hypoactive sexual desire disorder (HSDD), and sexual performance anxiety-protocol outlines were generated for frugal XCTs; the total estimated subject time burden is ≤1 hour. CONCLUSION: An XCT is a cost-effective method of evaluating new treatments, including sexual dysfunction and common mental disorders, if compliance is maintained by regular outreach while minimizing the time burden on subjects and handling consent and privacy issues appropriately. NS combinations might expand the opportunities for relief of sexual dysfunction if formulated with pharmacologically active doses of NS with already supported efficacy and safety. The feasibility of XCTs of NS combinations for sexual dysfunction might be tested most productively in men with ED, in women with HSDD, and in men and women with sexual performance anxiety. Pyke RE. Exo-Clinical Trials of Nutritional Supplements for Sexual Dysfunction: Precedents, Principles, and Protocols. Sex Med Rev 2019;7:251-258.


Assuntos
Ensaios Clínicos como Assunto , Suplementos Nutricionais , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Ensaios Clínicos como Assunto/economia , Estudos de Avaliação como Assunto , Estudos de Viabilidade , Feminino , Humanos , Internet , Masculino , Psicoterapia , Disfunções Sexuais Fisiológicas/dietoterapia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/dietoterapia , Disfunções Sexuais Psicogênicas/psicologia
14.
Sex Med Rev ; 7(2): 223-250, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29402732

RESUMO

BACKGROUND: Female sexual dysfunction (FSD) is a highly prevalent condition. Nevertheless, the scientific literature has only recently begun to accumulate evidence for treatment modalities that address the underlying etiologies of FSD. AIM: The purpose of this systematic review is to elucidate what treatments are effective across the various symptom complexes of FSD. METHODS: Utilizing Meta-analysis of Observational Studies in Epidemiology guidelines, we conducted a systematic review of PubMed, EMBASE, clinicaltrials.gov, and the Cochrane Review databases. Eleven search strings, encompassing the terms "female sexual dysfunction" and "treatment," in combination with "vulvovaginal atrophy," "vaginismus," "vaginal atrophy," "vulvodynia," "vestibulitis," "hypoactive sexual desire," "arousal disorder," "sexual pain disorder," "genitourinary syndrome of menopause," and "orgasmic disorder" were utilized. 605 Relevant articles were retrieved. A total of 103 original studies met inclusion criteria. OUTCOMES: We assess peer-reviewed literature. RESULTS: 42 Treatment modalities were utilized, including 26 different classes of medications. Although outcome measures varied, the most substantial improvement across multiple studies was noted with various hormonal regimens. The most common treatments included hormonal therapy (25 studies), phosphodiesterase type-5 inhibitors (9 studies), botulinum toxin A (5 studies), and flibanserin (5 studies). The psychotherapeutic approach was detailed in 36 articles while 3 studies utilized homeopathic treatments. Numerous treatments showed efficacy in a single case series, including the promising results associated with the micro-ablative carbon-dioxide laser. Despite the marked improvement in specific FSD domains, neither pharmacologic treatments nor psychotherapeutic interventions demonstrate consistent disease resolution. CONCLUSIONS: Treatment of FSD is multi-factorial; medications alone do not resolve FSD. The wide variability of treatment and outcome measures across the literature attests to the complexity of FSD and the need for a treatment algorithm that addresses all 4 domains of FSD. Weinberger JM, Houman J, Caron AT, et al. Female Sexual Dysfunction: A Systematic Review of Outcomes Across Various Treatment Modalities. Sex Med Rev 2019;7:223-250.


Assuntos
Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Feminino , Humanos , Resultado do Tratamento
15.
Acta Clin Croat ; 58(3): 508-515, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31969764

RESUMO

This study aimed to investigate whether infertility and its treatment affect couple sexuality. A systematic literature review was performed, focusing on female and male sexual dysfunctions due to infertility. The method was descriptive, using a meta-synthesis of scientific research published between 2012 and 2017 in the English language. The search for suitable studies was carried out with the research databases Medline, CINAHL, PubMed and ScienceDirect using the following keywords: infertility, sexual dysfunctions, couple. It can be concluded that infertility negatively affects the sexuality of an infertile couple, which is further proven by a high percentage of sexual dysfunctions (43%-90% among women and 48%-58% among men). Couples report less satisfaction with sexuality. Since lower satisfaction and dysfunctions are closely connected with infertility and its treatment, couples might benefit from sexual therapy and support during the process of infertility treatment. Further research should focus on the evaluation of different psychological interventions that would address sexuality in couples when diagnosed and treated for infertility.


Assuntos
Infertilidade/psicologia , Infertilidade/terapia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Sexualidade/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Infertilidade/fisiopatologia , Masculino , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/fisiopatologia
16.
Urologiia ; (6): 150-155, 2019 12 31.
Artigo em Russo | MEDLINE | ID: mdl-32003187

RESUMO

Delayed ejaculation is a form of sexual disorders, which is characterized by constant or intermittent delays or absence of ejaculation and orgasm, despite normal sexual arousal and erectile function. Delayed ejaculation is one of the most studied and rare types of male sexual dysfunctions, which leads to depression, anxiety, and often is a reason of low self-esteem, reduced satisfaction of a man with his partner, and worsening of relationships between partners. In some cases, delayed ejaculation and anejaculation cause infertility. Current views on epidemiology, diagnostics and treatment strategy of delayed ejaculation are presented in the article.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Ejaculação , Humanos , Masculino , Orgasmo , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
17.
Can J Cardiol ; 34(12): 1590-1599, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30527146

RESUMO

BACKGROUND: Decreased sexual activity (SA) is a common problem in patients with cardiovascular disease (CVD). Although there is evidence that cardiac rehabilitation (CR) is effective in improving physical outcomes and overall quality of life, its effects on SA remain unclear. In this systematic review we assessed the association between CR attendance and SA outcomes in adults with CVD. METHODS: Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL) were systematically searched in January 2018. Original studies that compared attendance to CR vs no attendance to CR in adults 18 years and older with diagnosed CVD that also reported on SA outcomes were included. A narrative synthesis was conducted because the data did not permit meta-analysis. RESULTS: Fourteen studies were identified: 6 randomized controlled trials, 5 nonrandomized controlled trials, and 3 prospective cohort studies. All CR programs included an exercise-based component and 4 included an SA-specific component. Seven studies reported a significant benefit in SA outcomes in the CR group, 1 study reported significant harm, and 11 studies reported a nonsignificant difference. CONCLUSIONS: The effect of CR on SA outcomes was generally reported to be equivocal or positive. CR showed some promise in improving sexual functioning and frequency, with mixed results with regard to sexual resumption and satisfaction. In conclusion, it remains uncertain if CR consistently improves sexual outcomes in adults with CVD but these data suggest that further exploration might be justified.


Assuntos
Reabilitação Cardíaca , Doenças Cardiovasculares , Comportamento Sexual , Humanos , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia
18.
Taiwan J Obstet Gynecol ; 57(6): 791-795, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30545528

RESUMO

OBJECTIVE: Hypoactive Sexual Desire Disorder (HSDD) was the most common subtype of female sexual dysfunction; however, little was known about why Chinese women with HSDD were willing to seek medical help. This study aimed to identify predictive factors of seeking treatment for HSDD. MATERIALS AND METHODS: 260 outpatient premenopausal women who met the DSM-IV-TR criteria for HSDD for at least 6 months were recruited. All cases were divided into groups of willing to be treated and unwilling to be treated. The main outcome measures in this study were the Sexual Desire Relationship Distress Scale (SDRDS) score, physical and psychosexual characteristics, and Health Belief Model (HBM) variables. RESULTS: Women with willingness to be treated were significantly associated with fewer experiences of sexual assault (P = 0.033), longer relationship with a partner (P = 0.039), greater agreement about the severity of mental health injury as a result of HSDD (P = 0.008), more cues to action of sexual treatment (P < 0.05), higher self-efficacy (P < 0.05), and lesser treatment barriers including embarrassment about discussing desire problems with a physician (P = 0.026) and partner disagreement (P = 0.005). A relationship of more than 36 months (OR = 7.92), cues to action (OR = 1.70), and self-efficacy (OR = 1.76) could significantly predict willingness to be treated. CONCLUSIONS: HBM was useful in predicting treatment intent in premenopausal women with HSDD. These findings suggest ways to increase the rate of those seeking treatment in the future.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Adulto , Estudos Transversais , Constrangimento , Feminino , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pré-Menopausa , Autoeficácia , Disfunções Sexuais Psicogênicas/terapia , Parceiros Sexuais/psicologia , Inquéritos e Questionários , Taiwan
19.
Int J Gynecol Cancer ; 28(9): 1737-1742, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30358703

RESUMO

OBJECTIVE: Sexual health is important to quality of life; however, the sexual health of gynecologic cancer patients is infrequently and inadequately addressed. We sought to understand patient experiences and preferences for sexual health care to help inform strategies for improvement. METHODS/MATERIALS: An anonymous, cross-sectional survey of outpatient gynecologic cancer patients at a large academic medical center was performed as part of a larger study examining patient and caregiver needs. The survey explored patient-provider discussions about sexuality across 3 domains (experiences, preferences, barriers) and 4 phases of cancer care (diagnosis, treatment, treatment completion, follow-up). Age, relationship status, sexual activity, and cancer type were recorded. RESULTS: Mean age was 63 years. Most patients had ovarian cancer (38%) or endometrial cancer (32%). Thirty-seven percent received treatment within the last month, 55% were in a relationship, and 35% were sexuality active. Thirty-four percent reported sexuality as somewhat or very important, whereas 27% felt that it was somewhat or very important to discuss. Importance of sexuality was associated with age, relationship status, and sexual activity but not cancer type. Fifty-seven percent reported never discussing sexuality. Age was associated with sexuality discussions, whereas relationship status, sexual activity, and cancer type were not. The most common barrier to discussion was patient discomfort. Follow-up was identified as the best time for discussion. Sexuality was most often discussed with a physician or advanced practice provider and usually brought up by the provider. CONCLUSIONS: Demographic predictors of importance of sexuality to the patient are age, relationship status, and sexual activity. Providers primarily use age as a proxy for importance of sexuality; however, relationship status and sexual activity may represent additional ways to screen for patients interested in discussing sexual health. Patient discomfort with discussing sexuality is the primary barrier to sexual health discussions, and awareness of this is key to developing effective approaches to providing sexual health care.


Assuntos
Neoplasias dos Genitais Femininos/terapia , Cuidados Paliativos/métodos , Disfunções Sexuais Psicogênicas/terapia , Saúde Sexual , Sexualidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Endométrio/fisiopatologia , Neoplasias do Endométrio/psicologia , Neoplasias do Endométrio/terapia , Feminino , Neoplasias dos Genitais Femininos/fisiopatologia , Neoplasias dos Genitais Femininos/psicologia , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/fisiopatologia , Neoplasias Ovarianas/psicologia , Neoplasias Ovarianas/terapia , Preferência do Paciente , Qualidade de Vida , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia
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