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

RESUMO

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


Assuntos
Comportamento Sexual , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Minorias Sexuais e de Gênero , Humanos , Masculino , Doenças do Pênis/diagnóstico , Doenças do Pênis/etiologia , Doenças do Pênis/psicologia , Doenças do Pênis/terapia , Pênis/anatomia & histologia , Pênis/lesões , Qualidade de Vida , Ruptura , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/psicologia , Disfunções Sexuais Psicogênicas/terapia , Minorias Sexuais e de Gênero/psicologia
2.
Curr Urol Rep ; 22(2): 8, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33420966

RESUMO

PURPOSE OF REVIEW: To review the most current literature on how the treatment for penile cancer can affect quality of life and to discuss current treatment options to overcome sexual dysfunction and ultimately improve patient wellbeing. RECENT FINDINGS: Multiple medical and surgical therapies exist to address the high incidence of sexual dysfunction following penile cancer treatment. Advancements and refinements in the neophalloplasty, penile prosthesis, and penile lengthening procedures have opened the door to improved long-term outcomes. Additionally, studies continue to highlight the severe psychological toll that penile cancer treatment can have on patients. We explore the potential options for addressing the inherent psychologic effects of these treatments and highlight the need for further research in this domain. Although rare, it is important for all urologists to be familiar with the treatments and post-treatment sequelae of penile cancer. Penile cancer is associated with dramatic decline in quality of life and sexual function. Multiple medical and surgical therapies exist that addresses these concerns. Additionally, urologists must also be mindful of the psychologic component regarding surgical disfigurement and the decline in sexual function.


Assuntos
Sintomas do Trato Urinário Inferior/terapia , Neoplasias Penianas/psicologia , Neoplasias Penianas/terapia , Pênis/cirurgia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Aconselhamento , Disfunção Erétil/terapia , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Metástase Linfática , Masculino , Neoplasias Penianas/diagnóstico , Neoplasias Penianas/etiologia , Prótese de Pênis/efeitos adversos , Implantação de Prótese/efeitos adversos , Implantação de Prótese/métodos , Psicoterapia , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Retalhos Cirúrgicos
3.
Rev. Hosp. Ital. B. Aires (2004) ; 40(1): 34-38, mar. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1102292

RESUMO

Las mujeres han sido tratadas por décadas con testosterona intentando aliviar una gran variedad de síntomas con riesgos y beneficios inciertos. En la mayoría de los países, la testosterona se prescribe "off-label", de modo que las mujeres están utilizando compuestos y dosis ideadas para tratamientos en hombres. En este sentido, varias sociedades médicas de distintos continentes adoptaron recientemente por consenso una toma de posición sobre los beneficios y potenciales riesgos de la terapia con testosterona en la mujer, explorar las áreas de incertidumbre e identificar prácticas de prescripción con potencial de causar daño. Las recomendaciones con respecto a los beneficios y riesgos de la terapia con testosterona se basan en los resultados de ensayos clínicos controlados con placebo de al menos 12 semanas de duración. A continuación se comentan las recomendaciones. (AU)


There are currently no clear established indications for testosterone replacement therapy for women. Nonetheless, clinicians have been treating women with testosterone to alleviate a variety of symptoms for decades with uncertainty regarding its benefits and risks. In most countries, testosterone therapy is prescribed off-label, which means that women are using testosterone formulations or compounds approved for men with a modified dose for women. Due to these issues, there was a need for a global Consensus Position Statement on testosterone therapy for women based on the available evidence from placebo randomized controlled trials (RCTs). This Position Statement was developed to inform health care professionals about the benefits and potential risks of testosterone therapy intended for women. The aim of the Consensus was to provide clear guidance as to which women might benefit from testosterone therapy; to identify symptoms, signs, and certain conditions for which the evidence does not support the prescription of testosterone; to explore areas of uncertainty, and to identify any prescribing practices that have the potential to cause harm. (AU)


Assuntos
Humanos , Feminino , Idoso , Testosterona/uso terapêutico , Pós-Menopausa/efeitos dos fármacos , Depressores do Apetite/efeitos adversos , Fenitoína/efeitos adversos , Placebos/administração & dosagem , Psicotrópicos/efeitos adversos , Tamoxifeno/efeitos adversos , Testosterona/administração & dosagem , Testosterona/análise , Testosterona/efeitos adversos , Testosterona/farmacologia , Fármacos Cardiovasculares/efeitos adversos , Indometacina/efeitos adversos , Hormônio Liberador de Gonadotropina/efeitos adversos , Pós-Menopausa/fisiologia , Ensaios Clínicos Controlados como Assunto , Antagonistas Colinérgicos/efeitos adversos , Anticoncepcionais Orais/efeitos adversos , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia , Danazol/efeitos adversos , Consenso , Inibidores da Aromatase/efeitos adversos , Uso Off-Label , Inibidores do Fator Xa/efeitos adversos , Anfetaminas/efeitos adversos , Antagonistas dos Receptores Histamínicos/efeitos adversos , Antagonistas de Androgênios/efeitos adversos , Androgênios/fisiologia , Cetoconazol/efeitos adversos , Entorpecentes/efeitos adversos
4.
Curr Opin Support Palliat Care ; 14(1): 80-86, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31789945

RESUMO

PURPOSE OF REVIEW: Recent advances in digital healthcare, combined with the increasing appreciation for the need for sexual health programming in cancer, has established a zeitgeist for further development of digital health interventions for sexual health in cancer. Developers of digital health interventions should consider two equally important factors: efficacy of the intervention, and participant engagement. This review describes the status of digital health interventions in sexual health within the oncology setting. RECENT FINDINGS: Sexual dysfunction and related psychological distress affecting patients and their partners is recognized as a significant survivorship care need in the oncology setting. Provision of care is challenged by traditional approaches to disease follow-up, and limited healthcare resources. Digital health interventions may offer efficient, accessible, and scalable care pathways. Digital health innovation in cancer survivorship and sexual health indicates trends toward efficacy, yet patient engagement remains a challenge. Implementation of established online patient engagement approaches are recommended. SUMMARY: Studies to date may underestimate the potential of digital health interventions in sexual health and cancer due to poor patient engagement. Developers of digital health intervention will benefit from effort in employing engagement strategies and engagement-efficacy analysis.


Assuntos
Intervenção Baseada em Internet , Neoplasias/psicologia , Psicoterapia/organização & administração , Disfunções Sexuais Psicogênicas/terapia , Saúde Sexual , Telemedicina/organização & administração , Sobreviventes de Câncer/psicologia , Humanos , Neoplasias/complicações , Disfunções Sexuais Psicogênicas/etiologia
5.
Psychooncology ; 29(4): 639-646, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31724261

RESUMO

OBJECTIVE: This pilot study aimed to evaluate the feasibility, acceptability, and psychosocial outcomes of a text-based online group therapy intervention, i-Restoring Body Image after Cancer (i-ReBIC). i-ReBIC was developed to reduce body image distress and psychosexual dysfunction among women diagnosed and treated for breast or gynecological cancer. METHODS: i-ReBIC was adapted from an empirically tested face-to-face group therapy intervention, ReBIC. Over the 8-week intervention, participants engaged in 90-minute weekly text-based online discussions. Each week, a new topic associated with reconnecting to the body, adjusting to a postcancer identity, and improving psychosexual functioning was addressed. Homework assignments included readings, guided imagery exercises, and journaling. RESULTS: Sixty women with cancer enrolled in the pilot study. Among them, 47 completed the intervention, and 44 filled out all prestudy and poststudy questionnaires. Ninety-three percent of participants (n = 41) were satisfied and reported that it met their expectations. Eighty percent of participants (n = 35) reported no technical difficulties during the intervention. Preoutcome and postoutcome measures on body image distress and experience of embodiment showed statistically significant improvements. Psychosexual distress and quality of life also showed improvements but were not statistically significant. CONCLUSIONS: This study suggests that i-ReBIC is feasible, well accepted, and effective in addressing persistent body image concerns experienced by women treated for breast or gynecological cancer. As an online group therapy, i-ReBIC can expand the reach of its original face-to-face intervention by mitigating barriers and improving access to care in a cost-effective manner.


Assuntos
Imagem Corporal/psicologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Intervenção Baseada em Internet , Aceitação pelo Paciente de Cuidados de Saúde , Psicoterapia , Disfunções Sexuais Psicogênicas/terapia , Adulto , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto
6.
J Sex Marital Ther ; 46(1): 1-17, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31124395

RESUMO

Rapidly growing new technologies are revolutionizing the field of mental health, in terms of both understanding and treating mental disorders. Among these, virtual reality (VR) is a powerful tool providing clients with new learning experiences benefiting their psychological well-being. This article offers an overview of the current literature on VR in psychotherapy, highlighting its relevance to sexual dysfunction (SD) treatment.A literature review of PubMed and Google Scholar databases was used to provide a description of the theoretical frameworks and clinical indications associated with VR use in psychotherapy and SD treatment. The effectiveness of VR exposure-based therapy has been empirically validated for several mental disorders, notably anxiety disorders. The emerging combined use of VR and mindfulness tends to focus on chronic pain treatment. Experimental research examining the use of immersive technologies in the treatment of SDs is lacking.Given the shortcomings of conventional SD treatments, exploring and developing specialized VR interventions may prove beneficial. VR offers promising avenues in sex therapy, particularly for the treatment of genital pain disorders or SDs in which anxiety plays a significant etiological role.


Assuntos
Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Terapia de Exposição à Realidade Virtual/métodos , Realidade Virtual , Humanos , Saúde Mental
7.
Psychol Health Med ; 25(1): 110-120, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31167551

RESUMO

Although sexual dysfunction after ovarian cancer (OC) treatment is a common side effect, intervention for this issue remains largely unaddressed in the literature. To address this gap, we recently developed and tested a theory-driven psychosexual intervention that successfully improved sexual function in OC survivors. This study is a secondary analysis to determine whether the intervention effects were consistent with our theoretical model. We expected that improved self-efficacy, sexual knowledge and emotional distress would relate to improved sexual function, and that effects of sexual knowledge and self-efficacy on sexual function would be mediated by emotional distress. 46 OC survivors completed study measures prior to and two-months following the intervention. Results indicated that self-efficacy, sexual knowledge, and emotional distress improved significantly post-intervention. While self-efficacy and emotional distress were both directly associated with sexual function; contrary to expectation, change in knowledge was not. Results also demonstrated that the relationship between self-efficacy and sexual function was not mediated by emotional distress. Clinical implications underscore the importance of promoting self-efficacy and decreasing emotional distress in the context of sexual rehabilitation treatment for OC survivors. Next steps include refining the intervention based on these findings and testing in a larger, randomized trial of gynecological cancer survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Avaliação de Processos e Resultados em Cuidados de Saúde , Neoplasias Ovarianas/psicologia , Angústia Psicológica , Psicoterapia de Grupo , Autoeficácia , Disfunções Sexuais Psicogênicas/terapia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
9.
Seizure ; 73: 64-74, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31759295

RESUMO

PURPOSE: Women with epilepsy (WWE) frequently experience sexual problems, including sexual dysfunction and sexual distress. Therefore, this study aimed to examine the efficacy of a mindfulness-based cognitive therapy for sexuality (MBCT-S) on sexual function and intimacy among older adult WWE in Iran. METHODS: A multicenter randomized controlled trial was conducted at 15 neurology clinics in three Iranian cities. WWE together with their partners and healthcare providers were randomly assigned in patient and partner (PP; n = 220), patient, partner, and healthcare provider (PPHP; n = 220), or treatment as usual (TAU; n = 220) group. WWE and their partners in both the PP and PPHP groups received eight weeks of MBCT-S sessions. In the PPHP group, three individual sessions on sexual counseling were added for healthcare providers. Self-assessment scales were used at baseline, one month and six months after completing the intervention. Mixed linear regression models were developed to determine differences among the three groups. Multilevel mediation analyses were conducted to understand the mediating effects of mindfulness, intimacy, patient-physicians relationship and sexual counseling barriers. RESULTS: Improvements in sexual function, sexual distress, and intimacy were found in both the PP and PPHP groups at one-month and six-month follow-ups. The PPHP group compared with the PP group had greater improvement in intimacy at both follow-ups. Regarding sexual function, the PPHP group performed better than the PP group at the six-month follow-up. CONCLUSIONS: The MBCT-S appears efficacious in enhancing sexual function and reducing sex-related distress in Iranian older adult WWE. Future studies should examine its efficacy in other populations.


Assuntos
Epilepsia/complicações , Atenção Plena/métodos , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Idoso , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Resultado do Tratamento
10.
J Sex Med ; 16(10): 1581-1596, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31570137

RESUMO

INTRODUCTION: Mindfulness-based therapies (MBT) are more and more frequently used in the treatment of sexual dysfunctions; therefore, it seems very important to assess evidence-based data on the clinical efficacy of these interventions. AIM: To provide a systematic review of published studies into the efficacy of MBT in the treatment of sexual dysfunctions. METHODS: The material for the analysis was obtained by searching 3 internet databases: EBSCO, PubMed, and ResearchGate. Articles describing therapeutic interventions on the basis of mindfulness and their efficiency in reducing sexual dysfunction symptoms in men and women were sought. MAIN OUTCOME MEASURES: 15 original research articles were included to the review: 4 articles were devoted to the analysis of the efficiency of the mindfulness-based therapy in the reduction of sexual dysfunction related to pain in the genital-pelvic area, 10 to desire or sexual arousal disorders or both in women, and 1 to erectile dysfunction in men. RESULTS: Studies indicate that MBT led to improvement in subjectively evaluated arousal and desire, sexual satisfaction, and a reduction of fear linked with sexual activity, as well as improving the consistency between the subjectively perceived arousal and genital response in women. The research indicated that MBT did not make a significant change in a reduction of pain during sexual activities. Evidence-based data were found on the efficacy of MBT in the treatment of male erectile dysfunction in 1 study. CLINICAL IMPLICATIONS: MBT could be effectively used in the treatment of female sexual dysfunction, specifically to improve sexual arousal/desire and satisfaction and to reduce sexual dysfunction associated with anxiety and negative cognitive schemas. STRENGTHS & LIMITATIONS: The few studies available are affected by several methodologic limitations, including small numbers of participants, patient selection, application of complex therapeutic interventions, and a lack of homework assessment, which makes definite conclusions difficult to draw. CONCLUSION: The effects of MBT in female sexual dysfunctions are promising. In future studies, the mindfulness-based monotherapies should be implemented to verify their potential in reducing symptoms of sexual dysfunction. More research is needed to explore the potential of MBT in the treatment of male sexual dysfunction. Jaderek I, Lew-Starowicz M. A Systematic Review on Mindfulness Meditation-Based Interventions for Sexual Dysfunctions. J Sex Med 2019;16:1581-1596.


Assuntos
Meditação/métodos , Atenção Plena/métodos , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Adulto , Idoso , Nível de Alerta , Disfunção Erétil/terapia , Feminino , Humanos , Libido/fisiologia , Masculino , Pessoa de Meia-Idade , Orgasmo/fisiologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Resultado do Tratamento
11.
Can J Urol ; 26(4): 9864-9866, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31469644

RESUMO

There are many factors that may contribute to infertility, including psychosocial issues. The understanding of the cultural and spiritual background of patients can help elicit a sexual history that may lead to a diagnosis and subsequent successful treatment plan. Within this context, we present a case report of a Hasidic couple with primary infertility. Evaluation revealed what we are referring to as "cultural anorgasmia," with the male partner having never been educated about nor experienced an orgasm due to his religious upbringing. Counseling about basic anatomy and the physiology of sexual arousal and orgasm was successful in overcoming anorgasmia and achieving pregnancy.


Assuntos
Infertilidade Masculina/psicologia , Judeus/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/diagnóstico , Feminino , Seguimentos , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/terapia , Masculino , Orgasmo/fisiologia , Encaminhamento e Consulta , Disfunções Sexuais Psicogênicas/terapia , Adulto Jovem
12.
PLoS One ; 14(7): e0219768, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314799

RESUMO

Women coping with female sexual interest/arousal disorder (FSIAD) report lower sexual and relationship satisfaction compared to healthy controls. In community samples, high sexual communal strength (i.e., the motivation to meet a partner's sexual needs) is associated with higher sexual desire and satisfaction, but high unmitigated sexual communion (i.e., the prioritization of a partner's needs to the exclusion of one's own needs) is associated with lower sexual satisfaction. People higher in sexual communal strength report engaging in sex for approach goals (i.e., to enhance intimacy in their relationship), but not for avoidance goals (i.e., to avert conflict or a partner's disappointment) and this is one reason why they report greater sexual desire. In the current sample of 97 women diagnosed with FSIAD and their partners we investigated the association between sexual communal strength and unmitigated sexual communion and sexual well-being (i.e., sexual desire, sexual satisfaction and sexual distress) and sexual goals (i.e., approach and avoidance goals). Women who reported higher sexual communal strength were more likely to pursue sex for approach goals and their partner reported greater sexual satisfaction. When partners reported higher sexual communal strength, they reported higher sexual desire, but when they reported higher unmitigated sexual communion, they reported higher sexual distress. Additional associations emerged for couples who engage in sex more (compared to less) frequently. Our findings demonstrate that being motivated to meet a partner's sexual needs is associated with greater sexual well-being for couples coping with FSIAD, but when this motivation involves neglecting one's own needs, people do not report greater sexual well-being and instead, partners report higher sexual distress.


Assuntos
Orgasmo , Comportamento Sexual , Disfunções Sexuais Psicogênicas/terapia , Adaptação Psicológica , Adulto , Idoso , Emoções , Feminino , Humanos , Libido , Masculino , Pessoa de Meia-Idade , Motivação , Disfunções Sexuais Psicogênicas/psicologia , Parceiros Sexuais , Inquéritos e Questionários , Adulto Jovem
13.
Arch Psychiatr Nurs ; 33(4): 389-399, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31280785

RESUMO

Sexual dysfunctions are prevalent disorders in psychiatric patients that too often are not addressed by psychiatric-mental health nurses. An integrative review was conducted using PubMed, Joanna Briggs Institute, SCOPUS, PsycINFO and CINAHL databases to evaluate the evidence for independent, nursing interventions for sexual dysfunction across all nursing literature that could be implemented by psychiatric-mental health nurses. Out of 2448 articles, nine papers met inclusion criteria and were synthesized. Best available evidence was found for sexual teaching interventions for female sexual dysfunction. The implications for psychiatric-mental health nursing practice and recommendations for future research are discussed.


Assuntos
Papel do Profissional de Enfermagem , Enfermagem Psiquiátrica , Disfunções Sexuais Psicogênicas/terapia , Competência Clínica , Feminino , Humanos
14.
J Natl Med Assoc ; 111(6): 682-687, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31155408

RESUMO

Multiple sclerosis (MS) is a relatively frequent inflammatory autoimmune illness of the central nervous system affecting about 2.5 million people around the world, and represents the most common cause of neurological disability among young adults. Indeed, the disease can affect sensory-motor, autonomic and cognitive function potentially leading to a high prevalence of sexual dysfunction (SD). Thus, the identification of barriers to help seeking for sexual concerns in patients with MS is an important, although still overlooked, issue. Aim of this overview is to briefly investigate the role of sexual counselling in managing SD in individuals with MS, highlighting the importance for the clinicians to get more knowledge about; the pathophysiology, assessment and treatment of MS-related SD.


Assuntos
Esclerose Múltipla/complicações , Aconselhamento Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Terapia Comportamental , Depressão/complicações , Humanos , Esclerose Múltipla/psicologia , Inibidores da Fosfodiesterase 5/uso terapêutico , Prevalência , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia
15.
Obstet Gynecol ; 134(1): 203-205, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31241595

RESUMO

Female sexual dysfunction encompasses various conditions that are characterized by reported personal distress in one or more of the following areas: desire, arousal, orgasm, or pain (). Although female sexual dysfunction is relatively prevalent, women are unlikely to discuss it with their health care providers unless asked (), and many health care providers are uncomfortable asking for a variety of reasons, including a lack of adequate knowledge and training in diagnosis and management, inadequate clinical time to address the issue, and an underestimation of the prevalence (). The purpose of this document is to provide an overview of female sexual dysfunction, to outline updated criteria for diagnosis, and to discuss currently recommended management strategies based on the best available evidence.


Assuntos
Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Saúde da Mulher , Feminino , Ginecologia , Humanos , Obstetrícia , Guias de Prática Clínica como Assunto , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Sociedades Médicas
16.
Obstet Gynecol ; 134(1): e1-e18, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31241598

RESUMO

Female sexual dysfunction encompasses various conditions that are characterized by reported personal distress in one or more of the following areas: desire, arousal, orgasm, or pain (). Although female sexual dysfunction is relatively prevalent, women are unlikely to discuss it with their health care providers unless asked (), and many health care providers are uncomfortable asking for a variety of reasons, including a lack of adequate knowledge and training in diagnosis and management, inadequate clinical time to address the issue, and an underestimation of the prevalence (). The purpose of this document is to provide an overview of female sexual dysfunction, to outline updated criteria for diagnosis, and to discuss currently recommended management strategies based on the best available evidence.


Assuntos
Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Feminino , Ginecologia , Humanos , Obstetrícia , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Sociedades Médicas , Estados Unidos
17.
Sex Med Rev ; 7(4): 551-558, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31204297

RESUMO

INTRODUCTION: Phase-specific diagnoses, such as hypoactive sexual desire disorder, are the norm in sexual medicine. Epidemiologic surveys and clinical trials show the value of this structure for understanding and treating premenopausal sexual dysfunction; however, postmenopausal women have sexual dysfunction in >1 phase, for example, in desire and arousal. OBJECTIVE: To evaluate the evidence for mixed or global sexual dysfunction in women, identify associated comorbidities, and determine the best available treatment. METHODS: Literature review of epidemiologic surveys and clinical trials to quantitate overlap in sexual dysfunction and render conclusions about treatments. MAIN OUTCOME MEASURES: The main outcome measures were the Changes in Sexual Functioning Questionnaire and the Female Sexual Function Index. RESULTS: Overlap of sexual dysfunction in women is low to moderate before menopause, but it is high after menopause. Data suggest that clinical trials of postmenopausal women diagnosed with hypoactive sexual desire disorder actually entered patients with mixed or global sexual dysfunction and that benefits were pan-phasic rather than concentrated on desire. Whether local/vaginal products for the genitourinary syndrome of menopause impact all phases of sexual dysfunction is under study. Women treated for breast or gynecologic cancer or taking antidepressants also have global sexual dysfunction. Treatment options are limited but support mindfulness-based cognitive behavioral therapy and others. Other strategies include adding or switching to a serotonin 1A receptor agonist (eg, buspirone, flibanserin), a serotonin 2A receptor antagonist (eg, flibanserin, trazodone), or a norepinephrine-dopamine reuptake inhibitor (eg, bupropion). Elimination of hormonal contraception in premenopausal women and adding hormonal therapies in postmenopausal women may be necessary. CONCLUSIONS: Practitioners should be alert to overlap of sexual dysfunction in women. Focusing diagnostics and treatment on individual phases of sexual function is appropriate in premenopausal patients, but global sexual dysfunction is more likely in women taking antidepressants or cancer chemotherapy or during and after the menopausal transition. More safe, broadly effective treatments for mixed sexual dysfunction are needed for these populations of women. Pyke RE, Clayton AH. Lumping, Splitting, and Treating: Therapies Are Needed for Women With Overlapping Sexual Dysfunctions. Sex Med Rev 2019;7:551-558.


Assuntos
Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Psicogênicas/terapia , Adulto , Neoplasias da Mama/psicologia , Terapia de Reposição de Estrogênios/métodos , Feminino , Neoplasias dos Genitais Femininos/psicologia , Humanos , Libido , Menopausa/fisiologia , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Saúde Sexual
18.
Ugeskr Laeger ; 181(18)2019 Apr 29.
Artigo em Dinamarquês | MEDLINE | ID: mdl-31036145

RESUMO

In this review, we present the status of mindfulness in the treatment of sexual difficulties in men and women. The prevalence of sexual difficulties is high among both men and women. Sexual difficulties are often associated with somatic and mental disorders, and therefore effective treatments are needed. Growing evidence shows, that standardised mindfulness programmes are effective in the treatment of stress, anxiety, depression and chronic pain. Evidence for mindfulness therapy in sexology is sparse, but results so far suggest, that mindfulness can be effective in sex therapy.


Assuntos
Atenção Plena , Disfunções Sexuais Psicogênicas/terapia , Feminino , Humanos , Masculino
19.
Sex Health ; 16(3): 225-232, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31064641

RESUMO

Background After hysterectomy, most patients experience psychological problems and sexual dysfunction that can affect their sexual quality of life (QOL). This study determined the effects of counselling based on the Extended Permission-Limited Information-Specific Suggestion-Intensive Therapy (EX-PLISSIT) model on sexual function and sexual QOL after hysterectomy among women attending hospitals in Sari, northern Iran. METHODS: A randomised controlled trial was conducted between 2016 and 2017. Of 354 women undergoing hysterectomy, 80 women without anxiety, stress or depression who showed signs of sexual dysfunction were selected and, using blocked randomisation, were assigned to the intervention and control groups. The intervention group received two 1-h counselling sessions each week based on the EX-PLISSIT model. The control group received no counselling. Mood and sexual function and quality of life were measured using established tools (i.e. Depression, Anxiety and Stress Scale, Female Sexual Function Index (FSFI), and the Sexual Quality of Life - Female (SQOL-F)). Eight weeks after completion of counselling, outcomes were compared between the intervention and control groups using independent t-tests and Chi-squared, Mann-Whitney U, Wilcoxon, and Fisher tests. RESULTS: There were no significant differences between the two groups in terms of demographics and most other outcome variables. However, there were significant differences between the intervention and control groups in terms of sexual functioning (median (interquartile range (IQR) FSFI score 32.45 (28.47-33.52) vs 23.85 (20.52-26.45) respectively) and sexual quality of life (median (IQR) SQOL-F score 107.50 (91-108) vs 87 (62.75-96.25), respectively) at the 8-week follow-up (P < 0.001 for both). CONCLUSION: Use of the EX-PLISSIT model is recommended to sexual health care professionals.


Assuntos
Histerectomia/psicologia , Qualidade de Vida , Aconselhamento Sexual/métodos , Disfunções Sexuais Psicogênicas/terapia , Adulto , Afeto , Feminino , Humanos , Irã (Geográfico) , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/psicologia
20.
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
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