Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 365
Filtrar
1.
J Sex Med ; 18(10): 1752-1758, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34417127

RESUMO

BACKGROUND: Vaginismus has an unknown etiology, is comorbid with anxiety, and is the most common sexual dysfunction in sexual dysfunction outpatient clinics in Turkey. AIM: This study aimed to determine the frequency of adult separation anxiety disorder (ASAD) and styles of attachment in patients with vaginismus and to investigate its relationship with female sexual dysfunction. METHODS: Sixty women with vaginismus and 60 healthy controls were compared using the Relationship Scales Questionnaire, Female Sexual Function Index (FSFI), and Adult Separation Anxiety Questionnaire (ASA-27). OUTCOMES: We report the results of the questionnaires with their implication on the etiology of vaginismus. RESULTS: Separation anxiety and fearful and dismissive avoidance attachment style in the vaginismus group were significantly higher than in the control group. Both total FSFI scores and arousal, pain, and satisfaction subscale scores were higher in the control group. CLINICAL IMPLICATIONS: ASAD should be evaluated and addressed separately, when necessary, in the treatment of vaginismus. STRENGTHS & LIMITATIONS: The relationship between ASAD and vaginismus has been shown for the first time. Study limitations included the assessment of factors influencing the study results based on self-reporting and possible recall bias. CONCLUSION: Attachment and comorbidity research in vaginismus needs to shift from just reporting disturbances, to identify various clinical variables, such as the severity of the vaginismus, response to therapy, and differences in therapeutic modalities, in terms of outcome. Unlubilgin E, Tetik S, Aksoy I, et al. Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus. J Sex Med 2021;18:1752-1758.


Assuntos
Dispareunia , Disfunções Sexuais Fisiológicas , Vaginismo , Adulto , Ansiedade de Separação , Dispareunia/epidemiologia , Feminino , Humanos , Inquéritos e Questionários
2.
J Sex Med ; 18(9): 1555-1570, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34366265

RESUMO

BACKGROUND: Genito-pelvic pain/penetration disorder, which consists of a combination of vaginismus and dyspareunia, is considered a new diagnosis in the latest version of the Diagnostic and Statistical Manual of Mental Disorders. Although the etiology of this diagnosis is not well known, a history of abuse has been suggested to be a primary factor in the emergence of this disorder. AIM: This systematic review and meta-analysis aimed to determine the association of abuse history with vaginismus and dyspareunia diagnosis. METHODS: Related keywords were used to search articles in PubMed, PsycArticles, PsycINFO, Scopus, Web of Science, and the Turkish scientific information database (TRDizin). All articles published in English and Turkish until August 2020 were systematically reviewed. A total of 14 case-control studies, including 1428 participants, were included in the final analysis. The fixed-effects model was used to pool odd ratios (ORs) and 95% confidence intervals (CIs) of the studies. Heterogeneity was evaluated using the I2 statistic. OUTCOMES: Case-control studies that reported vaginismus or dyspareunia outcomes in individuals with or without a history of abuse. RESULTS: A significant relationship was found between a history of sexual (1.55 OR; 95% CI, 1.14-2.10; 12 studies) and emotional abuse (1.89 OR; 95% CI, 1.24-2.88; 3 studies) and the diagnosis of vaginismus. A significant relationship was found between sexual abuse and dyspareunia (1.53 OR; 95% CI, 1.03-2.27; 6 studies). No statistically significant relationship was observed between physical abuse, vaginismus, and dyspareunia. No significant difference was found between sexual or physical abuse in terms of assessment methods for the diagnosis of vaginismus and dyspareunia. CLINICAL IMPLICATIONS: This systematic review and meta-analysis points out that in the assessment of vaginismus patients, the risk of sexual and emotional abuse and in the assessment for dyspareunia patients, the risk of sexual abuse should be questioned and addressed in its treatment. STRENGHT AND LIMITATIONS: The strength of the current meta-analysis is the inclusion of all forms of abuse, and studies published in Turkish and English with a broad and reproducible search strategy. The limitations of this meta-analysis are the exclusion of sources and design other than journal articles and case-control studies, including studies both childhood and adult abuse, which in some studies were not differentiated, having potential language and recall bias. CONCLUSION: The study analysis suggests an association of vaginismus with sexual and emotional abuse and dyspareunia with sexual abuse. However, both disorders showed no association with physical abuse. S. Tetik, ÖY. Alkar, Vaginismus, Dyspareunia, and Abuse History: A Systematic Review and Meta-analysis. J Sex Med 2021;18:1555-1570.


Assuntos
Dispareunia , Vaginismo , Adulto , Estudos de Casos e Controles , Criança , Manual Diagnóstico e Estatístico de Transtornos Mentais , Dispareunia/epidemiologia , Feminino , Humanos , Comportamento Sexual
3.
Reprod Health ; 18(1): 161, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321034

RESUMO

BACKGROUND: Recently known as the genito-pelvic pain/penetration disorder (GPPPD), Dyspareunia is considered a negative factor affecting a couple's sexual health. This paper analyzes pain in Dyspareunia cases and determines protective factors causing lower levels of sexual distress among patients. METHODS: In a population-based cross-sectional study conducted in 2017, the cluster quota sampling technique was adopted to randomly select 590 Iranian married women aged 18-70 years from 30 health centers. The research tools included demographic data, a sexual distress scale, and Binik's GPPPD questionnaire. RESULTS: In this study, the prevalence of self-report Dyspareunia, confirmed moderate Dyspareunia, and confirmed severe Dyspareunia (based on Binik's proposed criteria) were 33 %, 25.8 %, and 10.5 %, respectively. Interestingly, 32 (34 %) out of 94 women who experienced severe pain based on Binik's criteria reported no sexual distress. Compared to women with distress, they also had more positive body images, higher self-confidence, higher levels of sexual satisfaction, and more intimacy in their relationships (P = 0.000). In contrast, 8.5 % of the participants reported significant sexual distress even without confirmed Dyspareunia. CONCLUSIONS: Improving intrapersonal characteristics such as self-confidence and body image as well as interpersonal factors such as sexual satisfaction and intimacy with a spouse can effectively treat Dyspareunia by alleviating sexual distress. The partner's role in female pain and distress management would be more critical than previously thought.


Assuntos
Dispareunia , Adaptação Psicológica , Estudos Transversais , Dispareunia/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Comportamento Sexual , Parceiros Sexuais , Inquéritos e Questionários
4.
Medicine (Baltimore) ; 100(20): e25761, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011037

RESUMO

ABSTRACT: This study was to evaluate the impact of the symptoms of overactive bladder (OAB) syndrome on female sexual function. Seventy nine patients with OAB (OAB group) and 79 healthy women (control group) underwent physical examination at our center, and had their sexual function evaluated using the female sexual function index (FSFI). In accordance with the presence or absence of urge incontinence, the OAB group was further divided into the wet and dry groups. The sexual function was evaluated again after 3 months of pharmacotherapy. We investigate the difference of sexual function between OAB and control group. The effect of OAB severity and OAB pharmacotherapy on sexual function was also explored. There were no significant differences between OAB group and control group, including age, body mass index (BMI), education, occupation, fertility, parity, childbirth, and menopause. Compared with the control group, the OAB group had significantly lower FSFI scores. The respective mean ±â€Šstandard error FSFI scores in the control group and the OAB group were 2.98 ±â€Š1.07 and 2.27 ±â€Š0.96 for desire, 3.48 ±â€Š1.16 and 2.32 ±â€Š1.44 for arousal, 4.60 ±â€Š1.13 and 3.10 ±â€Š1.95 for lubrication, 3.37 ±â€Š0.87 and 2.63 ±â€Š1.04 for orgasm, 3.58 ±â€Š1.02 and 2.41 ±â€Š1.35 for sexual satisfaction, 3.58 ±â€Š1.02 and 2.41 ±â€Š1.35 for sexual pain, and 22.24 ±â€Š5.29 and 15.59 ±â€Š7.47 for the total score (P < .05 for all comparisons). The scores for desire, lubrication, orgasm, sexual satisfaction, pain, and total FSFI between the OAB-dry and OAB-wet subgroup were similar while score of arousal in OAB-wet subgroup was significantly increased compared with that of OAB-dry. OABSS score was commonly used in the assessment of OAB severity. The difference of the FSFI scores among mild OAB group, moderate OAB group, and severe OAB group was statistically significant (P < .05). Female FSFI sexual function scores were significantly improved after OAB pharmacotherapy (P < .05). Women with OAB syndrome have poorer sexual function than healthy women. Patients with more serious OAB experience more disturbing sexual dysfunction. Female sexual function scores were significantly improved after OAB pharmacotherapy.


Assuntos
Dispareunia/epidemiologia , Orgasmo , Excitação Sexual , Bexiga Urinária Hiperativa/complicações , Agentes Urológicos/uso terapêutico , Adulto , Estudos de Casos e Controles , Dispareunia/tratamento farmacológico , Dispareunia/etiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários/estatística & dados numéricos , Resultado do Tratamento , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária Hiperativa/psicologia
5.
BMC Pregnancy Childbirth ; 21(1): 327, 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33902479

RESUMO

BACKGROUND: Sexual function, a significant contributor to quality of life, is affected by various factors, including overall mental health. COVID-19 is a current pandemic that influences the mental health of various populations, especially pregnant women. Despite the importance of sexual health, the specific nature of its relationship to overall mental health during the COVID-19 pandemic is not clearly defined. Thus, this study investigates the relationship between sexual function and mental health during the COVID-19 pandemic in Iranian pregnant women. METHODS: This descriptive-analytical, cross-sectional study was carried out among 437 pregnant women using the sociodemographic and obstetrics characteristics questionnaire, Female Sexual Function Inventory, Stress, Depression, and Anxiety Scales. Random sampling was employed to select pregnant women who had a medical record in Health Centers of Tabriz city, Iran. The questionnaires were sent to the participants' cell phones via WhatsApp or text messages, including links of questionnaires and the participants completed these questionnaires. Spearman correlation test was used to determine the relationship between sexual function and stress, anxiety, and depression. Generalized linear modeling was used to estimate each of the independent variables (sociodemographic characteristics, stress, anxiety, and depression) on the dependent variable (sexual function). RESULTS: The mean (Standard Deviation) sexual functioning (total) score was 20.0 (8.50) from the available range of 2 to 36. The mean (SD) of depression, stress, and anxiety scale was 4.81 (5.22), 5.13 (4.37), and 7.86 (4.50) (possible score ranging from 0 to 21), respectively. Based on Spearman's correlation test, there was a significant reverse correlation between the total sexual function score and stress, anxiety, and depression, indicating that all three variables negatively impacted sexual functioning. Variables such as mild stress, spouse type of job, sufficient household income, living with parents, higher marital satisfaction, and higher gestational age had a significant, positive impact on sexual function and could predict 35.8% of the variance model. CONCLUSIONS: Sexual functioning was significantly impacted by stress, anxiety, and depression - all of which are heightened during a pandemic. This topic warrants further study, and the general public should be educated on the protective influence of safe sex/intimacy on overall mental health.


Assuntos
Ansiedade/psicologia , COVID-19 , Depressão/psicologia , Gestantes/psicologia , Saúde Sexual , Estresse Psicológico/psicologia , Adulto , Ansiedade/epidemiologia , Depressão/epidemiologia , Dispareunia/epidemiologia , Dispareunia/fisiopatologia , Dispareunia/psicologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Saúde Mental , Orgasmo , Gravidez , SARS-CoV-2 , Excitação Sexual , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
6.
Taiwan J Obstet Gynecol ; 60(2): 187-192, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33678316

RESUMO

Transvaginal mesh (TVM) insertion for the treatment of pelvic organ prolapse (POP) is significantly associated with lower failure rates, although its use remains controversial due to the potential risk of mesh-related complications. In this review, we collected the published literature regarding the use of TVM to treat POP in an attempt to assess both the efficacy and complications related to TVM usage in Taiwan. We searched 25 English language articles using PubMed related to TVM in Taiwan from 2010 to 2019. The present article focuses on the efficacy and complications of TVM and analyzes the data. There were 25 studies on TVM selected for this review. Regarding their success rate, 21 out of the 22 studies (95.5%) had more than a 90% objective success rate. Twenty studies (90.9%) had less than 10% major complications of TVM. Twenty out of the 25 studies (80.0%) had 5% or less mesh exposure. For self-cut TVM and the later single-incision TVM, both the complication rates and exposure rates decreased. The rate of de novo dyspareunia ranged from 2.6% to 14.3%, and the incidence decreased yearly from 2011 to 2019. This review showed both the high treatment efficacy and low complication rate of TVM usage for the short-term treatment of POP in Taiwan. However, a longer-term study is needed to draw a conclusion regarding the safety of this treatment.


Assuntos
Prolapso de Órgão Pélvico/cirurgia , Complicações Pós-Operatórias/epidemiologia , Slings Suburetrais/efeitos adversos , Telas Cirúrgicas/efeitos adversos , Vagina/cirurgia , Dispareunia/epidemiologia , Dispareunia/etiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Taiwan , Resultado do Tratamento
7.
Menopause ; 28(6): 706-716, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33739315

RESUMO

IMPORTANCE: Genitourinary syndrome of menopause (GSM) consists of genitourinary tract symptoms that occur due to physical changes caused by estrogen concentrations decline after menopause. Unlike menopausal symptoms, which subside with time, GSM symptoms persist throughout a woman's life. OBJECTIVE: This article aimed to systematically review the literature to investigate the prevalence of GSM and its treatment. EVIDENCE REVIEW: The search was conducted in the electronic databases PubMed, CENTRAL, and EMBASE until October 2020. Eligible for the systematic review were studies and surveys conducted via questionnaires or medical interviews evaluating the existence of GSM symptoms with or without gynecological examination in postmenopausal women or women >40 years of age. FINDINGS: After the application of predefined inclusion/exclusion criteria, 27 studies were included in the systematic review. The prevalence of GSM-related symptoms, such as vaginal dryness, irritation, itching, and dyspareunia, ranged from 13% to 87%. The use of GSM-specific treatment varied from 13% to 78%. Over-the-counter lubricants and moisturizers were the most popular therapeutic options (24.0%-85.5%), followed by low-dose vaginal estrogens (4.8%-35.0%). Vaginal health is not frequently discussed during doctor visits and awareness about the condition and the number of treatment options is low. Women are concerned about the long-term safety and side effects of hormonal treatment. The majority of women who suffer from genitourinary symptoms are dissatisfied by the treatment they have used. CONCLUSIONS AND RELEVANCE: GSM is a highly prevalent condition among women. Nevertheless, women are frequently not aware of its cause and its treatment options. The findings of this review underline the need for education of patients and healthcare professionals regarding GSM diagnosis and treatment options.


Assuntos
Dispareunia , Doenças Vaginais , Atrofia/patologia , Dispareunia/epidemiologia , Dispareunia/patologia , Feminino , Humanos , Menopausa , Prevalência , Vagina/patologia , Doenças Vaginais/patologia
8.
Eur J Obstet Gynecol Reprod Biol ; 258: 189-192, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33450709

RESUMO

OBJECTIVE: Vaginismus and dyspareunia are together categorized as a genito-pelvic pain and penetration disorder. We aimed to evaluate the threshold of pain and the pain sensitivity in women with vaginismus. STUDY DESIGN: In this prospective case-control study; 32 women with vaginismus and 29 healthy women were enrolled. Sociodemographic Information Form, Female Sexual Function Index (FSFI), Pain Beliefs Questionnaire (PBQ), Revised Fibromyalgia Impact Questionnaire (FIQR), The Lamont Scale of Vaginismus were applied. Threshold of pain was measured with algometer in terms of Newton (N). RESULTS: The pain thresholds vaginismus and control group were as follows; left posterior superior iliac crest (40.3 N, 84.9 N respectively;p < 0.001), right posterior superior iliac crest (42.9 N, 76.1 N respectively;p = 0.007), left lateral trochanter (42.0 N, 69.8 N respectively; p = 0.015), right lateral trochanter (43.8 N, 75.3 N respectively; p = 0.003), left anterior superior iliac spine (29.2 N, 51.2 N respectively; p = 0.003), left insertion of gracilis muscle (27.3 N, 45.2 N respectively; p = 0.038), left medial vastus muscle (37.0 N, 52.4 N respectively; p = 0.025) and the pain thresholds were significantly lower in the vaginismus patients. CONCLUSION: Women with vaginismus have a lower threshold of pain, and the pain threshold decreases in higher grades of vaginismus. The pain may aggravate the avoiding behavior of women from sexual intercourse.


Assuntos
Dispareunia , Vaginismo , Estudos de Casos e Controles , Coito , Dispareunia/epidemiologia , Dispareunia/etiologia , Feminino , Humanos , Estudos Prospectivos , Vaginismo/complicações
9.
BMC Womens Health ; 21(1): 19, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413295

RESUMO

BACKGROUND: Women with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall dissatisfaction with care. The emergence of multidisciplinary endometriosis centers aims to reduce diagnostic delays, improve pain management, and promote patient satisfaction; however, baseline data at the time of presentation to a multidisciplinary center are lacking. METHODS: A real-world, retrospective, single-site, cross-sectional study of women with surgically confirmed and/or clinically diagnosed endometriosis generated baseline data for a planned longitudinal assessment of multidisciplinary care of endometriosis. The primary objective was to determine the proportion of patients experiencing mild, moderate, or severe pain for dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia at entry into a multidisciplinary endometriosis clinic. Also explored were relationships between pain scores and clinical endpoints obtained from electronic medical records. RESULTS: More than half (59%) of the study participants (n = 638) reported experiencing pelvic pain for ≥ 5 years. Pain intensity was highest for patients reporting dysmenorrhea, followed by NMPP, and dyspareunia. Significant correlations were observed between total pelvic pain and patient age (r = -0.22, p < 0.001, n = 506) and number of previous healthcare providers (r = 0.16, p = 0.006, n = 292); number of previous providers and duration of pain (r = 0.21, p = < 0.0001, n = 279); and duration of pain and years since diagnosis (r = 0.60, p < 0.001, n = 302). Mean pain scores differed significantly by age group for dysmenorrhea (p < 0.001), NMPP (p = 0.005), and total pelvic pain (p < 0.001), but not for dyspareunia (p = 0.06), with the highest mean pain scores reported among those < 30 years of age. CONCLUSION: These real-world data indicate that in the single-provider model of care, unresolved pelvic pain is common among women with endometriosis. Alternative care models, including a multidisciplinary approach, need to be evaluated for improvements in clinical outcomes. These data also highlight the importance of addressing NMPP, which may be particularly troublesome for patients.


Assuntos
Dispareunia , Endometriose , Adulto , Estudos Transversais , Dismenorreia/epidemiologia , Dismenorreia/etiologia , Dispareunia/epidemiologia , Dispareunia/etiologia , Endometriose/complicações , Feminino , Humanos , Dor Pélvica/etiologia , Estudos Retrospectivos
10.
Arch Gynecol Obstet ; 303(1): 161-168, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32926208

RESUMO

PURPOSE: Deep infiltrating endometriosis (DIE) is associated with severe pelvic pain and functional impairment of bowel, urinary, and sexual functions. Though hormone therapy with progestins, either as single agents or combined with estrogens, is effective in managing symptoms, some patients may experience a suboptimal response. Endometrial thickness assessed by transvaginal ultrasound examination, reflecting the overall estrogen stimulation, may correlate with the clinical response to hormonal treatments. METHODS: A retrospective study was carried out on 61 women with DIE affecting the bowel or the recto-vaginal septum, undergoing hormone treatment. The symptoms of patients were evaluated at the baseline and after 12 months of therapy, calculating a global Visual Analogue Scale score (gVAS) encompassing dysmenorrhea, dyspareunia, chronic pelvic pain, dyschezia, abdominal pain and dysuria. Patients were divided into two subgroups using, as a calculated cut-off value, the mean endometrial thickness in our population at 12 months. The change in gVAS score during the 12 months of treatment was then compared between the two groups. RESULTS: Women with a thinner endometrium (< 3.3 mm) showed a better response to treatment in terms of symptoms control as compared to patients with a thicker endometrium (mean gVAS score reduction 9.2 ± 1.3 vs. 5.2 ± 1.3, p = 0.036). The correlation between endometrial thickness and symptomatic response was also confirmed (p = 0.041) on multivariate linear regression analysis including as covariates age, size of lesions of DIE, presence of uterine adenomyosis, ovarian endometriosis and type of medical treatment. CONCLUSION: Endometrial thickness on ultrasound transvaginal examination is correlated with better response rates to hormone therapy in terms of symptoms control. A thinner endometrium, probably resulting from a more efficient suppression of estrogen stimulation, is associated with improved symptoms. These results may aid clinicians in monitoring and tailoring hormonal treatments during follow-up of women with symptomatic DIE.


Assuntos
Endometriose/complicações , Endometriose/patologia , Endométrio/diagnóstico por imagem , Dor Pélvica/etiologia , Ultrassonografia/métodos , Adenomiose/complicações , Adulto , Dor Crônica , Constipação Intestinal , Dismenorreia/epidemiologia , Dismenorreia/etiologia , Dispareunia/epidemiologia , Dispareunia/etiologia , Endométrio/anatomia & histologia , Feminino , Humanos , Medição da Dor , Dor Pélvica/epidemiologia , Progestinas/uso terapêutico , Reto/patologia , Estudos Retrospectivos
11.
Int J Gynaecol Obstet ; 153(1): 14-24, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33300122

RESUMO

BACKGROUND: Dyspareunia is one of the most common postpartum sexual dysfunctions. OBJECTIVE: To estimate the prevalence of postpartum dyspareunia. SEARCH STRATEGY: Web of Science, Scopus, PubMed, and Embase databases were searched to July 2019 using keywords including 'perineal pain,' 'dyspareunia,' and 'sexual pain'. SELECTION CRITERIA: Observational studies on the prevalence of postpartum dyspareunia were included. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed articles and extracted data. Study heterogeneity was evaluated by I2 index; publication bias by Egger and Begg tests. MAIN RESULTS: Twenty-two studies enrolling 11 457 women were included. Based on meta-analysis, the overall estimated prevalence of dyspareunia was 35% (95% confidence interval [CI], 29%-41%). The prevalence was 42% (95% CI, 26%-60%) at 2 months, 43% (95% CI, 36%-50%) at 2-6 months, and 22% (95% CI, 15%-29%) at 6-12 months postpartum. Begg test showed no significant bias in data related to the prevalence of postpartum dyspareunia (p = 0.466). CONCLUSION: The prevalence of postpartum dyspareunia was 35% and decreased with increasing postpartum duration. Given the high prevalence and its impact on a woman's quality of life, special attention should be paid to this common complaint during the postpartum period.


Assuntos
Dispareunia/epidemiologia , Período Pós-Parto , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto , Feminino , Humanos , Dor Pélvica/etiologia , Prevalência , Qualidade de Vida
12.
J Obstet Gynaecol Can ; 43(4): 447-454, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33359553

RESUMO

OBJECTIVE: Provoked vestibulodynia (PVD) is a common chronic pain condition characterized by pain at the vulvar vestibule elicited by touch. Both PVD and sexual abuse lead to negative psychosocial and sexual consequences. However, little is known about the wellbeing of women with PVD and a history of sexual abuse. The aim of this study was to characterize a sample of women seeking treatment for PVD who have experienced sexual abuse. METHODS: A total of 404 women diagnosed with PVD completed self-report questionnaires of PVD symptoms and psychosocial and sexual wellbeing before and after participating in a multidisciplinary PVD treatment program. History of sexual abuse was assessed via self-report, and women were dichotomized into groups. RESULTS: No significant differences were found on sociodemographic variables, baseline psychosocial or sexual functioning between women with and without a self-reported history of sexual abuse (n = 40 and n = 364, respectively). Significantly more women with a history of sexual abuse than without reported other comorbid chronic pain conditions and radiating PVD pain. History of sexual abuse did not affect improvements in sexual distress scores following multidisciplinary treatment for their PVD. CONCLUSION: Ten percent of women in our sample self-reported a history of sexual abuse, but the two groups did not differ significantly with respect to their baseline psychosocial or sexual functioning concerns, and both groups reported reductions in sexual distress following treatment for PVD. These findings indicate that a history of sexual abuse does not significantly affect the efficacy of multidisciplinary treatment approaches for PVD.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Vítimas de Crime/psicologia , Dispareunia/epidemiologia , Dispareunia/etiologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/epidemiologia , Vulvodinia/psicologia , Adulto , Ansiedade , Depressão , Dispareunia/diagnóstico , Feminino , Humanos , Dor , Medição da Dor , Angústia Psicológica , Disfunções Sexuais Fisiológicas/diagnóstico , Inquéritos e Questionários , Vulvodinia/epidemiologia
13.
BMC Res Notes ; 13(1): 546, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33239095

RESUMO

OBJECTIVES: About 10-15% of women of childbearing age have endometriosis. The present study aimed to investigate the relationship between the severity of symptoms of endometriosis and the spread as well as the stage of the disease on ultrasonography. The present cross-sectional study evaluates the relationship between the severity of endometriosis symptoms and the spread of disease on ultrasonography in patients with endometriosis. RESULTS: Considering different analyses, the cumulative size of posterior deep infiltrative endometriosis (DIE) (less than 1 cm) is significantly correlated with minimal severity of dyspareunia and chronic pelvic pain. The incidence of dyspareunia was more prevalent in patients with complete stenosis of Douglas pouch than those with incomplete stenosis. Furthermore, the incidence of severe and very severe pain in patients with Douglas pouch stenosis is relatively higher than that in patients without stenosis. Only dyspareunia is related to the stage of endometriosis, and patients with dyspareunia are five times more at risk of a higher stage of the disease. The severity of dyspareunia is related to the stage of endometriosis and the severity of Douglas pouch stenosis. The results showed a correlation between chronic pelvic pain and r-ASRM score (revised American Society for Reproductive Medicine score).


Assuntos
Dispareunia , Endometriose , Estudos Transversais , Dismenorreia/diagnóstico por imagem , Dismenorreia/epidemiologia , Dispareunia/diagnóstico por imagem , Dispareunia/epidemiologia , Endometriose/complicações , Endometriose/diagnóstico por imagem , Feminino , Humanos , Dor Pélvica/diagnóstico por imagem , Dor Pélvica/etiologia , Ultrassonografia
14.
Eur J Obstet Gynecol Reprod Biol ; 254: 236-244, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33011507

RESUMO

OBJECTIVE: To meta-analyze possible associations between female genital mutilation (FGM) and female sexual dysfunction, dyspareunia and pelvic pain. METHOD: A systematic literature search was performed in PubMed, EMBASE, Scopus, Web of Science, African Index Medicus and Cochrane Library. The PICO protocol included Population: Studies evaluating girls or women; Intervention/Exposure: participants with FGM; Comparison: participants without FGM; Outcomes: female sexual function, dyspareunia or pelvic pain using validated tests. Random effect models were used for meta-analyses, and standardized mean differences (SMDs) and their 95 % confidence intervals (CIs) for any of the measured continuous outcomes were calculated when possible. Risk of bias was assessed with the Newcastle-Ottawa Scale. RESULTS: Fifteen studies (n = 6672 participants) reported on the outcomes of the 19-item Female Sexual Function Index (FSFI). The meta-analysis of the total FSFI score showed a SMD of -1.43 (95 % CI -2.17, -0.69) suggestive of female sexual dysfunction. In addition, scores for the six FSFI domains were significantly lower in women with FGM: SMDs for desire -0.62 (95 % CI -1.01, -0.22), arousal -0.88 (95 % CI -1.41, -0.35), lubrication -0.95 (95 % CI -1.45, -0.46), orgasm -1.07 (95 % CI -1.63, -0.50), satisfaction -0.96 (95 % CI -1.52, -0.41) and pain -0.48 (95 % CI -0.91, -0.05). Estimation of the prevalence of female sexual dysfunction with the FSFI was not possible since different cut-offs values were used in those studies that reported for this outcome. No other searched outcomes using other tools were reported. CONCLUSION: FGM seriously alters female sexual function as assessed with the FSFI, globally and per domain.


Assuntos
Circuncisão Feminina , Dispareunia , Disfunções Sexuais Fisiológicas , Circuncisão Feminina/efeitos adversos , Dispareunia/epidemiologia , Dispareunia/etiologia , Feminino , Humanos , Orgasmo , Dor Pélvica , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Inquéritos e Questionários
15.
Gynecol Endocrinol ; 36(11): 1015-1023, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32880200

RESUMO

AIM: To systematically compare sexual function between non-treated women with and without endometriosis. METHODS: A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis. RESULTS: In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea. CONCLUSION: Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.


Assuntos
Endometriose/complicações , Indicadores Básicos de Saúde , Doenças Peritoneais/complicações , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Dismenorreia/complicações , Dismenorreia/epidemiologia , Dismenorreia/fisiopatologia , Dismenorreia/psicologia , Dispareunia/diagnóstico , Dispareunia/epidemiologia , Dispareunia/etiologia , Dispareunia/psicologia , Endometriose/epidemiologia , Endometriose/fisiopatologia , Endometriose/psicologia , Feminino , Humanos , Orgasmo/fisiologia , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia , Dor Pélvica/fisiopatologia , Dor Pélvica/psicologia , Doenças Peritoneais/epidemiologia , Doenças Peritoneais/fisiopatologia , Doenças Peritoneais/psicologia , Satisfação Pessoal , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários
16.
Eur J Surg Oncol ; 46(11): 2050-2056, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32773139

RESUMO

AIM: Rectal-preserving strategies for managing rectal cancer are becoming more common for selected groups of patients. Oncological outcomes are similar, so long as patients are closely followed, and any local recurrence detected and managed promptly. Functional outcomes are now of increasing importance so patients can be appropriately counselled prior to treatment. We examine functional outcomes in patients managed by multimodal organ-preservation approaches allowing comparison of the full range of strategies. MATERIALS AND METHODS: Patients attending for surveillance after any of four rectal-preserving treatments for rectal cancer (radiotherapy [RT], local excision [LE], RT then LE or LE then RT) were asked to complete a questionnaire assessing general quality of life and bowel, urinary and sexual function. RESULTS: 100 patients completed questionnaires: 34 managed by neoadjuvant RT followed by 'watch and wait', 40 by LE, and 26 who had composite treatment (18 LE + RT and eight RT + LE). Questionnaires were completed a median of 10 months (IQ range 6-33) following treatment. The LE only group tended to have better bowel function, while the composite groups fared worse; significant differences were noted in LARS and some bowel symptoms scores. CONCLUSION: Bowel function appears better after LE alone compared with treatment strategies involving RT, and composite treatments have an additive effect on outcome impairment. Overall quality of life outcomes are good, despite the ongoing requirement for surveillance. As these treatments become more common it is important that patients can be better informed before deciding on a management pathway.


Assuntos
Quimiorradioterapia/métodos , Tratamentos com Preservação do Órgão/métodos , Protectomia/métodos , Qualidade de Vida , Neoplasias Retais/terapia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Antimetabólitos Antineoplásicos/uso terapêutico , Capecitabina/uso terapêutico , Quimiorradioterapia Adjuvante , Defecação , Dispareunia/epidemiologia , Disfunção Erétil/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Hemorragia Gastrointestinal/epidemiologia , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Terapia Neoadjuvante , Disfunções Sexuais Fisiológicas/epidemiologia , Conduta Expectante
17.
Obstet Gynecol ; 136(3): 492-500, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32769645

RESUMO

OBJECTIVE: To describe sexual activity and risks for dyspareunia after pelvic organ prolapse surgery. METHODS: This was a secondary analysis of data from four randomized trials conducted between 2002 and 2018. Standard assessments and validated measures of sexual function were assessed at baseline and at 12 months postoperatively. Anterior apical surgeries were grouped by approach: transvaginal native tissue repairs, transvaginal mesh or graft-augmented repairs, and abdominal sacrocolpopexy. Additional surgeries, which included posterior repair, hysterectomy, and slings, were analyzed. Bivariate analyses and logistic regression models identified risk factors for postoperative dyspareunia. RESULTS: Of the 1,337 women enrolled in the trials, 932 had sufficient outcome data to determine dyspareunia status. Of these before surgery, 445 (47.8%) were sexually active without dyspareunia, 89 (9.6%) were sexually active with dyspareunia, 93 (10.0%) were not sexually active owing to fear of dyspareunia, and 305 (32.7%) were not sexually active for other reasons. At 12 months, dyspareunia or fear of dyspareunia was present in 63 of 627 (10.0%); occurred de novo in 17 of 445 (3.8%) and resolved in 136 of 182 (74.7%). Multivariable regression demonstrated baseline dyspareunia as the only factor associated with postoperative dyspareunia (adjusted odds ratio 7.8, 95% CI 4.2-14.4). No other factors, including surgical approach, were significantly associated with postoperative dyspareunia. Too few had de novo dyspareunia to perform modeling. CONCLUSION: Dyspareunia is common in one in five women before undergoing prolapse surgery. Surgical repair resolves dyspareunia in three out of four women with low rates of de novo dyspareunia at less than 4%. Preoperative dyspareunia appears to be the only predictor of postoperative dyspareunia. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT00065845, NCT00460434, NCT00597935, and NCT01802281.


Assuntos
Dispareunia/fisiopatologia , Prolapso de Órgão Pélvico/cirurgia , Complicações Pós-Operatórias/fisiopatologia , Comportamento Sexual , Idoso , Dispareunia/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
18.
Climacteric ; 23(6): 603-607, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32720549

RESUMO

OBJECTIVE: The purpose of this survey was to assess the prevalence of genital and urinary tract symptoms among Japanese women with declining estrogen levels. METHODS: A health-related questionnaire survey was conducted among women in their 40s or older to inquire about their genital, intercourse-related, and urinary symptoms and concern over their symptoms. RESULTS: Of the consecutive 10,000 respondents recruited, 4488 (44.9%) reported having symptoms: 3546 (79.0%) expressed concern over their symptoms. Furthermore, 2173 women (21.7%) had incontinence, 1999 (20.0%) had urinary frequency, 1648 (16.5%) had itching, and 1560 (15.6%) reported odor; these were followed by looseness, dryness, and burning. Of the 2518 (25.2%) sexually active women, 518 (20.6%) reported having dyspareunia and more reported having urinary symptoms than genital symptoms. Of the symptomatic respondents, 33.1% had genital symptoms alone, 28.4% had urinary symptoms alone, and 38.4% had both. More sexually active women had genital symptoms, while more sexually inactive women had urinary symptoms. CONCLUSIONS: Genital and urinary symptoms were shown to be common and coexist in a considerable proportion of the respondents, highlighting the pathology of genitourinary syndrome of menopause. Again, dyspareunia and lower urinary tract symptoms were shown to be quite common among postmenopausal women.


Assuntos
Dispareunia/epidemiologia , Doenças Urogenitais Femininas/epidemiologia , Sintomas do Trato Urinário Inferior/epidemiologia , Menopausa , Avaliação de Sintomas/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Dispareunia/etiologia , Feminino , Doenças Urogenitais Femininas/etiologia , Inquéritos Epidemiológicos , Humanos , Japão/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Pessoa de Meia-Idade , Prevalência
19.
J Low Genit Tract Dis ; 24(4): 411-416, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32569019

RESUMO

OBJECTIVE: Breastfeeding-related hypoestrogenic state has been reported as a possible risk factor for postpartum dyspareunia. This study aimed to evaluate the prevalence and characteristics of postpartum vulvovaginal atrophy according to 3 different diagnostic methods and to estimate its association with postpartum dyspareunia and daily vulvovaginal symptoms. METHODS: This is a prospective cohort study of puerperal women attending a routine postpartum checkup. Participants completed a questionnaire and underwent a gynecological examination. Atrophy was diagnosed separately according to gynecologist impression, vaginal pH measurement (≥5.1), and cytologic vaginal maturation index. Patients were followed up with a telephone survey 2-3 months later, inquiring about symptoms possibly associated with atrophy. RESULTS: Of 117 participants, vaginal atrophy was diagnosed in 48% by gynecological examination, 62% by a pH level of 5.1 or greater, and 40.2% had cytological atrophy. Of the 35.9% of women who had resumed sexual intercourse (42/117), 69% reported dyspareunia. No significant association was found between dyspareunia and atrophy parameters. There was no difference in the rates of dyspareunia among women who were exclusively breastfeeding (21/27 = 78%), partially breastfeeding (4/7 = 57%), or not breastfeeding (4/8, 50%). Atrophy was more common in breastfeeding women according to the 3 criteria (gynecological examination: 57.6% vs 16.7%, p = .006; pH: 70% vs 22%, p < .001; vaginal maturation index: 51.1% vs 0%, p < .001). Of the 117 participants, 47% reported daily vulvovaginal symptoms. Those with daily symptoms reported more dyspareunia as compared with those without daily symptoms (85% vs 52%, p = .025). CONCLUSIONS: A high prevalence of atrophy was observed in puerperal women in association with breastfeeding. There was no significant association between atrophy and dyspareunia or daily vulvovaginal symptoms.


Assuntos
Aleitamento Materno/efeitos adversos , Dispareunia/epidemiologia , Doenças Vaginais/epidemiologia , Doenças da Vulva/epidemiologia , Adulto , Atrofia/patologia , Dispareunia/complicações , Feminino , Humanos , Israel/epidemiologia , Período Pós-Parto , Prevalência , Estudos Prospectivos , Fatores de Risco , Vagina/patologia , Doenças Vaginais/complicações , Doenças Vaginais/patologia , Vulva/patologia , Doenças da Vulva/complicações , Doenças da Vulva/patologia , Adulto Jovem
20.
BMC Womens Health ; 20(1): 124, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32532273

RESUMO

BACKGROUND: The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases. METHODS: The present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility Outpatient Clinic of the Instituto Ideia Fértil de Saúde Reprodutiva, Faculdade de Medicina do ABC, São Paulo, Brazil, were and responded to the Short Form (SF) Health Survey-36. Convenience sampling was used due to the authors' access to the study population; however, the sample number was calculated to be sufficient for 95% power in both groups. RESULTS: Homogeneity was observed between Grade I/II and Grade III/IV staging, with similar mean ages (35.27, ±3.64 years and 34.04, ±3.39 years, respectively, p = 0.133); types of infertility (p = 0.535); infertility time (p = 0.654); degrees of pain (p = 0.849); and symptoms common to endometriosis, namely, dysmenorrhea (p = 0.841), dyspareunia (0.466), chronic pelvic pain (p = 0.295), and intestinal (p = 0.573) or urinary (p = 0.809) diseases. Comparisons of median scores in the QoL domains demonstrated that the distributions of QoL and clinical symptoms were significantly related between the types of dyspareunia and the following domains: physical functioning (p = 0.017), role- emotional (p = 0.013), and general health (p = 0.001). Regarding pain outside of menstruation, there was significance in the pain domain (p = 0.017), and degree of pain was significance in physical functioning (p = 0.005) and role-physical (p = 0.011) domains. CONCLUSIONS: The present study pointed out that it is not the stage of endometriosis that interferes in the quality of life of women with endometriosis and infertility but rather the clinical manifestations, such as dyspareunia and pain. Thus, we can conclude that the patient's perception of the disease should be considered in health care and that the losses are independent of the degree of endometriosis in this population with the aggravating factor of infertility.


Assuntos
Depressão/etiologia , Dismenorreia/etiologia , Dispareunia/etiologia , Endometriose/complicações , Infertilidade Feminina/diagnóstico , Dor Pélvica/etiologia , Qualidade de Vida/psicologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Dismenorreia/epidemiologia , Dispareunia/epidemiologia , Endometriose/epidemiologia , Endometriose/psicologia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/psicologia , Dor Pélvica/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...