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3.
Int J Gynaecol Obstet ; 150(1): 98-102, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: covidwho-233289

RESUMO

OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on female sexual behavior in women in Turkey. METHODS: An observational study using data from a previous study conducted prior to the pandemic. We compared frequency of sexual intercourse, desire for pregnancy, Female Sexual Function Index (FSFI) score, contraception type, and menstrual abnormalities among women during the pandemic with 6-12 months prior to the pandemic. Participants were contacted by telephone for questioning. RESULTS: Average frequency of sexual intercourse was significantly increased during the pandemic compared with 6-12 months prior (2.4 vs 1.9, P=0.001). Before the pandemic 19 (32.7%) participants desired to become pregnant, whereas during the pandemic it had decreased to 3 (5.1%) (P=0.001). Conversely, use of contraception during the pandemic significantly decreased among participants compared with prior (24 vs 10, P=0.004). Menstrual disorders were more common during the pandemic than before (27.6% vs 12.1%, P=0.008). Participants had significantly better FSFI scores before the pandemic compared with scores during the pandemic (20.52 vs 17.56, P=0.001). CONCLUSION: Sexual desire and frequency of intercourse significantly increased during the COVID-19 pandemic, whereas quality of sexual life significantly decreased. The pandemic is associated with decreased desire for pregnancy, decreased female contraception, and increased menstrual disorders.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Comportamento Sexual/psicologia , Adulto , Infecções por Coronavirus/virologia , Características da Família , Feminino , Humanos , Libido , Pandemias , Pneumonia Viral/virologia , Gravidez , Qualidade de Vida/psicologia , Fatores Sexuais , Turquia
4.
Int J Gynaecol Obstet ; 150(1): 98-102, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32392400

RESUMO

OBJECTIVE: To evaluate the effect of the COVID-19 pandemic on female sexual behavior in women in Turkey. METHODS: An observational study using data from a previous study conducted prior to the pandemic. We compared frequency of sexual intercourse, desire for pregnancy, Female Sexual Function Index (FSFI) score, contraception type, and menstrual abnormalities among women during the pandemic with 6-12 months prior to the pandemic. Participants were contacted by telephone for questioning. RESULTS: Average frequency of sexual intercourse was significantly increased during the pandemic compared with 6-12 months prior (2.4 vs 1.9, P=0.001). Before the pandemic 19 (32.7%) participants desired to become pregnant, whereas during the pandemic it had decreased to 3 (5.1%) (P=0.001). Conversely, use of contraception during the pandemic significantly decreased among participants compared with prior (24 vs 10, P=0.004). Menstrual disorders were more common during the pandemic than before (27.6% vs 12.1%, P=0.008). Participants had significantly better FSFI scores before the pandemic compared with scores during the pandemic (20.52 vs 17.56, P=0.001). CONCLUSION: Sexual desire and frequency of intercourse significantly increased during the COVID-19 pandemic, whereas quality of sexual life significantly decreased. The pandemic is associated with decreased desire for pregnancy, decreased female contraception, and increased menstrual disorders.


Assuntos
Betacoronavirus , Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Comportamento Sexual/psicologia , Adulto , Infecções por Coronavirus/virologia , Características da Família , Feminino , Humanos , Libido , Pandemias , Pneumonia Viral/virologia , Gravidez , Qualidade de Vida/psicologia , Fatores Sexuais , Turquia
5.
Arch Sex Behav ; 49(5): 1823-1838, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32462413

RESUMO

Cognitive-emotional dimensions play a core role in predisposing and maintaining sexual difficulties. This study aimed to assess the role of personality traits, sexual beliefs, cognitive schemas, automatic thoughts and affective states in predicting sexual functioning in a Portuguese sample. A total of 226 lesbian women, 254 heterosexual women, 243 gay men, and 274 heterosexual men completed a web-survey. For each sample, hierarchical regression analyses were conducted, separately. Results indicated that positive affective states and fewer thoughts associated with failure and disengagement during sexual activity act as significant predictors for sexual functioning, in both lesbian and heterosexual women's groups. Specific predictors of better sexual functioning in lesbian women were lower activation of schemas of undesirability and incompetence, and fewer thoughts associated with sexual abuse, body-image and sexual passivity were, whereas particular predictors of better sexual functioning for heterosexual women were erotic thoughts, lower activation of schemas of undesirability and difference/loneliness, and beliefs related to sexual desire as a sin. For men's groups, the best predictor of sexual functioning was the presence of erotic thoughts. Particularly for gay men's group, fewer failure anticipation thoughts were also a predictor of better sexual functioning. Overall, this study supports the core and predictive role of cognitive-emotional dimensions in sexual functioning for lesbian and heterosexual women, as for gay and heterosexual men.


Assuntos
Cognição/fisiologia , Emoções/fisiologia , Heterossexualidade/psicologia , Libido/fisiologia , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
6.
Ágora (Rio J. Online) ; 23(1): 84-93, Jan.-Apr. 2020.
Artigo em Inglês | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1059207

RESUMO

Abstract: This study aims primarily to reflect on the role of symbiotic illusion in the construction of female identity in women with eating disorders (ED), using premises from psychoanalytic psychosomatics. Considering ED as psychopathologies related to the affective economy, Oedipal relations play crucial role in the process of identity constitution. Mother-daughter relationships in ED are shaped in the molds of symbiotic illusion, with weak father figures. We presented a case study to briefly illustrate the theoretical framework. The omissive posture of a father to interdict the symbiotic relation leads daughters to find themselves unable to libidinally invest in other objects.


Resumo: Este estudo teve como objetivo refletir sobre o papel da ilusão simbiótica na construção da identidade feminina em mulheres com transtornos alimentares (TAs), utilizando as premissas da psicossomática psicanalítica. Considerando-se os TAs como psicopatologias relacionadas à economia afetiva, as relações edípicas desempenham papel crucial no processo de construção de identidade. As relações mãe-filha nos TAs são moldadas pela ilusão simbiótica, com figuras paternas enfraquecidas. Nós apresentamos brevemente um estudo de caso para ilustrar os conceitos do referencial teórico. A postura omissa do pai para interditar a relação simbiótica com a mãe leva a filha à impossibilidade de investir libidinalmente em outros objetos.


Assuntos
Mulheres , Transtorno da Compulsão Alimentar , Libido
7.
Int J Clin Pract ; 74(5): e13480, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31927774

RESUMO

AIM: To assess the impact of baseline characteristics on Men's Sexual Health Questionnaire (MSHQ) total scores and to evaluate the clinical relevance of MSHQ changes and their association with spontaneously reported sexual adverse events (SexAEs) in patients with benign prostatic hyperplasia. METHODS: This was a post hoc analysis of the Phase 4 FDC116115 study, in which patients aged ≥50 years were randomised 1:1 to receive a fixed-dose combination of dutasteride 0.5 mg and tamsulosin 0.4 mg (DUT-TAM FDC), or placebo. End-points included: change in MSHQ total scores by baseline characteristics and SexAEs; cumulative distribution function for change from baseline to month 12 in MSHQ total score and the ejaculation, erection, satisfaction and sexual desire (libido) domain scores; and relationship between changes in MSHQ scores and SexAEs. RESULTS: The intent-to-treat population comprised 489 patients (DUT-TAM FDC, n = 243; placebo, n = 246). The mean reduction in total MSHQ score was greater in patients with SexAEs across both groups, compared with patients without SexAEs. Most patients reporting any SexAE (86% DUT-TAM FDC, 67% placebo) had a worsening of the MSHQ total score at month 12 compared with baseline. Specifically, 90% (DUT-TAM FDC) and 75% (placebo) of patients reporting an ejaculation SexAE and 73% (DUT-TAM FDC) and 87% (placebo) of patients reporting an erection SexAE had a worsening of MSHQ ejaculation and erection domain scores, respectively, at month 12. A threshold effect for incident SexAE was observed; patients showing a decrease of approximately 6-10 points in the total MSHQ score were more likely to report SexAEs. CONCLUSION: Findings support the clinical utility of the MSHQ tool in assessing the impact of DUT-TAM on sexual function by linking numerical changes in MSHQ scores to spontaneously reported SexAEs for the first time. The threshold effect for incidence of SexAEs warrants further investigation to determine its clinical relevance.


Assuntos
Dutasterida/efeitos adversos , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Hiperplasia Prostática/tratamento farmacológico , Saúde Sexual , Tansulosina/efeitos adversos , Idoso , Método Duplo-Cego , Dutasterida/uso terapêutico , Ejaculação/efeitos dos fármacos , Humanos , Libido/efeitos dos fármacos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Saúde do Homem , Pessoa de Meia-Idade , Ereção Peniana , Estudos Prospectivos , Hiperplasia Prostática/complicações , Comportamento Sexual , Inquéritos e Questionários , Tansulosina/uso terapêutico
8.
Estud. pesqui. psicol. (Impr.) ; 18(4): 1155-1174, out.-dez. 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-994981

RESUMO

O presente artigo tem por objetivo traçar uma genealogia possível da técnica psicanalítica apontando para a importância das dimensões histórica, política e social na construção da psicanálise. A partir do fenômeno do magnetismo animal, postulado por Franz Anton Mesmer, no século XVIII, passando pela hipnose e pela sugestão até alcançarmos a transferência na psicanálise, buscaremos remontar a influência como pressuposto ético-político que perpassa e, mesmo, possibilita todas essas práticas.(AU)


The present article aims to delineate a possible genealogy of the psychoanalytical technique indicating the importance of the historical, political and social dimensions in the construction of the psychoanalysis. From the animal magnetism phenomenon, postulated by Franz Anton Mesmer, in the eighteenth century, moving to hypnosis and suggestion until achieving the transference in psychoanalysis, we seek reassemble the influence as ethical-politic presuppose that passes through, and yet, makes possible all these practices.(AU)


El artículo tiene por objectivo trazar una genealogía possible de la técnica psicoanalítica marcando la importancia de las dimenciones históricas, política y sociales en la construcción de la psicoanálisis. A partir del fenômeno del magnetismo animal, propuesto por Franz Anton Mesmer, en siglo XVIII, pasando por la hipnosis y por la sugestión, hasta encuentrarmos la transferencia psicoanalítica, intentamos remontar la influencia como pressupuesto ético-político que atraviesa y possibilita todas esas practicas.(AU)


Assuntos
Humanos , Psicanálise , Política , Hipnose , Libido
9.
Artigo em Inglês | MEDLINE | ID: mdl-31671702

RESUMO

Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish women's sexual activity during each trimester of pregnancy. A total of 624 women were included in the study and filled in the questionnaire three times, once during each trimester of pregnancy. The first part of the survey included questions about socio-demographic characteristics, obstetric history, and medical details of a given pregnancy. The second part was the Polish version of the female sexual function index (FSFI) questionnaire. Comparison of the mean scores for the overall sexual function of each trimester revealed clinically relevant sexual dysfunction in the second and third trimesters (mean values 25.9 ± 8.7 and 22.7 ± 8.7, respectively; p < 0.01). Women were most sexually active during their second trimester. In the first trimester of pregnancy, women were most likely to choose intercourse in the missionary position. Women with vocational education were characterized by the lowest and homogenous FSFI values. Total FSFI score depended on the martial status-the highest value pertained to married women (25.2 ± 6.9; p = 0.02).


Assuntos
Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Emoções , Feminino , Humanos , Libido , Casamento , Gravidez , Trimestres da Gravidez , História Reprodutiva , Disfunções Sexuais Fisiológicas , Fatores Socioeconômicos , Adulto Jovem
10.
Obstet Gynecol ; 134(5): 899-908, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31599840

RESUMO

OBJECTIVE: To evaluate the safety and efficacy of bremelanotide for the treatment of premenopausal women with hypoactive sexual desire disorder. METHODS: Two identical phase 3, randomized, double-blind, placebo-controlled, multicenter clinical trials (RECONNECT) evaluated the safety and efficacy of bremelanotide 1.75 mg administered subcutaneously as needed in premenopausal women with hypoactive sexual desire disorder. Patients were randomized 1:1 to 24 weeks of treatment with bremelanotide or placebo. Sample size was estimated based on simulations from key endpoints in patients with hypoactive sexual desire disorder from a prior trial. Coprimary efficacy endpoints were change from baseline to end-of-study in the Female Sexual Function Index-desire domain score and Female Sexual Distress Scale-Desire/Arousal/Orgasm item 13. RESULTS: Study 301 began on January 7, 2015, and concluded on July 26, 2016. Study 302 began on January 28, 2015, and concluded on August 4, 2016. Of the 1,267 women randomized, 1,247 and 1,202 were in the safety and efficacy (modified intent-to-treat) populations, respectively. Most participants were white (85.6%), from U.S. sites (96.6%), and had a mean age of 39 years. From baseline to end-of-study, women taking bremelanotide had statistically significant increases in sexual desire (study 301: 0.30, P<.001; study 302: 0.42, P<.001; integrated studies 0.35, P<.001) and statistically significant reductions in distress related to low sexual desire (study 301: -0.37, P<.001; study 302: -0.29, P=.005; integrated studies -0.33, P<.001) compared with placebo. Patients taking bremelanotide experienced more nausea, flushing, and headache (10% or more in both studies) compared with placebo. CONCLUSIONS: Both studies demonstrated that bremelanotide significantly improved sexual desire and related distress in premenopausal women with hypoactive sexual desire disorder. The safety profile was favorable. Most treatment-emergent adverse events were related to tolerability and the majority were mild or moderate in intensity. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02333071 (study 301) and NCT02338960 (study 302). FUNDING SOURCE: Palatin Technologies, Inc., and AMAG Pharmaceuticals, Inc.


Assuntos
Libido/efeitos dos fármacos , Peptídeos Cíclicos , Receptor Tipo 3 de Melanocortina/agonistas , Receptor Tipo 4 de Melanocortina/agonistas , Disfunções Sexuais Psicogênicas , alfa-MSH/análogos & derivados , Adulto , Fármacos do Sistema Nervoso Central/administração & dosagem , Fármacos do Sistema Nervoso Central/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Injeções Subcutâneas , Peptídeos Cíclicos/administração & dosagem , Peptídeos Cíclicos/efeitos adversos , Pré-Menopausa/fisiologia , Pré-Menopausa/psicologia , Angústia Psicológica , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia , Resultado do Tratamento , alfa-MSH/administração & dosagem , alfa-MSH/efeitos adversos
11.
Obstet Gynecol ; 134(5): 909-917, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31599847

RESUMO

OBJECTIVE: To evaluate the long-term safety and efficacy of bremelanotide as treatment for hypoactive sexual desire disorder in premenopausal women. METHODS: Women who completed the 24-week double-blind core phase of RECONNECT, composed of two parallel phase 3 trials (301 and 302) examining the safety and efficacy of bremelanotide compared with placebo in premenopausal women with hypoactive sexual desire disorder, could enroll in the 52-week open-label extension, provided they had not experienced serious adverse events during the core phase. Efficacy was assessed using the coprimary endpoints from the core phase, and all adverse events were collected during the open-label extension. All statistical analyses were descriptive. RESULTS: The study 301 open-label extension began on July 17, 2015, and concluded on July 13, 2017; the study 302 open-label extension began on October 5, 2015, and concluded on June 29, 2017. Of the 856 eligible patients who completed the core phase, 684 elected to participate in the open-label extension, and 272 completed it. The most common treatment-emergent adverse events considered related to study drug were nausea (40.4%), flushing (20.6%), and headache (12.0%), and the only severe treatment-emergent adverse event experienced by more than one participant in both studies was nausea during the open-label extension. The change in Female Sexual Function Index-desire domain score and Female Sexual Distress Scale-Desire/Arousal/Orgasm item 13 from baseline to end of the open-label extension ranged from 1.25 to 1.30 and -1.4 to -1.7, respectively, for patients who received bremelanotide during the core phase, and 0.70-0.77 and -0.9, respectively, for patients who received placebo during the core phase. CONCLUSION: During the 52-week open-label extension of RECONNECT, no new safety signals were observed, and premenopausal women treated with bremelanotide exhibited sustained improvements in hypoactive sexual desire disorder symptoms. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT02333071 (study 301) and NCT02338960 (study 302). FUNDING SOURCE: Palatin Technologies, Inc., and AMAG Pharmaceuticals, Inc.


Assuntos
Libido/efeitos dos fármacos , Efeitos Adversos de Longa Duração , Peptídeos Cíclicos , Disfunções Sexuais Psicogênicas , alfa-MSH/análogos & derivados , Adulto , Fármacos do Sistema Nervoso Central/administração & dosagem , Fármacos do Sistema Nervoso Central/efeitos adversos , Feminino , Humanos , Injeções Subcutâneas , Efeitos Adversos de Longa Duração/induzido quimicamente , Efeitos Adversos de Longa Duração/diagnóstico , Peptídeos Cíclicos/administração & dosagem , Peptídeos Cíclicos/efeitos adversos , Angústia Psicológica , Receptor Tipo 3 de Melanocortina/agonistas , Receptor Tipo 4 de Melanocortina/agonistas , Estudos Retrospectivos , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/fisiopatologia , Disfunções Sexuais Psicogênicas/psicologia , Tempo , Resultado do Tratamento , alfa-MSH/administração & dosagem , alfa-MSH/efeitos adversos
13.
Crim Behav Ment Health ; 29(4): 227-238, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31478289

RESUMO

BACKGROUND: Sexual behaviour towards another person who does not or cannot consent to it causes serious harm to its victims. Understandable tendencies towards isolating or shaming the offenders, however, may actually increase risks of recidivism and further such harms. AIM: The study aims to consider evidence for the effectiveness of interventions for sex offenders, mainly in a U.K. context, across four areas: criminal justice system programmes, medication, interventions for sex offenders with personality disorder and a community-based model for the reintegration-Circles of Support and Accountability, and identify key evidence gaps. METHODS: We searched for reviews in the following four strands of work-psychosocial programmes, medication, personality focused therapies, and Circles of Support and Accountability-and identified gaps in knowledge. FINDINGS: Randomised controlled trials in this field are rare but have been achieved. Findings from more naturalistic outcome studies of sex offender treatment programmes are disappointing, but recidivism rates among released sex offender prisoners are low, regardless. Medication relying on substantial physiological change raises substantial ethical concerns. Not all sex offenders have a mental disorder but up to half have been diagnosed with a personality disorder, which may need specific treatment. Evidence is growing that lay work such as Circles of Support and Accountability is a valuable adjunct to other interventions. CONCLUSIONS AND IMPLICATIONS FOR FUTURE RESEARCH: In this field, where tensions between attributions swing between "madness" and "badness," there is growing evidence for optimism that complexity of history and presentation can be met through cooperation between the many disciplines, integrative strategies, and wider community engagement. The need now is for large, prospective controlled trials of interventions, with long periods of follow-up. Perhaps, the most exciting developments have come from the wider public. More research into the qualities of these volunteers might inform public education and health strategies supporting wider safety.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Antipsicóticos/uso terapêutico , Criminosos/psicologia , Libido/efeitos dos fármacos , Transtornos Mentais/tratamento farmacológico , Grupos de Autoajuda , Delitos Sexuais/prevenção & controle , Comportamento Sexual/efeitos dos fármacos , Responsabilidade Social , Apoio Social , Adulto , Antagonistas de Androgênios/efeitos adversos , Antipsicóticos/efeitos adversos , Feminino , Humanos , Masculino , Transtornos Mentais/etiologia , Prisioneiros , Reincidência/prevenção & controle , Delitos Sexuais/psicologia
14.
Trends psychiatry psychother. (Impr.) ; 41(3): 247-253, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1043531

RESUMO

Abstract Introduction Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. Methods The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. Results The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. Conclusion The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.


Resumo Introdução A disfunção sexual é comum em indivíduos com doenças psiquiátricas e sob o uso de medicações como antidepressivos e antipsicóticos. Várias escalas foram desenvolvidas para avaliar a função sexual desses doentes. A Arizona Sexual Scale (ASEX) é uma escala de cinco itens de avaliação que quantifica desejo sexual, excitação, lubrificação vaginal/ereção peniana, capacidade para atingir o orgasmo e satisfação com o orgasmo. Este artigo descreve o processo de tradução e adaptação transcultural da escala ASEX para a língua portuguesa, com o objetivo de contribuir para a avaliação da função sexual dos doentes medicados com fármacos psicotrópicos nos vários países onde se utiliza essa língua. Métodos A tradução e a adaptação transcultural seguiram de forma detalhada os passos recomendados pelo grupo de trabalho da International Society for Pharmacoeconomics and Outcomes Research (ISPOR), nomeadamente: preparação, tradução inicial, reconciliação, retroversão, revisão da retroversão, harmonização, teste cognitivo, revisão do teste cognitivo, finalização, leitura final e versão final. Resultados O processo foi completado com sucesso, e não foram observadas diferenças grandes entre as fases de tradução, reconciliação e retroversão, tendo sido feitos apenas pequenos ajustes. Conclusão A tradução da escala ASEX foi bem-sucedida, seguindo orientações internacionais de referência. A aplicação dessas orientações é a garantia de uma versão em língua portuguesa que é qualitativa e semanticamente equivalente à versão original da escala. A existência desta nova versão da escala permitirá estudos que avaliem a função sexual dos doentes em países nos quais se fale a língua portuguesa. Estudos futuros poderão atestar a validade da escala para essas populações.


Assuntos
Humanos , Masculino , Feminino , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Traduções , Disfunções Sexuais Psicogênicas/diagnóstico , Transtornos Mentais/psicologia , Orgasmo/fisiologia , Satisfação Pessoal , Nível de Alerta/fisiologia , Portugal , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Fisiológicas/induzido quimicamente , Vagina/fisiologia , Ereção Peniana/psicologia , Arizona , Comparação Transcultural , Inquéritos e Questionários , Disfunções Sexuais Psicogênicas/induzido quimicamente , Libido/fisiologia , Transtornos Mentais/tratamento farmacológico
15.
Artigo em Inglês | MEDLINE | ID: mdl-31450673

RESUMO

Chronic kidney disease (CKD) has considerable effects on the quality of life of patients, impairing everyday activities and leading to lifestyle changes, as well as affecting body image and intimate relationships. Our aim was to describe the experience of female patients with CKD at an ambulatory dialysis unit regarding body changes and sexuality. A qualitative phenomenological study exploring how 18 female patients, treated at the dialysis unit of a Spanish hospital, perceived their sexuality and intimate relationships. Data were collected using in-depth interviews, researcher field notes, and patients' personal letters. A thematic analysis was performed. Four main themes arose from the data describing the experience of how CKD impacts body changes and sexuality: (a) Accepting body changes, (b) The catheter, the fistula, and body image, (c) Experiencing a different sexuality, and (d) The catheter, the fistula, and sexuality. Patients experienced changes in their body, perceiving it as being bloated or deformed, together with overall decline. The catheter and/or the fistula triggered changes in the way the women dress in an attempt to hide port sites. Women experience sexuality changes, affecting sexual desire and satisfaction. The presence of catheters was found to be the most cumbersome during sexual acts.


Assuntos
Imagem Corporal , Libido , Diálise Renal , Adulto , Idoso , Instituições de Assistência Ambulatorial , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Qualidade de Vida , Insuficiência Renal Crônica/terapia , Espanha
16.
Sex Reprod Healthc ; 21: 75-80, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31395237

RESUMO

OBJECTIVES: Few studies, with contradictory results, evaluate intrauterine contraceptives (IUC) and sexual function specifically. This study compares perception of sexual desire related to IUC use and aspects of sexual function in women who use the Lng-IUS with those using the Cu-IUD. STUDY DESIGN: A secondary analysis regarding IUC use based on a larger cross-sectional survey of contraceptive use in Sweden, conducted in 2013. In total, 153 IUC users (103 Cu-IUD and 50 Lng-IUS users) answered the questionnaire. The only inclusion criterion was intrauterine contraceptive use. MAIN OUTCOME MEASURES: Were self-reported sexual desire changes related to contraceptive method. We also analysed aspects of sexual functioning; sexual desire level, sexual activity, orgasm frequency, satisfaction with sex life and satisfaction of desire level. RESULTS: A negative effect on sexual desire due to contraceptive method was reported by 28% of the Lng-IUS users and by 10.1% of the Cu-IUD users (p < 0.05). Results were more marked after adjusting for age, body mass index, depression, parity, switching behaviour, and partnership (OR 5.0; CI: 1.8-13.8). The adjusted odds of reporting low sexual desire level (never or almost never feeling sexual desire) (OR 3.5; CI: 1.1-11.2) as well as low satisfaction with sex life (OR 2.7; CI: 1.2-6.3) was higher in the Lng-IUS group (adjusted for same confounders as above). CONCLUSIONS: The women in this study using the Lng-IUS more often report negative sexual desire effects of their contraception as well as lower sexual desire level compared with women using the Cu-IUD.


Assuntos
Contraceptivos Hormonais/efeitos adversos , Dispositivos Intrauterinos de Cobre/efeitos adversos , Levanogestrel/efeitos adversos , Libido/efeitos dos fármacos , Sexualidade , Adulto , Estudos Transversais , Feminino , Humanos , Orgasmo , Percepção , Satisfação Pessoal , Inquéritos e Questionários , Adulto Jovem
17.
Trends Psychiatry Psychother ; 41(3): 247-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31390459

RESUMO

INTRODUCTION: Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. METHODS: The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. RESULTS: The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. CONCLUSION: The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.


Assuntos
Transtornos Mentais/psicologia , Psicotrópicos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Traduções , Arizona , Nível de Alerta/fisiologia , Comparação Transcultural , Feminino , Humanos , Libido/fisiologia , Masculino , Transtornos Mentais/tratamento farmacológico , Orgasmo/fisiologia , Ereção Peniana/psicologia , Satisfação Pessoal , Portugal , Escalas de Graduação Psiquiátrica , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/induzido quimicamente , Inquéritos e Questionários , Vagina/fisiologia
18.
J Obstet Gynaecol Res ; 45(11): 2255-2259, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31436874

RESUMO

AIM: To evaluate how the desire to have children and engage in sexual activity change after trachelectomy in Japanese women with early-stage cervical cancer who strongly desired to have children before surgery. METHODS: Desire to have children, coital pain, fear of sexual intercourse, sexual activity frequency and libido were assessed in cervical cancer patients who received follow-up after trachelectomy. An anonymous questionnaire survey was conducted via informed consent. RESULTS: Of the 151 patients who underwent trachelectomy at Kyushu University Hospital between 2005 and 2015, 46 patients were evaluated; the response rate was 30%. The desire to have children disappeared in 13 of 46 (28%) patients, and 14 (30%) patients experienced increased coital pain. Moreover, 19 (41%) patients experienced fear of sexual intercourse, and sexual frequency decreased in 24 (52%) patients. CONCLUSION: Trachelectomy is an important fertility-sparing surgical method; however, this study revealed loss of the desire to have children and/or to engage in sexual activity in some patients after surgery. Counseling about these issues is important and should be addressed.


Assuntos
Características da Família , Preservação da Fertilidade/psicologia , Comportamento Sexual/psicologia , Traquelectomia/psicologia , Neoplasias do Colo do Útero/psicologia , Adulto , Dispareunia/etiologia , Dispareunia/psicologia , Feminino , Preservação da Fertilidade/métodos , Humanos , Japão , Libido , Estadiamento de Neoplasias , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/psicologia , Período Pós-Operatório , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
19.
Curr Urol Rep ; 20(10): 58, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31468204

RESUMO

PURPOSE OF REVIEW: Lower urinary tract symptoms (LUTS) and sexual health have common links. Medical and surgical treatments for LUTS can significantly affect various domains of sexual health including erectile function, ejaculatory function, and libido. This review summarizes recent findings. RECENT FINDINGS: Current literature demonstrates a strong association between LUTS, sexual health, and metabolic syndrome. The role of miRNA is also being investigated. Combination medical therapy with phosphodiesterase 5 inhibitors (PDE5-I) shows promise but needs further investigation. Newer surgical therapies for benign prostatic hyperplasia (BPH) aim to preserve sexual function without sacrificing efficacy and durability. Although we are beginning to acknowledge the link between LUTS and sexual health, a better understanding of the underlying biochemistry is needed. Only then can more effective therapies be developed. Further prospective studies should focus on the long-term durability and safety of treatments for both conditions.


Assuntos
Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/terapia , Síndrome Metabólica/complicações , Saúde Sexual , Ejaculação , Humanos , Libido , Masculino , Síndrome Metabólica/cirurgia , Ereção Peniana , Inibidores da Fosfodiesterase 5/uso terapêutico , Estudos Prospectivos , Hiperplasia Prostática/complicações
20.
PLoS One ; 14(8): e0221063, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31415608

RESUMO

Data from clinical trials investigating on-demand medication often consist of an intentionally varying number of measurements per patient. These measurements are often observations of discrete events of when the medication was taken, including for example data on symptom severity. In addition to the varying number of observations between patients, the data have another important feature: they are characterized by a hierarchical structure in which the events are nested within patients. Traditionally, the observed events of patients are aggregated into means and subsequently analyzed using, for example, a repeated measures ANOVA. This procedure has drawbacks. One drawback is that these patient means have different standard errors, first, because the variance of the underlying events differs between patients and second, because the number of events per patient differs. In this paper, we argue that such data should be analyzed by applying a multilevel analysis using the individual observed events as separate nested observations. Such a multilevel approach handles this drawback and it also enables the examination of varying drug effects across patients by estimating random effects. We show how multilevel analyses can be applied to on-demand medication data from a clinical trial investigating the efficacy of a drug for women with low sexual desire. We also explore linear and quadratic time effects that can only be performed when the individual events are considered as separate observations and we discuss several important statistical topics relevant for multilevel modeling. Taken together, the use of a multilevel approach considering events as nested observations in these types of data is advocated as it is more valid and provides more information than other (traditional) methods.


Assuntos
Nível de Alerta , Libido , Disfunções Sexuais Psicogênicas , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/fisiopatologia
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