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1.
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
2.
Arch Endocrinol Metab ; 63(3): 190-198, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340240

RESUMO

OBJECTIVE: To summarize current evidence regarding testosterone treatment for women with low sexual desire. MATERIALS AND METHODS: The Female Endocrinology and Andrology Department of the Brazilian Society of Endocrinology and Metabolism invited nine experts to review the physiology of testosterone secretion and the use, misuse, and side effects of exogenous testosterone therapy in women, based on the available literature and guidelines and statements from international societies. RESULTS: Low sexual desire is a common complaint in clinical practice, especially in postmenopausal women, and may negatively interfere with quality of life. Testosterone seems to exert a positive effect on sexual desire in women with sexual dysfunction, despite a small magnitude of effect, a lack of long-term safety data, and insufficient evidence to make a broad recommendation for testosterone therapy. Furthermore, there are currently no testosterone formulations approved for women by the relevant regulatory agencies in the United States, Brazil, and most other countries, and testosterone formulations approved for men are not recommended for use by women. CONCLUSION: Therefore, testosterone therapy might be considered if other strategies fail, but the risks and benefits must be discussed with the patient before prescription. Arch Endocrinol Metab. 2019;63(3):190-8.


Assuntos
Androgênios/uso terapêutico , Libido/efeitos dos fármacos , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Testosterona/uso terapêutico , Adolescente , Adulto , Idoso , Androgênios/efeitos adversos , Androgênios/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Sociedades Médicas , Testosterona/efeitos adversos , Testosterona/sangue , Adulto Jovem
3.
BMC Womens Health ; 19(1): 58, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-31039769

RESUMO

BACKGROUND: Studies have demonstrated that women with low desire and low excitement have negative feelings regarding their physical and emotional satisfaction, as well as their happiness. In this study, we evaluate the efficacy of Libicare® - a multi-ingredient food supplement - to improve sexual function in postmenopausal women. METHODS: This was an exploratory, prospective, non-controlled, observational study. Postmenopausal women aged 45-65 with a risk of sexual dysfunction (Female Sexual Function Index (FSFI) < 25.83) were included during routine clinical visits and treated with 2 tablets of Libicare® daily for 2 months. Libicare® is an oral food supplement containing Trigonella foenum graecum, Turnera diffusa, Tribulus terrestris, and Ginkgo biloba dry extracts. Primary endpoint: change vs. baseline in FSFI score. Secondary endpoints: 1) changes in testosterone and serum steroid levels of free testosterone and sex hormone-binding globulin (SHBG) levels and 2) tolerability. RESULTS: A total of 29 patients (mean age: 54.69 years) were included. FSFI mean (SD) score showed a significant increase: 20.15 (4.48) vs 25.03 (6.94), baseline vs final; p = 0.0011, paired t-test. Most patients (86.2%) increased their FSFI score. All FSFI domains, except dyspareunia, showed significant increases. The highest increase was observed in the desire domain (p = 0.0004). Testosterone and SHBG levels were assessed in 21 patients. A significant increase in testosterone level was observed: 0.41 (0.26) vs. 0.50 (0.34) pg/mL, baseline vs. final; p = 0.038, Wilcoxon test. 52.4% of patients increased their testosterone levels. Finally, a significant decrease was observed in SHBG level: 85 (32.9) vs. 73 (26.8) nmol/L, baseline vs. final; p = 0.0001; paired t-test. 95.2% of patients decreased their SHBG levels. CONCLUSION: In this pilot study, a significant improvement in sexual function and related hormone levels was observed with Libicare®. Further studies must be conducted to confirm these exciting results. TRIAL REGISTRATION: Current Controlled Trial ISRCTN12928573 . Date of registration: 28/March/2019. Retrospectively registered.


Assuntos
Suplementos Nutricionais , Preparações de Plantas/administração & dosagem , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Feminino , Humanos , Libido/efeitos dos fármacos , Pessoa de Meia-Idade , Satisfação Pessoal , Projetos Piloto , Extratos Vegetais/administração & dosagem , Estudos Prospectivos , Resultado do Tratamento
4.
Psicol. USP ; 30: e180123, 2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-990270

RESUMO

Resumo A adicção sexual pode ser definida como quadro psicopatológico no qual o sexo é buscado de forma incontrolável, desenfreada, a despeito dos prejuízos emocionais, sociais e profissionais que suscita no cotidiano do adicto. Após o frenesi, a excitação e a adrenalina em ceder aos próprios impulsos urgentes e vorazes, o sex-addict percebe-se incapaz de gerenciar suas atuações sexuais, sendo consumido por sentimentos de vazio, fracasso e desespero. A problemática do prazer sexual "além do princípio de prazer", conjugada à da dor psíquica, nos conduz a uma interrogação mais rigorosa sobre a dimensão do masoquismo na vida subjetiva e sua relação com os estados destrutivos da psicossexualidade. Neste artigo, fundamentado sob o viés da psicanálise, procuramos examinar a estreita relação entre autodestruição e satisfação libidinal nos fenômenos próprios do quadro em questão.


Résumé La dépendance sexuelle peut être définie comme une condition psychopathologique dans laquelle le sexe est cherché de façon incontrôlable, effrénée, malgré les préjudices émotionnels, sociaux et professionnels causés à la vie quotidienne de le dépendent. Après la frénésie, l'excitation et l'adrénaline ressenties en s'adonnant à ses propres impulsions urgentes et voraces, le sex-addict se sent incapable de gérer ses performances sexuelles, consumés par des sentiments de vide, d'échec et de désespoir. Le problème du plaisir sexuel « au-delà du principe du plaisir ¼, combiné à celui de la douleur psychique, conduit à un questionnement plus rigoureux sur la dimension du masochisme dans la vie subjective et sa relation avec les états destructeurs de la psychosexualité. Dans cet article, basé sur la perspective de la psychanalyse, on cherche à examiner la relation étroite entre l'autodestruction et la satisfaction libidinale dans les phénomènes caractéristiques de la condition en question.


Resumen La adicción sexual puede ser definida como un cuadro psicopatológico en el cual se busca el sexo de forma incontrolable, desenfrenada, a pesar de los perjuicios emocionales, sociales y profesionales provocados en el cotidiano del adicto. Después del frenesí, de la excitación y de la adrenalina en ceder a los impulsos urgentes y voraces, el adicto sexual se percibe incapaz de gestionar sus actuaciones sexuales, siendo consumido por sentimientos de vacío, fracaso y desesperación. La problemática del placer sexual "más allá del principio de placer", combinada a la del dolor psíquico, nos conduce a una interrogación más rigurosa sobre la dimensión del masoquismo en la vida subjetiva y su relación con los estados destructivos de la psicosexualidad. Fundamentado en el sesgo del psicoanálisis, en este artículo nos proponemos analizar la estrecha relación entre la autodestrucción y la satisfacción libidinal en los fenómenos propios del cuadro en cuestión.


Abstract Sexual addiction can be defined as a psychopathological condition in which sex is sought in an uncontrollable, unrestrained manner, despite the emotional, social, and professional harm caused to the addict's daily life. After the frenzy, excitement, and adrenaline rush experienced in indulging in their own urgent and eager impulses, sexual addicts find themselves incapable to manage their sexual performances, being consumed by feelings of emptiness, failure, and despair. The issue of sexual pleasure "beyond the pleasure principle," combined with the issue of psychic pain, leads us to a more rigorous questioning about the dimension of masochism in subjective life and its relation with the destructive states of psychosexuality. In this article, based on the perspective of psychoanalysis, we seek to examine the close relation between self-destruction and libidinal satisfaction in the phenomena that are characteristic of the condition in question.


Assuntos
Humanos , Comportamento Sexual/psicologia , Comportamento Compulsivo/psicologia , Masoquismo/psicologia , Psicanálise , Libido
5.
Ágora (Rio J. Online) ; 21(3): 343-353, set.-dez. 2018.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-963601

RESUMO

RESUMO: Pretende-se neste artigo contextualizar a temática das depressões na neurose no cenário atual e, posteriormente, relacionar o abatimento e a deflação libidinal presentes nestes quadros com a função do desejo. Sugerimos que a depressão participa de uma nova economia libidinal na contemporaneidade. O depressivo contemporâneo vem caracterizando-se cada vez mais por uma posição de desistência dos embates inerentes à condição humana, refugiando-se cada vez mais numa posição protegida e paralisada, mais característica das inibições do que dos sintomas. Temas como os processos narcísicos e do luto surgem como horizonte para pensar as depressões neuróticas na contemporaneidade.


ABSTRACT: This article is intended to contextualize the issue of depression in the contemporary world in order to highlight the massive contingent of depression in the current scenario as formed by neurotics, and later to relate the depressive dejection and libidinal deflation present in these frames with the function of desire. We suggest that depression takes part in a new libidinal economy nowadays. The contemporary depression is characterized increasingly by a withdrawal position of the conflicts inherent in the human condition, increasingly taking refuge in a protected and paralyzed position more characteristic of inhibitions than the symptoms. Narcissism and mourning are central themes.


Assuntos
Humanos , Disfunções Sexuais Psicogênicas , Depressão , Libido , Transtornos Neuróticos
6.
BMC Womens Health ; 18(1): 204, 2018 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-30572853

RESUMO

BACKGROUND: Most studies on female sexual dysfunction are performed in population inventories and under specific clinical conditions. These approaches are performed using validated psychometric scales. Different scales to assess sexual function use different numbers of questions to characterize their domains. They also may or may not include domains of interaction between sexual partners. The objective of this study was to compare the precision between scales to be able to analyze their accuracy for better diagnosis of sexual dysfunction. METHODS: Fifty (50) healthy young women were enrolled in this study. Three questionnaires (FSFI, SQ-F, and GRISS) were applied to assess sexual function (n = 44). The accuracy measured by the area under the ROC curve (AUC) for individual domains and to cross-validated pairwise comparison of the three analyzed instruments was used. Kruskall-Wallis test to analyze individual domains of the scales was also used.The P-value was established as 0.05. RESULTS: The results showed that all domains and total FSFI and GRISS scores were significantly different between normal and dysfunctional women, but not for SQ-F domains. Indeed, AUC accuracy varied from excellent-good domain discrimination for FSFI and GRISS, but fair-poor for SQ-F. For the paired comparison between the three questionnaires a fair accuracy was detected. The specificity percentage was around 84% whereas that for sensibility was low, around 30%. CONCLUSIONS: The best agreement was between FSFI and SQ-F, probably being related to high similar shared questions when compared to GRISS. The agreement between SQ-F and GRISS was low possible due to low number of questions in SQ-F to characterize similar domains. This study evidenced high agreement between scales to sensitivity and low agreement for specificity, thereby conferring fair accuracy between them. Thus, the limited grade for discriminatory capacity (AUC) for sexual response should be considered when comparing results from these three different questionnaires and also when comparing with other different scales. In addition, despite the diversity of scales, the high reliability and fit for their desire domain suggest that the FSFI scale has good accuracy for the current clinical assessment of women's sexual health. CLINICAL TRIAL REGISTRATION: NCT03241524 . Retrospectively registered on 08/02/2017.


Assuntos
Libido , Comportamento Sexual/psicologia , Inquéritos e Questionários/normas , Saúde da Mulher , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Parceiros Sexuais
7.
Drug Alcohol Depend ; 190: 121-127, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30014887

RESUMO

BACKGROUND: Regular consumption of opioids exposes individuals to several side effects. One of these is a loss of libido, which has a negative impact on quality of life. We used a cross-sectional community-based survey of people who inject opioids to study factors associated with loss of libido, and more particularly the impact of the type of opioid injected. METHODS: This secondary study was conducted throughout France in 2015 and involved 514 people who inject opioids. Self-reported sociodemographic characteristics, drug consumption, injection-related data and loss of libido were collected using a brief questionnaire administered either through face-to-face interviews or online. Two different models were used to identify factors associated with loss of libido: simple logistic regression and a two-step Heckman model. RESULTS: Forty-three percent of the participants reported a loss of libido. The first model showed that filling in the questionnaire online (OR[95%CI] = 2.55[1.64;3.96]; p < 0.001), reporting that morphine sulfate (OR[95%CI] = 2.67[1.56;4.58]; p < 0.001) or methadone (OR[95%CI] = 2.50[1.13;5.56]; p = 0.030) was the opioid they injected most (versus buprenorphine), and reporting benzodiazepine use (OR[95%CI] = 1.62[1.07;2.44]; p = 0.033) were factors strongly associated with loss of libido. In the two-step, Heckman model which corrected for selection bias, along with these factors, reporting heroin as the opioid injected most was also strongly associated. CONCLUSION: Our findings showed that full-opioid agonists could have a negative impact on libido when injected regularly. Libido can improve quality of life and should be routinely discussed through counseling in prevention services with people who inject drugs.


Assuntos
Analgésicos Opioides/efeitos adversos , Libido/efeitos dos fármacos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologia , Inquéritos e Questionários , Adulto , Analgésicos Opioides/administração & dosagem , Buprenorfina/administração & dosagem , Buprenorfina/efeitos adversos , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Libido/fisiologia , Masculino , Pessoa de Meia-Idade , Morfina/administração & dosagem , Morfina/efeitos adversos , Qualidade de Vida/psicologia , Fatores de Risco , Adulto Jovem
8.
Curr Urol Rep ; 19(9): 68, 2018 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-29971696

RESUMO

PURPOSE OF REVIEW: Immune checkpoint therapy has grown in prominence in the last few decades and is being increasingly utilized in treatment of advanced cancers. Although information on toxicities of these drugs is forthcoming, not much is known regarding the toxicity profile of these drugs from a sexual function standpoint. We undertook the current review to appraise the literature for endocrine/sexual side effects of anti-PD-1/PD-L1 and anti-CTLA-4 therapy. RECENT FINDINGS: Our review included 32 articles and focused primarily on the programmed death (PD) pathway. We found that endocrine side effects after anti-PD-1/PD-L1 therapy are relatively rare, with hypothyroidism (range < 1 to 40%) and hypophysitis (range < 1 to 10%) being the two most common. None of the studies specifically commented on the infertility or sexual side effects of these drugs. However, two studies evaluating biochemical profiles of patients undergoing therapy with ipilimumab (a CTLA-4 inhibitor) or combination therapy (CTLA-4 + PD-1/PD-L1 inhibitors) noted that about < 1 to ~ 60% of the patients developed hypogonadotropic hypogonadism. None of the studies provided information regarding clinically meaningful sexual health endpoints such as libido, erectile function assessments, or sexual function-related quality of life. Endocrine side effects, although uncommon, are important and unique side effects of immune checkpoint therapy because they are often complex and can be life threatening. While side effects on sexual health may not be life threatening, they are lifestyle limiting. Thus, long-term follow-up, post-marketing surveillance, and future studies will need to elucidate the true rates of endocrine/sexual side effects and the mechanisms underlying them. This will aid in better counseling of the patients, as more of them undergo these novel immune checkpoint inhibitor therapies.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Neoplasias Urogenitais/tratamento farmacológico , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos Imunológicos/uso terapêutico , Antígeno B7-H1/antagonistas & inibidores , Antígeno CTLA-4/antagonistas & inibidores , Doenças do Sistema Endócrino/induzido quimicamente , Humanos , Infertilidade/induzido quimicamente , Ipilimumab/efeitos adversos , Ipilimumab/uso terapêutico , Libido/efeitos dos fármacos , Ereção Peniana/efeitos dos fármacos , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Qualidade de Vida , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Psicogênicas/induzido quimicamente , Saúde Sexual
9.
Curr Urol Rep ; 19(8): 65, 2018 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-29909472

RESUMO

PURPOSE OF REVIEW: Male pattern hair loss, mediated by dihydrotestosterone, is a common hair loss disorder, affecting over 50% of men over the age of 50. The 5-α reductase inhibitors, finasteride and dutasteride, are Food and Drug Administration-approved drugs for the treatment of this disorder. Several recent studies have reported adverse sexual and spermatogenic events among young men using 5-α reductase inhibitors, such as erectile dysfunction, decreased ejaculate volume, decreased libido, and infertility. In this review, we summarize and analyze the literature regarding the efficacy and safety of these medications, with an overall focus on men's health. RECENT FINDINGS: Finasteride for the treatment of male pattern hair loss was considered safe according to many previous clinical trials. However, these trials have been recently criticized for inadequate safety reporting. Comprehensive review of the current literature reveals that there is a disproportionately high number of men with 5-α reductase inhibitor-associated sexual dysfunction and infertility. Although uncommon, the use of 5-α reductase inhibitors is associated with serious and persistent sexual and reproductive side effects, such as erectile dysfunction, decreased ejaculate volume, decreased libido, and infertility.


Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Alopecia/tratamento farmacológico , Dutasterida/efeitos adversos , Dutasterida/uso terapêutico , Disfunção Erétil/induzido quimicamente , Finasterida/efeitos adversos , Finasterida/uso terapêutico , Humanos , Infertilidade Masculina/induzido quimicamente , Libido/efeitos dos fármacos , Masculino , Disfunções Sexuais Fisiológicas/induzido quimicamente
10.
Int J Risk Saf Med ; 29(3-4): 125-134, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29733030

RESUMO

OBJECTIVE: To investigate clinical reports of post-SSRI sexual dysfunction (PSSD), post-finasteride syndrome (PFS) and enduring sexual dysfunction following isotretinoin. METHODS: Data from RxISK.org, a global adverse event reporting website, have been used to establish the clinical features, demographic details and clinical trajectories of syndromes of persistent sexual difficulties following three superficially different treatment modalities.RESULTSWe report on 300 cases of enduring sexual dysfunction from 37 countries following 14 different drugs comprised of serotonin reuptake inhibiting antidepressants, 5α-reductase inhibitors and isotretinoin. While reports of certain issues were unique to the antidepressants, such as the onset of premature ejaculation and persistent genital arousal disorder (PGAD), there was also a significant overlap in symptom profile between the drug groups, with common features including genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. Secondary consequences included relationship breakdown and impaired quality of life.CONCLUSIONSThese data point to a legacy syndrome or syndromes comprising a range of disturbances to sexual function. More detailed studies will require developments in coding systems that recognise the condition(s). Further exploration of these tardive sexual syndromes may yield greater understanding of tardive syndromes in general.


Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Antidepressivos/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Isotretinoína/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Adolescente , Adulto , Idoso , Feminino , Humanos , Libido/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Vigilância de Produtos Comercializados , Qualidade de Vida , Adulto Jovem
12.
Medicine (Baltimore) ; 97(17): e0482, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29703008

RESUMO

BACKGROUND: The use of testosterone replacement therapy in obese men with low testosterone levels has been controversial. This review aims to analyze the effectiveness of testosterone therapy for weight loss and preventing cardiovascular complications in obese men with low testosterone levels. METHODS: We will perform a systematic review according to Cochrane Methodology of randomized studies, including crossover studies, wherein patients are allocated into one of the two groups: testosterone therapy and control (no treatment or placebo). The primary outcomes analyzed will be: weight loss, adverse events, quality of life, improvement of libido, control of obesity complications, frequency of cardiovascular events, and deaths. Four general and adaptive search strategies have been created for the following electronic health databases: Embase, Medline, LILACS, and CENTRAL. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least two trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence of the effect estimate of the intervention for the outcomes that could be plotted in the meta-analysis will be generated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group. RESULTS: Although testosterone replacement seems to be an attractive treatment modality for obese men with low testosterone, its potential benefits has been refuted by some studies, whose results have not shown significant differences between treated and untreated patients. CONCLUSION: For obese men with low testosterone concentrations, the proposed systematic review aims to answer the following questions: When compared with no treatment or placebo: Is testosterone therapy safe? Is testosterone therapy effective in promoting weight loss, a sustained reduction in body weight and changes in body composition? Is testosterone effective in improving quality of life, libido, and erectile function? Is testosterone therapy effective in controlling obesity complications and in preventing cardiovascular events?


Assuntos
Obesidade/tratamento farmacológico , Testosterona/uso terapêutico , Doenças Cardiovasculares/complicações , Humanos , Libido/efeitos dos fármacos , Masculino , Obesidade/complicações , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisão Sistemática como Assunto , Testosterona/administração & dosagem , Testosterona/efeitos adversos , Perda de Peso/efeitos dos fármacos
13.
Maturitas ; 112: 46-52, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29704917

RESUMO

Testosterone (T) is deeply involved in every step of the male sexual response. However, the occurrence of sexual disorders cannot be automatically related to a decline in T levels. In fact, this relationship is complicated by organic, relational and psychological factors, which can independently impair sexual function. For example, it is recognized that erectile dysfunction (ED) can result from vascular damage as well as from low levels of T. T therapy (TTh) can improve sexual function but meta-analyses show that it improves erectile function only in men with ED and overt hypogonadism. Similarly, impaired sexual desire can result from a wide range of organic, relational and psychological factors, although it is recognized as one of the most specific symptoms of hypogonadism. Accordingly, low desire is improved by TTh in men with overt hypogonadism. The association between low T levels and delayed ejaculation has not been well studied and needs further confirmation, as does the role of TTh in such cases. Meta-analyses have found that TTh can improve orgasmic function in hypogonadal men. Clinicians should bear in mind that sexual dysfunctions have multifactorial causes and hypogonadism represents only one of these. Only hypogonadal men are likely to improve their sexual symptoms when treated with TTh. The assessment of serum T levels is mandatory before patients are prescribed TTh, as are the assessment and possible treatment of other concomitant conditions.


Assuntos
Disfunção Erétil/etiologia , Testosterona/deficiência , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/psicologia , Humanos , Hipogonadismo/complicações , Libido , Masculino , Comportamento Sexual , Testosterona/sangue , Testosterona/uso terapêutico
14.
J Dermatol ; 45(7): 799-804, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29667763

RESUMO

Treatment with 5α-reductase inhibitors has been associated with sexual adverse events such as impotence (erectile dysfunction) and decreased libido. The primary objective of this study was to evaluate adverse events related to sexual function, based on their frequency, duration, persistence and associated treatment discontinuations, in men treated with dutasteride for androgenetic alopecia. Participants were randomized to receive double-blind dutasteride 0.5 mg or placebo once daily for 24 weeks, followed by open-label dutasteride 0.5 mg for an additional 24 weeks. Sexual adverse events were followed up until resolution or for up to 24 weeks after the last dose. Overall, 117 men, 23-50 years of age, were randomized. The incidence of sexual adverse events was approximately twofold higher in the dutasteride group (16%) than the placebo group (8%) during the double-blind period; the overall incidence of sexual adverse events was lower (5%) during the open-label period. All adverse events were mild to moderate in severity and considered treatment-related. The adverse events resolved while on study treatment or after the end of treatment and did not lead to treatment discontinuation. A limitation of this study was the small sample size. The sexual adverse events of impotence, decreased libido and ejaculation disorders reported in this study were expected and reversible.


Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Alopecia/tratamento farmacológico , Dutasterida/efeitos adversos , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Fatores Etários , Método Duplo-Cego , Humanos , Incidência , Libido/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Placebos/efeitos adversos , Estudos Prospectivos , Disfunções Sexuais Psicogênicas/induzido quimicamente , Resultado do Tratamento , Adulto Jovem
15.
Clin Neuropharmacol ; 41(3): 109-110, 2018 May/Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29634583

RESUMO

OBJECTIVES: Restless genital syndrome (RGS) includes discomfort, pain, numbness, vibration, restlessness, or a burning sensation involving the vagina, perineum, pelvis, penis, and proximal portion of the lower limbs in patients. The RGS has been sometimes reported in Parkinson disease. In patients without Parkinson disease, RGS is also known as persistent genital arousal disorder (PSAS), which includes uncontrollable genital arousal, with or without orgasm or genital engorgement, unrelated to sexual desire. Although withdrawal from selective serotonin reuptake inhibitors antidepressants is reported to induce PSAS, there is no report of RGS or PSAS induced by antidepressants. METHODS: We obtained the consent for the presentation and have not identified individuals for ethical reasons. RESULTS: We first report a woman patient with depression induced RGS by milnacipran (MLN). CONCLUSIONS: We discuss the relationship with restless legs syndrome and the difference from akathisia. It is highly possible MLN affected her RGS because she experienced RGS for the first time after the dose of MLN was increased. A limitation of this report is that we stopped MLN and administered gabapentin enacarbil immediately. We should join MLN to the list of compounds suspected of inducing RGS.


Assuntos
Antidepressivos/efeitos adversos , Ciclopropanos/efeitos adversos , Doenças dos Genitais Femininos/induzido quimicamente , Síndrome das Pernas Inquietas/induzido quimicamente , Idoso , Depressão/tratamento farmacológico , Feminino , Doenças dos Genitais Femininos/complicações , Humanos , Libido/efeitos dos fármacos , Milnaciprano , Síndrome das Pernas Inquietas/complicações
16.
Artigo em Espanhol | IBECS | ID: ibc-180734

RESUMO

En el centenario de la publicación de Introducción del narcisismo, vuelven a plantearse algunas discusiones a las que Freud respondía a sus colegas, sentando unas bases que provocarían intensos efectos en todo el edificio clínico y metapsicológico del psicoanálisis. Algunas de aquellas controversias siguen hoy vigentes, pero con nuevos actores en la escena psicoanalítica de nuestra época y renovados interlocutores. En el presente artículo, revisamos aquellas controversias


In the centenary of the publication of Introduction to Narcissism, new ideas are being considered on Freud's answers; answers that founded the basis that would provoke intense effects throughout the clinical and metapsychological institution of the Psychoanalysis. Some of those controversies are still valid today, but with new actors on the current psychoanalytic stage and renewed interlocutors. In the present article, those controversies are reviewed


Assuntos
Humanos , Transtornos da Personalidade/história , Narcisismo , Teoria Freudiana/história , Psicanálise/história , Apego ao Objeto , Amor , Libido
17.
Eur. j. psychiatry ; 32(1): 11-15, ene.-mar. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-179742

RESUMO

Background and objective: About one percent of the world's population are affected by Schizophrenia. It is assumed that antipsychotic drugs cause sexual dysfunction, but the main mechanism of it, is not specified. Few researches that have addressed this issue showed that there is a relationship between neuroleptics and sexual dysfunction. A number of studies found that bupropion could improve the sexual dysfunction. So the purpose of this study is to investigate the effect of bupropion on sexual function of the patients with Schizophrenia. Methods: This randomized clinical trial was performed on 40 schizophrenic patients admitted to Kamrani psychiatry clinic in Tehran during 2015–2016. Participants were randomly divided into two experimental and control groups. The experiment group was taken bupropion tablets 150 mg/day and the control group were given placebo for one-month. The sexual performance of participants was studied before and after the intervention by the sexual functioning questionnaire (SFQ). Obtained data were analyzed using the SPSS software with student t-test and chi-square tests. Results: 40 patients older than 18 year old participated in the study. Before treatment the two groups did not have significant difference based on a general score of SFQ questionnaire, but There was a significant difference between two groups after the intervention. Experiment group (bupropion) showed significant improvement in sexual function. Using bupropion in the experiment group led to significant change in the score of sexual desire, erection and orgasm, but it had no effect on sexual arousal and ejaculation. The associations of ejaculation and orgasm were significance. Using the bupropion changed the erection and orgasm in the two groups of control and experimental. Conclusion: This study shows that 150 mg/day dose have considerable effect on sexual dysfunction of patients that are under treatment with anti-psychotic drugs. Also, this drug does not have any special side effects


No disponible


Assuntos
Humanos , Masculino , Adulto , Bupropiona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Antipsicóticos/uso terapêutico , Disfunção Erétil/induzido quimicamente , Inquéritos e Questionários , Ejaculação , Efeito Placebo , Libido , Disfunção Erétil/fisiopatologia
19.
Oncology ; 94(4): 200-206, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29393227

RESUMO

PURPOSE: The aim of this study was to evaluate the prevalence of menopausal symptoms in young cancer survivors immediately following the completion of chemotherapy. METHODS: This prospective cohort study followed 124 young females with a new diagnosis of cancer requiring chemotherapy to assess symptoms of menopause before treatment and immediately following chemotherapy. Symptoms were compared before and after treatment using the McNemar test and between cancer patients and 133 similar-aged healthy controls using Pearson χ2 and Fisher's exact tests. RESULTS: Participants undergoing cancer therapy reported more menopausal symptoms compared to controls prior to the initiation of any treatment (hot flashes or night sweats 33 vs. 7%, p < 0.01, trouble sleeping 57 vs. 31%, p < 0.01, headaches 50 vs. 35%, p = 0.02, and decreased libido 36 vs. 16%, p < 0.01) and also reported a greater prevalence of symptoms immediately after cancer therapy compared to pretreatment prevalence (vasomotor symptoms, p < 0.01, vaginal dryness, p < 0.01, decreased concentration, p < 0.01, and body aches, p = 0.01). Cancer patients with lower anti-Müllerian hormone (AMH) levels after treatment (<0.10 ng/mL) had an increased risk of vasomotor symptoms (OR 2.2, p = 0.04), mood swings (OR 2.4, p = 0.03), feeling sad (OR 2.2, p = 0.04), trouble sleeping (OR 2.7, p = 0.02), and decreased libido (OR 3.0, p = 0.03) when controlled for age and cancer type, and the incidence of these symptoms was not affected by the use of systemic hormones or psychiatric medications. Treatment length, use of alkylating agents, pelvic radiation, and marital status were also not associated with the prevalence of menopausal symptoms. CONCLUSIONS: Premenopausal women with a new cancer diagnosis have more menopausal symptoms than females of similar age before and after cancer treatment, the effects of which are not mitigated by systemic hormone use. Decreased AMH levels were associated with an increased likelihood of reporting physiologic symptoms after therapy. IMPLICATIONS FOR CANCER SURVIVORS: This information is imperative for counseling; ultimately, improved symptom management during and after cancer therapies will improve quality of life in young cancer survivors.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fogachos/epidemiologia , Neoplasias/tratamento farmacológico , Transtornos do Sono-Vigília/epidemiologia , Sudorese , Adolescente , Adulto , Hormônio Antimülleriano/sangue , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Estudos de Casos e Controles , Feminino , Cefaleia/epidemiologia , Humanos , Libido/efeitos dos fármacos , Transtornos do Humor/epidemiologia , Neoplasias/sangue , Pré-Menopausa/sangue , Prevalência , Estudos Prospectivos , Fatores de Risco , Sudorese/efeitos dos fármacos , Adulto Jovem
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