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1.
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
2.
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
3.
Evol Psychol ; 17(2): 1474704919848116, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31122067

RESUMO

The presented data are part of a longitudinal within-subject study designed to examine ovulatory shifts in human sexuality in a diverse German sample using validated questionnaires. The final sample consists of 78 individuals (76 female, 2 agender) who declared to be mainly or exclusively attracted to males. Questionnaires were completed anonymously online at three cycle phases. Following the gold standard, the fertile window was calculated through the reverse cycle day method and confirmed via urinary tests detecting luteinizing hormone. The questionnaire included the Sexual Desire Inventory, Dresdner Body Image Inventory, the Revised Sociosexual Orientation Inventory, and an adjective list to measure mate preferences. One hundred eighty-four questionnaires were included in the data analysis using linear mixed models. Findings support previous research reporting heightened sexual desire and an improved body image during the fertile window. No shifts were found for mate preference or sociosexual orientation, thus adding to a growing body of literature contesting parts of the ovulatory shift hypothesis.


Assuntos
Imagem Corporal , Comportamento de Escolha/fisiologia , Período Fértil/fisiologia , Libido/fisiologia , Comportamento Sexual/fisiologia , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Hormônio Luteinizante/metabolismo , Ovulação/fisiologia , Adulto Jovem
4.
Trop Anim Health Prod ; 51(7): 1823-1827, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30945154

RESUMO

Zebu bulls are a shy breeder and they exhibit optimum libido in the presence of females with estrus phase. Continuous semen collection with the use of male dummy leads to lack of adequate sexual stimulation. Therefore, the present study was designed to test the effect of estrus-specific molecule(s) for effective sexual preparation of donor bulls. The bulls were divided into normal and poor libido group, five bulls in each group by taking 1-month control study data after collecting the information of individual bull's sexual behaviour during semen collection by regular semen collector. The bulls were never being exposed to female animals and semen was collected by an artificial vagina. The ten animals were exposed to a glycerol-water solution (50/50 v:v) as control and then exposed to estrus-specific molecules one by one. The estrus-specific molecules like squalene, 1-iodoundecane, acetic acid, coumarin, propionic acid, oleic acid, and 2-butanone were purchased from Sigma-Aldrich Company, USA, and the molecules were solubilised individually in a non-pressurised aerosol dispenser as 1.0% concentration in glycerol-water solution (50/50, v:v). Identical bulls were used as the control and exposed to each molecule one by one by giving a refractory period of 14 days. A nasal spray of acetic acid or 2-butanone significantly (p < 0.05) reduced reaction time (RT) and total time taken to ejaculate (TTTE) in normal libido bull group. Semen volume, sperm concentration, and the total number of sperm per ejaculation obtained did not show significant improvement in the normal libido group of bulls after the application of estrus-specific molecules as compared to the control. In poor libido group, acetic acid, oleic acid, and 2-butanone application showed significant (p < 0.01) improvement in RT and TTTE as compared to the control group, whereas semen production variables like sperm concentration and total sperm output per ejaculation increased significantly (p < 0.05) except semen volume. There was significant (p < 0.01) reduction in RT (%) and TTTE (%) after the application of acetic acid followed by 2-butanone and oleic acid. The sperm concentration and total sperm output per ejaculation were more after the application of each molecule but significant increase (p < 0.05) in sperm concentration was observed with 2-butanone (11.42%), acetic acid (11.42%), and oleic acid (10.13%), whereas total sperm output per ejaculation increased significantly (p < 0.05) only after the application of acetic acid and 2-butanone (24.75% and 26.84%). Hence, it can be concluded that acetic acid, 2-butanone, and oleic acid are effective for better sexual preparation of Sahiwal bulls and total sperm output per ejaculation.


Assuntos
Bovinos/fisiologia , Libido/fisiologia , Sêmen/fisiologia , Ácido Acético/farmacologia , Animais , Butanonas/farmacologia , Cumarínicos/farmacologia , Estro/fisiologia , Índia , Masculino , Ácido Oleico/farmacologia , Propionatos/farmacologia , Espermatogênese/efeitos dos fármacos , Esqualeno/farmacologia , Clima Tropical
5.
Psychoneuroendocrinology ; 104: 259-268, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30909007

RESUMO

Previous research has found lower serum levels of dehydroepiandrosterone (DHEA) or its sulfated form, DHEA-S, in women diagnosed with Hypoactive Sexual Desire Disorder (HSDD). Given that DHEA and DHEA-S have multiple direct actions on the brain as well as anti-glucocorticoid properties, it is possible that lower levels of DHEA directly impact women's sexual functioning. To date, the significance of the lower DHEA levels remains unclear. To our knowledge, there has been no empirical study of stress hormones as markers of HPA dysregulation in women with HSDD. To attend to this gap, the present study utilized several measures of HPA axis function - morning and evening cortisol and DHEA, the cortisol awakening response (CAR), diurnal cortisol slope, and cortisol:DHEA ratio - and examined their relationship with sexual functioning in N = 275 women with (n = 137) and without (n = 138) HSDD. Results demonstrated multiple hormonal markers of HPA dysregulation in women diagnosed with HSDD compared to control participants, specifically, lower AM cortisol and AM DHEA levels, a flatter diurnal cortisol slope, and a lower CAR. Overall, results of the present study indicate that persistently low sexual desire in women is associated with HPA axis dysregulation, with both cortisol and DHEA alterations potentially detrimental to sexual desire.


Assuntos
Libido/fisiologia , Disfunções Sexuais Psicogênicas/fisiopatologia , Adulto , Biomarcadores , Ritmo Circadiano/fisiologia , Desidroepiandrosterona/análise , Feminino , Humanos , Hidrocortisona/análise , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipotálamo-Hipofisário/fisiopatologia , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/metabolismo , Sistema Hipófise-Suprarrenal/fisiopatologia , Saliva/química , Caracteres Sexuais , Disfunções Sexuais Fisiológicas/fisiopatologia
6.
Rev. int. androl. (Internet) ; 17(1): 24-30, ene.-mar. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182211

RESUMO

Objetivo: El nivel de acuerdo entre medidas subjetivas y objetivas de la excitación sexual se denomina concordancia sexual. El sexo es uno de los principales moderadores y existe más correspondencia en los hombres que en las mujeres. El objetivo de este estudio es examinar la validez predictiva de las escalas Valoración de Excitación Sexual (VES) y Valoración de las Sensaciones Genitales (VSG), relacionando sus puntuaciones con la respuesta genital ante estímulos sexuales visuales, en hombres y en mujeres. Material y método: Se empleó una muestra formada por 159 jóvenes heterosexuales (69 hombres y 90 mujeres) que completaron, en primer lugar, un cuestionario sociodemográfico y de la historia sexual, las escalas Sexual Inhibition/Sexual Excitation Scales-Short Form y el SOS-6. En segundo lugar, en el laboratorio de sexualidad, eran expuestos a un vídeo neutro y otro de contenido sexual explícito, mientras se les evaluaba la excitación sexual subjetiva con las escalas VES y VSG, y se les registraba la respuesta genital a través de pletismografía (hombres) y fotopletismografía (mujeres). Resultados: Se obtuvieron correlaciones significativas entre la excitación sexual subjetiva y objetiva únicamente en los hombres: la escala VSG mostró capacidad para predecir la respuesta de erección ante estímulos sexuales visuales. Conclusiones: Se avala la teoría de las diferencias entre hombres y mujeres en concordancia sexual. Al encontrarse evidencias modestas solo en hombres sobre la validez predictiva de las escalas de evaluación de la excitación sexual subjetiva, se plantea la necesidad de realizar evaluación subjetiva y objetiva de la excitación sexual en el ámbito clínico y en investigación


Objective: The level of agreement between subjective and objective measures of sexual arousal is referred as sexual concordance. Sex is one of the principal moderators and there is a higher level of correspondence in men than in women. The aim of this study is to evaluate the predictive validity of the scales Ratings of Sexual Arousal (RSA) and Ratings of Genital Sensations (RGS), relating their scores with the genital response to visual sexual stimuli in men and women. Material and method: A sample of 159 young heterosexuals was used (69 men and 90 women) which completed, firstly, a sociodemographic and sexual story questionnaire, the Sexual Inhibition/Sexual Excitation Scales Short-Form and the SOS-6. At the laboratory, they were exposed to a neutral film and to an explicit sexual content film. The subjective sexual arousal was evaluated with the RSA and RGS scales and the genital response was registered through a plethysmography (men) and a photo-plethysmography (women). Results: Significant correlations were obtained between subjective and objective sexual arousal only in men. The RGS scale has the capacity to predict the erection response toward sexual stimuli. Conclusions: The theory of differences in sexual concordance between men and women was endorsed. Modest evidence about the predictive validity of the subjective sexual arousal evaluation scale was found only in men. It arises the need for subjective and objective assessment of sexual arousal, in clinical settings and research area


Assuntos
Humanos , Masculino , Feminino , Comportamento Sexual/estatística & dados numéricos , Coito/fisiologia , Libido/fisiologia , Sensação/fisiologia , Distribuição por Sexo , Reprodutibilidade dos Testes , Psicometria/instrumentação
7.
Arch Gynecol Obstet ; 299(4): 1173-1183, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30706181

RESUMO

PURPOSE: To assess the impact of serum androgen levels and androgen receptor CAG polymorphism on sexual function in 45 healthy midlife women living in a heterosexual relationship. METHODS: Cross-sectional study [Cantonal Ethics Committee Bern (Ref.-Nr. KEK-BE: 087/13)]. MAIN OUTCOME MEASURES: Association between androgen serum levels, androgen receptor CAG polymorphism and sexual function was assessed by the FSFI-d questionnaire. RESULTS: In our cohort of healthy, midlife, well-educated, middle-class, mostly postmenopausal women living in a heterosexual satisfying partnership, sexual function was perceived to remain stable or to decline during menopausal transition with sexual desire scoring lowest (FSFI-d 3.3 ± 0.9). Androgen serum levels did not correlate with sexual function. Mean CAG repeat number was 21.6 ± 1.9. There was a highly inverse though non-significant correlation between female sexual function and AR CAG repeat polymorphism with specifically higher numbers of CAG repeats being significantly positively correlated to more frequent or more severe pain during or after sexual intercourse. CONCLUSION: The AR polymorphism is a non-negligible factor in female sexual function. Future studies on female sexual (dys)function should incorporate its assessment.


Assuntos
Polimorfismo Genético , Receptores Androgênicos/genética , Comportamento Sexual/fisiologia , Repetições de Trinucleotídeos , Estudos Transversais , Feminino , Humanos , Libido/fisiologia , Masculino , Pessoa de Meia-Idade , Testosterona/sangue
8.
J Sex Med ; 16(2): 195-202, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30770068

RESUMO

INTRODUCTION: Vision of the human body has been shown to be key in eliciting sexual desire. However, whether the visual pattern characterizing sexual desire is different in women and men is still unclear. AIM: To investigate the effect of gender on visual patterns triggered by an identical set of stimuli depicting attractive heterosexual couples. METHODS: Heterosexual women and men (n = 106) were tested on a picture-viewing task associated with eye tracking. The context of sexual desire was activated by asking the participant whether they perceived such desire while looking at sensual pictures of heterosexual couples. Data were analyzed using mixed-subject design analyses of variance. MAIN OUTCOME MEASURE: Fixation durations were used to investigate visual patterns. 2 areas of interest were created to investigate visual patterns (face vs body area). RESULTS: Results showed longer fixations on body rather than face areas irrespective of participant gender. Moreover, all participants looked longer at women's than men's bodies and at the faces of the opposite sex. CLINICAL IMPLICATIONS: These findings shed light on the automatic processes underlying sexual desire, which has the potential to improve the care of patients suffering from sexual disorders by optimizing interventions. STRENGTHS & LIMITATIONS: The strengths of this study are the use of an eye-tracking paradigm, the dissociation between 2 fixation areas (ie, face and body), and the use of an identical set of stimuli allowing an accurate between-gender comparison of the visual pattern. The limitations are the small sample size, the use of healthy heterosexual individuals, and the absence of measures of sexual arousal and genital response. CONCLUSIONS: These findings confirm the association between the human body and sexual desire. They also reveal the unique attentional attractiveness of woman's bodies across genders. Bolmont M, Bianchi-Demicheli F, Boisgontier MP, et al. The Woman's Body (Not the Man's One) Is Used to Evaluate Sexual Desire: An Eye-Tracking Study of Automatic Visual Attention. J Sex Med 2019;16:195-202.


Assuntos
Identidade de Gênero , Heterossexualidade/fisiologia , Corpo Humano , Libido/fisiologia , Comportamento Sexual/fisiologia , Adulto , Emoções/fisiologia , Feminino , Humanos , Masculino , Homens
9.
Arch Sex Behav ; 48(3): 795-801, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30756211

RESUMO

Sexual desire contributes to overall sexual and relational health among long-term romantic partnerships. However, little research has examined the nuances of partner-level sexual desire and behavior on a daily level, despite evidence that it ebbs and flows and is more of a state than a static characteristic. Additionally, daily sexual behavior and desire may impact women differently than men. Therefore, understanding individual and partner-level dynamics among men and women may provide a more nuanced understanding of sexual desire as a situational state in the context of long term couples. A sample of 87 mixed-sex couples (174 individuals; M age = 33 years) in long-term relationships (M = 9.33 years) completed a daily electronic report for 30 days and reported on their daily sexual desire and sexual behavior. A series of four stability influence actor partner interdependence models were conducted to investigate the individual and partner-level link between men and women's daily levels of sexual desire and their sexual behavior and desire the following day. Findings indicated that daily sexual desire fuels sexual desire on the following day, particularly for men, regardless of whether sexual behavior was engaged in. Additionally, sexual desire on one day impacts next-day desire for partners, particularly on days when sexual behavior occurred. Contextual, partner-level contributing factors seem to have the largest impact on daily levels of sexual desire among long-term couples. Implications and future research directions are discussed.


Assuntos
Libido/fisiologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Adulto , Feminino , Humanos , Masculino
10.
J Sex Med ; 16(1): 96-110, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30621928

RESUMO

BACKGROUND: Colorectal cancer (CRC) is accompanied by specific treatment-related physical (ostomy, incontinence) and psychosexual (body image, depression) consequences on sexual health. AIM: To assess sexual health of patients with CRC 2 years after diagnosis. METHODS: We selected all patients with CRC from a French nationwide longitudinal study. Data sources included patient questionnaires, medical questionnaires, and medico-administrative databases. MAIN OUTCOME MEASURE: We evaluated sexual health using the Relationship and Sexuality Scale and assessed self-reported rates of discussion about sexuality with health care providers. RESULTS: Across the 487 patients, 258 were men and 229 were women; 77% were diagnosed with colon cancer and 23% with rectal cancer. Overall, 54% of patients reported a decrease in sexual desire, 61% a decrease in frequency of intercourse, and 48% a decrease in the possibility to reach an orgasm. Patients still experiencing fecal incontinence 2 years after diagnosis had decreases in all sexual desire, intercourse, orgasm, and satisfaction Relationship and Sexuality Scale items. Patients with rectal cancer had significantly more frequent troubles with desire and orgasm than did patients with colon cancer (P = .003 and P = .014, respectively). Regarding the discussion about sexuality, only 20% of men, 11% of women, 11% of patients with colon cancer, and 33% of patients with rectal cancer recalled having discussed sexuality with the medical team. Factors independently increasing the chance to have discussed sexuality with the medical team were younger age (odds ratio [OR] = 2.77 [1.31; 5.84]; P = .007), having an ostomy (OR = 2.93 [1.27; 6.73]; P = .011), and radiotherapy (OR = 2.78 [1.23; 6.27]; P = .014). CLINICAL IMPLICATIONS: These results highlight the need for developing interventions to improve information delivery at cancer announcement and for managing sexual troubles during survivorship in patients with CRC, particularly those experiencing fecal incontinence. STRENGTH & LIMITATIONS: Strengths are the sample size and the national representation using the data of a large-scale nation-wide survey, with the possibility of comparing colon and rectal cancers. Limitations are the assessment of sexuality 2 years after diagnosis and using only self-reported measures. CONCLUSION: This study highlights the lack of discussion about sexuality with the oncology team and the need for specific sexual rehabilitation interventions, especially for patients with rectal cancer and fecal incontinence. Developing these aspects may help patients with CRC improve their sexual prognosis. Almont T, Bouhnik A-D, Charif AB, et al. Sexual Health Problems and Discussion in Colorectal Cancer Patients Two Years After Diagnosis: A National Cross-Sectional Study. J Sex Med 2019;16:96-110.


Assuntos
Neoplasias do Colo/complicações , Neoplasias Retais/complicações , Comportamento Sexual , Saúde Sexual/estatística & dados numéricos , Adulto , Idoso , Imagem Corporal , Coito/fisiologia , Estudos Transversais , Incontinência Fecal/epidemiologia , Feminino , Humanos , Libido/fisiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Orgasmo/fisiologia , Sexualidade/fisiologia , Inquéritos e Questionários
11.
Endocrine ; 63(2): 332-340, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30269265

RESUMO

PURPOSE: Macroprolactinemia is characterized by predominance of macroprolactin molecules in circulation and generally has extra-pituitary origin. Macroprolactin is viewed as biologically inactive, therefore asymptomatic, and thus may not require any treatment or prolonged follow-up. In addition, data on prevalence of macroprolactinemia and its clinical manifestation are also rare. Therefore, the present study was aimed to find out prevalence of macroprolactinemia and its association, if any, with reproductive manifestations. MATERIAL AND METHODS: Macroprolactin was measured in 102 hyperprolactinemia cases (>100 ng/ml prolactin level), 135 physiological hyperprolactinemia cases (50 pregnant and 85 lactating females; >100 ng/ml prolactin level) and 24 controls. Poly ethylene glycol (PEG) precipitation method was carried out to screen macroprolactin. Prolactin recovery of <25% was considered overt macroprolactinemia. Detailed clinical data was recorded which included complete medical history, physical examination and hormone measurements besides CT/MRI for pituitary abnormalities. RESULTS: Prevalence of macroprolactinemia was 21.57% (22/102) in hyperprolactinemia (prolactin >100 ng/ml). There was no case of macroprolactinemia in physiological hyperprolactinemia, or healthy control females. Reproductive manifestations were present in 72.73% (16/22) macroprolactinemia cases, out of which macroprolactinemia was the sole cause of associated reproductive manifestations in 68.7% (11/16) cases. Reversal of reproductive dysfunction/s was observed in five cases with appropriate treatment for high macroprolactin. CONCLUSION: Macroprolactinemia prevalence was found to be 21.5%, out of which 72.73% cases had associated reproductive dysfunctions.


Assuntos
Hiperprolactinemia/epidemiologia , Hiperprolactinemia/fisiopatologia , Infertilidade/epidemiologia , Distúrbios Menstruais/epidemiologia , Reprodução/fisiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Aborto Espontâneo/sangue , Aborto Espontâneo/epidemiologia , Aborto Espontâneo/etiologia , Adulto , Estudos de Casos e Controles , Disfunção Erétil/sangue , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Feminino , Humanos , Hiperprolactinemia/sangue , Hiperprolactinemia/etiologia , Infertilidade/sangue , Infertilidade/etiologia , Libido/fisiologia , Masculino , Distúrbios Menstruais/sangue , Distúrbios Menstruais/etiologia , Pessoa de Meia-Idade , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/epidemiologia , Gravidez , Prevalência , Prolactina/sangue , Prolactinoma/complicações , Prolactinoma/epidemiologia , Fatores de Risco , Disfunções Sexuais Fisiológicas/sangue , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/sangue , Disfunções Sexuais Psicogênicas/etiologia , Adulto Jovem
12.
Sex Med Rev ; 7(1): 57-70, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30057137

RESUMO

BACKGROUND: Individually, thyroid disease and sexual dysfunction are common conditions that can have a detrimental effect on quality of life. Recent reports have documented an increased prevalence of sexual dysfunction among patients with thyroid disorders. As such, it is important for sexual medicine physicians to be primed on the presentation of patients with overlying sexual and thyroid dysfunction to allow for proper management. AIM: To review the available literature exploring the relationship between thyroid disease and sexual dysfunction in men and women. METHODS: A PubMed review of existing clinical and pre-clinical studies from 1978 through 2018 was performed. MAIN OUTCOME MEASURES: The prevalence, symptomatology, pathophysiology, diagnosis and management of patients with sexual dysfunction in the setting of thyroid disease were reviewed. RESULTS: The prevalence of sexual dysfunction in patients with hypothyroid (59-63% and 22-46% in men and women, respectively) and hyperthyroidism (48-77% and 44-60% in men and women, respectively) has been estimated in select populations. Both hypothyroidism and hyperthyroidism were strongly associated with erectile and ejaculatory dysfunction: hypothyroidism with delayed ejaculation, hyperthyroidism with pre-mature ejaculation. Hypothyroidism and hyperthyroidism have been reported to impair libido in men and women; however, evidence of hypothyroidism's impact on male libido is mixed. Hypothyroid and hyperthyroid women demonstrated impairments in desire, arousal/lubrication, orgasm, satisfaction, and pain during intercourse. Mechanistically, hypothyroidism and hyperthyroidism exert effects on circulating sex hormone levels through peripheral and central pathways and can indirectly provoke psychiatric and autonomic dysregulation that can impair sexual function. Correction to euthyroid state was associated with dramatic resolution of sexual dysfunction in both male and female patients with hypothyroidism or hyperthyroidism. CONCLUSION: By improving awareness of the link between thyroid disease and sexual dysfunction, sexual medicine physicians may sooner identify patients whose sexual symptoms may be remedied by treating an underlying thyroid disorder. Gabrielson AT, Sartor RA, Hellstrom WJG. The Impact of Thyroid Disease on Sexual Dysfunction in Men and Women. Sex Med Rev 2019;7:57-70.


Assuntos
Libido/fisiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Saúde Sexual , Doenças da Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/metabolismo , Feminino , Humanos , Masculino , Prevalência , Qualidade de Vida , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Disfunções Sexuais Fisiológicas/terapia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/psicologia , Doenças da Glândula Tireoide/terapia , Testes de Função Tireóidea
13.
Sex Med Rev ; 7(1): 29-45, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30057138

RESUMO

BACKGROUND: There is limited evidence that current sexuality measures accurately reflect the experience of sexuality among older people. AIM: This review investigates whether sexuality scales that examine aspects of sexuality for heterosexual men and women in mid-life and beyond accurately reflect the experiences of these individuals as discussed within qualitative studies. METHODS: Online databases and reference lists were searched for articles from 1997 that investigated experiences of sexuality, aging, and validated sexuality scales. Articles describing scales were included if they reported on a statistically validated measurement scale that was used to measure 1 or more aspects of sexuality for heterosexual adults aged 45 years and above. Qualitative articles were included if they discussed the sexuality experiences of this population. OUTCOMES: 19 Qualitative articles and 11 sexuality scales were located. RESULTS: Aspects of sexuality identified in the qualitative studies were sexual thoughts and fantasies, sexual desire, sexual beliefs, sexual attitudes, sexual values, sexual behaviors and practices, sexual roles, and thoughts and/or feelings about intimacy and relationships. Aspects assessed in the sexuality scales were sexual desire, sexual beliefs, sexual attitudes, sexual behaviors and practices, sexual roles, and thoughts and/or feelings about intimacy and relationships. Gaps between how sexuality at mid-life and later life is experienced and how it is measured in existing scales were found. Existing validated measurement tools fail to provide a nuanced picture of the sexual experiences of adults in mid-life and beyond, which may impact the success of clinical interventions. This article demonstrated the need for more comprehensive sexuality measurement scales. However, it focused exclusively on the experiences of heterosexual adults aged 45 years and above. CONCLUSION: To validly evaluate the sexual expression of older people, new measurement scales are needed that assess multiple aspects of sexuality within a single scale. Macleod A, McCabe MP. How Well Do Measurement Scales Reflect the Actual Experience of Sexuality in Mid-Life and Beyond? Sex Med Rev 2019;7:29-45.


Assuntos
Envelhecimento/psicologia , Libido/fisiologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/epidemiologia , Parceiros Sexuais/psicologia , Idoso , Envelhecimento/fisiologia , Atitude , Interpretação Estatística de Dados , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Comportamento Sexual/fisiologia
14.
Med Sci Sports Exerc ; 51(2): 234-236, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30212398

RESUMO

OBJECTIVE: Exercise hypogonadal male condition is a well-recognized condition in women but much less understood in men. The aim of this case report is to highlight exercise-induced hypogonadotropic hypogonadism in a male who recovered with lifestyle modifications. METHODS: We report a case of an adolescent male who developed hypogonadotropic hypogonadism secondary to excessive exercise and malnutrition that was followed up for a year without exogenous testosterone supplementation. Informed consent was obtained from the patient for his information to be used in a manuscript submitted to a journal. RESULTS: An 18-yr-old adolescent male presented to the clinic with symptoms of fatigue and low endurance, low libido, and lack of morning erections. At the time of his presentation, he was running about 60 miles per week for school cross-country team in addition to cross training with kickboxing. Physical examination was remarkable for low body mass index of 19 kg·m but was otherwise normal. Biochemical workup confirmed hypogonadotropic hypogonadism and a mild pancytopenia. Other pituitary laboratory values and MRI of the brain were unremarkable. Bone marrow biopsy performed for anemia showed features consistent with malnutrition. With a working diagnosis of exercise hypogonadal male condition, he was advised to reduce the frequency and intensity of his exercise and increase calorie intake. Cell counts and testosterone levels normalized, and his symptoms resolved without any further interventions. CONCLUSION: Significant reversible hypogonadism can develop after intensive and prolonged exercise. One of the mechanisms of hypogonadism in endurance athletes performing intensive exercise could be relative malnutrition. Further studies to evaluate the role of nutrition and body mass index in male endurance athletes presenting with hypogonadism are needed to identify the underlying mechanism of this condition.


Assuntos
Hipogonadismo/etiologia , Desnutrição/complicações , Condicionamento Físico Humano/efeitos adversos , Resistência Física/fisiologia , Adolescente , Índice de Massa Corporal , Fadiga/etiologia , Humanos , Hipogonadismo/sangue , Hipogonadismo/terapia , Libido/fisiologia , Estilo de Vida , Masculino , Pancitopenia/etiologia , Corrida/fisiologia , Testosterona/sangue , Fatores de Tempo
15.
Behav Res Ther ; 115: 90-102, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30466714

RESUMO

Low resting heart rate variability (HRV) has been associated with poor sexual arousal function in women. In a recent study, a single session of autogenic training increased HRV and facilitated improvements in both sexual arousal and perceived genital sensations among women experiencing decreased arousal. The current study expands upon these findings by examining the efficacy of HRV biofeedback, with and without autogenic training, as a treatment for sexual arousal dysfunction in an at-home setting. Participants (N = 78) were randomized into one of three conditions: HRV biofeedback, HRV biofeedback + autogenic training, or waitlist control. Each condition included three laboratory sessions; participants in the two active conditions completed 4-6 biofeedback sessions at home, and participants in the HRVB + A condition listened to a 14-min autogenic training recording before completing the biofeedback. Across the three laboratory visits, participants in the three conditions singficnatly differed in their genital arousal, subjective sexual arousal, and their perceived genital sensations. Compared to women in the control group, women who engaged in HRV biofeedback at home, with and without additional autogenic training, experienced increases in genital arousal, subjective sexual arousal, and perceived genital sensations. These results provide preliminary support for the contribution of heart rate variability level to female sexual arousal function and for the use of either of these interventions in the treatment of sexual arousal concerns.


Assuntos
Biorretroalimentação Psicológica/métodos , Frequência Cardíaca/fisiologia , Libido/fisiologia , Disfunções Sexuais Psicogênicas/terapia , Adolescente , Adulto , Feminino , Humanos , Disfunções Sexuais Psicogênicas/fisiopatologia , Resultado do Tratamento , Adulto Jovem
16.
J Sex Res ; 56(1): 85-101, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29028456

RESUMO

Visual attention patterns measured with eye-tracking techniques provide indirect clues about sexual response. This study aimed to test the category specificity of sexual responses to stimuli varying in gender and age by evaluating both early and late attention of gynephilic and androphilic men and women. We simultaneously presented sexually preferred and nonpreferred stimuli and measured time to first fixation and total duration of fixation on four areas of interest: entire body, then face, chest, and pelvis. Androphilic women's early attention patterns were nonspecific, whereas gynephilic women and both groups of men showed a category-specific pattern for the entire body. In contrast, all groups showed gender-specific patterns of late attention for all areas of interest. We also found support for age specificity of early and late visual attention in all four groups, with greater attention to adult than child stimuli. This study supports the usefulness of a competing stimulus eye-tracking paradigm as a method to examine gender specificity in gynephilic women and androphilic and gynephilic men, and as a measure of age specificity in gynephilic and androphilic men and women.


Assuntos
Nível de Alerta/fisiologia , Libido/fisiologia , Caracteres Sexuais , Comportamento Sexual/fisiologia , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Fatores Sexuais , Adulto Jovem
17.
Int J Impot Res ; 31(4): 282-287, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30446698

RESUMO

The aim of this study was to provide validity evidence of the Model of the Subjective Orgasm Experience (MSOE) associating its components with different types of sexual excitation. A total of 96 participants (48 men and 48 women) performed an experimental laboratory task, in which neutral and erotic content films were presented while the genital response was registered. After exposure to sexual stimulus presentation, participants reported their subjective sexual arousal. In addition, four dimensions (affective, sensory, intimacy, and rewards) of the subjective orgasm experience and the individual propensity for sexual excitation were assessed. Results showed that, in men, the affective, sensory, and rewards dimensions of the orgasm experience significantly correlated with the propensity for becoming sexually excited, and the intimacy dimension correlated with the genital response. In women, the sensory dimension of the orgasm experience positively correlated with the subjective sexual arousal. Types of sexual excitation which previously correlated with the orgasm experience were able to predict its four dimensions. The validation of the MSOE provides a more delimited explanation of the psychological experience of orgasm applicable to both sexes. It is an adequate model for both clinical and research purposes.


Assuntos
Orgasmo , Comportamento Sexual/psicologia , Adolescente , Adulto , Afeto , Literatura Erótica , Feminino , Genitália/anatomia & histologia , Humanos , Libido/fisiologia , Masculino , Modelos Psicológicos , Estimulação Luminosa , Recompensa , Sensação , Inquéritos e Questionários , Adulto Jovem
18.
Arch Med Res ; 50(8): 567-576, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-32062429

RESUMO

BACKGROUND: Women's experiences of female sexual difficulties are shaped by cultural expectations. AIM OF THE STUDY: To investigate the cultural validity and clinical utility of the classification of female sexual dysfunctions (FSD) in the International Classification of Diseases - 11th Revision (ICD-11) among Indian Women. METHODS: A purposive sample of 22 married women with probable sexual problems underwent cognitive interviews that were conducted using a semi-structured guide. The interviews were transcribed and analyzed qualitatively to help establish the content and cultural validity of the ICD-11 classification of FSD. RESULTS: Most participants had limited knowledge of the sexual act, felt unskilled in sex, and were led by their husbands in sexual matters. Many participants reported problems related to sexual dysfunction and sexual pain-penetration. Many participants with sexual pain-penetration issues and some with low sexual desire considered these symptoms to be problematic; however, this was rarely the case with the absence or lack of sexual arousal and orgasm. The application of the 'independent focus of clinical attention' requirement for diagnosis reduced cases by half for Hypoactive Sexual Desire Disorder (HSDD) and almost eliminated all cases of Female Sexual Arousal Dysfunction (FSAD) and Anorgasmia. Hence, this requirement was moved from essential (required) features to 'additional features' of the final ICD-11 sexual dysfunction guidelines. CONCLUSION: Advancement toward a more precise nomenclature and classification system of FSD will facilitate better diagnosis which will ultimately lead to improved care for women with sexual dysfunction.


Assuntos
Classificação Internacional de Doenças , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Adulto , Idoso , Nível de Alerta/fisiologia , Grupo com Ancestrais do Continente Asiático , Cognição , Feminino , Humanos , Índia , Libido/fisiologia , Pessoa de Meia-Idade , Orgasmo/fisiologia , Saúde da Mulher
19.
J Sex Med ; 15(11): 1537-1546, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30415810

RESUMO

INTRODUCTION: The effect of testosterone depends on the exposure of and the sensitivity of the androgen receptor (AR). It has been shown that a cytosine-adenine-guanine (CAG) trinucleotide repeat polymorphism in the AR gene has an impact on AR functional capacity in men. However, large studies are lacking on the impact of this polymorphism on female sexual function. AIM: To determine whether the CAG repeat length was associated with different aspects of women's sexual function and dysfunction, including desire, arousal, lubrication, orgasm, satisfaction, sexual pain, and sexually related personal distress. METHODS: This cross-sectional study included 529 healthy women, aged 19-65 years. Participants completed a questionnaire to provide demographic and sexual data. The CAG repeat length was analyzed in a blood sample. The correlations between CAG repeat lengths and different aspects of sexual function were calculated. Independent Student t-tests were performed to evaluate differences in the mean number of CAG repeats in the short and long allele and of the biallelic mean length determined by simple calculation and X-inactivation analysis, respectively, between women with sexual problems and women without sexual problems. P values <.05 were considered statistically significant. MAIN OUTCOME MEASURE: We used the Female Sexual Function Index, with 6 subdomains, to distinguish between women without and women with impaired sexual function; low sexual desire; impaired arousal, lubrication, or orgasm; diminished satisfaction; or pain during sex. The Female Sexual Distress Scale was used to measure sexually related personal distress. RESULTS: Overall, we found that increasing numbers of CAG repeats were correlated to increased sexual function. We found that women with problems achieving orgasm had a significantly lower number of CAG repeats than women that reported no problems reaching orgasm. We found no associations between CAG repeat lengths and other aspects of female sexual dysfunction, including hypoactive sexual desire disorder. CLINICAL IMPLICATIONS: The results could indicate an impact of the AR on women's sexual function, including the ability to reach orgasm. STRENGTH & LIMITATIONS: This is a large study using validated sexual questionnaires. A limitation is the cross-sectional design. Owing to the study design, this study is explorative and hypothesis generating. CONCLUSION: In this large cross-sectional study, we demonstrated that CAG repeat length is positively correlated to sexual function and that women with a reduced ability to reach orgasm had smaller numbers of CAG repeats in the AR gene than women with no orgasmic problems. These findings indicated that androgens and ARs might play a role in women's sexual function. Wåhlin-Jacobsen S, Flanagan JN, Pedersen AT, Kristensen E, Arver S, Giraldi A. Androgen Receptor Polymorphism and Female Sexual Function and Desire. J Sex Med 2018;15:1537-1546.


Assuntos
Receptores Androgênicos/genética , Disfunções Sexuais Psicogênicas/genética , Adulto , Idoso , Estudos Transversais , Dinamarca , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Libido/fisiologia , Pessoa de Meia-Idade , Polimorfismo Genético , Receptores Androgênicos/sangue , Disfunções Sexuais Psicogênicas/sangue , Inquéritos e Questionários , Repetições de Trinucleotídeos , Saúde da Mulher , Adulto Jovem
20.
Sci Rep ; 8(1): 15815, 2018 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-30361518

RESUMO

Problems related to low sexual desire in women are common clinical complaints, and the aetiology is poorly understood. We investigated predictors of change in levels of sexual desire using a novel network approach, which assumes that mental disorders arise from direct interactions between symptoms. Using population-based data from 1,449 Finnish women, we compared between-subject networks of women whose sexual desire decreased, increased, or remained stable over time. Networks were estimated and analyzed at T1 (2006) and replicated at T2 (2013) using R. Domains included were, among others, sexual functions, sexual distress, anxiety, depression, body dissatisfaction, and relationship status. Overall, networks were fairly similar across groups. Sexual arousal, satisfaction, and relationship status were the most central variables, implying that they might play prominent roles in female sexual function; sexual distress mediated between general distress and sexual function; and sexual desire and arousal showed different patterns of relationships, suggesting that they represent unique sexual function aspects. Potential group-differences suggested that sex-related pain and body dissatisfaction might play roles in precipitating decreases of sexual desire. The general network structure and similarities between groups replicated well; however, the potential group-differences did not replicate. Our study sets the stage for future clinical and longitudinal network modelling of female sexual function.


Assuntos
Libido/fisiologia , Comportamento Sexual/fisiologia , Adolescente , Adulto , Feminino , Humanos , Modelos Teóricos , Reprodutibilidade dos Testes , Adulto Jovem
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