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1.
Artigo em Alemão | MEDLINE | ID: mdl-34661689

RESUMO

BACKGROUND: In the last decade, the negative effects of sexual violence on health have again become a focus of health policies worldwide. So far, representative population data on lifetime prevalence for different age groups and specific links to health-related factors for Germany are lacking. OBJECTIVES: The study aimed to assess 1) the lifetime prevalence of self-reported nonconsensual sexual intercourse and sexual touch in childhood and across the lifespan and 2) associations with health-related factors. MATERIALS AND METHODS: Using a two-step stratified, randomized sample of residents' registration offices, 4955 persons aged 18 to 75 years were interviewed within the scope of the nationwide scientific survey on health and sexuality in Germany (GeSiD). The associations between experiences of sexual violence and socio-demographic and health-related factors were age-adjusted and stratified for gender using logistic regression. RESULTS: For women, the lifetime prevalence of (attempted/completed) nonconsensual intercourse was 14.9% and in the form of (attempted/completed) nonconsensual sexual touching was 40.8%; for men the prevalences were 3.1% and 13.2%, respectively. Regarding forced experiences in childhood, the prevalence of sex was 2.1% and of sexual touching was 7.5%. For both genders, the prevalence of nonconsensual intercourse was significantly higher in the case of low quality of life, poor health condition, a chronic illness or disability, or treatment for depression or for another mental disorder. CONCLUSIONS: The results illustrate the strong links between sexual violence and mental and somatic health. This points to the urgency to routinely explore experiences of sexual aggression.


Assuntos
Qualidade de Vida , Tato , Coito , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Sexualidade
2.
Artigo em Inglês | MEDLINE | ID: mdl-34682377

RESUMO

Several studies have identified explicative factors for adolescents' sexual risk behaviors and related outcomes such as unintended pregnancy; however, less is known about the mechanisms through which such factors act. Our study explored the role of female education and partner age difference as explicative mechanisms of the association between age at first sexual intercourse (AFSI) and unintended pregnancy while controlling for the role of other contextual factors (i.e., socioeconomic status, ethnicity, religious beliefs, and place of residence) and sexual-related mechanisms (i.e., number of sexual partners) that are known to be associated with adolescent pregnancy. The sample consisted of 613 sexually experienced female adolescents who did not intend to become pregnant: 349 were pregnant for the first time, and 264 had never been pregnant. Mediation and moderation analyses were performed. An earlier AFSI was associated with unintended pregnancy 1-6 years after first sexual intercourse by increasing the adolescents' likelihood of having less education and being involved with partners older than themselves. There was no significant direct effect of AFSI on pregnancy occurrence after controlling for the mediators. Our findings bring to light nonsexual mechanisms that must be considered in public health interventions aimed at preventing unintended pregnancies among adolescents who engaged in sexual intercourse at early ages. Specific implications are discussed.


Assuntos
Gravidez na Adolescência , Gravidez não Planejada , Adolescente , Coito , Feminino , Humanos , Gravidez , Gravidez na Adolescência/prevenção & controle , Assunção de Riscos , Comportamento Sexual
3.
Eur J Obstet Gynecol Reprod Biol ; 265: 90-95, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34474227

RESUMO

OBJECTIVES: Women with a previous trachelectomy have an increased risk of premature delivery and second trimester miscarriage. In this study we aim to evaluate factors and regimes possibly affecting the risk for prematurity following fertility sparing robotic radical trachelectomy (RRT) in cervical cancer. METHODS: A retrospective study of the reproductive outcome following RRT with a cervical cerclage performed at one of four academic centers between 2007 and 2019. Factors possibly related to premature delivery, such as postoperative non-pregnant cervical length, previous vaginal deliveries, preservation of the uterine arteries, and the use of a second trimester oral metronidazole/no sexual intercourse regime, were assessed. RESULTS: 109 women remained for analyses after excluding recurrences before pregnancy (n = 8), secondary hysterectomy (n = 2), and women with less than six months follow up (n = 10). 74 pregnancies occurred in 52/71 women attempting to conceive, 56 of which developed past the first trimester. Two of 22 women (9%) who were prescribed an oral metronidazole regime (400 mg × 2 from gestational week 15 + 0 to 21 + 6 and abstaining from sexual intercourse for the duration of the pregnancy) had a premature delivery, compared with 13/31 (42%) where the regime was not applied (p = 0.009). The association remained after regression analyses including possible contributing factors as of above, none of which associated with prematurity at regression analyses (p = 0.001). CONCLUSIONS: The observed four-fold reduction in premature delivery indicates that an oral metronidazole/no sexual intercourse regime may reduce second trimester miscarriage and premature deliveries following an RRT. No association was observed for other investigated factors.


Assuntos
Aborto Espontâneo , Preservação da Fertilidade , Traquelectomia , Neoplasias do Colo do Útero , Coito , Feminino , Humanos , Metronidazol/uso terapêutico , Recidiva Local de Neoplasia , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Retrospectivos , Neoplasias do Colo do Útero/cirurgia
4.
BMJ Case Rep ; 14(9)2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479899

RESUMO

Primary pneumomediastinum is the presence of air in the interstitium of the mediastinum. The exact aetiology is unclear; nevertheless, it has been reported more frequently in patients with asthma and in individuals who use recreational drugs. It is commonly preceded by a sharp rise in intrathoracic pressure as in a Valsalva-like manoeuvre. We describe a rare case of severe pneumomediastinum with a small pneumothorax related to cannabis smoking and aggravated by vigorous sexual intercourse. The patient was successfully treated conservatively due to clinical and radiological stability and the absence of secondary cause.


Assuntos
Cannabis , Enfisema Mediastínico , Pneumotórax , Coito , Humanos , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/etiologia , Fumantes
5.
Artigo em Inglês | MEDLINE | ID: mdl-34574671

RESUMO

OBJECTIVE: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. DATA SOURCES: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). METHODS OF STUDY SELECTION: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. TABULATION, INTEGRATION AND RESULTS: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. CONCLUSIONS: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic-therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome.


Assuntos
Laparoscopia , Doenças Vaginais , Coito , Feminino , Humanos , Ruptura/cirurgia , Doenças Vaginais/cirurgia
6.
BMC Womens Health ; 21(1): 307, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412604

RESUMO

BACKGROUND: Studies have examined the impact of contextual factors on the use of contraceptives among adolescents and found that many measures of income and social inequality are associated with contraceptive use. However, few have focused on maternal and primary health indicators and its influence on adolescent contraceptive use. This paper assesses whether maternal mortality rates, antenatal care visits, and primary healthcare coverage are associated with pill and condom use among female adolescents in Brazil. METHODS: We used data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national, school-based cross-sectional study conducted in Brazil. A subsample of all female adolescents who had ever had sexual intercourse and were living in one of the 26 State capitals and the Federal District was selected (n = 7415). Multilevel mixed effects logistic regression models were estimated to examine the effect of contextual variables on pill and condom use. RESULTS: Sixty-five percent of female adolescents reported using pill while 21.9% reported using condom during the last sexual intercourse. Adolescents living in municipalities with low maternal mortality and high antenatal care coverage were significantly more likely to use pill during the last sexual intercourse compared to those from municipalities with high maternal mortality and low antenatal care coverage. Primary healthcare coverage (proportion of the population covered by primary healthcare teams) was not significantly associated with either condom or pill use during the last sexual intercourse. CONCLUSION: Our findings suggest that promoting the use of pill among female adolescents may require approaches to strengthen healthcare systems rather than those focused solely on individual attributes.


Assuntos
Comportamento do Adolescente , Preservativos , Adolescente , Brasil , Coito , Estudos Transversais , Feminino , Humanos , Gravidez , Comportamento Sexual
7.
J Sex Med ; 18(10): 1797-1806, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34419416

RESUMO

BACKGROUND: Secondary vaginal stenosis may occur after reconstruction of genital malformations in childhood or after failed vaginal aplasia repair in adults. AIM: This study focusses on the results of the surgical treatment of these patients in our multidisciplinary transitional disorders/differences of sex development team of pediatric surgeons and gynecologists. METHODS: A retrospective analysis was carried out on adult and female identified disorders/differences of sex development patients with vaginal stenoses treated between 2015 and 2018 in a single center with revision vaginoplasty. The underlying type of malformation, the number and surgical techniques of vaginoplasties in infancy, techniques of revision of the stenotic vagina, vaginal length and caliber, possibility of sexual intercourse, and temporary vaginal dilatation. A review of literature with regard to recommended surgical techniques of revision vaginoplasties was accomplished. OUTCOMES: To describe the surgical technique, the main outcome measures of this study are vaginal calipers after revision vaginoplasty as well as ability for sexual intercourse. RESULTS: Thirteen patients presented with vaginal stenosis with a median age of 19 years (range 16-31). All patients had one or more different types of vaginoplasties in their medical history, with a median age at first vaginoplasty of 15 months (0-233). Underlying anatomical conditions were urogenital sinus (n = 8), vaginal agenesis (n = 2), persistent cloacae (n = 2), and cloacal exstrophy (n = 1). The main symptoms were disability of sexual intercourse in 13 patients due to stenotic vaginal tissue. The most frequently performed surgical technique was partial urogenital mobilization with a perineal or lateral flaps (n = 10), followed by bowel vaginoplasty (n = 2), in 1 patient a revision vaginoplasty failed due to special anatomical conditions. In a median follow-up of 11 months, all but one patient presented with physiological vaginal length and width, and normal sexual intercourse in those with a partnership. CLINICAL IMPLICATIONS: Perineal flap with partial urogenital mobilization should be considered as a treatment of choice in severe cases of distal vaginal stenosis and after multiple failed former vaginoplasties, while bowel vaginoplasty should be reserved only for cases of complete cicatrization or high located stenosis of the vagina. STRENGTHS & LIMITATIONS: The strength of this study is the detailed description of several cases while the retrospective character is a limitation. CONCLUSION: In patients after feminizing genital repair, perineal flap with partial urogenital mobilization provides a normal anatomical outcome and allows unproblematic sexual intercourse. Ellerkamp V, Rall KK, Schaefer J, et al. Surgical Therapy After Failed Feminizing Genitoplasty in Young Adults With Disorders of Sex Development: Retrospective Analysis and Review of the Literature. J Sex Med 2021;18:1797-1806.


Assuntos
Coito , Transtornos do Desenvolvimento Sexual , Adolescente , Adulto , Criança , Constrição Patológica , Transtornos do Desenvolvimento Sexual/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Estudos Retrospectivos , Vagina/cirurgia , Adulto Jovem
8.
J Sex Marital Ther ; 47(7): 731-737, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34346289

RESUMO

INTRODUCTION: Given the important role of sexual activity in most people's lives, in response to the question of whether the coronavirus is transmitted through sexual contact, this study was conducted to investigate the association of coronavirus transition with sexual contact. METHODS: Based on the PRISMA checklist, we review published articles on sexual contact with the Corona virus until 15 February 2021. Electronic databases based on search strategy including PubMed, Scopus, Web of Science was searched to identify relevant papers in English language. RESULTS: Retrieved from 4671, 29 titles and abstracts articles screened, eight were excluded. There were 21 articles in the selection criteria. Of the 21 studies whose full text was read, only 5 studies stated that coronavirus was not transmitted through sexual contact, and 16 articles argued that sexual transmission of the virus could not be ignored. Most studies have confirmed the transmission of the virus through semen, but its transmission through vaginal secretions is unknown. CONCLUSION: Transmission of the virus through semen should be taken seriously in patients and the necessary education should be given to men and their sexual partners. Health care providers need to increase their knowledge and awareness to provide the best practices to reduction the risks related to Covid-19 sexual transmission through counseling and appropriate approaches.


Assuntos
COVID-19/prevenção & controle , COVID-19/transmissão , Coito , SARS-CoV-2/isolamento & purificação , Sêmen/virologia , Parceiros Sexuais , Doenças Virais Sexualmente Transmissíveis/prevenção & controle , Doenças Virais Sexualmente Transmissíveis/virologia , COVID-19/virologia , Feminino , Humanos , Masculino , Sexo Seguro , Doenças Virais Sexualmente Transmissíveis/transmissão , Vagina/metabolismo , Vagina/virologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34360215

RESUMO

The objective of this study was to investigate the association between first sexual intercourse and sexual violence victimization, symptoms of depression, and suicidal ideation among sexually active adolescents in the United States. Data for this study came from the U.S. 2017 and 2019 iterations of the National Youth Risk Behavior Survey. An analytic sample of 6252 adolescents aged 14-18 years old (49.5% female) who reported ever having sexual intercourse was analyzed using Poisson regression. The outcome variables investigated in this study were sexual violence victimization, symptoms of depression, suicidal ideation, a suicide plan, and suicide attempts, and the main explanatory variables were age at first sexual intercourse and forced sexual intercourse. We also analyzed differences by gender and race. Of the 6252 adolescents who reported ever having sexual intercourse, 7.1% had their first sexual intercourse before age 13, and 14.8% experienced forced sexual intercourse. About 16% of adolescents experienced sexual violence during the past year, 42.6% reported symptoms of depression, 23.9% experienced suicidal ideation, 19.3% made a suicide plan, and 11.1% attempted suicide during the past year. In the regression analysis, early sexual intercourse was significantly and positively associated with suicidal ideation (relative risk (RR) = 1.15, 95% Confidence Interval (CI) = 1.02-1.30), suicide plan (RR = 1.18, 95% CI = 1.00-1.38), and suicide attempts (RR = 1.36, 95% CI = 1.15-1.61). Controlling for the effects of covariates, history of forced sexual intercourse was positively associated with the five outcomes examined with the relative risk ranging between 1.59 and 6.01. Findings of this study suggest that history of early or forced sexual intercourse is associated with poor mental health outcomes among adolescents and underscores the importance of developing interventions that offer psychological support in reducing the adverse impact of early sexual intercourse and forced sexual intercourse on adolescent health.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Delitos Sexuais , Adolescente , Coito , Depressão/epidemiologia , Feminino , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual , Ideação Suicida , Estados Unidos/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34205495

RESUMO

Vulvodynia is one the most common causes of pain during sexual intercourse in premenopausal women. The burden of vulvodynia in a woman's life can be devastating due to its consequences in the couple's sexuality and intimacy, in activities of daily living, and psychological well-being. In recent decades, there has been considerable progress in the understanding of vulvar pain. The most significant change has been the differentiation of vulvar pain secondary to pathology or disease from vulvodynia. However, although it is currently proposed that vulvodynia should be considered as a primary chronic pain condition and, therefore, without an obvious identifiable cause, it is still believed that different inflammatory, genetic, hormonal, muscular factors, etc. may be involved in its development. Advances in pain neuroscience and the central sensitization paradigm have led to a new approach to vulvodynia from a neurobiological perspective. It is proposed that vulvodynia should be understood as complex pain without relevant nociception. Different clinical identifiers of vulvodynia are presented from a neurobiological and psychosocial perspective. In this case, strategies to modulate altered central pain processing is necessary, changing the patient's erroneous cognitions about their pain, and also reducing fear avoidance-behaviors and the disability of the patient.


Assuntos
Vulvodinia , Atividades Cotidianas , Coito , Feminino , Humanos , Comportamento Sexual , Parceiros Sexuais , Vulvodinia/epidemiologia , Vulvodinia/etiologia
11.
J Paediatr Child Health ; 57(10): 1558-1559, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34165852

RESUMO

This paper is a theoretical discussion that explores medical confidentiality within the context of Brazilian law about underage consent sex. Brazilian law determines that the age of consent for sexual intercourse is 14 years. Before this limit, physicians should report the sexual activity of adolescents, breaking the confidentiality of the consultation. The medical code of ethics prohibits the breach of professional confidentiality of a minor patient, including their parents or legal representatives, unless a lack of disclosure may cause harm to the patient. The legal issue seems to go beyond the ethical issue; however, the breach of confidentiality can cause more risks than benefits by removing these adolescents from health services. The law aims to protect the sexual dignity of teenagers under 14 years old, but the particularities of each case must be considered, and flexibility concerning medical confidentiality should be included.


Assuntos
Coito , Confidencialidade , Adolescente , Brasil , Humanos , Consentimento Livre e Esclarecido , Comportamento Sexual
12.
Andrologia ; 53(8): e14142, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34105178

RESUMO

In the present study, we aimed to evaluate the association between asexual trait, erectile dysfunction (ED) and porn addiction in a community sample of young men. Between August 2019 and October 2019, a total of 559 young male adults were subjected to an online survey sponsored by social networks with the aim of assessing their sexual habits. The following questionnaires were administered: The International Index of Erectile Function (IIEF-5), Masturbation Erection index (MEI), Pornography Craving Questionnaire (PCQ) and Asexuality Identification Scale (AIS). The overall rate of ED according to IIEF-5 was 26.0% (165/478), the rate of ED according to MEI was 16.9% (81/478) and the rate ED in patients with AIS ≥23 indicating asexual trait was 10.0% (48/478). We found that IIEF-5 was positively associated with MEI (b = 0.32; p < .01) and negatively with AIS (b = -0.36; p < .01) and MEI was negatively associated with AIS (b = -0.36; p < .01). We found that MEI (odds ratio [OR]: 0.86; p < .01) and IIEF-5 (OR: 0.89; p < .01) were inversely associated with asexual trait. The presence of asexual trait can hide a greater risk of finding ED both in intercourse or masturbation. These results should be taken into consideration during the general assessment of the patient with sexual problems.


Assuntos
Disfunção Erétil , Ereção Peniana , Adulto , Coito , Humanos , Masculino , Masturbação , Comportamento Sexual , Inquéritos e Questionários
13.
Forensic Sci Int ; 325: 110847, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34098472

RESUMO

Condom evidence has become in the past years a very relevant item of evidence in sexual assault or rape cases, being an objective help in the reconstruction of the activity. Traces recovered from a vaginal swab might help to identify whether a condom or other lubricants were used, and thereby possibly confirming or infirming allegations of the parties. However, the interpretation of condom traces can be challenging and requires a detailed understanding of various factors like condom lubricant chemical composition and occurrence on the market, transfer and persistence parameters and background. Herein, we aimed at improving our understanding of factors affecting the transfer variability of condom residues recovered from vaginal matrix. This work employed Diffuse Reflectance Infrared Fourier Transform Spectroscopy (DRIFTS) to provide new data for a characterization of condom lubricants and their traces after a transfer in a vaginal matrix has occurred. Condom traces were recovered from volunteers and the traces characteristics were investigated and analyzed. The effects of donor (condom) and receiver (vaginal matrix) were firstly evaluated, as they are known factors, and these data that could be obtained in real caseworks. Using principal component analysis (PCA), this study highlighted that the effect of the donor was more important than the receiver effect. Vaginal matrix residues were not detected in transferred extracts. The discrimination pattern amongst the donor was found to be indistinguishable from the one obtained on reference material using ATR-FTIR (Attenuated Total Reflectance).


Assuntos
Preservativos , Lubrificantes/análise , Vagina/química , Coito , Feminino , Ciências Forenses , Humanos , Análise de Componente Principal , Espectroscopia de Infravermelho com Transformada de Fourier
14.
Arch Esp Urol ; 74(5): 519-525, 2021 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34080572

RESUMO

OBJECTIVES: Premature ejaculation (PE) is one of the most frequently seen causes of sexual dysfunction in males. The aim of this study is to investigate whether the music therapy is effective in the treatment of acquired PE and compare the intravaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), and anxiety scores of patients with acquired PE symptoms that underwent music therapy to patients that were treated with 30 mg dapoxetine. MATERIALS AND METHODS: The study's inclusion criteria was as following: age range from 20-35, married, has regular sexual intercourse, non-smokers, and has no known comorbidities. All participants of the study were with acquired PE based on the International Society for Sexual Medicine criteria. Experimental group (group 1) included 60 patients that were asked to listen to relaxing music and meditate for 45 minutes before the sexual intercourse while continuing their daily routine. This group was selected randomly and prospectively from young healthy individuals. Meanwhile, control group (group 2) included 60 patients who were treated with 30 mg dapoxetine for PE and whose datas were collected from the hospital archive. The patients were evaluated before treatment and re-evaluated (PEDT, IELT, anxiety level) after 60 days. State-Trait Anxiety Inventory was used to assess state and trait anxiety. RESULTS: In both groups, a significant difference (p<0.001) was observed in pre and post-treatment IELT, PEDT, and anxiety scores. Although group 2 showed better improvement in both IELT and PEDT scores, there was no significant difference between two groups. CONCLUSION: Listening to music and other similar anxiety decreasing methods can be a part of treatment plan for PE.


Assuntos
Música , Ejaculação Precoce , Terapia Comportamental , Coito , Ejaculação , Humanos , Masculino , Ejaculação Precoce/terapia
16.
J Sex Med ; 18(6): 1083-1091, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33967000

RESUMO

BACKGROUND: Provoked vestibulodynia (PVD) is characterized by severe pain, often induced by penetrative sex. This may lead to women abstaining from sexual intercourse, hence the recording of pain intensity levels in PVD research is often challenging. The standardized tampon test was designed as an alternative outcome measure to sexual intercourse pain and has frequently been used in clinical studies. AIM: The aim of this mixed methods study is to evaluate the tampon test as a primary outcome measure for an upcoming randomized clinical trial for women with PVD. METHODS: An explanatory sequential design was applied, integrating quantitative and qualitative methods. In phase one, pain intensity levels were evaluated with the tampon test amongst 10 women, aged 18-33, with PVD. The test was repeated on day 1, 7 and 14. Pain intensity was rated on the Numerical Rating Scale (NRS), (0-10), 10 being worst possible pain. In phase two, the participants' experiences with the test were explored with semi-structured interviews using a descriptive and inductive qualitative design. All participants were recruited from the Vulva Clinic, Oslo University Hospital, Norway. OUTCOMES: The tampon test data and interviews were brought together to see how the interviews could refine and help to explain the quantitative findings. RESULTS: The tampon test data demonstrated large intra- and inter-individual variability. Median tampon pain intensity was 4.5 (min=1.7; max=10; Q1=2.5; Q3=6). Many experienced the test as an inadequate representation of pain during intercourse as it was less painful, different in nature and conducted in an entirely different context. Four participants had a mean score of four or lower on the NRS, whilst concurrently reporting high levels of pain during sexual intercourse. CLINICAL IMPLICATIONS: The findings indicate that the tampon test may underestimate severity of pain among some women with PVD. Participants with low pain scores would be excluded from studies where the tampon test is part of the trial eligibility criteria, even though severe pain was experienced during sexual intercourse. Large intra-individual variability in pain scores also reduces the test's ability to register clinical meaningful changes and hence necessitates repeated measurements per assessment time point. CONCLUSION: Although the tampon test has many advantages, this study indicates several potential problems with the application of the test as a primary outcome measure in PVD. In our opinion the test is most useful as a secondary outcome, preferably undertaken repeatedly in order to increase precision of the pain estimation. Kaarbø MB, Danielsen KG, Haugstad GK, et al. The Tampon Test as a Primary Outcome Measure in Provoked Vestibulodynia: A Mixed Methods Study. J Sex Med 2021;18:1083-1091.


Assuntos
Vulvodinia , Coito , Feminino , Humanos , Avaliação de Resultados em Cuidados de Saúde , Comportamento Sexual , Inquéritos e Questionários , Vulvodinia/diagnóstico
17.
Andrologia ; 53(7): e14097, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33964032

RESUMO

Clinical characteristics of 216 adult males previously diagnosed with premature ejaculation (PE) were studied. Using a survey questionnaire, characteristics included intravaginal ejaculation latency time (IELT), penile hardness scores and the refractory period (RP). Ninety-four PE patients reported they had experienced vaginal intercourse more than once (2 to 4 times) in one day (~44%). IELT was significantly increased at the second and subsequent intercourses, and IIEF-15 (International Index of Erectile Function-15) and relevant subclass scores were markedly improved compared to their first intercourse and also compared to the single intercourse group in this cohort study. Overall sexual satisfaction was achieved in the PE patients with multiple intercourse experiences. The same trend was observed in both the patients diagnosed with lifelong and acquired PE. Based on the evidence, the argument is that the PE patients who were diagnosed using their performance at the first intercourse but who have the ability to participate in multiple vaginal intercourses in one day are unlikely to be true PE. The false PE may account for over 40% of PE patients diagnosed by current guidelines and definitions.


Assuntos
Disfunção Erétil , Ejaculação Precoce , Adulto , Estudos de Coortes , Coito , Ejaculação , Feminino , Humanos , Masculino , Ejaculação Precoce/diagnóstico , Ejaculação Precoce/epidemiologia
18.
J Sex Med ; 18(6): 1024-1041, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34020921

RESUMO

BACKGROUND: Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. AIMS: In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and partnered sexual behaviors, (2) examine how frequently participants enacted certain rough sex sexual behaviors (e.g., light spanking, hard spanking, choking, slapping, and others), (3) assess participants' frequency of experiencing certain rough sex behaviors, (4) describe participants' frequency of threesome/group sex, (5) assess the characteristics of participants' experiences with choking during sex; and (6) examine choking and face slapping in regard to consent. METHODS: A confidential, online cross-sectional survey of 4,989 randomly sampled undergraduate students at a large U.S. university. OUTCOMES: Participants reported having engaged in a broad range of solo and partnered sexual activities, including rough sex behaviors. RESULTS: The most prevalent general sexual behaviors were solo masturbation (88.6%), oral sex (79.4% received, 78.4% performed), penile-vaginal intercourse (73.5%), and partnered masturbation (71.1%). Anal intercourse was the least prevalent of these behaviors (16.8% received, 25.3% performed). Among those with any partnered sexual experience, 43.0% had choked a partner, 47.3% had been choked, 59.1% had been lightly spanked and 12.1% had been slapped on the face during sex. CLINICAL TRANSLATION: College health clinicians and educators need to be aware of the diverse and evolving range of solo and partnered sexual behaviors reported by students. In addition to counseling students about pregnancy and sexually transmitted infection risk, clinicians might assess patients' engagement in diverse sexual behaviors, such as choking/strangulation during sex, given the risk for serious outcomes including death. STRENGTHS AND LIMITATIONS: Strengths of our research include the large sample size, use of random sampling, high response rate for college populations, broad range of behaviors assessed, and novel data on choking during sex. Among our limitations, we did not assess to what extent the experiences were wanted, pleasurable, or appealing to participants. Except for in relation to choking and slapping, we also did not assess issues of consent. CONCLUSION: Participants reported engaging in diverse sexual behaviors, some of which have important clinical implications, are understudied, and warrant further research. Herbenick D, Patterson C, Beckmeyer J, et al. Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. J Sex Med 2021;18:1024-1041.


Assuntos
Coito , Comportamento Sexual , Estudos Transversais , Feminino , Humanos , Gravidez , Probabilidade , Estudantes , Inquéritos e Questionários
19.
Vasa ; 50(3): 246-247, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33938230

Assuntos
Coito , Humanos
20.
Cochrane Database Syst Rev ; 4: CD012654, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33871063

RESUMO

BACKGROUND: Dietary supplements with ginseng, or ginseng alone, are widely used for a broad range of conditions, including erectile dysfunction. Ginseng is particularly popular in Asian countries. Individual studies assessing its effects are mostly small, of uneven methodological quality and have unclear results. OBJECTIVES: To assess the effects of ginseng on erectile dysfunction. SEARCH METHODS: We conducted systematic searches on multiple electronic databases, including CENTRAL, MEDLINE, Embase, CINAHL, AMED, and loco-regional databases of east Asia, from their inceptions to 30 January 2021 without restrictions on language and publication status. Handsearches included conference proceedings. SELECTION CRITERIA: We included randomized or quasi-randomized controlled trials that evaluated the use of any type of ginseng as a treatment for erectile dysfunction compared to placebo or conventional treatment. DATA COLLECTION AND ANALYSIS: Two authors independently classified studies and three authors independently extracted data and assessed risk of bias in the included studies. We rated the certainty of evidence according to the GRADE approach. MAIN RESULTS: We included nine studies with 587 men with mild to moderate erectile dysfunction, aged from 20 to 70 years old. The studies all compared ginseng to placebo. We found only short-term follow-up data (up to 12 weeks).  Primary outcomes Ginseng appears to have a trivial effect on erectile dysfunction when compared to placebo based on the Erectile Function Domain of the International Index of Erectile Function (IIEF)-15 instrument (scale: 1 to 30, higher scores imply better function; mean difference [MD] 3.52, 95% confidence interval [CI] 1.79 to 5.25; I² = 0%; 3 studies; low certainty evidence) assuming a minimal clinically important difference (MCID) of 4.  Ginseng probably also has a trivial effect on erectile function when compared to placebo based on the IIEF-5 instrument (scale: 1 to 25, higher scores imply better function; MD 2.39, 95% CI 0.89 to 3.88; I² = 0%; 3 studies; moderate certainty evidence) assuming a MCID of 5. Ginseng may have little to no effect on adverse events compared to placebo (risk ratio [RR] 1.45, 95% CI 0.69 to 3.03; I² = 0%; 7 studies; low certainty evidence). Based on 86 adverse events per 1000 men in the placebo group, this would correspond to 39 more adverse events per 1000 (95% CI 27 fewer to 174 more). Secondary outcomes Ginseng may improve men's self-reported ability to have intercourse (RR 2.55, 95% CI 1.76 to 3.69; I² = 23%; 6 studies; low certainty evidence). Based on 207 per 1000 men self-reporting the ability to have intercourse in the placebo group, this would correspond to 321 more men (95% CI 158 more to 558 more) per 1000 self-reporting the ability to have intercourse. Ginseng may have a trivial effect on men's satisfaction with intercourse based on the Intercourse Satisfaction Domain of the IIEF-15 (scale: 0 to 15, higher scores imply greater satisfaction; MD 1.19, 95% CI 0.41 to 1.97; I²=0%; 3 studies; low certainty evidence) based on a MCID of 25% improvement from baseline. It may also have a trivial effect on men's satisfaction with intercourse based on item 5 of the IIEF-5 (scale: 0 to 5, higher scores imply more satisfaction; MD 0.60, 95% CI 0.02 to 1.18; 1 study; low certainty evidence) based on a MCID of 25% improvement from baseline. No study reported quality of life as an outcome. We found no trial evidence to inform comparisons to other treatments for erectile dysfunction, such as phosphodiesterase-5 inhibitors. We were unable to conduct any predefined subgroup analyses. AUTHORS' CONCLUSIONS: Based on mostly low certainty evidence, ginseng may only have trivial effects on erectile function or satisfaction with intercourse compared to placebo when assessed using validated instruments. Ginseng may improve men's self-reported ability to have intercourse. It may have little to no effect on adverse events. We found no trial evidence comparing ginseng to other agents with a more established role in treating erectile dysfunction, such as phosphodiesterase-5 inhibitors.


Assuntos
Disfunção Erétil/tratamento farmacológico , Panax , Fitoterapia/métodos , Adulto , Idoso , Coito , Intervalos de Confiança , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Placebos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
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