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1.
Reumatol. clín. (Barc.) ; 19(5): 249-254, May. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-219777

RESUMO

Introducción: La artritis psoriásica (APs) es un trastorno inflamatorio crónico que afecta principalmente a las articulaciones y las entesis. Además, se asocia con el síndrome depresivo (SD), la enfermedad cardiovascular, la hipertensión (HTA), la diabetes mellitus (DM), la obesidad y la psoriasis (Pso). Existen pocos estudios dirigidos a analizar la asociación de la afectación del aparato locomotor con las alteraciones de la calidad sexual (CS). Métodos. Se propuso un estudio observacional transversal en pacientes diagnosticados de APs, a los que aplicaron cuestionarios validados autoaplicados para determinar alteraciones de la CS: MGH-SFQ y CSFQ-14, que valoran los cuatro dominios de la función sexual; Qualisex y DLQI diseñados para patología articular y dermatológica respectivamente, que exploran aspectos sexuales. El objetivo fue describir la existencia de alteraciones sexuales de pacientes con APs, analizar la asociación entre las características sociodemográficas, comorbilidades (Pso, SD, factores de riesgo cardiovascular) y los tratamientos de los pacientes sobre la CS y describir diferencias de CS en función del género. Resultados: Se valoraron 72 pacientes y se observó que las variables de los pacientes con APs que se asociaron con mayor fuerza con puntuaciones más bajas en CS fueron ser mujer y la edad en el CSFQ-14 y MGH-SFQ; el nivel de ingresos, el tratamiento con AINE, la dislipemia (DL) y la depresión se asociaron a peores resultados en algunos dominios de la esfera sexual. Conclusiones: Los pacientes con APs presentaban una CS deteriorada, especialmente mujeres, de mayor edad, bajo nivel de ingresos y DL. Los tratamientos antiinflamatorios se asociaron con mejor CS. Globalmente, la enfermedad crónica y la carga psicológica de padecerla se comportaron como factores predisponentes de disfunción sexual.(AU)


Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disorder that primarily affects the joints and entheses. In addition, it is associated with depressive syndrome (DS), cardiovascular disease, hypertension (HT), diabetes mellitus (DM), obesity and psoriasis (Pso). There are few studies aimed to analyze the association of the involvement of the musculoskeletal system with sexual function (SF). Methods: A cross-sectional observational study was proposed in patients diagnosed with PsA, to whom self-administered validated questionnaires were applied to determine alterations in SF: MGH-SFQ and CSFQ-14, which assess the 4 domains of sexual function; Qualisex and DLQI designed for joint and dermatological pathology respectively, which explore sexual aspects. The objective was to describe the existence of altered sexual function in patients with PsA; analyze the association between sociodemographic characteristics, comorbidities (Pso, DS, cardiovascular risk factors) and the treatments of patients on SF; and describe differences of SF according to gender. Results: 72 patients were evaluated. It was observed that the variables of patients with PsA that were associated with lower scores in SF were gender and age in the CSFQ-14 and MGH-SFQ; annual incomes, treatment with NSAIDs, DL and depression were associated with worse results in some domains of the sexual sphere. Conclusions: Patients with PsA had impaired SF, especially women, elder patiens, those with low annual incomes, DL and emotional disorders. Anti-inflammatory treatments were associated with better SF. Globally, the chronic disease and the psychological burden behaved as factors associated with sexual dysfunction.(AU)


Assuntos
Humanos , Masculino , Feminino , Disfunções Sexuais Fisiológicas , Psoríase , Artrite Psoriásica , Sexualidade , Comorbidade , Reumatologia , Estudos Transversais
3.
J Korean Med Sci ; 38(18): e144, 2023 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-37158776

RESUMO

BACKGROUND: The role of the cervix in female sexual functioning is controversial. The loop electrosurgical excision procedure (LEEP) induces structural changes in the cervix. This study aimed to investigate whether LEEP affected sexual dysfunction in Korean women. METHODS: A prospective cohort study enrolled 61 sexually active women with abnormal Papanicolaou smear or cervical punch biopsy results and required LEEP. The patients were assessed before and six to twelve months after LEEP using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). RESULTS: The prevalence of female sexual dysfunction according to FSFI scores before and after LEEP was 62.5% and 66.7%, respectively. LEEP-related changes in total FSFI and FSDS scores were not significant (P = 0.399 and P = 0.670, respectively). The frequency of sexual dysfunction in the desire, arousal, lubrication, orgasm, satisfaction, and pain subdomains of the FSFI was not significantly altered by LEEP (P > 0.05). The proportion of women experiencing sexual distress according to FSDS scores did not significantly increase after LEEP (P = 0.687). CONCLUSION: A large proportion of women with cervical dysplasia experience sexual dysfunction and distress both before and after LEEP. LEEP itself may be not associated with negative effects on female sexual function.


Assuntos
Eletrocirurgia , Disfunções Sexuais Fisiológicas , Feminino , Humanos , Povo Asiático , Eletrocirurgia/efeitos adversos , Eletrocirurgia/métodos , Estudos Prospectivos , República da Coreia , Disfunções Sexuais Fisiológicas/etiologia , Colo do Útero/cirurgia
4.
BMC Womens Health ; 23(1): 213, 2023 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-37131197

RESUMO

BACKGROUND: Alcohol abuse among women is a significant health problem. Consuming alcohol in high amounts causes decreased sexual stimulation, vaginal lubrication, dyspareunia, and difficulty reaching orgasm. Due to the different effects of alcohol consumption on sexual function, this study aimed to investigate the effect of alcohol consumption on sexual dysfunction in women. METHODS: In this study, the researchers conducted a systematic search of several databases, including PubMed, Google Scholar, Scopus, Web of Science, Embase, and ScienceDirect, as well as the Google Scholar search engine, to identify studies reporting the impact of alcohol consumption on female sexual dysfunction. The search was conducted up until July 2022. A total of 225 articles were searched in the databases, and an additional 10 relevant articles were identified through manual search. After removing 93 articles due to duplication, 90 articles were excluded based on the study's inclusion and exclusion criteria. During the merit evaluation phase, 26 articles were excluded through the full-text study based on the study's inclusion and exclusion criteria, while 26 articles were excluded due to their low quality. Ultimately, only 7 studies were deemed suitable for the final evaluation. The analysis was conducted using a random effects model, while the heterogeneity of the studies was assessed using the I2 index. Data analysis was performed using the Comprehensive Meta-Analysis Version 2 software. RESULTS: Based on the review of 7 studies involving a total sample size of 50,225 women and using the random effects method, the calculated odds ratio was 1.74 (95% CI: 1.006-3.04). This indicates that alcohol consumption increases the likelihood of sexual dysfunction in women by 74%. The Begg and Mazumdar rank correlation test, was used to analyze the distribution bias, but the results were not significant at the 0.1 significance level (p = 0.763). CONCLUSION: The findings of this study demonstrate a significant correlation between alcohol consumption and an increased risk of sexual dysfunction in women. These results highlight the need for policymakers to prioritize this issue and raise awareness regarding the harmful effects of alcohol consumption on female sexual function and its impact on population health and reproduction.


Assuntos
Consumo de Bebidas Alcoólicas , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Dispareunia , Alcoolismo
5.
Eur Rev Med Pharmacol Sci ; 27(8): 3457-3466, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37140295

RESUMO

OBJECTIVE: Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations. PATIENTS AND METHODS: Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile's type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications. RESULTS: A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients. CONCLUSIONS: Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments.


Assuntos
Fraturas Ósseas , Ossos Pélvicos , Disfunções Sexuais Fisiológicas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Dados Preliminares , Fraturas Ósseas/complicações , Ossos Pélvicos/lesões , Pelve , Fixação Interna de Fraturas
6.
PLoS One ; 18(4): e0284014, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37018316

RESUMO

Female sexual dysfunction (FSD) is a common problem among postpartum women. However, little is known about this topic in Malaysia. This study aimed to determine the prevalence of sexual dysfunction and its associated factors in postpartum women in Kelantan, Malaysia. In this cross-sectional study, we recruited 452 sexually active women at six months postpartum from four primary care clinics in Kota Bharu, Kelantan, Malaysia. The participants were asked to fill in questionnaires consisting of sociodemographic information and the Malay Version of the Female Sexual Function Index-6. The data were analyzed using bivariate and multivariate logistic regression analyses. With a 95% response rate, the prevalence of sexual dysfunction among sexually active, six months postpartum women was 52.4% (n = 225). FSD was significantly associated with the older husband's age (p = 0.034) and lower frequency of sexual intercourse (p<0.001). Therefore, the prevalence of postpartum sexual dysfunction in women is relatively high in Kota Bharu, Kelantan, Malaysia. Efforts should be made to raise awareness among healthcare providers about screening for FSD in postpartum women and for their counseling and early treatment.


Assuntos
Disfunções Sexuais Fisiológicas , Feminino , Humanos , Malásia/epidemiologia , Estudos Transversais , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários , Período Pós-Parto
8.
Artigo em Inglês | MEDLINE | ID: mdl-37036931

RESUMO

INTRODUCTION: Pelvic fractures are severe injuries that can drastically affect a woman's quality of life through sexual dysfunction (SD), genitourinary dysfunction (GD), and increasing the potential need for future cesarean section (C-section). Limited research has captured long-term outcomes after pelvic fractures in women of childbearing age. This study aimed to determine the association between pelvic fractures and rates of C-section, SD, and GD. METHODS: All women of childbearing age who sustained a pelvic fracture were identified in a national insurance database. A comparison group of patients with lower extremity long-bone fractures was selected. Patients who gave birth after injury were additionally identified. A minimum of 5 years of follow-up was required for inclusion. Rates of C-section, SD, and GD were compared between cohorts. Multivariate logistic regression analysis was conducted with the inclusion of diabetes, tobacco, hypertension, obesity, and advanced maternal age. RESULTS: A total of 6,174 patients with pelvic fracture and 27,154 control fracture patients were identified. 434 patients with pelvic fracture (7.0%) and 1,258 control fracture patients (4.6%) gave birth after fracture. Patients with pelvic fracture had a significantly higher rate of C-section (50.0% versus 38.8%, P < 0.001), SD diagnosis (10.9% versus 8.8%, P < 0.001), and urinary retention diagnosis (3.5% versus 2.8%, P < 0.001). No significant difference in global GD diagnosis was identified. Multivariate analyses showed that pelvic fracture was associated with C-section (odds ratio [OR]: 1.78; 95% confidence interval [95% CI]: 1.42 to 2.23, P < 0.001), SD diagnosis (OR: 1.23; 95% CI: 1.12 to 1.35, P < 0.001), and urinary retention diagnosis (OR: 1.35; 95% CI: 1.15 to 1.57, P < 0.001). DISCUSSION: Pelvic fractures confer an intrinsic level of risk of C-section, SD, and urinary retention that is elevated beyond what would be expected from a traumatic lower extremity injury alone. Treating orthopaedic surgeons should actively counsel women regarding increased risks, openly discuss postinjury sequelae, and coordinate interspecialty care beyond initial treatment of acute trauma.


Assuntos
Fraturas Ósseas , Disfunções Sexuais Fisiológicas , Retenção Urinária , Humanos , Feminino , Gravidez , Cesárea/efeitos adversos , Retenção Urinária/complicações , Qualidade de Vida , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/complicações
9.
Support Care Cancer ; 31(5): 265, 2023 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-37058163

RESUMO

PURPOSE: Sexual well-being has been identified as an unmet supportive care need among many individuals with genitourinary (GU) cancers. Little is known about the experiences of using sexual well-being interventions among men and their partners. METHODS: This review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and followed a systematic review protocol. Data extraction and methodological quality appraisal were performed, and a narrative synthesis was conducted. RESULTS: A total of 21 publications (reporting on 18 studies) were included: six randomised control trials, seven cross-sectional studies, three qualitative studies, and five mixed methods studies. Sexual well-being interventions comprised medical/pharmacological and psychological support, including counselling and group discussion facilitation. The interventions were delivered using various modes: face-to-face, web-based/online, or telephone. Several themes emerged and included broadly: (1) communication with patient/partner and healthcare professionals, (2) educational and informational needs, and (3) timing and/or delivery of the interventions. CONCLUSION: Sexual well-being concerns for men and their partners were evident from diagnosis and into survivorship. Participants benefited from interventions but many articulated difficulties with initiating the topic due to embarrassment and limited access to interventions in cancer services. Noteworthy, all studies were only representative of men diagnosed with prostate cancer, underscoring a significant gap in other GU cancer patient groups where sexual dysfunction is a prominent consequence of treatment. IMPLICATIONS FOR CANCER SURVIVORS: This systematic review provides valuable new insights to inform future models of sexual well-being recovery interventions for patients and partners with prostate cancer, but further research is urgently needed in other GU cancer populations.


Assuntos
Neoplasias da Próstata , Disfunções Sexuais Fisiológicas , Masculino , Humanos , Estudos Transversais , Comportamento Sexual/psicologia , Neoplasias da Próstata/psicologia , Pessoal de Saúde , Disfunções Sexuais Fisiológicas/terapia , Parceiros Sexuais
10.
Medicine (Baltimore) ; 102(16): e33504, 2023 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-37083787

RESUMO

The objective of this study was to explore the impact on hospital-family integrated continuation care based on information technology on the negative emotions, family function, and sexual function of patients after cervical cancer surgery. The clinical case data onto 114 postoperative cervical cancer patients who were nursing in our hospital from July 2019 to July 2021 were selected and were divided into a control group and an observation group. The control group used routine nursing care, and on this basis, the observation group used information technology as the basis for hospital-family integrated continuation care, and we observed and compared the differences in the 2 groups of patients bad mood, family function, and sexual function. The score of anxiety (P = .017), depression (P = .009), fatigue rating (P = .012), and anger (P < .001) in the observation group after care were significantly lower than those in the control group. Problem solving, role, emotional response, emotional involvement, and family function total score in the observation group after care was significantly lower than those in the control group (P < .05). Sexual desire score, sexual arousal score, vaginal lubrication score, orgasm score, sexual satisfaction score, dyspareunia score, and Female Sexual Function Inventory total scores in the observation and control groups after care were significantly higher than those before care (P < .05). The sexual function scores in the observation group after care was significantly higher than those in the control group (P < .05). The hospital-family integrated continuation care based on information technology is more effective than conventional nursing care for patients after cervical cancer surgery.


Assuntos
Dispareunia , Disfunções Sexuais Fisiológicas , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/cirurgia , Tecnologia da Informação , Inquéritos e Questionários
11.
Int J Clin Pract ; 2023: 9528335, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37101856

RESUMO

Objective: Female sexual dysfunction is a common distressing problem among women, which may result from reducing circulating endogenous estrogen. Humulus lupulus L. (hop) has antioxidant, anti-inflammatory, anticancer, and estrogenic properties. Therefore, this study aimed to assess the efficacy of hop on postmenopausal sexual dysfunction. Methods: In the current randomized clinical trial, study populations consisted of 63 postmenopausal women who were randomly categorized into two groups. In the hop group (N = 33), women received the vaginal gel containing Hop extract every day for seven days and then continued for two months, twice weekly. In the estradiol group (N = 30), women were treated with vaginal estradiol (0.625 mg) over two 28-day cycles (21 days of therapy and seven days rest). The sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire before and after intervention. Results: No statistically significant differences in FSFI scores (sexual desire, sexual arousal, vaginal lubrication, satisfaction, orgasm, sexual pain, and total FSFI) (P > 0.05) were noticed after treatment between the hop and estradiol groups. Conclusion: Vaginal hop was as effective as estradiol in improving the sexual dysfunction among postmenopausal women with no adverse events. This trial is registered with IRCT20210405050859N1.


Assuntos
Humulus , Disfunções Sexuais Fisiológicas , Feminino , Humanos , Pós-Menopausa , Comportamento Sexual , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Estradiol/uso terapêutico , Estradiol/farmacologia
12.
Rev. int. androl. (Internet) ; 21(1): 1-5, ene.-mar. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-216606

RESUMO

Objective: Female sexual dysfunction (FSD) is a significant public health issue, and it has a high global prevalence. Few effective treatment options are available for the treatment of FSD. We conducted a prospective clinical pilot study to investigate the beneficial effects of Pilates exercise on sexual function in women with FSD. Methods: Women aged between 20 and 50 years and who had regular menstrual cycles and sexual relationships and participating Pilates exercise program were asked to complete Beck Depression Inventory (BDI) and Female Sexual Function Index (FSFI) questionnaires before starting the Pilates exercise program. If the total FSFI score was less than 26.55, which is the cut-off for FSD, the subject was invited to participate in the study. Primary endpoints were changes in total and individual domain scores on the FSFI and BDI. Results: A total of 36 premenopausal women were included in the study. After a 12-week Pilates program, all domains of the FSFI were significantly improved, with mean±SD total FSFI scores increasing from 12.0±4.9 to 29.3±3.4 (P<0.0001). BDI scores were significantly decreased from 25.1±14.3 to 1.6±3.7 (P<0.0001) after the exercise program. Conclusions: This pilot study showed that Pilates exercise could improve sexual functions in women with FSD. Pilates may facilitate the treatment of sexual dysfunction in women. (AU)


Objetivo: La disfunción sexual femenina (DSF) es un importante problema de salud pública, y tiene una alta prevalencia mundial. Se dispone de pocas opciones terapéuticas eficaces para el tratamiento de la DSF. Realizamos un estudio piloto clínico prospectivo para investigar los efectos beneficiosos del ejercicio de Pilates en la función sexual de las mujeres con DSF. Métodos: A las mujeres de entre 20 y 50 años que tenían ciclos menstruales y relaciones sexuales regulares, y que participaban en el programa de ejercicios de Pilates se les pidió que completaran los cuestionarios del Inventario de Depresión de Beck (BDI) y del índice de función sexual femenina (FSFI) antes de comenzar el programa de ejercicios de Pilates. Si la puntuación total del FSFI era inferior a 26,55, que es el punto de corte para la FSD, se invitaba al sujeto a participar en el estudio. Los puntos finales primarios fueron los cambios en las puntuaciones totales y de dominio individual en el FSFI y el BDI. Resultados: Un total de 36 mujeres premenopáusicas fueron incluidas en el estudio. Después de un programa de Pilates de 12 semanas, todos los dominios del FSFI mejoraron significativamente, con puntuaciones medias±SD del FSFI total que aumentaron de 12,0±4,9 a 29,3±3,4 (p<0,0001). Las puntuaciones del BDI disminuyeron significativamente de 25,1±14,3 a 1,6±3,7 (p<0,0001) después del programa de ejercicios. Conclusiones: Este estudio piloto mostró que el ejercicio de Pilates podría mejorar las funciones sexuales en las mujeres con FSD. El Pilates puede facilitar el tratamiento de la disfunción sexual en las mujeres. (AU)


Assuntos
Humanos , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Técnicas de Exercício e de Movimento , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários , Projetos Piloto
13.
Arch Ital Urol Androl ; 95(1): 11236, 2023 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-36924366

RESUMO

Sexual health impairment is one of the most important issues worldwide, with an increasing number of men and women affected. Specifically in male sexual dysfunction (SD), several risk factors were established such as atherosclerosis, hypertension, diabetes mellitus, smoking or obesity. The co-presence of more than one of risk factors identifies a condition, defined as the metabolic syndrome (MetS), related directly to the SD. However, not all the physicians involved in the MetS management routinely discussed the sexual impairment, increasing the bothering feelings of patients. Furthermore, the lack of knowledge, insufficient time, lack of attention, ambiguities about responsibility, insufficient training and experience, shared among physicians, regarding the communication and treatment of sexual dysfunction, are all reported factors involved in under-valuation of SD. The current paper represents a warning to the experts, with the aim of increasing the awareness of SD among clinicians and to promote the education, training and collaboration with sex therapists, through a multidisciplinary team, that can lead to a holistic approach in SD assessment and treatment.


Assuntos
Médicos , Disfunções Sexuais Fisiológicas , Humanos , Masculino , Feminino , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/terapia , Fatores de Risco , Comportamento Sexual , Obesidade/complicações
14.
J Sex Med ; 20(4): 447-466, 2023 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-36857309

RESUMO

BACKGROUND: Sexual function after hysterectomy can be a concern for patients, and research remains inconclusive about changes in sexual function associated with hysterectomy. AIM: We meta-analyzed studies on change in sexual function from pre- to posthysterectomy and the role of total vs subtotal hysterectomy and concomitant bilateral salpingo-oophorectomy (BSO) in differences in such change. METHODS: We searched PubMed, Embase, and Cochrane databases from inception to January 2022. Two reviewers screened and included studies if they were published in a peer-reviewed journal and reported on sexual function pre- and posthysterectomy for benign nonprolapse indication. Methodological quality was assessed with the STROBE checklist. We used random effects multilevel models to meta-analyze standardized mean differences in pre- to postoperative sexual function and the posthysterectomy Female Sexual Function Index mean across study groups in R (RStudio). OUTCOMES: Outcomes included overall sexual function, dyspareunia, desire, arousal, lubrication, and orgasm. RESULTS: Thirty-two articles were analyzed: 8 randomized controlled trials, 20 prospective studies, 2 retrospective studies, 1 cross-sectional study, and 1 secondary analysis, comprising a total of 4054 patients. Each study provided data for at least 1 outcome. Study quality was moderate, and effect sizes showed large between-study heterogeneity. Hysterectomy was not associated with significant change in overall sexual function irrespective of surgical route, with patients tending to report potentially remaining sexual dysfunction posthysterectomy. Cervix removal was not significantly associated with differences in magnitude of change. Hysterectomy without BSO was associated with significantly stronger improvement in lubrication and orgasm than hysterectomy with BSO, which was not the case for desire, arousal or overall sexual function. However, these significant differences were not replicated within studies that directly compared cases with and without BSO. CLINICAL IMPLICATIONS: Clinicians should address remaining sexual dysfunction posthysterectomy, and BSO should not be considered if not medically required. STRENGTHS AND LIMITATIONS: We analyzed a comprehensive number of trials and studied clinically relevant factors that might relate to differences in change in sexual function. Conclusions need to be interpreted with caution since many studies showed moderate methodological quality and large effect size heterogeneity. CONCLUSION: Subtotal and total hysterectomy was not associated with significant change in overall sexual function irrespective of surgical route, with patients tending to report potentially remaining sexual dysfunction posthysterectomy. Hysterectomy without BSO was associated with significantly stronger improvement in lubrication and orgasm than hysterectomy with BSO. Future research on hysterectomy should analyze predictors of sexual function change trajectories, such as different indications.


Assuntos
Histerectomia , Disfunções Sexuais Fisiológicas , Feminino , Humanos , Estudos Retrospectivos , Estudos Prospectivos , Estudos Transversais , Histerectomia/efeitos adversos , Disfunções Sexuais Fisiológicas/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
J Sex Med ; 20(4): 488-497, 2023 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-36869682

RESUMO

BACKGROUND: Women with lichen sclerosus (LS) may suffer sexually because of dyspareunia, fissures, and introital narrowing. However, the literature remains limited on the biopsychosocial aspects of LS and its impact on sexual health. AIM: To examine the biopsychosocial aspects and impact of LS on the sexual health of Danish women with vulvar LS. METHODS: The study was conducted with a mixed methods approach, including women with LS from a Danish patient association. The quantitative sample consisted of 172 women who completed a cross-sectional online survey that included 2 validated questionnaires: the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS). The qualitative sample consisted of 5 women with LS who volunteered for audiotaped, individual, semistructured interviews. OUTCOMES: This mixed methods study combined data from 2 quantitative questionnaires (FSFI and FSDS) with qualitative interviews to achieve a comprehensive insight into the biopsychosocial aspects of sexual health in women living with LS. RESULTS: The sexual function of women with LS was considerably affected, with FSFI scores below the cutoff value of 26.55, indicating a risk of sexual dysfunction. On average, 75% of the women were sexually distressed, with a total FSDS score of 25.47. Furthermore, 68% of the sexually active women were considerably affected in terms of sexual function and sexual distress, thus meeting international criteria for sexual dysfunction. However, a negative impact on sexual function was not always related to sexual distress and vice versa. The qualitative analysis identified 4 overarching themes: (1) decrease in or loss of sexual activity, (2) interference with relationship dynamics, (3) importance of sex and intimacy - loss and restoration, and (4) worries about sexual insufficiency. CLINICAL IMPLICATIONS: Insight into the influence of LS on sexual health is important for health care professionals, including doctors, nurses, sex therapists, and physiotherapists, to provide the best guidance, support, and management for women with LS. STRENGTHS AND LIMITATIONS: The strengths of the study are its use of a mixed methods design and the inclusion of sexual function and sexual distress. A limitation is related to the properties of the FSFI regarding women with no sexual activity. CONCLUSIONS: LS has a considerable influence on women's sexual health in terms of sexual function and sexual distress, as supported by quantitative and qualitative measures. Our understanding of the complex interactions among sexual activity, intimate relations, and causes of psychological distress has been enriched.


Assuntos
Líquen Escleroso e Atrófico , Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Saúde Sexual , Feminino , Humanos , Líquen Escleroso e Atrófico/complicações , Estudos Transversais , Comportamento Sexual/psicologia , Saúde da Mulher , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Inquéritos e Questionários , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/psicologia
16.
J Sex Med ; 20(5): 651-660, 2023 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-36941211

RESUMO

BACKGROUND: Prostate cancer (PCa) and its treatments can have a significant negative impact on the sexual health of survivors and couples, but few studies have specifically examined the impact of PCa-related sexual dysfunction on female partners of survivors. AIM: Our objective was to perform a qualitative study to comprehensively characterize female partners' perceptions of the implications of PCa on their sex lives, as well as partners' sexual health concerns and unmet needs. METHODS: We conducted semi-structured telephone interviews about sexual health and unmet needs with female partners of PCa survivors recruited from multiple clinical locations and support groups for PCa caregivers from September 2021 to March 2022. Interviews were audio-recorded, transcribed verbatim, and independently coded. Participants were recruited until thematic saturation was achieved. OUTCOMES: Outcomes of this study were female partner sexual health concerns and unmet needs. RESULTS: Among 12 participants, the median age was 65 (range 53 to 81) years, 9 were White, the median time since their partner's PCa diagnosis was 2.25 years (range 11 months to 20 years), and a majority reported that their partner had undergone radical prostatectomy, radiation, and/or hormonal therapy. Major emergent themes pertained to the significant impact of age- and PCa-related sexual dysfunction on female sexual quality of life, the dyadic nature of sexual dysfunction and recovery, the role of the partner in coping with and adjusting to sexual dysfunction, difficulties communicating about sexual dysfunction in an intimate relationship, a lack of physician-led sexual health counseling and support, and the benefit of peer interactions and proactive information seeking in addressing unmet sexual health needs. CLINICAL IMPLICATIONS: Future efforts should continue to explore the impact of PCa on partner sexual health and address unmet needs through sexual health education and support. STRENGTHS AND LIMITATIONS: In this study, we identified female partners' sexual health concerns both related to and independent of PCa survivor sexual health. Limitations include exclusion of male partners of survivors and potential responder bias, as partners who agreed to participate may have experienced more sexual health concerns. CONCLUSION: We found that female partners experience PCa-related sexual dysfunction as a couple's disease, grief due to age- and PCa-related sexual losses, and a lack of physician-led sexual health counseling and information. Our results highlight the importance of including partners of PCa survivors in the sexual recovery process and of developing sexual care programs to address partners' unmet sexual health needs.


Assuntos
Sobreviventes de Câncer , Neoplasias da Próstata , Disfunções Sexuais Fisiológicas , Saúde Sexual , Humanos , Masculino , Pré-Escolar , Criança , Sobreviventes de Câncer/psicologia , Próstata , Qualidade de Vida , Parceiros Sexuais/psicologia , Sobreviventes/psicologia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/psicologia , Neoplasias da Próstata/cirurgia
17.
J Plast Reconstr Aesthet Surg ; 80: 28-35, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36989880

RESUMO

BACKGROUND: Vaginal tightening or vaginoplasty has been gaining popularity, while validated methods of evaluation and treatment are still lacking. Herein, we describe a bilateral wall tightening technique for vaginal laxity and evaluate the feasibility of this method. METHODS: From April 2020 to September 2021, 25 women with vaginal laxity underwent vaginal tightening, and 22 women were included in this retrospective observational study. The inclusion criteria were as follows: participants with at least one delivery and reported vaginal laxity, but without a history of underlying diseases. Vaginal pressure tests and questionnaires were used to evaluate vaginal laxity and sexual quality before and 6 months after the surgery. RESULTS: The study included 22 women (aged 29-46 years), and the follow-up period was 14.1 ± 3.3 months. The score based on the vaginal laxity questionnaire was improved as a result of surgery (preoperative median: 2.00, interquartile range [IQR]: 1.00-2.00; postoperative median: 5.00, IQR: 5.00-6.25, p < 0.001). The vaginal pressure increased from 2.3 ± 1.8 mm/Hg to 21.4 ± 3.7 mm/Hg. Sexual distress changed from 24.2 ± 8.9-16.1 ± 4.8 after surgery (p < 0.001), and sexual dysfunction with an average score of 20.1 ± 10.6 before surgery improved after the procedure (26.0 ± 10.8, p < 0.001). Women also reported improved scores in desire, arousal, orgasm, and satisfaction. In addition, there were no intraoperative complications or significant events during the follow-up period. CONCLUSIONS: Bilateral vaginal tightening without mucosal excision is a feasible and effective surgical approach for the management of vaginal laxity.


Assuntos
Mercúrio , Terapia por Radiofrequência , Disfunções Sexuais Fisiológicas , Feminino , Humanos , Vagina/cirurgia , Comportamento Sexual , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/cirurgia , Inquéritos e Questionários
19.
Rev Bras Ginecol Obstet ; 45(2): 89-95, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36977406

RESUMO

OBJECTIVE: We evaluated internal consistency, test-retest reliability, and criterion validity of the Brazilian Portuguese version of the Female Sexual Function Index 6-item Version (FSFI-6) for postpartum women. METHODS: Therefore, questionnaires were applied to 100 sexually active women in the postpartum period. The Cronbach α coefficient was used to evaluate the internal consistency. Test-retest reliability was analyzed by Kappa for each item of the questionnaire and by the Wilcoxon parametric test, comparing the total scores of each evaluation. For the assessment of criterion validity, the FSFI was used as the gold standard and the receiver operating characteristic (ROC) curve was constructed. Statistical analysis was performed using IBM SPSS Statistics for Windows, version 21.0 (IBM Corp., Armonk, NY, USA). It was found that the internal consistency of the FSFI-6 questionnaire was considerably high (0.839). RESULTS: The test-retest reliability results were satisfactory. It can also be stated that the FSFI-6 questionnaire presented excellent discriminant validity (area under the curve [AUC] = 0.926). Women may be considered as having sexual dysfunction if the overall FSFI-6 score is < 21, with 85.5% sensitivity, 82.2% specificity, positive likelihood ratio of 4.81 and negative likelihood ratio of 0.18. CONCLUSION: We conclude that the Brazilian Portuguese version of FSFI-6 is valid for use in postpartum women.


OBJETIVO: Avaliamos a consistência interna, a confiabilidade teste-reteste e a validade de critério do questionário FSFI-6 para a população brasileira no pós-parto. MéTODOS: Foram aplicados questionários em 100 mulheres sexualmente ativas no pós-parto. O coeficiente alfa de Cronbach foi utilizado para avaliar a consistência interna. A confiabilidade teste-reteste foi analisada pelo Kappa para cada item do questionário e pelo teste paramétrico de Wilcoxon, comparando-se os escores totais de cada avaliação. Para avaliar a validade de critério, o FSFI foi utilizado como padrão-ouro e a curva característica de operação de receptor (ROC, na sigla em inglês) foi construída. As análises estatísticas foram realizadas utilizando-se o software IBM SPSS Statistics for Windows, versão 21.0 (IBM Corp., Armonk, NY, USA). RESULTADOS: Os resultados da confiabilidade teste-reteste foram satisfatórios. O FSFI-6 apresentou uma excelente validade discriminante (área sob a curva [AUC, na sigla em inglês] = 0,926). Considera-se presente a disfunção sexual se o escore geral do FSFI-6 for < 21, com sensibilidade de 85,5%, especificidade de 82,2%, razão de verossimilhança positiva de 4,81 e razão de verossimilhança negativa de 0,18. CONCLUSãO: Concluímos que a versão em português do FSFI-6 se mostrou válida para uso em mulheres no pós-parto.


Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Feminino , Humanos , Brasil , Reprodutibilidade dos Testes , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários , Período Pós-Parto , Psicometria , Disfunções Sexuais Psicogênicas/epidemiologia
20.
Biomed Pharmacother ; 161: 114166, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36898260

RESUMO

BACKGROUND: Although Post-SSRI Sexual Dysfunction (PSSD) has finally been recognized by the European Medicines Agency as a medical condition that can outlast discontinuation of SSRI and SNRI antidepressants, this condition is still largely unknown by patients, doctors, and researchers, and hence, poorly understood, underdiagnosed, and undertreated. OBJECTIVE: Becoming familiar with the symptomatology of PSSD and understanding the underlying mechanisms and treatment options. METHOD: We applied a design thinking approach to innovation to 1) provide insights into the medical condition as well as the personal needs and pains of a targeted patient; and 2) generate ideas for new solutions from the perspective of this particular patient. These insights and ideas informed a literature search on the potential pathophysiological mechanisms that could underlie the patient's symptoms. RESULTS: The 55-year-old male patient developed symptoms of low libido, delayed ejaculation, erectile dysfunction, 'brain zaps', overactive bladder and urinary inconsistency after discontinuation of the SNRI venlafaxine. In many of these symptoms a dysregulation in serotonergic activity has been implicated, with an important role of 5-HT1A receptor downregulation and possible downstream effects on neurosteroid and oxytocin systems. CONCLUSIONS: The clinical presentation and development of symptoms are suggestive of PSSD but need further clinical elaboration. Further knowledge of post-treatment changes in serotonergic - and possibly noradrenergic - mechanisms is required to improve our understanding of the clinical complaints and to inform appropriate treatment regimes.


Assuntos
Disfunção Erétil , Inibidores da Recaptação de Serotonina e Norepinefrina , Disfunções Sexuais Fisiológicas , Masculino , Humanos , Pessoa de Meia-Idade , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Inibidores da Recaptação de Serotonina e Norepinefrina/efeitos adversos , Disfunções Sexuais Fisiológicas/induzido quimicamente , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Antidepressivos/uso terapêutico , Disfunção Erétil/tratamento farmacológico
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