RESUMEN

In 36 patients treated on account of chronic inflammations of the genitals a check-up examination was made 5 to 6 months after termination of spa treatment. Attention was paid to the gynaecological palpation finding, the mental state of the patients and their sex life. It was found that the palpation finding improved markedly or became normal (p < 0.0001). The values of Zung's self-assessment anxiety scale SAS were significantly more favourable (p < 0.001). Almost 40% of the examined women (14 probands) reported improvement of sex life. Treatment of chronic gynaecological inflammations in Frantiskovy Lázne is thus effective and helps affected women.

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RESUMEN

On the basis of sexuological examination of 152 married women with pelvic inflammatory disease it is proposed to use the term of dyspareunia in patients who have pains during coitus and who are dissatisfied with the course of sexual intercourse. For probands who had unpleasant or even painful feelings during coitus but were in 93% of cases satisfied with sexual life, it would be suitable to use the term of algopareunia.

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Using the interview method, three sexologists examined over a period of 36 years the sexual development and life of 2425 gynecological patients who were sent to Frant. Lázne (Franzensbad) for post-treatment of conditions following gynecological inflammations or surgery. They had all been married at least one year and when interviewed were 20-40 years old. After their division into individual decades of birth between 1911 and 1970 it was ascertained that the percentage of coitally orgastic women continuously increased from 31% to 80%. This was accompanied by a distinct increase of coital activity. On the basis of results of new sociological studies the authors try to explain the increase of sexual satisfaction mainly through changes in the course of sexual life of women. These were caused through changes of social milieu not only after the second world war but also in the course of the whole twentieth century. The authors are of the opinion that the sexual satisfaction in women will remain due to biological differences always somewhat lower than in men.

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Using an interview based on a uniform examination pattern comprising 70 items, the authors examined the sex life of 152 women aged 21-40 years, married for at least one year, treated at the time for chronic gynaecological inflammations in Frantiskovy Lázne. It was revealed that 55 probands (36.2%) did not report any marked changes in the course of sex life. 58 patients (38.2%) had unpleasant or painful sensations during coitus to which they responded in a rational way: by change or adjustment of the position, care taken by the partner, sometimes by discontinuation of coitus. The third sub-group was formed by 39 probands (25.6%) who were not satisfied with their sex life.

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In a group of 771 Czech girls aged 16 to 18 years who were examined by means of an interview, the influence of three psychosocial factors on their sexual development was studied. Through statistical analysis of data it was found that probands living in towns had their first sexual intercourse significantly earlier (p < 0.004) than village girls and further they had more experience with cunnilingus and fellatio. Their level of education and that of both parents was significantly higher than in probands living in villages. However, in the second study we ascertained that sexual development of students in comparison with girl-apprentices was highly significantly retarded (p < 0.004). In the third study a comparison of psychosexual development of 535 girls who lived in complete and stable families, and of 166 probands from divorced marriages was carried out. Sexual development in the later group was accelerated (p < 0.02). The emotional atmosphere in disrupting families and the incompleteness after divorce influenced negatively the development of girls during their adolescence in different directions.

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RESUMEN

During treatment of chronic pelvic inflammatory diseases the authors examined by interviews conducted by two sexuologists in Frantiskovy Lázne 152 women married for at least one year, aged 21 to 40 years. After analysis of the results of sexuological examinations the authors recommend to use the term algopareunia for patients who have painful sensations during coitus but react rationally and are satisfied with their sex life. The term dyspareunia covers women who with regard to pain during intercourse report that they are dissatisfied with their sex life.

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Sexual development and behavior of 771 Czech girls 16 to 18 years old had been investigated by two sexuologists during the period of 1986 till 1994. A standardized interview of 78 items had been applied in a setting of a rehabilitation facility in Franzensbad. The majority of probands were there for rehabilitation after appendectomy. There were 389 examinees (158 apprentices and 231 students) interviewed before "the velvet revolution" and 382 girls (159 apprentices and 223 students) in the course of the years 1990 to 1994. A comparison of these two groups revealed a definite change in the psychosexual development of girls in the Czech society after the "Velvet Revolution". Particularly the motivation for the first coitus had changed. After November 1989 it was noticed that the answer "obliged her partner" had significantly decreased and the answer "wished it for myself" has substantially increased. Also in the group of probands with multiple sexual partners (21.5% of the sample) their average number decreased unexpectedly after "the Velvet Revolution".

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BACKGROUND: It was revealed that sexual development and behaviour of adolescents, in particular girls, reflect rapidly and immediately changes in the social environment. The objective of the present investigation was to assess whether changes of the psychosexual development of girls occurred, i.e. girls examined in 1986 to 1989 and those examined after "velvet revolution" between 1990 to 1994. METHODS AND RESULTS: Using a interview based on a uniform examination pattern comprising 78 items, two sexologists examined in 1986 to 1994 the sexual development and behaviour of 771 Czech girls aged 16-18 years. This number comprised 317 apprentices and 454 secondary school students. The sexological examination was made in Frantiskovy Lázne where the probands were sent for preventive treatment, mostly after appendectomies. Comparison of the two sub-groups revealed that the apprentices and students reported changes as regards the motivation of the first sexual intercourse. After November 1989 there was a decline in the group "complied" and a marked increase of the number in the category "desired herself". It was surprising that the psychosexual development of girls after the "velvet revolution" was rather retarded than hastened. The most marked change was recorded in the category "intercourse with several partners" -a drop by 12% (p < 0.03). CONCLUSIONS: The findings that despite a markedly increased motivation for the first intercourse in the examined girls no changes were recorded in the girls in some items which characterize the development of sex life, is surprising.

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By means of interviews two sexologists examined in 1986-1994 771 Czech girls aged 16-18 years during their stay in the spa of Frantiskovy Lázne. Up to the end of 1989 the authors studied the sexual development of 158 girls apprentices and 231 girl students. After the "Velvet Revolution" 159 apprentices and 223 students were examined. Comparison of these sub-groups revealed that the sexual development of students was highly significantly retaried, as compared with the apprentices; this applied to the period before and after 1989. This difference is interpreted mainly by the higher education, expressed by the sum of years of school attendance of both parents of the examined girls and a higher standard of the education process in secondary schools as compared with schools for apprentices.

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By means of interviews the sexual development of 16 to 18-year-old Czech girls was investigated: 163 lived in rural communities with less than 2,000 inhabitants and 271 lived in towns with more than 100,000 inhabitants. Comparison of these two groups, using Schofield's diagram, revealed that the difference in the course of sexual development was not statistically significant. However, when individual items of the examination were analyzed, significant differences were found in the education of probands and both their parents, education being higher in the group of urban girls. In urban girls the prevalence of broken marriages of their parents was also higher, the loss of the father before the child was 18 years was more frequent and the number of siblings was smaller. The age at the first sexual intercourse was lower in urban girls and they had more frequent experience with cunnilingus and fellatio.

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Out of a group of 700 Czech girls aged 16 to 18 years questioned by means of interviews 344 (49.1%) already had their first heterosexual coitus. Thirty-three of them reached orgasm during their first sexual intercourse and during second and further intercourses they were orgasmic mostly or always. The second subgroup comprised 32 girls who were anorgasmic not only during their first sexual intercourse but also during their further sexual life. Statistically significant differences between these two subgroups were found in the following items: Orgasmic girls were more frequently longing for their first sexual intercourse whereas of the anorgasmic girls the motives were curiosity or the effort to satisfy their partners. The majority of these girls experienced the first sexual intercourse as unpleasant and reported frequent occurrence of bleeding. Furthermore, they had to regret more frequently the loss of their fathers during the first 6 years of their lives than the girls of the first subgroup had.

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The authors describe the course of the first sexual intercourse in 344 Czech girls examined at the age of 16-18 years. Attention was paid in particular to the following factors: age during first intercourse, period of preceding emotional relationship, age of coital partners, environment where first intercourse took place, motivation of probands, difficulties during first intercourse, contraception used, frequency of sexual intercourse during period following first coitus.

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Examination of a group of 602 Czech girls and group of 192 Czech boys aged 16 to 18 years revealed that differences in the occurrence of masturbation are in our population markedly greater than in German or American university students. In the examined groups cca 90% boys and only 6% of the examined girls masturbated. There were also marked differences in the frequency of masturbation. In our population so far the consequences of sexual liberalization after social changes at the end of 1989 are not yet manifest. It can be, however, assumed that in our country liberalization will also lead to a diminution of differences in the occurrence and frequency of masturbation between the two sexes. The authors hold the view that an important part is played also by biological factors, in particular those of a hormonal character.

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Out of a sample of 2,425 gynecological patients aged 21-40 and married for at least one year, three groups were selected according to the frequency of coital orgasm. The first group contained 1,266 (52.2%) orgastic women, the second group included 172 (7.1%) patients who did not reach orgasm during coitus, and the third group consisted of 55 (2.3%) patients whose absent orgasms were felt by the examinees as distressing. Significant differences were found between the three groups concerning family environment and childhood, level of education and professional standing, sexual development and life, and in the incidence of psychopathological symptoms. It appears that the absent capacity of women to attain orgasm in sexual intercourse is caused by several factors of both biological and psychosocial nature.

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The authors investigated by interviews in Frantiskovy Lázne the sexual development and sex life in 614 Czech girls aged 16 to 18 years. It was revealed that the sexual development in 311 girls, where in the course of the year before convalescent treatment in Frantiskovy Lázne appendectomy was performed and in 89 probands who were operated twice or more frequently, was highly significantly retarded as compared with 163 probands who had no surgery so far. Comparison of the findings in 426 girls from complete and emotionally balanced families and 140 probands of divorced parents did not reveal a significant difference in their sexual development.

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A group of 609 Czech 16 to 18 years old girls was divided according to the age of the first menses into three subgroups: first with menarche between 10 to 12 years, second in 13 and 14 years, third in 15 and 16 years. It was found that the age of menarche did not distinctly influence the course of their sexual development during the puberal period. The mean age of first rendezvous and coitarche did not significantly differ between the followed three subgroups. Out of the whole group of 609 probands 304 girls already had sexual intercourse. The percentage of coitally orgastic girls was highest in the subgroup with an early first menstrual bleeding between 10 and 12 years of age and the difference to the other two subgroups with a later menarche was statistically highly significant (p < 0.005). The opinion is expressed that changes in brain which enable girls to fall in love for the first time are from the point of view of biological prerequisites more important for the beginning of full sexual life in pubertal girls than hormonal development manifested by first menstrual bleeding.

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The authors applied the Atropine test in 28 patients with the motor type of urgent incontinence in an attempt to establish the prognosis of the success of treatment with parasymthatholytics. Atropine was administered in amounts of 0.01 mg/kg body weight by the i.m. route and after 30 mins. a urodynamic control examination was made. The assumption that a reduced frequency or amplitude of detrusor contractions will occur or that they will disappear in patients, where subsequent treatment with parasympatholytics will be successful, was not confirmed. The patients were subsequently treated by a combination of dilthiazem (Diacordin), 3 X 30 mg by the oral route per day and oxyphenonium (Oxyphenon dupl.) 2 X 10 mg by the oral route per day. After evaluation of the therapeutic results the group was divided into two sub-groups. The first one comprised patients where during the urodynamic check-up examination a drop of the intracystic pressure occurred after Atropine administration. The second group comprised patients where the drop of intracystic pressure did not occur. The therapeutic effect in these groups was evaluated separately. In the course of treatment there was a relatively high percentage of undesirable side-effects of the drugs in 43% of the patients. After the general evaluation of the therapeutic effect when the patients had no complaints or improved markedly in 70.4% there were no marked differences between the sub-groups.

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