RESUMEN
Introdução: A disfunção sexual é mais frequente entre as mulheres, com prevalências entre 25 e 63% naquelas acima de 18 anos. Por meio do questionário Female Sexual Function Index, este estudo busca estimar a frequência de disfunções sexuais em mulheres adultas de duas Equipes de Saúde da Família em Florianópolis, Santa Catarina. Objetivo: O objetivo deste estudo é avaliar a prevalência de disfunção sexual feminina (DSF) nessas populações e investigar a relação entre variáveis sociodemográficas e os domínios representados no escore FSFI. Métodos: Utilizamos o questionário FSFI para avaliar a frequência de disfunções sexuais e realizamos uma análise das variáveis sociodemográficas entre as unidades de saúde. Foram incluídas mulheres adultas atendidas em duas Equipes de Saúde da Família em Florianópolis. Resultados: A prevalência geral de DSF encontrada foi de 67,8%, com uma distribuição homogênea entre as diferentes unidades de saúde e variáveis sociodemográficas. Observamos associações entre anos de estudo e maiores índices de DSF, especialmente nos domínios de desejo, excitação e lubrificação, e entre maior idade e melhor desempenho nos domínios de desejo e excitação. Conclusões: A alta prevalência de distúrbios sexuais femininos em Florianópolis, distribuída de maneira homogênea entre as variáveis sociodemográficas estudadas, destaca a importância da capacitação dos profissionais de saúde na abordagem dessas questões na Atenção Primária
Introduction: Sexual dysfunction is more common among women, with prevalence ranging from 25 to 63% in those over 18 years of age. Through the Female Sexual Function Index (FSFI) questionnaire, in this study we aim to estimate the frequency of sexual dysfunctions in adult women from two Family Health Teams in Florianópolis, state of Santa Catarina, Brazil. Objective: The objective of this study is to evaluate the prevalence of female sexual dysfunction (FSD) in these populations and investigate the relationship between sociodemographic variables and the domains represented in the FSFI score. Methods: The FSFI questionnaire was used to assess the frequency of sexual dysfunctions, and an analysis of sociodemographic variables among the health units was performed. Adult women seen at two Family Health Teams in Florianópolis were included. Results: The overall prevalence of FSD was 67.8%, with a homogeneous distribution among different health units and sociodemographic variables. We observed associations between years of formal education and higher rates of FSD, especially in the domains of desire, arousal, and lubrication, and between older age and better performance in the domains of desire and arousal. Conclusions: The high prevalence of female sexual disorders in Florianópolis, homogeneously distributed among the sociodemographic variables studied, underscores the importance of training healthcare professionals in addressing these issues in Primary Health Care.
Introducción: La disfunción sexual es más común entre las mujeres, con prevalencias que oscilan entre el 25 y el 63% en aquellas mayores de 18 años. A través del cuestionario del Índice de Función Sexual Femenina (FSFI, por sus siglas en inglés), este estudio tiene como objetivo estimar la frecuencia de disfunciones sexuales en mujeres adultas de dos Equipos de Salud Familiar en Florianópolis, Santa Catarina. Objetivo: El objetivo de este estudio es evaluar la prevalencia de la disfunción sexual femenina (DSF) en estas poblaciones e investigar la relación entre variables sociodemográficas y los dominios representados en la puntuación FSFI. Métodos: Utilizamos el cuestionario FSFI para evaluar la frecuencia de disfunciones sexuales y realizamos un análisis de variables sociodemográficas entre las unidades de salud. Se incluyeron mujeres adultas atendidas en dos Equipos de Salud Familiar en Florianópolis. Resultados: La prevalencia general de DSF fue del 67.8%, con una distribución homogénea entre diferentes unidades de salud y variables sociodemográficas. Observamos asociaciones entre años de estudio y mayores índices de DSF, especialmente en los dominios de deseo, excitación y lubricación, y entre mayor edad y mejor desempeño en los dominios de deseo y excitación. Conclusiones: La alta prevalencia de trastornos sexuales femeninos en Florianópolis, distribuida homogéneamente entre las variables sociodemográficas estudiadas, subraya la importancia de capacitar a los profesionales de la salud en abordar estas cuestiones en la Atención Primaria.
Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Atención Primaria de Salud , Disfunciones Sexuales Fisiológicas , Disfunciones Sexuales PsicológicasRESUMEN
O desempenho sexual humano é influenciado por uma variedade de fatores biopsicossociais e a prática regular de exercícios pode trazer efeitos benéficos sobre a saúde física e emocional e prevenir disfunções sexuais. Este artigo tem como objetivo analisar a influência do exercício físico no desempenho sexual humano. Para a população feminina, exercitar-se tem efeitos positivos sobre a função sexual pela melhora na excitação sexual em decorrência do aumento na atividade do sistema nervoso simpático e fatores endócrinos. Praticantes de exercícios regulares apresentam melhor função sexual e vascularização clitoriana e menor sofrimento sexual, em comparação com mulheres sedentárias, sendo os benefícios mediados por determinantes biológicos e psicológicos. Para a população masculina, níveis mais altos de atividade física estão associados à melhora da função erétil e ao controle da ejaculação, pelo aumento da consciência interoceptiva e melhor equilíbrio simpático-vagal durante essa atividade, mediados por vias psicológicas e fisiológicas. As evidências sugerem que níveis moderados a altos (mas não excessivos) de atividade física beneficia a saúde sexual, caracterizando uma estratégia não farmacológica para a promoção do bem-estar sexual. A relação entre exercício físico e desempenho sexual reforça a importância de incorporar atividades físicas regulares como parte de um estilo de vida saudável, visando não apenas a saúde geral, mas também o bem-estar sexual. Com a crescente prevalência de disfunções sexuais, o exercício físico emerge como intervenção preventiva e terapêutica promissora, enfatizando a necessidade de mais estudos para explorar plenamente o potencial dessa intervenção.
Asunto(s)
Humanos , Masculino , Femenino , Ejercicio Físico , Salud Sexual , Disfunciones Sexuales Fisiológicas , Enfermedad Crónica , SexualidadRESUMEN
Objective: To evaluate and compare the sexual function and pelvic floor muscles (PFM) function of women with endometriosis and chronic pelvic pain (CPP) with and without Myofascial Pelvic Pain Syndrome (MPPS). Methods: Cross-sectional study conducted between January 2018 and December 2020. Women with deep endometriosis underwent assessments for trigger points (TP) and PFM function using the PERFECT scale. Electromyographic activity (EMG) and sexual function through Female Sexual Function Index (FSFI) were assessed. Statistical analyses included chi-square and Mann-Whitney tests. Results: There were 46 women. 47% had increased muscle tone and 67% related TP in levator ani muscle (LAM). Weakness in PFM, with P≤2 was noted in 82% and P≥3 in only 17%. Incomplete relaxation of PFM presented in 30%. EMG results were resting 6.0, maximal voluntary isometric contraction (MVIC) 61.9 and Endurance 14.2; FSFI mean total score 24.7. We observed an association between increased muscle tone (P<.001), difficulty in relaxation (P=.019), and lower Endurance on EMG (P=.04) in women with TP in LAM. Participants with TP presented lower total FSFI score (P=.02). TP in the right OIM presented increased muscle tone (P=.01). TP in the left OIM presented lower values to function of PFM by PERFECT (P=.005), and in MVIC (P=.03) on EMG. Conclusion: Trigger points (TP) in pelvic floor muscles (PFM) and obturator internus muscle (OIM) correlates with poorer PFM and sexual function, particularly in left OIM TP cases. Endometriosis and chronic pelvic pain raise muscle tone, weaken muscles, hinder relaxation, elevate resting electrical activity, lower maximum voluntary isometric contraction, and reduce PFM endurance.
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Electromiografía , Endometriosis , Síndromes del Dolor Miofascial , Diafragma Pélvico , Dolor Pélvico , Humanos , Femenino , Estudios Transversales , Adulto , Síndromes del Dolor Miofascial/fisiopatología , Diafragma Pélvico/fisiopatología , Endometriosis/complicaciones , Endometriosis/fisiopatología , Dolor Pélvico/fisiopatología , Dolor Pélvico/etiología , Disfunciones Sexuales Fisiológicas/fisiopatología , Disfunciones Sexuales Fisiológicas/etiología , Persona de Mediana Edad , Adulto Joven , Puntos Disparadores/fisiopatologíaRESUMEN
BACKGROUND: Premenopausal, high-risk, hormone receptor-positive breast cancer patients are often treated with ovarian suppression in combination with aromatase inhibitors (AI). This combination has important adverse effects, particularly in sexual function, such as vaginal dryness and loss of libido. There is no effective therapy for reduced sexual function in this setting. Our study aimed to determine the efficacy and safety, particularly regarding sexual function, of a low-dose, topical testosterone gel administration. METHODS: This is a pilot, single-center study, designed to evaluate the efficacy of topical testosterone gel (3 mg/day) in improving sexual function in 29 premenopausal patients on ovarian suppression in combination with an AI. The primary safety endpoint was to assess serum estradiol elevation. The primary efficacy endpoint was sexual function improvement, assessed by the Female Sexual Function Index questionnaire. RESULTS: We report the results on 29 patients. Twenty-two patients (75%) completed the 3-month treatment, and seven discontinued treatment before completion, mostly due to logistical difficulties related to the COVID-19 pandemic. All patients maintained the value of baseline mass spectrometry assay for estradiol of less than 2.7 pg/mL during the undertaken measurements. We observed a significant improvement in Female Sexual Function Index measures over the visits, with an increase from a mean of 11.7 at baseline to 19.1 in the third month (p < 0.001), with the greatest improvement observed between the second and third months. CONCLUSIONS: Our findings suggest that topical testosterone seems to be safe and may be effective in improving sexual function in patients on ovarian suppression and AI. TRIAL REGISTRATION: The project was submitted and approved through the hospital's SGPP platform in 11/26/2019 (Project No. SGPP 393819) and CAAE (Research Ethics Committee) (CAAE No 25609719.5.0000.007).
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Inhibidores de la Aromatasa , Neoplasias de la Mama , Testosterona , Humanos , Femenino , Inhibidores de la Aromatasa/administración & dosificación , Inhibidores de la Aromatasa/efectos adversos , Inhibidores de la Aromatasa/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Testosterona/administración & dosificación , Testosterona/sangre , Persona de Mediana Edad , Adulto , Proyectos Piloto , Administración Tópica , Resultado del Tratamiento , Estradiol/administración & dosificación , Estradiol/efectos adversos , COVID-19 , Premenopausia , Disfunciones Sexuales Fisiológicas/etiología , Ovario/efectos de los fármacos , Ovario/metabolismo , SARS-CoV-2RESUMEN
BACKGROUND: Mindfulness-based cognitive therapy (MBCT) includes regular home practice of mindfulness exercises as a key means of cultivating mindfulness. Although there are instruments available for measuring homework adherence following cognitive behavioral therapy (CBT), little is known about measuring homework practice in MBCT studies for sexual dysfunction. AIM: In this review we sought to investigate which items and instruments are the most used for the assessment of homework adherence in studies evaluating MBCT for the treatment of female sexual dysfunction (FSD). We also investigated the types of homework used in these interventions. METHODS: Five databases (PubMed, Scopus, PsycINFO, Embase, and Web of Science) were searched and a total of 30 articles were included in this review. OUTCOMES: Our main findings revealed that there was no gold standard instrument used to assess homework adherence in patients using MBCT interventions for FSD, and that most of the reported studies did not provide information on how they assess homework adherence. RESULTS: Six of the 9 studies for which the articles reported how homework was assessed used only ad hoc measures. Only 3 studies used psychometrically validated instruments. We also found that mindfulness, psychoeducation, and CBT exercises were the most prescribed homework. STRENGTHS AND LIMITATIONS: This review uniquely integrates homework adherence measures with studies on FSD that evaluate mindfulness, finding no gold standard for assessing adherence. However, limitations including both MBCT and CBT interventions, limiting generalization to MBCT alone, the predominance of Western-based studies, and the lack of reporting on instruments used to assess adherence, indicating a gap in the field. CONCLUSION: Further studies should consider adapting existing instruments that assess homework adherence in studies of CBT for other psychopathologies or seek to develop new psychometrically validated instruments for MBCT interventions that assess homework adherence.
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Terapia Cognitivo-Conductual , Atención Plena , Humanos , Femenino , Atención Plena/métodos , Terapia Cognitivo-Conductual/métodos , Disfunciones Sexuales Psicológicas/terapia , Disfunciones Sexuales Fisiológicas/terapia , Cooperación del PacienteRESUMEN
OBJECTIVES: To assess the prevalence and factors associated with dyspareunia and the lack of sexual intercourse in women between 50 and 70 years cohabiting with their partners. METHODS: This is a descriptive and exploratory cross-sectional study using the snowball technique with prospective data collection using a structured questionnaire to describe multiple aspects of health and sexuality among 266 cohabiting Brazilian couples aged 50 to 70. RESULTS: The prevalence of lack of sexual activity was 20%. Factors associated with sexual inactivity were female sexual dysfunction (OR: 9.87, 95% CI: 3.24-30.10, P < 0.001), female dissatisfaction with the partner as a lover (OR: 5.86, 95% CI: 2.03-16.88, P = 0.001), male sexual dysfunction (OR: 4.51, 95% CI: 1.60-12.70, P = 0.004), and poor self-rated male health (OR: 3.66, 95% CI: 1.29-10.40, P = 0.015). The prevalence of dyspareunia was 42.3% in the sample of sexually active women. Factors associated with dyspareunia were female sexual dysfunction (OR: 2.7, 95%, CI: 1.26-5.77, P = 0.010), moderate/severe vaginal dryness (OR: 4.67, 95% CI: 2.21-9.87, P < 0.001), and vaginal discomfort (OR: 4.03, 95% CI: 1.77-9.17, P < 0.001). CONCLUSIONS: The results showed that male, female, and dyadic factors were associated with a lack of sexual activity. On the other hand, only female factors were associated with dyspareunia among sexually active couples.
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Coito , Dispareunia , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Estudios Transversales , Masculino , Persona de Mediana Edad , Dispareunia/epidemiología , Anciano , Brasil/epidemiología , Prevalencia , Disfunciones Sexuales Fisiológicas/epidemiología , Encuestas y Cuestionarios , Parejas Sexuales , Conducta Sexual/estadística & datos numéricos , Envejecimiento/fisiología , Estudios ProspectivosRESUMEN
BACKGROUND: Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life. AIM: The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH. METHODS: A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey. OUTCOMES: Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant. RESULTS: A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life. CLINICAL IMPLICATION: The data reinforce the need for rehabilitation programs and social support for this population. STRENGTHS AND LIMITATIONS: This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse. CONCLUSION: We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life.
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Hipertensión Arterial Pulmonar , Calidad de Vida , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Calidad de Vida/psicología , Estudios Transversales , Persona de Mediana Edad , Hipertensión Arterial Pulmonar/fisiopatología , Hipertensión Arterial Pulmonar/psicología , Disfunciones Sexuales Fisiológicas/psicología , Disfunciones Sexuales Fisiológicas/epidemiología , Adulto , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in the treatment of vasomotor, sexual dysfunction, and recurrent depression in postmenopausal women. METHODS: This prospective, open study evaluated 112 postmenopausal women with vasomotor symptoms. Sexual dysfunction has cultural, social, biological, and emotional issues and divided into two groups: G1, without depression (n=65) and G2, with recurrent depression (n=47). The subjects underwent 12 sessions of in-person cognitive behavioral therapy and 12 sessions of home-based activity over a period of 6 months. They were evaluated at 3 months following the completion of therapy. Depression, memory, and attention-related functions, as well as climactic symptoms, were assessed using a questionnaire. RESULTS: In the depression questionnaire, the G1 group had a lower initial score than the G2 group (p<0.01). Following 6 months of therapy, both groups had similar improved scores. In the depression questionnaire, the women in group G1 had higher baseline values. In the assessment of vasomotor symptoms, the values in both groups were similar and showed an improvement in vasomotor symptoms after 24 weeks of treatment, but these effects disappeared after the follow-up of 48 weeks in the G2 group. Both groups improved the sexual dysfunction after 24 weeks. CONCLUSION: Cognitive behavioral therapy may be effective in reducing vasomotor symptoms and ameliorate the sexual dysfunction and recurrent depression in postmenopausal women after 24 weeks of treatment.
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Terapia Cognitivo-Conductual , Posmenopausia , Humanos , Femenino , Posmenopausia/fisiología , Posmenopausia/psicología , Terapia Cognitivo-Conductual/métodos , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento , Encuestas y Cuestionarios , Sofocos/terapia , Sofocos/psicología , Depresión/terapia , Disfunciones Sexuales Fisiológicas/terapia , Recurrencia , Anciano , Disfunciones Sexuales Psicológicas/terapia , Disfunciones Sexuales Psicológicas/psicologíaRESUMEN
Objective: The purpose of this study was to analyze the available evidence regarding the efficacy of iPDE5 in the treatment of female sexual dysfunction (FSD). Methods: A comprehensive literature search was conducted in March 2023 through the main scientific databases. Results: A total of 53 articles were identified, out of which, 6 met the predefined inclusion criteria. All of these were randomized controlled trials. Among the included studies, 4 demonstrated the effectiveness of sildenafil in improving sexual response and addressing FSD, while 2 studies failed to establish its efficacy in this context. Conclusion: Overall, the efficacy of sildenafil in the treatment of FSD remains controversial and inconclusive based on the available evidence. Further research is necessary to clarify the therapeutic potential of iPDE5 in addressing FSD and to better understand the factors that influence treatment outcomes.
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Disfunciones Sexuales Fisiológicas , Citrato de Sildenafil , Humanos , Femenino , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Citrato de Sildenafil/uso terapéutico , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores de Fosfodiesterasa/uso terapéutico , Resultado del TratamientoRESUMEN
BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with worldwide representation that impacts every domain of a patient´s life, extending to sexual and reproductive domains. The study characterized sexual health (SH) and reproductive health (RH) in Mexican RA outpatients and identified factors associated with impaired sexual function (ISF). METHODS: From September 1, 2020-January 31, 2022, consecutive RA participants had semi-structured interviews focusing on their SH and RH biographies, and self-administered questionnaires were applied to assess patient-reported outcomes, including fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). ISF was defined based on published cut-offs of the International Index of Erectile Function (IIEF) in males and the Female Sexual Function Index (FSFI) in females (≥1 sexual intercourse in the last four weeks was required for index scoring). Multivariable logistic regression analysis was used to identify the factors associated with ISF. RESULTS: There were 268 participants, and 246 (91.8%) were females. Participants had 13 years of disease duration. Among females, 151 (61.4%) had FSFI applied, and the satisfaction domain was impaired in 111 (73.5%). Among males (N = 22), 17 (77.3%) had IIEF applied, and erectile dysfunction was present in 5 (29.4%). Almost half of the participants denied using a family planning method, were in their 50s, and receiving teratogenic drugs; 89.7% of the participants had children. ISF was detected in 94 (62.3%) females and 3 (17.6%) males. Male sex (aOR: 0.07, 95%CI: 0.01-0.36, p = 0.001), FACIT-F score (aOR: 0.96, 95%CI: 0.92-1.00, p = 0.03), and cohabitation with the couple (aOR: 0.32, 95%CI: 0.11-0.96, p = 0.04) were associated with ISF. CONCLUSIONS: We observed a disproportionate burden of ISF among women with RA compared to male participants. Male sex, lesser fatigue, and cohabitation with the couple were protective against ISF. Regardless of the prevalent use of teratogenic medications, contraceptive use was suboptimal among the participants.
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Artritis Reumatoide , Disfunciones Sexuales Fisiológicas , Humanos , Artritis Reumatoide/psicología , Artritis Reumatoide/fisiopatología , Artritis Reumatoide/complicaciones , Masculino , Femenino , México/epidemiología , Persona de Mediana Edad , Adulto , Disfunciones Sexuales Fisiológicas/epidemiología , Salud Sexual , Encuestas y Cuestionarios , Salud Reproductiva , Fatiga/epidemiología , Fatiga/psicología , AncianoRESUMEN
PURPOSE: The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. METHODS: Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. RESULTS: Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. CONCLUSIONS: The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.
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Orgasmo , Personas Transgénero , Humanos , Masculino , Femenino , Adulto , Estudios Transversales , Personas Transgénero/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Satisfacción Personal , Conducta Sexual , Disfunciones Sexuales Fisiológicas/etiologíaRESUMEN
BACKGROUND: Vaginal laxity (VL) is a complaint of excessive vaginal looseness with a prevalence ranging from 24% to 38% across studies. AIM: The study sought to compare the effect of radiofrequency (RF) and pelvic floor muscle training (PFMT) on the treatment of women with VL. METHODS: From February 2020 to December 2021, a prospective, parallel, noninferiority, randomized clinical trial was carried out in women ≥18 years of age and complaining of VL in a tertiary hospital. Two groups (RF and PFMT) were evaluated at the beginning of the study and 30 days and 6 months postintervention. A total of 42 participants per arm was sufficient to demonstrate a difference in sexual function on the Female Sexual Function Index at 90% power, 1-sided type 1 error of 0.025 with a noninferiority margin of 4 on the FSFI total score. Analysis was intention-to-treat and per-protocol based. OUTCOMES: The primary endpoint was the change of FSFI score after treatment, and the secondary outcomes were improvement in symptoms of VL and changes in questionnaire scores of sexual distress, vaginal symptoms, and urinary incontinence, in the quantification of pelvic organ prolapse, and pelvic floor muscle (PFM) contraction. RESULTS: Of 167 participants recruited, 87 were included (RF: n = 42; PFMT: n = 45). All questionnaires improved (P < .05) their total scores and subscales in both groups and during the follow-ups. After 30 days of treatment, RF was noninferior to PFMT to improving FSFI total score (mean difference -0.08 [95% confidence interval, -2.58 to 2.42]) in the per-protocol analysis (mean difference -0.46 [95% confidence interval, -2.92 to 1.99]) and in the intention-to-treat analysis; however, this result was not maintained after 6 months of treatment. PFM contraction improved significantly in both groups (RF: P = .006, 30 days; P = .049, 6 months; PFMT: P < .001, 30 days and 6 months), with better results in the PFMT group. CLINICAL IMPLICATIONS: Sexual, vaginal, and urinary symptoms were improved after 30 days and 6 months of treatment with RF and PFMT; however, better results were observed in the PFMT group after 6 months. STRENGTHS & LIMITATIONS: The present randomized clinical trial used several validated questionnaires evaluating quality of life, sexual function and urinary symptoms, in addition to assessing PFM contraction and classifying the quantification of pelvic organ prolapse aiming at anatomical changes in two follow-up periods. The limitations were the lack of a sham-controlled group (third arm) and the difficulty of blinding researchers to assess treatments due to the COVID-19 pandemic. CONCLUSION: After 30 days and 6 months of treatment, sexual, vaginal, and urinary symptoms improved with RF and PFMT; however, better results were observed in the PFMT group after 6 months. RF was noninferior to PFMT in improving FSFI total score after 30 days; however, this result was not maintained after 6 months of treatment.
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Terapia por Ejercicio , Diafragma Pélvico , Vagina , Humanos , Femenino , Diafragma Pélvico/fisiopatología , Persona de Mediana Edad , Vagina/fisiopatología , Estudios Prospectivos , Terapia por Ejercicio/métodos , Adulto , Disfunciones Sexuales Fisiológicas/terapia , Prolapso de Órgano Pélvico/terapia , Incontinencia Urinaria/terapia , Incontinencia Urinaria/fisiopatología , Resultado del TratamientoRESUMEN
Antecedentes: En las mujeres con endometriosis, son frecuentes las disfunciones sexuales, particularmente el dolor/dispareunia. Objetivo: Evaluar y caracterizar la prevalencia de disfunciones sexuales en las mujeres con endometriosis en Armenia (Quindío), Colombia. Método: Estudio de corte transversal, en 137 mujeres mayores de 18 años con diagnóstico de endometriosis confirmada histológicamente, atendidas en tres clínicas de alta complejidad entre 2017 y 2022. Se utilizó como instrumento el Índice de Función Sexual Femenina (IFSF). Resultados: La edad promedio de las participantes fue de 34,68 ± 7,32 años. La prevalencia de disfunciones sexuales fue del 75,91%, caracterizando en primer lugar el dolor/dispareunia (75,91%), seguido de disminución del deseo sexual (56,93%) y en tercer lugar problemas de lubricación (54,01%). El promedio en la puntuación del IFSF fue de 20,82 ± 7,22 y la proporción de mujeres con puntuación ≥ 26,55 fue del 24,08%. La mediana en el número de disfunciones sexuales fue 3 (rango: 1 y 6). Conclusiones: En las mujeres con endometriosis se evidencia una alta prevalencia de disfunciones sexuales, equivalente a tres cuartas partes de las afectadas. Al momento de atender una mujer con este padecimiento se requiere evaluar sus efectos en la función sexual para poder implementar intervenciones terapéuticas oportunas.
Background: Sexual dysfunctions, particularly pain/dyspareunia, are common in women with endometriosis. Objective: To evaluate and characterize the prevalence of sexual dysfunctions in women with endometriosis in Armenia (Quindío), Colombia. Method: Cross-sectional study in 137 sexually active women older than 18 years with a diagnosis of histologically confirmed endometriosis, attended in three highly complex clinics between 2017 and 2022. The Female Sexual Function Index (FSFI) was used as an instrument. Results: The average age of the participants was 34.68 ± 7.32 years. The prevalence of sexual dysfunctions reported 75.91%, characterizing pain/dyspareunia in the first place (75.91%), followed by decreased sexual desire (56.93%) and thirdly problems of lubrication (54.01%). The average score of the FSFI was 20.82 ± 7.22; the proportion of women with a score ≥ 26.55 was 24.08%. The median in the number of sexual dysfunctions reached 3 (range: 1 and 6). Conclusions: In women with endometriosis there is evidence of a high prevalence of sexual dysfunctions, equivalent to three-quarters of the affected women. When caring for a woman with this condition, it is necessary to evaluate its effects on sexual function in order to implement timely and effective therapeutic interventions.
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Humanos , Femenino , Adolescente , Adulto , Adulto Joven , Disfunciones Sexuales Fisiológicas/epidemiología , Endometriosis/complicaciones , Disfunciones Sexuales Fisiológicas/etiología , Prevalencia , Estudios Transversales , Encuestas y Cuestionarios , Colombia/epidemiología , Dispareunia/complicacionesRESUMEN
INTRODUCTION: One of the changes caused by pelvic cancers is the decrease in patients' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency. OBJECTIVES: This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer. METHODS: Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome. RESULTS: Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported. CONCLUSION: Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.
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Tratamiento Conservador , Neoplasias de la Próstata , Disfunciones Sexuales Fisiológicas , Humanos , Masculino , Neoplasias de la Próstata/terapia , Neoplasias de la Próstata/complicaciones , Disfunciones Sexuales Fisiológicas/terapia , Disfunciones Sexuales Fisiológicas/etiología , Calidad de VidaRESUMEN
BACKGROUND: Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults. METHODS: Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines. RESULTS: Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups. CONCLUSION: Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
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Ensayos Clínicos Controlados Aleatorios como Asunto , Yoga , Humanos , Femenino , Adulto , Masculino , Disfunciones Sexuales Fisiológicas/terapia , Persona de Mediana Edad , Conducta Sexual , AncianoRESUMEN
BACKGROUND: The assessment of female sexual function after diagnosis and treatment of breast cancer is relevant, as cancer can negatively affect sexuality and, therefore, quality of life. Instruments assessing female sexuality can be useful in clinical practice. However, there are few validated instruments available for this purpose. This study aimed to translate the Female Sexual Function Index Adaptation for Breast Cancer Patients (FSFI-BC) into Brazilian Portuguese and culturally adapt it for use in Brazil. PATIENTS AND METHODS: Translation and cross-cultural adaptation followed the linguistic validation process, according to international guidelines. The instrument was translated and back-translated by independent translators. Sixty women aged 25 to 70 years who had been diagnosed and surgically treated for breast cancer at least 6 months previously participated in the cultural adaptation process. Participants were stratified into sexually active or inactive. Internal consistency was analyzed using Cronbach's alpha coefficient. RESULTS: Mean participant age was 52.5 years. For sexually active women, reliability analysis (Cronbach's alpha) showed excellent internal consistency between the items of the subscales 'Desire/Arousal' (α = 0.912) and 'Orgasm' (α = 0.904), and good internal consistency for 'Lubrication' (α = 0.814) and 'Pain' (α = 0.839). For sexually inactive women, excellent internal consistency was observed between the items of the subscale 'Reason for Inactivity - difficulty lubricating' (α = 0.930), and good internal consistency for the other subscales. The instrument had face and content validity. CONCLUSIONS: FSFI-BC was translated and culturally adapted to the context of the Brazilian population.
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Neoplasias de la Mama , Calidad de Vida , Conducta Sexual , Humanos , Femenino , Neoplasias de la Mama/psicología , Persona de Mediana Edad , Brasil , Adulto , Anciano , Encuestas y Cuestionarios , Conducta Sexual/psicología , Traducciones , Reproducibilidad de los Resultados , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/psicología , Psicometría/métodos , Comparación TransculturalRESUMEN
INTRODUCTION: Sexual dysfunction (SD) is highly prevalent and multifactorial; nevertheless, recent research has shed light on a notable phenomenon: male patients with systemic lupus erythematosus (SLE) exhibit an elevated prevalence of sexual function disorders compared with the general population. Despite this recognition, the precise nature and extent of this association remain incompletely understood. OBJECTIVES: This comprehensive review aims to clarify the link by providing an overview of the fundamental components of normal male sexual function, delving into the pathogenesis of male SD and exploring the primary factors predisposing male SLE patients to SD. Additionally, the review offers insights into potential screening, diagnostic, and treatment strategies based on the current body of literature. METHODS: A meticulous search of relevant literature was conducted using the PubMed and Google Scholar databases. RESULTS: Studies exploring the correlation between SLE and SD in both genders have revealed a nearly 2-fold increased risk of SD among individuals with SLE compared with healthy counterparts. Moreover, these studies suggest that male SLE patients may have a higher susceptibility to SD, with reported prevalence ranging from 12% to 68%, compared with 0% to 22% in healthy individuals. Male patients with SLE are influenced by a spectrum of pathological factors, including pharmacological, psychological, and disease-related determinants, which, through their intricate interplay, elevate the likelihood of developing SD. CONCLUSION: Healthcare professionals must remain vigilant in understanding the intricacies of human sexuality and its dysfunction, particularly in males with SLE. The objective is to establish effective and potentially standardized methods for promptly diagnosing and optimally managing SD, recognizing its significant impact on the quality of life for males living with SLE. The pivotal role of rheumatologists in initiating discussions about sexual health, diagnosing SD, investigating causes, and implementing tailored strategies is underscored as crucial in addressing this multifaceted issue.
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Lupus Eritematoso Sistémico , Disfunciones Sexuales Fisiológicas , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/fisiopatología , Masculino , Disfunciones Sexuales Fisiológicas/etiología , Reumatólogos , PrevalenciaRESUMEN
Se investiga la región uretro-vaginal (pared posterior de la uretra pared anterior de la vagina), en el área que corresponde a la descripción del "punto G", con el fin de colaborar a la discusión respecto de si existe una estructura morfológica que lo identifique. Se destaca una mayor y ocasional distribución venosa en esta zona, que puede explicar el fenómeno fisiológico descrito por Gräfenberg. Para los ginecólogos, urólogos y sexólogos, el conocimiento de la anatomía funcional de esa región tiene importancia para tratar las disfunciones orgásmicas además de la incontinencia urinaria. Esta situación controvertida influye en el marco actual de la seguridad del paciente
The urethro-vaginal region (posterior wall of the urethra anterior wall of the vagina) is investigated, in the area that corresponds to the description of the "G-spot", in order to contribute to the discussion regarding whether there is a morphological structure that identifies it. A greater and occasional venous distribution in this area stands out, which may explain the physiological phenomenon described by Gräfenberg. For gynecologists, urologists and sexologists, knowledge of the functional anatomy of that region is important to treat orgasmic dysfunctions in addition to urinary incontinence. This controversial situation influences the current framework of patient safety
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Humanos , Femenino , Orgasmo , Disfunciones Sexuales Fisiológicas/patología , Uretra/patología , Incontinencia Urinaria/patología , Vagina/patologíaRESUMEN
PURPOSE: To evaluate the quality of life, sexual function, anxiety, and depression of women with endometriosis according to pain symptoms and infertility. METHODS: This cross-sectional multicenter study included 229 women with endometriosis followed up at a tertiary hospital in Campinas, a tertiary hospital in São Paulo, and a reproductive medicine clinic in Campinas from 2018 to 2021. The women were divided into four groups according to the presence of pain symptoms and infertility. The Endometriosis Health Profile Questionnaire, Female Sexual Function Index, Beck Depression Inventory, and Beck Anxiety Index were applied to assess quality of life, sexual function, depression, and anxiety of women with endometriosis. RESULTS: The women were grouped as follows: group 1 (45 women without infertility and without pain), group 2 (73 women without infertility and with pain), group 3 (49 women with infertility and without pain), and group 4 (62 women with infertility and pain). Of the women with infertility, the majority had primary infertility. Most women had deep endometriosis (p = 0.608). Women with pain had higher anxiety and depression scores and worse quality of life than women without pain (p < 0.001). Regarding sexual function, all the groups were at risk for sexual dysfunction (p = 0.671). The group of women with pain and infertility have worse anxiety scores (25.31 ± 15.96) and depression (18.81 ± 11.16) than the other groups. CONCLUSION: Pain symptoms worsen anxiety, depression, and quality of life of women with endometriosis and when associated with infertility, greater impairment of psychological aspects may occur.