RESUMEN
ABSTRACT Purpose: Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs) . Methods: A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results: After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions: The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.
RESUMO Objetivo: Disfunção sexual feminina é uma condição complexa acomete as mulheres, e a relação entre a função sexual e a dislipidemia é muito pouco estudada. Este estudo objetivou avaliar esta relação em mulheres na menacme que fazem uso de contraceptivos orais combinados (COCs). Métodos: Um total de 49 mulheres saudáveis com vida sexual ativa receberam pílulas anticoncepcionais contendo etinilestradiol 30 mcg (EE30) associado a levonorgestrel 150 mcg (LNG150). As mulheres foram divididas em dois grupos, de acordo com o perfil lipídico. Dislipidemia foi definida como nível de lipoproteína de alta densidade (HDL) < 50 mg/dL, ou nível de lipoproteína de baixa densidade (LDL) > 130 mg/dL. A função sexual feminina foi avaliada utilizando o questionário de Índice de Função Sexual Feminina (IFSF). O IFSF e os parâmetros lipídicos e lipoproteicos foram obtidos no início e após o sexto ciclo do estudo. Resultados: Após seis ciclos de uso dos COCs, as mulheres com LDL > 130 mg/dL, tiveram redução dos níveis de colesterol total e colesterol LDL de 14,7% e 22,1% respectivamente. Nas mulheres com níveis HDL < 50 mg/dL no momento basal, o nível de HDL aumentou 15,5% ao final do estudo. Os domínios de excitação, orgasmo e os escores totais do IFSF aumentaram significativamente nas mulheres com e sem dislipidemia. Os domínios de desejo e satisfação aumentaram no final do período de tratamento exclusivamente no grupo sem dislipidemia. Conclusões: A formulação EE30/LNG150 aumentou a função sexual das mulheres, sendo positivamente correlata somente com os níveis de colesterol HDL. Estes achados demonstram baixa correlação entre a função sexual e as alterações no metabolismo lipídico e lipoproteico.
Asunto(s)
Humanos , Femenino , Anticonceptivos Orales Combinados/uso terapéutico , Dislipidemias/tratamiento farmacológico , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Dislipidemias/sangre , Dislipidemias/complicaciones , Lípidos/sangre , Lipoproteínas/sangre , Orgasmo/efectos de los fármacos , Conducta Sexual , Disfunciones Sexuales Fisiológicas/sangre , Disfunciones Sexuales Fisiológicas/complicacionesRESUMEN
OBJECTIVE: The objective of this study was to evaluate the efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women and evaluate its effect on the serum levels of testosterone. METHODS: We performed a prospective randomized, double-blinded, placebo-controlled study, during 18 months. A total of 45 healthy sexually active postmenopausal women reporting diminished libido were selected to participate in the study and were randomly assigned to receive 750âmg/d of T terrestris or placebo for 120 days. Randomization was performed using sealed envelopes. All participants answered the Female Sexual Function Index and the Sexual Quotient-female version questionnaires and had their serum levels of prolactin, thyroid-stimulating hormone, total testosterone, and sex hormone-binding globulin measured. RESULTS: A total of 36 participants completed the study, because 3 from each group were excluded due to side effects and 3 dropped out due to personal reasons. FSFI questionnaire results demonstrated an improvement in all domains in both groups (Pâ<â0.05) except for lubrication which was improved only in the study group. QS-F results showed a significant improvement in the domains of desire (Pâ<â0.01), arousal/lubrication (Pâ=â0.02), pain (Pâ=â0.02), and anorgasmia (Pâ<â0.01) in women who used T terrestris, whereas no improvement was observed in the placebo group (Pâ>â0.05). Moreover, free and bioavailable testosterone levels showed a significant increase in the T terrestris group (Pâ<â0.05). CONCLUSIONS: Tribulus terrestris might be a safe alternative for the treatment of hypoactive sexual desire disorder in postmenopausal women, because it was effective in reducing symptoms with few side effects. Its probable mechanism of action involves an increase in the serum levels of free and bioavailable testosterone.
Asunto(s)
Extractos Vegetales/uso terapéutico , Posmenopausia/fisiología , Disfunciones Sexuales Psicológicas/tratamiento farmacológico , Tribulus , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Libido/efectos de los fármacos , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Fitoterapia , Placebos , Estudios Prospectivos , Encuestas y Cuestionarios , Testosterona/sangre , Resultado del TratamientoRESUMEN
Purpose Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs). Methods A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.
Asunto(s)
Anticonceptivos Orales Combinados/uso terapéutico , Dislipidemias/tratamiento farmacológico , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Dislipidemias/sangre , Dislipidemias/complicaciones , Femenino , Humanos , Lípidos/sangre , Lipoproteínas/sangre , Orgasmo/efectos de los fármacos , Conducta Sexual , Disfunciones Sexuales Fisiológicas/sangre , Disfunciones Sexuales Fisiológicas/complicacionesRESUMEN
INTRODUCTION: Female libido is multifactorial and complex. Declining estrogen levels in postmenopausal women affects vaginal function. AIM: The aim of this study was to evaluate female sexual function after using topical estrogen, testosterone, or polyacrylic acid as vaginal lubricants with K-Y jelly as a placebo lubricant. METHODS: This was a randomized controlled clinical trial on 80 postmenopausal women between 40 and 70 years of age with follow-up at the Menopause Clinic of the CAISM Unicamp. The women were randomized to treatment with topical vaginal estrogen, testosterone, polyacrylic acid, or oil lubricant alone, three times a week for a period of 12 weeks from November 2011 to January 2013. MAIN OUTCOME MEASURE: We used the Female Sexual Function Index (FSFI) to assess changes in sexual response at baseline, and after 6 and 12 weeks. RESULTS: After 12 weeks of treatment, polyacrylic acid and topical testosterone produced improvements in the FSFI domains of sexual desire, lubrication, satisfaction, reduced pain during intercourse, and total score compared with lubricant alone. Treatment with topical estrogen in comparison with lubricant alone showed an improvement in the FSFI field of desire. The intragroup analysis over the time of the treatment showed improvements in the fields of desire, lubrication, and reduced pain for polyacrylic acid, testosterone, and estrogen. Furthermore, women who used testosterone showed improvements over time in the fields of arousal, orgasm, and satisfaction. CONCLUSIONS: Treatment of postmenopausal women with symptoms of vaginal atrophy with polyacrylic acid, testosterone, and estrogen for 12 weeks produced improvements in self-reported female sexual function when compared with a placebo lubricant.
Asunto(s)
Resinas Acrílicas/administración & dosificación , Andrógenos/administración & dosificación , Estrógenos/administración & dosificación , Posmenopausia/efectos de los fármacos , Conducta Sexual/efectos de los fármacos , Testosterona/administración & dosificación , Administración Intravaginal , Adulto , Anciano , Celulosa/administración & dosificación , Celulosa/análogos & derivados , Moduladores de los Receptores de Estrógeno/uso terapéutico , Femenino , Glicerol/administración & dosificación , Humanos , Libido/efectos de los fármacos , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Fosfatos/administración & dosificación , Glicoles de Propileno/administración & dosificación , Cremas, Espumas y Geles Vaginales/administración & dosificaciónRESUMEN
Sexual dysfunctions caused by the use of antidepressants are relatively common. Agomelatine has demonstrated antidepressant properties in comparative studies with sertraline, fluoxetine, and venlafaxine as active controls. The aim of this study was to evaluate the effects of agomelatine on sexual response. Acutely depressed patients (n = 25) treated with agomelatine (25-50 mg/day) were evaluated over 12 weeks. Agomelatine showed a favorable response on depressive symptoms using the Montgomery-Åsberg Depression Rating Scale throughout the study. The Clinical Global Impression improvement score at the end of the study was 1.70 (SD = 0.89). The author assessed sexual response using the Arizona Sexual Experiences Scale, the International Index of Erectile Function, and a Visual Analogue Scale for desire, arousal, time, and intensity of orgasm and vaginal lubrication. Arizona Sexual Experiences Scale scores improved after 3 weeks of treatment, mainly attributable to an improvement in women rather than in men. The Visual Analogue Scale showed improvement in all stages of sexual response in women, with minimal changes in men. Clinical Satisfaction Scores at the end of the study for all patients were 7.00 (SD = 1.53). In conclusion, agomelatine appears to be a good option for the treatment of depression because it would not have adverse effects on sexual function.
Asunto(s)
Acetamidas/administración & dosificación , Antidepresivos/administración & dosificación , Trastorno Depresivo/tratamiento farmacológico , Libido/efectos de los fármacos , Satisfacción del Paciente , Acetamidas/efectos adversos , Adulto , Antidepresivos/efectos adversos , Depresión/tratamiento farmacológico , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Orgasmo/efectos de los fármacos , Disfunciones Sexuales Psicológicas/inducido químicamente , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the effect of the addition of methyltestosterone to estrogen and progestogen therapy on postmenopausal sexual energy and orgasm. METHODS: Sixty postmenopausal women in a stable relationship with a partner capable of intercourse, and presenting sexual complaints that appeared after menopause, were randomly divided into two groups: EP (n = 29) received one tablet of equine estrogens (CEE) 0.625 mg plus medroxyprogesterone acetate (MPA) 2.5 mg and one capsule of placebo; EP + A (n = 31) received one tablet of CEE 0.625 mg plus MPA 2.5 mg and one capsule of methyltestosterone 2.0 mg; The treatment period was 12 months. The effects of treatment on sexual energy were assessed using the Sexual Energy Change Scale. The ability to reach orgasm in sexual relations with the partner was verified through monthly calendars and by calculating the ratio between monthly frequency of orgasms in sexual relations and monthly sexual frequency. RESULTS: There was a significant relationship between improvement in level of sexual energy and the addition of methyltestosterone to CEE/MPA treatment (p = 0.021). No significant effect on orgasmic capacity was noted after the treatment period. CONCLUSION: Addition of methyltestosterone to CEE/MPA therapy may increase sexual energy, but might not affect the ability to obtain orgasm in sexual relations.
Asunto(s)
Terapia de Reemplazo de Estrógeno , Estrógenos/farmacología , Libido/efectos de los fármacos , Metiltestosterona/farmacología , Orgasmo/efectos de los fármacos , Progestinas/farmacología , Adulto , Estudios de Cohortes , Método Doble Ciego , Moduladores de los Receptores de Estrógeno/metabolismo , Terapia de Reemplazo de Estrógeno/efectos adversos , Terapia de Reemplazo de Estrógeno/métodos , Estrógenos/sangre , Estrógenos Conjugados (USP) , Femenino , Humanos , Libido/fisiología , Persona de Mediana Edad , Orgasmo/fisiología , Posmenopausia , Progestinas/sangreRESUMEN
INTRODUCTION: Sexual dysfunction frequently occurs in patients with schizophrenia under antipsychotic therapy, and the presence of sexual side effects may affect compliance. The aim of this study was to review and describe clinical findings relating to the appropriate management of such dysfunctions. MATERIAL AND METHODS: The research was carried out through Medline (from 1966 to March 2005), PsycInfo (from 1974 to March 2005), and Cochrane Library (from 1965 to March 2005) and included any kind of study, from case reports to randomized trials. RESULTS: The most common sexual dysfunctions found in the literature were libido decrease, difficulties in achieving and maintaining erection, ejaculatory dysfunction, orgasmic dysfunction, and menstrual irregularities. Thirteen papers were found: eight of them were open-label studies, four were descriptions of cases, and only one was a randomized clinical trial. All of them were short-term and had small sample sizes. The agents used were: bromocriptine, cabergoline, cyproheptadine, amantadine, shakuyaku-kanzo-to, sildenafil and selegiline. DISCUSSION: There was no evidence that those agents had proper efficacy in treating the antipsychotic-induced sexual dysfunction. An algorithm for managing sexual dysfunction induced by antipsychotics is suggested as a support for clinical decisions. Since the outcome from schizophrenia treatment is strongly related to compliance with the antipsychotics, prevention of sexual dysfunction is better than its treatment, since there is a scarcity of data available regarding the efficacy of intervention to deal with these problems.
INTRODUÇÃO: Disfunção sexual freqüentemente ocorre em pacientes com esquizofrenia em terapia com antipsicóticos e a presença de efeitos adversos sexuais pode afetar a adesão ao tratamento. O objetivo do estudo é rever e descrever achados clínicos relacionados ao manejo apropriado de tais disfunções. MATERIAIS E MÉTODOS: A pesquisa foi feita pelo Medline (de 1966 a março de 2005), PsycInfo (de 1974 a março de 2005) e Biblioteca Cochrane (de 1965 a março de 2005) e incluiu qualquer tipo de desenho de estudo de relato de caso a estudos clínicos randomizados. RESULTADOS: As disfunções sexuais mais comuns encontradas na literatura foram diminuição da libido, dificuldades em alcançar e manter ereção, disfunção ejaculatória, orgásmica e irregularidades menstruais. Treze artigos foram encontrados: oito deles eram estudos abertos, quatro descrições de casos e somente um estudo clínico randomizado. Todos eram de curta duração e com tamanho de amostra pequeno. Os agentes usados foram: bromocriptina, cabergolina, ciproheptadina, amantadina, shakuyaku-kanzo-to, sildenafil e selegilina. DISCUSSÃO: Não há evidências de eficácia apropriada destes agentes no tratamento da disfunção sexual induzida por antipsicóticos. Um algoritmo foi sugerido para manejo da disfunção sexual induzida por antipsicóticos, suportando decisões clínicas. Como o desfecho da esquizofrenia é fortemente relacionado a adesão ao tratamento com antipsicóticos, a prevenção da disfunção sexual é melhor que seu tratamento, visto que muito poucos dados estão disponíveis sobre a eficácia de intervenções destes problemas.
Asunto(s)
Humanos , Masculino , Femenino , Antipsicóticos/efectos adversos , Medicina Basada en la Evidencia , Esquizofrenia/tratamiento farmacológico , Disfunciones Sexuales Fisiológicas/inducido químicamente , Algoritmos , Agonistas de Dopamina/uso terapéutico , Libido/efectos de los fármacos , Trastornos de la Menstruación/complicaciones , Orgasmo/efectos de los fármacos , Erección Peniana/efectos de los fármacos , Inhibidores de Fosfodiesterasa/uso terapéutico , Antagonistas de la Serotonina/uso terapéutico , Disfunciones Sexuales Fisiológicas/tratamiento farmacológicoRESUMEN
OBJECTIVES: Determine which social, demographic and sexual function variables that most influence libido or desire and orgasm domains in the premenopausal and postmenopausal women. METHODS: A cross-sectional analysis of 231 Colombian-born women, aged 40-62 years. The sexual function was measured by self-questionnaire. The analysis was performed by using the chi2-test and multivariate regression analysis. The sexual function was divided in five domains: desire, arousal, lubrication, orgasm, pain; additionally satisfaction was included. RESULTS: The women with a higher level of education and with a good perception of their satisfaction with their partners, reported better performance in the desire. Age and the non existence of sexual partner influenced in a negative way on the desire. In sexual active women the orgasm was negatively influenced by low satisfaction scores, lack of emotional closeness with their partners and low educational level. High scores in lubrication and desire were associated with a good performance in the orgasm. The hormone therapy (HT) was associated with better scores in orgasm. CONCLUSIONS: Age, level of education, the presence or lack of sexual partner, degree of satisfaction with emotional closeness with the partner and adequate lubrication, influence the desire and orgasm domains in a significant way. By identifying these associations we can then perform some inexpensive interventions. Improving lubrication for menopausal women. Including men in educational activities to sensitize them toward women's feelings. Organizing educational campaigns for middle-aged women to demystify that sexuality is only for young people.
Asunto(s)
Libido/fisiología , Orgasmo/fisiología , Conducta Sexual/fisiología , Adulto , Factores de Edad , Distribución de Chi-Cuadrado , Colombia , Estudios Transversales , Escolaridad , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Libido/efectos de los fármacos , Menopausia/efectos de los fármacos , Menopausia/fisiología , Menopausia/psicología , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Análisis de Regresión , Educación Sexual/métodos , Conducta Sexual/efectos de los fármacos , Conducta Sexual/psicología , Parejas Sexuales , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Sexual dysfunction frequently occurs in patients with schizophrenia under antipsychotic therapy, and the presence of sexual side effects may affect compliance. The aim of this study was to review and describe clinical findings relating to the appropriate management of such dysfunctions. MATERIAL AND METHODS: The research was carried out through Medline (from 1966 to March 2005), PsycInfo (from 1974 to March 2005), and Cochrane Library (from 1965 to March 2005) and included any kind of study, from case reports to randomized trials. RESULTS: The most common sexual dysfunctions found in the literature were libido decrease, difficulties in achieving and maintaining erection, ejaculatory dysfunction, orgasmic dysfunction, and menstrual irregularities. Thirteen papers were found: eight of them were open-label studies, four were descriptions of cases, and only one was a randomized clinical trial. All of them were short-term and had small sample sizes. The agents used were: bromocriptine, cabergoline, cyproheptadine, amantadine, shakuyaku-kanzo-to, sildenafil and selegiline. DISCUSSION: There was no evidence that those agents had proper efficacy in treating the antipsychotic-induced sexual dysfunction. An algorithm for managing sexual dysfunction induced by antipsychotics is suggested as a support for clinical decisions. Since the outcome from schizophrenia treatment is strongly related to compliance with the antipsychotics, prevention of sexual dysfunction is better than its treatment, since there is a scarcity of data available regarding the efficacy of intervention to deal with these problems.
Asunto(s)
Antipsicóticos/efectos adversos , Esquizofrenia/tratamiento farmacológico , Disfunciones Sexuales Fisiológicas/inducido químicamente , Algoritmos , Agonistas de Dopamina/uso terapéutico , Medicina Basada en la Evidencia , Femenino , Humanos , Libido/efectos de los fármacos , Masculino , Trastornos de la Menstruación/complicaciones , Orgasmo/efectos de los fármacos , Erección Peniana/efectos de los fármacos , Inhibidores de Fosfodiesterasa/uso terapéutico , Antagonistas de la Serotonina/uso terapéutico , Disfunciones Sexuales Fisiológicas/tratamiento farmacológicoRESUMEN
INTRODUCTION: Female sexual dysfunction and its therapeutic approach is a growing area. AIM: We aimed to assess the subjective and objective changes of the female sexual response, in patients with orgasmic sexual dysfunction using 3 mg SL Apomorphine (APO). METHODS: Twenty-four patients (mean age 32 years old, SD: 9.69) were included in a prospective randomized cross-over protocol. Sexual response was evaluated objectively (duplex ultrasound) and subjectively (self-reported questionnaire) following vibrator stimuli with the addition of 3 mg SL APO or placebo. MAIN OUTCOME MEASURE: Sexual response objective (PSV, EDV, RI) and subjective (arousal and lubrication degree and orgasm achievement). Adverse events were also recorded. RESULTS: Clitoral hemodynamical changes, particularly peak systolic velocity (PSV), were significantly higher with APO (P = 0.003), mean increase of PSV poststimulus was 72.50% with placebo (from 9.7 cm/second to 17.0 cm/second) and 139.14% with APO (from 9.7 cm/second to 21.4 cm/second). SUBJECTIVE CHANGES (AROUSAL AND LUBRICATION) WERE ALSO SIGNIFICATIVE WITH APO (P < 0.05). CONCLUSION: According to our observations, APO seemed to produce more subjective and objective changes in the sexual arousal phase of women with orgasmic sexual dysfunction than placebo. Future research is needed to evaluate the place of this drug in the treatment of the female sexual dysfunction.
Asunto(s)
Apomorfina/uso terapéutico , Conducta Sexual/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Administración Sublingual , Adulto , Apomorfina/administración & dosificación , Estudios Cruzados , Agonistas de Dopamina/administración & dosificación , Agonistas de Dopamina/uso terapéutico , Femenino , Humanos , Orgasmo/efectos de los fármacos , Placebos , Estudios Prospectivos , Resultado del TratamientoRESUMEN
The loss of sexuality observed in the climacteric period is difficult to evaluate. An important advance has been the development of the Female Sexual Function Index (FSFI), a test based on the norms of the International Consensus Development Conference on Sexual Female Dysfunctions. Aim: To study the effects of hormone replacement therapy (HRT) on sexuality, applying the FSFI. Material and methods: The FSFI was applied to 300 healthy women between 45-64 years, sexually active, beneficiaries of the Southern Metropolitan Health Service. Results: The mean age of the sample studied was 51±5 years, 27% were HRT users, 21% had had an hysterectomy and 98% had a stable couple. The total score of the FSFI decreased from 27.3±5.8 in women between 45 and 49 years of age to 19.3±7.0 in women between 60 and 64 years (p <0.01). A significantly better sexuality was observed in HRT users, with FSFI scores of 28.1±5.5 and 24.6±6.8 in HRT users and non users, respectively (p <0.01). Women on HRT obtained a higher score in all of the test domains, especially in lubrication, orgasm and sexual satisfaction. Conclusions: Female sexuality decreases with aging. HRT users have a better sexual function than non users (Rev Méd Chile 2003; 131: 1251-55 ).
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Disfunciones Sexuales Fisiológicas , Terapia de Reemplazo de Estrógeno , Posmenopausia , Sexualidad/efectos de los fármacos , Disfunciones Sexuales Fisiológicas , Estudios de Cohortes , Estudios Transversales , Libido/efectos de los fármacos , Orgasmo/efectos de los fármacos , Encuestas y CuestionariosRESUMEN
BACKGROUND: The loss of sexuality observed in the climacteric period is difficult to evaluate. An important advance has been the development of the Female Sexual Function Index (FSFI), a test based on the norms of the International Consensus Development Conference on Sexual Female Dysfunctions. AIM: To study the effects of hormone replacement therapy (HRT) on sexuality, applying the FSFI. MATERIAL AND METHODS: The FSFI was applied to 300 healthy women between 45-64 years, sexually active, beneficiaries of the Southern Metropolitan Health Service. RESULTS: The mean age of the sample studied was 51 +/- 5 years, 27% were HRT users, 21% had had an hysterectomy and 98% had a stable couple. The total score of the FSFI decreased from 27.3 +/- 5.8 in women between 45 and 49 years of age to 19.3 +/- 7.0 in women between 60 and 64 years (p < 0.01). A significantly better sexuality was observed in HRT users, with FSFI scores of 28.1 +/- 5.5 and 24.6 +/- 6.8 in HRT users and non users, respectively (p < 0.01). Women on HRT obtained a higher score in all of the test domains, especially in lubrication, orgasm and sexual satisfaction. CONCLUSIONS: Female sexuality decreases with aging. HRT users have a better sexual function than non users.
Asunto(s)
Terapia de Reemplazo de Estrógeno , Posmenopausia , Disfunciones Sexuales Fisiológicas/etiología , Sexualidad/efectos de los fármacos , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Libido/efectos de los fármacos , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/diagnóstico , Encuestas y CuestionariosRESUMEN
A 12-week, double-blind, placebo-controlled, multicenter study evaluated the efficacy and safety of flexible-dose sildenafil citrate (Viagra) treatment (25, 50 or 100 mg) in Brazilian and Mexican men with erectile dysfunction (ED) of broad-spectrum etiology. Efficacy was assessed on the basis of responses to the 15-item International Index of Erectile Function (IIEF) questionnaire, completed at baseline and after 12 weeks of treatment. At end point, mean scores for all IIEF domains of sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) were significantly (P<0.0001) higher in the sildenafil group (n=109) than in the placebo group (n=105). These findings confirm the significant increases in frequency of penetration and frequency of maintained erections reported previously. Sildenafil treatment was well tolerated. The most common adverse events were headache and flushing. In conclusion, sildenafil is a well-tolerated and effective treatment for ED of broad-spectrum etiology in Latin American men.
Asunto(s)
Disfunción Eréctil/tratamiento farmacológico , Piperazinas/administración & dosificación , Vasodilatadores/administración & dosificación , Administración Oral , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Humanos , Libido/efectos de los fármacos , Masculino , México , Persona de Mediana Edad , Orgasmo/efectos de los fármacos , Satisfacción del Paciente , Piperazinas/efectos adversos , Piperazinas/uso terapéutico , Purinas , Seguridad , Citrato de Sildenafil , Sulfonas , Resultado del Tratamiento , Vasodilatadores/efectos adversos , Vasodilatadores/uso terapéuticoRESUMEN
OBJECTIVE: To determine the effect on male sexual function of initiating any one of the cardiovascular medications most frequently prescribed at our institution. DESIGN: Men were surveyed via telephone when they received a new prescription for hydrochlorothiazide, furosemide, lisinopril, verapamil, nifedipine, or diltiazem, and after 30 days of daily medication ingestion. To assess Hawthorne effect, men who had no change to their medication regimen also were surveyed at the time of medication refill for maintenance therapy and 30 days later. PARTICIPANTS: Community-dwelling male veterans who received a single new prescription between January 1 and April 1, 1992 (n = 134). MAIN OUTCOME MEASURES: Responses to questions about sexual interest, erectile function, orgasmic ability, and sexual satisfaction. RESULTS: Men who had no change to their medication regimen showed no change in sexual interest, erectile function, orgasmic ability, or satisfaction. Hydrochlorothiazide was associated with decreased orgasmic ability (p = 0.008). Although none of the other changes were statistically significant (p < 0.05), both nifedipine and diltiazem showed a trend toward improved sexual function. CONCLUSIONS: Hydrochlorothiazide may be associated with anorgasmia. More study is needed to determine if nifedipine and diltiazem improve erectile function. Furosemide, lisinopril, and verapamil likely have no effect on sexual function.