RESUMO
AIMS: To evaluate the prevalence of hypoactive sexual desire disorder (HSDD) among postmenopausal women diagnosed with metabolic syndrome (MS) and to compare it to that of a control group without MS. METHODS: This is a cross-sectional study carried out in 2 public tertiary hospitals in the state of São Paulo, Brazil, with a sample of 291 postmenopausal women aged between 40 and 65 years. Sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria and was related to the diagnosis of MS, which was determined according to the guidelines defined by the Adult Treatment Panel. MAIN OUTCOME MEASURES: Analysis of sexual function with emphasis on sexual desire (HSDD), the incidence of MS, and the components of MS. RESULTS: The prevalence of HSDD was significantly higher among women diagnosed with MS than among women without MS (P = .01). Women diagnosed with high blood pressure (P < .01) and increased triglycerides (P = .03) also had a higher prevalence of HSDD than did women without these conditions. The FSFI domain scores for desire, arousal, lubrication, orgasm, and satisfaction and the total FSFI score were significantly lower for postmenopausal women with MS, whereas the pain domain score was not significantly different between the groups (P = .913). The incidence of female sexual dysfunction was significantly higher among women with MS, regardless of the diagnostic criteria used (P < .05). CONCLUSION: Postmenopausal women diagnosed with MS have higher rates of HSDD than do women without MS. CLINICAL TRIAL REGISTRATION: ID NCT02430987. Dutra da Silva GM, Rolim Rosa Lima SM, Reis BF, et al. Prevalence of Hypoactive Sexual Desire Disorder Among Sexually Active Postmenopausal Women With Metabolic Syndrome at a Public Hospital Clinic in Brazil: A Cross-sectional Study. J Sex Med 2020;8:545-553.
RESUMO
OBJECTIVE: The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. METHODS: This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0-29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). RESULTS: The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p = 0.028 and p = 0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p < 0.05). The total FSFI score statistically differed among the BMI categories (p = 0.027). CONCLUSION: In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.
OBJETIVO: A incidência de obesidade, que é uma condição crônica, aumentou nos últimos anos. A associação entre obesidade e disfunção sexual feminina ainda não está clara, particularmente em mulheres após a menopausa. No presente estudo, avaliamos se a obesidade é um fator de risco para disfunção sexual em mulheres após a menopausa. MéTODOS: Este é um estudo transversal que analisou dados de entrevistas de mulheres após a menopausa no Ambulatório de Climatério a partir de 2015 até 2018. Após a aplicação dos critérios de inclusão e exclusão, 221 mulheres com idade entre 40 e 65 anos foram selecionadas e convidadas a participar do estudo. Obesidade foi diagnosticada de acordo com o índice de massa corpórea (IMC). Os participantes foram agrupados nas seguintes categorias de IMC: grupo 1: 18,524,9 kg/m2 (normal); grupo 2: 25,029,9 kg/m2 (sobrepeso); e grupo 3: ≥ 30,0 kg/m2 (obesidade). A função sexual foi avaliada através do questionário Female Sexual Function Index (FSFI, na sigla em inglês). Pontos de corte de ≥ 23 e ≥ 26,5 foram adotados para definir um diagnóstico de disfunção sexual feminina (DSF) com base no Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª Edição, Texto Revisto DSM-IV-TR. RESULTADOS: Os escores de desejo e excitação foram estatisticamente maiores no grupo com IMC normal do que no grupo obesidade (p = 0,028 e p = 0,043, respectivamente). Os escores de satisfação foram estatisticamente maiores no grupo com IMC normal do que nos grupos com sobrepeso e obesidade (p < 0,05). A pontuação total do FSFI diferiu estatisticamente entre as categorias de IMC (p = 0,027). CONCLUSãO: No presente estudo, mulheres após a menopausa obesas e com sobrepeso tiveram escores totais mais altos do que mulheres com IMC normal. Nossos resultados mostram que mulheres obesas e com sobrepeso após a menopausa apresentaram índices mais altos de disfunção no desejo e excitação e menor satisfação sexual do que mulheres com peso normal.
Assuntos
Obesidade/fisiopatologia , Obesidade/psicologia , Pós-Menopausa/fisiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Abstract Objective The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. Methods This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0- 29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). Results The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p=0.028 and p=0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p<0.05). The total FSFI score statistically differed among the BMI categories (p=0.027). Conclusion In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.
Resumo Objetivo A incidência de obesidade, que é uma condição crônica, aumentou nos últimos anos. A associação entre obesidade e disfunção sexual feminina ainda não está clara, particularmente emmulheres após amenopausa. No presente estudo, avaliamos se a obesidade é um fator de risco para disfunção sexual em mulheres após a menopausa. Métodos Este é umestudo transversal que analisou dados de entrevistas demulheres após a menopausa no Ambulatório de Climatério a partir de 2015 até 2018. Após a aplicação dos critérios de inclusão e exclusão, 221 mulheres com idade entre 40 e 65 anos foram selecionadas e convidadas a participar do estudo. Obesidade foi diagnosticada de acordo com o índice de massa corpórea (IMC). Os participantes foram agrupados nas seguintes categorias de IMC: grupo 1: 18,5-24,9 kg/m2 (normal); grupo 2: 25,0-29,9 kg/m2 (sobrepeso); e grupo 3: ≥30,0 kg/m2 (obesidade). A função sexual foi avaliada através do questionário Female Sexual Function Index (FSFI, na sigla em inglês). Pontos de corte de ≥23 e ≥26,5 foram adotados para definir um diagnóstico de disfunção sexual feminina (DSF) com base no Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª Edição, Texto Revisto DSM-IV-TR. Resultados Os escores de desejo e excitação foram estatisticamente maiores no grupo com IMC normal do que no grupo obesidade (p=0,028 e p=0,043, respectivamente). Os escores de satisfação foram estatisticamente maiores no grupo com IMC normal do que nos grupos comsobrepeso e obesidade (p<0,05). A pontuação total do FSFI diferiu estatisticamente entre as categorias de IMC (p=0,027). Conclusão No presente estudo,mulheres após a menopausa obesas e com sobrepeso tiveram escores totais mais altos do que mulheres com IMC normal. Nossos resultados mostram que mulheres obesas e com sobrepeso após a menopausa apresentaram índices mais altos de disfunção no desejo e excitação e menor satisfação sexual do que mulheres com peso normal.
Assuntos
Humanos , Feminino , Adulto , Disfunções Sexuais Fisiológicas/epidemiologia , Pós-Menopausa/psicologia , Disfunções Sexuais Psicogênicas/epidemiologia , Obesidade/fisiopatologia , Obesidade/psicologia , Brasil/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Fatores de Risco , Pessoa de Meia-IdadeRESUMO
Objective The aim of this study was to study the effects of Tribulus terrestris on sexual function in menopausal women. Methods This was a prospective, randomized, double-blind, placebo-controlled clinical trial that included 60 postmenopausal women with sexual dysfunction. The women were divided into two groups, placebo group and Tribulus group, and evaluated by using the Sexual Quotient-female version (SQ-F) and Female Intervention Efficacy Index (FIEI) questionnaires. Results There was no significant difference between the groups in age, age at menopause, civil status, race, and religion. In the evaluation with the SQ-F questionnaire, there were significant differences between the placebo (7.6±3.2) and Tribulus (10.2±3.2) groups in the domains of desire and sexual interest (p d" 0.001), foreplay (3.3±1.5 versus 4.2±1.0) (p d" 0.01), arousal and harmonious interaction with the partner (5.7±2.1 versus 7.2±2.6) (p d" 0.01), and comfort in sexual intercourse (6.5±2.4 versus 8.0±1.9) (p d" 0.01). There was no significant difference between the placebo and Tribulus groups in the domains of orgasm and sexual satisfaction (p = 0.28). In the FIEI questionnaire, there was a significant improvement (p < 0.001) in the domains of vaginal lubrication during coitus and/or foreplay (20 versus 83.3%), sensation in the genitalia during sexual intercourse or other stimuli (16.7 versus 76.7%), sensation in the genital region (20 versus 70%), sexual intercourse and/or other sexual stimulations (13.3 versus 43.3%), and the ability to reach orgasm (20% versus 73.3%). There was no significant difference in adverse effects between the two groups. Conclusions After 90 days of treatment, at the doses used, we found Tribulus terrestris to be effective in treating sexual problems among menopausal women.
Objetivo Estudar os efeitos doTribulus terrestris na função sexual demulheres após a menopausa. Métodos Ensaio clínico, prospectivo, randomizado, duplo-cego, placebo controlado, com 60 mulheres após a menopausa com disfunção sexual, divididas em dois grupos: Grupo Placebo e Grupo Tribulus, avaliadas através dos questionários Quociente Sexualversão Feminina (QS-F) e Female Intervention Efficacy Index (FIEI). Resultados Não houve diferença significante entre os grupos quanto à idade, idade de menopausa, estado civil, raça e religião. Na avaliação do questionário QS-F houve diferença significante entre os grupos Placebo (7,6±3,2) e Tribulus (10,2±3,2) nos aspectos desejo e interesse sexual (p d" 0,001), preliminares (3,3±1,5 versus 4,2±1,0) (p d" 0,01), excitação da mulher e sintonia com o parceiro (5,7±2,1 versus 7,2±2,6) (p d" 0,01) e no aspecto conforto na relação sexual (6,5±2,4 versus 8,0±1,9) (p d" 0,01). O aspecto orgasmo e satisfação sexual não houve diferença significante entre o Grupo Placebo e Tribulus (p = 0,28). No questionário FIEI houve melhora significante (p < 0,001) na lubrificação vaginal durante o coito e/ou preliminares (20 versus 83,3%), na sensação nas genitálias durante a relação sexual ou outros estímulos (16,7 versus 76,7%), na sensação na área genital (20 versus 70%), nas relações sexuais e/ou outras estimulações sexuais (13,3 versus 43,3%) e na capacidade de ter orgasmo (20% versus 73,3%). Quanto aos efeitos colaterais não houve diferença significante entre os dois Grupos. Conclusões Após noventa dias, podemos concluir que o Tribulus terrestris nas doses utilizadas demonstrou ser efetivo no tratamento das queixas sexuais dasmulheres após a menopausa.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Menopausa , Fitoterapia , Extratos Vegetais/uso terapêutico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Tribulus , Método Duplo-Cego , Estudos Prospectivos , Comportamento SexualRESUMO
OBJECTIVE: The aim of this study was to study the effects of Tribulus terrestris on sexual function in menopausal women. METHODS: This was a prospective, randomized, double-blind, placebo-controlled clinical trial that included 60 postmenopausal women with sexual dysfunction. The women were divided into two groups, placebo group and Tribulus group, and evaluated by using the Sexual Quotient-female version (SQ-F) and Female Intervention Efficacy Index (FIEI) questionnaires. RESULTS: There was no significant difference between the groups in age, age at menopause, civil status, race, and religion. In the evaluation with the SQ-F questionnaire, there were significant differences between the placebo (7.6 ± 3.2) and Tribulus (10.2 ± 3.2) groups in the domains of desire and sexual interest (p ≤ 0.001), foreplay (3.3 ± 1.5 versus 4.2 ± 1.0) (p ≤ 0.01), arousal and harmonious interaction with the partner (5.7 ± 2.1 versus 7.2 ± 2.6) (p ≤ 0.01), and comfort in sexual intercourse (6.5 ± 2.4 versus 8.0 ± 1.9) (p ≤ 0.01). There was no significant difference between the placebo and Tribulus groups in the domains of orgasm and sexual satisfaction (p = 0.28). In the FIEI questionnaire, there was a significant improvement (p < 0.001) in the domains of vaginal lubrication during coitus and/or foreplay (20 versus 83.3%), sensation in the genitalia during sexual intercourse or other stimuli (16.7 versus 76.7%), sensation in the genital region (20 versus 70%), sexual intercourse and/or other sexual stimulations (13.3 versus 43.3%), and the ability to reach orgasm (20% versus 73.3%). There was no significant difference in adverse effects between the two groups. CONCLUSIONS: After 90 days of treatment, at the doses used, we found Tribulus terrestris to be effective in treating sexual problems among menopausal women.
Assuntos
Menopausa , Fitoterapia , Extratos Vegetais/uso terapêutico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Tribulus , Idoso , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Comportamento SexualRESUMO
OBJECTIVE: To assess efficacy and tolerability of a isoflavone (Glycine max L. Merr.) vaginal gel to the treatment of vaginal atrophy in postmenopausal women. METHODS: The double-blind, randomized, placebo-controlled, clinical trial. Ninety women were treated for 12 weeks with isoflavone vaginal gel 4% (1g/day) and a placebo gel and conjugated equine estrogen cream (0.3mg/day). After 4 and 12 weeks, the vaginal atrophy symptoms were classified at none, mild, moderate and severe and the vaginal cytology were taken to determine the maturation value. The endometrial safety (by transvaginal ultrasonography) was evaluated through at screening and the end of the trial. RESULTS: Isoflavone vaginal gel appears to be effective for relief of vaginal dryness and dyspareunia symptoms and an increase in the intermediate and superficial cells was noted. These results were similar to the effects with use of conjugated equine estrogens and superior to placebo gel. No changes in endometrial thickness, sera FSH and estradiol levels were observed at study endpoint. CONCLUSION: Glycine max (L.) Merr. at 4% vaginal gel on a daily basis in postmenopausal women led to improvements in vaginal atrophy symptoms and a significant increase in cell maturation values. Isoflavones proved good treatment options for relief of vulvovaginal symptoms especially in women who do not wish to use hormonal therapy or have contra-indications for this treatment.