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Objetivo: Analizar la percepción de la imagen corporal y su impacto en la función sexual orgásmica en mujeres estudiantes de la educación superior de Chillán, 2021. Métodos: Estudio cuantitativo, analítico, de corte transversal. Se evaluaron cuatro variables: datos demográficos, imagen corporal, orgasmo y función sexual. Se utilizó un Google Formulario a mujeres estudiantes entre 18 y 44 años de edad, de la educación superior en la ciudad de Chillán. Posterior a ello, los datos obtenidos se recopilaron y tabularon en el programa estadísticos SPSS 23. Resultados: Las dimensiones del índice de función sexual femenino alteradas con mayor frecuencia fueron: satisfacción (80,6 %), excitación (73,8 %) y orgasmo (51,5 %). El 99,0 % de las encuestadas presentaron disfunción sexual. Con respecto a la relación entre la dimensión de excitación y la pobre imagen corporal producida por el propio cuerpo (p = 0,019 r = -0,223) presentó correlación estadísticamente significativa, no así entre los puntajes totales de ambos instrumentos (p = 0,34; r = 0,09). Finalmente, las correlaciones entre la dimensión de dolor al momento de tener relaciones sexuales y la autodesvalorización por la apariencia física correlacionaron positivamente (p = 0,049; r = 0,196). Conclusión: Se observó alterado el orgasmo por la percepción de cómo se sienten con su propio cuerpo las encuestadas, lo que crearía una imagen corporal negativa llevando a una insatisfacción corporal(AU)

Objective: Analyze the perception of body image and its impact on orgasmic sexual function in female higher education students in Chillán, 2021. Methods: Quantitative, analytical, cross-sectional study. Four variables were evaluated: demographic data, body image, orgasm and sexual function. A Google Form was used for female students between 18 and 44 years of age, from higher education in the city of Chillán. Subsequently, the data obtained were compiled and tabulated in the statistical program SPSS 23. Results: The most frequently altered dimensions of the female sexual function index were: satisfaction (80.6%), arousal (73.8%), and orgasm (51.5%). 99.0% of the respondents had sexual dysfunction. Regarding the relationship between the arousal dimension and the poor body image produced by one's own body (p = 0.019; r = -0.223), there was a statistically significant correlation, but not between the total scores of both instruments (p = 0.34; r = 0.09). Finally, the correlations between the dimension of pain at the time of sexual intercourse and self-depreciation due to physical appearance were positively correlated (p = 0.049; r = 0.196). Conclusion: The orgasm was observed to be altered by the perception of how the respondents felt about their own body, which would create a negative body image leading to body dissatisfaction(AU)

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The anatomy and physiology of the female orgasm are often neglected. The female orgasm is a normal psychophysiological function to all women, and some even can achieve ejaculation as part of the normal physiological response at the height of sexual arousal. The complexity of female sexuality requires a deep understanding of genital anatomy. The clitoris is the principal organ for female pleasure. The vaginal stimulation of the anterior vaginal wall led women to orgasm due to the stimulation of the clitourethrovaginal complex and not due to stimulation of a particular organ called the G spot in the anterior distal vaginal wall. Female ejaculation follows orgasm. It consists of the orgasmic expulsion of a smaller quantity of whitish fluid produced by the female prostate. Squirting can be differentiated from female ejaculation because it is the orgasmic transurethral expulsion of a substantial amount of diluted urine during sexual activity, and it is not considered pathological. The female orgasm is influenced by many aspects such as communication, emotional intimacy, long-standing relationship, adequate body image and self-esteem, proper touching and knowledge of the female body, regular masturbation, male sexual performance, male and female fertility, chronic pain, and capacity to engage in new sexual acts. Stronger orgasms could be achieved when clitoral stimulation, anterior vaginal wall stimulation, and oral sex is involved in the same sexual act.

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Abstract Objective To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women. Data Sources We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied. Selection of Studies We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women. Data Collection Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors. Data Synthesis A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study). Conclusion We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

Resumo Objetivo Avaliar a eficácia das abordagens hormonais e não hormonais para os sintomas de disfunção sexual e atrofia vaginal em mulheres na pós-menopausa. Fontes de Dados Pesquisamos as bases de dados PubMed, Embase, Scopus, Web of Science, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), e Cumulative Index to Nursing and Allied Health Literature (CINAHL), assim como bancos de dados de ensaios clínicos. Foram analisados estudos publicados entre 1996 e 30 de maio de 2020. Nenhuma restrição de idioma foi aplicada. Seleção dos Estudos Foram selecionados ensaios clínicos randomizados que avaliavam o tratamento das disfunções sexuais em mulheres na pós-menopausa. Coleta de Dados Três autores (ACAS, APFC e JL), revisaram cada artigo com base em seu título e resumo. Os dados relevantes foram posteriormente retirados do texto completo do artigo. Quaisquer discrepâncias durante a revisão foram resolvidas por consenso entre todos os autores listados. Síntese dos Dados Ao todo, 55 estudos foram incluídos na revisão sistemática. As abordagens testadas para tratar a disfunção sexual foram: lubrificantes e hidratantes (18 estudos); fitoestrogênios (14 estudos); deidroepiandrosterona (DHEA; 8 estudos); ospemifeno (5 estudos); testosterona vaginal (4 estudos); exercícios para os músculos do assoalho pélvico (2 estudos); oxitocina (2 estudos);laser de CO2 vaginal (2 estudos); lidocaína (1 estudo), e vitamina E vaginal (1 estudo). Conclusão Identificou-se falta de coerência na literatura quanto aos tratamentos propostos e medidas de resultados selecionadas. Apesar da grande diversidade de modalidades de tratamento e medidas de resultados, esta revisão sistemática pode lançar luz sobre alvos potenciais para o tratamento, que é considerado necessário para a disfunção sexual, assumindo que a maioria dos estudos randomizados foi avaliada com baixo risco de viés de acordo com a ferramenta de avaliação de risco de viés de Cochrane Collaboration. Esta revisão tem cadastro no International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

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We investigated the relationship between Brazilian women's reported reasons for pretending orgasm, their performance of mate retention behaviors, and their relationship satisfaction. Additionally, we secured evidence of the validity and reliability of a Brazilian-Portuguese adaptation of the Reasons to Pretend Orgasm Inventory (RPOI). Participants were 295 Brazilian women in a heterosexual relationship (Mage = 24.9 years, SDage = 5.4 years). Participants completed a Brazilian-Portuguese adaptation of the Mate Retention Inventory-Short Form, and the translated RPOI (the Escala de Razões para Fingir Orgasmo; ERFO). The resulting 47-item ERFO represents well the original 63-item RPOI. The frequency with which Brazilian women pretend orgasm was negatively associated with their relationship satisfaction. Our sample size may not be sufficient to detect small effects. In addition, due to the exploratory nature of the study, the results should be interpreted with caution and future research may attempt to replicate these findings with larger samples and in other countries.

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Female ejaculation is a contentious topic. From a review of the literature, history indicates that it is not a modern concept; some females were aware of it in times past without understanding the role of the fluid or composition of the ejaculate. Over time, scholars experimented, mainly with anatomical studies, in an attempt to identify the source of the ejaculate and explore its physiological and anatomical benefits for the female sexual experience. Despite these studies, views about female ejaculation remain controversial and inconsistent, with no clear conclusion as to its function. This review discusses the history of studies of female ejaculation and presents various hypotheses from an anatomical and physiological perspective. After reviewing 44 publications from 1889 to 2019, it became apparent that clinical and anatomical studies conducted during recent decades provide substantial evidence in support of the female ejaculatory phenomenon. Anatomical studies have shown that the ejaculate originates in the paraurethral (Skene's) glands, but its composition has been debated. Female ejaculate differs from urine in its creatinine and urea concentrations. The fluid also contains prostate specific antigen (PSA) and could have antibacterial properties that serve to protect the urethra. While the specific function of female ejaculation remains a topic of debate, there is sufficient evidence to support the existence of the phenomenon.

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Objetivo: evaluar la eficacia y seguridad de dos terapias hormonales sustitutivas, combinadas con testosterona, en el tratamiento del trastorno del deseo sexual hipoactivo en mujeres en climaterio. Materiales y métodos: ensayo clínico, aleatorizado, controlado, no enmascarado. Se incluyeron mujeres mayores o igual a 40 años y menores de 60 años, con útero, con actividad sexual en las últimas seis semanas, aquejadas por síntomas vasomotores, cuyo motivo de co sulta consistió en bajo deseo sexual. Se utilizó como instrumento el cuestionario Índice de Función Sexual Femenina (IFSF). Se asignaron dos grupos aleatorizados: grupo «A¼ (51 recibieron estrógenos conjugados de equinos y edroxiprogesterona más testosterona) y grupo «B¼ (54 tibolona más testosterona). El estudio fue realizado entre julio de 2015 y diciembre de 2016, en Armenia, Quindío, Colombia. Resultados: se analizó una población de 105 mujeres. La media de edad fue de 55,8 (DS±9,38) años. En la población total, al inicio del estudio, la mediana fue de 3 encuentros sexuales por mes. Al final la mediana fue de 5 encuentros sexuales por mes, (grupo «A¼ 4 encuentros y grupo «B¼ 7 encuentros, p=0,0036). Al finalizar la investigación se observó que las mujeres del grupo «B¼, mostraron puntuaciones promedias significativamente más altas en el IFSF (28,56 DS±4,63 puntos), al compararlas con las mujeres del grupo «A¼ (27,57 DS±4,32) (p<0,0001). Conclusiones: la terapia con tibolona asociada a testosterona es una opción de tratamiento efectiva en el trastorno del deseo sexual hipoactivo en mujeres en climaterio..(AU)

Objective: to evaluate the efficacy and safety of two hormone replacement therapies, combined with testosterone, in the treatment of hypoactive sexual desire disorder in women in climacteric. Materials and methods: clinical trial, randomized, controlled, not masked. Women over 40 years old and under 60 years old, with a uterus, with sexual activity in the last six weeks, suffering from vasomotor symptoms, whose reason for consultation consisted of low sexual desire were included. The Female Sexual Function Index questionnaire was used as an instrument. Two randomized groups were assigned: group "A" (51 received conjugated estrogens from equines and medroxyprogesterone plus testosterone) and group "B" (54 tibolone plus testosterone). The study was conducted between July 2015 and December 2016, in Armenia, Quindío, Colombia. Results: a population of 105 women was analyzed. The average age was 55,8 (SD ± 9,38) years. In the total population, at the beginning of the study, the median was 3 sexual encounters per month. In the end, the median was 5 sexual encounters per month, (group «A¼ 4 meetings and group «B¼ 7 meetings, p = 0,0036). At the end of the investigation, it was observed that the women of the «B¼ group showed significantly higher average scores in the IFSF (28,56 SD ± 4,63 points), compared with values in the women of the «A¼ group (27,57 DS ± 4,32) (p<0,0001). Conclusions: testosterone-associated tibolone therapy is an effective treatment option in hypoactive sexual desire disorder in women in climacteric..(AU)

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OBJECTIVES: We aimed to evaluate the effectiveness of microablative fractional radiofrequency (MAFRF) in the non-hormonal treatment of genitourinary syndrome of menopause. METHODS: We examined the cases of 55 postmenopausal women before and after treatment with regard to their vaginal health index (VHI), vaginal microbiota, vaginal pH, and cell maturation. Three applications of MAFRF were performed in the vagina/vaginal introitus. During the treatment, six vaginal smears were obtained and stained with the Papanicolaou stain for determining the degree of cell maturation and with Gram stain for classification of vaginal flora, as per the criteria of Spiegel and Amsel. For vaginal pH determination, pH indicator strips were applied against the vaginal wall. Statistical analysis was performed using SPSS for Windows (version 17.0). Data were reported as mean±standard deviation. The differences were analyzed using the statistical method of generalized estimation equations with autoregressive correlation structure "1" and robust standard errors. RESULTS: The mean age was 59.8±4.2 years, and the mean time of menopause was 15.4±4.5 years. After treatment, there was an increase in the percentage of Lactobacillus spp. (p<0.001). Consequently, there was a progressive decrease in vaginal pH during the treatment (p<0.001). Regarding cell maturation, there was a decrease in the percentage of parabasal cells (p=0.001) and an increase in the rate of superficial cells (p<0.001). Additionally, there was an improvement in the VHI index. The mean VHI values before and after treatment were 13.2±5.6 and 22.5±3.7, respectively (p<0.001). CONCLUSION: MAFRF treatment is well tolerated and leads to improvement in the vaginal microenvironment.

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Resumen Introducción: La anorgasmia es el retraso persistente, o recurrente o ausencia de orgasmo después de una fase de excitación sexual normal, resultando en dificultades personales o interpersonales. El tratamiento se aborda desde diferentes perspectivas. Objetivo: Presentar los resultados de la efectividad y seguridad del uso del dispositivo EROS-CTD en el manejo de la anorgasmia femenina, en un grupo de mujeres del Quindío. Materiales y métodos: Estudio de reporte de casos, de tipo observacional, descriptivo, prospectivo, de mujeres intervenidas por trastorno del orgasmo, en Armenia, Quindío, Colombia, en el periodo de 2012 a 2017. Resultados: Se intervino 39 mujeres; edad media de 35,1 (DS ± 3,7) años. La anorgasmia primaria fue del 61,53% y la secundaria del 38,36%. El promedio de seguimiento del uso del dispositivo EROS-CTD, fue de 23,7 (DS ± 4,5) meses por paciente. Al finalizar el estudio, la satisfacción global con el uso del dispositivo es del 89,74%, ninguna de las mujeres presentó complicaciones relacionadas con el uso del aparato. Conclusiones: La efectividad del tratamiento de la anorgasmia femenina con el dispositivo EROS-CTD, ha beneficiado favorablemente a las mujeres del estudio.

Abstract Introduction: Anorgasmia is the persistent, or recurrent, or absence of orgasm after a normal phase of sexual arousal, resulting in personal or interpersonal difficulties. Treatment is approached from different perspectives. Objective: To present the results of the effectiveness and safety of the use of the EROS-CTD in the management of female anorgasmia in a group of women from Quindío. Materials and methods: A descriptive, prospective observational study of case reports was carried out with women intervened by orgasm disorder in Armenia, Quindío, Colombia, from 2012 to 2017. Results: 39 women were intervened whose average age was 35.1 (DS ± 3.7). Primary anorgasmia was 61.53% and the secondary was 38.36%. The average follow-up of the use of EROS-CTD was 23.7 (DS ± 4.5) months per patient. At the end of the study, overall satisfaction with the use of the device is 89.74%, none of the women presented complications related to the use of the appliance. Conclusions: The effectiveness of the treatment of female anorgasmia with EROS-CTD has benefited the women of the study.

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Resumen Introducción. La masturbación es un tema que encierra múltiples mensajes, tanto culturales negativos como sexológicos positivos. Esta diversidad es una ventana para explorar la sexualidad femenina. Objetivo. Establecer la prevalencia de masturbación en estudiantes universitarias del área metropolitana de Bucaramanga, Colombia. Materiales y métodos. Estudio descriptivo transversal con cuestionario de autorreporte. Se realizó análisis descriptivo e inferencial con nivel de significancia de p<0.05. Resultados. Se encuestaron 1 039 mujeres (edad mediana: 20, RIC: 4). La prevalencia de masturbación fue del 32.2%; de ellas, solo el 73.1% llegaba al orgasmo por esta estimulación. 1 de cada 3 mujeres que se no se masturba reportó incapacidad para alcanzar el orgasmo. La masturbación fue más frecuente en mujeres >35, de estratos socioeconómicos altos, no religiosas o católicas con poco o nulo nivel de religiosidad, que estudian, trabajan como independiente y se autoidentifican como bisexuales. Conclusiones. 1 de cada 3 mujeres que no refiere masturbarse reporta disfunción orgásmica; de esta forma, las actividades masturbatorias son un factor protector de la disfunción. Es importante realizar educación desde la autoexploración para que la mujer pueda conocerse y disfrutar plenamente de su sexualidad.

Abstract Introduction: Masturbation is a topic that contains multiple messages, both culturally negative and positive for sexology. This diversity becomes a window to explore female sexuality. Objective: To establish the prevalence of female masturbation among university students from the metropolitan area ofBucaramanga, Colombia. Materials and methods: Descriptive cross-sectional study using a self-report questionnaire. Descriptive and inferential analysis was performed finding a significance level of p<0.05. Results: 1 039 women were surveyed (median age: 20, IQR: 4). The prevalence ofmasturbation was 32.2%, of which only 73.1% reached orgasm through this stimulation. 1 in 3 women who do not masturbate reported anorgasmia. Masturbation was more frequent in women >35 years of age, from high socioeconomic status, non-religious or Catholic with little or no religiousness, who study, work independently and self-identify as bisexual. Conclusions: 1 in 3 women who claim that they do not masturbate reported orgasmic dysfunction; therefore, masturbatory activities are a protective factor for the dysfunction. Providing self-exploration education is important so that women can get to know their body and fully enjoy their sexuality.

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ABSTRACT Objectives: to examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters. Materials and Methods: The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed. Results: The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients' preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages. Conclusion: Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.

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OBJECTIVES: To examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters. MATERIALS AND METHODS: The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed. RESULTS: The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients' preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages. CONCLUSION: Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.

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Introducción:La eyaculación femenina es un fenómeno caracterizado por la salida de un líquido, diferente a la orina, a través de la uretra, en el momento del orgasmo.Objetivos: Determinar la prevalencia de la eyaculación femenina, en un grupo de trabajadoras sexuales, y evaluar las características físicoquímicasdel fluido uretral expulsado.Materiales y métodos: Estudio descriptivo de corte transversal y prospectivo. Se enrolaron mujeres entre 18 y 39 años, atendidas en la consulta del investigador entre enero del 2012 y junio del 2016, en la consulta externa de una clínica privada de Armenia. Se incluyeron trabajadoras sexuales, sin incontinencia urinaria, sin infecciones de transmisión sexual o vaginosis, y no gestantes ni en puerperio. Se midió la prevalencia de la eyaculación femenina (expulsión de fluido a través de la uretra, durante la excitación y el orgasmo), y se evaluaron las características físicoquímicasde dicha secreción (ácido cítrico, fosfatasa ácida, fructosa, PSA, densidad, osmolaridad, pH, viscosidad y volumen).Resultados: Se evaluaron un total de 78 mujeres. La edad promedio fue de 32,6±8,2 años. La prevalencia de la eyaculación femenina fue del 69,23%. El volumen promedio deleyaculado fue de29,73±7,08 ml(rango entre 0 y 57 ml). En el análisis físico químico del líquido uretral se encontró que el color varió entre nacarado y gris opalescente, con una osmolaridad de 269,3±3,57 mOsm/Kg, pH de 5,4, densidad de 1.032 g/L, la viscosidad fue de 12,75 mm para el filamento y un volumen promedio de 29,73 cc; las sustancias más comunes fueron PSA 0,75 ng/ml con una concentración promedio de fructosa de 12 mmol/L y de ácido cítrico de 729 mg/L.Conclusión: La eyaculación femenina es una realidad en nuestra población, alrededor de dos de cada tres mujeres la presentan.

Introduction:Female ejaculation is a phenomenon characterized by the exit of a liquid, different fromurine, through the urethra, at the moment of orgasm.Objetives:To determine the prevalence of female ejaculation, in a group of sex workers, and to evaluate the physical and chemical characteristics of the ejected urethral fluid.Materials and methods: Descriptive study of cross section and prospective. Women between 18 and 39 years of age were enrolled, assisted in the researcher's consultation between January 2012 and June 2016, in the outpatient clinic of a private clinic in Armenia. Sex workers were included, without urinary incontinence, without sexually transmitted infections or vaginosis, and not pregnant or in puerperium. The prevalence of female ejaculation (expulsion of fluid through the urethra during excitement and orgasm) was measured and thephysical and chemical characteristics of this secretion were evaluated (citric acid, acid phosphatase, fructose, PSA, density, osmolarity, pH, viscosity and volume).Results: A total of 78 women were evaluated. The average age was 32.6 ± 8.2 years. The prevalence of female ejaculation was 69.23%. The average volume of the ejaculate was 29.73 ml. In the physical-chemical analysis of the urethral fluid it was found that the color varied between pearly and opalescent gray, with an osmolarity of 269.3 ± 3.57 mOsm / Kg, pH of 5.4, density of 1.032 g / L, viscosity it was 12.75 mm for the filament and an average volume of 29.73 cc; the most common substances were PSA 0.75 ng / ml with an average fructose concentration of 12 mmol / L and citric acid of 729 mg / L.Conclusión: Female ejaculation is a reality in our population, about two out of three women present it.

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Purpose: The aim of this study was to evaluate sexual function in women with chronic pelvic pain (CPP) compared to a control group without CPP and to investigate the factors associated with sexual dysfunction in women with CPP. Methods: This cross-sectional study included 100 women with CPP and 100 controls. Sexual function was evaluated using the Female Sexual Function Index (FSFI) and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS). A generalized linear model was used to compare the groups with respect to the overall FSFI score and the scores obtained for each FSFI domain. Multiple logistic regression analysis was used to identify the factors associated with sexual dysfunction in the study group. Results: Anxiety was present in 66.0% of women with CPP in the study group compared to 49.0% of the controls (P=0.022). Depression was detected in 63.0% of women with CPP in the study group and in 38.0% of the controls (P=0.001). Sexual dysfunction was identified in 81.0% of the women with CPP in the study group compared to 58.0% of the controls (P=0.003). Following adjustment, the women with CPP had significantly lower mean scores compared to the controls in the FSFI domains of desire (3.0±1.3 vs 3.6±1.3; P=0.038), arousal (2.6±1.6 vs 3.4±1.9; P=0.002), lubrication (3.2±1.9 vs 3.7±2.3; P=0.011), orgasm (3.0±1.9 vs 3.6±2.2; P<0.002), and pain (2.5±1.7 vs 3.4±2.2; P<0.001). There was no difference between the groups for the satisfaction domain (P=0.337) or for the overall score (P=0.252). A positive and independent association was found between depression and sexual dysfunction in the women with CPP (P=0.012). Conclusion: In the women with CPP, sexual dysfunction was more common, and the scores in most of the sexual function domains were poorer than in the control group. Concurrently, depression was found to be positively associated with sexual dysfunction in the women with CPP.

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ABSTRACT Objective: To determine the prevalence and characterisation of sexual dysfunctions in a population of sexually active women with ages ranging between 18 and 72 years, in 12 Colombian cities. Materials and methods: Descriptive cross-sectional study that included women 18 years of age and older, sexually active within the past six weeks, living in Colombia. Excluded were illiterate and pregnant women, women in the first 6 months postpartum, women with a psychiatric disease or neurological deficit, and women with a history of cancer. The study was conducted in healthcare centres in twelve cities (Bogotá, Medellín, Cali, Barranquilla, Cartagena, Cúcuta, Ibagué, Bucaramanga, Villavicencio, Pereira, Manizales and Armenia) between June 2009 and December 2016. A consecutive sampling method was used. The "Female Sexual Function Index" validated in Spanish was applied. Sociodemographic variables, a history of sexual and reproductive health, sexual behaviour, and frequency of overall sexual dysfunction and by type of dysfunction assessed were measured. A descriptive analysis of the data was performed using absolute and relative measurements. A stratified description was made by age under or over 40 years. Results: Of a total of 72,894 candidates for enrolment, 50,991 (69,95%) were ultimate analysed. Mean age was 30.9±10.8 years. The prevalence of sexual dysfunction in the study group was 32.97% (16,812 women). The score on the FSFI in the affected women was 24.07±6.18 points. Issues were found with libido in 32.97%, orgasm in 21.93%, arousal in 16,86%, lubrication in 14,79%, and pain in 7.56%. Median sexual dysfunction per woman was 2, found in 64.16%. Conclusion: Among Colombian women, a prevalence of sexual dysfunction is found in close to one-third of the population, characterised mainly by issues with libido and orgasm. Interventions are required in order to establish an immediate diagnostic and therapeutic plan.

RESUMEN Objetivo: Establecer la prevalencia y caracterizar la disfunción sexual en una población de mujeres sexualmente activas, con edades entre 18 y 72 años, en doce ciudades colombianas. Materiales y métodos: Estudio de corte transversal descriptivo. Se incluyeron mujeres mayores de 18 años con actividad sexual en las últimas 6 semanas, y residentes en Colombia. Se excluyeron las mujeres analfabetas, embarazadas o en primeros 6 meses posparto, pacientes psiquiátricas, con deficit neurológico o historial de cáncer. El estudio se llevó a cabo en la consulta externa ginecológica de instituciones hospitalarias privadas en 12 ciudades del país (Bogotá, Medellín, Cali, Barranquilla, Cartagena, Cúcuta, Ibagué, Bucaramanga, Villavicencio, Pereira, Manizales y Armenia) entre junio de 2009 y diciembre de 2016. Se realizó muestreo consecutivo. Se aplicó el Índice de Función Sexual Femenina validado en español. Se midieron variables sociodemográficas, antecedentes de salud sexual y reproductiva, comportamiento sexual, frecuencia de disfunción sexual global y por tipo de disfunción evaluada. Se realizó un análisis descriptivo de la información utilizando medidas de frecuencia absoluta y relativa para los datos. Se hace descripción estratificada por edad (40 años o menos y mayor de 40 años). Resultados: De un total de 72.894 mujeres candidatas a ingresar se analizaron finalmente 50.991 (69,95 %). La edad promedio fue de 30,9 ± 10,8 años. La prevalencia de disfunción sexual en el grupo estudiado fue del 32,97 % (16.812 mujeres). La puntuación del Índice de Función Sexual Femenina (IFSF) en las mujeres afectadas fue de 24,07 ± 6,18 puntos. Se presentaron dificultades con el deseo (32,97 %), el orgasmo (21,93 %), la excitación (16,86 %), la lubricación (14,79 %) y dolor (7,56 %). La mediana de disfunciones sexuales por mujer fue de 2, que se hizo presente en el 64,16 %. Conclusión: En las mujeres colombianas existe una prevalencia de disfunciones sexuales cercana a la tercera parte de la población, caracterizadas principalmente por trastornos del deseo y del orgasmo. Se requieren intervenciones para establecer un plan diagnóstico y terapéutico inmediato.

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Objetivo: revisar la literatura presente, respecto a la evidencia científica existente, en relación al punto "G". Materiales y métodos:Se realizó una búsqueda bibliográfica en diferentes bases de datos electrónicas para identificar literatura relevante EBSCO, Elsevier, Interscience, Medline, Ovid, Pubmed, SciELO, Scopus (1950 al 2016), Cochrane Group (julio 31 del 2016) y libros de texto impresos, así como de revistas de sexología científica indexadas y sociedades sexológicas reconocidas como: Advances in Sexual Medicine, American Journal of Sexuality Education, British Journal of Sexual Medicine (BJSM), European Journal of Sexual Health, Sexology and The Journal of Sexual Medicine; tratando de encontrar la mejor evidencia científica existente en relación al punto "G".Resultados:Se revisaron 75 títulos, de los cuales 65 cumplían con nuestros criterios de selección, correspondientes a artículos de revisión, diseños de tipo transversal, casos y controles. El termino Punto "G", no es un término usado en la anatomía humana; y no existen imágenes anatómicas ni ecográficas de dicho punto, por lo tanto, el punto "G" no existe; y a pesar de ser ampliamente aceptado entre las mujeres, los estudios anatómicos, bioquímicos e histológicos no han demostrado su existencia. Conclusiones: La literatura muestra que la vagina no tiene ninguna estructura anatómica que pueda desencadenar un orgasmo; y así como las teorías que afirmaban la existencia del punto "G", por más de treinta años tuvieron su auge, hoy por hoy, la evidencia de su no existencia, también está cogiendo eco.

Objective: to review the present literature, in relation to point "G". EBSCO, Elsevier, Interscience, Medline, Ovid, Pubmed, SciELO, Scopus (1950 to 2016), Cochrane Group (July 31, 2016) and books Advances in Sexual Medicine, American Journal of Sexual Education, British Journal of Sexual Medicine (BJSM) ), European Journal of Sexual Health, Sexology and The Journal of Sexual Medicine; .results: 75 titles were reviewed, of which 65 met our selection criteria, corresponding to review articles, cross-sectional designs, cases and controls. The term "G" is not a term used in human anatomy; and there are no anatomical or ultrasound images of this point, therefore, point "G" does not exist; Anatomical, biochemical and histological studies have not proved their existence. Conclusions: The literature shows that the vagina does not have any anatomical structure that can trigger an orgasm; and as well as the theories that affirmed the existence of point "G", for more than thirty years took place its today, today, the evidence of its existence, is also catching echo.

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Abstract Purpose To identify pregnancy as a causative factor of sexual dysfunction among expectant women. Methods A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student’s t-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (X2) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any p values less than 0.05 were considered significant. Results Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant (p < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78). Conclusions Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

Resumo Objetivo Identificar a gravidez como fator causador de disfunção sexual entre mulheres gestantes. Métodos Estudo prospectivo com 225 gestantes atendidas no ambulatório de prénatal de uma universidade federal. A função sexual foi avaliada por meio do Female Sexual Function Index (FSFI), e todos os domínios foram analisados (desejo, excitação, lubrificação, orgasmo, satisfação e dor). Inicialmente, uma análise univariada da amostra foi feita. As médias para cada domínio de acordo com o risco de disfunção sexual (FSFI ≤ 26,5) foram comparadas pelo teste t de Student para amostras independentes. A força da correlação entre a disfunção sexual e todas as variáveis sociodemográficas, clínicas e comportamentais foi medida pelo teste do qui-quadrado (X2). A partir desta perspectiva, foram aferidos os odds ratios (ORs) e seus respectivos intervalos de confiança para a análise bivariada. Quaisquer valores de p inferiores a 0,05 foram considerados significativos. Resultados Cerca de dois terços das mulheres (66,7%) mostraram sinais de risco de disfunção sexual (FSFI ≤ 26,5). Dentro destes casos, todos os domínios de disfunção sexual (desejo, excitação, lubrificação, orgasmo, satisfação e dor) foram estatisticamente significativos (p < 0,001). Os domínios mais afetados foram o desejo (2,67), a satisfação (2,71) e a excitação (2,78). Conclusões A gravidez parece ser um importante fator causador de disfunção sexual entre mulheres gestantes.

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O gozo feminino é considerado por Lacan como Outro em relação ao do homem. Em todo caso, este gozo é difícil de ser discernido, ainda mais que ele pode, como nos mostra a clínica, ser facilmente simulado por uma mulher. Mas por que uma mulher se coloca na posição de simular um orgasmo? O que está em jogo para ela nessa prática? Tentaremos mostrar que a simulação não é apenas sinônimo de frigidez. Não que ela não o possa ser, mas a simulação é também fonte de prazer para uma mulher e, de forma pardoxal, algo capaz de favorecer o "encontro" com o outro.

The enjoyment of the dissatisfaction in the sexual relationship. The feminine enjoyment is considered by Lacan, as "Other", compared to the enjoyment of the man. Anyway, it is difficult to enclose, especially since enjoyment can be, as shown by the clinic, easily simulated by a woman. But why does a woman put herself in the position of simulating the orgasm? What are the stakes of this practice? We would try to show that faking orgasm is not only a synonymous of frigidity. It could be, of course, but it is also a spring of pleasure for a woman and, paradoxically, an expedient capable of making possible the "gathering" with the other.

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O gozo feminino é considerado por Lacan como Outro em relação ao do homem. Em todo caso, este gozo é difícil de ser discernido, ainda mais que ele pode, como nos mostra a clínica, ser facilmente simulado por uma mulher. Mas por que uma mulher se coloca na posição de simular um orgasmo? O que está em jogo para ela nessa prática? Tentaremos mostrar que a simulação não é apenas sinônimo de frigidez. Não que ela não o possa ser, mas a simulação é também fonte de prazer para uma mulher e, de forma pardoxal, algo capaz de favorecer o "encontro" com o outro (AU)

The enjoyment of the dissatisfaction in the sexual relationship. The feminine enjoyment is considered by Lacan, as "Other", compared to the enjoyment of the man. Anyway, it is difficult to enclose, especially since enjoyment can be, as shown by the clinic, easily simulated by a woman. But why does a woman put herself in the position of simulating the orgasm? What are the stakes of this practice? We would try to show that faking orgasm is not only a synonymous of frigidity. It could be, of course, but it is also a spring of pleasure for a woman and, paradoxically, an expedient capable of making possible the "gathering" with the other (AU)

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Objetivos: Comparar os exercícios perineais e exercícios sexuais como método de tratamento fisioterapêutico na disfunção orgásmica feminina. Métodos: Comparou-se dois grupos: exercícios sexuais (ES) e exercícios sexuais e perineais (ESP). Após a anamnese, avaliou-se a função muscular do assoalho pélvico através das escalas AFA e Esquema PERFECT e foi preenchido o questionário "Quociente Sexual - Versão Feminina". As pacientes do grupo ES receberam um folheto explicativo com exercícios que deveriam seguir três vezes ao dia, retornando ao ambulatório para reavaliação. Já as pacientes do grupo ESP, além de receberem as mesmas orientações do grupo ES, passaram por protocolos de exercícios perineais. Passadas as semanas de exercícios perineais, a paciente retornou para responder ao "QS-F" e passou pela avaliação final do assoalho pélvico. Resultados: Foram incluídas 14 pacientes, sendo cinco no grupo ES e nove no grupo ESP. Nossos achados demonstraram que 80% das pacientes do grupo ES conseguiram alcançar o orgasmo através da masturbação, e 40% das pacientes do mesmo grupo conseguiram alcançar o orgasmo na masturbação na presença do companheiro, enquanto este número oscilou de 11,1 a 22,2% no grupo ESP. Com relação à avaliação da função muscular, os resultados mostraram que houve aumento. Conclusões: A educação sexual é de extrema importância no tratamento da anorgasmia. A masturbação e o estímulo à fantasia são imprescindíveis para o conhecimento dos pontos eróticos. O programa de reabilitação do assoalho pélvico melhora a força muscular perineal, a sensibilidade e consciência perineal, e o prazer genital durante a penetração, além da qualidade sexual, comprovado pelo QS-F.

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O objetivo desta pesquisa exploratória foi identificar o início da atividade sexual, a satisfação e as preferências sexuais de mulheres jovens da cidade de São Paulo. A amostra foi composta por 60 mulheres com idade entre 18 e 21 anos, sexualmente ativas, que responderam um questionário preparado pelas pesquisadoras. Os resultados indicaram um início precoce da atividade sexual, apontaram que a maioria das jovens desta amostra prefere a penetração vaginal e o sexo oral recebido do parceiro. A grande maioria dessas mulheres afirmou estar satisfeita sexualmente, porém creditam esta satisfação ao parceiro e ao estabelecimento de um relacionamento amoroso e não à qualidade da relação sexual, nem ao orgasmo em si. Outros estudos com foco na satisfação sexual feminina são necessários e importantes para que essas mulheres sejam compreendidas e para que possam ter mais prazer nas relações sexuais.(AU)

It is an exploratory research in order to identify the onset of sexual activity, satisfaction and sexual preferences of young women in São Paulo. A group of 60 women aged 18 to 21, with regular sexual activity, answered a questionnaire prepared by the researchers. The results indicate an early onset of sexual activity, they showed that most young women in the sample prefer vaginal penetration and oral sex received from the partner. The vast majority of these women claimed to be sexually satisfied, but credit this satisfaction to the partner and the establishment of a loving relationship and not to the quality of intercourse or to the orgasm itself. Other studies focusing on female sexual satisfaction are necessary and important for these women to be understood and to improve the pleasure in sexual intercourse.(AU)

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