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It is estimated that microorganisms colonize 90% of the body surface. In some tracts, such as the genitourinary tract, the microbiota varies throughout life, influenced by hormonal stimulation and sexual practices. This study evaluated the semen differences and presence of Lactobacillus crispatus, Lactobacillus iners, Gardnerella vaginalis and Atopobium vaginae in semen samples from patients with symptoms of chronic prostatitis and men asymptomatic for urogenital infections. Fifty-three semen samples were included: 22 samples from men with symptoms of chronic prostatitis and 31 asymptomatic men (control group). In addition to the presence of L. crispatus, L. iners, G. vaginalis and A. vaginae, semen parameters, total antioxidant capacity of seminal plasma, prostatic antigen and some proinflammatory cytokines were evaluated in each semen sample. Volunteers with symptoms of chronic prostatitis presented a lower percentage of sperm morphology (4.3% vs. control group 6.0%, p = 0.004); in the semen samples of volunteers in the group asymptomatic for urogenital infections, microorganisms associated with the vaginal microbiota were detected more frequently. The presence of bacteria in the vaginal microbiota can also benefit male reproductive health, which undergoes various modifications related to lifestyle habits that are susceptible to modification. Microorganisms associated with the vaginal microbiota, such as L. crispatus, L. iners, G. vaginalis and A. vaginae, may have a protective role against the development of male genitourinary diseases such as prostatitis.

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Resumen OBJETIVO: Describir la caracterización clínica, atención médica y quirúrgica de los casos de laceración poscoital y proponer un protocolo de atención para mejorar la calidad del diagnóstico y tratamiento. MATERIALES Y MÉTODOS: Estudio retrospectivo de serie de casos de pacientes con diagnóstico de laceración vaginal poscoital atendidas en dos hospitales rurales entre 2017 y 2022. RESULTADOS: Se encontraron 6 pacientes que ingresaron al servicio de Urgencias con diagnóstico de laceración vaginal poscoital. Todas fueron intervenidas quirúrgicamente después de la lesión. La mediana de edad de las pacientes fue de 29.5 años (límites 19 y 68 años). Tres de las pacientes eran nuligestas e igual cantidad refirió coito por primera vez, 2 pacientes tenían una pareja estable y 2 nueva pareja. El tiempo transcurrido desde el coito hasta el momento de la atención tuvo una mediana de 2 horas (límites 1 y 3 horas). Solo 2 pacientes requirieron trasfusión de un paquete globular. El sitio de la laceración fue el fondo de saco vaginal posterior en 3 de los 6 casos; no se registraron decesos. CONCLUSIONES: La laceración poscoital es una urgencia rara que puede complicarse por la excesiva pérdida sanguínea, que es mayor si existe retraso en la búsqueda de atención y diagnóstico. Para obtener desenlaces favorables su tratamiento debe ser quirúrgico inmediato, basado en un protocolo estandarizado.

Abstract OBJECTIVE: To describe the clinical characterization, medical and surgical management of cases of postcoital laceration and to propose a management protocol to improve the quality of diagnosis and treatment. MATERIALS AND METHODS: Retrospective case series study of patients diagnosed with post-coital vaginal laceration seen in two rural hospitals between 2017 and 2022. RESULTS: We found 6 patients admitted to the emergency department with a diagnosis of postcoital vaginal laceration. All underwent surgical intervention following the injury. The median age of the patients was 29.5 years (range 19 to 68 years). Three of the patients were nulligestas and the same number reported having sexual intercourse for the first time, 2 patients had a regular partner and 2 had a new partner. The median time from intercourse to treatment was 2 hours (range 1 and 3 hours). Only 2 patients required a globule pack transfusion. The site of laceration was the posterior vaginal fornix in 3 of 6 cases; no deaths were recorded. CONCLUSIONS: Postcoital laceration is a rare emergency that may be complicated by excessive blood loss, which is increased if there is a delay in seeking care and diagnosis. For a favourable outcome, treatment should be immediate surgery based on a standardised protocol.

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Esta pesquisa tem por objetivo investigar a relação entre autoestima e satisfação sexual feminina, e outras variáveis relacionadas ao comportamento sexual. Participaram 105 mulheres, com idades entre 18 e 61 anos (M=24,5; DP=6,06), de diferentes orientações sexuais. Os instrumentos utilizados foram Escala de Autoestima de Rosenberg, Escala de Satisfação Sexual Feminina e Questionário de Sexualidade Feminina. Os resultados indicaram correlações positivas e moderadas entre a autoestima e satisfação sexual. A preocupação pessoal com o sexo foi o principal fator predito pela autoestima. Concluiu-se que quanto maior a autoestima, maior a satisfação sexual feminina. Foi encontrado também que ter relações sexuais com uma mesma pessoa, ainda que sem o status de um relacionamento formal, assim como ter relações sexuais com frequência, estão associados com a satisfação sexual de mulheres. Espera-se fomentar a discussão acerca da sexualidade feminina, indicando a importância da autoestima feminina para experiências sexuais prazerosas.

This research aims to investigate the relationship between women's self-esteem and sexual satisfaction, and other variables related to sexual behavior. The participants were 105 women aged 18 to 61 years (M = 24.5; SD = 6.06), from different sexual orientations participated. The instruments used were the Rosenberg's Self-esteem Scale, The Female Sexual Satisfaction Scale and the Female Sexuality Questionnaire. The results showed positive and moderate correlations between self-esteem and sexual satisfaction, as well as the person's concern for sex as the main factor predicted by self-esteem. In conclusion, that the higher self-esteem, the greater the sexual satisfaction of women. We also observed that having sex with the same person, even without the status of a formal relationship, and frequent sexual relations were associated with women's sexual satisfaction. We hope to stimulate discussion about female sexuality, by pointing to the importance of female self-esteem for pleasurable sexual experiences.

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This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse.

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Resumen INTRODUCCIÓN: Las úlceras de Lipschütz son una causa infrecuente de úlcera genital, de alivio espontáneo y casi siempre benignas, aunque en algunas pacientes pueden dejar cicatrices genitales. Lo común es que aparezcan en mujeres jóvenes, antes del inicio de la vida sexual activa, en coincidencia con un cuadro catarral o pseudogripal. CASO CLÍNICO: Paciente de 18 años con una úlcera vulvar dolorosa, coincidente con un episodio de amigdalitis aguda y fiebre de 38 ºC. La paciente negó haber tenido relaciones sexuales. La úlcera alcanzó 3 a 4 cm, profunda, purulenta, con apertura del labio menor derecho y con importante componente necrótico. Para el control del dolor se le indicaron: corticoides, doxiciclina oral, crema con lidocaína y antiinflamatorios. Los análisis de laboratorio descartaron que se tratara de infección de trasmisión sexual. Al término del esquema terapéutico prescrito la evolución fue favorable, con desaparición de los síntomas, pero con una secuela: apertura del labio mayor derecho. CONCLUSIONES: La úlcera de Lipschütz es una causa infrecuente de úlcera vulvar. Su tratamiento consiste en el control de los síntomas y casi siempre se cura en el transcurso de 4 a 6 semanas, sin dejar lesiones. El diagnóstico solo puede establecerse luego de excluir otras causas más frecuentes de úlcera vulvar.

Abstract INTRODUCTION: Lipschütz ulcers are an infrequent cause of genital ulcer, of spontaneous relief and almost always benign, although in some patients they may leave genital scars. They usually appear in young women, before the onset of active sexual life, coinciding with a catarrhal or flu-like condition. CLINICAL CASE: 18-year-old female patient with a painful vulvar ulcer, coinciding with an episode of acute tonsillitis and fever of 38 ºC. The patient denied having had sexual intercourse. The ulcer was 3 to 4 cm, deep, purulent, with opening of the right labium minora and with a significant necrotic component. For pain control she was prescribed corticosteroids, oral doxycycline, lidocaine cream and anti-inflammatory drugs. Laboratory tests ruled out sexually transmitted infection. At the end of the prescribed therapeutic scheme the evolution was favorable, with disappearance of symptoms, but with a sequel: opening of the right labium majus. CONCLUSIONS: Lipschütz ulcer is a rare cause of vulvar ulcer. Its treatment consists of symptom control and it almost always heals within 4 to 6 weeks, leaving no lesions. The diagnosis can only be established after other more frequent causes of vulvar ulceration have been excluded.

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Introducción: El embarazo en la adolescencia se ha convertido en un fenómeno de alcance mundial, lo que ha traído aparejado el aumento de las complicaciones propias de una gestación en este período de la vida; de ahí la importancia del estudio constante del comportamiento de este suceso. Objetivo: Identificar el comportamiento de importantes variables relativas a las embarazadas adolescentes. Métodos: Se efectuó una investigación descriptiva transversal en el Policlínico Docente 30 de Noviembre de Santiago de Cuba, durante los años 2016 y 2017, a partir de las historias obstétricas de las adolescentes que se embarazaron y parieron en esos años. Se seleccionaron variables de interés como edad, edad gestacional a la captación, edad de inicio de las relaciones sexuales, escolaridad, deserción escolar, evaluación nutricional a la captación, además de la edad de la pareja sexual y el peso del niño al nacer. Resultados: Las adolescentes mostraron una media de inicio de las relaciones sexuales de 15,7 años de edad, el mayor por ciento de deserciones escolares fue en la secundaria básica, las edades de las parejas sexuales entre 20 y 39 años tuvo mayor frecuencia y las que fueron evaluadas con peso deficiente a la captación aportaron mayor cantidad de recién nacidos con bajo peso. Conclusiones: El estudio frecuente del comportamiento del embarazo en la etapa de adolescencia es determinante en el enfrentamiento a este fenómeno y constituye un arma esencial para el mejoramiento del estado de salud de la población en este grupo de edad(AU)

Introduction: Adolescent pregnancy has become a worldwide phenomenon, which has brought about the increase in complications typical of childbearing in this period of life; hence, the importance of constant study about the behavior of this event. Objective: To identify the behavior of important variables concerning pregnant adolescents. Methods: A cross-sectional and descriptive research was carried out at 30 de Noviembre Teaching Polyclinic in Santiago de Cuba, during the years 2016 and 2017, based on the obstetric histories of the adolescents who became pregnant and gave birth in those years. Variables of interest were selected, such as age, gestational age at first prenatal visit, age of onset of sexual intercourse, schooling, dropout, nutritional assessment at first prenatal visit, in addition to the age of the sexual partner and the child weight at birth. Results: The adolescents showed a mean of onset of sexual relations of 15.7 years, the highest percentage of school dropouts corresponded to the basic secondary school, the ages of their sexual partners between 20 and 39 years were more frequent, and those were evaluated with deficient weight at first prenatal visit contributed a greater number of newborns with low weight. Conclusions: The frequent study of pregnancy background in the adolescent stage is decisive in coping with this phenomenon and constitutes an essential resource for improving the health status of the population in this age group(AU)

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RESUMEN Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.

ABSTRACT Injuries to the female genital tract after sexual intercourse are a frequent problem in gynecological emergencies, but little studied except for their medico-legal aspect. Its incidence is unknown since many women do not go to their specialist out of fear or embarrassment. Early recognition of these injuries and their correct treatment may prevent the appearance of sequelae that will accompany our patient for the rest of her life. We present the case of an 18-year-old patient with a perineal tear with intact vaginal mucosa after her first sexual intercourse.

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BACKGROUND: Studies that evaluated health-risk behaviors with boarding students are scarce. There are no studies with representative samples among adolescents residing in educational institutions in Latin America. To better assess the role of resident status on such behaviors, this study aimed to compare health-risk behaviors between boarding and non-resident students assessed by the Brazilian National Adolescent School Health Survey (PeNSE). METHODS: A cross-sectional study was conducted using the 2015 PeNSE database. A sample of 101,788 students (aged 11-19 years) from both public and private schools throughout all the Brazilian states completed the survey. A self-administered questionnaire was used to evaluate multiple health-related behaviors (sociodemographic characteristics; sexual behavior; cigarette use; drug use; and alcohol use). Poisson regression model-based analyses were performed and the effects measured through the prevalence ratio (PR) and its 95% confidence interval (CI). RESULTS: Boarding residents reported more health-risk behaviors than non-residents: previous sexual intercourse (PR 1.17, 1.10-1.25), smoking experience (PR 1.12, 1.03-1.21), monthly smoking frequency (PR 1.68, 1.42-1.99), monthly alcohol intake (PR 2.12, 1.79-2.50), inebriation (PR 1.51, 1.35-1.71), drug use experience (PR 1.23, 1.10-1.38), and monthly drug use frequency (PR 1.59, 1.31-1.94). CONCLUSIONS: Boarding residents reported more health-risk behaviors than did non-residents. The results provide insights into an under-researched subject, helping to highlight potential points of intervention for supporting public health programs within the boarding-school student population.

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Resumen: Objetivo: Caracterizar el uso de condón en la primera y última relación sexual en diferentes cohortes para observar posibles diferencias entre grupos generacionales. Material y métodos: Mediante la Encuesta Nacional de Niños, Niñas y Mujeres 2015, representativa a nivel nacional, se ajustaron modelos de regresión Poisson para buscar asociación de variables de interés con el uso del condón en la primera y última relación sexual. Resultados: Las cohortes más jóvenes, con mayor educación y riqueza tienen mayores posibilidades de usar condón en su primera y última relación sexual; hablar lengua indígena se asocia con menores posibilidades de uso en ambos eventos. El uso de condón en el debut sexual incrementa la posibilidad de uso en la última relación sexual. Conclusiones: Existe un cambio generacional en el uso del condón en la primera y última relación sexual entre las más jóvenes. La utilización del condón en el debut sexual favorece su uso posterior.

Abstract: Objective: Characterize the use of condoms in the first and last sexual intercourse in different birth cohorts, to observe possible differences among generations. Materials and methods: Using the National Survey of Boys, Girls and Women, 2015, representative at the national level, we adjust Poisson regression models to find associations between variables of interest and the use of condoms in first and last intercourse. Results: Women from younger cohorts, with higher education and wealth are more likely to use a condom in their first and last sexual intercourse; speaking an indigenous language is associated with a lower likelihood of condom use at both events. Using condom in sexual debut increases the likelihood of using in last intercourse. Conclusions: There is a generational change in condom use at first and last sex among younger cohorts. The use of the condom in sexual debut favors its later use.

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OBJECTIVE: Characterize the use of condoms in the first and last sexual intercourse in different birth cohorts, to observe possible differences among generations. MATERIALS AND METHODS: Using the National Survey of Boys, Girls and Women, 2015, representative at the national level, we adjust Poisson regression models to find associations between variables of interest and the use of condoms in first and last intercourse. RESULTS: Women from younger cohorts, with higher education and wealth are more likely to use a condom in their first and last sexual intercourse; speaking an indigenous language is associated with a lower likelihood of condom use at both events. Using condom in sexual debut increases the likelihood of using in last intercourse. CONCLUSIONS: There is a generational change in condom use at first and last sex among younger cohorts. The use of the condom in sexual debut favors its later use.

OBJETIVO: . Caracterizar el uso de condón en la primera y última relación sexual en diferentes cohortes para observar posibles diferencias entre grupos generacionales. MATERIAL Y MÉTODOS: .Mediante la Encuesta Nacional de Niños, Niñas y Mujeres 2015, representativa a nivel nacional, se ajustaron modelos de regresión Poisson para buscar asociación de variables de interés con el uso del condón en la primera y última relación sexual. RESULTADOS: Las cohortes más jóvenes, con mayor educación y riqueza tienen mayores posibilidades de usar condón en su primera y última relación sexual; hablar lengua indígena se asocia con menores posibilidades de uso en ambos eventos. El uso de condón en el debut sexual incrementa la posibilidad de uso en la última relación sexua. CONCLUSIONES: Existe un cambio generacional en el uso del condón en la primera y última relación sexual entre las más jóvenes. La utilización del condón en el debut sexual favorece su uso posterior.

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PURPOSE: Mexico has implemented comprehensive sexuality education. We hypothesized that young women who received sexuality education as adolescents would be more likely to report modern contraceptive use at first sexual intercourse. METHODS: We used a nationally representative survey of Mexican women aged 20-24 years who were asked about experiences during adolescence. We defined our treatment variable in three mutually exclusive groups: comprehensive sexuality education (receipt of education in nine topics); incomplete sexuality education (receipt of at least one topic in each of three themes); or no sexuality education. Our outcome was use of modern contraception at first sexual intercourse. We included individual- and household-level sociodemographic factors. All presented data used survey weights. We used multivariable logistic regression and predicted probabilities to estimate the association between sexuality education and using modern contraception at first intercourse. RESULTS: In our sample (n = 2,725; population N = 4,008,722), 60.6% of participants reported receipt of comprehensive, 15.6% of incomplete, and 23.9% of no sexuality education; 62.5% reported utilizing a modern method of contraception at first intercourse. Women who reported receiving comprehensive (adjusted odds ratio: 2.3, 95% confidence interval [CI]: 1.7, 3.2) or incomplete (adjusted odds ratio: 2.4, 95% CI: 1.3, 4.2) sexuality education had higher odds of using contraception at first intercourse compared with no sexuality education. The absolute multivariable probabilities of using modern contraception at first intercourse were 57.5% (95% CI: 55.2%-59.8%), 60.4% (95% CI: 56.0%-64.9%), and 37.6% (95% CI: 33.9%-41.3%) among comprehensive, incomplete, and no sexuality education, respectively. CONCLUSIONS: Sexuality education is associated with contraception use at first intercourse among young women in Mexico.

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Men who have sex with men (MSM) are disproportionally affected by the HIV epidemic globally. In Chile, HIV prevalence among MSM is estimated at 20%, and condomless anal intercourse is the predominant mode of HIV transmission. This cross-sectional study aimed to estimate a broad array of characteristics in a sample of Chilean MSM including condomless anal intercourse (CLAI), as well as to explore possible associations between these characteristics and CLAI. MSM were recruited through respondent-driven sampling between June and October of 2016. A final sample size of 246 MSM was analyzed using CLAI as the outcome and sociodemographic, clinical and sexual risk behavior characteristics as exposure variables. Results show that close to half of the participants reported CLAI with casual sex partners during the last six months, and this outcome had an increased risk associated with use of drugs prior to sex and having had >5 sexual partners.

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Resumo Este artigo aborda o tema da iniciação sexual na adolescência, com foco nas narrativas de dez jovens com experiência de aborto induzido, moradoras de uma favela do Rio de Janeiro. A análise lança mão da descrição do processo de entrada na sexualidade como estratégia para elucidar o contexto da gravidez e do primeiro aborto clandestino na trajetória afetivo-sexual das jovens aqui entrevistadas. Considera-se a iniciação um domínio da sexualidade e da vida social que envolve socialização, interpretação de regras e significados, sistema de atitudes, formas de aproximação, controle e modelação dos afetos, das emoções e das relações de gênero. Os resultados mostraram que a diferença de idade entre os pares na iniciação amorosa sexual é significativa, clarificando o contexto em que ocorreram as decisões sobre métodos contraceptivos, gravidez e aborto. Notou-se que as adolescentes se submetem a difíceis decisões sobre sua sexualidade e reprodução, em um momento de vida em que ainda lhes falta experiência sexual e reprodutiva. A partir dos dados, demonstra-se a importância do fortalecimento de políticas públicas, discussões sobre gênero e direitos sexuais e reprodutivos na adolescência em diversos âmbitos da sociedade, como escola, família e demais instituições.

Abstract This paper discusses the topic of first sexual intercourse in adolescence focusing on the course of ten young girls with experience of induced abortion living in a favela in Rio de Janeiro. The analysis uses the description of the process of entry into sexuality as a strategy to elucidate the context of pregnancy and the first clandestine abortion in the affective-sexual path of girls interviewed. The first sexual intercourse is a realm of sexuality and social life involving socialization, interpretation of rules and meanings, system of attitudes, ways of approximation, control and modeling of affections, emotions and gender relationships. The results showed that the age difference between couples in sexual initiation is significant, clarifying the context in which decisions on contraceptive methods, pregnancy and abortion were held. We noted that adolescents subject to difficult decisions about their sexuality and reproduction at a time of life where they still lack sexual and reproductive experience. The data collected show the importance of strengthening of public policies, discussions on gender and adolescent sexual and reproductive rights in many spheres of society, such as schools, family and other institutions.

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Este trabalho tem por finalidade examinar certa faceta da polêmica que gira em torno dos termos diferença dos sexos, gênero e diferença sexual em repercussão no campo psicanalítico. Inicialmente, versa sobre a incorporação de gender como instrumento da pesquisa sobre a sexualidade efetuada por Robert Stoller. Sua tese a respeito do núcleo de identidade de gênero foi analisada por Judith Butler e serviu-lhe de contraponto para o desenvolvimento de sua noção de performatividade de gênero. Acompanhamos a polêmica concernente à noção de diferença sexual em psicanálise. Se, por um lado, é interpretada pelos estudos de gênero como mantenedora duma norma binária que é avessa à multiplicidade; por outro, tem o mérito de resguardar o termo sexo, justamente este que é excluído do espectro contemplado por gênero e é exaltado pelo feminismo francês. Constatamos que a proposição stolleriana também foi criticada por Jacques Lacan no contexto de sua elaboração da noção de semblante do seminário XVIII, que prevê uma espécie de relação entre os sexos. Por fim, defendemos que Lacan não recorre à diferença sexual nem a gênero visando defini-los, mas entra nesse debate privilegiando a relação entre um sexo e outro enquanto impossível, concepção que é subsumida na expressão diferença dos sexos e que foi tema tratado extensamente e com grande rigor de formalização em sua teoria da sexuação.

This work aims to examine a certain facet of the controversy that revolves around the terms difference of the sexes, gender and sexual difference in repercussion in the psychoanalytic field. Initially, it focuses on the incorporation of gender as an instrument of research on sexuality carried out by Robert Stoller. His thesis on the core of gender identity was analyzed by Judith Butler and served as a counterpoint to the development of his gender performativity notion. We follow the controversy concerning the notion of sexual difference in psychoanalysis. If, on the one hand, it is interpreted by gender studies as maintaining a binary norm that is contrary to multiplicity; on the other, there is the merit of safeguarding the term sex, precisely the one that is excluded from the spectrum contemplated by gender and is exalted by French feminism. We find that the Stollerian proposition was also criticized by Jacques Lacan in the context of his elaboration of the semblant notion in Seminar XVIII, which foresees a kind of relationship between the sexes. Finally, we argue that Lacan does not resort to sexual difference or gender in order to define them, but he enters into this debate favoring the relationship between one sex and the other as impossible, a concept that is subsumed in the expression of difference of the sexes, with great rigor of formalization in his theory of sexuation.

El objetivo de este trabajo es evaluar una faceta de la polémica en relación a los términos diferencia de los sexos, género y diferencia sexual con repercusión en el campo psicoanalítico. Inicialmente, trata sobre la incorporación de gender como instrumento de la investigación acerca de la sexualidad hecha por Robert Stoller. Su tesis a respecto del núcleo de identidad de género fue evaluada por Judith Butler y le sirvió de contra-punto para el desarrollo de su noción de performatividad de género. Acompañamos la polémica en relación a la noción de diferencia sexual en psicoanálisis. Si, por un lado, es interpretada por los estudios de género como mantenedora de una norma binaria que es contraria a la multiplicidad; por otro, tiene el mérito de resguardar el término sexo, justamente este que es excluido del espectro contemplado por género y es exaltado por el feminismo francés. Constatamos que la proposición stolleriana también fue criticada por Jacques Lacan en el contexto de su elaboración de la noción de semblante del seminario XVIII, que prevé una especie de relación entre los sexos. Por fin, defendemos que Lacan no recurre a diferencia sexual ni a género visando definirlos, pero entra en ese debate privilegiando la relación entre un sexo y otro mientras imposible, concepción que es ampliada en la expresión diferencia de los sexos y que fue tema tratado extensamente y con gran rigor de formalización en su teoría de la sexualización.

Ce travail a pour objectif d'examiner une certaine facette de la polémique autour de termes comme "différence des sexes", "sexes et différence sexuelle" en évidence dans le champ psychanalytique. Initialement, cet article concerne à l'intégration des sexes comme outil de recherche sur la sexualité mené par Robert Stoller. La thèse de Stoller sur le noyau de l'identité des sexes a été analysée par Judith Butler et lui a servi de contrepoint au développement de sa notion de performativité des sexes. On a suivi la polémique concernente à la notion de différence sexuelle chez la Psychanalyse. Si, d'une part, les études sur les sexes interprètent la différence sexuelle comme une norme binaire contraire à la multiplicité; de l'autre, elle a le mérite de préserver le terme "sexe", précisément celui qui est exclu du spectre envisagé par "genre" et exalté par le féminisme français. On a constaté que la proposition de Stoller a été également critiquée par Jacques Lacan dans le contexte de son élaboration de la notion de semblant dans le Séminaire XVIII, qui prévoit une sorte de relation entre les sexes. Enfin, on soutien que Lacan ne recours pas à la différence sexuelle ou au genre avec l'objectif de les définir. En fait, Lacan défend dans ce débat que la relation entre un sexe et l'autre est impossible, concept qui est englobé dans l'expression "différence des sexes", qui a été traité avec une grande rigueur de formalisation dans sa théorie de la sexuation.

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Abstract Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age. Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data. Results The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years. Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.

Resumo Objetivo Avaliar os aspectos de saúde das mulheres brasileiras após os 65 anos de idade. Métodos O estudo foi retrospectivo, e incluiu 1.001mulheres brasileiras atendidas no ambulatório de ginecologia geriátrica de nossa instituição. Foi feita uma análise transversal de mulheres com idade acima de 65 anos, incluindo dados demográficos, sintomas clínicos (sintomas vasomotores), morbidades associadas, bem como alterações no exame físico e queixas em relação à atividade sexual. Utilizamos o teste qui-quadrado para avaliar os dados. Resultados A idade das pacientes na primeira visita clínica variou de 65 a 98 anos, com média etária de 68,56 ± 4,47 anos. A média etária de entrada na menopausa foi de 48,76 ± 5,07 anos. Os sintomas clínicos mais frequentes relatados durante o período analisado foram os sintomas vasomotores (n = 188), seguidos de artropatia, astenia e vagina seca. Asmorbidades associadasmais frequentes após os65anos foram hipertensão arterial sistêmica, distúrbios gastrintestinais, diabete melito e depressão, entre outras. A avaliação do índice de massa corporal (IMC) mostrou redução deste parâmetro antropométrico com o progredir da idade. No momento da visita, 78 pacientes relataram ter relações sexuais. A maioria das mulheres que relatou ter relações sexuais (89,75%, n = 70) estava entre 65 e 69 anos, 8,97% (n = 7) tinham entre 70 e 74 anos, e apenas 1,28% (n = 1) eram mais velhas do que 75 anos de idade. Conclusões Nossos achados sugerem que os sintomas vasomotores podem persistir após os 65 anos. Houve uma diminuição significativa na relação sexual com o aumento da idade. Os distúrbios cardiovasculares em nosso estudo são preocupações de saúde nestas mulheres.

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En el presente estudio se buscó determinar las opiniones sobre los métodos anticonceptivos y la relación existente entre la variable de estudio, el programa académico y el género en estudiantes de la facultad de humanidades de la Universidad del Magdalena. Mediante el cual se brindan datos actualizados sobre las conductas sexuales de riesgo de los estudiantes, los cuales pueden ser útiles para la prevención de esta problemática, por ello se realizó un estudio descriptivo-correlacional, utilizando un muestreo intencional, con una participación de 120 estudiantes. Los hallazgos permitieron concluir que los estudiantes plantean opiniones positivas y mayor uso sobre el preservativo y las píldoras; asimismo poseen opiniones negativas de la abstinencia, el dispositivo intrauterino y los implantes. Por otro lado, no se encontró relación entre el género y las opiniones sobre los métodos anticonceptivos, igualmente la opinión de los estudiantes no difiere según el programa.

In the present study views on contraception and the relationship between the variable gender study and students of the faculty of humanities at the University of Magdalena are determined. This article would provide data on sexual risk behaviors of students, which can be useful for the prevention of this problem, thus a descriptive correlational study was conducted using purposive sampling, with a participation of 120 students. The findings support the conclusion that students pose positive reviews and increased use of condoms and pills also have negative opinions of abstinence, intrauterine devices and implants. On the other hand, there is no relationship between gender and views on contraception, also the opinion of students does not differ according to the program.

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O enfraquecimento da musculatura do assoalho pélvico pode prejudicar a função urinária e sexual das mulheres. A perda de alguma função fisiológica, mesmo que temporária, causa alterações no cotidiano das pacientes, provocando impacto psicossocial e na sua qualidade de vida. O presente estudo busca quantificar o impacto da incontinência urinária (IU) na qualidade de vida sexual das mulheres através de uma revisão da literatura atual disponível, publicada entre 2000 e 2015. Apesar dos dados serem ainda inconsistentes, comprovou-se que a incontinência urinária afeta de maneira importante a sexualidade e a qualidade de vida de parte importante das mulheres acometidas.(AU)

The pelvic floor muscles weakness can impair urinary and sexual function of women. The loss of some physiological function, even if temporary, causes changes in the daily lives of patients, causing psychosocial impact and affecting their quality of life. This study seeks to quantify the impact of urinary incontinence (UI) in the quality of sexual life of women through a review of the currently avaiable data, publishe between 2000-2015. Even data are still inconsistent it was demonstrated that urinary incontinence significantly affects sexuality and important part of quality of life of affected women.(AU)

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INTRODUCTION: Infertility has a high prevalence worldwide. There is also a high prevalence of sexual problems, mainly in gynecological care settings, but many women are unlikely to discuss sexual problems with their physicians. AIMS: To verify how second-year gynecology residents (SGRs) assess the sexual function of infertile women who are undergoing assisted reproductive techniques (ART) at a single infertility tertiary care center in Brazil. MAIN OUTCOME MEASURES: Medical records of patients. METHODS: This retrospective cohort study evaluated all medical records of women who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) between January 2011 and December 2012 at a fertility clinic of the Hospital das Clinicas of Ribeirão Preto Medical School, University of São Paulo. RESULTS: A total of 616 women underwent ART during the study period. The mean patient age was 34.5 ± 4.4 years, mean weight was 65.6 ± 12.4 kg, mean height was 163 ± 0.6 cm, and mean body mass index (BMI) was 24.8 ± 4.3 kg/m(2). We classified the methods that medical residents used to assess the sexual frequency of these women as a numerical method, by categorization, or none (no assessment). A total of 26.7% (n = 166) of the SGRs did not assess female sexual function and 26.2% (n = 163) made assessments using categorization. SGRs who used a numerical method rather than categorization to classify the sexual frequency of their female patients were more likely to record answers to other questions on sexual desire, arousal, and orgasm. CONCLUSION: SGRs typically do not assess female sexual function in infertile couples. There was considerable heterogeneity among SGRs in their assessment of coital frequency and female sexual function.

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Este estudio descriptivo y retrospectivo se desarrolló en el servicio multidisciplinario de Ginecología Infanto-Juvenil, del municipio Plaza de la Revolución, con el propósito de caracterizar la relación entre las edades de la menarquia y las primeras relaciones sexuales en las usuarias que asistieron a la consulta, desde julio de 1996 hasta diciembre de 2011. Se trabajó con el universo de los casos vistos (3 091). Se examinó la edad de la menarquia, la edad de la primera relación sexual, así como el empleo de métodos de protección y la búsqueda de orientación previa a esta experiencia. La información se recolectó a partir de la revisión de la historia clínica individual del servicio y se procesó mediante análisis de frecuencia, media y rango. Se identificó que la edad promedio de la menarquia fue de 12,3 años y de las primeras relaciones sexuales fue 15,1. La diferencia entre la edad media de la menarquia y de las primeras relaciones sexuales fue 2,8 años. El 50,5 % de las usuarias declaró el uso de algún método anticonceptivo: el condón fue el más frecuente (78,4 %). La atención sistematizada en estos servicios contribuiría a mejorar su salud sexual y reproductiva.

This descriptive and retrospective study was carried out in the multidisciplinary service of Infanto-Juvenile Gynecology of the municipality Plaza de la Revolución with the aim of characterizing the relation between the ages of the menarche and the first sexual intercourse in patients assisting to the consultation from July 1996 to December 2011. The patients’ age at the menarche, their age at the moment of the first sexual intercourse, and also the use of protection methods and search for information previous to the experience were taken into account. Data were collected from the individual clinical records of the service and processed analyzing frequency, media and range. It was identified that the average age of arrival to menarche was 12.3 years, and the average age when having the first sexual intercourse was 15.1 years. The difference between both parameters was 2.8 years. 50.5 % of the patient stated the use of any contraceptive method; condom was the most frequent one (78.4 %). The systematic attention in these services would improve their sexual and reproductive health.

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RESUMO Investigou-se a interrupção/retomada da vida sexual após o tratamento do câncer de mama e sua relação com a satisfação e outros aspectos valorizados em um relacionamento. Foram empregados métodos mistos de pesquisa com a análise dos dados de uma survey realizada com 139 mulheres e dados provenientes de entrevistas com roteiro semiestruturado realizadas com 24 participantes. Um percentual expressivo de mulheres (66%) sexualmente ativas interrompeu as atividades sexuais durante o tratamento. Observou-se que a interrupção e retomada da vida sexual relacionou-se às concepções pessoais de sexualidade, influenciadas pelas relações de gênero e pela qualidade do relacionamento amoroso. A identificação de necessidades relacionadas à intimidade sexual pelo profissional de saúde pode contribuir para a assistência apropriada no processo de reabilitação psicossocial da mulher.

ABSTRACT Interruption and the re-start of sex life after breast cancer treatment as well as satisfaction and other valued aspects of the relationship were investigated. Mixed methods of data analysis were used including the results of a survey with 139 women and qualitative data of 24 interviews using a semi-structured guideline. An expressive proportion of women (66%) sexually active interrupted their sexual activities during the treatment. The results indicated that interruption and re-start of sex life is related to personal conceptions of sexuality, and is influenced by the concept of gender and the quality of the relationship. The identification of needs related to the sexual intimacy by health professional can contribute to appropriate care of women in their process of psychosocial rehabilitation.