Laceración vaginal poscoital: Revisión de casos y propuesta de atención médica / Postcoital vaginal laceration: Review of cases and proposed approach

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.

Avaliação da Associação entre Autoestima, Satisfação e Comportamento Sexual em Mulheres / Evaluation of the Association Between Self-Esteem, Satisfaction and Sexual behavior in Women

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.

Influence of Sexual Relationships using Drugs Consumption among Young Citizen in Melitopol, Ukraine

Purpose. The research work is aimed at studying and analyzing the onset of sexual activity and injecting drug use among young people of Melitopol (Zaporizhzhya region), which will make it possible to plan a number of preventive measures in order to prevent deviant behavior. Theoretical basis. The authors focus on the social problems associated with the late informing young people about the possible risks of early sexual relations and the use of drugs. Namely: students, young people, who move to another city or country, thus remaining without parental control. Scientific originality. This study allowed us to see the dynamics of attitudes (2010–2021) to injection drugs of boys and adolescent girls in cities with a population of up to 200 thousand (on the example of Melitopol, Zaporizhia region); track the tendency to awareness and care about your health during early sexual intercourse; plan a number of preventive measures to prevent the above phenomena. Conclusion. Young people between the ages of 13 and 15 put themselves at risk of becoming injecting drug users, getting infected with AIDS virus, Hepatitis B/C: 3,5% of those registered were infected with AIDS virus between the ages of 13 and 18; 28,5% were infected at the age of 18 – 24 years. The consumption of psychoactive substances (surfactants) from the injection form of consumption turned into a form of smoking and taking pills. Priority areas for further research have been identified: to conduct research with an interval of three years; to reach students of higher educational institutions, pupils of city colleges, with the aim of further cooperation with deans of educational institutions for holding lectures, talks, and thematic evenings for students on healthy lifestyles, AIDS virus and the dangers of psychoactive substances consumption.

Forma necrótica de úlcera de Lipschütz / Necrotic type of Lipschütz ulcer

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.

Características de las adolescentes embarazadas de un área de salud / Characteristics of Pregnant Adolescents in a Health Area

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)

Desgarro perineal con mucosa vaginal íntegra tras primera relación sexual / Perineal tear with intact vaginal mucosa after first sexual intercourse

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.

Cambios en el calendario de uso de condón masculino en la primera y última relación sexual en distintas cohortes de mujeres / Changes in male condom use at first and last sexual intercourse in different birth cohorts

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.

Experimentação e aprendizagem na trajetória afetiva e sexual de jovens de uma favela do Rio de Janeiro, Brasil, com experiência de aborto clandestino / Experiment and learning in the affective and sexual life of young women from a favela in Rio de Janeiro, Brazil, with experience of clandestine abortion

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.

A não relação sexual lacaniana em face do debate entre gênero e diferença sexual / The non-lacanian sexual relation in the face of the debate between gender and sexual difference / La no-relación sexual lacaniana ante el debate entre género y diferencia sexual / Le non-rapport sexuel lacanien face au débat entre genre et différence sexuelle

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.

Brazilian Women's Health after 65 Years of Age / Saúde de brasileiras acima dos 65 anos de idade

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.

Prevalence And Incidence Of Hepatitis B Virus Among Expectant Mothers In Lagos Island General Hospital, Nigeria

Hepatitis B Virus (HBV) is an infection characterized as one of the major public health problems in the globe, particularly in Nigeria. This may be because of unguided sexual intercourse and inadequate knowledge of the disease. The study examined prevalence and incidence of HBV among expectant mothers in Lagos Island general hospital, Nigeria. Descriptive survey research design was used for the study. Hat and draw sampling technique was adopted for study location while volunteer sampling method was used to draw a hundred subjects. Instrument used was a revalidated questionnaire using test-retest method of reliability coefficient and the result yielded 0.89. The instrument was factor loaded using exploratory factor analysis setting nunnally criterion at 0.6. Hypotheses were tested using X2 statistics at 0.05 alpha level. Findings showed significant relationships in incidence of HBV based on unsafe sexual activity (X2= 62.8,p<0.05) and inadequate knowledge (X2=53.6,p<0.0). The practice of safe sex and being knowledgeable about HBV may prevent its incidence among expectant mothers. A significant relationship also exists in terms of managing the occurrence of HBV among expectant mothers (X2=47.6, p<0.05). This indicates that though there exist HBV, it can still be managed. The study concluded that inadequate knowledge, unsafe sexual activity may lead to HBV infection.

OPINIONES SOBRE LAS PRÁCTICAS ANTICONCEPTIVAS EN ESTUDIANTES DE UNA FACULTAD DE HUMANIDADES EN SANTA MARTA / ATTITUDES ABOUT OPINIONS AND PRACTICES IN STUDENTS OF BIRTH CONTROL A FACULTY OF HUMANITIES IN SANTA MARTA

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.

Impacto da incontinência urinária na qualidade de vida sexual da mulher / Impact of the urinary incontinence in the sexual life quality of the women

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)

Menarquia y primeras relaciones sexuales coitales en adolescentes del municipio Plaza de la Revolución, La Habana. 1996-2011 / Menarche and first coital sexual relations in teenagers of Plaza de la Revolución, La Habana. 1996-2011

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.

Interrupção e Retomada da Vida Sexual após o Câncer de Mama / Interruption and Re-Start of Sex Life after Breast Cancer

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.

Sexual behaviour and practices of men who have sex with men in Ahmedabad city.

Background: Because many Men who have Sex with Men (MSM) in India do not openly acknowledge their sexual behaviour, this has resulted in scanty knowledge about their sex behavior and its context. Without this knowledge it is difficult to plan effective MSM-related HIV prevention. The objective was to study the different socio-demographic characteristics of the MSM population, their pattern of sexual behavior and practices and to find out various reasons for sexual acts with men. Methods: Descriptive cross sectional study was conducted amongst 410 MSM in Drop In Centers of Non-Governmental Organization (NGO) working for MSM in Ahmedabad city through purposive sampling during the period of December 2010 – December 2011. Results: The mean age of the study population was 33.6 ± 9.4 years. The sexual practices of MSM were not limited to male partners only. 74.6% MSM had their first sexual act in adolescent age group (10-19 years) and the mean age of the first sexual act was only 17.2 ± 4.3 years. First sexual partner of MSM was a male friend (57.3%) followed by girlfriend (12.7%), relative (10%) etc. MSM had an average 3.8 different male partner per month with weekly average frequency of sexual act 7.4 which indicates more frequent sexual act with multiple male sexual partners. Preferred place for sexual act was at home (57.3%) followed by at Hotel (31.2%). The commonest reasons for sexual act of men with men given were for specific sexual acts either anal or oral sex (67.8%), desire for other men gender and or sexual orientation (66.1%) etc. Only 42.2% MSM were using condom consistently and 9.5% did not have knowledge that HIV can be transmitted by unprotected sexual intercourse while knowledge regarding HIV transmission by infected blood contact, infected needle and syringes and parent to child transmission were 57.8%, 48.5% and 27.6% respectively. Conclusions: MSM had more frequent sexual act with multiple male sexual partners preferably at home and 47.8% MSM were not using condom consistently.

Frequency, perceptions and complications of sexual activity during pregnancy among a group of Nigerian women.

Background: Hormonal, emotional and physical changes that occur in pregnancy as well as cultural influences in our society may impact on women’s sexual responses and influence their sexual practices and perceptions regarding sexual intercourse during pregnancy. Aim: This study was undertaken to evaluate the frequency, practices, perceptions and safety of sexual intercourse during pregnancy among pregnant women in Jos, Nigeria. Materials and methods: This was a cross-sectional study of 204 healthy pregnant women at term over a 6-month period. They anonymously completed self-administerd questionnaires regarding sexual activities during pregnancy. Data collected included coital frequency, perceptions and concerns of sexual intercourse during pregnancy, its benefits and problems encountered. Statistical analysis was done using SPSS version 16. Descriptive statistics was performed and chi square test was used to ascertain associations between categorical variables. P < 0.05 was considered significant. Results: All women were sexually active throughout pregnancy but with overall decrease coital frequency compared to the pre-pregnency period. Most adopted sexual positions included side-by-side, man on top and rear positions. Advanced maternal age > 35 years (P = 0.67, OR 1.19, 95% CI 0.54 – 2.65), primigravidity (P = 0.52, OR 0.80, 95% CI 0.40 - 1.60)and nulliparity (P = 0.60, OR 0.83, 95% CI 0.43 – 1.62) had no influence on coital frequency. More than 90.0% of them opined that sex during pregnancy is safe and beneficial including widening of the birth canal, maintenance of emotional attachment between couples, satisfaction of sexual desire and prevention of spousal infidelity. Only 32 (15.7%) of the women developed transient sexual problems including vaginal bleeding and discharge, soreness/pain in the vagina and abdominal pain. Conclusion: There was an observed decrease coital frequency among pregnant women in this study, nevertheless many still have positive attitude towards it, albeit with few misconceptions. Hence, Health providers should include sex education into antenatal care programs so as to dispel fears and clear these sexual misconceptions.

Effects of Sexual Intercourse on Suicidal Behaviors among Adolescents in South Korea

PURPOSE: For the current article an examination was done as to whether engaging in sexual intercourse before or during adolescence has a negative impact on the suicidal behaviors of suicide ideation, suicide attempt, and suicide lethality and whether the impact varies according to the context of sexual intercourse and/or gender METHODS: Adolescents who experienced casual sex and romantic sex were compared to adolescents who retained their virginity. Data was from samples drawn from the three waves (2010~2012) of the Korea Youth Risk Behavior Web-Based Survey. Logistic models were used to adjust for a wide array of confounding variables. RESULTS: Any type of sexual intercourse increases risk of all suicidal behaviors. Sexual intercourse in a romantic relationship exhibits enhanced risk of suicidal behaviors compared to casual sex. Adjusting for experience of sexual violence, however, decreases risk of romantic sex substantially, turning some estimates statistically insignificant. In addition, risks for suicide lethality are greater for girls than boys. CONCLUSION: Romantic sex put adolescents at higher risk for suicidal behaviors than casual sex owing to prevalent sexual violence in the relationships. Girls suffer more substantively adverse outcomes than boys. These results suggest that adolescents will benefit from comprehensive education on sexuality and sexual behaviors regarding how to form and maintain a romantic relationship that is characterized by personal integrity and mutual respect. It is also important to help victims of sexual violence recover from traumatic events by providing emotional support and effective counseling.

Estudo clínico aberto para avaliação de segurança e tolerabilidade de lubrificante para uso íntimo / Open clinical trial to evaluate the safety and tolerability of a personal lubricant

Introdução: O uso de lubrificantes íntimos pode ser recomendado para reduzir o desconforto da lubrificação insuficiente, proporcionando conforto aos parceiros, particularmente em mulheres portadoras de ressecamento vaginal, decorrente da menopausa ou por outras condições ginecológicas1. Os lubrificantes íntimos são compostos por géis inertes ou que contenham ingredientes com ação calmante1. O presente estudo avaliou a segurança e a tolerabilidade de um gel lubrificante íntimo. Métodos: 115 voluntárias foram avaliados nas etapas do estudo. Inicialmente 55 voluntárias participaram de uma etapa para avaliação de potencial irritante primário e cumulativo e sensibilizante, através de aplicações repetidas de apósitos oclusivos no dorso. Paralelamente 27 voluntárias participaram de uma etapa para avaliação de potencial fotoirritante e fotossensibilizante através de aplicações repetidas de apósitos oclusivos, combinadas com irradiação com UVA. Finalmente, 35 voluntárias com queixas de dispareunia e ressecamento vaginal participaram de um estudo sob condições normais de uso, com utilização do produto durante 21 dias. As voluntárias responderam a um questionário sobre a performance do produto. Resultados: Não foi observada nenhuma positividade nos estudos de dermatotoxicologia. No estudo de segurança e tolerabilidade, nenhum evento adverso foi observado. O produto foi bem avaliado pela maior parte dos voluntários, que referiram maior lubrificação e sensação de bem-estar durante o ato sexual. Conclusão: O lubrificante íntimo avaliado no presente estudo demonstrou ser seguro e foi capaz de promover uma melhora da lubrificação íntima, promovendo uma melhor qualidade do ato sexual. O produto pode ser declarado como hipoalergênico, pela ausência de positividade nos estudos de dermatotoxicologia...

Sexarca, informação e uso de métodos contraceptivos: comparação entre adolescentes / First sexual intercourse, information and contraceptive use: a comparison between adolescents / Sexarca, información y uso de métodos anticonceptivos: comparación entre adolescentes

Este trabalho teve por objetivo comparar a idade da primeira relação sexual, a informação sobre métodos contraceptivos, além de seu uso com a ocorrência da gestação na adolescência em dois grupos (50 grávidas e 50 não grávidas). Foi utilizado um questionário desenvolvido para o estudo que investigou essas variáveis. Verificou-se que não há diferença significativa nos grupos entre idade da sexarca, uso de contracepção na sexarca e tipo de contraceptivo utilizado. Contudo, os grupos diferem em relação ao uso de métodos contraceptivos nas relações sexuais subsequentes. Os dados revelam a multiplicidade de fatores envolvidos no comportamento contraceptivo demonstrando a necessidade de absorção desses fatores por parte das políticas públicas voltadas para o público adolescentes...

This study aimed to compare the age at first sexual intercourse, information about contraceptive methods, besides its use with the occurrence of adolescent pregnancy in two groups (50 pregnant and 50 nonpregnant). The questionnaire developed for the study investigated these variables. It was found that there is no significant difference between groups in age at first sexual intercourse, use of contraception at first sexual intercourse and type of contraceptive used. However, the groups differ with respect to the use of contraceptives in the subsequent sexual intercourses. The data reveals the multiplicity of factors involved in contraceptive behavior demonstrating the need for absorption of these factors on the part of public politics directed to adolescents...

Este estudio tuvo como objetivo comparar la edad de la primera relación sexual, la información sobre los métodos anticonceptivos, además de su uso con la ocurrencia del embarazo en la adolescencia en dos grupos (50 embarazadas y 50 no embarazadas). El cuestionario elaborado para el estudio investigó esas variables. Se encontró que no hay diferencia significativa en los grupos entre edad de la sexarca, el uso de anticonceptivos en la sexarca y el tipo de anticonceptivo utilizado. Sin embargo, los grupos difieren con respecto a la utilización de anticonceptivos en las relaciones sexuales posteriores. Los datos revelan la multiplicidad de factores implicados en el comportamiento anticonceptivo que demuestran la necesidad de absorción de estos factores en las políticas públicas vueltas a los adolescentes...