Prevalencia y caracterización de las disfunciones sexuales en mujeres en transición a la menopausia / Prevalence and characterization of sexual dysfunctions in women in transition to menopause

Objetivo: Caracterizar las disfunciones sexuales y estimar la prevalencia en un grupo de mujeres en transición a la menopausia, así como evaluar la frecuencia de la sintomatología climatérica. Método: Estudio de corte transversal, entre 2017 y 2020, que incluyó 411 mujeres en transición a la menopausia, residentes en el Quindío, con pareja estable y actividad sexual en las últimas 6 semanas. Se utilizó como instrumento el FSFI-6 (6-Item Female Sexual Function Index). Resultados: La edad promedio fue de 46,53 ± 2,87 años. La prevalencia de disfunciones sexuales fue del 38,92%, caracterizadas por dificultades con el deseo sexual (38,92%), seguido de dolor/dispareunia (35,52%). El promedio general en la puntuación del FSFI-6, en la totalidad de la población participante, fue de 22,29 ± 0,84 puntos; en la población afectada (< 19 puntos) fue de 15,78 ± 3,94. En los dominios, la puntuación más baja estuvo en el deseo (3,14 ± 0,56). La mediana de disfunciones sexuales por mujer fue de tres (23,84%). Conclusiones: más de un tercio de las mujeres del Quindío en transición a la menopausia presentan disfunciones sexuales; el trastorno más común fue el bajo deseo. Se deben hacer esfuerzos para aumentar la conciencia en los asuntos de salud sexual.

Objective: To characterize sexual dysfunctions and estimate the prevalence in a group of women in transition to menopause, as well as to evaluate the frequency of climacteric symptoms. Method: Cross-sectional study, between 2017 and 2020, included 411 women in transition to menopause, residents of Quindío, with a stable partner and sexual activity in the last 6 weeks. The FSFI-6 (6-Item Female Sexual Function Index) was used as an instrument. Results: The mean age was 46.53 ± 2.87 years. The prevalence of sexual dysfunctions was 38.92%, characterized by difficulties with sexual desire (38.92%), followed by pain/dyspareunia (35.52%). The general average, in the FSFI-6 score, in the entire participating population, was 22.29 ± 0.84 points; while in the affected population (< 19 points), it was 15.78 ± 3.94. In the domains, the lowest score was in desire (3.14 ± 0.56). The median number of sexual dysfunctions per woman was three (present in 23.84%). Conclusions: This study showed that more than one third of the women in Quindío, in transition to menopause, had sexual dysfunctions; the most common type of disorder was low desire. Efforts should be made to increase awareness about sexual health issues.

Calidad de vida laboral y riesgo de disfunción sexual en enfermeras

Las experiencias y relaciones personales insatisfactorias en el ámbito laboral se asocian a resultados negativos en el aspecto sexual. La disfunción sexual femenina (DSF) es la alteración de cualquiera de las fases del orgasmo. La calidad de vida laboral (CVL) es la percepción del trabajador entre las exigencias del trabajo y las técnicas de afrontamiento. Objetivo: Determinar la asociación entre la calidad de vida laboral y el riesgo de disfunción sexual femenina en enfermeras de un hospital público del Callao, Perú. Método: Estudio observacional, transversal y analítico realizado en enfermeras del Hospital Nacional Daniel Alcides Carrión (HNDAC) de la provincia Constitucional del Callao, Perú. El riesgo de DSF fue medido con la prueba de Rosen. La CVL fue medida con el cuestionario de CVP-35. El análisis estadístico se realizó con el programa STATA versión 15. Se consideró significativo un valor de p<0,05 con un IC de 95%. Resultados: El estudio contó con la participación de 168 enfermeras que respondieron de forma completa. Las dimensiones de CVL asociadas a DSF fueron apoyo directo (p=0,01), motivación intrínseca (p=0,003), la pregunta sobre desconexión de trabajo (p=0,007), el ingreso mensual (p=0,003), el estado civil (p=0,001) y consumo de alcohol (p=0,014). No hubo asociación en el análisis multivariado. Conclusión: En el presente estudio no existió una asociación entre las dimensiones de la calidad de vida laboral y el riesgo de disfunción sexual femenina ajustado por confusores.

Unsatisfactory personal experiences and relationships in the work environment are associated with negative sexual outcomes. Female sexual dysfunction (FSD) is the disturbance of any of the phases of orgasm. Quality of work life (QWL) is the worker's perception between work demands and coping techniques. Objective: To determine the association between quality of work life and the risk of female sexual dysfunction in nurses of a public hospital in Callao, Peru. Methods: Observational, cross-sectional, analytical study conducted in nurses of the Hospital Nacional Daniel Alcides Carrión (HNDAC) of the Constitutional province of Callao, Peru. The risk of FSD was measured with the Rosen test. CVL was measured with the CVP35 questionnaire. Statistical analysis was performed with the STATA version 15 program. A value of p<0.05 with a 95% CI was considered significant. Results: The study involved 168 nurses who responded completely. The dimensions of CVL associated with DSF were direct support (p=0.01), intrinsic motivation (p=0.003), the question on work disconnection (p=0.007), monthly income (p=0.003), marital status (p=0.001) and alcohol consumption (p=0.014). There was no association in the multivariate analysis. Conclusion: In the present study there was no association between dimensions of quality of work life and confounder-adjusted risk of female sexual dysfunction.

Associação da educação sexual, cinesioterapia e terapia manual no tratamento de mulheres anorgásmicas: um estudo de caso / Association of sex education, kinesiotherapy and manual therapy in the treatment of anorgasmic women: a case study

O orgasmo é o ápice da excitação sexual e, quando comumente não experienciado, denomina-se anorgasmia, segunda queixa sexual mais frequente entre mulheres. A fisioterapia é um recurso que visa beneficiar a qualidade de vida das mulheres anorgásmicas por meio da prevenção, reparação de função e tratamento de quadros álgicos. O estudo teve como objetivo avaliar os efeitos da associação das técnicas de cinesioterapia aplicada à musculatura do assoalho pélvico, massagem perineal e conscientização acerca da sexualidade das participantes. Os métodos utilizados foram educação sexual, massagem perineal e cinesioterapia associada ao uso da sonda uroginecológica New PelviFit Trainer, como biofeedback visual, para promover conscientização e estimar os efeitos sobre a condição da musculatura do assoalho pélvico de mulheres com relato de anorgasmia. O resultado obtido com o protocolo da associação das técnicas terapêuticas em mulheres com disfunção orgásmica apresentou melhora da função sexual feminina, aumento da força e do estado de relaxamento da musculatura do assoalho pélvico, avaliados pelo questionário Índice de Função Sexual Feminina, quantificados por meio da escala de Oxford modificada e da escala de avaliação de flexibilidade vaginal, respectivamente. Como conclusão, a aplicação das técnicas fisioterapêuticas aliadas ao tratamento humanizado, com enfoque na conscientização das mulheres, autopercepção corporal e manutenção da função sexual, promoveu melhora da disfunção sexual orgásmica. Apesar de necessário maior embasamento científico relativo ao tema, a presente abordagem para o tratamento em questão apresentou-se promissora e pertinente à base de dados. (AU)

Orgasm is the peak of sexual excitement, when not commonly experienced, it is called anorgasmia, second most frequent sexual complaint among women. Physiotherapy is a resource that aims to improve the quality of life of anorgasmics women through prevention, function repair and pain management. The purpose of the study was to evaluate the effects of kinesiotherapy techniques applied on the pelvic floor muscles, associated with perineal massage and the participants' sexual awareness. The methods used were sexual education, perineal massage, kinesiotherapy associated with the use of the New PelviFit Trainer urogynecological probe, as a visual feedback, to promove awearness and estimate its effects on the pelvic floor muscles condition in women reporting anorgasmia. The result obtained with the protocol of association of therapeutic techniques in women with orgasmic dysfunction showed improvement in the female sexual function, assessed by the Female Sexual Function Index questionnaire, increased strength and pelvic floor muscles relaxation, quantified using the Modified Oxford scale and the vaginal flexibility assessment scale, respectively. As a conclusion, the application of physiotherapeutic techniques combined with humanized treatment, with a focus on awareness of women, body self-perception and maintenance of sexual function, promoted improvement of orgasmic sexual dysfunction. Despite the need for a greater scientific basis on the subject, the present approach to the treatment in question was promising and relevant to the database. (AU)

Female sexual dysfunction in chronic obstructive pulmonary disease

Background: Sexual life of women with chronic obstructive pulmonary disease (COPD) can be affected by breathing difficulties, a decrease in functional status, depressive mood and fatigue. Objetive: To evaluate the sexual dysfunction in female COPD patients and the possible explanatory mechanisms or correlations between these conditions. Methods: The study included 70 female patients with COPD aged between 36-65 and 70 age-matched controls. All the subjects completed questionnaires for the Female Sexual Functional Index (FSFI), BECK depression inventory and, spirometry. Results: Statistically significant sexual dysfunction was noted in COPD patients compared to the non-COPD group (p0.005). In linear regression analysis determining depression, no statistically significant factor was found among age, number of comorbidities, and FEV1/ forced vital capacity (FVC) % predicted (p>0.05). In multivariable analysis, only fatigue during intercourse was found to be a statistically significant factor in predicting sexual dysfunction among factors like age, presence of comorbidities, duration of the disease, smoking status, FEV1%, m MRCpoints, 6-minutes walk test, BECK depression scores (p=0.008). Conclusion: Sexual dysfunction is reported in many COPD females and seems to be related not to spirometric measures or exercise capacity but to fatigue. Depression is also a common comorbidity, of which both disorders are often neglected.

Antecedentes: La vida sexual en mujeres con enfermedad pulmonar obstructiva crónica (EPOC) es afectada por dificultades respiratorias, disminución del estado funcional, estado de ánimo depresivo y fatiga. Objetive: Evaluar la disfunción sexual en mujeres con EPOC y posibles mecanismos explicativos de esas dos condiciones Métodos: Participaron 70 pacientes mujeres con EPOC, rango edad 36-65 años y 70 controles emparejados por edad. Todos los sujetos respondieron un cuestionario para el índice funcional sexual femenino e inventario de depresión de BECK, mas una espirometría. Resultados: Se observó disfunción sexual significativa en las pacientes con EPOC comparado con el grupo sin EPOC. Las puntuaciones del inventario de depresión BECK fueron significativamente inferiores a las del grupo control. No hubo correlación entre las puntuaciones del FSFI y la depresión BECK con las características de las "mujeres" (r=-0.055). No se encontraron diferencias significativas en edad, FEV1% y antecedentes de exacerbación del año anterior según la gravedad de la depresión. En la regresión lineal para determinar la depresión, no hubo ningún factor estadísticamente significativo entre edad, número de comorbilidades y FEV1/FVC% predicho. En el multivariado, sólo la fatiga durante el coito resultó ser un factor significativo para predecir la disfunción sexual entre factores como edad, presencia de comorbilidades, duración de la enfermedad, hábito tabáquico, FEV1%, m MRCpoints, prueba de la marcha de 6 minutos y puntuaciones de depresión de BECK. Conclusiones: La disfunción sexual parece no estar relacionada con las medidas espirométricas o la capacidad de ejercicio, pero si con la fatiga. La depresión es una comorbilidad frecuente, de la que a menudo se descuidan ambos trastornos.

Sexual dysfunction in Brazilian patients with multiple sclerosis / Disfunção sexual em pacientes brasileiros com esclerose múltipla

Abstract Background People with multiple sclerosis (PwMS) show an increased risk of sexual dysfunction (SD), both in women and men. Objective The aim of the present study was to apply the Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and evaluate our results by comparing them with those in in the literature, as well as to assess the ease of applying the scale and the engagement of the patients in discussing the topic of sexuality. Methods We developed and applied a web-based Google form questionnaire that the respondents completed online, which included the MSISQ-19, for the assessment of sexual function. Baseline characteristics were reported as proportions and mean ± standard deviation (SD) or median ± interquartile range (IQR) as appropriate according to data distribution. Categorical variables were stratified by sex and compared with chisquared tests. Statistical analyses were performed using STATA v. 16 (StataCorp., College Station, TX, USA). Results Of the 621 respondents, 541 were included in the analysis. Among the patients with MS, a total of 347 (64.14%) exhibited SD. When stratified by gender, the frequencies of SD were not significantly different. Conclusion There is a high incidence of sexual dysfunction among PwMS and we need to identify the reasons for this and implement strategies to treat and counsel our patients. The MSISQ-19 can be used to help clinicians to assess sexual functioning in a quick and easy way and give patients the possibility to address this topic and receive appropriate help and support.

Resumo Antecedentes Pacientes com esclerose múltipla apresentam altas taxas de disfunção sexual em diversos estudos. Objetivo Avaliar a aplicação e resultados da ferramenta para avaliação de disfunção sexual em pacientes com Esclerose Multipla, Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19), bem como comparar os resultados encontrados com a literatura já existente e ter a percepção do engajamento dos pacientes sobre o tema. Métodos Realizado através de questionário on-line na plataforma Google Forms, composto por questões sobre perfil demográfico e relacionadas à doença e o questionário MSISQ-19. Os dados demográficos e sobre a doença foram descritos como proporções e média ± desvio padrão (DP) ou mediana ± intervalo interquartil (IIQ). As variáveis categóricas foram estratificadas por sexo e comparadas com testes de qui-quadrado. As análises estatísticas foram realizadas no programa STATA v. 16 (StataCorp., College Station, TX, EUA). Resultados Um total de 621 pacientes responderam ao questionário, sendo inclusos na análise 541 respostas, após a aplicação dos critérios de elegibilidade. Um total de 347 (64,14%) pacientes apresentaram disfunção sexual, sem diferença entre os gêneros. Conclusão Disfunção sexual apresenta alta prevalência no grupo estudado, sendo necessário identificar as causas e implementar estratégias de tratamento. O MSISQ-19 é uma ferramenta fácil e rápida de ser aplicada, podendo ser utilizada para facilitar a comunicação com os pacientes sobre o tema, possibilitando assim o tratamento das disfunções sexuais nessa população.

Comparison of sexual functions in women with and without type 1 diabetes

SUMMARY OBJECTIVE: This study aimed to investigate female sexual function in patients with type 1 diabetes by comparing female sexual function index scores between women with and without type 1 diabetes. METHODS: A total of 62 women with type 1 diabetes and 69 age-matched women without diabetes but with similar backgrounds were enrolled in the patient and control groups, respectively. All participants were sexually active and had no systemic diseases other than diabetes in the patient group. RESULTS: The frequency of female sexual dysfunction was significantly higher, and the mean female sexual function index score was significantly lower in women with diabetes compared to the control group (p=0.01). There was a significant relationship between sexual dysfunction and duration of diabetes, glycosylated hemoglobin test, and body mass index (p<0.05). CONCLUSION: This study demonstrates that female sexual dysfunction is more common among women with type 1 diabetes than among women without type 1 diabetes. Patients with type 1 diabetes should be evaluated in terms of sexual health. Health professionals should give more attention to and provide guidance regarding sexual function in women with type 1 diabetes.

EVALUATION OF FEMALE SEXUAL DYSFUNCTION IN THE DIABETIC WOMEN IN A TERTIARY CARE MEDICAL COLLEGE AND HOSPITAL IN EASTERN INDIA

Background: In women, the evidences regarding the association between diabetes and sexual dysfunction are less conclusive as compared to males. Diabetes-induced vascular and nerve dysfunctions may impair the sexual response by producing structural and functional changes in the female genitalia. The present study is significant in this regard that it has been conducted among individuals hailing from urban, suburban and rural areas of the state of West Bengal making questionnaires in vernacular languages to reach maximum number of individuals possible. The data obtained was analysed statistically to derive conclusions. In this cross- Methods: sectional 100 female patients with type 2 diabetes mellitus attending the diabetes clinic in Endocrine OPD of Medical College and Hospital Kolkata were screened and included as the study population. Sexual dysfunctions in women was measured here using the standard questionnaire and the FSFI score <24 was taken as the criteria for accepting the presence of sexual dysfunction. The FSD score was compared against parameters like age, duration of diabetes, Body mass index (BMI), blood sugar (glycemic status) fasting and post-prandial , diabetes-related complications and addiction and prevalence was calculated. Prevalence of se Results : xual dysfunction in the study population is 51% showing association between diabetes and female sexual dysfunction.The prevalence of FSD was found to be maximum (75%) in the age group 41- 50years. Strong association of FSD with age is found as p-value is 0.002. the prevalence of FSD was maximum (92.31%) in the participants whose Duration of diabetes more than equal to 11 years. Very Strong association of FSD with Duration of diabetes is found as p-value < 0.001. The prevalence of FSD was found to be maximum (94.74%) in the group (19% of the study population) who are on insulin. Extremely strong association of FSD with insulin usage is found as p-value is 0.000. The prevalence of FSD was found to be maximum (71.43%) in the group (42% of the study population) who do not have controlled ppbg (>180 mg/dl). Quite strong association of FSD with ppbg control is found as p-value is 0.001. The prevalence of FSD was found to be maximum (72.5%) in the participants who were overweight.11% of the population is obese and in them prevalence of FSD is 63.64. Very strong association of FSD with BMI of the participant is found as p-value is 0.000.Major association of FSD was seen absent with addiction, OHA intake, micro and macrovascular compications in the patients. Of all the six domains evaluated to reach FSFI score, majority of the patients had decreased desire. Prevalence Conclusion: of sexual dysfunction in the study population is 51%. Longer duration of diabetes, inadequate diabetes control, insulin intake, obesity (higher BMI) and higher age of the participant has a role to play in the development of FSD as per this study. The ability to diagnose and treat FSD in unsuspecting diabetics will result in long term improvement in quality of life

Evaluation of sexual function and depression in female patients with fibromyalgia

SUMMARY OBJECTIVE: Fibromyalgia is one of the most important problems, especially for women. Studies point to disorders in the sexual functions of fibromyalgia patients that reduce their quality of life. The aim of this study was to investigate sexual dysfunction and its relationship with disease severity and depression in women with fibromyalgia. METHODS: This study included 98 female patients diagnosed with fibromyalgia and 54 healthy women. The Female Sexual Function Index was used to assess sexual dysfunction. Fibromyalgia disease severity was measured with the Fibromyalgia Impact Questionnaire. Hamilton Depression Scale was filled in to evaluate the depression status of the patients. RESULTS: According to the female sexual function index data, female sexual dysfunction was found in 78 (79.6%) patients with fibromyalgia and only in 12 (22.2%) controls. When the female sexual function index scores of fibromyalgia patients with and without depression were compared, patients with additional depression had lower female sexual function index scores, and this difference was statistically significant (p=0.002). In the correlation analysis, the female sexual function index score showed a significant negative correlation with the hamilton depression scale (rho=-0.235, p=0.020) and fibromyalgia impact questionnaire (rho=-0.215, p=0.033) scores. CONCLUSION: This study highlights the high prevalence of sexual dysfunction in female fibromyalgia patients and the significant correlation between sexual dysfunction and both disease severity and depression.

Sexual dysfunction in women with type 2 diabetes mellitus: A single-centre cross-sectional study from Bangladesh

ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.

Current status and new progress of drug therapy for premature ejaculation / 现代泌尿外科杂志

Premature ejaculation (PE) is the most common male sexual dysfunction with a high incidence, which seriously affects the relationship between a husband and wife and family harmony. Drug therapy is a first-line treatment for PE patients with premature ejaculation, and has achieved good efficacy, but the clinically available drugs are single and the abandonment rate is high. Coupled with the ineffective treatment of some patients, new drug research and development is imminent. This paper systematically reviews the current status of drug treatment for premature ejaculation, focusing on the research and development of new drugs and research progress in order to provide a reference for clinicians.

Incidence rate and protection strategy of sexual dysfunction after minimally invasive surgery for benign prostatic hyperplasia / 现代泌尿外科杂志

In recent years, minimally invasive surgery has been rapidly developed and has become the first choice for the treatment of moderate to severe benign prostatic hyperplasia (BPH). Although it can significantly improve the lower urinary tract symptoms, reduce complications, and enhance security, postoperative sexual dysfunction(SD) is still common, which affects the patients’ quality of life. In this paper, we discuss the incidence rate of SD after BPH surgery, the protection strategy of sexual function, and how to choose reasonable treatment from the perspective of sexual function protection.

The risk factors of low anterior resection syndrome and its influence on psychological status and quality of life in rectal cancer patients / 中华普通外科杂志

Objective:To investigate the effects of low anterior resection syndrome (LARS) on psychological and physical function and quality of life in patients with rectal cancer.Methods:From May 2014 to May 2019, 200 patients were included. LARS scale score was adopted, and the clinical and pathological data were collected. Univariate analysis and multivariate Logistic regression analysis were performed. the European Organization for Research and Treatment of Cancer Quality of Life core questionnaire and psychological distress management screening tool survey were conducted to evaluate the quality of life and psychological state. The incidence of postoperative sexual dysfunction in male patients was analyzed.Results:The incidence of LARS was 43.0%. Multivariate analysis showed that body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance ≤5 cm from anal margin, and preoperative radiotherapy were independent risk factors for LARS ( OR=2.123, 15.109, 7.302, 12.682, all P<0.05).The overall health level and the scores of physical function and emotional function in the functional dimension of patients in the severe LARS group were significantly lower than those in the no/mild LARS group ( t=5.788, 8.831, 8.745, all P<0.05). The scores of fatigue and diarrhea were significantly higher than those in the no/mild LARS group ( t=26.280, 49.476, all P<0.05). The psychological distress thermometer score and the scores of communication , emotional and physical problems in the severe LARS group were significantly higher than those in the no/mild LARS group ( t=4.246, 6.563, 5.913, 4.408, all P<0.05). Conclusion:LARS is a common complication after Dixon procedure for rectal cancer. Body mass index ≥24 kg/m 2, anastomotic leakage, anastomotic distance from anal margin ≤5 cm, and preoperative radiotherapy are independent risk factors for LARS.

Post-stroke sexual dysfunction / 国际脑血管病杂志

Sexual function is a basic component of adult life quality. Studies have shown that both men and women can experience sexual dysfunction after stroke. The prevalence of post-stroke sexual dysfunction is likely to be higher than expected. This article reviews the epidemiology, influencing factors, evaluation and intervention of post-stroke sexual dysfunction.

Transsphenoidal surgery for prolactinomas in male patients: a retrospective study / 亚洲男科学杂志(英文版)

Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone <2.3 ng ml-1 was an independent predictor of improvement in erectile dysfunction. In conclusion, our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma. The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.

TCM understanding and treatment strategy of hypertension complicated with sexual dysfunction / 中国中药杂志

Hypertension and its target organ damage have become a major public health problem. Sexual dysfunction is a new problem in the treatment of modern hypertension. Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction. In addition, three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction. In traditional Chinese medicine(TCM), hypertension belongs to "vertigo" "headache" "head wind", etc. In the past, the understanding of the TCM pathogenesis of hypertension was mainly from the perspectives of "liver wind" and "Yang hyperactivity". However, based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice, it has been identified that kidney deficiency was the key pathogenesis. Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM, especially the deficiency of kidney Yin. Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure, improve sexual dysfunction, reverse risk factors, and protect target organs. This article systematically discussed the TCM understanding, modern pathophysiological mechanism, and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds) in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.

Microablative fractional radiofrequency for sexual dysfunction and vaginal Trophism: A randomized clinical trial

Abstract Objectives: To evaluate Microablative Fractional Radiofrequency (MAFRF) as a possible option in treating vaginal atrophy. Methods: This was a randomized, controlled clinical trial with postmenopausal women diagnosed with vaginal atrophy. The treatment consisted of three sessions of MAFRF, compared to vaginal estrogen administration and an untreated control group. Assessments occurred at baseline and 90 days. The primary endpoints were sexual function, evaluated by the Female Sexual Function Index (FSFI), and vaginal health, assessed by the Vaginal Health Index (VHI). Secondary outcomes included vaginal microbiota composition (Nugent score) and epithelial cell maturation (Maturation Value ‒ MV). Results: One hundred and twenty women (40 in each group) were included. Concerning the FSFI, both groups, MAFRF (median 4.8 [3.6‒6.0]) and vaginal estrogen (mean 4.7 ± 1.1), experienced improved sexual desire when compared to the control group (median 3.6 [2.4‒4.8]). Regarding the total score of VHI, the authors observed an improvement in the mean of the MAFRF (23.7 ± 2.0) and vaginal estrogen groups (23.5 ± 1.9) when compared to the control (14.8 ± 2.9). The Nugent score was reduced in the MAFRF and estrogen groups (p < 0.01) compared to the control group. Lastly, the MV was modified after treatment with MAFRF (p < 0.01) and vaginal estrogen (p < 0.001). No differences existed between the MAFRF and vaginal estrogen groups in the studied variables. No adverse effects were reported following the MAFRF protocol. Conclusions: Radiofrequency was comparable in efficacy to estrogen administration for treating vulvovaginal atrophy. It deserves consideration as a viable option in managing this condition.

Sexual dysfunction in the climacteric period and associated factors / Disfunção sexual no climatério e fatores associados

Abstract Objectives: to evaluate associated factors with sexual dysfunction among middle-aged women. Methods: cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period. Results: among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance. Conclusion: the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Resumo Objetivos: avaliar os fatores associados à disfunção sexual entre as mulheres de meia-idade. Métodos: estudo de corte transversal e analítico realizado com mulheres climatéricas atendidas em uma Unidade de Estratégia de Saúde da Família no município de Montes Claros-MG, Brasil. As mulheres elegíveis responderam a um formulário contendo questões sociodemográficas, comportamentais, antropométricas, fatores ginecológicos e sexualidade. Utilizou-se o Índice e Massa Corporal e a circunferência da cintura para avaliar o estado nutricional e risco metabólico. Para avaliar a qualidade de vida e o desempenho sexual foram utilizados a Menopause Rating Scale e o Quociente Sexual -Versão Feminina, respectivamente. Empregou-se análise bivariada e regressão múltipla hierarquizada para identificar fatores associados à disfunção sexual no climatério. Resultados: dentre 195 mulheres, 29,6% apresentaram disfunção sexual. A prevalência de desempenho sexual insatisfatório foi maior entre as mulheres que declararam sintomas climatéricos moderados a graves (OR = 2,47) e o menor grau de escolaridade (OR = 1,95). No entanto, a idade da menarca abaixo de 12 anos (OR = 0,43) e a cor de pele não branca (OR = 0,36) parecem ter efeito protetor para o bom desempenho sexual. Conclusão: a prevalência de disfunção sexual foi elevada e o nível de escolaridade e a sintomatologia climatérica foram fatores associados a esse resultado.

¿Cómo evalúan los cardiólogos la actividad sexual de sus pacientes? / How do cardiologists assess their patients' sexual activity?

Resumen Objetivo: Los pacientes con enfermedad coronaria y sus familias, a menudo enfrentan numerosos cambios en sus vidas. Las recomendaciones sobre la actividad sexual (AS) deben incluirse en el manejo de estos pacientes. El objetivo de este estudio fue evaluar el grado de conocimiento y la actitud profesional con respecto a la AS del paciente. Método: Se realizó un estudio descriptivo y analítico de corte transversal. Los datos se obtuvieron a partir de una encuesta estructurada, virtual y anónima, realizada entre médicos cardiólogos/as. Resultados: Se analizaron 345 encuestas. El 63.8% consideró la disfunción sexual como un marcador de riesgo cardiovascular. Asimismo, el 68.1% consideró relevante o muy relevante interrogar acerca de la AS. En relación con el asesoramiento, se cree que fundamentalmente lo debería comenzar el cardiólogo/a. Se observó una actitud más activa, respecto al abordaje del reinicio de la AS luego de un evento cardiovascular, un mayor interés por capacitarse en temas relacionados con la AS y una mayor solicitud de dosaje de testosterona e indicación de inhibidores de la fosfodiesterasa tipo 5 en los profesionales > 60 años y de sexo masculino en comparación con los médicos más jóvenes o de sexo femenino, respectivamente. Conclusiones: Este estudio mostró que el grado de conocimiento sobre los aspectos relacionados con la AS de los pacientes fue deficiente. Dada la relevancia del tema, consideramos importante fortalecer la educación médica en todos los ámbitos.

Abstract Background: Patients with coronary heart disease and their families often face numerous changes in their lives. Recommendations on sexual activity (SA) should be included in the management of these patients. The objective of this study was to evaluate the degree of knowledge and professional attitude regarding the patient's SA. Objective: A descriptive and analytical cross-sectional study was carried out. The data were obtained from a structured, virtual and anonymous survey that was carried out among cardiologists. Results: Three hundred forty-five surveys were analyzed. In total, 63.8% considered sexual dysfunction as a cardiovascular risk marker. Likewise, 68.1% considered it relevant or very relevant to ask patients about SA. Regarding counseling, it is believed that it should be initiated primarily by the cardiologist. A more active attitude regarding the re-initiation of SA after a cardiovascular event, a greater interest in SA training, more testosterone orders and more indications of phosphodiesterase inhibitors were observed in professionals older than 60 years and male compared to younger or female physicians, respectively. Conclusions: This study showed that the degree of knowledge of the patients about the aspects related to SA was poor. Given the relevance of the topic, we consider it important to strengthen medical education in all areas.

A Cross Sectional Study on Sexual Dysfunction and Quality of Life in Patients with Bipolar Affective Disorder

Introduction: Sexual dysfunction is one of the leading causes of psychological distress in bipolar affective disorder patients. The current study aims to study the relationship between sexual dysfunction and quality of life in patients with Bipolar affective disorder in remission. Materials and methods: A cross-sectional study of purposively sampled bipolar patients in remission (N=60) was conducted in an OPD setting. After reinforcing confidentiality and privacy, data was collected and analyzed. Results: 73% with BD reported impaired sexual function. About 51.7% and 48.3% of male and female participants, respectively, had at least one form of sexual dysfunction. Better sexual function was associated with a higher degree of satisfaction with sexual life and higher QoL score. Conclusion: Sexual dysfunction is associated impaired quality of life, poor functioning and poor medication adherence. Hence, it should be made a routine practice to evaluate and address the problem of sexual dysfunction in patients with Bipolar affective disorder.

Body image and sexual function in women with polycystic ovary syndrome: a case-control study

SUMMARY OBJECTIVES: The study aimed to determine the impact of polycystic ovary syndrome on women's body image and sexual function. METHODS: In this case-control study, 97 women with polycystic ovary syndrome and 95 healthy women were interviewed in a hospital using the Personal Information Form, Body Image Scale, and Female Sexual Function Index. RESULTS: The total score of body image of women in the polycystic ovary syndrome group was found to be 132.11±19.44 and it was 133.35±21 in the control group; there was no statistically significant difference between them (p>0.05). In this study, 74.23% of the women with polycystic ovary syndrome (+) experienced sexual dysfunction. Sex drive, arousal, lubrication, orgasm, and averages of pain subscales and female sexual function index total score were found to be significantly lower in the polycystic ovary syndrome group than in the control group (p<0.05). CONCLUSION: The findings suggest a difference between women with polycystic ovary syndrome and healthy women in terms of sexual function, while body image was similar in both groups. Our data suggest that the polycystic ovary syndrome has a negative effect on the sexuality.