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.

Validação da escala curta de avaliação funcional do desejo sexual feminino / Validation of the female sexual desire functional short scale

A disfunção do desejo sexual feminino é prevalente e impacta negativamente sobre a função sexual e a qualidade de vida, mas não existem escalas funcionais que levem em conta função e disfunção. OBJETIVO: construir e validar uma escala curta para avaliação funcional do desejo sexual feminino. MÉTODO: Correlação dos resultados de função do desejo sexual avaliado pelo Índice de Função Sexual Feminina (FSFI) e a nova escala funcional, em uma amostra via internet da população feminina brasileira em geral por meio do teste T de Student e o coeficiente de Spearman. Curva ROC fomentou a análise de corroboração entre os dados do domínio disfunção do desejo do FSFI com a nova escala de avaliação funcional. RESULTADOS: Metade das mulheres da amostra apresentou disfunção sexual pelo FSFI, sendo que um terço apresentou disfunção do desejo sexual. Houve boa correlação entre os resultados da nova escala e do domínio desejo sexual do FSFI, bem como boa sensibilidade e especificidade do modelo pela curva ROC. CONCLUSÃO: a nova escala curta de avaliação funcional do desejo sexual feminino com base na Classificação Internacional de Funcionalidade, Incapacidade e Saúde pode ser uma ferramenta útil na avaliação da função do desejo sexual feminino.

Female sexual desire dysfunction is prevalent and negatively impacts sexual function and quality of life, but there are no functional scales that take into account function and dysfunction. OBJECTIVE: To construct and validate a short scale for functional evaluation of female sexual desire. METHOD: Correlation of sexual desire function results assessed by the Female Sexual Function Index (FSFI) and the new functional scale in an internet sample of the Brazilian female population in general through the Student's t test and the Spearman coefficient. ROC curve fostered corroborating analysis between data from the FSFI desire dysfunction domain with the new functional assessment scale. RESULTS: Half of the women in the sample had sexual dysfunction by FSFI, and one third had sexual desire dysfunction. There was a good correlation between the results of the new scale and the FSFI sexual desire domain, as well as good sensitivity and specificity of the model by the ROC curve. CONCLUSION: The new short functional rating scale for female sexual desire based on the International Classification of Functioning, Disability and Health may be a useful tool in assessing the function of female sexual desire.

Sleep, Sleep Disorders, and Sexual Dysfunction

Good sleep is necessary for good health. Sleep health is increasingly recognized as important for physical and mental health by both the medical profession and the general public, and there is great interest in how to avoid and treat sleep disorders and problems. Recent research indicates that insufficient sleep, disrupted sleep, and sleep disorders affect many aspects of human health including sexual function. In fact, patients with urological disorders or erectile dysfunction (ED) may have a sleep disorder that contributes to their urological or sexual dysfunction. Obstructive sleep apnea, insomnia, shift work disorder, and restless legs syndrome are all common sleep disorders and are associated with ED and/or other urological disorders. Therefore, careful attention should be paid to the diagnosis and treatment of concomitant sleep disorders in patients with sexual dysfunction. In this review, we provide an overview of what sleep is and how it is assessed in the clinic or laboratory; our current understanding of the functions of sleep and sleep health; a description of common sleep disorders, as well as how they are diagnosed and treated; and how sleep and its disorders are associated with male sexual dysfunction. Sleep is considered to be a ‘third pillar of health’, along with diet and exercise. With an understanding of common sleep disorders and how they can impact male sexual function, the urologist can ensure that sleep disorders are considered as a contributor to sexual dysfunction in their patients in order to provide them with the optimal treatment for overall health.

Self-reported assessment of female sexual function among Brazilian undergraduate healthcare students: a cross-sectional study (survey)

ABSTRACT BACKGROUND: The present study aimed to evaluate female sexual function among young undergraduate women. DESIGN AND SETTING: Cross-sectional survey conducted among Brazilian undergraduate students. METHODS: This study used online questionnaires to assess sociodemographic and health-related data and used the Brazilian version of the Female Sexual Function Index (FSFI) among female undergraduate students aged 18 to 25 years who were regularly enrolled in undergraduate healthcare courses. The FSFI is composed of 19 items that measure female sexual function over the last four weeks, in six domains: desire and subjective stimulation, sexual arousal, lubrication, orgasm, satisfaction and pain or discomfort. RESULTS: Among the 149 female undergraduate students evaluated, 43 (28.8%) presented sexual dysfunction (score < 26.55). Health conditions were not associated with female sexual dysfunction. Among the women with sexual dysfunction, all domains of the sexual response cycle were affected (P < 0.001). CONCLUSIONS: Sexual dysfunction was identified in at least a quarter of these young undergraduate women and it was not associated with gynecological problems, menstrual cycles, dysmenorrhea, contraceptive use or physical activity.

The tendency towards the development of psychosexual disorders in androgenetic alopecia according to the different stages of hair loss: a cross-sectional study

Abstract: Background: Androgenetic alopecia is a common dermatological condition affecting both genders. Objective: To evaluate the tendency towards development of psychosexual disorders according to the clinical stages of androgenetic alopecia. Methods: A cross-sectional study was conducted including 353 patients of both sexes on different clinical stages of hair loss, and the patients were enquired about self-perception, self-esteem, sexual experiences, anxiety and depression states. Hair loss was classified by standardized hair loss scales, and psychological effects were assessed with questionnaires. Results were compared to p<0.05. Results: Negative effects on each psychological parameter of androgenetic alopecia in females were higher than in males. While overall comparisons according to hair loss stages for each parameter were significant in males, only sexual experiences, anxiety and depression values were significant in females. Sexual experiences and depression values were higher in Ludwig 3 than in 1&2, while anxiety was higher in Ludwig 3 than 1. Self-perception values in Norwood 2&2A were higher than 3A, 3V, 4 and 4A, while self-esteem values in 2A were higher than 3&4. Sexual experiences values in 2&2A were lower than 3, 3A, 3V, 4 and 4A, while 3&3A were lower than 4&4A. Depression was lower in 2A than 3, 3A, and 3V, and lower in 2A than 4A. Anxiety was lower in 2A than in 4&4A. Study limitations: Relatively small number of patients, who were from a single center. Conclusions: In the management of androgenetic alopecia, it should be considered that patients may need psychological support according to the clinical stages, because of increased tendency to develop psychosexual disorders.

A fisioterapia pélvica melhora a dor genitopélvica/desordens da penetração? / Does the pelvic physical therapy improves genitopelvic pain/penetration disorder?

Muitas vezes, as Disfunções Sexuais Femininas (DSF) são subdiagnosticadas, têm causas multifatoriais e não recebem devida atenção para o tratamento. Estas disfunções podem se manifestar em qualquer idade, sobretudo em mulheres adultas e idosas, e de diferentes formas. Para ajudar essa mulher na resolução do seu problema, o ideal é que profissionais especializados em saúde sexual a aborde, cada um em sua área de atuação. Além de apoio médico e psicológico, a fisioterapia tem papel fundamental na reabilitação sexual da dor genitopélvica/desordens da penetração (vulvodínea, vestibulodínea, dispareunia e vaginismo). O fisioterapeuta utiliza recursos como terapia manual, cinesioterapia, eletroestimulação, biofeedback, eletromiografia, cones vaginais e dilatadores na conduta terapêutica para essas disfunções. A literatura ainda apresenta-se restrita neste tema, mas é possível afirmar que a fisioterapia pélvica, se bem conduzida, é resolutiva, proporcionando satisfação e melhora da qualidade de vida da mulher.(AU)

Often, Female Sexual Dysfunction (FSD) is underdiagnosed, have multifactorial causes and do not receive adequate attention for treatment. These dysfunctions may appear at any age, especially in adult and elderly women, and in different ways. To help this woman in the resolution of her problem, the ideal is that professionals specialized in sexual health address her, each one in its area of operation. In addition to medical and psychological support, physiotherapy plays a key role in sexual rehabilitation genito-p-elvic pain/penetration disorders (vulvodynea, vestibulodynea, dyspareunia and vaginismus). The physical therapist works with manual therapy, therapeutic exercise, electrical stimulation, biofeedback, electromyography, vaginal cones and dilators in the therapeutic approach. The literature also presents restricted in this area, but we can say that the pelvic physical therapy, if well conducted, is resolute, providing satisfaction and improving quality of life of women.(AU)

Esquemas mal adaptativos tempranos del área de la autovaloración y satisfacción sexual en adultos jóvenes de la ciudad de Medellín / Early maladaptive schemas in self-esteem and sexual satisfaction in young adults of Medellin / Esquemas mal adaptativos precoces da área da autovalorização e satisfação sexual nos adultos jovens da cidade de Medellín

Objetivo: describir la relación entre la presencia de esquemas mal adaptativos tempranos del área de la autovaloración y el índice de satisfacción sexual en adultos, hombres y mujeres con preferencia heterosexual, del área metropolitana de Medellín, Antioquia. La satisfacción sexual es un tema de interés de estudio propio de la psicología, pero que ha sido tratado por la ginecología y la urología en nuestro país. Los esquemas mal adaptativos tempranos son estructuras cognitivo-afectivas, con una alta carga emocional que se desarrollan en los primeros años de vida a partir de las interacciones del bebé con los cuidadores y que posteriormente se relacionan directa o indirectamente con trastornos y problemáticas psicológicas. Metodología: investigación cuantitativa, estudio analítico de tipo no experimental, de corte transversal. No se manipularon deliberadamente las variables ni se influyó sobre ellas. Se establecieron comparaciones y se analizaron las relaciones entre el área de la autovaloración de los esquemas mal adaptativos tempranos y el índice de satisfacción sexual en adultos jóvenes del área metropolitana. Resultados: del total de la muestra el 59.3% de la población, tiene activos uno o varios esquemas mal adaptativos tempranos del área de la autovaloración; se encontró que el 60.3% de los sujetos con esquemas activos en el área de autovaloración está insatisfecho sexualmente. Conclusiones: se confirman relaciones estadísticas (p <0.01) y con relevancia clínica, entre esquemas mal adaptativos tempranos del área de la autovaloración y la satisfacción sexual. El esquema con mayor correlación con el índice de satisfacción sexual fue el de Defectuosidad/Inamabilidad.

Objective: To describe the relationship between the presence of early maladaptive schemas in self-esteem and sexual satisfaction in adults; men and women with heterosexual preference in the Medellin metropolitan area. Sexual satisfaction is a topic of interest in the field of psychology, which in Colombia has been treated by gynecologists and urologists. Early maladaptive schemas are cognitive-affective structures with a high emotional charge which develop during the first years of life as a result of the interaction between baby and caregivers and which later on are directly or indirectly related to psychological disorders. Methodology: Observational, analytical, cross-sectional study. Variables were not deliberately manipulated nor influenced upon. Comparisons were established and the relationships between early maladaptive schemas in self-esteem and the index of sexual satisfaction in young adults in Medellin were analyzed. Results: Of the sample total, 59.3% of the population had one or more active early maladaptive schemas in self-esteem; 60.3% of subjects with active schemas in self-esteem were sexually dissatisfied. Conclusions: Statistical relationships (p <0.01) with clinical relevance were confirmed amongst early maladaptive schemas in self-esteem and sexual satisfaction. Defectiveness/unkindness was the schema with highest correlation with the sexual satisfaction index.

Objetivo: descrever a relação entre a presença de esquemas mal adaptativos precoces da área da autovalorização e o índice de satisfação sexual nos adultos, homens e mulheres com preferência heterossexual, da área metropolitana de Medellín, Antioquia. A satisfação sexual é um assunto de interesse de estudo próprio da psicologia, mas que há sido tratado pela ginecologia e a urologia no nosso país. Os esquemas mal adaptativos precoces são estruturas cognitivo-afetivas, com uma alta carga emocional que se desenvolvem nos primeiros anos de vida a partir das interações do bebê com os cuidadores e que posteriormente se relacionam direta ou indiretamente com transtornos e problemáticas psicológicas. Metodologia: investigação quantitativa, estudo analítico de tipo não experimental, de corte transversal. Não se manipularam deliberadamente as variáveis nem se influiu sobre elas. Se estabeleceram comparações e se analisaram as relações entre a área da autovalorização dos esquemas mal adaptativos precoces e o índice de satisfação sexual nos adultos jovens da área metropolitana. Resultados: do total da amostra 59.3% da população, têm ativos um ou vários esquemas mal adaptativos precoce da área da autovalorização; se encontrou que 60.3% dos sujeitos com esquemas ativos na área de autovalorização está insatisfeito sexualmente. Conclusões: se confirmam relaciones estatísticas (p <0.01) e com relevância clínica, entre esquemas mal adaptativos precoces da área da autovalorização e a satisfação sexual. O esquema com maior correlação com o índice de satisfação sexual foi o de Defeituoso/Apego.

Flibanserin for Treating Hypoactive Sexual Desire Disorder

There have been several products developed for male sexual dysfunction. However, developing agents for female sexual dysfunction is lagging behind for various reasons. Sildenafil citrate (Viagra) and Tadalafil (Cialis), which have been prescribed for male sexual function disorders, are known to act on vessels.[1] On the other hand, flibanserin is thought to act on brain. Flibanserin has been approved by U. S. Food and Drug Administration (FDA) for treatment of hypoactive sexual desire disorder (HSDD) of premenopausal women in 2015, and is expected to be released in South Korea soon. Authors wrote this article to acknowledge flibanserin to sexologists for females or physicians for menopausal medicine, so that this agent can be safely used for females who have HSDD.

Distribution pattern of psoriasis, anxiety and depression as possible causes of sexual dysfunction in patients with moderate to severe psoriasis

Abstract BACKGROUND: Psoriasis may significantly impair sexual function. Depression and organic factors appear to play a key role in this relation. However, beyond genital psoriasis, the importance of the disease's distribution patterns has not been considered. OBJECTIVES: To research sexual function in psoriasis patients and investigate the roles of anxiety, depression and psoriasis' distribution patterns in sexual dysfunction. METHODS: A comparative study matched for sex and age was performed. Eighty patients with moderate to severe psoriasis and 80 healthy controls were included. The participants completed the Massachusetts General Hospital-Sexual Functioning Questionnaire, the Hospital Anxiety and Depression Scale, and the Self-Administered Psoriasis Area and Severity Index. RESULTS: Psoriasis was associated with sexual dysfunction, odds ratio=5.5 (CI 95% 2.6-11.3; p<0.001). Certain distribution patterns of psoriasis, involving specific body regions, were associated with an increase in sexual dysfunction in the group presenting the disease, odds ratio 7.9 (CI 95% 2.3-33.4; p<0.001). Multivariate logistic regression analysis identified anxiety and depression, and the involvement of these specific areas, as possible independent risk factors for sexual dysfunction in patients with moderate to severe psoriasis. CONCLUSION: This study identifies body areas potentially related to sexual dysfunction, independently of anxiety and depression, in psoriasis patients. The results suggest that the assessment of sexual dysfunction and the involvement of these body areas should be considered as disease severity criteria when choosing the treatment for psoriasis patients. .

Adaptação sociocultural do short personal experiences questionnaire (SPEQ) no Brasil / Sociocultural adaptation of the short personal experiences questionnaire (SPEQ) in Brazil

OBJETIVO: traduzir e adaptar culturalmente o Short Personal Experiences Questionnaire (SPEQ) para a língua portuguesa, no Brasil, em mulheres climatéricas. MÉTODOS: a versão original do questionário, em inglês, proveniente da Universidade de Melbourne (Austrália), inicialmente foi traduzida para a língua portuguesa e retraduzida ao inglês. Procedeu-se, então, à adaptação sociocultural do vocabulário e da construção linguística para melhor compreensão. O questionário foi então aplicado para pré-teste em 50 mulheres, em etapas sucessivas, até que não houvesse mais dúvidas. A versão final do instrumento adaptado foi utilizada em estudo de base populacional, autorrespondido anonimamente por 378 mulheres pesquisadas, entre 40 e 65 anos e com 11 anos ou mais de escolaridade, nascidas no Brasil. Foi aplicada uma análise de confiabilidade (consistência interna, pelo alfa de Cronbach), uma análise de validade do construto (correlação de pares de itens que compõem o SPEQ e cada um destes com os quatro fatores obtidos e com o escore total), e uma análise de validade de critério (correlação entre os quatro fatores obtidos com o escore de classificação geral da vida sexual). RESULTADOS: cento e oitenta mulheres responderam a todas as perguntas do SPEQ e foram incluídas na análise. A consistência interna (alfa de Cronbach) para os nove itens do SPEQ situou-se entre 0,55 e 0,77 e o alfa geral foi 0,68. Na análise de validade do construto, a maioria dos coeficientes de correlação se mostrou significativo (valores p<0,005). A análise de validade de critério mostrou coeficientes de correlação significativos em sua maior parte. CONCLUSÕES: a versão em português do instrumento SPEQ, após processo de adaptação, mostrou-se útil e adequada para levantar informações relativas à função sexual e dispareunia em mulheres brasileiras entre 40 e 65 anos e com 11 anos ou mais de escolaridade.

PURPOSE: to translate into Brazilian Portuguese and culturally adapt the Short Personal Experiences Questionnaire (SPEQ) to climacteric women. METHODS: the original English version from the University of Melbourne, Australia, was initially translated into Portuguese and back-translated into English. A sociocultural adaptation of vocabulary and linguistic constructions was performed to facilitate comprehension. The questionnaire was then pretested in successive stages in 50 women, until no doubts remained. The final version of the adapted instrument was self-responded by 378 Brazilian-born women, between 40 to 65 years old, with 11 years or more of schooling in a population-based study. The reliability (internal consistency as measured by Cronbach's alpha), the construct validity (correlation coefficients between the items comprising the SPEQ and selected variables) and the criterion validity (correlation coefficient between sexual dysfunction score and overall score of sexual life classification) were analyzed. RESULTS: one hundred and eight women answered all the questions of the SPEQ and were included in the study. Internal consistency (Cronbach's alpha) for all the nine SPEQ items ranged from 0.55 to 0.77 and the general alpha was 0.68. In the construct validity analysis, most of the correlation coefficients were significant (p<0.005). The criterion validity analysis showed significant correlation coefficients in most cases. CONCLUSIONS: following the adaptation process, the Portuguese version of the SPEQ was deemed useful and appropriate for collecting data on sexual function and dyspareunia in Brazilian women, aged 45 to 65 years, with at least 11 years of schooling.

Tradução para português, adaptação cultural e validação do Female Sexual Function Index / Translation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index

OBJETIVO: traduzir para o português, adaptar culturalmente e validar o questionário Female Sexual Function Index (FSFI). MÉTODOS: dois tradutores brasileiros, cientes dos objetivos desta pesquisa, preparam duas versões do FSFI para o português, as quais foram retro-traduzidas por outros dois tradutores ingleses. As diferenças foram harmonizadas e pré-testadas em um estudo piloto. As versões finais do FSFI e de outro questionário, o Short-Form Health Survey, já vertido e publicado em português, foram simultaneamente administradas a cem pacientes. Foram testadas as propriedades psicométricas do FSFI, como confiabilidade (consistência interna e teste-reteste) e validades de construto. O reteste foi realizado após quatro semanas, a partir da primeira entrevista. RESULTADOS: o processo de adaptação cultural não alterou a versão em português do FSFI comparado ao original. O alfa de Cronbach padronizado do questionário foi 0,96; avaliado por domínios, variou de 0,31 a 0,97. Como medida de confiabilidade teste-reteste, foi aplicado o coeficiente de correlação intra-classes, que foi considerado forte e idêntico (1,0). O coeficiente de correlação de Pearson entre o FSFI e o Short-Form Health Survey foi positivo, mas fraco na maioria dos domínios afins, variando de 0,017 a 0,036. CONCLUSÕES: a versão do FSFI foi traduzida para o português e adaptada culturalmente e é válida para avaliação da resposta sexual das mulheres brasileiras.

PURPOSE: to translate from English into Portuguese, adapt culturally and validate the Female Sexual Function Index (FSFI). METHODS: knowing the objectives of this research, two Brazilian translators have prepared a version each from the FSFI into Portuguese. Both versions have then been retro-translated into English by two English translators. After harmonizing the differences, they have been pre-tested in a pilot study. The final versions from the FSFI and from another questionnaire, the Short-Form Health Survey, which had already been translated and published in Portuguese, have then been simultaneously administered to one hundred patients, to test the FSFI psychometric proprieties concerning reliability (internal consistency and testing-retesting) and construct validity. Retesting was done after four weeks from the first interview. RESULTS: the process of cultural adaptation has not altered the Portuguese version of the FSFI, as compared to the original. The FSFI standardized Cronbach alpha was 0.96, and the evaluation by domains has varied from 0.31 to 0.97. As a measure of test-retest confidentiality, it was applied the intra-class coefficient, which has been considered strong and identical (1.0). Pearson's correlation coefficient between the FSFI and the Short-Form Health Survey was positive, but weak in most of the interrelated domains, varying from 0.017 to 0.036. CONCLUSIONS: the FSFI English version has been translated into Portuguese and culturally adapted, being reliable to evaluate the sexual response of Brazilian women.