Effects of water pilates on urinary loss, genital self-image and sexual function of elderly women

Descriptive, quasi experimental study with pre and post-test, which aimed to investigate the effects of Water Pilates (PA) on urinary incontinence, genital self-image and sexual function of elderly women. The sample consisted of seventeen elderly women aged 60 years or over, from a city in the interior of Rio Grande do Sul. The International Consultation on Incontinence Questionnaire -Short Form (ICIQ-SF) was used as instruments to assess the impact of UI in quality of life and qualify urinary loss, the Female Sexual Function Index (FSFI) to assess sexual function and Female Genital Self-Image Scale (FGSIS) to assess women's perception of their own genitalia. The PA protocol was performed twice a week for 50 minutes performed for eight weeks, totaling 16 sessions. The protocol was divided into warm-up, strengthening exercises and stretching. It was observed that the sample was composed ofyoung elderly women (69.5 ± 5.9 years), overweight and with low FSFI and FGSIS scores. There was no significant change in the mean values before and after the intervention of the ICIQ-SF, FGSIS and FSFI scores. It was concluded that the PA method had no effect on urinary loss, sexual function and genital self-image.

Older adult sexuality in the practice and training of geriatricians: a qualitative study / Sexualidade do idoso na prática e formação de geriatras: estudo qualitativo

OBJECTIVE: To understand the academic training of geriatrics residents and their supervisors regarding the sexuality of older adults, as well as practical approaches to the subject in their work routines. METHODS: This qualitative study was conducted with geriatrics residents and their supervisors at a public hospital in Recife, PE, Brazil in 2019 and 2020. RESULTS: A partial understanding of the respondents' concept of sexuality was identified through statements that expressed confusion between sexual intercourse and sexuality, as well as a lack of knowledge about sexuality on an individual level. Although the respondents affirmed the importance of discussing the subject, they reported that they do not, except passively. The respondents discuss this issue depending on the patient's questions, despite acknowledging their difficulty in seeking a health service to talk about sexuality-related issues. Finally, the lack of an approach to sexuality in geriatric consultations was linked with gaps in undergraduate and specialization programs about general care for older adults, resulting in a feeling of unpreparedness to face the taboos and prejudices associated with sexuality. CONCLUSION: Although professionals consider it important to address sexuality with patients, most of them do not do so in medical consultations due to a number of difficulties, including the lack of a protocol to follow, which leads to a passive approach. Therefore, professionals acknowledge the difficulty of addressing the subject and associate it with deficiencies in their academic training.

Compreender a formação acadêmica de preceptores e residentes de geriatria acerca do conteúdo sobre sexualidade em idosos, bem como a abordagem prática do assunto nas suas rotinas médicas. MÉTODOS: Trata-se de um estudo qualitativo realizado entre 2019 e 2020, com preceptores e residentes de geriatria em um hospital público de Recife (PE), Brasil. RESULTADOS: Foi identificada compreensão parcial do conceito de sexualidade, observando-se falas que denotam confusão dos conceitos de relação sexual e sexualidade, além do desconhecimento da sexualidade no âmbito individual. Verificou-se, ainda, que, apesar de os profissionais de saúde afirmarem a importância de se discutir o tema, eles relatam que não o fazem e que, quando o fazem, utilizam a abordagem passiva, dependendo dos questionamentos do paciente, embora percebam a dificuldade dos idosos em buscar o serviço de saúde para falar sobre questões relacionadas à sexualidade. Por fim, a ausência de abordagem sobre sexualidade nas consultas geriátricas foi relacionada às lacunas deixadas pelos cursos de graduação e de especialização na preparação para um atendimento adequado aos idosos de maneira geral, resultando em uma sensação de despreparo para enfrentar seus tabus e preconceitos ao falar sobre sexualidade. CONCLUSÃO: Apesar de os profissionais considerarem importante abordar o tema com os pacientes, a maioria não o faz nas consultas médicas por diversas dificuldades, entre elas a ausência de um protocolo a seguir, o que os leva a uma abordagem passiva do tema. Portanto, os profissionais entendem a dificuldade de abordagem do assunto e a associam à deficiência em sua formação acadêmica.

La promiscuidad en los adolescentes en una institución de educación católica / Promiscuity in adolescents in a Catholic education institution

INTRODUCCIÓN: la promiscuidad activa indica una condición sexual psicológica y comportamiento mental de la persona que vive plenamente en misma sin ningún tipo de ataduras. Por el otro lado la pasiva indica una condición sexual psicológica de cualquier persona cuyos actos no siempre son acordes a su sexualidad voluntaria. OBJETIVOS: determinar las causas y consecuencias de la promiscuidad en los adolescentes del Colegio San Antonio de la ciudad de Milagro, Periodo 2018-2019, analizar la influencia de los medios de comunicación sobre las relaciones sexuales a temprana edad. METODOLOGÍA: en este trabajo se utiliza una técnica bibliográfica-documental y de corte transversal descriptivo, se utilizó plataformas virtuales como Scielo y obteniendo datos de los últimos años, también se tomó una muestra de 100 estudiantes entre las edades de los 18 a 19 años del colegio San Antonio de la Ciudad de Milagro, aplicando una encuesta de 10 ítems en donde se utilizó para la recolección de información. RESULTADOS: el 51% de los encuestados declaró que eran sexualmente activos y el 34% manifestó que han tenido de 2-5 parejas, mientras que el 15% dijo que han tenido entre 6-9 parejas hasta la actualidad. CONCLUSIÓN: este estudio pudo indicar que es importante que los adolescentes lleven una vida sexual con responsabilidad y que los medios de comunicación son una influencia de que los adolescentes comiencen sus relaciones sexuales a temprana edad y que conozcan los tipos de métodos anticonceptivos para cuidarse.

INTRODUCTION: active promiscuity indicates a psychological sexual condition and mental behavior of the person who lives fully in promiscuity without any bindings. On the other hand, the passive indicates a psychological sexual condition of any person whose actions are not always in line with their voluntary sexuality. OBJECTIVES: to determine the causes and consequences of promiscuity in adolescents of the San Antonio College of the city of Milagro Period 2018-2019, analyze the influence of the media on sexual relations at an early age. METHODOLOGY: in this work a bibliographic-documentary and descriptive cross-sectional technique is used, virtual platforms such as Scielo were used and obtaining data from recent years, a sample of 100 students was also taken between the ages of the 18 to 19 years of the San Antonio School of the City of Miracle, applying a survey of 10 items where it was used for the collection of information. RESULTS: 51% of respondents said they were sexually active and 34% said they have had 2-5 couples while 15% said they have had 6-9 partners to date. CONCLUSION: this study may indicate that it is important for adolescents to lead a sexual life responsibly and that the media is an influence on adolescents starting their sex at an early age and knowing the types contraceptive methods to take care of the way.

Mientras haya vida, hay todo: una mirada en la sexualidad del adulto mayor / While there is life, there is everything: a look at the elderly sexuality

Introducción.Desde un punto de vista integral, la sexualidad comprende aspectos de orden biopsicosocial. Los prejuiciosy el desconocimiento llevan a evitar hablar sobre este tema en la consulta con el adulto mayor (AM).Objetivo.Profundizar en la vivencia de la sexualidad del AM.Metodología.Estudio cualitativo, fenomenológico, realizado en dos centros de actividades recreativas para AM en SanMiguel de Tucumán, que incluyó 13 entrevistas semiestructuradas en profundidad a pacientes mayores de 60 años, 11 desexo femenino, seleccionados en forma intencional y por conveniencia en Agosto de 2018.Resultados.Existe una dicotomía entre quienes hablan del tema y quienes no; sin embargo, todos expresan el deseode naturalizarlo tanto en su círculo social como en la consulta médica. Los AM aceptan el proceso de envejecimiento,tienen una autopercepción positiva de su imagen y pese a los prejuicios, experiencias, comorbilidades y adversidades, seadaptan buscando formas para sentirse bien y disfrutar de una sexualidad plena.Conclusión.El envejecimiento y la sexualidad son conceptos dinámicos que confluyen con las experiencias de vida.Creemos que como médicos de familia es importante brindar una atención integral, abordando las diferentes dimensionesdel ser humano, incluyendo su sexualidad. (AU)

Introduction.Sexuality from an integral point of view includes aspects of biopsychosocial order. Prejudice and ignorancelead to avoid talking about this topic in the medical consultation with the Eldery.Objective.To deepen the experience of the sexuality of the Eldery.Methodology.Qualitative, phenomenological study, conducted in two centres of recreational activities for Senior Citizensin San Miguel de Tucumán, which included 13 in-depth semi-structured interviews to patients over 60 years of age, 11female, selected intentionally and for convenience in August 2018.Results.There is a dichotomy between those who talk about the subject and those who do not; however, all of themexpress the desire to naturalize it in both, their social circle and the medical consultation. The eldery patients acceptthe ageing process, have a positive self-perception of their image and despite prejudices, experiences, comorbidities andadversities, they adapt looking for ways to feel good and enjoy a full sexuality.Conclusion.Aging and sexuality are dynamic concepts that converge with life experiences. We believe that, as familydoctors, it is important to provide comprehensive care, addressing the different dimensions of the human being, wheresexuality is included. (AU)

Estudo da função sexual e da aptidão funcional em mulheres idosas / Study of sexual function and functional fitness in elderly women

Introdução: O processo de envelhecimento sedentário apresenta influência negativa na capacidade física e sexual. Objetivo:comparar a função sexual entre idosas classificadas com aptidão funcional boa e ruim. Casuística e Métodos:participaram do estudo 74 idosas praticantes de atividade física com média de idade de 67,56± 7,15 anos. Para avaliação da função sexual foi utilizado o Female sexual function índex. As variáveis elencadas para identificar a aptidão funcional foram: agilidade, equilíbrio dinâmico e resistência aeróbica avaliados pelos testes físicos da bateria de testes Senior Fitness Test - SFT. Resultados:aproximadamente 65% das idosas não eram sexualmente ativas, sendo também em maior porcentagem solteiras, viúvas ou divorciadas. Dentre as idosas ativas sexualmente verificou-se que as qualificadas com boa aptidão funcional apresentaram em média maiores escores de função sexual do que as qualificadas com aptidão funcional ruim, 25,40 e 22,00.Conclusão: Idosas participantes de um projeto de atividade física, com melhor aptidão funcional, apresentam melhor função sexual.

Introduction: The aging process has a major influence on the physical ability and sexual function. Objective: to compare the sexual function of elderly women classified with good and bad physical fitness. Patients and Methods: The study included 74 elderly women engaged in physical activity with a mean age of 67.56 ± 7.15 years. For evaluation of sexual function was used function index sexual Female. The variables listed to identify physical fitness were: agility, dynamic balance and aerobic endurance evaluated by physical tests of battery Senior Fitness Test Tests - SFT. Results:approximately 65% of the women were not sexually active and is also a greater percentage single, widowed or divorced. Among the sexually active older women found that qualified with good physical fitness had on average higher scores of sexual function then those classified with bad physical fitness 25.40 and 22.00. Conclusion:the sexual function of elderly women who exercise is affected by the level of physical fitness.

Vulnerabilidades de pescadores de comunidades ribeirinhas às Infecções Sexualmente Transmissíveis / Vulnerabilidad de los pescadores de las comunidades costeras a las infecciones de transmisión sexual / Vulnerability of fishermen from coastal communities to sexually transmitted infections

RESUMO Introdução: as Infecções Sexualmente Transmissíveis, especificamente a Síndrome da Imunodeficiência Adquirida são patologias que representam grandes desafios para a saúde no contexto mundial, merecendo destaque devido ao seu alto potencial de disseminação. No universo masculino, verifica-se que vem se intensificando o aumento da incidência dessas patologias, sobretudo nos grupos representados pelos adolescentes e jovens. Objetivo: analisar as vulnerabilidades de pescadores de comunidades ribeirinhas às infecções sexualmente transmissíveis. Métodos: trata-se de uma pesquisa exploratória e descritiva de abordagem qualitativa, realizada nas comunidades ribeirinhas do interior piauiense, Brasil. A amostra foi composta por 18 homens que vivem nessas comunidades. Resultados: os resultados foram divididos em duas categorias, a saber: Vulnerabilidades de pescadores relacionadas as infecções sexualmente transmissíveis e práticas preventivas; Políticas públicas de saúde voltadas para a saúde sexual dos homens. Percebeu-se que há uma grande deficiência de conhecimento dos pescadores sobre essas infecções, devido ao baixo grau de escolaridade e a ausência de ações educativas em saúde por parte da Estratégia de Saúde da Família, o que os torna muito vulneráveis às Infecções Sexualmente Transmissíveis. Conclusão: há uma necessidade de realizar ações educativas em saúde para os pescadores, por parte da Estratégia Saúde da Família, visto que as políticas de saúde para os homens contemplam ações para as populações mais vulneráveis(AU)

RESUMEN Introducción: las infecciones de transmisión sexual son enfermedades que constituyen importantes desafíos para la salud en el contexto global, y el síndrome de inmunodeficiencia adquirida merece una mención especial debido a su alto potencial de propagación. En el universo masculino, parece que se está intensificando la creciente incidencia de estas enfermedades, especialmente en los grupos representados por adolescentes y jóvenes. Objetivo: analizar las vulnerabilidades de pescadores de comunidades ribereñas con las infecciones de transmisión sexual. Métodos: estudio con enfoque cualitativo, exploratorio y descriptivo, llevado a cabo en las comunidades ribereñas de Piauí interior. La muestra consistió en 18 hombres que viven en estas comunidades. Resultados: se dividieron en dos categorías, a saber: los pescadores de vulnerabilidad relacionados con las prácticas de prevención de infecciones y las políticas públicas de salud centrados en la salud sexual de los hombres de transmisión sexual. Se observó que existe deficiencia de los conocimientos de los pescadores sobre estas infecciones, debido al bajo nivel de educación y la falta de las acciones en salud en la Estrategia Salud de la Familia, que los hace muy vulnerables a las infecciones de transmisión sexual. Conclusión: se necesitan actividades de educación en la salud de los pescadores, mediante la estrategia de salud de la familia, como las políticas de salud para los hombres que incluyen acciones para las poblaciones más vulnerables(AU)

ABSTRACT Introduction: Sexually transmitted infections, specifically the acquired immunodeficiency syndrome are diseases that pose major challenges for health in the global context deserves special mention because of its high potential for spread. In the male universe, it appears that is intensifying the increasing incidence of these diseases, especially in the groups represented by adolescents and youth. Objective: Analyze the fishing vulnerabilities related to sexuality and sexually transmitted infections prevention practices. Methods: This is an exploratory and descriptive qualitative approach, carried out in the riverine communities of Piaui interior. The sample consisted of 18 men who live in these communities. Results: The results were divided into two categories, namely: Vulnerability fishermen related and prevention practices Sexually Transmitted Infections; health public policies focused on the sexual health of men. It was noticed that there is a big fishermen's knowledge deficiency on these infections, due to the low level of education and lack of educative health actions by the Family Health Strategy, which makes them very vulnerable to sexually transmitted infections. Conclusion: There is a need for educational activities in health for fishermen, by the Family Health Strategy, as health policies for men include actions for the most vulnerable populations(AU)

Female urinary incontinence and sexuality

ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

ABSTRACT Purpose To determine whether there is a difference in sexual function after modified and classical TOT procedures. Materials and Methods Of the 80 sexually active women with SUI, 36 underwent an original outside-in TOT as described by Delorme, and 44 underwent modified TOT procedure, between 2011 and 2015. The severity of incontinence and sexual function were evaluated using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Female Sexual Function Index (FSFI) questionnaires preoperatively and 3 months after surgery. Results The postoperative ICIQ-SF score was significantly lower than the preoperative ICIQ-SF score in both groups (p=0.004 for modified TOT and p=0.002 for classical TOT). There was no significant difference in the ICIQ-SF score reduction between the two groups (14.1±2.1 vs. 14.4±1.9; p=0.892). Complication rates according to the Clavien-Dindo classification were also similar in both groups. In both groups, difference between preoperative and postoperative FSFI scores revealed a statistically significant improvement in all domains. Comparison of postoperative 3-month FSFI scores of modified and classical TOT groups showed statistically significant differences in arousal, lubrication and orgasm domains. Desire, satisfaction, pain and total FSFI scores did not differ significantly between two groups. Conclusion The modified TOT technique is a simple, reliable and minimal invasive procedure. The cure rate of incontinence and complication rates are the same as those of the classical TOT technique. However, due to the positive effects of minimal tissue damage on sexual arousal and orgasmic function, modified TOT has an advantage over the classical TOT.

Sexualidad y climaterio: una mirada integral / Sexuality and climacteric: a comprehensive approach

Cuando hablamos de sexualidad humana debemos saber que estamos hablando de una compleja y cambiante interacción de factores biológicos y socioemocionales altamente influenciables por la familia, la religión y los patrones culturales. Esto se ve en los hombres y en las mujeres, especialmente en las mujeres. La sexualidad es un concepto intuitivo que cuesta definir. Según la Organización Mundial de la Salud, se define salud sexual como "un estado de bienestar físico, emocional, mental y social relacionado con la sexualidad, la cual no es solamente la ausencia de enfermedad, disfunción o incapacidad". Es una definición que tiene en cuenta varios conceptos, muy importantes todos ellos. La respuesta sexual consiste en una serie de cambios neurofisiológicos, hemodinámicos y hormonales que involucran al conjunto del organismo. Si bien es similar en ambos sexos, en las mujeres no siempre el inicio y la progresión se correlacionan en forma sistemática o lineal como en los hombres. Y de ese intrigante devenir de la respuesta sexual femenina surge la dificultad del diagnóstico de la "disfunción sexual femenina". Podríamos resumirla en "un conjunto de trastornos en los que los problemas fisiológicos o psicológicos dificultan la participación o la satisfacción en las actividades sexuales; lo cual se traduce en la incapacidad de una persona para participar en una relación sexual de la forma que le gustaría hacerlo"16. La menopausia es percibida por muchas mujeres como el fin de la sexualidad, y no solo como el fin de la vida reproductiva. Si bien es cierto que en esta etapa la actividad sexual suele declinar y puede verse afectada por una serie de factores hormonales, psicológicos y socioculturales, para la mayoría de las mujeres la sexualidad sigue siendo importante. Debemos comprender que la disfunción sexual femenina, en cualquier etapa de la vida, es multicausal y multidimensional. A la hora de realizar el abordaje de una paciente, debemos tener en cuenta todos los factores involucrados y saber con qué herramientas contamos. El abordaje terapéutico clásicamente incluye la terapia psicológica y la terapia hormonal. Sin embargo, recientemente se ha incorporado una nueva droga recientemente aprobada por la FDA de los Estados Unidos para el tratamiento del deseo sexual hipoactivo en la mujer: el flibanserín, un psicofármaco que actúa a nivel de mediadores del deseo sexual en el sistema nervioso central, favoreciéndolo. (AU)

When we talk about human sexuality, we know that we are talking about a complex and changing interaction between biological and socioemotional factors, which are highly influenced by society, family, religion and cultural norms. This can be seen in men and women especially in women. Sexuality is an intuitive concept difficult to define. According to the World Health Organization, it is defined as "A state of physical, emotional, mental and social well being related to sexuality, which is not merely the absence of disease, dysfunction or disabilityˮ. It is a definition that takes into account several concepts, all very important. Sexual response is a series of neurophysiological, hemodynamic and hormonal changes involving the whole body. While similar in both sexes, women are not always the onset and progression correlate systematically or linearly as in men. And that intriguing evolution of the female sexual response, the difficulty of diagnosis of "female sexual dysfunctionˮ. We could summarize it in "a group of disorders in which the physiological or psychological problems impede participation or satisfaction in sexual activities; which results in the inability of a person to participate in a sexual relationship the way she or he would like to do itˮ16. Menopause is perceived by many women as to the end of sexuality, not only as the end of reproductive life. Sexual activity declines with age, and may be affected by a number of hormonal, psychological and sociocultural factors, but, for most women it continues to be important. We must understand that female sexual dysfunction, at any stage of life is multicausal and multidimensional. When approaching a patient, it is important to know all the factors that are involved, and which tools we have for deal with it. Classically, the therapeutic approach has consisted of psychological therapy and hormone therapy. However, we have to consider a recently approved drug by the FDA for the treatment of hypoactive sexual desire in women: Flibanserin. It is a psychotropic substance that acts on the mediators of sexual desire on the central nervous system favoring it. (AU)

Índice de función sexual en mujeres que ejercen el comercio sexual / Sexual function index in women engaged in sex work

ANTECEDENTES: La sexualidad se muestra como un reflejo del nivel de bienestar físico, psicológico y social. Por lo tanto, las experiencias sexuales negativas pueden afectar el completo desarrollo como seres humanos. En Chile no existen estudios que indaguen en la presencia de disfunciones sexuales en la trabajadora sexual. OBJETIVO: El objetivo de este estudio es evaluar el Índice de Función Sexual Femenina (IFSF) en mujeres trabajadoras sexuales con respecto a su desempeño sexual con su pareja estable y compararlas con mujeres no trabajadoras sexuales. MÉTODO: Mujeres sexualmente activas mayores de 18 años. La toma de la muestra fue dirigida no probabilística intencional. El número final a estudiar fue de 58 mujeres, de las cuales 23 mujeres fueron trabajadoras sexuales (grupo estudio) y 35 mujeres que no se dedicaban al comercio sexual (grupo control). RESULTADOS: La edad promedio fue 33 años para el grupo control y de 35 años en el caso de las trabajadoras sexuales. El 4% de las trabajadoras sexuales presentaba estudios universitarios, el 70% se encontraban solteras y utilizaron como principal método anticonceptivo el dispositivo intrauterino. En tanto, el 34% del grupo control presentaba estudios universitarios, el 57% se encontraban solteras y utilizaron como principal método anticonceptivo el hormonal. No hubo diferencias significativas en el IFSF en general y por dominios, entre los grupos. CONCLUSIONES: A pesar de presentar varios factores que aumentan el riesgo de disfunción sexual, las mujeres que desempeñan el comercio sexual no exhiben diferencias significativas en el IFSF respecto al grupo control.

BACKGROUND: Sexuality is displayed as a reflection of the level of physical, psychological and social wellbeing. Therefore, negative sexual experiences can affect the entire development as human beings. In Chile, there are no studies that investigate the presence of sexual dysfunctions in the sex worker. AIM: To evaluate the Female Sexual Function Index (FSFI) in women sex workers about their sexual performance with his regular partner and compared with women not sex workers. METHODS: Sexually active women over 18 years. We work with purposive intentional non probabilistic sampling. The final number of women studied was 58, of which 23 women were sex workers (study group) and 35 women were not involved in the sex trade (control group). RESULTS: The average age was 33 years for the control group and 35 years in the case of sex workers. 4% of sex workers had university education, 70% were unmarried and used as main contraceptive the IUD. Meanwhile, 34% of the control group had university education, 57% were single and used as primary contraceptive the hormone method. There were no significant differences in overall IFSF and domains, between groups. CONCLUSIONS: Despite presenting several factors that increase the risk of sexual dysfunction, women played the sex trade do not exhibit significant differences in the FSFI with respect to the control group.

Efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres com fibromialgia / Kinesiotherapy effect on quality of life, sexual function and climacteric symptoms in women with fibromyalgia

Objetivo: Avaliar e comparar o efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres climatéricas com e sem fibromialgia. Métodos: Participaram 90 mulheres climatéricas, divididas em dois grupos: fibromialgia (47) e controle (43). As pacientes foram avaliadas nas variáveis: qualidade de vida (Utian Quality of Life [UQOL]), função sexual (questionário do quociente sexual/versão feminina [QS-F]) e intensidade dos sintomas climatérios (Índice Menopausal de Blatt-Kupperman [IMBK]). Os grupos fizeram cinesioterapia para o assoalho pélvico, composto de 20 sessões, duas vezes por semana. Análise estatística foi feita por meio dos testes t de Student pareado, análise de variância de delineamento misto e Kappa de Cohen. Resultados: Na qualidade de vida, foi observada melhoria em ambos os grupos para todos os domínios avaliados. Na análise intergrupo foi evidenciada diferença nos domínios emocional (p = 0,01), saúde (0,03) e sexual (p = 0,001) com ganhos mais expressivos para o grupo controle. Na função sexual, foi verificada melhoria nos grupos, após a intervenção; na análise intergrupo as fibromiálgicas apresentaram escores inferiores ao grupo controle (p < 0,001). Em relação aos sintomas climatéricos não houve diferença na análise intergrupo pós-intervenção (p = 0,73). Entretanto, ambos os grupos apresentaram redução significativa da sintomatologia após a intervenção (p < 0,001). Conclusões: A cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e sem fibromialgia na fase do climatério. Entretanto, a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados .

Objective: To evaluate the effect of the kinesiotherapy in the quality of life, sexual function and menopause-related symptoms and compare in climacteric women with and without fibromyalgia (FM). Methodology: The group was composed of 90 climacteric women divided in 2 groups: FM (47) and control (43). The patients were analyzed on their quality of life (Utian Quality of Life [UQoL]), sexual function (Sexual Quotient-Female Version [SQ-F] questionnaire) and intensity of the climacteric symptoms (Blatt–Kupperman menopausal index [BKMI]). Both groups performed pelvic floor kinesiotherapy, composed of 20 sessions, twice a week. Statistical analysis was performed using Student's t-test, mixed-design analysis of variance (ANOVA) and Cohen's Kappa. Results: In the quality of life, an improvement was noticed in both groups for all domains analyzed. In the comparison between groups it was noticed a difference in the emotional (p = 0.01), health (p = 0.03) and sexual (p = 0.001) domains with considerable gains verified in the control group. Improvement was also noticed in the sexual function. In the analysis between groups, FM group showed a lower score compared to the control group (p < 0.001). With respect to the climacteric symptoms, there was no difference in the analysis between groups after the intervention (p < 0.001). Conclusions: The pelvic floor kinesiotherapy promotes a positive effect in the domains of quality of life, sexual function and climacteric symptoms in women with and without fibromyalgia in the climacteric period; however, fibromyalgia seems to be a limiting factor to achieve better results in some of the aspects evaluated. .

Intersexualidade: uma clínica da singularidade / Intersexuality: a clinical singularity / Intersexualidad: una clínica de la singularidad

A intersexualidade é considerada um problema médico. A má-formação do genital pode impedir a definição do sexo ao nascer, o que exige cuidado por parte dos responsáveis pela criança. Como acontece no humano a definição do sexo? É importante a definição do sexo ao nascer ou pode-se deixá-la para mais tarde? Dependendo do referencial teórico, as intervenções, a condução e o tratamento podem acontecer de maneira diversa e contraditória. O presente trabalho faz um breve relato dos diversos modos de leitura realizados por diferentes campos do conhecimento sobre a intersexualidade e aborda o tema mediante a teoria psicanalítica.

The intersexuality is considered a medical problem. Genital malformation can impede the definition of gender at birth and requires special care on the part of those responsible for the child. How does sexual definition occur among humans? Is it important to define gender at birth, or can this be postponed? Depending on the theoretical framework, intervention, conduct and treatment can occur in diverse and contradictory ways. We briefly summarize the diferent interpretations of intersexuaity in different fields of knowledge, and addresses the theme through psychoanalytic theory.

La intersexualidad es considerada un problema médico. La malformación de los genitales puede impedir la definición del sexo al nacer, lo que requiere el cuidado de aquellos que son responsables por el niño. ¿Como ocurre la definición del sexo en el humano? ¿Es importante la definición del sexo en el nacimiento o se puede dejar para más tarde? En función del marco teórico, las intervenciones, la conducta y el tratamiento puede acontecer de manera diversa y contradictoria. El presente artículo ofrece una breve reseña de los distintos modos de lectura realizados por los diferentes campos de conocimiento acerca de la intersexualidad y aborda el tema mediante la teoría psicoanalítica.

Abordaje de la sexualidad en la adolescencia / Approach to adolescence sexuality

La sexualidad es una faceta de la identidad y el desarrollo sexual saludable es un objetivo importante de la adolescencia. Las decisiones que están asociadas al desarrollo sexual adolescente, tienen a menudo importantes implicancias para la salud y la educación, así como para las relaciones actuales y futuras. La mayoría de los jóvenes inicia su vida sexual en la adolescencia, logra evitar embarazos no deseados e infecciones de transmisión sexual y desarrolla relaciones saludables respetuosas y comprometidas. Sin embargo, comparados a otros grupos de edad, los adolescentes tienen tasas desproporcionadamente altas de morbilidades derivadas de la conducta, incluyendo infecciones de transmisión sexual y embarazos no deseados. Los jóvenes que no adscriben a las normas socioculturales de expresión sexual y de género, tienen riesgos adicionales para su salud física, emocional y social. Los clínicos que atienden adolescentes necesitan saber sobre el desarrollo general y psicosexual del adolescente, las tendencias que rodean sus conductas sexuales, los beneficios y riesgos que acompañan a estas conductas y los recursos y las intervenciones que están disponibles. La información que ofrezcan debe ser precisa, completa y libre de prejuicios, para que puedan tomar decisiones saludables y seguras.

Sexuality is an aspect of identity, and healthy sexual development is an important goal of adolescence. Decisions that are associated with adolescent sexual development often have important implications for health and education, as well as for current and future relationships. Most young people initiate sexual activity in adolescence, prevent unwanted pregnancies and sexually transmitted infections and develop respectful and healthy relationships. However, compared to other age groups, teens have disproportionately high rates of morbidity resulting from behavior, including sexually transmitted infections and unwanted pregnancies. Youth who do not ascribe to the cultural norms of sexual expression and gender have additional risks to their physical, emotional and social health. Clinicians need to know about adolescent general and psychosexual development, trends surrounding their sexual behaviors, benefits and risks associated with these behaviors, and resources and interventions that are available. The information they provide must be accurate, complete, and unbiased, so teens can make healthy and safe decisions.

Sexualidad en la adolescente: consejería / Sexuality in adolescent: counseling

La adolescencia es una etapa de la vida durante la cual se desarrolla la identidad sexual. En este período muchas adolescentes inician su actividad sexual. Por ello, es de vital importancia entregarles consejería, que debe considerar prevención de embarazo e infecciones de transmisión sexual, prevención de conductas de riesgo y favorecer la adquisición de conductas protectoras. El objetivo del presente artículo es entregar una propuesta de consejería integral enfocada en adolescentes. Está dirigido a los profesionales de la salud que tienen el enorme desafío y la responsabilidad de prevenir el embarazo no planificado y las infecciones de transmisión sexual; y apoyar a los adolescentes en el desarrollo de una sexualidad sana.

The adolescence is a stage of life where sexual identity develops. In this period many teenagers become sexually active, so it is vital counseling in pregnancy prevention and sexuality transmitted diseases, as well as in risk behavior, creating in the adolescents the acquisition of protective behaviors. The aim of this article is to provide a proposal for comprehensive counseling adolescents to health professionals that works with them and have the enormous challenge and responsibility not only in pregnancy prevention as well as sexually transmitted disease, also in helping adolescents in the developing of a healthy sexuality.

Quality of life and sexuality comparison between sexually active ovarian cancer survivors and healthy women / 부인종양

OBJECTIVE: compare quality of life (QoL) and sexual functioning between sexually active ovarian cancer survivors and healthy women. METHODS: A cross-sectional study was performed in 103 successfully treated ovarian cancer survivors and 220 healthy women. All women had engaged in sexual activity within the previous 3 months, and ovarian cancer survivors were under surveillance after primary treatment without evidence of disease. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), Ovarian Cancer Module (EORTC QLQ-OV28), and the Female Sexual Function Index (FSFI). Propensity score matching was used to adjust covariates between the ovarian cancer survivor and healthy women groups. In total, 73 ovarian cancer survivors and 73 healthy women were compared. RESULTS: Poorer social functioning (mean, 82.4 vs. 90.9; p=0.010) and more financial difficulties (mean, 16.4 vs. 7.8; p=0.019) were observed among ovarian cancer survivors than among healthy women. Sexuality, both in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain and in terms of interest in sex, sexual activity, and enjoyment of sex (EORTC QLQ-OV28) were similar between the groups. However, vaginal dryness was more problematic in ovarian cancer survivors, with borderline statistical significance (p=0.081). CONCLUSION: Sexuality was not impaired in ovarian cancer survivors who were without evidence of disease after primary treatment and having sexual activities, compared with healthy women, whereas social functioning and financial status did deteriorate. Prospective cohort studies are needed.

La pérdida del estro / Loss of estrus

La pérdida del estro es un cambio biológico sumamente importante pues implica el cese del control hormonal sobre la sexualidad femenina, que desde allí en más es dependiente de la actividad de los centros nerviosos superiores. Además, ello ha permitido el desarrollo y afianzamiento de la pareja humana, hecho social fundamental en la evolución de la humanidad...

The loss of the estrus is an important biologic change of the women, because involved the end of the hormonal control of their sexuality, which will be dependent of the activity of the superior nervous centers. The loss of the estrous also will be determinant of the pair bondind of the human sex-pair, with the improvement of the children care and supervivence...

Disfunción sexual en mujeres climatéricas afrodescendientes del Caribe Colombiano / Sexual dysfunction in climacteric women of African descent from the Colombian Caribbean region

Introducción: Colombia es el tercer país americano con mayor población afrodescendiente, después de Estados Unidos y Brasil. Objetivo: calcular la prevalencia de disfunción sexual (DS) en mujeres climatéricas afrodescendientes. Metodología: estudio transversal con el Índice de Función Sexual Femenina (FSFI), en mujeres afrodescendientes saludables (40-59 años), hijas de padres de raza negra, naturales de municipios del Caribe Colombiano, voluntarias, anónimas y captadas en sus comunidades. A mayor puntaje mejor sexualidad. La DS se establece con un puntaje total de 26,55 o menos. Resultados: se estudiaron 461 mujeres; 305 de ellas (66,2%) con actividad sexual, 70,8% eran premenopáusicas y 29,2%, posmenopáusicas. Los puntajes promedio de los dominios fueron: deseo (4,1 ± 1,1), excitación (4,4 ± 1,0), lubricación (4,9 ± 1,0), orgasmo (4,7 ± 1,0), satisfacción (5,3 ± 1,0) y dolor (4,3 ± 1,5). La media del puntaje total fue 27,7 ± 4,7 y la prevalencia de disfunción sexual, 38,4%. El hábito de fumar (OR: 3,3 [IC95%: 1,0-10,6; p = 0,041] y la hipertensión arterial (OR: 2,2 [IC95%: 1,1-4,4; p = 0,026] incrementaron el riesgo de DS, mientras que la escolaridad mayor de diez años (OR: 0,4 [IC95%: 0,2-0,8; p = 0,003] lo redujo. La prevalencia de DS aumentó con el cambio en el estado menopáusico (p <0,001). Todos los dominios se deterioraron, excepto el dolor, con el paso a la posmenopausia (p <0,001). Conclusión: en mujeres afrodescendientes del Caribe Colombiano, una de cada tres premenopáusicas y la mitad de las posmenopáusicas presentan DS.

Introduction: After the United States and Brazil, Colombia is the third American country with the greatest population of African descent. Objective: To estimate the prevalence of sexual dysfunction (SD) in climacteric women of African descent. Methods: Cross sectional study carried out with the Female Sexual Function Index (FSFI), in healthy women, whose mother and father were of black race, living in municipalities from the Colombian Caribbean region, who volunteered to anonymously participate in the study, and were recruited in their communities. Higher scores correlated with better sexuality. Results: 461 women were studied; 305 (66.2%) with sexual activity; 70.8% were premenopausal and 29.2%, postmenopausal. Average scores of the domains were: Sexual desire (4.1 ± 1.1), sexual arousal (4.4 ± 1.0), lubrication (4.9 ± 1.0), orgasm (4.7 ± 1.0), satisfaction (5.3 ± 1.0) and pain (4.3 ± 1.5). Average total score was 27.7 ± 4.7. Prevalence of SD was 38.4%. Smoking (OR: 3.3 [IC95%: 1.0-10.6; p = 0.041] and arterial hypertension (OR: 2.2 [IC95%:1.1-4.4; p = 0.026] increased the risk of SD, while schooling higher than ten years (OR: 0.4 [IC95%: 0.2-0.8; p = 0.003] decreased it. Prevalence of SD increased with the change in the menopausal status (p <0,001). All domains deteriorated, except pain, with the transition to the postmenopausal status (p <0.001). Conclusion: In females of African descent from the Colombian Caribbean region, one third of the premenopausal and half of the postmenopausal have SD.

Tradução e validação de questionário de função sexual na gravidez (PSFQ) / Translation and validation of the Pregnancy and Sexual Function Questionnaire (PSFQ)

OBJETIVO: Adaptar o Pregnancy and Sexual Function Questionnaire (PSFQ) para uso no Brasil, além de avaliar suas propriedades psicométricas. MÉTODOS: Foi realizado um estudo de adaptação e validação com mulheres no último trimestre de gestação, residentes em Rio Branco, Acre. O questionário foi traduzido para a língua portuguesa, revisado e avaliado por um grupo de especialistas, tendo sido realizado um pré-teste. A validação do constructo do instrumento foi avaliada por análise fatorial, a consistência interna, pelos coeficientes alfa de Cronbach e ômega de McDonald e a reprodutibilidade, pela estatística kappa por teste-reteste em uma amostra das gestantes. RESULTADOS: A análise fatorial demonstrou a presença de seis domínios: subjetividade, dor e desconforto; frequência e receptividade; desejo; satisfação; orgasmo e estímulo. A consistência interna segundo o alfa foi de 0,6, enquanto na análise do ômega foi de 0,7. Na amostra, o valor de kappa foi superior a 0,7 em todas as questões. CONCLUSÃO: A versão em português do PSFQ pode ser utilizada para avaliar a função sexual durante a gravidez. .

PURPOSE: To adapt the Pregnancy and Sexual Function Questionnaire (PSFQ) for use in Brazil and to evaluate its psychometric properties. METHODS: An adaptation and validation study was performed with women in the last trimester of pregnancy living in Rio Branco, Acre. The questionnaire was translated into Portuguese, reviewed and evaluated by specialists, and a pretest was carried out. Construct validity was evaluated by factor analysis; internal consistency was estimated by Cronbach's alpha coefficient and MacDonald's omega, and reproducibility was evaluated by the kappa statistics and test-retest in a sample of pregnant women. RESULTS: Factor analysis identified the following six domains: subjectivity, pain and discomfort; frequency and receptivity; desirability; satisfaction; orgasm; and stimulus. The internal consistency by Cronbach's alpha was 0.6, while MacDonald's omega was 0.7. The kappa value was higher than 0.7 in all questions. CONCLUSION: The Portuguese version of the PSFQ was considered to be adequate for evaluating sexual function during pregnancy. .

Sexual Function in Male Patients with Metabolic Syndrome and Effective Parameters on Erectile Dysfunction

Purpose: We aimed to investigate the relationship between metabolic syndrome and sexual function and effective parameters on erectile dysfunction (ED). Materials and Methods: A total of 1300 individuals were included in this study between January 2009 and July 2012. All of individuals were asked to fill in an International Index for Erectile Function (IIEF) questionnaire. The presence of metabolic syndrome was determined when any three or more of the five risk factors were present according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP)-III. Obese individuals were divided into six groups according to modified World Health Organization (WHO) definition. Effective parameters on erectile dysfunction were investigated in individuals with metabolic syndrome. Results: Metabolic syndrome was detected in 455 individuals (35%). Mean domain scores of IIEF for all parameters were higher in individuals without metabolic syndrome than individuals with metabolic syndrome (p < 0.05). Mean domain scores of IIEF were lower in individuals with class 3 obesity than individuals with other obese groups (p < 0.05) for erectile dysfunction. There was statistical difference in terms of mean score of IIEF-Erectile function between smoking and nonsmoking groups (p < 0.05). Seventy percent of individuals with metabolic syndrome and 45% of individuals without metabolic syndrome had ED (p < 0.001). Logistic regression analysis revealed that waist circumference (WC) was the most important criteria for ED (p < 0.05). Conclusions: Metabolic syndrome, smoking and obesity seem to be potential risk factors for ED. We recommend individuals with metabolic syndrome, smoking and obesity should be questioned about ED. .