Sexualidad y salud sexual / Sexuality and sexual health

En este trabajo se recuerdan las definiciones de salud sexual y su relación con la sexualidad. Se menciona la sexología clínica como disciplina reciente y su aporte a la promoción de la salud. Se detallan algunos trastornos sexuales que constituyen el campo de acción de la sexología clínica. Se citan estudios y estadísticas de los problemas sexuales más frecuentes. Se hace hincapié en su relación con el bienestar y la calidad de vida. Se remarca el avance científico de la sexología clínica en el siglo XXI. (AU)

In this work the definitions of sexual health and its relationship with sexuality are recalled. Clinical sexology is mentioned as a recent discipline and its contribution to health promotion. Some sexual disorders that constitute the clinical sexologys field of action are detailed. Studies and statistics of the most frequent sexual problems are cited. It emphasizes its relation to well-being and the quality of life. The scientific advance of clinical sexology in the XXI century is highlighted. (AU)

Consecutive nightly measurements are needed for accurate evaluation of nocturnal erectile capacity when the first-night laboratory recording is abnormal / 亚洲男科学杂志(英文版)

Multiple measurements of nocturnal penile tumescence and rigidity (NPTR) are widely accepted as a method to differentiate psychogenic erectile dysfunction (ED) from organic ED. However, direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan. Here, we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights, particularly when abnormal first-night measurements are recorded in a laboratory setting. We retrospectively reviewed 105 patients with a complaint of ED, who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), for two consecutive nights, during the period from November 2015 to May 2016. NPTR parameters were collected and analyzed. We found that more effective nocturnal erections were detected during the second night than during the first night (P <0.001). Twenty percent of all patients had no effective erection during the first night, but exhibited at least one effective erection during the second night. The negative predictive value of NPTR measurement during the first night was 43.2%; this was significantly lower than that on the second night (84.2%; P = 0.003). Most NPTR parameters were better on the second night than on the first night. The first-night effect might be greater among patients younger than 40 years of age. In conclusion, two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect; moreover, these measurements more accurately reflect erectile capacity, especially when the first-night record is abnormal in a laboratory setting.

Translation and cross-cultural adaptation of the Arizona Sexual Scale (ASEX) into Portuguese / Tradução e adaptação transcultural da Arizona Sexual Scale (ASEX) para a língua portuguesa

Abstract Introduction Sexual dysfunction is common in individuals with psychiatric disorders and under psychotropic medication such as antidepressants and antipsychotics. Several scales have been developed to assess sexual function in these patients. The Arizona Sexual Scale (ASEX) is a five-item rating scale that quantifies sex drive, arousal, vaginal lubrication/penile erection, ability to reach orgasm, and satisfaction from orgasm. We describe the translation and cross-cultural adaptation of the ASEX into the Portuguese language, with the goal of contributing to the assessment of sexual function in Portuguese-speaking psychiatric patients under treatment with psychotropic drugs. Methods The translation and cross-cultural adaptation process thoroughly followed the steps recommended by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), namely: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing, finalization, proofreading, and final version. Results The process was successfully completed and no major differences were found between the translation, reconciliation and back-translation phases, with only small adjustments being made. Conclusion The translation of the ASEX was completed successfully, following international reference guidelines. The use of these guidelines is a guarantee of a Portuguese version that is qualitatively and semantically equivalent to the original scale. This availability of this new scale version will enable studies evaluating the sexual function of Portuguese-speaking psychiatric patients. Future studies may assess the validity of the scale for Portuguese-speaking populations.

Resumo Introdução A disfunção sexual é comum em indivíduos com doenças psiquiátricas e sob o uso de medicações como antidepressivos e antipsicóticos. Várias escalas foram desenvolvidas para avaliar a função sexual desses doentes. A Arizona Sexual Scale (ASEX) é uma escala de cinco itens de avaliação que quantifica desejo sexual, excitação, lubrificação vaginal/ereção peniana, capacidade para atingir o orgasmo e satisfação com o orgasmo. Este artigo descreve o processo de tradução e adaptação transcultural da escala ASEX para a língua portuguesa, com o objetivo de contribuir para a avaliação da função sexual dos doentes medicados com fármacos psicotrópicos nos vários países onde se utiliza essa língua. Métodos A tradução e a adaptação transcultural seguiram de forma detalhada os passos recomendados pelo grupo de trabalho da International Society for Pharmacoeconomics and Outcomes Research (ISPOR), nomeadamente: preparação, tradução inicial, reconciliação, retroversão, revisão da retroversão, harmonização, teste cognitivo, revisão do teste cognitivo, finalização, leitura final e versão final. Resultados O processo foi completado com sucesso, e não foram observadas diferenças grandes entre as fases de tradução, reconciliação e retroversão, tendo sido feitos apenas pequenos ajustes. Conclusão A tradução da escala ASEX foi bem-sucedida, seguindo orientações internacionais de referência. A aplicação dessas orientações é a garantia de uma versão em língua portuguesa que é qualitativa e semanticamente equivalente à versão original da escala. A existência desta nova versão da escala permitirá estudos que avaliem a função sexual dos doentes em países nos quais se fale a língua portuguesa. Estudos futuros poderão atestar a validade da escala para essas populações.

Lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis

OBJECTIVES: To assess the prevalence and interrelationship between lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis (MS). METHODS: In a cross-sectional study, we evaluated 41 men (mean age 41.1±9.9 years) with MS from February 2011 to March 2013, who were invited to participate irrespective of the presence of lower urinary tract symptoms or sexual dysfunction. Neurological impairment was assessed with the Expanded Disability Status Scale; lower urinary tract symptoms were evaluated with the International Continence Society male short-form questionnaire, and sexual dysfunction was evaluated with the International Index of Erectile Function. All patients underwent transabdominal urinary tract sonography and urine culture. RESULTS: The mean disease duration was 10.5±7.3 years. Neurological evaluation showed a median Expanded Disability Status Scale score of 3 [2-6]. The median International Continence Society male short-form questionnaire score was 17 [10-25]. The median International Index of Erectile Function score was 29 [15-46]. Twenty-nine patients (74.4%) had sexual dysfunction as defined by an International Index of Erectile Function score <45. Voiding dysfunction and sexual dysfunction increased with the degree of neurological impairment (r=0.02 [0.02 to 0.36] p=0.03 and r=-0.41 [-0.65 to -0.11] p=0.008, respectively). Lower urinary tract symptoms and sexual dysfunction also displayed a significant correlation (r=-0.31 [-0.56 to -0.01] p=0.04). CONCLUSIONS: Most male patients with MS have lower urinary tract symptoms and sexual dysfunction. The severity of the neurological disease is a predictive factor for the occurrence of voiding and sexual dysfunctions.

Translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese / Tradução e adaptação transcultural do Questionário de Função Sexual (SFQ) para o português do Brasil

Abstract Introduction Sexual dysfunction is common in patients with psychotic illness. This article describes the translation and cross-cultural adaptation of the Sexual Function Questionnaire (SFQ) into Brazilian Portuguese. Methods The translation and cross-cultural adaptation followed the guidelines for adapting self-report instruments proposed by the Task Force of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Briefly, ISPOR steps include: preparation, forward translation, reconciliation, back-translation, back-translation review, harmonization, cognitive debriefing, review of cognitive debriefing and finalization, before proofreading and final version. The original authors authorized the translation and participated in the study. Results There was good agreement between translations and between the back-translation and the original English version of the SFQ. The final version was prepared with certificated evaluators in the original language and in Portuguese. Few changes were necessary to the new version in Portuguese. Conclusion The translated and adapted Brazilian Portuguese version of the SFQ is reliable and semantically equivalent to the original version. Studies on psychotropic-related sexual dysfunction may now test the validity of the instrument and can investigate sexual dysfunction in Portuguese-speaking patients.

Resumo Introdução A disfunção sexual é comum em pacientes com doença psicótica. Este artigo descreve a tradução e adaptação transcultural do Questionário de Função Sexual (SFQ) para o português do Brasil. Métodos A tradução e a adaptação transcultural seguiram as diretrizes para a adaptação de instrumentos de autorrelato propostas pela Força-Tarefa da Sociedade Internacional de Pesquisa Farmacológica e de Resultados (International Society for Pharmacoeconomics and Outcomes Research, ISPOR). As etapas da ISPOR incluem: preparação, primeiras traduções, reconciliação, retrotradução, revisão da retrotradução, harmonização, interrogatório cognitivo, revisão do interrogatório cognitivo e finalização, antes da revisão e versão final. Os autores originais autorizaram a tradução e participaram do estudo. Resultados Houve boa concordância entre as traduções e entre a retrotradução e a versão original em inglês do SFQ. A versão final foi preparada com avaliadores certificados na língua original e em português. Poucas mudanças foram necessárias para a nova versão em português. Conclusão A versão brasileira traduzida e adaptada do SFQ é confiável e semanticamente equivalente à versão original. Estudos sobre disfunção sexual relacionada a psicotrópicos podem agora testar a validade do instrumento e investigar a disfunção sexual em pacientes brasileiros.

Disfunción sexual de la mujer en edad reproductiva / Sexual dysfunction in women of reproductive age

La disfunción sexual femenina (DSF) es un trastorno que se produce cuando hay cambio en el compor- tamiento sexual habitual de la mujer; disminuyen o incluso desaparecen los pensamientos y fantasías sexuales, posponen o evitan las relaciones sexua- les y existe incapacidad para disfrutar el acto sexual y se presenta entre el 22% a 43% de la población en general. Objetivo Conocer la prevalencia de disfun- ción sexual en la mujer en edad reproductiva de 19 a 35 años en la comunidad del bordo del rio Santa Ana en el I semestre del 2015. Pacientes y Métodos: Estudio de alcance descriptivo, corte transversal, enfoque cuantitativo. La población; 247 mujeres en edad fértil (de 19 a 35 años), muestra de 71 muje- res que consintieron participar. Criterios de exclusión mujeres menores de 19 y mayores de 35 y solteras de 19 a 35 años. La información se obtuvo median - te un instrumento tipo cuestionario con escala lic- ker, procesando los datos en programa EPI-INFO. Resultados Están satisfechas con su vida sexual 36 (51%) y 35 (49%) refirieron no estarlo, 21(30%) te - nían satisfacción plena con su vida sexual y 50(70%) no estaban satisfechas. 35 (54%) de las parejas, no le muestran afecto a la mujer, durante el acto se- xual y tampoco colaboran para tener un orgasmo. Conclusiones La prevalencia de la disfunción sexual en la mujer en edad reproductiva es elevada, casi la mitad está sufriendo algún trastorno en las fases de deseo, excitación, dolor o lubricación lo que le impi- de tener una adecuada respuesta sexual humana...(au)

A Model for the Management of Female Sexual Dysfunctions / Modelo para abordagem das disfunções sexuais femininas

Abstract Introduction Sexual pleasure is fundamental for the maintenance of health and well-being, but it may be adversely affected by medical and psychosocial conditions. Many patients only feel that their health is fully restored after they resume normal sexual activities. Any discussion of sexuality in a doctor's office is typically limited, mainly because of a lack of models or protocols available to guide the discussion of the topic. Objectives To present a model designed to guide gynecologists in the management of female sexual complaints. Methods This study presents a protocol used to assess women's sexual problems. A semi-structured interview is used to assess sexual function, and the teaching, orienting and permitting (TOP) intervention model that was designed to guide gynecologists in the management of sexual complaints. Results The use of protocols may facilitate the discussion of sexual issues in gynecological settings, and has the potential to provide an effective approach to the complex aspects of sexual dysfunction in women. The TOP model has three phases: teaching the sexual response, in which the gynecologist explains the physiology of the female sexual response, and focuses on the three main phases thereof (desire, excitement and orgasm); orienting a woman toward sexual health, in which sexual education is used to provide information on the concept and healthy experience of sexuality; and permitting and stimulating sexual pleasure, which is based on the assumption that sexual pleasure is an individual right and is important for the physical and emotional well-being. Conclusion The use of protocols may provide an effective approach to deal with female sexual dysfunction in gynecological offices.

Resumo Introdução O prazer sexual é fundamental para a manutenção da saúde e do bem-estar da mulher, mas pode ser afetado negativamente por condições médicas e psicossociais. Em muitos casos, a mulher sente que sua saúde geral é restaurada após retomar sua vida sexual. Porém, a discussão sobre função sexual no consultório do ginecologista é limitada devido à falta de modelos ou protocolos disponíveis para orientar a intervenção neste tema. Objetivos Apresentar um modelo de intervenção nas disfunções sexuais femininas para ser utilizado pelo ginecologista. Métodos Foi realizada uma revisão da literatura com levantamento de estudos sobre o manejo das disfunções sexuais femininas nas diferentes culturas. A partir desta revisão, foi elaborado um protocolo que consiste da história clínica e de um modelo de intervenção para orientar os ginecologistas no tratamento das queixas sexuais femininas. Resultados O uso de protocolos pode facilitar a discussão sobre questões sexuais pelo ginecologista, e pode fornecer uma abordagem eficaz para lidar com os aspectos complexos da disfunção sexual feminina. O modelo proposto, ensinar, orientar e permitir (EOP), tem três fases: ensinar sobre a resposta sexual, na qual o ginecologista explica a fisiologia da resposta sexual feminina, e se concentra nas suas três principais fases (desejo, excitação e orgasmo); orientar sobre saúde sexual para fornecer informações sobre vivência saudável da sexualidade; e permitir a estimulação do prazer sexual, que é um direito individual e importante para o bem-estar físico e emocional do indivíduo. Conclusão O uso de protocolos pode fornecer uma abordagem eficaz para o ginecologista lidar com a disfunção sexual feminina.

Climacteric Symptoms and Sexual Dysfunction: Association between the Blatt-Kupperman Index and the Female Sexual Function Index / Sintomatologia climatérica e disfunção sexual: associação entre o índice de Kupperman e Blatt e o índice de função sexual feminina

Abstract Objective To investigate the association between the intensity of climacteric symptoms and sexual dysfunction in women aged 40 to 65 years. Methods Observational, analytic, cross-sectional study conducted with 63 women aged 40 to 65 treated at the gynecology outpatient clinic of a public hospital in northeastern Brazil. A questionnaire was used to collect identification data, clinical information, gynecological-obstetric data, lifestyle traits and information on chronic diseases. Climacteric symptoms and sexual function were evaluated by means of the Blatt-Kupperman index and the Female Sexual Function Index (FSFI) respectively. The association between the two indices was investigated using the chi-squared test; the difference in mean scores on the FSFI as a function of menopausal status was evaluated by Student's t-test. The significance level was set to p < 0.05. Results The mean value of the Blatt-Kupperman index was 26.42 (standard deviation [SD]: 4.52); 36.51% of the women exhibited severe symptoms. The mean score on the FSFI was 21.84 (SD: 4.11). More than half of the analyzed women (58.73%) exhibited sexual dysfunction (FSFI ≤ 26.5). Regarding the association between the Blatt- Kupperman index and the FSFI, the greater the intensity of the climacteric symptoms (Blatt-Kupperman), the higher the frequency of sexual dysfunction (FSFI). Sexual dysfunction was exhibited by 100% of the participants with severe climacteric symptoms, 70.59% of those with moderate symptoms, and only 9.09% with mild symptoms (p < 0.001). Conclusions The application of the Blatt-Kupperman index and of the FSFI allowed the detection of an association between the severity of climacteric symptoms and the prevalence of sexual dysfunction.

Resumo Objetivo Verificar, em mulheres de 40 a 65 anos, a associação entre a intensidade dos sintomas climatéricos e a disfunção sexual. Métodos Estudo observacional, analítico, transversal, comamostra de 63 mulheres entre 40 e 65 anos atendidas em um ambulatório de ginecologia de um hospital público do Nordeste do Brasil. Foi aplicado um questionário com dados de identificação, informações clínicas, dados ginecológico-obstétricos, hábitos de vida e doenças crônicas. Os sintomas climatéricos e a função sexual foram avaliados utilizando o índice de Kupperman e Blatt e o índice de função sexual feminina (IFSF) respectivamente. Para avaliar a associação entre estes índices, foi utilizado o teste do qui-quadrado, e, para avaliar a diferença entre as médias do IFSF de acordo com o status menopausal, foi utilizado o teste t de Student. Um valor de p < 0,05 foi considerado significante. Resultados A média do índice de Kurpperman e Blatt da população estudada foi de 26,42 (desvio-padrão [DP]: 4,52). Houve presença de sintomas acentuados em 36,51% das mulheres estudadas. A média do IFSF entre as pacientes estudadas foi de 21,84 (DP: 4,11). Mais da metade das mulheres em estudo (58,73%) apresentou disfunção sexual (FSFI ≤ 26,5). Quando analisada a associação entre o índice de Kupperman e Blatt e o IFSF, foi observado que, quanto maior a intensidade dos sintomas climatéricos (Kupperman e Blatt), maior a frequência de disfunção sexual (IFSF). Apresentaram disfunção sexual 100% das pacientes com sintomas climatéricos acentuados, sendo que 70,59% com sintomas moderados, e apenas 9,09% com sintomas leves (p < 0,001). Conclusões No presente estudo, quando aplicados o índicesde Kupperman e Blatt e o IFSF, observou-se associação entre a gravidade dos sintomas climatéricos e a prevalência de disfunção sexual.

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Indicadores clínicos de disfunção sexual em mulheres grávidas: revisão integrativa de literatura / Indicadores clínicos de disfunción sexual en mujeres embarazadas: revisión integradora de literatura / Clinical indicators of sexual dysfunction in pregnant women: integrative literature review

RESUMO Objetivo: identificar os indicadores clínicos do diagnóstico de enfermagem disfunção sexual em mulheres grávidas. Método: revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "sexual*", "pregnan*" e"function*". Foram incluídos estudos com resumo disponível para análise, referentes a grávidas com idade igual ou superior a 18 anos, escritos em português, francês, espanhol e inglês, com data de publicação entre 2010 e 2014. Foram excluídos estudos que reportassem grávidas com patologia associada. Resultados: a disfunção sexual na grávida é consistente na literatura. Foram identificadas nove características definidoras e 16 fatores relacionados, alguns não classificados na NANDA Internacional. Conclusão: indicadores clínicos podem ser adicionados ao diagnóstico de enfermagem de modo a favorecer um diagnóstico acurado e intervenções efetivas na vigilância da gravidez como um período de vivência sexual saudável.

RESUMEN Objetivo: identificar los indicadores clínicos del diagnóstico de enfermería disfunción sexual en mujeres embarazadas. Método: revisión integradora de la literatura, con investigación en bases de datos, utilizando las palabras clave "sexual*", "pregnan*" y "function*". Fueron incluidos estudios con resumen disponible para análisis, referentes a embarazadas con edad igual o superior a 18 anos, escritos en português, francés, espanol e inglés, con fecha de publicación entre 2010 y 2014. Fueron excluidos estudios que reportasen embarazadas con patología asociada. Resultados: la disfunción sexual en la embarazada es consistente en la literatura. Fueron identificadas nueve características definidoras y 16 factores relacionados, algunos no clasificados en la NANDA Internacional. Conclusión: indicadores clínicos pueden ser agregados al diagnóstico de enfermería de modo a favorecer un diagnóstico preciso e intervenciones efectivas en la vigilancia del embarazo como un período de vivencia sexual sana.

ABSTRACT Objective: to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women. Method: it is an integrative literature review, with research in databases using the keywords "sexual*", "pregnan*" and "function*". Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded. Results: sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International. Conclusion: clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.

Sexual dysfunction among men in secondary care in southern India: Nature, prevalence, clinical features and explanatory models.

Background. Sexual dysfunction, common in general medical practice, is under-recognized and inadequately managed resulting in significant morbidity and reduction in quality of life. We examined the nature, prevalence, clinical features and explanatory models of illness among men with sexual dysfunction in a general healthcare setting. Methods. We recruited 270 consecutive men attending a general health clinic. Participants were evaluated using a structured interview. The International Index of Erectile Function-5, the Chinese Index of Premature Ejaculation-5, Short Explanatory Model Interview and the Revised Clinical Interview Schedule were used to assess sexual dysfunction, explanatory models and psychiatric morbidity. Results. Premature ejaculation and erectile dysfunction were reported by 43.0% and 47.8% of men, respectively. The most common perceived causes were loss of semen due to masturbation and nocturnal emission. Popular treatments were herbal remedies and resources used were traditional healers. The factors associated with erectile dysfunction were diabetes mellitus, financial stress, past history of psychiatric treatment and common mental disorders such as depression and anxiety; those associated with premature ejaculation were common mental disorders, older age and financial debt. Sexual dysfunctions and concerns were under-diagnosed by physicians when compared to the research interview. Conclusion. There is a need to recognize sexual problems and effectively manage them in general medical settings. The need for sex education in schools and through the mass media, to remove sexual misconceptions, cannot be under-emphasized.

Development and Validation of the Korean Version of the Female Sexual Function Index-6 (FSFI-6K)

PURPOSE: To evaluate the validity and reliability of the Korean version of the Female Sexual Function Index-6 (FSFI-6K). MATERIALS AND METHODS: Participants were recruited from February 2013 to July 2013. The primary survey was conducted for 220 participants, and a follow-up was conducted 3 weeks (+/-1 week) after the primary survey. The FSFI-6K data were analyzed and compared to the reference values in the original FSFI. RESULTS: Of the 220 participants, 199 (90.5%) returned to follow-up, 18 (8.2%) had no further contact, and 3 (1.4%) declined to respond. The internal consistency of the FSFI-6K as measured by Cronbach's alpha was 0.888 and the reliability based on test-retest intraclass correlation was 0.606; these values were acceptable. The cutoff used for diagnosis of female sexual dysfunction by an receiver operating characteristics (ROC) curve was a score of 21; the sensitivity and specificity for this curve are 0.89 and 0.86, respectively. The area under the receiver operating curve was 0.948. CONCLUSION: The FSFI-6K has high internal consistency and acceptable reliability. This validated questionnaire can be used for the Korean population.

The prevalence of sexual dysfunction among patients with end stage renal disease in Jamaica / Prevalencia de la disfunción sexual entre los pacientes con enfermedad renal en etapa terminal en Jamaica

BACKGROUND: Sexual performance and gratification impact quality of life. Although recognized in the literature as a problem, sexual dysfunction among patients with end stage renal disease (ESRD) has never been studied in Jamaica. SUBJECTS AND METHOD: The prevalence ofsexual dysfunction was determined among 268 adult Jamaican patients (166 males, 102 females) with ESRD who had been on haemodialysis for at least three months. Erectile dysfunction (ED) was assessed using the International Index of Erectile Function (IIEF). Female sexual dysfunction (FSD) was determined using the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases (ICD)-10 classifications of sexual disorders. Prevalence, severity of sexual dysfunctions and relationships with the primary aetiology ofESRD and anaemia were assessed. RESULTS: Erectile dysfunction, desire disorder and orgasmic disorder were found in 91.4%, 88.3%, and 81.6% of male subjects, respectively. The majority of male patients were dissatisfied with their performance at intercourse after progressing to ESRD. Hypoactive sexual disorder, sexual arousal and orgasmic disorders, and aversion sexual disorder were prevalent, found in 96%, 88.1% and 87.1% of female patients. All diabetic patients with ESRD reported hypoactive sexual disorder and orgasmic dysfunction; arousal disorder was found in 94.7%. Aversion sexual disorder was found more among patients with underlying chronic glomerulonephritis. All patients with severe anaemia were found to have hypoactive sexual disorder and among these, 87.5% and 97.8% had severe arousal and orgasmic disorders, respectively. CONCLUSION: Sexual dysfunction among patients with ESRD in Jamaica was prevalent in males and females. Associations exist between sexual dysfunction and diabetes mellitus, chronic glomerulonephritis and anaemia.

ANTECEDENTES: El funcionamiento y la satisfacción sexual afectan la calidad de vida. Aunque la literatura la reconoce como un problema, la disfunción sexual entre los pacientes con enfermedad renal en etapa terminal (ERET) nunca se ha estudiado en Jamaica. SUJETOS Y MÉTODOS: Se determinó la prevalencia de la disfunción sexual entre 268pacientes jamaicanos adultos (166 varones y 102 hembras) con ERET, que habían estado en hemodiálisis por al menos tres meses. La disfunción eréctil (DE) fue evaluada mediante el índice internacional de función eréctil (IIFE). La disfunción sexual femenina (DSF) se determinó usando el Manual diagnóstico y estadístico de trastornos mentales, cuarta edición (DSM-IV) y las clasificaciones de trastornos sexuales en la Clasificación internacional de enfermedades (CIE)-10. Se evaluaron laprevalencia, la gravedad de las disfunciones sexuales y las relaciones con la principal etiología de ERETy la anemia. RESULTADOS: Se halló disfunción eréctil, trastorno de deseo, y trastorno orgásmico en 91.4%, 88.3% y 81.6% de los sujetos masculinos, respectivamente. La mayoría de los pacientes masculinos estaban insatisfechos con su desempeño en las relaciones sexuales después del avance de ERET. Trastornos sexuales hipoactivo, trastornos de la excitación sexual y del orgasmo, así como trastornos de aversión se caracterizaron por su prevalencia, y fueron hallados en 96%, 88.1% y 87.1% de los pacientes femeninos, respectivamente. Todos los pacientes diabéticos con ERET reportaron trastorno sexual hipoactivo y disfunción orgásmica. Se hallaron trastornos de excitación en el 94.7%. El trastorno de aversión sexual se observó más entre los pacientes con glomerulonefritis crónica subyacente. Se halló que todos los pacientes con anemia presentaban trastorno sexual hipoactivo y entre éstos, 87.5% y 97.8%presentaban trastornos severos de excitación y orgasmo, respectivamente. CONCLUSIÓN: La disfunción sexual entre los pacientes con ERET en Jamaica fue prevalente tanto en los varones como en las hembras. Existen asociaciones entre la disfunción sexual y la diabetes mellitus, la glomerulonefritis crónica y la anemia.

Sintomas de disfuncao sexual em homens com 40 ou mais anos de idade: prevalencia e fatores associados / Sexual dysfunction symptoms in men age 40 or older: Prevalence and associated factors

Objetivo: O estudo objetivou verificar os fatores associados aos sintomas sexuais do envelhecimento masculino em uma amostra representativa em homens com idade igual ou superior a 40 anos da cidade de Pelotas, RS. Métodos: Foi realizado um estudo transversal de base populacional, incluindo 421 homens que residiam na zona urbana do município. Para avaliar os sintomas sexuais do envelhecimento masculino foi utilizada a dimensão sexual da escala AMS - The Aging Male´s Symptoms Scale . Resultados: A prevalência dos sintomas sexuais do envelhecimento masculino foi de 64,3% (IC 95%: 59,3%-69,1%). Na análise multivariável o desfecho esteve associado diretamente idade e inversamente a autopercepção de saúde. Conclusão: Concluiu-se que a prevalência de sintomas sexuais na população masculina é importante. Políticas de saúde pública aliada ao aumento de hábitos de vida saudáveis poderiam minimizar esta prevalência e proporcionar melhor qualidade de vida a homens de meia idade e idosos. .

Objective: This study aimed to identify factors associated with sexual symptoms of aging male's in a representative sample of men aged 40 or older from Pelotas, southern Brazil. Methods: We performed a population-based cross-sectional study including 421 men who lived in urban area. To evaluate the sexual symptoms of aging male's was used the sexual dimension of the AMS scale - The Aging Male's Symptoms Scale. Results: The prevalence of sexual symptoms of male aging was 64.3% (95% CI: 59.3%-69.1%). Multivariable analysis identified direct association with age and inverse association with health self-rated. Conclusion: We conclude that the prevalence of sexual symptoms in older males is high and important. Public health policies coupled with increased healthy lifestyle habits could minimize the prevalence and provide better quality of life for middle-age and older men. .

Aspectos demográficos y clínicos de las disfunciones sexuales femeninas / Clinical and demographic aspects of female sexual dysfunctions

Se presenta una entrevista en la cual se discuten los principales aspectos epidemiológicos, demográficos, médicos y psicológicos de estas afecciones en el contexto regional, en un enfoque dirigido al médico general y de atención primaria de la salud.

Trastornos sexuales femeninos en la actualidad / [Female sexual disorders nowadays].

This article makes a brief overview of the most frequent female sexual disorders seen in our clinical practice. It highlights the increasing number of women presenting with hypoactive sexual desire and the efforts practitioners put on helping these female patients. The article also shows the pharmacological strategies that are investigated to solve these dysfuntions.

Qualidade de vida e função sexual de participantes de programa de reabilitação cardiopulmonar e metabólica / Quality of life and sexual function of participants from cardiopulmonary and metabolic rehabilitation program

A disfunção sexual está correlacionada às doenças cardiovasculares e metabólicas, sendo considerado um importante problema de saúde relacionado à qualidade de vida. O objetivo deste estudo foi traças o perfil da qualidade de vida e função sexual de indivíduos de ambos os sexos, participantes há mais de seis meses de Programa de Rehabilitação Cardiopulmonar e Metabólica. Foram entrevistados 46 homens e 45 mulheres com média de idade 62,80 e 63,88 anos, respectivamente. Para avaliar a qualidade de vida, foi utilizado o questionário de qualidade de vida SF-36; a função sexual masculina foi avaliada por meio do Índice Internacional de Função Erétil e a feminina pelo Índice de Função Sexual Feminino (IFSF). Os dados obtidos foram analisados com uso da estatística descritiva. Os indivíduos apresentaram qualidade de vida moderada nos domínios dor, estado geral de saúde, vitalidade, aspectos sociais e da saúde mental. Os domínios capacidade funcional, limitações por aspectos físicos e aspectos emocionais representaram bons índices. A disfunção erétil representou 60.9%, sendo que 39,2% dos homens com disfunção apresentaram grau leve, 14,2% leve a moderado, 10,7% moderado e 35,7% grave. O escore total do IFSF leve a moderado, 10,02 sendo que os domínios mais comprometidos foram dor, excitação, lubrificação e orgasmo. Os participantes do Programa de Reabilitação Cardiopulmonar e Metabólica, referem uma qualidade de vida moderada para boa, apesar de a disfunção erétil ser prevalente e o resultado da função sexual feminina ser menos satisfatório.

Sexual dysfunction is related to cardiovascular and metabolic diseases and is considered a major health-related quality of life. The objective of this study was to profile the quality of life and sexual function in individual of both sexes, participating for more than six months of Cardiopulmonary and Metabolic Rehabilitation Program. Interviews took place with 46 men and 45 women with mean age 63,88 years and 62.80, respectively. The SF-36 questionnaire was applied to assess the quality of life, male sexual function was assessed using the International Index of Erectile Function and female the Female Sexual Function Index (FSFI). Data was analyzed using descriptive statistics. The subjects had moderate quality of life in the domains of pain, general health, vitality, social functioning and mental health. The functional capacity, limitations on physical and emotional aspects represented good rates. Already, the erectile dysfunction accounted for 60.9% whereas 39.2% from those had low dysfunction, 14.29% moderately light, 10.7% moderate and 35.7% severe. The total score was 10.02 FSFI being that the areas most affected were pain, arousal, lubrication and orgasm. Participants of Cardiopulmonary and Metabolic Rehabilitation Program report a moderatte to good quality of life, in spite of the prevalent erectile dysfunction and the less satisfactory result of female sexual function.

Função sexual feminina: aspectos normais e patológicos, prevalência no Brasil, diagnóstico e tratamento / Female sexual function: normal and pathological aspects, prevalence in Brazil, diagnosis and treatment

A função sexual representa um componente importante da saúde e da qualidade de vida. O objetivo deste artigo foi descrever aspectos normais e patológicos da função sexual feminina e expor os métodos diagnósticos e terapêuticos, abordando a prevalência no Brasil. Para isso, foi realizada uma revisão da literatura, de artigos publicados entre 1985 e 2012, dos quais foram selecionados 56, indexados no PubMed/Medline e SciELO. Os achados indicam que as disfunções sexuais nas mulheres apresentam etiologia multifatorial e são pouco estudadas na população brasileira. A terapêutica deve ser adaptada de acordo com a necessidade da paciente e desenvolvida por uma equipe multidisciplinar

Sexual function represents an important component of health and quality of life. The purpose of this article was to describe normal and pathological aspects of female sexual function and expose the diagnostic and therapeutic methods, addressing the prevalence in Brazil. For this, was realized a literature review, of articles published from 1985 to 2012, which 56 were selected, indexed in PubMed/Medline and SciELO. The findings indicate that female sexual dysfunctions have multifactorial etiology and are not very well studied in the Brazilian population. Therapy should be tailored according to the needs of the patient and done by a multidisciplinary team

Disfunción eréctil en población masculina mayor de 35 años en la ciudad de Siguatepeque / Erectile dysfunction in men above 35 in Siguatepeque, Honduras

Las funciones sexuales y eréctiles son importantes en la salud de los hombres y el bienestar de las parejas. La disfunción eréctil (DE) tiene una alta prevalencia fundamentalmente en las últimas décadas de la vida y se halla relacionada con múltiples factores de riesgo. Objetivo: establecer algunos factores de riesgo y enfermedades concomitantes así como la prevalencia de la disfunción eréctil en la población masculina mayor de 35 años de la ciudad de Siguatepeque, Honduras, agosto del 2009. Metodología; estudio descriptivo de corte transversal. La población fue de 5,200 hombres mayores de 35 años. La muestra de 371 hombres. El método de muestreo fue estratificado según barrios de la ciudad. La unidad de estudio fue seleccionada en forma aleatoria. Para la recolección de datos se utilizaron dos instrumentos, una encuesta con datos de carácter general; otro instrumento utilizado fue el Test de SHIM (Sexual Health Inventory for Men), cuestionario sobre salud sexual masculina, versión abreviada del IIEF (Índice Internacional de Función Eréctil) del que se seleccionaron 5 preguntas sobre sexualidad masculina en los últimos 6 meses, con el propósito de detectar DE en grupos de riesgo. Se considera DE cuando la puntuación es igual o inferior a 21. Resultados; La prevalencia de DE encontrada fue de 214(58%) del total de la muestra, los grados de disfunción fueron: Leve 114(53%), de Leve a Moderada 57(27%), Moderada 18(8%), y Grave 25(12%). La DE encontrada según rangos de edad fue para mayores de 60 años 94(44%), de 45 a 59 años 95(45%), de 35 a 44 años 25(11%). Los hábitos tóxicos: hombres que en el pasado ingirieron bebidas alcohólicas y al momento de la entrevista consumían y tenían DE 104(49%) y 50(23%) respectivamente. Tabaquismo como antecedente de consumo y al momento de la entrevista presentaban DE, 96(45%) y 55(26%) respectivamente. El consumo de otras drogas 3(1%). Las enfermedades concomitantes que se relacionan con DE fueron: problemas cardiovascular...