Sexual quality of life and body image of breast cancer patients: uncovering the meaning behind the symptoms / Calidad de vida sexual e imagen corporal de pacientes con cáncer de mama: descubriendo el significado detrás de los síntomas

Abstract: Introduction: Breast cancer symptoms and the side effects of treatment can significantly affect different domains of women’s functioning. Objective: The aim of this study was to examine the quality of life in women with breast cancer. Method: Our sample consisted of 240 women aged 30-68 (M=52, SD=8.68). Approximately 50% had undergone a mastectomy, while 40% had breast reconstruction. A structured questionnaire consisted of social-demographical data, SQOL-F, EORTC QLQ-C30 & EORTC QLQ-BR23. Results: Results suggest that our BC patients had lower quality of life and more financial difficulties than in most other studies, implying some cultural or health system differences. Not having a mastectomy was associated with better sexual quality of life, global health, and physical functioning. In contrast, women who underwent mastectomy reported impaired body image and sexual functioning, with more prominent breast symptoms. Reconstruction was related to the lower quality of life and no improvement in body image. Conclusions: Sexual quality of life was mainly related to global health status, emotional functioning, treatment side effects and body image. Emotional functioning and side effects were significant predictors of sexual quality of life, while impaired sexual functioning was associated with distorted body image. These findings can serve as guidance for forming interventions aimed at enhancing the quality of life. (AU)

Resumen:Introducción: Los síntomas del cáncer de mama y los efectos secundarios del tratamiento pueden afectar significativamente a diferentes áreas funcionales de las mujeres. Objetivo: examinar la calidad de vida de mujeres con cáncer de mama. Método: la muestra estuvo compuesta por 240 mujeres de entre 30 y 68 años (M=52; DT=8,68). Aproximadamente el 50% se había sometido a una mastectomía, mientras que al 40% se le había realizado una reconstrucción mamaria. Un cuestionario estructurado constaba de datos sociodemográficos, SQOL-F, EORTC QLQ-C30 y EORTC QLQ-BR23. Resultados: Los resultados sugieren que nuestros pacientes con BC tenían una menor calidad de vida y más dificultades financieras que en la mayoría de los otros estudios, lo que implica algunas diferencias culturales o del sistema de salud. No someterse a una mastectomía se asoció con una mejor calidad de vida sexual, salud global y funcionamiento físico. Por el contrario, las mujeres que se sometieron a mastectomía informaron problemas de imagen corporal y funcionamiento sexual, con síntomas mamarios más prominentes. La reconstrucción se relacionó con una menor calidad de vida y ninguna mejora en la imagen corporal. Conclusiones: La calidad de vida sexual se relacionó principalmente con el estado de salud global, el funcionamiento emocional, los efectos secundarios del tratamiento y la imagen corporal. El funcionamiento emocional y los efectos secundarios fueron predictores importantes de la calidad de vida sexual, mientras que el funcionamiento sexual deteriorado se asoció con una imagen corporal distorsionada. Estos hallazgos pueden servir como guía para formular intervenciones destinadas a mejorar la calidad de vida. (AU)

An observational, national and multicentric study to describe the detection, diagnosis and treatment of erectile dysfunction and premature ejaculation from the patient's perspective / Estudio observacional, nacional y multicéntrico, para describir la detección, el diagnóstico y el tratamiento de la disfunción eréctil y la eyaculación precoz desde la perspectiva del paciente

Introduction and objectives: To examine the opinions, attitudes and perceptions of patients regarding the diagnosis and treatment protocols of erectile dysfunction (ED) and premature ejaculation (PE) and their interaction with the urology specialists. Material and methods: Observational, national and multicentric study based on a self-designed online questionnaire in which ED and PE patients described their perception of ED and PE at diagnosis and during treatment and monitoring, the patient-physician relationship and the role of the patient's partner in the course of the disease. Results: 306 ED and 70 PE participants were recruited. After the occurrence of the first symptoms, the time elapsed until the patient decided to go to the doctor was 28.6 months for PE and 14.0 months for ED (p<0.001). ED patients saw physicians more frequently (especially those aged between 60 and 69 years: 60.7%, p<0.001) than PE patients (52.1% vs 36.8%, respectively; p<0.001) and discussed this problem with their partner more (34.0% vs 22.8%, p<0.001). These disorders were mainly diagnosed at the urologist's office (ED: 74.8% vs 42.5%; PE: 75.7% vs 34.3%; diagnosis vs detection). One third of all participants reported that the sexual problem was not the main reason for the visit. The time elapsed between the first consultation for related symptoms and therapy was 8.7 months (oral drugs) and 7.6 months (dapoxetine) for ED and PE, respectively. ED patients and their partners felt particularly better once treatment had started (p<0.001). PE patients presented the highest degree of sexual dissatisfaction (78%). 50% of the patients agreed with the statement that initiating a discussion about sexual concerns was regarded as taboo and most of them did not say that their partner had encouraged them to seek medical advice. (AU)

Introducción y objetivos: Analizar las opiniones, actitudes y percepciones de los pacientes respecto a los protocolos de diagnóstico y tratamiento de la disfunción eréctil (DE) y la eyaculación precoz (EP) así como su interacción con los especialistas en urología. Material y métodos: Estudio observacional, nacional y multicéntrico, a través de un cuestionario online predefinido, en el que los pacientes con DE y EP describieron su percepción acerca de la DE y la EP, en el diagnóstico, durante el tratamiento y seguimiento, así como la relación médico-paciente y el papel de la pareja en el trascurso de la enfermedad. Resultados: Se incluyeron 306 participantes con DE y 70 con PE. El tiempo transcurrido, desde la aparición de los primeros síntomas hasta que el paciente decidió acudir al médico, fue de 28,6 meses para la EP y de 14,0 meses para la DE (p < 0,001). Los pacientes con DE acudieron al médico con mayor frecuencia (especialmente en edades entre 60 y 69 años: 60,7%, p < 0,001) respecto a los pacientes con EP (52,1 vs. 36,8%, respectivamente; p < 0,001) y comentaron más el problema con su pareja (34,0 vs. 22,8%, p < 0,001). El diagnóstico de ambas disfunciones se llevó a cabo principalmente en consultas de urología (DE: 74,8 vs. 42,5%; EP: 75,7 vs. 34,3%; diagnóstico vs. detección). Una tercera parte de todos los participantes indicó que el problema sexual no motivó principalmente la visita. El tiempo transcurrido, desde la primera consulta motivada por síntomas relacionados y el establecimiento de terapia, fue de 8,7 meses (fármacos orales) y 7,6 meses (dapoxetina) para la DE y la EP, respectivamente. Los pacientes con EP presentaron mayor grado de insatisfacción sexual (78%). De los pacientes estudiados, 50% mostró acuerdo con la afirmación de que iniciar una conversación sobre las preocupaciones sexuales se consideraba un tabú y la mayoría reconoció que su pareja no le había animado a la hora de buscar consejo médico. (AU)

An observational, national and multicentric study to describe the detection, diagnosis and treatment of erectile dysfunction and premature ejaculation from the patient's perspective.

INTRODUCTION AND OBJECTIVES: To examine the opinions, attitudes and perceptions of patients regarding the diagnosis and treatment protocols of erectile dysfunction (ED) and premature ejaculation (PE) and their interaction with the urology specialists. MATERIAL AND METHODS: Observational, national and multicentric study based on a self-designed online questionnaire in which ED and PE patients described their perception of ED and PE at diagnosis and during treatment and monitoring, the patient-physician relationship and the role of the patient's partner in the course of the disease. RESULTS: 306 ED and 70 PE participants were recruited. After the occurrence of the first symptoms, the time elapsed until the patient decided to go to the doctor was 28.6 months for PE and 14.0 months for ED (p<0.001). ED patients saw physicians more frequently (especially those aged between 60 and 69 years: 60.7%, p<0.001) than PE patients (52.1% vs 36.8%, respectively; p<0.001) and discussed this problem with their partner more (34.0% vs 22.8%, p<0.001). These disorders were mainly diagnosed at the urologist's office (ED: 74.8% vs 42.5%; PE: 75.7% vs 34.3%; diagnosis vs detection). One third of all participants reported that the sexual problem was not the main reason for the visit. The time elapsed between the first consultation for related symptoms and therapy was 8.7 months (oral drugs) and 7.6 months (dapoxetine) for ED and PE, respectively. ED patients and their partners felt particularly better once treatment had started (p<0.001). PE patients presented the highest degree of sexual dissatisfaction (78%). 50% of the patients agreed with the statement that initiating a discussion about sexual concerns was regarded as taboo and most of them did not say that their partner had encouraged them to seek medical advice. CONCLUSION: A concerted effort is called for to expand ED and PE patients' proactivity in taking care of their own and their partner's sexual health. Current therapies would appear to have a benefit in couples' sexual relationships.

Asociación entre el inicio de la vida sexual y las lesiones intraepiteliales / Association between age at onset of active sexual life and intraepithelial lesion

Introducción: El cáncer cervicouterino inicia con una lesión precancerosa llamada displasia, pudiendo ser de bajo grado o alto grado; uno de los factores más importantes en este sentido es la edad de inicio de la vida sexual activa (IVSA). Objetivo: Conocer si existe asociación entre la edad de inicio de la vida sexual activa y la lesión intraepitelial escamosa de alto grado (LIEAG). Material y métodos: Estudio descriptivo, retrospectivo, observacional, en 52 expedientes de mujeres de 15 a 60 años, con Papanicolaou en el HGZ MF No. 1, previa autorización del CLIS 301 y el CEI 3018, con folio R-2022-301-021. Se recolectaron los datos de expedientes que cumplieron los criterios de inclusión; se realizó un análisis estadístico con frecuencias, porcentajes para variables cualitativas nominales, con medidas de tendencia central y dispersión en variables cuantitativas, con determinación de chi2 y prueba de Kruskal-Wallis, respetándose los principios de Belmont en consideración a la Justicia y Beneficencia, los principios éticos de la Declaración de Helsinki 1964 y la Ley General de Salud en México. Resultado: Al evaluar 52 expedientes de pacientes, la edad fue de 37.81 ± 9.949 años; se encontró asociación entre el IVSA y la LIEAG, sin significación estadística, de acuerdo con la prueba de chi2, con un valor de p = 0.538 (IC 95%: 0.403-0.674), y una asociación significativa por la prueba de Kruskal-Wallis entre la LIEAG y la edad de la paciente, con un valor de p = 0.019 (IC 95%: 0.000-0.057). Conclusión: El IVSA no se correlaciona con el tipo de LIEAG.

Introduction: Cervical cancer begins with a precancerous lesion called dysplasia, which can be low grade or high grade. One of the most important factors is the age at which an active sexual life begins. Objective: To know if there is an association between the age of beginning of active sexual life (BASL) and high-grade squamous intraepithelial lesions (HGSIEL). Material and methods: Descriptive, retrospective, observational study, in 52 files of women aged 15 to 60 years with Pap smear at HGZ MF No. 1, prior authorization from CLIS 301 and CEI 3018 with folio R-2022-301-021. Data were collected from files that met the inclusion criteria, a statistical analysis was carried out with frequencies, percentages for nominal qualitative variables, with measures of central tendency and dispersion in quantitative variables, with determination of chi2 and Kruskal-Wallis, respecting the principles of Belmont in consideration of Justice and Beneficence, the ethical principles of the Declaration of Helsinki 1964, the General Health Law in México. Result: When evaluating 52 patient records, the age was 37.81 ± 9.949 years, the association of BASL and HGSIEL was found without statistical significance according to the chi2 with a p = 0.538 (95% CI, 0.403-0.674) and a significant association by Kruskal-Wallis between HGSIEL and patient age, with p = 0.019 (95% CI, 0.000-0.057). Conclusion: The beginning of an active sexual life has no association with the type of high-grade squamous intraepithelial lesions.

Adaptação transcultural e validade do Questionnaire on Sexual Quality of Life - Female (SQoL-F) para o Brasil / Cross-cultural adaptation and validity of the Questionnaire on Sexual Quality of Life - Female (SQoL-F) in Brazil

RESUMO Objetivo A qualidade de vida sexual abarca a satisfação sexual e com a parceria, a expressão de desejos e valores sexuais, a boa imagem corporal, além de questões de ordem física, comportamentais, psicológicas e emocionais que afetam a sexualidade. Não há instrumentos confiáveis e válidos para avaliar a qualidade de vida sexual das mulheres brasileiras, portanto este estudo buscou traduzir o Questionnaire on Sexual Quality of Life - Female (SQoL-F) e apresentar evidências de validade do instrumento no contexto brasileiro. Métodos Foram realizados tradução, avaliação da validade de conteúdo, teste da versão pré-final e análise fatorial exploratória do instrumento. Resultados Identificou-se a presença de um único fator que explicou 49% da variância, condizente com o proposto no questionário original. Esse modelo unifatorial apresentou cargas fatoriais adequadas (entre 0,36 e 0,85). Conclusão O questionário apresentou boa consistência interna e foram apresentadas evidências de validade satisfatórias para o uso com mulheres brasileiras.

ABSTRACT Objective The quality of sexual life encompasses sexual satisfaction and with partnership, the expression of sexual desires and values, good body image, in addition to physical, behavioral, psychological and emotional issues that affect sexuality. There are no reliable and valid instruments to assess the quality of sexual life of Brazilian women, so this study sought to translate the Questionnaire on Sexual Quality of Life - Female (SQoL-F) and present evidence of validity of the instrument in the Brazilian context. Methods The translation, content validity evaluation, pre-final version test and exploratory factor analysis were performed. Results The presence of a single factor was identified that explained 49% of the variance, consistent with what was proposed in the original questionnaire. This one-factor model presented adequate factor loadings (between 0.36 and 0.85). Conclusion The questionnaire had good internal consistency and presented satisfactory evidence of validity for use with Brazilian women.

Effectiveness of Counseling Based on Functional Analytic Psychotherapy with Enhanced Cognitive Therapy on the Sexual Quality of Life of Married Adolescent Women / Eficácia do aconselhamento baseado em psicoterapia analítica funcional - Com abordagem de terapia cognitiva aprimorada (FECT) na qualidade de vida sexual de mulheres adolescentes casadas

Abstract Objective Early marriage has many deleterious effects on the health of girls, such as sexual dissatisfaction, an inevitable result of the lack of sufficient knowledge about sexual issues at the time of the marriage. The goal of the present study was to determine the effectiveness of counseling based on functional analytic psychotherapy with enhanced cognitive therapy (FECT) on the sexual quality of life of married adolescent women. Methods This clinical trial was conducted between July and October 2019 on 150 married adolescent women who met the inclusion criteria. In the intervention group, FECTwas conducted in sixteen 90-minute sessions twice a week. The Sexual Quality of Life-Female (SQOL-F) questionnaire was used. When the study ended, the control group was given the choice of receiving the same intervention as the intervention group. Results The paired t-test showed a significant difference between the mean score of sexual quality of life before (52.33±23.09) and after (88.08±10.51) counseling in the intervention group (p<0.0001). According to the analysis of covariance, there was a significant difference between the score on sexual quality after counseling between the intervention (88.08±10.51) and control (60.32±23.73) groups (p<0.0001). There was also a significant difference between the mean score on the four dimensions of sexual quality of life in the intervention group (p<0.0001). Conclusion The results showed that counseling based on FECT improved the sexual quality of life in all dimensions in married adolescent women.

Resumo Objetivo O casamento precoce tem muitos efeitos deletérios sobre a saúde das meninas, como a insatisfação sexual, resultado inevitável da falta de conhecimento suficiente sobre questões sexuais no momento do casamento. O objetivo do presente estudo foi determinar a eficácia do aconselhamento baseado em psicoterapia analítica funcional com terapia cognitiva aprimorada (FECT) na qualidade de vida sexual de mulheres adolescentes casadas. Métodos Este ensaio clínico foi realizado entre julho e outubro de 2019 em 150 mulheres adolescentes casadas que preencheram os critérios de inclusão. No grupo de intervenção, FECT foi realizado em dezesseis sessões de 90 minutos duas vezes por semana. Foi utilizado o questionário Sexual Quality of Life-Female (SQOL-F). Quando o estudo terminou o grupo de controle teve a opção de receber a mesma intervenção do grupo de intervenção. Resultados O teste t pareado mostrou diferença significativa entre o escore médio da qualidade de vida sexual antes (52,33±23,09) e após (88,08±10,51) o aconselhamento no grupo intervenção (p<0,0001). De acordo com a análise de covariância houve diferença significativa entre o escore de qualidade sexual após aconselhamento entre os grupos intervenção (88,08±10,51) e controle (60,32±23,73) (p<0,0001). Também houve diferença significativa entre a pontuação média nas quatro dimensões da qualidade de vida sexual no grupo de intervenção (p<0,0001). Conclusão Os resultados mostraram que o aconselhamento baseado no FECT melhorou a qualidade de vida sexual em todas as dimensões em mulheres adolescentes casadas.

[Health, sex and sexual behaviour: sexually active life expectancy]. / Salud, sexo y comportamiento sexual: la esperanza de vida sexual activa.

OBJECTIVE: To measure sexually active life expectancy (SALE) estimating the average age at which sexually active life finishes, paying special attention to the older population. Variations in SALE according to self-rated health are examined. METHOD: Descriptive analysis with cross-sectional data. SALE was calculated for the population by age group (30 to 80 years old) and sex using the Sullivan Method, with data from the Human Mortality Database and the National Survey of Sexual Health (Spain). The analysis distinguishes between individuals that have had coital sex in the last year and those who have not. RESULTS: Coital activity continues in those aged from 55-59 years old, the SALE is 13.3 years in males and 8 in females. Coital activity is related to health and sexual health, diverging depending on sex and age group. The males showed a more extended sexually active trajectory than the females, but were also more influenced by good general health (adding 2.6 and 1 years respectively) and good sexual health (5.2 and 4.3 years). SALE also varies when poor health (subtracting 2.7 years and adding 2 years) and poor sexual health (subtracting 2.9 and 1.3 years) are considered. CONCLUSIONS: the results reveal that sexual health programmes must be extended to the older ages, given that it is confirmed that sexual activity continues in old age.

Qualidade de vida sexual de mulheres no pós-tratamento radioterápico de câncer de colo uterino / Sexual quality of life of women after cervical cancer radiotherapy

A qualidade de vida sexual é frequentemente afetada após tratamento oncológico em ginecologia. Reportamos a qualidade de vida sexual de pacientes em seguimento no serviço de Oncologia Ginecológica da Universidade Federal do Triângulo Mineiro, por meio da aplicação do questionário validado FSFI (Female Sexual Function Index), comparando pacientes diagnosticadas com câncer de colo uterino que receberam tratamento radioterápico com aquelas que foram submetidas a tratamento para câncer de colo uterino no qual não foi necessária a realização de radioterapia. Foi realizada análise estatística utilizando os testes D'Agostino-Pearson e o teste não paramétrico Mann-Whitney. Concluiu-se que a diminuição do desejo e da excitação foi mais frequente nas mulheres tratadas com radioterapia e que não houve diferença significativa entre as pacientes a respeito de lubrificação, orgasmo, satisfação e dispareunia.(AU)

Quality of sexual life is often affected after oncological treatment in gynecology. We report the quality of sexual life of patients in a follow-up at the Gynecological Oncology service of the Federal University of Triângulo Mineiro, through the application of a questionnaire validated in the Portuguese language. The purpose of this study was to compare cervical cancer patients diagnosed who received radiotherapy with those who have been submitted to treatment for cervical cancer in which it was not necessary to perform radiotherapy. Decreased desire and arousal were more frequent in women treated with radiotherapy. Statistical analysis was performed using the D'Agostino-Pearson tests and the non-parametric Mann-Whitney test. It was concluded that decreased desire and arousal were more frequent in women treated with radiotherapy, and that there was no significant difference between patients regarding lubrication, orgasm, satisfaction and dyspareunia.(AU)

Conducta sexual y reproductiva durante la adolescencia de los estudiantes de la Universidad Mayor de San Simón / Sexual and reproductive behavior during adolescence of students of the San Simon University

OBJETIVOS: analizar los factores relacionados con la conducta sexual de riesgo, durante la adolescencia de los estudiantes de la Universidad Mayor de San Simón, gestión 2018. MÉTODOS: estudio retrospectivo, de cohorte, el muestreó fue no probabilístico con criterios de inclusión y exclusión. Se aplicó una encuesta auto administrada en cuatro sitios diferentes de la universidad. El análisis de los datos se realizó con el programa Epi-info v.7.2, empleando análisis uni y bivariado, como medidas de asociación OR, chi2 con un valor de p significante menor o igual a 0,05. RESULTADOS: la proporción de participantes que iniciaron su vida sexual activa durante la adolescencia fue del 50%, de estos el 31% no utiliza ningún método anticonceptivo y el 69% si utiliza algún método de anticoncepción, de los cuales el 46% prefiere utilizar el preservativo masculino o la píldora del día siguiente. Se encontró una relación significativa del inicio de vida sexual precoz (antes de los 16 años) con las variables: ser varón, provenir de una familia disfuncional, poco acceso a fuentes de información sobre sexualidad, consumo de sustancias psicoactivas antes de la relación sexual y el haber tenido una pareja sexual informal o casual. CONCLUSIÓN: una conducta sexual adecuada en el adolescente depende en gran medida de un entorno familiar funcional y del acceso adecuado a información sobre sexualidad y reproducción. La prevención de embarazos no deseados y de infecciones de transmisión sexual en adolescentes debe centrarse también en el entorno familiar y de la sociedad del adolescente.(AU)

OBJECTIVES: to analyze factors related to sexual risk behavior during the adolescence of students at the San Simón University, management 2018. METHODS: retrospective cohort study, sampling was non-probability with inclusion and exclusion criteria. A self-administered survey wasapplied in 4 different sites of the university. The analysis of the data was carried out with the program Epi-info v.7.2, using uni and bivariate analysis, as association measures OR, chi2 with a significant p value less than or equal to 0.05. RESULTS: the proportion of participants who began their active sexual life during adolescence was 50%, of whom 31% do not use any contraceptive method and 69% if they use any method of contraception, of whom 46% prefer to use the male condom or the morning-after pill. A significant relationship of early sexual debut (before age 16) was found with the variables: being male, coming from a dysfunctional family, little access to sources of information about sexuality, consumption of psychoactive substances before sexual intercourse, and having had an informal or casual sexual partner. CONCLUSIONS: adequate sexual behavior in the adolescent depends to a large extent on a functional family environment and adequate access to information on sexuality and reproduction. The prevention of unwanted pregnancies and sexually transmitted infections in adolescents must also focus on the adolescent's family environment and society.(AU)

Evaluation of Sexual Life and Marital Satisfaction in Patients with Anogenital Wart. / Evaluación de la vida sexual y de la satisfacción matrimonial en pacientes con verruga anogenital.

Anogenital wart (AGW) resulting from human papilloma virus (HPV) is one of the most common sexually transmitted diseases worldwide. Herein, we aimed to evaluate the effects of AGW on patients'marital satisfaction and sexual function. This cross-sectional study was consisted of 74 consecutive patients including 37 patients with AGW and 37 healthy controls. ENRICH Marital Satisfaction Scale and Arizona Sexual Experience Scale were completed and analyzed for all patients. ENRICH scale items were not significantly different between the two groups. Sexual function was found to be lower in female than male patients (P<.001). According to our findings marital satisfaction was not affected by AGW. However, a history of previous treatment for HPV decreased the marital satisfaction. In addition, AGW had more adverse effects on females' sexual function compared to males. Our findings suggest that the psychiatric treatments should be considered when managing an AGW patient.

[Assessment of scar satisfaction and quality of sexual life after conservative surgical treatment. Our experience]. / Valoración de la cicatriz y de la calidad de vida sexual del tratamiento conservador del cáncer de pene. Nuestra experiencia.

The aim of the present study was to evaluate the overall scar satisfaction and quality of life in the conservative surgical treatment of penis cancer with reconstruction according to the Bracka technique. In order to do this, we passed out the questionnaire «Patient Scar Assessment Questionnaire¼ and the IIEF-15 questionnaire. From 2015 to 2017, 5 conventional glandectomy and reconstruction according to the Bracka technique were performed. 100% of the patients were very satisfied with the result, were slightly aware of the presence of the wound and lacked discomfort in relation to the scar. Regarding the quality of sexual life, an average improvement of 18 points was observed in the IIEF-15. We observed improvement in satisfaction of the sexual relationship (P6-8), orgasmic function (P9-10), overall satisfaction (P13-14) and confidence to maintain sexual intercourse (P15). Lesions at the level of the penis represent an important alteration in quality of sexual life. By performing a minimally invasive surgery with subsequent reconstruction, the patient presents a significant improvement in the quality of sexual life.

Evaluación de las conductas sexuales de riesgo y hábitos anticonceptivos en una muestra de población mexicana / Evaluation of sexual risk behaviors and contraceptive habits in a sample of the Mexican population

Resumen OBJETIVO: Evaluar, a través de una encuesta, la situación actual de las conductas sexuales de riesgo en una muestra de población mexicana de entre 15-60 años, e identificar los métodos de planificación familiar más utilizados y el promedio de inicio de la vida sexual. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, con muestreo no probabilístico tipo "bola de nieve". Se aplicó una encuesta validada internacionalmente de conductas sexuales de riesgo, entre julio y octubre de 2017, en una muestra mexicana de 15-60 años de edad. Se excluyeron las encuestas incompletas y con discordancias, y personas de otras nacionalidades. Entre las variables estudiadas se incluyeron: sexo, edad y estado socioeconómico. Se calculó un tamaño de muestra de 385, con un intervalo de confianza de 95% (IC95%). Los datos se reunieron en el programa de Excel 2016, donde se analizaron e interpretaron. RESULTADOS: Se encuestaron 689 sujetos, pero se excluyeron 38; de esta forma se registraron 650 casos. El 87.4% de los casos inició su vida sexual entre los 16 y 25 años; un tercio la calificó satisfactoria. El 50% de los encuestados de entre 13 y 15 años utilizó preservativo. El 61% refirió la comunicación de temas sexuales con sus padres poco satisfactoria o inexistente; 6.6% no utiliza o es usuario de algún método de planificación y 40.3% recurre a uno poco efectivo. CONCLUSIÓN: Es importante conocer las prácticas sexuales de la población mexicana, para identificar las áreas de oportunidad, promover la prevención de prácticas sexuales de riesgo y aumentar la difusión de la información.

Abstract OBJECTIVE: Evaluate, through an internationally validated survey, the risky sexual behavior in a Mexican sample between 15-60 years, the average of initiation of sexual activity and the most used contraceptive methods. MATERIALS AND METHODS: Descriptive, cross-sectional study, with non-probabilistic sampling type snowball. We apply an internationally validated survey of Risky Sexual Behavior between July and October 2017 through social networks to Mexican population between 15 and 60 years. Incomplete surveys were excluded, with disagreements in responses and people of other nationalities. The variables studied included sex, age and socioeconomic status. A sample size of 385 was calculated with a confidence level of 95%. The data was gathered in an Excel sheet 2016 where they were analyzed and interpreted. RESULTS: A total of 689 subjects were surveyed, 38 were excluded; In this way, a total of 650 cases were registered. 87.4% started sexual life between 16 and 25 years old, being satisfactory in a third of the cases. 50% of people between 13 and 15 years used condoms and 56% between 16 and 18 years. 61% reported the communication of sexual issues with their parents unsatisfactory or non-existent. 6.6% of people do not have a planning method while 40.3% have a little cash. CONCLUSION: It is important to know the sexual practices in the Mexican population to detect areas of opportunity, make changes in the prevention of risky sexual actions and in the distribution of information.

Factores asociados al inicio de vida sexual y al embarazo adolescente en Colombia. Estudio de corte transversal / Factors associated with the beginning of sexual life and adolescent pregnancy in Colombia. Cross-sectional study

RESUMEN Introducción: En Colombia, entre el año 2008 y 2014 el 23.4% de los nacimientos fueron producto de embarazos adolescentes, los cuales tienen graves consecuencias a nivel social, emocional y biológico tanto para la madre joven como para el bebé. Material y métodos: Estudio de corte transversal con componente analítico dónde se tomó una muestra representativa de 13.313 mujeres entre 13 y 19 años quienes respondieron la Encuesta Nacional de Demografía y Salud (ENDS) 2010. Se realizaron análisis bivariados y análisis de regresión logística multinomial con el fin de identificar factores individuales, del hogar y del comportamiento sexual asociados con el inicio de la vida sexual y con el embarazo en adolescentes colombianas. Resultados: A través del análisis multivariado se encontró que tener mayor edad, convivir en pareja, haber sufrido violencia parental y haber sufrido violencia sexual fueron factores de riesgo tanto para inicio de vida sexual como para embarazo adolescente. Se identificó que el hecho de estar asistiendo al colegio es un factor protector para ambos eventos. La pobreza, el hacinamiento y la falta de educación estuvieron asociados con el embarazo adolescente pero no con el inicio de la vida sexual. Conclusiones: Existen múltiples factores asociados con el inicio temprano de vida sexual y con el embarazo adolescente susceptibles de intervención. Este estudio presenta factores clave para generar programas de prevención para esta problemática.

ABSTRACT Introduction: In Colombia, between 2008 and 2014, 23.4% of births were product of adolescent pregnancies, which have serious social, emotional and biological consequences for both the young mother and the baby. Materials and methods: Cross-sectional study with analytical component, with a sample of 13,313 women between 13 and 19 years of age who answered the National Survey of Demography and Health (ENDS) 2010. Bivariate analyzes and multinomial logistic regression analysis were carried out in order to identify individual, home-related, and sexual behavior factors associated with sexual debut and adolescent pregnancy among Colombian adolescents in 2010. Results: Multivariate analysis shown that being older, living together as a couple, having suffered parental violence, and having suffered sexual violence, were risk factors for initiation of sexual life and teenage pregnancy. School attendance was found to be a protective factor for both events. Poverty, overcrowding and lack of education were associated with teen pregnancy but not with sexual debut. Conclusions: There are multiple factors associated with early sexual debut and adolescent pregnancy which are susceptible to intervention. This study presents key factors to generate prevention programs for these situations.

[Sexual life quality of spinal cord-injured men receiving pharmacological treatment for erectile dysfunction and their partners]. / Calidad de la vida sexual de varones heterosexuales con lesión medular en tratamiento farmacológico para la disfunción eréctil y de sus compañeras.

OBJECTIVE: To assess the quality of sexual life reported by spinal cord-injured men treated with oral drugs for erectile dysfunction (ED) and their female partners. MATERIAL AND METHOD: Men with spinal cord injuries (SCI) complaining of ED and their female partners were evaluated using the Sexual Life Quality Questionnaire (SLQQ), a fully validated instrument in Spain. Two studies were conducted. A transversal study (1) on patients who were already on treatment with phosphodiesterase type 5 inhibitors (PDE5Is) and their partners, with 73 couples providing valid data. An additional prospective study (2) assessed SCI patients naive to PDE5Is in which both the patients and their spouses answered the SLQQ before treatment and after 3 months taking PDE5Is regularly, with 12 couples completing the study. RESULTS: The SLQQ scores of SC injured men on PDE5Is (study 1) were under the remembered pre-lesion level, with lower scores reported by those with complete lesions (P<.2 vs incomplete). Their partners' SLQQ scores were apparently similar to pre-injury times. The SLQQ scores of the patients and their partners were well correlated (r = 0.57, P<.0001), and they both reported high treatment satisfaction. Study 2: Untreated SCI patients reported very low SLQQ scores that were improved by PDE5Is treatment (P<.004), albeit without reaching the pre-injury level. A similar trend was found in their partners. Again both patients and partners reported high treatment satisfaction scores (P <.001). CONCLUSION: The sexual life quality levels of SC injured men on PDE5Is and their able-bodied spouses are well correlated. Both partners report high treatment satisfaction scores.

O aborto e uma história de vida: Cuidar de si, filhos e parceiros em circulação / Abortion and a life story: Taking care of yourself, children and partners in circulation / El aborto y una historia de vida: cuidarse de sí, hijos y parejas en circulación

Resumo Este artigo pretende discutir, a partir de um relato biográfico, a prática de aborto em contexto popular enquanto estratégia de cuidar de si. Para tanto, analisa a história de vida de Helena, uma mulher de camada popular, marcada pela violência de gênero e a desigualdade social. Trata das leituras e das práticas de eventos da vida sexual e reprodutiva como "regra", "fazer descer", "abortar", "ter filhos" e "ter companheiro", com o intuito de compreender o manejo empreendido entre códigos hegemônicos, usos cotidianos e modos de sobrevivência da solidão e da violência.

Abstract This article discusses the practice of abortion in a popular context as a strategy of caring for oneself, by analyzing the life story of Helena, a working class woman whose trajectory is marked by gender violence and social inequality. It deals with the understanding and practices of sexual and reproductive life events, such as "menses", "provoking menstruation", "abortion", "having children" and "having a partner", in order to understand the management undertaken at the intersection of hegemonic codes, daily practices, and modes of surviving solitude and violence.

Resumen Este artículo pretender discutir, a partir de una biografía, la práctica del aborto en un contexto popular como uno de los modos de una cuidarse a sí misma. Por eso, analiza la historia de vida de Helena, una mujer de estrato popular, marcada por la violencia de género y por la desigualdad social. Por eso, son abordadas las interpretaciones de eventos de la vida sexual y reproductiva como la "regla", "hacer bajar la menstruación", "abortar", "tener hijos" y "estar en pareja", para comprender el manejo de códigos sociales hegemónicos, sus usos cotidianos y modos de sobrevivencia a la solitud y a la violencia.

Erectile dysfunction in patients with chronic pain treated with opioids. / Disfunción eréctil en pacientes con dolor crónico tratados con opioides.

INTRODUCTION AND OBJECTIVE: Chronic pain is associated with comorbidities that have an impact on the quality of life of patients and, among others, affect their sexual functioning. One of the most relevant side effects of opioid analgesics is erectile dysfunction (ED), due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels. To evaluate ED and effectiveness of treatment in men with chronic pain treated with long-term opioids. MATERIAL AND METHODS: Prospective observational study lasting 3 years, where the intensity of pain (visual analogue scale, 0-10cm), erectile function (IIEF-EF, range 1-30 points), quality of life (EQ-VAS, 0-100mm), quality of sexual life (MSLQ-QOL, 0-100 points), anxiety/depression (HAD, 0-21 points) and testosterone levels, was assessed in patients who reported sexual dysfunction (ED or libido modification). A 6-month follow-up was applied to each patient after administering the usual treatment in the Andrology Unit. The study was approved by the Clinical Research Ethics Committee and data were statistically analyzed with the GraphPad Prism 5 software. RESULTS: ED was observed in 27.6% of patients (n=105, 57±12.2 years, mean dose of morphine equivalent=107.1±107.9mg/day, 84.3% adjuvant analgesics). After 6 months, 42% of patients showed a significant improvement after being treated with iPDE5 (48.5%) and/or testosterone gel (81.8%), with a resolution rate of 31% (p=0.000). A positive correlation was observed between the improvement of IIEF and quality of sexual life (55.5±25.7 points, p=0.000), as well as anxiety (7.4±4.3 points, p=0.048). No significant changes were observed in the levels of testosterone, in the levels of pain nor in the quality of life, which remained moderate. CONCLUSIONS: Erectile function and quality of sexual life, as well as anxiety, improved in patients treated chronically with opioids after administering andrological treatment. The management of patients with pain should include a review of their sexual health history given the significant emotional impact posed to the patient, the impact on their overall quality of life and its good clinical response to an interdisciplinary treatment.

Influence of Dyslipidemia on the Quality of Sexual Life in Women in the Menacme using a Combined Oral Contraceptive / Influência da dislipidemia na qualidade de vida sexual de mulheres na menacme usando contraceptivos orais combinados

ABSTRACT Purpose: Female sexual dysfunction is a complex and common condition that affects women, and the relationship between sexual function and dyslipidemia is poorly studied. This study aims to assess this relationship in the reproductive life women in the menacme who use combined oral contraceptives (COCs) . Methods: A total of 49 healthy women who were sexually active received COC pills that contained ethinylestradiol 30 mcg (EE30) plus levonorgestrel 150 mcg (LNG150). The women were divided into two groups according to their lipid profiles. Dyslipidemia was defined as a high-density lipoprotein (HDL) level < 50 mg/dL or a low-density lipoprotein (LDL) level > 130 mg/dL. Sexual function was assessed using the Female Sexual Function Index (FSFI) Questionnaire. Lipid and lipoprotein parameters were obtained at baseline and after the sixth cycle. Results: After six cycles of the COCs, the total cholesterol and LDL cholesterol levels in the women with a LDL level > 130 mg/dL decreased by 14.7% and 22.1% respectively. In the women with a HDL level < 50 mg/dL at baseline, the HDL level increased by 15.5% at the end of the study. The arousal and orgasm domains and the FSFI total scores significantly increased in women with and without dyslipidemia. The desire and satisfaction domains increased only in the group without dyslipidemia at the end of the treatment period. Conclusions: The EE30/LNG150 formulation increased the sexual function and it was only positively correlated with the HDL cholesterol level. These data indicated a low correlation between sexual function and the changes in the lipid and lipoprotein metabolism.

RESUMO Objetivo: Disfunção sexual feminina é uma condição complexa acomete as mulheres, e a relação entre a função sexual e a dislipidemia é muito pouco estudada. Este estudo objetivou avaliar esta relação em mulheres na menacme que fazem uso de contraceptivos orais combinados (COCs). Métodos: Um total de 49 mulheres saudáveis com vida sexual ativa receberam pílulas anticoncepcionais contendo etinilestradiol 30 mcg (EE30) associado a levonorgestrel 150 mcg (LNG150). As mulheres foram divididas em dois grupos, de acordo com o perfil lipídico. Dislipidemia foi definida como nível de lipoproteína de alta densidade (HDL) < 50 mg/dL, ou nível de lipoproteína de baixa densidade (LDL) > 130 mg/dL. A função sexual feminina foi avaliada utilizando o questionário de Índice de Função Sexual Feminina (IFSF). O IFSF e os parâmetros lipídicos e lipoproteicos foram obtidos no início e após o sexto ciclo do estudo. Resultados: Após seis ciclos de uso dos COCs, as mulheres com LDL > 130 mg/dL, tiveram redução dos níveis de colesterol total e colesterol LDL de 14,7% e 22,1% respectivamente. Nas mulheres com níveis HDL < 50 mg/dL no momento basal, o nível de HDL aumentou 15,5% ao final do estudo. Os domínios de excitação, orgasmo e os escores totais do IFSF aumentaram significativamente nas mulheres com e sem dislipidemia. Os domínios de desejo e satisfação aumentaram no final do período de tratamento exclusivamente no grupo sem dislipidemia. Conclusões: A formulação EE30/LNG150 aumentou a função sexual das mulheres, sendo positivamente correlata somente com os níveis de colesterol HDL. Estes achados demonstram baixa correlação entre a função sexual e as alterações no metabolismo lipídico e lipoproteico.

Infecção do trato urinário em mulheres com vida sexual ativa / Urinary tract infection in women with active sex life

As infecções do trato urinário (ITUs) estão entre as queixas mais frequentes em consultas de atendimento primário, principalmente entre mulheres. As ITUs ocorrem em 1% a 3% das meninas em idade escolar, com aumento acentuado da incidência com o início da atividade sexual. Calcula-se uma incidência anual de 7% em mulheres de todas as idades, atingindo um pico máximo entre 15 e 24 anos de idade e entre mulheres com mais de 65 anos. Escherichia coli e Staphylococcus saprophyticus estão envolvidos em cerca de 80% das infecções urinárias não complicadas encontradas na população. O aumento da resistência aos antibióticos reforça a necessidade da escolha do medicamento com o auxílio de cultura e sensibilidade bacterianas. A profilaxia da ITU está recomendada em determinados casos, principalmente em mulheres que apresentam recorrência; dentre elas estão as sexualmente ativas.

Urinary tract infections (UTIs) are the most common complaint in primary care appointment, mainly for women. UTI occurs between 1% and 3% of school-age children with increasing incidence due to the beginning of sexual life. It is estimated an incidence of 7% in women of all ages reaching the highest peak between the ages of 15-24 and more than 65 years old. Escherichia coli and Staphylococcus are involved in about 80% of uncomplicated urinary infections in population. The increasing antibiotic resistance supports the necessity of medicament choice with bacterial culture and sensitivity assistance. Prophylaxis for urinary tract infections (UTIs) is recommended in some cases, mainly for women who show recurrence; among those that are sexually active.

Mujer posmenopáusica. ¿Fin de la vida sexual? / Post menopausal woman. End of sexual life?

Introducción: la etapa del climaterio y la menopausia ha sido motivo de menciones históricas, literarias y culturales, a pesar de que en muchas ocasiones es ignorada y hasta subestimada por las mujeres y por muchos profesionales. Objetivos: identificar los cambios en la respuesta sexual después de la menopausia. Material y Métodos: se realizó un estudio descriptivo de corte transversal a 223 mujeres posmenopáusicas, en el consultorio No. 6 del Policlínico «Federico Capdevila¼. En el período comprendido entre septiembre del 2008 y febrero del 2009 fueron seleccionadas las pacientes mediante la revisión de fichas familiares. Se escogieron como criterios de inclusión el consentimiento informado, ser residente del área, no tener trastornos cognitivos ni depresivos. Se aplicó una encuesta, la muestra estuvo constituida por 223 mujeres, de un universo de 263. Resultados: prevalecieron las mujeres posmenopáusicas con prácticas sexuales, en el subgrupo de 65 a 69 años, la edad promedio de la menopausia quedó entre los 50 y 54 años, y lo que más se modificó de la respuesta sexual fue la fase del deseo, siendo esta la principal causa de prácticas sexuales no satisfactorias. Conclusiones: se demuestra que en esta etapa de la vida, la mujer sigue teniendo deseos y relaciones sexuales satisfactorias, y que la solidez y la comunicación con su pareja son vitales para una relación feliz en este período final de la vida.

Introduction: climacteric and menopausal period has been historically, literally and culturally mentioned, and in other cases ignored and even underestimated by women and professionals. Objective: identifying changes in sexual response after menopause. Material and methods: a descriptive transversal cut study was performed on 223 postmenopausal women from Doctor's office 6 belonging to Federico Capdevila Polyclinic. Women were selected after revising their medical records in a period between September 2008 and February 2009. Inclusion criteria comprised informed consent, to live in the health area, and not to have cognitive or depressive disorders. A survey was done to a universe of 263 and only 223 constituted the sample. Results: postmenopausal women having sexual relations prevailed in the 65 to 69 year-old group; average age for menopause period was determined to be between 50 and 54 years old, and what changed the most in the sexual response was the desire phase, which is the main cause of the non satisfactory sexual practices. Conclusions: the results revealed that at this point women still want and have satisfactory sexual relations in which the communication with their partners and firmness of the relationship are vital to have a happy kinship in this final stage of life.

Mujer posmenopáusica. ¿Fin de la vida sexual? / Post menopausal woman. End of sexual life?

Introducción: la etapa del climaterio y la menopausia ha sido motivo de menciones históricas, literarias y culturales, a pesar de que en muchas ocasiones es ignorada y hasta subestimada por las mujeres y por muchos profesionales. Objetivos: identificar los cambios en la respuesta sexual después de la menopausia.Material y Métodos: se realizó un estudio descriptivo de corte transversal a 223 mujeres posmenopáusicas, en el consultorio No. 6 del Policlínico Federico Capdevila. En el período comprendido entre septiembre del 2008 y febrero del 2009 fueron seleccionadas las pacientes mediante la revisión de fichas familiares. Se escogieron como criterios de inclusión el consentimiento informado, ser residente del área, no tener trastornos cognitivos ni depresivos. Se aplicó una encuesta, la muestra estuvo constituida por 223 mujeres, de un universo de 263.Resultados: prevalecieron las mujeres posmenopáusicas con prácticas sexuales, en el subgrupo de 65 a 69 años, la edad promedio de la menopausia quedó entre los 50 y 54 años, y lo que más se modificó de la respuesta sexual fue la fase del deseo, siendo esta la principal causa de prácticas sexuales no satisfactorias.Conclusiones: se demuestra que en esta etapa de la vida, la mujer sigue teniendo deseos y relaciones sexuales satisfactorias, y que la solidez y la comunicación con su pareja son vitales para una relación feliz en este período final de la vida(AU)

Introduction: climacteric and menopausal period has been historically, literally and culturally mentioned, and in other cases ignored and even underestimated by women and professionals. Objective: identifying changes in sexual response after menopause. Material and methods: a descriptive transversal cut study was performed on 223 postmenopausal women from Doctor's office 6 belonging to Federico Capdevila Polyclinic. Women were selected after revising their medical records in a period between September 2008 and February 2009. Inclusion criteria comprised informed consent, to live in the health area, and not to have cognitive or depressive disorders. A survey was done to a universe of 263 and only 223 constituted the sample. Results: postmenopausal women having sexual relations prevailed in the 65 to 69 year-old group; average age for menopause period was determined to be between 50 and 54 years old, and what changed the most in the sexual response was the desire phase, which is the main cause of the non satisfactory sexual practices. Conclusions: the results revealed that at this point women still want and have satisfactory sexual relations in which the communication with their partners and firmness of the relationship are vital to have a happy kinship in this final stage of life(AU)