Role of the different sexuality domains on the sexual function of women with premature ovarian failure.

INTRODUCTION: Women with premature ovarian failure (POF) often manifest complaints involving different aspects of sexual function (SF), regardless of using hormone therapy. SF involves a complex interaction between physical, psychological, and sociocultural aspects. There are doubts about the impact of different complaints on the global context of SF of women with POF. AIM: To evaluate the percentage of influence of each of the sexuality domains on the SF in women with POF. METHODS: Cross-sectional study with 80 women with POF, matched by age to 80 women with normal gonadal function. We evaluated SF through the "Female Sexual Function Index" (FSFI), a comparison between the POF and control groups using the Mann-Whitney test. Component exploratory factor analysis was used to assess the proportional influence of each domain on the composition of the overall SF for women in the POF group. MAIN OUTCOME MEASURES: SF was evaluated using FSFI. Exploratory Factor Analysis for components was used to evaluate the role of each domain on the SF of women with POF. RESULTS: The FSFI score was significantly worse for women with POF, with a decrease in arousal, lubrication, orgasm, satisfaction, and dyspareunia. Exploratory factor analysis of SF showed that the domain with greater influence in the SF was arousal, followed by desire, together accounting for 41% of the FSFI. The domains with less influence were dyspareunia and lubrication, which together accounted for 25% of the FSFI. CONCLUSION: Women with POF have impaired SF, determined mainly by changes in arousal and desire. Aspects related to lubrication and dyspareunia complaints have lower determination coefficient in SF. These results are important in adapting the approach of sexual disorders in this group of women.

Papillary squamous cell carcinoma of the uterine cervix, high-risk human papilloma virus infection and p16(INK4a) expression: a case report.

BACKGROUND: Papillary squamous cell carcioma is rare form of squamous cell carcinoma of the uterine cervix occurring in women in the sixth decade of life and is frequently misdiagnosed as high-grade intraepithelial lesion. Few reports with cytologic study have been performed, especially with cytology in liquid-based specimens. CASE: A 58-year-old woman who had 8 gestations (no abortions) and mitral cardiopathy treated with coumarin medication was referred for transvaginal bleeding of 20 days' duration. Specular examination showed an exophytic, easily bleeding lesion occupying all of the uterine cervix and superior third of the vagina. Liquid-based cytology showed squamous cells, mostly basaloid but some bizarre or in fiber, with clearly atypical nuclei. Second-generation hybrid capture for high-risk human papillomavirus was positive, with a viral load of 404 relative light unit/positive control B, and the tumor expressed p16(INK4a). CONCLUSION: This report adds further experience with liquid-based cytology to the existing conventional and liquid-based cytologic findings, particularly in the Brazilian female population.

Candidíase vulvovaginal recorrente: fisiopatogênese, diagnóstico e tratamento / Recurrent vulvovaginal candidiasis: pathophysiology, diagnosis and treatment

A candidíase vaginal representa uma das ginecopatias mais frequentes, acometendo, pelo menos uma vez na vida, cerca de 75 da população feminina sexualmente ativa. Apesar de sua alta frequência, existem outras doenças vulvovaginais que mimetizam a candidíase vaginal, dificultando o diagnóstico e induzindo a tratamentos inadequados. A candidíase vulvovaginal pode assumir a forma recorrente quando se faz presente por três ou mais episódios agudos no decorrer do período de um ano, desde que apropriadamente diagnosticados (através de exames clínico e microbiológico) e tratados. Este artigo se propõe a revisar os principais tópicos referentes à identificação do fungo, sinais e sintomas, resposta imune vaginal para Candida sp, ação do sêmen sobre a imunidade vaginal, possíveis interferências genéticas e as estratégias de tratamento nos quadros recorrentes. Os autores levam em consideração que habitualmente não existe uma relação direta entre a concentração da cândida na vagina e a expressão dos sintomas clínicos. Outro aspecto considerado é que a maioria das mulheres rotuladas como portadoras de candidíase vulvovaginal recorrente não tem evidência bacterioscópica do fungo na vagina e que essa doença não pode ser distinguida de outras pela sintomatologia.