Assuntos
Defeitos do Tubo Neural , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Lactente , Masculino , Defeitos do Tubo Neural/classificação , Defeitos do Tubo Neural/complicações , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/terapia , Centros de Atenção Terciária , Incontinência Urinária/etiologia , Incontinência Urinária/terapiaRESUMO
The frequency of female sexual dysfunction increases with age, and the menopausal transition has a negative effect on the sexuality. Pharmacological treatment options for female sexual dysfunction during the peri- and post-menopause include hormone therapy or sildenafil. A limited number of randomized, controlled trials have been conducted and evidence suggests that systemic hormone therapy with estrogen, estrogen/progesterone, estrogen/testosterone and tibolone have a positive impact on sexual dysfunction during the peri- and postmenopause. Further, there is evidence that treatment with local estrogen relieves vaginal dryness and dyspareunia. Recent knowledge on side effects related to hormone therapy necessitates careful evaluation of the indication for hormone therapy and the duration of postmenopausal hormone therapy should be as short as possible. Long-term side effects of testosterone have not yet been fully investigated. A positive effect of sildenafil has been observed in a limited group of women; those with arousal problems but with no desire problems. The results suggest an intensified focus on new pharmaceutical products for the treatment of female sexual dysfunction in the postmenopause. For the time being the effect of testosterone therapy and tibolone on female sexual dysfunction is being investigated. Sexual dysfunction in women (Female Sexual Dysfunction, FSD) is multi-factorial and influenced by physiological, psychological, social and emotional factors. FSD is defined in four diagnostic groups: desire-, arousal-, orgasm- and pain problems. Recently, it has been suggested that the woman herself should assess the dysfunction as distressful to be diagnosed as having a sexual dysfunction [1]. There are only a limited number of well-conducted population surveys on the prevalence of FSD. Further, relatively few randomized, controlled trials of pharmacological treatment of FSD have been carried out.
Assuntos
Menopausa , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Disfunções Sexuais Psicogênicas/tratamento farmacológico , 3',5'-GMP Cíclico Fosfodiesterases/antagonistas & inibidores , Antagonistas de Androgênios/uso terapêutico , Estradiol/sangue , Terapia de Reposição de Estrogênios , Estrogênios/administração & dosagem , Estrogênios/sangue , Estrogênios/fisiologia , Feminino , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Norpregnenos/uso terapêutico , Perimenopausa , Piperazinas/uso terapêutico , Purinas , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Citrato de Sildenafila , Sulfonas , Testosterona/administração & dosagem , Testosterona/uso terapêutico , Vagina/efeitos dos fármacosRESUMO
The frequency of female sexual dysfunction increases with age, and the menopause has a negative influence on sexual life. Pharmacological treatment options of female sexual dysfunctions in the menopause include hormone therapy and sildenafil. Few randomised controlled studies have been done, and there is evidence suggesting that systemic hormone therapy, such as estrogen, estrogen/progesterone, estrogen/testosterone and tibolone, has a positive impact on sexual dysfunction in the menopause. There is evidence that local estrogen relieves vaginal dryness and dyspareunia. The recent discoveries of the side effects of hormone therapy necessitate careful evaluation of the indication for hormone therapy, and the duration of treatment is recommended to be as short as possible. The long-term side effects of testosterone in women have not yet been fully investigated. Sildenafil has shown a positive effect on female sexual dysfunction only in a limited group of women: those with arousal problems without desire problems. This result demands a focus on new pharmaceutical products, and at present the effect of testosterone and selective estrogen receptor modulators on female sexual dysfunction is being investigated.
