Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(6):312-321
DOI 10.1590/S0100-72032008000600008
Sexual dysfunction prevalence is high among women. However, doctors rarely ask about their patients' sexual life, because they feel uncomfortable or because their knowledge about investigation techniques is insufficient. The PLISSIT model, a useful tool to access human sexual function, is composed by four elements: permission, limited information, specific suggestions, and intensive therapy, that favor dialogue between the doctor and the patient allowing the access to the sexual complaints. The therapeutics consists of counseling measures, drug prescription, basic orientations about sexual function and interventions on anatomic and functional aspects of the sexual apparatus with positive impact in the woman's sexual life. The present review shows how to use it. In addition, many aspects of female sexual dysfunction are discussed, such as prevalence, diagnostic and treatment options for female sexual dysfunction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):580-587
DOI 10.1590/S0100-72032007001100006
PURPOSE: to investigate women’s age at their first sexual intercourse and its correlation with their present age, human papillomavirus (HPV) infection and cytological abnormalities at Pap smear. METHODS: women from the general population were invited to be screened for cervical cancer and pre-malignant lesions. After answering a behavior questionnaire, they were submitted to screening with cervical cytology and high-risk HPV testing with Hybrid Capture 2 (HC2). This report is part of the Latin American Screening (LAMS) study, that comprises centers from Brazil and Argentina, and the data presented herein refer to the Brazilian women evaluated at the cities of Porto Alegre, São Paulo and Campinas. RESULTS: from 8,649 women that answered the questionnaire, 8,641 reported previous sexual activity and were included in this analysis. The mean age at the interview was 38.1±11.0 years and the mean age at the first sexual intercourse was 18.5±4.0 years. The age at the first sexual intercourse increased along with the age at the interview, i.e., younger women reported they had begun their sexual life earlier than older women (p<0.001). From the total of women who had already begun having sexual intercourse, 3,643 patients were tested for high-risk HPV infection and 17.3% of them had positive results. In all the centers, it became clear that the women with the first sexual intercourse at ages below the mean age of all the population interviewed presented higher rates of HPV infection (20.2%) than the women with the first sexual intercourse at ages above the mean (12.5%) - Odds Ratio (OR) 1.8 (IC95% 1.5-2.2;p<0,001). According to the cytology, the women with first sexual intercourse at ages under the mean, presented higher percentage of abnormal cytology > or = ASC-US (6.7%) than the women with the first sexual intercourse at ages above the mean (4.3%) - OR 1.6 (IC95% 1.3-2.;p<0.001). CONCLUSIONS: the high-risk HPV infection and cytological abnormalities identified during the asymptomatic population screening were significantly associated to the women’s age at the first sexual intercourse. Additionally, we have also identified that the women’s age at the first sexual intercourse has decreased during the last decades, suggesting an important contribution to the increase of HPV infection and the subsequent cervical lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):519-524
DOI 10.1590/S0100-72032007001000005
PURPOSE: to identify the impact of pelvic reconstructive surgery on female sexual function, as well as the changes in vaginal anatomy, and to detect possible correlations between them. METHODS: a prospective, descriptive study, including 43 sexually active women with genital dystopy, undergoing surgery for pelvic organ prolapse, conducted between October 2004 and September 2006. The women completed the same multiple-choice questionnaire regarding sexual function, and analogic scales to quantify the degree of desire, arousal and satisfaction, and were clinically assessed using the pelvic organ prolapse quantification (POP-Q) staging system, before the surgery and three and six months after it. Statistical analysis was performed through the Bowker test for symmetry, Wilcoxon test, Student t test, chi2 and analysis of variance (ANOVA) as appropriate, with statistical significance set at 5% (p<0.05). RESULTS: all 43 women completed the follow-up at three and six months after the surgery, but two of them lost their partners after the surgery. Quality of sexual life improved significantly (p=0.03). Symptoms such as dyspareunia (25.6% before versus 17.1% after surgery), discomfort (27.9 versus 0%), embarrassment (20.9% versus 0%) and fear (2.3% versus 0%) significantly improved (p<0.001). Analogical scales scores regarding desire (5 versus 7, p=0.001), arousal (6 versus 8, p<0.001) and satisfaction with sexual life (5 versus 7, p<0.001) also improved. There was a statistically significant improvement (p<0.001) of the POP-Q stages after the surgery. However, there was no statistically significant correlation between changes in vaginal dimensions and changes in sexual function. CONCLUSIONS: after pelvic reconstructive surgery, there was a significant improvement in the quality of sexual life and of the POP-Q stages. However, there was no correlation between them.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(2):139-146
DOI 10.1590/S0100-72032004000200009
PURPOSE: to evaluate whether oral and vaginal sex practice, with or without exposure to semen, decrease the occurrence of recurrent spontaneous abortion. METHOD: this was a case-control study carried out between May 2000 and April 2003. A questionnaire was applied analyzing the clinical, obstetric and sexual history of women, who were divided into two groups: a case group comprised 116 patients with a history of at least two spontaneous abortions, without previous pregnancy longer than 22 weeks, and a control group that included 241 women with history of one or more term pregnancies with live birth and no miscarriage. The analyzed variables included the number of sexual partners, condom use, oral sex practice, and the exposure of female oral mucosa to semen. RESULTS: in the control group 38.8%, and in the patients group 35.7% of the women had only one partner. In both groups about 75% of the women reported that the partners did not use condom. Approximately 55% of the women of both groups referred oral sex practice, and 13.8% of those with recurrent abortion and 20.3% with a history of successful pregnancies had oral mucosa exposed to semen. There was no difference between the patients with recurrent abortion and women with successful pregnancies regarding number of sexual partners, use of condom, practice of oral sex, and exposure of oral mucosa to the partner's semen. CONCLUSION: our results did not confirm the hypothesis that sexual behavior influences the occurrence of spontaneous abortion.