Sexual dysfunction, physiological Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Impact of pregnancy on female sexual function

    Rev Bras Ginecol Obstet. 2013;35(5):205-209

    Summary

    Original Article

    Impact of pregnancy on female sexual function

    Rev Bras Ginecol Obstet. 2013;35(5):205-209

    DOI 10.1590/S0100-72032013000500003

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    PURPOSE: To investigate the impact of pregnancy on female sexual function. METHODS: An analytical, cross-sectional study was conducted on 181 non-pregnant and 177 pregnant women aged 18 to 45 years. The study included premenopausal, sexually active women with a steady partner and excluded those taking antidepressants or with a diagnosis of depression. Eleven of these women (6.2%) were in the first trimester, 50 (28.2%), in the second trimester and 116 (65.5%), in the third trimester of pregnancy. The evaluation consisted of an interview in which the Female Sexual Function Index (FSFI) was applied. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. The nonparametric Mann-Whitney test was used to compare the mean FSFI values of pregnant and non-pregnant women. RESULTS: Sexual dysfunction was 40.4% among pregnant women and 23.3% among non-pregnant women, with a significant difference between the scores of the studied groups (p=0.01). The difference in the mean global FSFI values between the groups was also significant (p<0.0001). There were significant differences between pregnant and non-pregnant women regarding desire (p<0.0001), excitation (p=0.003), lubrication (p=0.02), orgasm (p=0.005) and satisfaction (p=0.03). The same was not observed regarding pain. CONCLUSION: We conclude that pregnancy negatively influences female sexual function, particularly the desire and excitement domains, revealing the importance of addressing the issue by professionals dealing with pregnant women.

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  • Original Article

    Pelvic floor muscle training in female sexual dysfunctions

    Rev Bras Ginecol Obstet. 2010;32(5):234-240

    Summary

    Original Article

    Pelvic floor muscle training in female sexual dysfunctions

    Rev Bras Ginecol Obstet. 2010;32(5):234-240

    DOI 10.1590/S0100-72032010000500006

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    PURPOSE: to evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunctions. METHODS: twenty-six women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and/or dyspareunia) were included in a clinical trial with a before/after approach . The assessment was carried out before, during (after five sessions) and at the end of the treatment (after ten sessions) by two-digit palpation (assessment of pelvic floor muscle, PFM, strength), intravaginal electromyography (EMG) (capture of PFM contraction amplitudes) and Female Sexual Function Index (FSFI, a questionnaire for the evaluation of sexual function). The women underwent PFMT in different positions for ten sessions (once or twice a week). For statistical analysis, absolute and relative frequencies were used for clinical characteristics and PFM strength. The Friedman test was used to compare the FSFI domain scores and EMG values, the Students t-test was used to determine the association between these values and the characteristics of the women, and the Wilcoxon test for percent modification of the EMG. The Mann-Whitney test permitted us to compare these values with clinical characteristics. The Spearman correlation test was used to correlate the EMG values with mean total score. Results were considered statistically significant if p<0.05. RESULTS: a significant improvement (p<0.0001) of FSFI scores was observed at the end of treatment compared to the values observed before and in the middle of treatment. Regarding the EMG, the amplitudes of tonic and phasic contractions increased significantly during treatment (p<0.0001). Pelvic floor strength increased, which 69% of the women presenting grade 4 or 5 at the end of treatment, with a total improvement of sexual complaints. CONCLUSIONS: the PFMT improved muscle strength and electromyography contraction amplitudes, with improved sexual function, indicating that this physiotherapy approach may be successfully used for the treatment of female sexual dysfunctions.

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    Pelvic floor muscle training in female sexual dysfunctions
  • Original Article

    Prevalence of sexual dysfunction in two women groups of different socioeconomic status

    Rev Bras Ginecol Obstet. 2010;32(3):139-143

    Summary

    Original Article

    Prevalence of sexual dysfunction in two women groups of different socioeconomic status

    Rev Bras Ginecol Obstet. 2010;32(3):139-143

    DOI 10.1590/S0100-72032010000300007

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    PURPOSE: to identify if there is a difference in the prevalence of sexual dysfunction and in the sexual domain scores between a group of women attended at a public service and a group attended at a private service, and to investigate if there is an association between sexual dysfunction, family income and educational status. METHODS: transversal study including 201 sexually active women aged from 18 to 45 years, 90 of them from a public service and 111 from private services. We evaluated age, marital status, use of hormonal contraception, income and educational status, and all women were submitted to the Female Sexual Function Index (FSFI), an instrument for the evaluation of their sexuality. The Statistical Package for Social Sciences, version 15.0, was used for statistical analysis. The χ2 test was applied for categorical variables and the Student's t-test to independent samples. RESULTS: there was no significant difference regarding the prevalence of sexual dysfunction between groups (public versus private) (20 and 23.4%, p=0.5), or concerning the domain scores, desire (3.9±1.3 and 3.8±1.0, p=0.6), sexual arousal (4.5±0.8 and 4.4±0.9, p=0.5), lubrication (5.2±1.2 and 5.0±0.9, p=0.1), orgasm (5.0±1.2 and 4.9±1.1, p=0.5), satisfaction (5.2±1.2 and 5.1±1.0, p=0.9), and pain (5.3±1.1 and 5.2±1.0, p=0.8). Sexual dysfunction was detected in 28% of the women with income between two and four minimum wages, in 17.5% of those with an income of five wages or more, and in 14.3% among those with an income of one wage or less (p=0,1). The dysfunction occurred in 30.2% of women with elementary education, in 24.2% of those with high school education and in 13.4% of those with higher education (p=0.09). CONCLUSIONS: There was no significant difference in the prevalence of sexual dysfunction or in the sexual domain scores between groups, nor was there an association with income or education status.

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  • Original Article

    Sexuality evaluation in women submitted to hysterectomy for the treatment of uterine leiomyoma

    Rev Bras Ginecol Obstet. 2009;31(10):503-507

    Summary

    Original Article

    Sexuality evaluation in women submitted to hysterectomy for the treatment of uterine leiomyoma

    Rev Bras Ginecol Obstet. 2009;31(10):503-507

    DOI 10.1590/S0100-72032009001000006

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    PURPOSE: to evaluate the impact of hysterectomy on the sexuality of women with uterine leiomyoma. METHODS: prospective study including 33 sexually active women, with ages from 35 to 50 years old, with orgasmic experience and with a fit stable partner. All the women were submitted to two instruments for the evaluation or their sexuality: Sexual Quotient - Female Version (SQF) and Sexual Satisfaction Inventory - Female Version (SSIF). Both instruments were applied by the same examiner, before and six months after the hysterectomy. RESULTS: the SQF has shown that 39.4% of the patients presented deterioration in the sexual intercourse, even though there has not been found an association between the SQF results before and after hysterectomy (χ2= 0.6; degree of freedom=12; p=0.05). The mean scores obtained after the application of the SSIF have shown significant deterioration in the following parameters: sexual satisfaction (p=0.03); expression of feminine sensuality (p=0.01); vaginismus/dyspareunia (p=0.02) and anorgasmia (p=0.04). CONCLUSIONS: it seems that hysterectomy has a negative impact on women's sexual life, with reports of decreased libido, arousal and orgasmic capacity.

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  • Review Article

    The assessment and management of female sexual dysfunction

    Rev Bras Ginecol Obstet. 2008;30(6):312-321

    Summary

    Review Article

    The assessment and management of female sexual dysfunction

    Rev Bras Ginecol Obstet. 2008;30(6):312-321

    DOI 10.1590/S0100-72032008000600008

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    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.

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    The assessment and management of female sexual dysfunction

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