Sexuality Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):409-413
DOI 10.1590/S0100-72032012000900004
PURPOSE: To evaluate, in healthy women in the second trimester of pregnancy, a possible association between sexual function and quality of life, and between sexual function and sexual satisfaction. METHODS: This cross-sectional study involved 51 pregnant women managed at a low-risk antenatal care clinic. Sexual function was evaluated through the Sexual Quotient - Female Version (QS-F) questionnaire. Quality of life and sexual satisfaction were evaluated though the brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-bref). Inclusion criteria were pregnancy between 15-26 weeks, maternal age 20 or more years, at least five years of scholling, in a relationship with a single partner for the last 6 months, having sexual intercourse with vaginal penetration in the last 15 days. We excluded women with a history of sexual violence, previous or current depression, habitual abortion or obstetric complications in the index pregnancy (premature rupture of membranes, preterm labor or hemorrhage). The χ² and Fisher exact tests were used for statistical analyses and p<0.05 was considered significant. RESULTS: Most of the participants (64.8%) obtained "regular to excellent" grades on the QS-F and 58.8% classified their quality of life as "good". As to sexual satisfaction, 35.3 and 15.7% declared that they were "satisfied" and "very satisfied" with their sexual life, respectively. The study detected significant associations between "bad to poor" QS-F grades with a "poor" quality of life (p=0.002), and with "regular to good" and "good to excellent" QS-F grades with "satisfaction" or "high" sexual satisfaction" (p<0.001). CONCLUSIONS: Sexual function is associated with quality of life and with sexual satisfaction in healthy women in the second trimester of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):409-413
DOI 10.1590/S0100-72032012000900004
PURPOSE: To evaluate, in healthy women in the second trimester of pregnancy, a possible association between sexual function and quality of life, and between sexual function and sexual satisfaction. METHODS: This cross-sectional study involved 51 pregnant women managed at a low-risk antenatal care clinic. Sexual function was evaluated through the Sexual Quotient - Female Version (QS-F) questionnaire. Quality of life and sexual satisfaction were evaluated though the brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-bref). Inclusion criteria were pregnancy between 15-26 weeks, maternal age 20 or more years, at least five years of scholling, in a relationship with a single partner for the last 6 months, having sexual intercourse with vaginal penetration in the last 15 days. We excluded women with a history of sexual violence, previous or current depression, habitual abortion or obstetric complications in the index pregnancy (premature rupture of membranes, preterm labor or hemorrhage). The χ² and Fisher exact tests were used for statistical analyses and p<0.05 was considered significant. RESULTS: Most of the participants (64.8%) obtained "regular to excellent" grades on the QS-F and 58.8% classified their quality of life as "good". As to sexual satisfaction, 35.3 and 15.7% declared that they were "satisfied" and "very satisfied" with their sexual life, respectively. The study detected significant associations between "bad to poor" QS-F grades with a "poor" quality of life (p=0.002), and with "regular to good" and "good to excellent" QS-F grades with "satisfaction" or "high" sexual satisfaction" (p<0.001). CONCLUSIONS: Sexual function is associated with quality of life and with sexual satisfaction in healthy women in the second trimester of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):329-334
DOI 10.1590/S0100-72032012000700007
PURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2 - 3.5); 2.4 (95%CI 1.5 - 4.1); 2.3 (95%CI 1.4 - 3.8), and 2.2 (95%CI 1.3 - 3.6) times higher, respectively, compared to those without any risk. CONCLUSION: Climacteric symptoms seem to influence the sexual function in middle-aged women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):329-334
DOI 10.1590/S0100-72032012000700007
PURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2 - 3.5); 2.4 (95%CI 1.5 - 4.1); 2.3 (95%CI 1.4 - 3.8), and 2.2 (95%CI 1.3 - 3.6) times higher, respectively, compared to those without any risk. CONCLUSION: Climacteric symptoms seem to influence the sexual function in middle-aged women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(5):219-224
DOI 10.1590/S0100-72032011000500003
To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Student's t and X² tests were used to compare differences between groups and p<0.05 was considered significant. RESULTS: The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). CONCLUSIONS: The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(5):219-224
DOI 10.1590/S0100-72032011000500003
To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Student's t and X² tests were used to compare differences between groups and p<0.05 was considered significant. RESULTS: The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). CONCLUSIONS: The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):503-507
DOI 10.1590/S0100-72032009001000006
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(10):503-507
DOI 10.1590/S0100-72032009001000006
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(2):61-67
DOI 10.1590/S0100-72032009000200003
PURPOSE: to evaluate the quality of life and sexuality features of women with breast cancer, according to the type of surgery they underwent and their sociodemographic characteristics. METHODS: transversal study with 110 women treated for breast cancer, for at least one year in the Centro de Atenção Integral à Saúde da Mulher of UNICAMP. The quality of life was assessed by the WHOQOL-bref questionnaire, and the issues on sexuality, by a specific questionnaire in which Cronbach's Alpha coefficient was used to validate the concordance of responses (alpha=0.72) and the technique of factor analysis, with the criterion of self value and variance maximum rotation, resulting in two components: intrinsic or intimacy ( how the woman sees herself sexually) and extrinsic or attractiveness (how the woman believes the others see her sexually). Sociodemographic variables have been assessed according to the WHO questionnaire, and the sexuality components, through the Kruskal-Wallis followed by the Mann-Whitney's test and Spearman correlation test. RESULTS: age, schooling, type of surgery and lapse of time from the surgery did not influence the quality of life concerning physical, environmental, and psychological aspects, as well as the social relationships. Women with a stable marital relationship got higher scores in the psychological area (p=0.04) and in the area of social relationships (p=0.02). Higher socioeconomic level influenced the quality of life concerning physical appearance (p=0.01) and environment (p=0.002). Regarding the sexuality, age had influence in the extrinsic component (p=0.0158). Women with a stable marital relationship had higher scores of quality of life in both components of sexuality. Higher schooling influenced in a positive way the intrinsic factor. Women submitted to quadrantectomy or mastectomy with immediate breast reconstruction showed higher scores relating to attractiveness in comparison to mastectomized women without reconstruction. CONCLUSIONS: better socioeconomic level and better schooling, stable marital relationship and surgery with breast conservation are linked to better rates of quality of life, including sexuality.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(2):61-67
DOI 10.1590/S0100-72032009000200003
PURPOSE: to evaluate the quality of life and sexuality features of women with breast cancer, according to the type of surgery they underwent and their sociodemographic characteristics. METHODS: transversal study with 110 women treated for breast cancer, for at least one year in the Centro de Atenção Integral à Saúde da Mulher of UNICAMP. The quality of life was assessed by the WHOQOL-bref questionnaire, and the issues on sexuality, by a specific questionnaire in which Cronbach's Alpha coefficient was used to validate the concordance of responses (alpha=0.72) and the technique of factor analysis, with the criterion of self value and variance maximum rotation, resulting in two components: intrinsic or intimacy ( how the woman sees herself sexually) and extrinsic or attractiveness (how the woman believes the others see her sexually). Sociodemographic variables have been assessed according to the WHO questionnaire, and the sexuality components, through the Kruskal-Wallis followed by the Mann-Whitney's test and Spearman correlation test. RESULTS: age, schooling, type of surgery and lapse of time from the surgery did not influence the quality of life concerning physical, environmental, and psychological aspects, as well as the social relationships. Women with a stable marital relationship got higher scores in the psychological area (p=0.04) and in the area of social relationships (p=0.02). Higher socioeconomic level influenced the quality of life concerning physical appearance (p=0.01) and environment (p=0.002). Regarding the sexuality, age had influence in the extrinsic component (p=0.0158). Women with a stable marital relationship had higher scores of quality of life in both components of sexuality. Higher schooling influenced in a positive way the intrinsic factor. Women submitted to quadrantectomy or mastectomy with immediate breast reconstruction showed higher scores relating to attractiveness in comparison to mastectomized women without reconstruction. CONCLUSIONS: better socioeconomic level and better schooling, stable marital relationship and surgery with breast conservation are linked to better rates of quality of life, including sexuality.
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. 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. 2005;27(3):118-124
DOI 10.1590/S0100-72032005000300004
PURPOSE: to evaluate the effects of the association of estrogen and androgen on the quality of life and sexuality of women during climacterium. METHODS: ninety-six postmenopausal women with vasomotor symptoms and sexual dysfunction were included. The participants were randomly divided into three treatment groups with 32 pacients each: placebo, conjugated equine estrogens (CEE) (0.625 mg per day) and CEE (0.625 mg per day) associated with methyltestosterone (2.5 mg per day). The length of the treatment period was three months. The Women Health Questionnaire (WHQ) and the Modified Sexuality Questionnaire were applied to evaluate the quality of life and sexuality before and after the treatment. Some parameters of cardiovascular risk, endometrial echo and hepatic toxicity were evaluated. ANOVA was used for data analysis followed by the Fisher test and the Shapiro-Wilk post hoc test. RESULTS: the improvement in WHQ parameters was significant in the hormonal treatment groups (CEE and CEE + methyltestosterone) compared to the placebo group. However, there were no differences in somatic symptoms among the three groups. The association of estrogen with androgen significantly improved sexual function (score (mean): 64 vs 67, p<0.05) and depressive humor (score (mean): 75 vs 80, p<0.05) compared to estrogen alone. This therapy also presented a large number of WHQ questions with a high score (p<0.05). The use of CEE associated with methyltestosterone decreased the total cholesterol (212±42 and 194±43, before and after the treatment, respectively) and HDL colesterol (56±16 and 48±14, before and after the treatment, respectively), and slightly increased the endometrial echo (4.7±2.3 and 5.5±2.3, before and after the treatment, respectively). No signifcant changes in liver enzymes during the treatment period was detected. CONCLUSIONS: estrogen associated with methyltestosterone resulted in significant improvement in the quality of life and sexuality of postmenopausal women. This effect was superior to estrogen alone and placebo. The effect of treatment with the estrogen-androgen association was evident regarding depressive humor and sexual function questions of the WHQ.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(3):118-124
DOI 10.1590/S0100-72032005000300004
PURPOSE: to evaluate the effects of the association of estrogen and androgen on the quality of life and sexuality of women during climacterium. METHODS: ninety-six postmenopausal women with vasomotor symptoms and sexual dysfunction were included. The participants were randomly divided into three treatment groups with 32 pacients each: placebo, conjugated equine estrogens (CEE) (0.625 mg per day) and CEE (0.625 mg per day) associated with methyltestosterone (2.5 mg per day). The length of the treatment period was three months. The Women Health Questionnaire (WHQ) and the Modified Sexuality Questionnaire were applied to evaluate the quality of life and sexuality before and after the treatment. Some parameters of cardiovascular risk, endometrial echo and hepatic toxicity were evaluated. ANOVA was used for data analysis followed by the Fisher test and the Shapiro-Wilk post hoc test. RESULTS: the improvement in WHQ parameters was significant in the hormonal treatment groups (CEE and CEE + methyltestosterone) compared to the placebo group. However, there were no differences in somatic symptoms among the three groups. The association of estrogen with androgen significantly improved sexual function (score (mean): 64 vs 67, p<0.05) and depressive humor (score (mean): 75 vs 80, p<0.05) compared to estrogen alone. This therapy also presented a large number of WHQ questions with a high score (p<0.05). The use of CEE associated with methyltestosterone decreased the total cholesterol (212±42 and 194±43, before and after the treatment, respectively) and HDL colesterol (56±16 and 48±14, before and after the treatment, respectively), and slightly increased the endometrial echo (4.7±2.3 and 5.5±2.3, before and after the treatment, respectively). No signifcant changes in liver enzymes during the treatment period was detected. CONCLUSIONS: estrogen associated with methyltestosterone resulted in significant improvement in the quality of life and sexuality of postmenopausal women. This effect was superior to estrogen alone and placebo. The effect of treatment with the estrogen-androgen association was evident regarding depressive humor and sexual function questions of the WHQ.