No description available.

The comorbidity between female sexual dysfunction (FSD) and major depressive disorder (MDD) is well documented; however, the mechanism(s) underlying the relationship between these disorders has not been defined. The literature has associated the adrenal hormones cortisol and dehydroepiandrosterone (DHEA) with FSD and MDD, suggesting a biological mechanism that may elucidate the comorbidity between these disorders. Based on evidence pointing to a high cortisol/DHEA ratio (C/D Ratio) in MDD and low DHEA in FSD, this study investigated if the potential association between a high C/D Ratio and FSD would be greater for women with a history of MDD when compared to women without a history of MDD. Two groups of women (MDD history group; control group), each with a range of sexual function, collected saliva samples, completed questionnaires, and participated in a clinical interview and a psychophysiological assessment. Results did not support the hypothesis that the relationship between the C/D Ratio and sexual function would be greater for women with a history of MDD. Relevant to the effects of hormones on sexual function, a higher C/D Ratio was associated with lower frequency of sexual activity and lower sexual assertiveness. Results also showed DHEA positively associated with overall frequency of sexual activity, while cortisol was associated with lower subjective assessment of sexual desire/arousal prior to erotic stimuli. Lastly, secondary analyses revealed a positive association between DHEA and frequency of sexual activity, which was mediated by women's sexual desire. These results suggest that the effects of the C/D Ratio on FSD are not associated with a history of MDD. Results also point to contrasting roles for C/D Ratio and DHEA in FSD. In particular, a high C/D Ratio may have inhibitory effects on frequency of sexual activity and sexual assertiveness, while high DHEA may have facilitatory effects on sexual activity frequency through heightened sexual desire. Lastly, high cortisol may predispose women to have a negative assessment of sexual stimuli. These findings contribute to a further understanding of the roles of the C/D Ratio, DHEA, and cortisol in female sexuality and offer support for future studies investigating the role of these hormones in FSD.

The comorbidity between female sexual dysfunction (FSD) and major depressive disorder (MDD) is well documented; however, the mechanism(s) underlying the relationship between these disorders has not been defined. The literature has associated the adrenal hormones cortisol and dehydroepiandrosterone (DHEA) with FSD and MDD, suggesting a biological mechanism that may elucidate the comorbidity between these disorders. Based on evidence pointing to a high cortisol/DHEA ratio (C/D Ratio) in MDD and low DHEA in FSD, this study investigated if the potential association between a high C/D Ratio and FSD would be greater for women with a history of MDD when compared to women without a history of MDD. Two groups of women (MDD history group; control group), each with a range of sexual function, collected saliva samples, completed questionnaires, and participated in a clinical interview and a psychophysiological assessment. Results did not support the hypothesis that the relationship between the C/D Ratio and sexual function would be greater for women with a history of MDD. Relevant to the effects of hormones on sexual function, a higher C/D Ratio was associated with lower frequency of sexual activity and lower sexual assertiveness. Results also showed DHEA positively associated with overall frequency of sexual activity, while cortisol was associated with lower subjective assessment of sexual desire/arousal prior to erotic stimuli. Lastly, secondary analyses revealed a positive association between DHEA and frequency of sexual activity, which was mediated by women's sexual desire. These results suggest that the effects of the C/D Ratio on FSD are not associated with a history of MDD. Results also point to contrasting roles for C/D Ratio and DHEA in FSD. In particular, a high C/D Ratio may have inhibitory effects on frequency of sexual activity and sexual assertiveness, while high DHEA may have facilitatory effects on sexual activity frequency through heightened sexual desire. Lastly, high cortisol may predispose women to have a negative assessment of sexual stimuli. These findings contribute to a further understanding of the roles of the C/D Ratio, DHEA, and cortisol in female sexuality and offer support for future studies investigating the role of these hormones in FSD.

INTRODUÇÃO: as disfunções sexuais femininas (DSF) são altamente prevalentes na população, e as opções terapêuticas disponíveis ainda constituem desafio para a prática do ginecologista. Este estudo tem como objetivo avaliar os efeitos da terapia cognitivo-comportamental (TCC) em grupo de mulheres com disfunção sexual. MÉTODO: foram incluídas 106 mulheres com diagnóstico de disfunção sexual atendidas no Setor de Sexualidade da Divisão de Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, as quais foram divididas em dois grupos: o primeiro (n=53) submetido a TCC em grupo, com duração de oito encontros; o segundo (n=53) a tratamento expectante. A função sexual foi avaliada pelo quociente sexual feminino (QSF) na entrevista inicial, e após seis meses em ambos os grupos. O poder da amostra foi de 95%. Os resultados foram comparados entre os grupos com o uso de testes de Mann-Whitney. RESULTADOS: ambos os grupos apresentaram características semelhantes quanto à resposta sexual, autoimagem e relacionamento com parceiro na entrevista inicial. O grupo submetido à terapia apresentou melhora significativa na função sexual quando comparado com o grupo controle, tanto pelo resultado global do QSF, com variação média de 18,08 pontos (IC95% 12,87 23,28) para o primeiro contra -0,83 pontos (IC95% -3,43 1,77) do segundo (p<0,001), assim como para os domínios discriminados pelo questionário: Desejo e Interesse (p=0,003), Preliminares (p=0,003), Excitação e Sintonia (p<0,001), Conforto (p<0,001) e Orgasmo e Satisfação (p<0,001). CONCLUSÃO: a TCC em grupo mostrou ser ferramenta eficaz para o tratamento das disfunções sexuais femininas / Introduction: Female Sexual Dysfunction (FSD) have high prevalence, and therapeutic options available are a challenge in gynaecological practice. Objective: to evaluate the effects of group cognitive-behavioral therapy (CBT) for women with sexual dysfunction. Methods: A total of 106 women diagnosed with sexual dysfunctions was equally divided into subjects (n=53), who underwent group CBT for 8 weekly sessions, and controls (n=53), who were given expectant treatment. Assessment of sexual function was carried out at an interview at baseline and at the endpoint after six months using Abdos female sexual quotient questionnaire (FSQ). Results: At baseline both groups had similar characteristics as to sexual response, self-image and relationship with a partner. The women who went into therapy showed significant improvement in sexual function when compared with those in the control group: The FSQ had an average growth of 18.08 points (95%CI: 12.87 to 23.28) in the therapy group against an average decrease of 0.83 points (95%CI: 3.43 to 1.77) among the controls (p<0.001). The five domains discriminated by the questionnaire also showed significant improvement in the therapy group: desire and interest (p=0.003), foreplay (p=0.003), excitation and tuning (p<0.001), comfort (p<0.001), and orgasm and satisfaction (p<0.001). Conclusion: group CBT was shown to be an effective tool for the treatment of female sexual dysfunctions

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No. of bitstreams: 2 Dissertação - Flávia Ligia Silva - 2017.pdf: 2950181 bytes, checksum: 96cad1cc5b7a643197df1d001a42e1d0 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-06-29 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Outro / Introduction: Female sexual dysfunction (FSD) is a complex condition that can be influenced by several factors including psychological, hormonal, vascular and emotional processes, which affects both physical and mental health and women quality of life. FSD is associated with obesity, a low grade inflammatory state that promotes important physiological changes and impairs sexual function. Obesity and FSD are influenced by the practice of physical exercise however, until the present moment, no study has tested the influence of Mat Pilates on the sexual function and quality of life of overweight women. Objectives: To evaluate the influence of a protocol of exercises based on the Mat Pilates method in the symptoms of sexual dysfunction and the quality of life of overweight women as well as their influence on risk factors for cardiovascular diseases. Methods: Twenty-two overweight women with symptoms of sexual dysfunction were divided into two groups: trained group - TG (n = 12), which underwent 12 weeks of training with exercises based on the Mat Pilates method and the control group - CG (n = 10), which did not perform any physical exercise in the intervention period. All participants were evaluated before and after the 12 weeks of intervention by the FSFI and IWQOL-Lite questionnaires. Lipid profile, fasting glycemia and testosterone level were also analyzed. Results: The TG showed improvement in the excitement, orgasm and pain domains, as well as in the FSFI overall score when compared to the CG. Parameters related to the quality of life, including the physical function, sexual life and overall score domains, showed improvement in the TG. The Pilates training did not change the variables of lipid profile and waist circumference, but decreased the body weight of the TG. There was a negative correlation between the physical function domain of the IWQOL - Lite questionnaire and the desire and excitation variables of the FSFI questionnaire. Conclusion: Training with exercises based on the Mat Pilates method during 12-weeks is effective in improving sexual function and quality of life of overweight women regardless of changes in blood parameters such as lipid profile, blood glucose and testosterone level. / Introdução: A disfunção sexual feminina (DSF) é um fenômeno complexo que pode ser influenciado por diversos fatores entre eles psicológicos, hormonais, vasculares e emocionais interferindo tanto na saúde física e mental quanto na qualidade de vida das mulheres. A DSF está associada à obesidade, um estado inflamatório de baixo grau que promove alterações fisiológicas importantes, impedindo uma adequada função sexual. As duas condições são influenciadas pela prática de exercício físico e, não há até o momento, estudos sobre a influência dos exercícios baseados no método Pilates de solo na função sexual e qualidade de vida de mulheres com excesso de peso. Objetivos: Avaliar a influência de um protocolo de exercícios baseados no método Pilates de solo nos sintomas de disfunção sexual e na qualidade de vida de mulheres com excesso de peso bem como sua influência em fatores de risco para doenças cardiovasculares como medida de cintura e perfil lipídico. Métodos: Foram selecionadas 22 mulheres com sintomas de disfunção sexual e excesso de peso e divididas em dois grupos: grupo treinado - GT (n=12) que realizou 12 semanas de treinamento com exercícios baseados no método Pilates de solo e grupo controle – GC (n=10) que não realizou nenhum exercício físico no período de intervenção. Todas as participantes foram avaliadas antes e após as 12 semanas de intervenção pelos questionários FSFI e IWQOL- Lite, e além disso, foram realizadas as análises de perfil lipídico, glicemia de jejum e nível de testosterona. Resultados: O GT apresentou melhora nos domínios de excitação, orgasmo, dor e no escore geral total do FSFI em comparação ao GC. Quanto à qualidade de vida, o GT apresentou melhora nos domínios de função física, vida sexual e no escore total. O treinamento não alterou as variáveis de perfil lipídico e medida de cinturas, mas diminuiu o peso no GT. Houve correlação negativa entre o domínio da função física do questionário IWQOL – Lite e as variáveis de desejo e excitação do questionário FSFI. Conclusão: O treinamento com 12 semanas de exercícios baseados no método Pilates de solo é eficaz na melhora da função sexual e da qualidade de vida de mulheres com excesso de peso independente de alterações nos parâmetros sanguíneos como perfil lipídico, glicemia e nível de testosterona.

INTRODUÇÃO: as disfunções sexuais femininas (DSF) são altamente prevalentes na população, e as opções terapêuticas disponíveis ainda constituem desafio para a prática do ginecologista. Este estudo tem como objetivo avaliar os efeitos da terapia cognitivo-comportamental (TCC) em grupo de mulheres com disfunção sexual. MÉTODO: foram incluídas 106 mulheres com diagnóstico de disfunção sexual atendidas no Setor de Sexualidade da Divisão de Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, as quais foram divididas em dois grupos: o primeiro (n=53) submetido a TCC em grupo, com duração de oito encontros; o segundo (n=53) a tratamento expectante. A função sexual foi avaliada pelo quociente sexual feminino (QSF) na entrevista inicial, e após seis meses em ambos os grupos. O poder da amostra foi de 95%. Os resultados foram comparados entre os grupos com o uso de testes de Mann-Whitney. RESULTADOS: ambos os grupos apresentaram características semelhantes quanto à resposta sexual, autoimagem e relacionamento com parceiro na entrevista inicial. O grupo submetido à terapia apresentou melhora significativa na função sexual quando comparado com o grupo controle, tanto pelo resultado global do QSF, com variação média de 18,08 pontos (IC95% 12,87 23,28) para o primeiro contra -0,83 pontos (IC95% -3,43 1,77) do segundo (p<0,001), assim como para os domínios discriminados pelo questionário: Desejo e Interesse (p=0,003), Preliminares (p=0,003), Excitação e Sintonia (p<0,001), Conforto (p<0,001) e Orgasmo e Satisfação (p<0,001). CONCLUSÃO: a TCC em grupo mostrou ser ferramenta eficaz para o tratamento das disfunções sexuais femininas / Introduction: Female Sexual Dysfunction (FSD) have high prevalence, and therapeutic options available are a challenge in gynaecological practice. Objective: to evaluate the effects of group cognitive-behavioral therapy (CBT) for women with sexual dysfunction. Methods: A total of 106 women diagnosed with sexual dysfunctions was equally divided into subjects (n=53), who underwent group CBT for 8 weekly sessions, and controls (n=53), who were given expectant treatment. Assessment of sexual function was carried out at an interview at baseline and at the endpoint after six months using Abdos female sexual quotient questionnaire (FSQ). Results: At baseline both groups had similar characteristics as to sexual response, self-image and relationship with a partner. The women who went into therapy showed significant improvement in sexual function when compared with those in the control group: The FSQ had an average growth of 18.08 points (95%CI: 12.87 to 23.28) in the therapy group against an average decrease of 0.83 points (95%CI: 3.43 to 1.77) among the controls (p<0.001). The five domains discriminated by the questionnaire also showed significant improvement in the therapy group: desire and interest (p=0.003), foreplay (p=0.003), excitation and tuning (p<0.001), comfort (p<0.001), and orgasm and satisfaction (p<0.001). Conclusion: group CBT was shown to be an effective tool for the treatment of female sexual dysfunctions

Persistent Genital Arousal Disorder (PGAD) is a complex, poorly understood condition characterized by unremitting, unwanted, distressing genital arousal which occurs frequently and for extended periods of time, often in the absence of sexual stimuli. The pathophysiology is unknown. Researchers have hypothesized underlying disorders of neurological, vascular, pharmacological and psychological origins. Possible causalities have been suggested including anxiety disorder, SSRI use, and pudendal nerve neuropathies among others. Despite the uncertainty of etiology, other aspects of the disorder are clearer, including distress and poor quality of life for many. In this study, I used a biopsychosocial model to examine three potential psychological predictors 'depression, stress, and anxiety' as well as moderators including erotophobia and perceived partner support on a sample of 51 women with PGAD. Quantitative survey methodology was used to collect information from women with PGAD who had sought care for their condition from a sexual medicine specialty clinic (San Diego Sexual Medicine) and members of an online PGAD support group. Results of the study indicated depression as the most significant predictor of distress of the three psychological variables under study. Neither erotophobia nor perceived social support moderated any of the psychological factors studied. Scores on the Female Sexual Distress Scale-Revised demonstrated clinically important levels of distress. The findings highlight the need for a biopsychosocial treatment approach to the condition, including psychological therapy. Implications for social change include the preservation of quality of life and reduced depression rates in women with PGAD.

No description available.

Após o sucesso de vendas do Viagra, medicamento indicado para o tratamento da disfunção erétil, lançado em 1998, houve uma rápida proliferação de artigos, livros e encontros sobre as disfunções sexuais femininas. Desde 2000, um intenso debate sobre o envolvimento da indústria farmacêutica na produção biomédica sobre as disfunções sexuais femininas e a concomitante busca por um medicamento similar ao Viagra destinado às mulheres tem envolvido profissionais de diferentes disciplinas. Esta dissertação teve como objetivo investigar os discursos científicos sobre as disfunções sexuais femininas, através do exame dos artigos publicados no periódico Archives of Sexual Behavior, desde sua fundação, em 1971, até 2007. O periódico foi escolhido por sua legitimidade neste campo de saberes, por abranger um amplo período (36 anos) e seu caráter multidisciplinar. Pretendeu-se investigar quando, como e por quais grupos profissionais as disfunções sexuais femininas foram descritas e abordadas no periódico. No caso das chamadas disfunções sexuais, as descrições científicas, que vêm aumentando significativamente nos últimos anos, dão origem a prescrições de terapias, medicamentos, intervenções cirúrgicas, programas de educação sexual e políticas públicas. Ou seja, subjacente a esse discurso, que afirma ser empírico e imparcial, estão processos que se encontram muito além dos limites de um laboratório ou das atividades de um pesquisador. Buscou-se, assim, pensar a produção científica como produto de articulações e negociações que se desenrolam em esferas diversas, envolvendo processos culturais, sociais, econômicos e também cognitivos ou científicos, em contraposição às concepções que caracterizam a ciência como um projeto que apenas revela verdades. Para tanto, foi apresentado o contexto do surgimento de uma ciência da sexualidade, no decorrer do século XIX e, em seguida, o contexto no qual emergiram os discursos sobre as disfunções sexuais femininas, o que propiciou sua emergência naquele dado momento, o modo como foram definidas e por quem, como se articularam a processos sociais, econômicos e culturais e que transformações sofreram ao longo dos anos. / After the sale success of Viagra, a medicament indicated for the treatment of erectile dysfunction, which was launched in 1998, there was a fast proliferation of articles, books and meetings on female sexual dysfunctions. Since 2000, an intense debate about the involvement of the pharmaceutical industry in the biomedical production related to female sexual dysfunctions and the simultaneous search for a medicament similar to Viagra aimed to women has been involving professional from different areas. The goal of this dissertation was to investigate scientific discourses on female sexual dysfunctions through the analysis of articles published in the periodical Archives of Sexual Behavior, since its foundation in 1971 until 2007. The periodical was chosen due to its legitimacy in this field of knowledge, for covering a vast period (36 years) and for its multidisciplinary nature. The intention was to locate when, how and by which professional groups female sexual dysfunctions were described and dealt with in the periodical. In the case of the so-called sexual dysfunctions, scientific descriptions, which have been significantly increasing in recent years, originate therapeutic prescriptions, medicaments, chirurgical interventions, sexual education programs and public policies. That is, subjacent to this discourse, which poses as empirical and impartial processes were found that reach quite beyond the limits of a lab or the activities of a researcher. Therefore, the aim was to think of the scientific production as a product of articulations and negotiations unfolded in diversified domains and involving cultural, social and economical processes, as well as cognitive and scientific ones, in contrast to the conceptions that characterize science as a project that only brings about the truth. For this, the context in which a science of sexuality emerged throughout the 19th Century was presented, followed by the context in which the discourses on female sexual dysfunctions appeared: what has facilitated their emergence in that given moment, how and by whom were they defined, how were they articulated to social, economical and cultural processes and which transformations they suffered throughout the years.

Após o sucesso de vendas do Viagra, medicamento indicado para o tratamento da disfunção erétil, lançado em 1998, houve uma rápida proliferação de artigos, livros e encontros sobre as disfunções sexuais femininas. Desde 2000, um intenso debate sobre o envolvimento da indústria farmacêutica na produção biomédica sobre as disfunções sexuais femininas e a concomitante busca por um medicamento similar ao Viagra destinado às mulheres tem envolvido profissionais de diferentes disciplinas. Esta dissertação teve como objetivo investigar os discursos científicos sobre as disfunções sexuais femininas, através do exame dos artigos publicados no periódico Archives of Sexual Behavior, desde sua fundação, em 1971, até 2007. O periódico foi escolhido por sua legitimidade neste campo de saberes, por abranger um amplo período (36 anos) e seu caráter multidisciplinar. Pretendeu-se investigar quando, como e por quais grupos profissionais as disfunções sexuais femininas foram descritas e abordadas no periódico. No caso das chamadas disfunções sexuais, as descrições científicas, que vêm aumentando significativamente nos últimos anos, dão origem a prescrições de terapias, medicamentos, intervenções cirúrgicas, programas de educação sexual e políticas públicas. Ou seja, subjacente a esse discurso, que afirma ser empírico e imparcial, estão processos que se encontram muito além dos limites de um laboratório ou das atividades de um pesquisador. Buscou-se, assim, pensar a produção científica como produto de articulações e negociações que se desenrolam em esferas diversas, envolvendo processos culturais, sociais, econômicos e também cognitivos ou científicos, em contraposição às concepções que caracterizam a ciência como um projeto que apenas revela verdades. Para tanto, foi apresentado o contexto do surgimento de uma ciência da sexualidade, no decorrer do século XIX e, em seguida, o contexto no qual emergiram os discursos sobre as disfunções sexuais femininas, o que propiciou sua emergência naquele dado momento, o modo como foram definidas e por quem, como se articularam a processos sociais, econômicos e culturais e que transformações sofreram ao longo dos anos. / After the sale success of Viagra, a medicament indicated for the treatment of erectile dysfunction, which was launched in 1998, there was a fast proliferation of articles, books and meetings on female sexual dysfunctions. Since 2000, an intense debate about the involvement of the pharmaceutical industry in the biomedical production related to female sexual dysfunctions and the simultaneous search for a medicament similar to Viagra aimed to women has been involving professional from different areas. The goal of this dissertation was to investigate scientific discourses on female sexual dysfunctions through the analysis of articles published in the periodical Archives of Sexual Behavior, since its foundation in 1971 until 2007. The periodical was chosen due to its legitimacy in this field of knowledge, for covering a vast period (36 years) and for its multidisciplinary nature. The intention was to locate when, how and by which professional groups female sexual dysfunctions were described and dealt with in the periodical. In the case of the so-called sexual dysfunctions, scientific descriptions, which have been significantly increasing in recent years, originate therapeutic prescriptions, medicaments, chirurgical interventions, sexual education programs and public policies. That is, subjacent to this discourse, which poses as empirical and impartial processes were found that reach quite beyond the limits of a lab or the activities of a researcher. Therefore, the aim was to think of the scientific production as a product of articulations and negotiations unfolded in diversified domains and involving cultural, social and economical processes, as well as cognitive and scientific ones, in contrast to the conceptions that characterize science as a project that only brings about the truth. For this, the context in which a science of sexuality emerged throughout the 19th Century was presented, followed by the context in which the discourses on female sexual dysfunctions appeared: what has facilitated their emergence in that given moment, how and by whom were they defined, how were they articulated to social, economical and cultural processes and which transformations they suffered throughout the years.