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Factors affecting sexual function and sexual satisfaction among females with or without rectal cancer or gynecological cancerLi, Chia-Chun 01 February 2012 (has links)
This descriptive, comparative, correlational study explored the relationships among demographic characteristics, health histories, disease characteristics, body image, anxiety and depression, sexual relationship power, female sexual function, and sexual satisfaction; examined sexual self-schema as a moderator or mediator on female sexual function and sexual satisfaction; and compared the differences in female sexual function and sexual satisfaction between women with gynecological or rectal cancer and women without any cancer. Fifty-five females with gynecological or rectal cancer in the study group and 72 females without any cancer in the comparison group completed seven structured questionnaires.
For females in the study group, a significant negative relationship existed between time since surgery and anxiety and depression, between the number of cancer treatments and female sexual function, and between performance status and anxiety and depression. In addition, a significant positive relationship existed between performance status and sexual relationship power and between the number of cancer treatments and sexual satisfaction. Further, body image was significantly related to anxiety and depression, sexual relationship power, sexual self-schema, and sexual satisfaction. The anxiety and depression factor was significantly linked with sexual relationship power, female sexual function, and sexual satisfaction. There was a significant negative relationship between sexual satisfaction and sexual relationship power and between sexual satisfaction and female sexual function. Also, females in the study group reported significantly worse sexual function and sexual satisfaction than females in the comparison group.
A hierarchical multiple regression model accounted for 40% of the variance in female sexual function, and gynecological/rectal cancer, body image, and the interaction between sexual relationship power and sexual self-schema were three significant predictors. After controlling for gynecological/rectal cancer, body image, sexual relationship power, sexual self-schema, and the interaction term between sexual relationship power and sexual self-schema, female sexual function accounted for 17% of the variance in sexual satisfaction. In unsolicited comments, females in the study group described the changes in their sexual lives after surgery and treatments, emphasizing that sexual information should be provided promptly and effectively by health care providers. The study findings led to implications and recommendations for the conceptual framework, nursing practice, research, and education. / text
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THE RECIPROCAL DYNAMICS OF NORMATIVE AFFECTIVE STATES AND PATHOLOGICAL MOOD WITH FEMALE SEXUAL PROBLEMS: A DAILY STUDY OF YOUNG WOMENKalmbach, David A. 02 July 2014 (has links)
No description available.
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Sexuální dysfunkce u obézních žen po bariatrické léčbě obezity. / Sexual Dysfunction in the Obese Female after Bariatric Surgery.Pichlerová, Dita January 2019 (has links)
6 Abstract Background: Obesity and associated comorbidities increase the probability of sexual disorders. We aimed to assess sexual satisfaction in obese women before and after bariatric surgery using the validated Female Sexual Function Index (FSFI) and also to assess sexual satisfaction in obese women in comparison with women of normal weight. We also compared the frequency of female sexual dysfunction (FSD) of the participants. Methods: 60 obese women 5.99 completed the questionnaire on sexual satisfaction (FSFI) before a bariatric procedure (laparoscopic adjustable gastric banding, 22 women; gastric plication, 33 women; and biliopancreatic diversion, 5 women), 6 months and 12 months after the procedure, i.e. after a significant weight reduction (final BMI of . The control group consisted of 60 women of normal weight (mean BMI of 22.2 1.9 domains, with higher scores indicating better sexual function. The FSFI total score (range 2- dicating FSD. Results: Baseline sexual function in the preoperative obese female was significantly lower than in the control group of women of normal weight (p < 0.01) in each domain. Average postoperative FSFI scores increased from preoperative levels in all domains, but significant improvement occurred only in the domain for desire (p < 0.01). The results at 6 and 12 months...
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Assessing predictors of sexual function in mid-aged sexually active womenChedraui, Peter, Pérez López, Faustino R., Mezones Holguín, Edward, San Migue, Glenda, Avila, Carlos 24 March 2015 (has links)
institutochedraui@gmail.com / Objective: To assess predictors of sexual function in mid-aged women. Methods: We analyzed data of 262 healthy sexually active women (40–59 years) who filled out the Female Sexual Functioning Index (FSFI), the Menopause Rating Scale (MRS) and a general questionnaire containing female/partner data. Correlations between these two measures were also analyzed. Results: Significant inverse correlations were found between all FSFI and MRS scores. This was most evident for the MRS urogenital score in relation to FSFI total, pain and lubrication scores. Multiple linear regression analysis determined best model predicting total FSFI index scores that explained a 66% of the variance. In this model, MRS urogenital score was an important predictor of female sexual function (total FSFI scores) with a significant inverse relation. Additionally total FSFI scores displayed a significant positive correlation with female educational level and HT use and an inverse relation with partner age and female parity. Conclusion: Several female/partner factors predicted female sexual function in this mid-aged series. MRS urogenital scores significantly correlated with total FSFI scores.
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Beauty in the Eye of the Holder: The Contribution of Body Appreciation to Sexual Health in Adult WomenRobbins, Anne-Rose January 2017 (has links)
Perhaps one of the most embodied of human experiences, sexuality can be greatly affected by the way in which women perceive their body. Historically, scholars have dedicated their attention to negative facets of body image and how it is associated with poorer female sexual health, while mostly overlooking the positive aspects of this relationship. Similarly, although ageing is a key factor to consider when examining body image and sexual health, only a dearth of studies has attempted to describe the experiences of non-university aged women. To fill these gaps, this research program was designed to investigate the associations between positive and negative aspects of body image and explore how each contributes to sexual health in age-varied samples of adult women. Two survey studies were carried out. A total of 215 heterosexual women, aged 18 to 88, participated in the first study. Despite a high statistical overlap between body appreciation (i.e., positive body image) and body dissatisfaction (i.e., negative body image), the former was found to be a greater contributing factor to indicators of sexual health. Specifically, body appreciation was related to improved sexual function, lower sexuality-related distress, and higher sexual satisfaction, even when controlling for body mass index. Although many changes occur to the body as women get older, body appreciation was unrelated to age in this sample. Nevertheless, it was shown to moderate the negative association between age and sexual satisfaction, such that older women with high appreciation for their body reported being significantly more sexually satisfied than those with low body appreciation. While the first study explored the body image and sexual health experiences of adult women in general, the second article focused on the mechanisms through which one is related to the other in midlife and older women specifically. A total of 193 heterosexual women, aged 50 to 83, completed an online survey. Support was provided for the use of objectification theory (Frederickson & Roberts, 1997), a well-established theoretical framework in body image research, in explaining sexual health in midlife and older women. Body self-consciousness during sex partially explained the relationship between body shame, appearance anxiety, and sexual function, distress, and satisfaction. High body appreciation mitigated the detrimental effect of self-objectification constructs (i.e., body surveillance, appearance anxiety) and body self-consciousness during sex on midlife and older women's sexual health. Overall, based on the results of this dissertation, body appreciation appears to serve as a protective factor for improved sexual health. Similar to sexual satisfaction and sexual distress, positive and negative aspects of body image are related, but nonetheless distinct, concepts that should not be used interchangeably. Furthermore, midlife and older women's body image and sexual experiences differ from that of their younger counterparts; systematic generalisation of findings from one group to the other is thus unwarranted. Consideration for these various distinctions is not only required for increased understanding of the complex links between body image and sexuality across adulthood, but also relevant to guide prevention efforts at a sociocultural level and clinical interventions at the individual level.
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Fatores associados às disfunções sexuais entre mulheres de meia-idade da Região Norte do Brasil / Factors associated with sexual dysfunctions among middle-aged women from the Northern region of BrazilAndréa Ramos da Silva Bessa 10 December 2013 (has links)
Introdução - A disfunção sexual é uma queixa comum, porém, ainda pouco valorizada no âmbito da saúde pública, acometendo indistintamente homens e mulheres e com potenciais reflexos negativos na sua qualidade de vida e bem-estar. Objetivo - Avaliar a prevalência de disfunções sexuais e seus possíveis fatores associados entre mulheres de meia-idade residentes na Região Norte do Brasil. Métodos - Estudo transversal e prospectivo, envolvendo 1.415 mulheres entre 35 e 65 anos atendidas no Ambulatório de Ginecologia do Hospital das Clínicas do município de Rio Branco - Acre - Brasil. Para avaliar a sintomatologia menopausal e a sua função sexual, foram aplicados a Escala de Classificação da Menopausa e o Índice da Função Sexual Feminina. Na análise dos dados, usou-se o pacote estatístico Stata 10, aceitando-se um nível de significância de 5 por cento . Na análise de proporções, usou-se o teste não paramétrico do Qui-Quadrado de Pearson. No estudo dos fatores associados às disfunções sexuais, recorreu-se à análise multivariada através de regressão logística múltipla. Resultados - A média etária das mulheres estudadas foi de 47,7 (+8,5) anos. A sua maioria era de baixa escolaridade (6,4+4,6) anos completos de estudo. A menarca, em média, foi aos 13,4 (+1,6) anos. A maioria referiu gestações anteriores (4,6+2,8). Cerca de 35,9 por cento eram pós-menopáusicas, tendo a menopausa ocorrido ao redor dos 48,3 (+4,9) anos. A autopercepção de saúde foi considerada pelas entrevistadas ruim/muito ruim em 54,6 por cento . A irritabilidade foi a queixa mais frequente (78,3 por cento ), seguida pelos problemas osteoarticulares (74,8 por cento ) e ansiedade (72,7 por cento ). A prevalência de disfunção sexual foi de 62,3 por cento . Ajustados os possíveis fatores de confusão, mostraram-se associados a disfunção sexual: baixa escolaridade (OR:1,70; [IC 95 por cento :1,31-2,19]; p<0,001); sedentarismo (OR:1,73; [IC 95 por cento :1,23-2,42]; p=0,001); autopercepção de saúde ruim/muito ruim (OR:1,99; [IC 95 por cento :1,55-2,57]; p<0,001); estado de ânimo depressivo (OR:1,16; [IC 95 por cento :1,05-1,27]; p=0,002); problemas sexuais (OR:2,50; [IC 95 por cento :1,96-3,20]; p<0,001); ressecamento vaginal (OR:1,49; [IC 95 por cento :1,33-1,66]; p<0,001) e a fase de pós-menopausa (OR:1,82; [IC 95 por cento :1,39-2,38]; p<0,001). Conclusão - Entre a população de mulheres da Região Norte Brasileira estudada, a prevalência de disfunção sexual encontrada foi elevada e a análise dos possíveis fatores associados a sua ocorrência revelaram a influência das condições socioeconômicas, estilo de vida, além da sintomatologia e do estado menopausal, desvelando uma multidimensionalidade de aspectos biológicos e não biológicos envolvidos na sua gênese. / Introduction - Sexual dysfunction is a common complaint, under-recognized by public health services, that affects both men and women equally and has potentially negative impacts on the quality of life and general well-being of sufferers. Objective - To assess the prevalence of sexual dysfunctions, and their possible associated factors, among middle-aged women from the Northern region of Brazil. Methods - A cross-sectional, prospective study was carried out involving 1,415 women aged 35-65 years attended at the Gynecology Outpatient unit of the Clinicas Hospital of Rio Branco city - Acre state - Brazil. Menopausal symptomatology and female sexual function were assessed by applying the Menopause Rating Scale and Female Sexual Index. The Stata 10 statistics package was used for all data analysis, adopting a level of statistical significance of 5 per cent . Pearsons Chi-squared nonparametric association test was used for proportions analysis. Multivariate analysis using multiple logistic regression was employed to study the factors associated with sexual dysfunctions. Results - Mean age of the women studied was 47.7 (+8.5) years. The majority had a low educational level averaging (6.4+4.6) full years of schooling. Mean age at menarche was 13.4 (+1.6) years. The majority reported previous gestations (4.6+2.8). Approximately 35.9 per cent were post-menopausal with menopause occurring at around 48.3 (+4.9) years. Self-perceived health among respondents was rated as poor/very poor by 54.6 per cent . Irritability was the most frequent complaint (78.3 per cent ), followed by osteoarticular problems (74.8 per cent ), and anxiety (72.7 per cent ). The prevalence of sexual dysfunction was 62.3 per cent . After adjusting for potential confounding factors, the following were found to be associated with sexual dysfunction: low educational level (OR:1.70; [95 per cent CI:1.31-2.19]; p<0.001); sedentarism (OR:1.73; [95 per cent CI:1.23-2.42]; p=0.001); poor/very poor self-perceived health (OR:1.99; [95 per cent CI:1.55-2.57]; p<0,001); depressive mood (OR:1.16; [95 per cent CI:1.05-1.27]; p=0.002); sexual problems (OR:2.50; [95 per cent CI:1.96-3.20]; p<0.001); vaginal dryness (OR:1.49; [95 per cent CI:1.33-1.66]; p<0.001) and the post-menopausal stage (OR:1.82; [95 per cent CI:1.39-2.38]; p<0.001). Conclusion - A high prevalence of sexual dysfunction was found among women from Brazils Northern region, where socioeconomic conditions, lifestyle, as well as menopausal symptoms and status, influenced its occurrence, revealing a multidimensionality of biological and non-biological aspects involved in its genesis.
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Fatores associados às disfunções sexuais entre mulheres de meia-idade da Região Norte do Brasil / Factors associated with sexual dysfunctions among middle-aged women from the Northern region of BrazilBessa, Andréa Ramos da Silva 10 December 2013 (has links)
Introdução - A disfunção sexual é uma queixa comum, porém, ainda pouco valorizada no âmbito da saúde pública, acometendo indistintamente homens e mulheres e com potenciais reflexos negativos na sua qualidade de vida e bem-estar. Objetivo - Avaliar a prevalência de disfunções sexuais e seus possíveis fatores associados entre mulheres de meia-idade residentes na Região Norte do Brasil. Métodos - Estudo transversal e prospectivo, envolvendo 1.415 mulheres entre 35 e 65 anos atendidas no Ambulatório de Ginecologia do Hospital das Clínicas do município de Rio Branco - Acre - Brasil. Para avaliar a sintomatologia menopausal e a sua função sexual, foram aplicados a Escala de Classificação da Menopausa e o Índice da Função Sexual Feminina. Na análise dos dados, usou-se o pacote estatístico Stata 10, aceitando-se um nível de significância de 5 por cento . Na análise de proporções, usou-se o teste não paramétrico do Qui-Quadrado de Pearson. No estudo dos fatores associados às disfunções sexuais, recorreu-se à análise multivariada através de regressão logística múltipla. Resultados - A média etária das mulheres estudadas foi de 47,7 (+8,5) anos. A sua maioria era de baixa escolaridade (6,4+4,6) anos completos de estudo. A menarca, em média, foi aos 13,4 (+1,6) anos. A maioria referiu gestações anteriores (4,6+2,8). Cerca de 35,9 por cento eram pós-menopáusicas, tendo a menopausa ocorrido ao redor dos 48,3 (+4,9) anos. A autopercepção de saúde foi considerada pelas entrevistadas ruim/muito ruim em 54,6 por cento . A irritabilidade foi a queixa mais frequente (78,3 por cento ), seguida pelos problemas osteoarticulares (74,8 por cento ) e ansiedade (72,7 por cento ). A prevalência de disfunção sexual foi de 62,3 por cento . Ajustados os possíveis fatores de confusão, mostraram-se associados a disfunção sexual: baixa escolaridade (OR:1,70; [IC 95 por cento :1,31-2,19]; p<0,001); sedentarismo (OR:1,73; [IC 95 por cento :1,23-2,42]; p=0,001); autopercepção de saúde ruim/muito ruim (OR:1,99; [IC 95 por cento :1,55-2,57]; p<0,001); estado de ânimo depressivo (OR:1,16; [IC 95 por cento :1,05-1,27]; p=0,002); problemas sexuais (OR:2,50; [IC 95 por cento :1,96-3,20]; p<0,001); ressecamento vaginal (OR:1,49; [IC 95 por cento :1,33-1,66]; p<0,001) e a fase de pós-menopausa (OR:1,82; [IC 95 por cento :1,39-2,38]; p<0,001). Conclusão - Entre a população de mulheres da Região Norte Brasileira estudada, a prevalência de disfunção sexual encontrada foi elevada e a análise dos possíveis fatores associados a sua ocorrência revelaram a influência das condições socioeconômicas, estilo de vida, além da sintomatologia e do estado menopausal, desvelando uma multidimensionalidade de aspectos biológicos e não biológicos envolvidos na sua gênese. / Introduction - Sexual dysfunction is a common complaint, under-recognized by public health services, that affects both men and women equally and has potentially negative impacts on the quality of life and general well-being of sufferers. Objective - To assess the prevalence of sexual dysfunctions, and their possible associated factors, among middle-aged women from the Northern region of Brazil. Methods - A cross-sectional, prospective study was carried out involving 1,415 women aged 35-65 years attended at the Gynecology Outpatient unit of the Clinicas Hospital of Rio Branco city - Acre state - Brazil. Menopausal symptomatology and female sexual function were assessed by applying the Menopause Rating Scale and Female Sexual Index. The Stata 10 statistics package was used for all data analysis, adopting a level of statistical significance of 5 per cent . Pearsons Chi-squared nonparametric association test was used for proportions analysis. Multivariate analysis using multiple logistic regression was employed to study the factors associated with sexual dysfunctions. Results - Mean age of the women studied was 47.7 (+8.5) years. The majority had a low educational level averaging (6.4+4.6) full years of schooling. Mean age at menarche was 13.4 (+1.6) years. The majority reported previous gestations (4.6+2.8). Approximately 35.9 per cent were post-menopausal with menopause occurring at around 48.3 (+4.9) years. Self-perceived health among respondents was rated as poor/very poor by 54.6 per cent . Irritability was the most frequent complaint (78.3 per cent ), followed by osteoarticular problems (74.8 per cent ), and anxiety (72.7 per cent ). The prevalence of sexual dysfunction was 62.3 per cent . After adjusting for potential confounding factors, the following were found to be associated with sexual dysfunction: low educational level (OR:1.70; [95 per cent CI:1.31-2.19]; p<0.001); sedentarism (OR:1.73; [95 per cent CI:1.23-2.42]; p=0.001); poor/very poor self-perceived health (OR:1.99; [95 per cent CI:1.55-2.57]; p<0,001); depressive mood (OR:1.16; [95 per cent CI:1.05-1.27]; p=0.002); sexual problems (OR:2.50; [95 per cent CI:1.96-3.20]; p<0.001); vaginal dryness (OR:1.49; [95 per cent CI:1.33-1.66]; p<0.001) and the post-menopausal stage (OR:1.82; [95 per cent CI:1.39-2.38]; p<0.001). Conclusion - A high prevalence of sexual dysfunction was found among women from Brazils Northern region, where socioeconomic conditions, lifestyle, as well as menopausal symptoms and status, influenced its occurrence, revealing a multidimensionality of biological and non-biological aspects involved in its genesis.
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Using the Dual Control Model to explore female sexual function and dysfunction in a Swedish sample: A cross-sectional study / Att använda Dual Control Model för att undersöka kvinnlig sexuell funktion och dysfunktion i en svensk population: En tvärsnittsstudieBohman Ljung, Daniella, Ekeroth, Lina January 2014 (has links)
No description available.
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Disfunções sexuais em mulheres de casais infertéis / Sexual disfunction in women infertile couplesMendonça, Carolina Rodrigues de 23 January 2014 (has links)
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Previous issue date: 2014-01-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: Infertility, besides being a medical condition that deserves
medical attention and treatment, is a disturbing development, with
implications on various aspects of life of infertile couples and individuals
(personal, relational, social and sexual). The impact of infertility on women's
sexuality is not entirely clear. Studies that have investigated the topic
reported contradictory results and methodological limitation. Objectives: •
Review important aspects of female sexual function, including, in Brazil the
prevalence, diagnosis and treatment. • Establish the risk of female sexual
dysfunction in infertile couples. • Determine the prevalence of sexual
dysfunction among infertile and fertile women and among women undergoing
the techniques of low and high complexity. • Compare the dysfunctions in
fertile and infertile women and in women subjected to low and high technical
complexity. Methods: A literature review article, constructed from research
on PubMed/Medline and SciELO databases between 1985 and 2012 was
drafted. Then an original article where a study of the case-control was
developed with 278 infertile participants met at the Laboratory of Huma n
Reproduction, Hospital das Clínicas and fertile patients recruited at the Clinic
of Gynecology in the same hospital, from March 2012 to September 2013.
The case group consisted of 92 women with sexual dysfunction and a control
group of 186 women without sexual dysfunction. The questionnaire Female
Sexual Function Index (FSFI) Portuguese version, which assesses the
domains desire, arousal, lubrication, orgasm, satisfaction and pain, was
used. Data were collected through interviews after signing the WIC. Two
controls per case were randomly selected. The odds ratio (OR) was
calculated for chance of female sexual dysfunction in infertile couples (p ≤
0.05). Results: In the literature, it is observed that female sexual dysfunction
have a multifactorial etiology, prevalence ranged from 35.9 % to 49.0 % and
is rarely studied in the Brazilian population. Infertile and fertile women have
the same chance for sexual dysfunction (OR = 1.45, 95% CI 0.86 to 2.44, p =
0.20). The prevalence of sexual dysfunction in infertile women was 36.31 %,
and the fertile women was 28.18 %. In women undergoing low technical
complexity prevalence was 38.88 %, 34.37 % and high complexity. Desire
and arousal were significantly lower in infertile women. No significant
differences were observed in relation to sexual dysfunction in women
subjected to the techniques of low and high complexity. Conclusions: The
risk of infertile women experiencing sexual dysfunction is the same fertile
women. There was no statistical difference regarding the prevalence in
infertile women compared to fertile, and women undergoing fertilization of low
complexity when compared to high complexity. The desire and arousal
domains were the most affected in infertile women. No differences were
observed in the areas in relation to the techniques of low and high
complexity. / Introdução: A infertilidade, além de ser uma condição clínica que merece
atenção médica e tratamento, é um acontecimento perturbador, com
implicações em diversas dimensões da vida dos casais e indivíduos inférteis
(pessoal, relacional, social e sexual). O impacto da infertilidade na
sexualidade da mulher não está inteiramente claro. Os estudos que
investigaram o tema apresentam resultados contraditórios e limitações
metodológicas. Objetivos: • Revisar aspectos importantes sobre a função
sexual feminina, incluindo, prevalência no Brasil, diagnóstico e tratamento. •
Estabelecer o risco de disfunções sexuais femininas em casais inférteis. •
Determinar a prevalência de disfunção sexual entre mulheres inférteis e
férteis e entre mulheres submetidas às técnicas de baixa e alta
complexidade. • Comparar as disfunções em mulheres férteis e inférteis e
em mulheres submetidas às técnicas baixa e alta complexidade. Métodos:
Foi redigido um artigo de revisão da literatura, construído a partir de
pesquisa nas bases de dados PubMed/Medline e SciELO entre 1985 e 2012.
Em seguida um artigo original onde um estudo do tipo caso-controle foi
desenvolvido com 278 participantes inférteis atendidas no Laboratório de
Reprodução Humana do Hospital das Clínicas e pacientes férteis recrutadas
no Ambulatório de Ginecologia do mesmo hospital, no período de março de
2012 a setembro de 2013. O grupo caso foi composto por 92 mulheres com
disfunção sexual e o grupo controle por 186 mulheres sem disfunção sexual.
Foi utilizado o questionário Female Sexual Function Index (FSFI) versão em
português, que avalia os domínios desejo, excitação, lubrificação, orgasmo,
satisfação e dor. Os dados foram colhidos por entrevista após assinatura do
TCLE. Dois controles por caso foram selecionados aleatoriamente. Foi
calculado o odds ratio (OR) para chance de disfunção sexual feminina em
casais inférteis (p ≤0,05). Resultados: Na revisão da literatura, observa-se
que as disfunções sexuais femininas apresentam etiologia multifatorial, a
prevalência pode variar de 35,9% a 49,0% e é pouco estudada na população
brasileira. Mulheres inférteis e férteis apresentam a mesma chance para
disfunção sexual (OR= 1,45; IC 95% 0,86–2,44; p= 0,20). A prevalência de
disfunção sexual em mulheres inférteis foi de 36,31%, e nas mulheres férteis
foi de 28,18%. Em mulheres submetidas à técnica de baixa complexidade a
prevalência foi de 38,88%, e alta complexidade 34,37%. Desejo e excitação
foram significativamente inferiores em mulheres inférteis. Não foram
observadas diferenças significativas em relação às disfunções sexuais em
mulheres submetidas às técnicas de baixa e alta complexidade.
Conclusões: O risco de mulheres inférteis apresentarem disfunção sexual é
o mesmo de mulheres férteis. Não houve diferença estatística em relação à
prevalência em mulheres inférteis quando comparadas às férteis, e em
mulheres submetidas à fertilização de baixa complexidade quando
comparadas a alta complexidade. Os domínios desejo e excitação foram os
mais comprometidos em mulheres inférteis. Não foram observadas
diferenças nos domínios em relação às técnicas de baixa e alta
complexidade.
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