Since the late 1990s, researchers have reported a high degree of sexual dysfunction among American women that is associated with significant negative consequences (e.g., reduced quality of life and sexual satisfaction). In addition, sexual satisfaction is a primary factor in marital stability. Because of the widespread impact on both individual well-being and marital relationships, female sexual dysfunction is a significant public health problem. Most research has supported the predominance of psychocultural factors in women's sexual issues. Authenticity, defined by Kernis and Goldman as acting in accord with one's natural inclinations, is associated with increased well-being, but researchers have often overlooked it in the literature on female sexual dysfunction. This study, guided by Kernis and Goldman's authenticity theory, argued that gender culture impairs the ability of women to be authentic in the sexual realm, and, thereby, increases the risk of sexual problems. The purpose of this research study was to examine the relationship between authenticity, as measured by The Authenticity Inventory, Version 3, and female sexual dysfunction, as measured by The Female Sexual Function Index and The Female Sexual Distress Scale, Revised, in a group of 55 women attending an online university. The hypothesis was that women with higher rates of dysfunction and/or distress would score lower on authenticity. The results from a regression analysis did not reach significance and failed to confirm the hypothesis; however, there was an association between distress and dysfunction. This study contributes to social change by examining an association between authenticity and female sexual dysfunction that is of help to researchers and therapists working with women in the area of sexual health.

The aim of this thesis is to probe the link between female sexual dysfunctions in the Czech Republic and physical activity and self-awareness (mindfulness) of women using specialised questionnaires. The goal was to engage women across the Czech Republic to gather large and diverse dataset. The questionnaires used were International Physical Activity Questionnaire (IPAQ) measuring physical activity, Female Sexual Function Index (FSFI) measuring sexual dysfunctions and Five Facet Mindfulness Questionnaire measuring mindfulness. Analysis of the data is used to provide a basis for therapy of female sexual dysfunctions.

Bakgrund: Bäckenbottendysfunktion innebär onormal funktion i bäckenbottenmuskulaturen som orsakas av ökad eller minskad muskeltonus och nedsatt koordination av bäckenbottenmusklerna.  Det innefattar flera olika funktionella problem och delas upp i urologiska, gynekologiska eller kolorektala. Biofeedback är en apparat som kan användas som ett tillägg till vanlig bäckenbottenträning. Den är till för att lära sig använda rätt teknik och kontrollera och identifiera rätt muskler. Man kan använda biofeedback till att träna styrka, uthållighet, koordination samt avslappning. Syfte: Undersöka effekten av bäckenbottenträning med biofeedback på blås- och tarmtömningsbesvär (utöver urin- och fekalinkontinens), livskvalitet och sexuell funktion jämfört med bäckenbottenträning utan biofeedback/sedvanlig behandling/ingen träning alls. Metod: Systematisk litteraturstudie med databaserna PubMed och Web of Science. Studiernas kvalitet granskades med PEDro och resultatets tillförlitlighet granskades enligt Uppsala Universitets Fysioterapeutsprograms bedömningsmall för systematiska översikter.  Resultat: Sju randomiserade kontrollerade studier inkluderades. Alla studier visade signifikant förbättring hos interventionsgrupperna. Fyra studier undersökte tömningssvårigheter, tre undersökte livskvalitet och två studier undersökte sexuell dysfunktion. Fem studier undersökte biverkningar av biofeedback utan fynd. Alla studier hade god kvalitet enligt PEDro, men samtliga visade på mycket låg tillförlitlighet (+) enligt Uppsala Universitets Fysioterapeutsprograms bedömningsmall för systematiska översikter. Konklusion: Det tyder på att bäckenbottenträning med biofeedback har positiv effekter på blås- och tarmtömningssvårigheter, livskvalitet och sexuell funktion hos personer med bäckenbottendysfunktion. Inga fynd av biverkningar av bäckenbottenträning med biofeedback hittades. Studierna hade god kvalitet enligt PEDro och dess sammanvägda resultat hade mycket låg tillförlitlighet (+). Resultatet bör därför tas med försiktighet och fler randomiserade kontrollerade studier behövs för att kunna dra några slutsatser. / Background: Pelvic floor dysfunction means abnormal function of the pelvic floor muscles caused by increased or decreased muscle tone and reduced coordination of the pelvic floor muscles. It includes several different functional problems such as urological, gynecological or colorectal. Biofeedback is a device that can be used as an addition to regular pelvic floor training. It helps people to use the right technique and to control and identify the right muscles. Biofeedback can be used to train strength, endurance, coordination and relaxation. Objective: Investigate the effect of pelvic floor training with biofeedback on bladder- and bowel voiding difficulties (except for urinary- and fecal incontinence), quality of life and sexual function compared to pelvic floor training without biofeedback/usual care/no training. Method: Systematic literature study which used the databases PubMed and Web of Science. The quality of the studies was reviewed using PEDro and the reliability of the results were reviewed according to Uppsala University's Physiotherapy program assessment template for systematic reviews. Results: Seven randomized controlled trials were included in this study. All studies showed significant improvement in the intervention groups. Four studies examined voiding difficulties, three examined quality of life and two studies examined sexual dysfunction. Five studies investigated side effects of biofeedback with no findings. All studies had good quality according to PEDro, however all showed very low reliability (+) according to Uppsala University's Physiotherapy program assessment template for systematic reviews. Conclusion: It indicates that pelvic floor training with biofeedback has positive effects on bladder- and bowel voiding difficulties, quality of life and sexual function in people with pelvic floor dysfunction. There are no findings of side effects of pelvic floor training with biofeedback. The studies were of good quality according to PEDro and their combined results had very low reliability (+). The result should therefore be taken with caution and more randomized controlled trials are needed to reach more reliable conclusions.

Cardiovascular disease (CVD) and erectile dysfunction (ED) have common etiologies, such as increased adiposity and chronic diseases. Incident ED is known to be a sentinel of CVD, providing a unique opportunity for early lifestyle interventions to attenuate the progression of disease. The internal pudendal artery (IPA) plays an important role in controlling resistance to penile blood flow and thereby erections. Although morphological and functional disturbances in the IPA have been associated with ED, few studies have characterized changes in the IPA as it relates to increased adiposity and chronic diseases (e.g., chronic kidney disease [CKD]). Finally, although both vascular calcification and ED have been shown to be prevalent in patients with CKD, there has yet to be an assessment of associated mechanisms. The effect of lifestyle modifications on erectile function was evaluated in both experimental and clinical settings. Specifically, the studies assessed the effect of caloric restriction (CR) in rats and of chronic exercise in sedentary, overweight or obese male and female subjects. In rats, structural and functional changes of the IPA and erectile responses were characterized in relation to increasing adiposity and to CKD. Experimentally, the susceptibility of various vascular beds to calcification in CKD was determined. Clinically, erectile and female sexual function was assessed in patients with Stage 3 to 5 CKD, who had no history of CVD. In rats, CR blunted the accumulation of abdominal adiposity, and attenuated progression of both endothelial dysfunction and ED, independently of morphological changes in the IPA. Rats with CKD had an increased frequency of ED, greater endothelial dysfunction, and altered vascular morphology, yet vascular calcification per se did not account for ED. In the clinical study, sedentary and overweight or obese males with ED, but not females, had a significantly higher body mass index (BMI) and waist circumference. Chronic exercise significantly improved ED and female sexual dysfunction (FSD). Clinically, CKD was associated with ED and FSD as well as increased coronary artery calcification and endothelial dysfunction. These findings support the concept that early detection of cardiovascular abnormalities, using incident ED as a sentinel, should facilitate early interventions in otherwise asymptomatic populations. / Thesis (Ph.D, Pharmacology & Toxicology) -- Queen's University, 2013-09-30 22:33:20.436

Bakgrund: Sexualitet och sexuell hälsa är två begrepp som hör samman. Sexualitet innebär närhet och kontakt medan sexuell hälsa innebär att det ska vara tryggt och säkert att utföra sexuella aktiviteter. Cervix tillhör kvinnans inre reproduktionsorgan. Globalt sett är cervixcancer en av den vanligaste cancerformen bland kvinnor. Mortaliteten är högre i utvecklingsländer än industriländer. Humant papillomvirus, HPV, är en av de bidragande faktorer till cervixcancer där kirurgi, cytostatika och strålbehandling är olika typer av behandling. Ett cancerbesked kan ge upphov till reaktioner som påverkar både den fysiska och psykiska hälsan.  Syfte: Syftet var att belysa kvinnors sexuella hälsa efter diagnostisering av cervixcancer. Metod: Denna litteraturöversikt sammanställdes genom insamling av material från tidigare forskning inom ett vårdvetenskapligt kunskapsområde. Tio stycken vetenskapliga artiklar som berör cervixcancer och sexualitet ligger till grund för resultatet. Materialet granskades och analyserades enligt Fribergs metod för att slutligen sammanfattas i huvudteman och underteman i en litteraturöversikt.  Resultat: Resultatet presenteras i tre huvudteman; Fysiska aspekter, Psykiska aspekter och Sociala aspekter. Resultatet visade att kvinnans sexualitet och sexuella hälsa påverkas i samband med cervixcancer. Positiva upplevelser som uttrycktes var att kvinnor uppskattade sexuella aktiviteter mer efter sjukdomen och negativa upplevelser som rapporterades var att kvinnor inte vågade utföra sexuella aktiviteter där samlagssmärta var en orsak. Sexuella hinder påverkade den sexuella funktionen och skapade oro hos kvinnorna. Behandlingen av cervixcancer påverkade kvinnan genom olika kroppsliga förändringar och obehag vid samlag.  Diskussion: De fysiska aspekterna påverkar kvinnans sexualitet och identitet. Ett behov av kunskap kring cervixcancer relaterat till sexualitet kan urskiljas hos kvinnorna, där sjuksköterskans ansvar är att tillhandahålla kvinnorna med denna information. Sjuksköterskan kan ta hjälp av Virginia Hendersons behovsteori och Cancercentrums Vårdprogram. / Background: Sexuality and sexual health are two concepts that belong together. Sexuality means proximity and contact while sexual health means that it is safe and secure to perform sexual activities. Cervix is a part of women's inner reproductive organs. Cervical cancer is globally seen as one of the most common forms of cancer amongst women where pain is a late symptom of cervical cancer. Mortality is higher in developing countries than industrialized countries. Human papillomavirus, HPV is the most common cause of cervical cancer, where surgery, cytostatic and radiation therapy are different types of treatment. Cytological changes do not always mean cancer. Getting a cancer message can induce emotional reactions such as anxiety, anger and concern. At different coping strategies; Active and passive, the woman can adapt to the new life situation. A cancer diagnosis can develop reactions that affect both the physical and the mental health. Aim: The purpose was to highlight women’s sexual health after diagnosis of cervical cancer. Method: This literature review was compiled by collecting material from previous research within a healthcare knowledge area. Ten scientific articles related to cervical cancer and sexuality are the basis for the outcome. The material was reviewed and analyzed according to Fribergs method and finally summarized into mainthemes and subthemes in a literature review. Results: The result is presented in three main themes; Physical aspects, Mental aspects, and Social aspects. The results showed that cervical cancer affected women’s sexuality and sexual health. Positive experiences expressed by the women were an increased estimation on sexual activity after the disease. While negative experiences that were reported was a fear of performing sexual activities where dyspareunia was a cause. Sexual barriers affected the sexual function and created a concern among the women. The treatment of cervical cancer affected the woman through various bodily changes and discomfort during sexual intercourse.   Discussion: The physical changes that the woman experience is affecting her sexuality and identity. A need for knowledge about cervical cancer related to sexuality was noted in the women, where the nurse's responsibility is to provide women with this information. Virginia Henderson's behavior theory and the Cancer center care program may be a support for the nurse.

A prostatectomia radical é o método terapêutico mais utilizado no tratamento do câncer de próstata localizado. O objetivo deste estudo é avaliar a readaptação urinária e sexual no período pós- operatório. Método: Foram estudados 46 homens tratados por Prostatectomia Radical à quatro tempos: pré-cirurgia e após três meses; seis meses e um ano após cirurgia, através dos seguintes instrumentos: escala adaptativa operacionalizada redefinida- (EDAO-R); questionário de avaliação da disfunção sexual masculina - (QSM); questionário de incontinência urinária - (ICIQ-SF) e o questionário de comprometimento cognitivo - (MEEM). Em um ano de estudo a análise estatística avaliou quantitativamente a eficácia adaptativa em quatro setores, estruturados nos seguintes pressupostos: Afetivo-Relacional (A-R); Produtividade (Pr); Orgânico (Or) e Socio-Cultural (S-C). Resultados: Encontrou-se diferença significativa nos valores da adequação diagnóstica pela EDAO-R entre o momento 3 (6 meses de PR: G1 8,7%; G2 15,2%; G3 17,4%; G4 28,3%; G5 30,4%) e o momento 4 (1 ano de PR: G1 8,7%, G2 17,4%; G3 23,9%, G4 19,6%; G5 30,4%) em relação ao momento 1(précirurgíco: G1 28,3%; G2 17,4%; G3 26,1%; G4 17,4%, G5 10,9%). E no momento 3 (6 meses de PR: G1 8,7%; G2 15,2%; G3 17,4%; G4 28,3%; G5 30,4%) houve um aumento significativo em relação ao momento 2 (3 meses de PR: G1 10,9%; G2 17,4%; G3 37,0%; G4 17,4%; G5 17,4%). O ICIQ-SF diagnosticou diferenças significativas entre os todos os momentos (p < 0,001). O MEEM resultou no momento 2 (um ano de PR) com valores significativamente maiores que os apresentados no momento 1 pré-cirúrgico (p=0,001). O QS-M revelou no momento pré-cirúrgico que 80,5% dos pacientes se encontravam num escore de bom a excelente em relação ao desempenho sexual e que 19,5% se encontravam num escore de desfavorável a regular. No momento 4 (um ano de PR), os achados foram: 21,7% dos pacientes classificados na categoria de bom a excelente; 54,4%, na categoria de ruim a desfavorável e 23,9%, na categoria de nulo a ruim. Conclusão: Os homens submetidos à PR durante o período do estudo ficaram comprometidos na organização e na readaptação às alterações urinárias e sexuais decorrentes do tratamento / Radical prostatectomy (RP) is the most widely used therapeutic method in the treatment of localized prostate cancer. The aim of this study is to evaluate the urinary and sexual rehabilitation in the postoperative period. Methods: A study was done of 46 men treated with radical prostatectomy at four time intervals: pre-surgery, three months, six months and one year postsurgery. The following instruments were used: Revised Operational Adaptive Diagnostic Scale - (ROADS); questionnaire for the assessment of male sexual dysfunction - (QS -M); International Consultation on Incontinence Questionnaire - Short Form (ICIQ -SF) and the cognitive impairment test (Mini-Mental State Examination - MMSE). In a year of study the statistical analysis quantitatively evaluated the adaptive efficacy in four sectors, structured in the following assumptions: Affective - relational (AR); Productivity (Pr); Organic (Or) and Socio-Cultural (S- C). Results: There was a significant difference in the values of diagnostic suitability for the ROADS between time interval 3 (6 months of RP: G1 8.7%; G2 15.2%; G3 17.4%; G4 28.3%; G5 30.4%) and time interval 4 (1 year RP: G1 8.7%; G2 17.4%; G3 23.9%; G4, 19.6%; G5 30.4%) relative to time interval 1 (pre-surgical: G1 28.3%; G2 17.4%; G3 26.1%; G4 17.4%; G5 10.9%). Additionally at time interval 3 (6 months of RP: G1 8.7%; G2 15.2%; G3 17.4%; G4 28.3%; G5 30.4%) there was a significant increase compared to the second time interval (RP 3 months: G1 10.9%; G2 17.4%; G3 37.0%; G4 17.4%; G5 17.4%). The ICIQ-SF diagnosed significant differences between all four time intervals (p < 0.001). The MMSE resulted in time interval 2 (1year os RP) having significantly higher values than those presented pre-surgery in time interval 1 (p = 0.001). The QS-M revealed that 80.5% of the patients were found to have a good to excellent score in relation to sexual performance and that 19.5% had an unfavorable to regular score prior to surgery. At time interval 4 (one year PR), the findings were: 21.7% of patients were classified as good to excellent; 54.4% were classified as bad to unfavorable and 23.9% were in the null to bad category. Conclusion: The men submitted to PR during the study period were committed to the organization and rehabilitation of the urinary and sexual changes due to treatment

INTRODUÇÃO: As disfunções sexuais (DS) são um grupo heterogêneo de transtornos que têm em comum um prejuízo clinicamente significativo na capacidade do indivíduo responder sexualmente ou experimentar o prazer sexual, causando sofrimento psíquico. Porque há crescente evidência de que as DS são bastante frequentes e que estão relacionadas a cognições disfuncionais acerca da sexualidade (pensamentos e crenças sexuais), torna-se essencial a identificação destas cognições, a fim de contribuir com o tratamento de indivíduos que têm dificuldades sexuais. OBJETIVO: Desenvolver versões com evidências de validade e confiabilidade dos instrumentos: Questionário de Crenças Sexuais Disfuncionais (QCSD), Escala de Pensamentos Automáticos (EPA) e Sexual Self-Schema Scale (SSSS) para uso da população brasileira. MÉTODOS: Após a etapa de adaptação transcultural, os questionários em processo de validação foram disponibilizados em uma plataforma online, juntamente com Questionário de dados Sociodemográficos Clínico e Sexual, Quociente Sexual Feminino (QS-F) e Quociente Sexual Masculino (QSM). Foram convidados a participar do estudo homens e mulheres maiores de 18 anos, com vida sexual ativa. A análise exploratória dos dados foi realizada por Análise de Componentes Principais (PCA). O Teste de Kaiser-Meyer-Olkin (KMO) e o Teste de Bartlett foram conduzidos para assegurar as condições mínimas de fatoração. Como medida de validade convergente, foram testadas as correlações entre os escores obtidos no QCSD, EPA e SSSS com os escores do QS-M e QS-F. Como medidas de confiabilidade, o alpha Cronbach (A) foi utilizado para a análise de consistência interna dos instrumentos como um todo, bem como seus domínios, e o reteste foi realizado em parte da amostra após um intervalo de quatro semanas. RESULTADOS: Um total de 590 mulheres (M = 34,6, DP = 8,8) e 411 homens (M= 35,2, DP = 9,8) respondeu a todos os questionários. As análises psicométricas revelaram que, para a amostra brasileira, a versão feminina do QCSD é composta por 5 fatores, tendo A = 0,86. A versão masculina, 3 fatores, sendo A = 0,94. A versão feminina da EPA apresenta 6 fatores, tendo A = 0,92. A versão masculina, 5 fatores, com A = 0,90. O SSSS é composto por 3 fatores com A = 0,8. Os instrumentos tiveram correlação negativa com o QS-M e QS-F, evidenciando que quanto mais cognições disfuncionais, pior a função sexual. O teste reteste mostrou que todos os questionários apresentam boa estabilidade ao longo do tempo. CONCLUSÕES: As versões brasileiras dos questionários QCSD, EPA e SSSS apresentam evidências de validade e de confiabilidade e são recomendadas tanto no contexto clínico, quanto acadêmico/científico para identificação de crenças, pensamentos e autoesquema sexual que estão relacionados às disfunções sexuais / INTRODUCTION: Sexual dysfunction (DS) is a heterogeneous group of disorders that have in common a clinically significant impairment in the individual\'s ability to respond sexually or to experience sexual pleasure, causing psychological distress. Because there is growing evidence that DS are quite frequent and are related to dysfunctional cognitions about sexuality (sexual thoughts and beliefs), it becomes essential to identify these cognitions in order to contribute to the treatment of individuals who have sexual difficulties. OBJECTIVE: To develop versions with evidence of validity and reliability of the instruments: Dysfunctional Sexual Beliefs Questionnaire (QCSD), Automatic Thinking Scale (EPA) and Sexual Self-Schema Scale (SSSS) for use by the Brazilian population. METHODS: After the cross-cultural adaptation procedure, the questionnaires were available on an online platform, along with the Clinical and Sexual Sociodemographic Questionnaire, Female Sexual Quotient (QS-F), and Male Sexual Quotient (QS-M). Men and women over 18 years of age with an active sex life were invited to participate in the study. The exploratory analysis of the data was performed by Principal Component Analysis (PCA). The Kaiser-Meyer-Olkin Test (KMO) and the Bartlett Test were conducted to ensure the minimum conditions of factorization. As a measure of convergent validity, we tested the correlations between the scores obtained in the QCSD, EPA and SSSS with the QS-M and QS-F scores. As reliability measures, the Cronbach alpha (A) was used for the internal consistency analysis of the instruments as a whole, as well as their domains, and the retest was performed in part of the sample after an interval of four weeks. RESULTS: A total of 590 women (M = 34.6, SD = 8.8) and 411 men (M = 35.2, SD = 9.8) responded to all the questionnaires. The psychometric analysis revealed that, for the Brazilian sample, the female version of the QCSD is composed of 5 factors, with A = 0.86. The male version, 3 factors, where A = 0.94. The female version of the EPA has 6 factors, with A = 0.92. The male version, 5 factors, with A = 0.90. The SSSS consists of 3 factors with A = 0,8. The instruments had negative correlation with the QS-M and the QS-F, showing that the more dysfunctional cognitions, the worse the sexual function. The retesting test showed that all questionnaires have good stability over time. CONCLUSIONS: The Brazilian versions of the QCSD, EPA and SSSS questionnaires present evidence of validity and reliability and are recommended for both clinical and academic/scientific context in order to identify sexual beliefs, thoughts and self-schema that are related to sexual dysfunctions

Made available in DSpace on 2016-04-28T20:40:04Z (GMT). No. of bitstreams: 1 Melina Serra.pdf: 2242068 bytes, checksum: 30be35b07de632805e2a2638dce6d946 (MD5) Previous issue date: 2009-04-27 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The vaginismus is characterized by ICD-10 (1993) as a spasm of muscles surrounding the vagina, causing occlusion of the vaginal opening, making possible the penetration of the penis or painful. Since 1990, the World Health Organization says the sex as one of the pillars for ensuring the quality of life. This study sought to understand how women, with vaginismus diagnoses and living in the city of São Paulo experience quality of life, from Psychology phenomenological approach. Four women participated in this research, aging between 34 and 43 years. The instruments used were: WHOQOL-bref, Instrument of Self-Perceived Quality of Life (Serra and Bassani) and open interview. Data were analyzed from the features of human existence - being in the world, temporalizing, and choose spatialization (Forghieri, 2004). The data indicated that sexual disorders affect any of the participants. The vaginismus seems to underline the world of these women, in their relationships with the environment, with others or with themselves. Most of the participants can live with keeping their experiences, expanding their temporalizing. They reported having lived alternatives ways of existence, with a prevalence of concerned and focused; information about sexual disorders and treatment options can provide a better understanding of the vaginismus, in order to facilitate the achievement of choices. This study indicates that: 1) the vaginismus affects all areas of life of these participants, with more intensity: health, sexual and emotional ones. 2) Health, sexual, family and social affairs, are the areas most directly affected on the overall assessment of quality of life. 3) getting information, understanding of the disorder and being able to attend to properly treatment, can promote the welfare of participants. 4) The resolution of the complaint of vaginismus influences the improvement and new meanings for quality of life / O vaginismo é caracterizado pela CID-10 (1993) como um espasmo dos músculos que circundam a vagina, causando oclusão da abertura vaginal, tornando a penetração do pênis impossível ou dolorosa. Desde 1990, a Organização Mundial de Saúde ressalta o sexo como um dos pilares para garantia de qualidade de vida. O presente estudo buscou compreender, a partir de um olhar fenomenológico, como mulheres moradoras no Estado de São Paulo e diagnosticadas com vaginismo, vivenciam a qualidade de vida em seu dia-a-dia. Participaram quatro mulheres, entre 34 e 43 anos. Os instrumentos utilizados foram: Questionário de Qualidade de Vida (WHOQOL-bref), Instrumento de Auto-Percepção de Qualidade de Vida (Serra e Bassani) e entrevista aberta. Os dados foram analisados a partir das características do existir humano ser-no-mundo, temporalizar, espacializar e escolher (Forghieri, 2004). Os dados obtidos ressaltam que a disfunção sexual afeta o existir das participantes. O vaginismo parece permear o ser-no-mundo dessas mulheres, seja nas relações com o ambiente, com outras pessoas ou consigo mesmas. A maioria das participantes consegue vivenciar com sintonia suas experiências, expandindo o temporalizar. Alternam as maneiras de existir, com prevalência das preocupada e sintonizada; Informações sobre a disfunção sexual e opções de tratamento proporcionam uma melhor compreensão do vaginismo, facilitando a realização de escolhas. Este estudo indica que: 1) O vaginismo afetou todos os âmbitos da vida das participantes, com mais intensidade os de saúde, sexual e emocional. 2) Os âmbitos que influenciaram diretamente a avaliação geral de qualidade de vida variaram para cada participante, destacam-se os âmbitos: saúde, sexual, familiar e social. 3) Obter informações, compreender a disfunção e ter a possibilidade de fazer tratamento, favorecem o bem-estar das participantes. 4) A resolução da queixa de vaginismo influencia na melhoria e na avaliação da qualidade de vida

Introdução: Embora a contracepção seja bastante prevalente no Brasil (77%), apenas dois métodos predominam: o contraceptivo hormonal oral e a esterilização cirúrgica (LT). No entanto a LT não é inócua e pode trazer diversas conseqüências para a vida dessas mulheres que se submetem a ela. Dentre estas pode estar a deterioração da função sexual o que seria contraditório visto que a LT objetiva uma vida sexual melhor, menos atemorizada pelo medo da gravidez. O presente estudo teve como objetivo avaliar a função sexual de mulheres submetidas à LT. Métodos: Estudo transversal de 235 casos, representativos de 1826, com dados obtidos através de inquérito da função sexual entre as mulheres laqueadas pelo SUS em Ribeirão Preto(SP) entre 2000 e 2004, utilizando-se o Female Sexual Function Index (FSFI) adaptado para o contexto brasileiro. Resultados: As entrevistadas tinham em média 35,9 anos e foram esterilizadas em média aos 33,3 anos; 89,8% estavam em união marital, 57,9% declararam-se brancas e 66,8%, católicas, tinham em média 6,1 anos de estudo e 76,6% pertenciam às classes C e D; 93,4% referiram ter um bom relacionamento conjugal e 59,5% declararam que o relacionamento não mudou após o procedimento. A média de filhos vivos foi 3,2, resultaram aborto 8,8% das gestações, 71,2% resultaram partos vaginais e 28,8%, cesáreas; 52,3% usaram pílula 6 meses antes da cirurgia; 98,7% responderam estar satisfeita com a cirurgia e 6,8% referiram dor pélvica. Em geral, 32,5% das mulheres apresentaram escores de índice com risco para disfunção sexual medido pelo FSFI. Foi observada associação entre a variável disfunção sexual e categoria de escolaridade, renda per capita, dor pélvica, número de gravidezes, número de partos vaginais e de cesáreas. Observou-se correlação negativa entre o escore de função sexual e o número de filhos vivos e correlação positiva entre o escore e renda familiar, renda per capita e os valores de classificação econômica. Conclusão: A partir dos dados obtidos, pôde-se observar que dentre as mulheres laqueadas do estudo a presença de disfunção sexual estava associada à dor pélvica e maior número de cesarianas, assim como a situações ligadas à vulnerabilidade social (baixa renda e escolaridade e maior número de filhos). / Introduction: Although contraception is high prevalent in Brazil (77%), only two methods prevail: the hormonal pills and the surgical sterilization. However female sterilization is not innocuous and it can bring several consequences for those women\'s life. Among these consequences it can be to deterioration of the sexual function what is contradictory sees that the use of contraceptional methods aims at a better sexual life, less frightened by the fear of pregnancy. The present study had as objective evaluates the women\'s sexual function submitted to LT. Methods: prevalence study of 235 cases, representative of 1826, with data obtained through inquiry of the sexual function among the women sterilized by the public health system in Ribeirão Preto(SP) between 2000 and 2004. There has been used the Sexual Female Function Index (FSFI) adapted for the Brazilian context. Results: The interviewees were 35,9 years old on average and they were sterilized on average to the 33,3 years; 89,8% were in marital union, 57,9% pronounced white and 66,8%, catholic, they had on average of 6,1 years of study and 76,6% belonged to the classes C and D; 93,4% referred to have a good matrimonial relationship and 59,5% declared that the relationship didn\'t change after the procedure. The alive children\'s average was 3,2, 8,8% of the gestations resulted abortion, 71,2% resulted vaginal childbirths and 28,8%, cesarean; 52,3% used pill 6 months before the surgery; 98,7% answered to be satisfied with the surgery and 6,8% referred pelvic pain. In general, 32,5% of the women presented index scores with risk for sexual dysfunction measured by FSFI. Association was observed between the variable sexual dysfunction and education category, per capita income, pelvic pain, number of pregnancies, number of vaginal childbirths and of Cesarean. Negative correlation was observed between the score of sexual function and the number of alive children and positive correlation among the score and surrender family, per capita income and the values of economical classification. Conclusion: Starting from the obtained data, it could be observed that among the sterilized women the presence of sexual dysfunction was associated to the pelvic pain and larger number of cesarean operations, as well as linked situations to the social vulnerability (low income and education and larger number of children).

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2015-02-04T09:15:08Z No. of bitstreams: 2 Dissertação - Carolina Rodrigues de Mendonca - 2014.pdf: 3841382 bytes, checksum: 079c00331419687a5cc6570935d83e03 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-02-05T14:11:04Z (GMT) No. of bitstreams: 2 Dissertação - Carolina Rodrigues de Mendonca - 2014.pdf: 3841382 bytes, checksum: 079c00331419687a5cc6570935d83e03 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-02-05T14:11:04Z (GMT). No. of bitstreams: 2 Dissertação - Carolina Rodrigues de Mendonca - 2014.pdf: 3841382 bytes, checksum: 079c00331419687a5cc6570935d83e03 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) 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.