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Transdermal Testosterone For Menopause-Related Hyposexual Desire Disorder: Current Guidelines And Provider Perceptions, Knowledge, And PracticeWhite, Kelly Christine 01 January 2017 (has links)
Hypoactive sexual desire or low libido in women are collectively referred to as hypoactive sexual desire disorder (HSDD). HSDD is estimated to occur in 10% to 15% of adult women. HSDD is likely the most common female sexual dysfunction (FSD) in menopausal women. The hallmark of the diagnosis is personal distress and interpersonal difficulties resulting from low sex drive. Most women will not seek help for this problem. Studies have suggested that primary care providers and gynecologic healthcare providers report not feeling qualified to treat patients with sexual dysfunction, especially HSDD. Testosterone, specifically transdermal testosterone, has been suggested to play an integral part in the treatment of HSDD in menopause. It is proven to increase the frequency of satisfying sexual activity, sexual desire, and orgasmic response, and to decrease personal distress. Testosterone has a demonstrated a safety history and medication tolerance when prescribed for this purpose. In spite of its proven efficacy in relation to HSDD, the Food and Drug Administration (FDA) has not approved testosterone for this purpose, though its use for HSDD is currently suggested by the Endocrine Society in their Clinical Practice Guidelines (CPGs). The primary purpose of this study was to assess Vermont primary care providers' and gynecologic healthcare providers' perceptions, knowledge, and practices regarding treatment of HSDD in naturally induced menopause with a focus on transdermal testosterone. After respondent inclusion criteria and demographic information about the respondents was collected, the study asked questions and tested knowledge about topics regarding menopause and sexuality, evaluation of FSD, and treatment of low libido and diminished sexual desire with a focus on testosterone. The study was a descriptive cross-sectional online survey that was completed electronically on a secure server through the University of Vermont. The conclusions were that providers believe sexuality and sexual satisfaction are quality of life indicators and perceived that maintaining sexual function is important to naturally occurring menopausal women. The majority of providers would prescribe a pharmaceutical treatment for menopausal women seeking to maintain their sexual function, enhance sexual satisfaction, and/or treat symptoms of HSDD as long as there were no contraindications. However, testosterone, a proven treatment for women with complaints of low libido and/or diminished sexual desire, was reportedly underutilized. This may be related to inconsistent screening for FSD in menopause at each comprehensive visit and lack of provider knowledge about testosterone (including safety and efficacy) impacting confidence to prescribe testosterone for this purpose. Further, providers were divided on whether low libido and/or diminished sexual desire in naturally occurring menopause is a medical condition or disorder or a natural part of aging. It is unclear how the aforementioned divisions impact evaluation and treatment.
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La variabilité dans l'intensité ou l'orientation des interactions sexuelles chez le bélier : Etude des structures centrales impliquées / Variability in the intensity of direction of sexual interactions in the ram : a study of central structures involvedSantos, Fernando Carlos Borja Dos 14 December 2011 (has links)
L’objectif principal de cette thèse est de comprendre l’origine de la variabilité d’expression du comportement sexuel (CS). Nous avons trouvé que l’approche latérale est le CS le plus exprimé et que sa quantification peut servir comme mesure de la libido et donner une idée de la performance. Nous avons montré des effets remarquables de l’âge et de la lumière sur le CS du bélier. Nous avons également montré que les structures cérébrales impliquées dans la phase motivationnelle et consommatoire ne étaient pas les mêmes et que quel que soit le partenaire sexuel préféré, l’exposition à ce partenaire provoquait une activation des mêmes structures cérébrales ; le niveau de libido semble être déterminé par des sites spécifiques et bien précis comme l’aire préoptique, le noyau paraventriculaire et la partie médiane du Lit de la strie terminale. Le Cortex ent pourrait fonctionner comme un inhibiteur de la motivation hétérosexuelle. / The main objective of this thesis was to acquire a better understanding of the origin of the variability of the expression of sexual behavior. The nudging is most expressed sexual behavior and quantification of this behavior can be used to measure their libido and give a clue on their performance. We have discovered the remarkable effects of age et lighting of the ram's sexual behavior and that the cerebral structures involved in the motivation phase and consummatory phase are not the same and seems that, no matter which sexual partner is chosen, the fact of being exposed to this partner provokes the activation of these cerebral structures et what the expression of sexual motivation level seems to have specific and precise sites in the Preoptic Area, the Paraventricular Nucleus (PVN) and the Nucleus of the bed of the striae terminalis medial (BNSTmed). The Entorhinal cortex could function as an inhibitor of heterosexual motivation.
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Imago Dei: da proto-imagem ao conceito: um estudo da formação do conceito da Imago Dei nas Obras de C. G. JungBezinelli, João 22 June 2007 (has links)
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Previous issue date: 2007-06-22 / The aim of this work is an understanding of C. G. Jung s concept of the Imago Dei, throughout its development, since Jung s first ideas expressed in The Zofingia Lectures in 1896, to the publication of the book Psychology of the Unconscious in 1912. The study of Jung s thought during this period of time allows the observation of the development of the concept of the unconscious and of the libido, as well as its constructive dynamics through religious symbols, which points to the epistemological need for a later concept of Self and its representation on the Imago Dei. The following of these ideas that contributed and led to the formation of the Imago Dei, demonstrates that it is, by its very nature, conceptual and necessarily paradoxical from its beginning / Este trabalho tem como objetivo apresentar uma compreensão do conceito de Imago Dei em C. G. Jung através da trajetória de sua formação, desde as suas idéias iniciais recolhidas nas palestras proferidas na Sociedade Estudantil de Zofíngia , em 1896, até a publicação do seu livro Transformações e Símbolos da Libido , em 1912. O estudo do pensamento de Jung deste período permite observar o desenvolvimento dos conceitos de inconsciente e libido bem como a dinâmica construtiva da libido através dos símbolos religiosos que apontam a necessidade epistemológica do ulterior conceito de Self e sua representação na Imago Dei. O acompanhamento dessas idéias que contribuíram e confluíram para a formação da Imago Dei demonstra também que esta é conceitual e necessariamente paradoxal desde sua origem
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O medo e os vínculos sociais no Brasil / The fear and social links in BrazilDurand, Marina 10 June 2005 (has links)
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Previous issue date: 2005-06-10 / Fundação de Amparo a Pesquisa do Estado de São Paulo / The subject matter of this study is the link between unequal persons; organized by command-obedience relationships so as to configure the terms dominant-dominated. The link is a notion that embraces simultaneously the social relationships and the psychical process underneath them; thus it s a useful theoretical tool when the matter of the investigation are psychosocial processes.
The analysis of command-obedience relationships points to the presence of elements of paternalistic culture, even in openly capitalist work relationships. The effects of this culture hit the worker s subjectivity, making more complex the effort to fight for his rights. Workers oscillate between two forms of ordination of the link; the moral one, keen to the paternalistic culture, alternates with the interest-aimed ordination, proper of the capitalist means of production. One can observe how the ideology of the work system uses emotional disposition and traditional significants in order to achieve its profit goals.
There s a special interest in following some of the effects or paternalistic culture on social life, such as: the difficulty to exert authority even when one is entitled to, to stand for one s rights and to cope with corrupt authorities. There are also the subjective effects, specially the paranoid feeling, the threat represented by autonomy issues and the lowering of self-esteem, resulting of narcissistic gaps associated to the lack of public property sense. To identify with one s aggressor implies living with a negative sense of one s own ideal. One consequence is self-rejection, experienced by Brazilians as a rule.
I suggest there are structural conflicts both in our subjectivity and bidding, leading us to live as first and second rate people; the answers are manifold, but each one will have to deal with this question his own way. Brazil is a name that lives within us, and the place where we live. The way by which the law is enforced by many authorities who don t represent it, but end up substituting it, intensifies the echoes of paternalistic culture.
The thesis outline starts from a nucleus: the analysis of work relations among damaged workers in order to identify the processes that lead to work accidents. Furthermore, it seeks to mesurate work relations as relationships between dominant and subaltern classes, pervaded by mistrust . The social status of dependency and the subjection bond are also common terms to both situations, the enduring repressed element is the wish for autonomy, to be one s own person as opposite to be the one who serves.
The analysis of the praxis from professional members of the public health system indicates the construction of a psychical and ideological organization with premises that are distinct from paternalism. Therefore, the other won t represent an opportunity to demonstrate some sort of superiority but a chance to offer the better one has to offer instead. This reciprocity might establish links, which are less sadist-masochist and more in agreement to the genital organization of the libido, that is to say, fertile to both. The diference, in this case, has no qualities added / A matéria deste estudo é o vínculo entre desiguais, organizado por relações de mando-obediência de forma a configurar os termos dominante-dominado. O vínculo é uma noção que abrange simultaneamente a relação social e o processo psíquico a ela subjacente, por isso é um instrumento teórico útil quando o interesse da investigação são processos psicossociais.
A análise das relações de mando-obediência indica a presença de elementos da cultura paternalista, mesmo em relações de trabalho francamente capitalistas. Os efeitos desta cultura atingem a subjetividade do trabalhador tornando mais complexo o esforço de lutar por seus interesses. Os operários oscilam entre duas formas de ordenação do vínculo; a ordenação moral, própria da cultura paternalista, se alterna com a ordenação por interesse, própria do modo capitalista de produção. Observamos como a ideologia da organização de trabalho utiliza as disposições emocionais e significantes tradicionais para melhor realizar seus objetivos de lucro.
É de especial interesse acompanhar alguns dos efeitos da cultura paternalista sobre a vida social, como a dificuldade para autorizar-se diante do que se tem efetivamente autoridade, fazer valer direitos e conviver com autoridades corruptas. Há também os efeitos sobre a subjetividade, em especial o sentimento paranóide, a ameaça que representa formas de autonomia, o rebaixamento da auto-estima, resultado de falhas narcísicas associadas à carência de sentido do que é público. A identificação com o agressor coloca o problema de vivermos com um ideal cujo sentido é negativo em relação ao sujeito. Uma conseqüência é a rejeição do brasileiro por ele mesmo.
Sugiro haver conflitos estruturantes da nossa subjetividade e dos vínculos, levando-nos a viver como gente de primeira e de segunda; as respostas são diversas, mas cada um terá de se haver com esta questão. Brasil é um nome que nos habita e que habitamos. A maneira como se pratica a lei, em que muitas vezes a autoridade não a representa, mas acaba por substituí-la intensifica as ressonâncias da cultura paternalista.
O desenho da tese é partir de um núcleo: análise das relações de trabalho com trabalhadores acidentados para identificar os processos que conduzem ao acidente de trabalho. A seguir, dimensionar a relação de trabalho como relação entre classes dominantes e subalternas, permeia a essas relações a suspeição. A condição social de dependência e o vínculo de sujeição também são termos comuns a ambas situações, o elemento que permanece reprimido é a ânsia por autonomia, ser par si em contraposição ser para servir.
A análise da práxis de profissionais da rede pública de saúde indica a construção de uma organização psíquica e ideológica com pressupostos distintos dos paternalistas, de forma que o outro não seja ocasião para demonstrar uma superioridade qualquer , mas de oferecer a ele o que se tem de melhor, construindo, com reciprocidade, um vínculo com menos características sado-masoquistas e mais em conformidade com a organização genital da libido, ou seja, fecundo para ambos. A diferença, no caso, não tem adjetivação
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O medo e os vínculos sociais no Brasil / The fear and social links in BrazilDurand, Marina 10 June 2005 (has links)
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o medo e os vinculos sociais no brasil.pdf: 1006706 bytes, checksum: f6cb177b7ba54a36ecdf1f4afe47bb70 (MD5)
Previous issue date: 2005-06-10 / Fundação de Amparo a Pesquisa do Estado de São Paulo / The subject matter of this study is the link between unequal persons; organized by command-obedience relationships so as to configure the terms dominant-dominated. The link is a notion that embraces simultaneously the social relationships and the psychical process underneath them; thus it s a useful theoretical tool when the matter of the investigation are psychosocial processes.
The analysis of command-obedience relationships points to the presence of elements of paternalistic culture, even in openly capitalist work relationships. The effects of this culture hit the worker s subjectivity, making more complex the effort to fight for his rights. Workers oscillate between two forms of ordination of the link; the moral one, keen to the paternalistic culture, alternates with the interest-aimed ordination, proper of the capitalist means of production. One can observe how the ideology of the work system uses emotional disposition and traditional significants in order to achieve its profit goals.
There s a special interest in following some of the effects or paternalistic culture on social life, such as: the difficulty to exert authority even when one is entitled to, to stand for one s rights and to cope with corrupt authorities. There are also the subjective effects, specially the paranoid feeling, the threat represented by autonomy issues and the lowering of self-esteem, resulting of narcissistic gaps associated to the lack of public property sense. To identify with one s aggressor implies living with a negative sense of one s own ideal. One consequence is self-rejection, experienced by Brazilians as a rule.
I suggest there are structural conflicts both in our subjectivity and bidding, leading us to live as first and second rate people; the answers are manifold, but each one will have to deal with this question his own way. Brazil is a name that lives within us, and the place where we live. The way by which the law is enforced by many authorities who don t represent it, but end up substituting it, intensifies the echoes of paternalistic culture.
The thesis outline starts from a nucleus: the analysis of work relations among damaged workers in order to identify the processes that lead to work accidents. Furthermore, it seeks to mesurate work relations as relationships between dominant and subaltern classes, pervaded by mistrust . The social status of dependency and the subjection bond are also common terms to both situations, the enduring repressed element is the wish for autonomy, to be one s own person as opposite to be the one who serves.
The analysis of the praxis from professional members of the public health system indicates the construction of a psychical and ideological organization with premises that are distinct from paternalism. Therefore, the other won t represent an opportunity to demonstrate some sort of superiority but a chance to offer the better one has to offer instead. This reciprocity might establish links, which are less sadist-masochist and more in agreement to the genital organization of the libido, that is to say, fertile to both. The diference, in this case, has no qualities added / A matéria deste estudo é o vínculo entre desiguais, organizado por relações de mando-obediência de forma a configurar os termos dominante-dominado. O vínculo é uma noção que abrange simultaneamente a relação social e o processo psíquico a ela subjacente, por isso é um instrumento teórico útil quando o interesse da investigação são processos psicossociais.
A análise das relações de mando-obediência indica a presença de elementos da cultura paternalista, mesmo em relações de trabalho francamente capitalistas. Os efeitos desta cultura atingem a subjetividade do trabalhador tornando mais complexo o esforço de lutar por seus interesses. Os operários oscilam entre duas formas de ordenação do vínculo; a ordenação moral, própria da cultura paternalista, se alterna com a ordenação por interesse, própria do modo capitalista de produção. Observamos como a ideologia da organização de trabalho utiliza as disposições emocionais e significantes tradicionais para melhor realizar seus objetivos de lucro.
É de especial interesse acompanhar alguns dos efeitos da cultura paternalista sobre a vida social, como a dificuldade para autorizar-se diante do que se tem efetivamente autoridade, fazer valer direitos e conviver com autoridades corruptas. Há também os efeitos sobre a subjetividade, em especial o sentimento paranóide, a ameaça que representa formas de autonomia, o rebaixamento da auto-estima, resultado de falhas narcísicas associadas à carência de sentido do que é público. A identificação com o agressor coloca o problema de vivermos com um ideal cujo sentido é negativo em relação ao sujeito. Uma conseqüência é a rejeição do brasileiro por ele mesmo.
Sugiro haver conflitos estruturantes da nossa subjetividade e dos vínculos, levando-nos a viver como gente de primeira e de segunda; as respostas são diversas, mas cada um terá de se haver com esta questão. Brasil é um nome que nos habita e que habitamos. A maneira como se pratica a lei, em que muitas vezes a autoridade não a representa, mas acaba por substituí-la intensifica as ressonâncias da cultura paternalista.
O desenho da tese é partir de um núcleo: análise das relações de trabalho com trabalhadores acidentados para identificar os processos que conduzem ao acidente de trabalho. A seguir, dimensionar a relação de trabalho como relação entre classes dominantes e subalternas, permeia a essas relações a suspeição. A condição social de dependência e o vínculo de sujeição também são termos comuns a ambas situações, o elemento que permanece reprimido é a ânsia por autonomia, ser par si em contraposição ser para servir.
A análise da práxis de profissionais da rede pública de saúde indica a construção de uma organização psíquica e ideológica com pressupostos distintos dos paternalistas, de forma que o outro não seja ocasião para demonstrar uma superioridade qualquer , mas de oferecer a ele o que se tem de melhor, construindo, com reciprocidade, um vínculo com menos características sado-masoquistas e mais em conformidade com a organização genital da libido, ou seja, fecundo para ambos. A diferença, no caso, não tem adjetivação
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La sexualité analyseur : théories et politiques des sexualités / Non communiquéGras, Olivier 16 January 2012 (has links)
La sexualité est arrivée au statut d’objet scientifique à la suite des découvertes psychanalytiques. L’élargissement du sexuel avec Freud par la théorie de la libido a permis une investigation beaucoup plus large et complète de la sexualité, la faisant apparaître comme un phénomène de totalité. Les sciences sociales n’ont pourtant pas nécessairement intégré cet élargissement dans leurs théorisations sur la sexualité livrant une définition de celle-ci selon leurs paradigmes et cadres interprétatifs disciplinaires. De même, la politisation de la sexualité a dans un premier temps interpréter la question de la libido freudienne dans une utopie critique, celle de la libération sexuelle de Mai 68. Dans un second temps, elle a idéologisé et partialisé la question sexuelle en orientant les débats sur les questions des minorités sexuelles. La démarche critique adoptée dans cette thèse permet de montrer en quoi la sexualité en tant qu’objet est l’analyseur des sexualités concrètes. La sexualité est une force originaire au fondement de la subjectivité, de l’intersubjectivité et des formations sociales. Elle ne peut donc être conceptualisée de façon réductrice. Cette complexité est nécessairement polémique car elle comprend des enjeux épistémologiques, politiques, mais aussi éthiques, praxéologiques et métaphysiques. / Sexuality become a scientific object following psychoanalysic discoveries. The extension of sexuality by Freud with the libido theory allow more complete and broader investigation of sexuality, showing it as a phenomenon of totality. Social sciences however did not insert this enlargement into their theorizings on the sexuality delivering a definition of this one according to their paradigms and disciplinary interpretative frames. Also, the politicization of sexuality has at first interpreted the question of freudian libido in a critical utopia, that of the sexual liberation of Mai 68. In second time, it has ideologised ans partialised the sexual question by orientating the debate on the sexual minorites questions. Critical step adopted in this thesis allows to show that sexuality as object is the analyser of concrete sexualities. Sexuality is a native force in the foundation of subjectivity, intersubjectivity and social trainings. Sexuality can’t be conceptualised in a reductionnist way. This complicacy is necessarily polemical because it consists in epistemological and political stakes, but also in ethical, praxeological and metaphysical stakes.
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La clinique par l'écrit. Une étude des fonctions de l'écriture du sujet dans des cas de psychoses.Combres, Laurent 07 July 2007 (has links) (PDF)
La relecture des travaux de Freud et Lacan suivie de l'interprétation du travail d'écriture de deux jeunes adultes psychotiques rencontrés par le biais d'un dispositif clinique nous conduit à formuler l'hypothèse suivante : chez des sujets structurés sur le mode de la psychose, peut exister une pratique de l'écriture qui n'est pas création littéraire, mais qui soutient l'inscription sociale de ces mêmes sujets, sans les désagréments causés par la formation de substituts psychotiques et ce qu'ils sont seulement comme tentatives d'inscriptions. Nous montrons alors que d'une manière générale, de telles pratiques de l'écriture réinscrivent dans l'appareil psychique l'élément affectif et/ou l'élément représentation au départ rejeté par la problématique psychotique.
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Den helande bilden : kopplat till bildterapi och Jungs analytiska psykologi ...Gunnarsson, Petra January 2008 (has links)
<p>Jag vill med min uppsats ta med läsaren på en djupdykning i bilden och symbolernas värld även om det med ord kan vara svårt att beskriva, då det ju i själva verket rör sig om en nivå som kommer före ordet. Mitt huvudsakliga syfte är att utforska huruvida bilderna och symbolerna fortfarande är livsnödvändiga för människans psykiska och kanske därmed fysiska överlevnad? Kan vi fortfarande än i dag, låta oss beröras av deras kraftfält och därmed göra förändringen, utvecklingen, transformationen och helandet möjligt?!</p><p>Vidare vill jag undersöka bildens dubbla roll som både ”symtomavslöjare” och framåtblickande ”transformerande helare”, samt kopplingen till shamanism och alkemi. Vad kan nutidsmänniskan lära av detta? Vad kan vi ta till oss i dag? Och vad mår den enskilde individen och ett samhälle bäst av i längden?</p><p>Jag vill betona en psykodynamisk syn på människan där även Jungs analytiska psykologi ingår, och använda objektrelationsteoretikerna som en gemensam bro mellan Jung, Freud och bildterapi. Min bakgrund är konstnärens och bildterapeutens (med psykodynamisk grund).</p><p>Och det är med dessa ögon som jag har tagit mig an ämnet. Jag säger inte att det är den enda vägen till helande och transformation, andra terapiformer kan fungera lika bra, beroende på person och bakgrund och orsak. Men bildens väg är min väg...</p>
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Sexual function in women with neurological disordersHulter, Birgitta January 1999 (has links)
<p>The purpose of this investigation was to study sexual function in women with neurological disorders at fairly distinct and separate locations. The dissertation comprises descriptive, retrospective, quantitative studies on sexual functioning in women with hypothalamo-pituitary disorders (HPD) (<i>n</i>:48), multiple sclerosis (MS)(<i>n</i>:47), and insulin-dependent diabetes mellitus (IDDM) (<i>n</i>:42). The results werecompared with those in an age-matched control group (C) (<i>n</i>:42), and as reported by representative Swedish women (<i>n</i>:742) in the Swedish sex survey SiS). The studies were based on comprehensive interviews, neurological examinations, incl. Vibration Perception Thresholds (IDDM), concentrations of prolactin and testosterone in serum (HPD), and a checklist on life satisfaction (IDDM, C, and SiS).</p><p>Sexual dysfunction was prevalent in almost all women with HPD and MS, and in 40% of the IDDM group. The problem of insufficient vaginal lubrication was more common in those with neurological disorders than among women in the SiS group. Sexual problems caused by reduced libido and orgasmic difficulties were more commonin the HPD and MS groups than in the SiS group. In the HPD group, women with intrasellar adenomas had better sexual function than women having expansively growing pituitary adenomas with both intra- and suprasellar extension. Normal serum testosterone values correlated to masturbation activity. Amenorrhea and older age werecorrelated with sexual problems in all groups. In the MS group, symptoms of a weak pelvic floor and of bladder and bowel dysfunction were correlated with reduced lubrication and orgasmic ability. In the IDDM group, signs of autonomic neuropathy were correlated with sexual dysfunction. Concerning life satisfaction generally,proportionately fewer women with IDDM were satisfied or very satisfied, though differing significantly from the other two groups in only two domains of life: contacts with friends, and physical health.</p>
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Sexual function in women with neurological disordersHulter, Birgitta January 1999 (has links)
The purpose of this investigation was to study sexual function in women with neurological disorders at fairly distinct and separate locations. The dissertation comprises descriptive, retrospective, quantitative studies on sexual functioning in women with hypothalamo-pituitary disorders (HPD) (n:48), multiple sclerosis (MS)(n:47), and insulin-dependent diabetes mellitus (IDDM) (n:42). The results werecompared with those in an age-matched control group (C) (n:42), and as reported by representative Swedish women (n:742) in the Swedish sex survey SiS). The studies were based on comprehensive interviews, neurological examinations, incl. Vibration Perception Thresholds (IDDM), concentrations of prolactin and testosterone in serum (HPD), and a checklist on life satisfaction (IDDM, C, and SiS). Sexual dysfunction was prevalent in almost all women with HPD and MS, and in 40% of the IDDM group. The problem of insufficient vaginal lubrication was more common in those with neurological disorders than among women in the SiS group. Sexual problems caused by reduced libido and orgasmic difficulties were more commonin the HPD and MS groups than in the SiS group. In the HPD group, women with intrasellar adenomas had better sexual function than women having expansively growing pituitary adenomas with both intra- and suprasellar extension. Normal serum testosterone values correlated to masturbation activity. Amenorrhea and older age werecorrelated with sexual problems in all groups. In the MS group, symptoms of a weak pelvic floor and of bladder and bowel dysfunction were correlated with reduced lubrication and orgasmic ability. In the IDDM group, signs of autonomic neuropathy were correlated with sexual dysfunction. Concerning life satisfaction generally,proportionately fewer women with IDDM were satisfied or very satisfied, though differing significantly from the other two groups in only two domains of life: contacts with friends, and physical health.
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