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[PMID]:28742430
[Au] Autor:Andac T; Aslan E
[Ad] Endereço:a Kemal Haciyüzbasioglu Aile Sagligi Merkezi Kartal , Istanbul , Turkey.
[Ti] Título:Sexual life of women in the climacterium: A community-based study.
[So] Source:Health Care Women Int;38(12):1344-1355, 2017 Dec.
[Is] ISSN:1096-4665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Our purpose of conducting this community-based study was to determine sexual functions of women in climacterium and effects of menopausal symptoms on sexual functions. It was descriptive, cross-sectional, and community-based. The study sample consisted of 282 climacteric women. Menopause Rating Scale (MRS), Female Sexual Function Index (FSFI), and Sexual Satisfaction Scale for Women (SSS-W) were used for data collection. The total score was 13.42 ± 8.82 for MRS, 18.73 ± 9.79 for FSFI, and 82.56 ± 18.07 for SSS-W. Seventy-nine-point four percent of the women had sexual dysfunction. While complaints typical of the climacteric period increased, sexual functions and satisfaction decreased.
[Mh] Termos MeSH primário: Climatério
Menopausa
Satisfação Pessoal
Comportamento Sexual/fisiologia
[Mh] Termos MeSH secundário: Idoso
Climatério/fisiologia
Climatério/psicologia
Estudos Transversais
Feminino
Seres Humanos
Menopausa/fisiologia
Menopausa/psicologia
Meia-Idade
Qualidade de Vida
Disfunções Sexuais Fisiológicas/epidemiologia
Disfunções Sexuais Psicogênicas
Fatores Socioeconômicos
Inquéritos e Questionários
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1080/07399332.2017.1352588


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[PMID]:29406067
[Au] Autor:Miner MM; Heidelbaugh J; Paulos M; Seftel AD; Jameson J; Kaplan SA
[Ad] Endereço:Department of Family Medicine and Urology, The Men's Health Center, The Miriam Hospital, The Warren Alpert Medical School of Brown University, 164 Summitt Avenue, Providence, RI 02906, USA. Electronic address: Martin_Miner@Brown.edu.
[Ti] Título:The Intersection of Medicine and Urology: An Emerging Paradigm of Sexual Function, Cardiometabolic Risk, Bone Health, and Men's Health Centers.
[So] Source:Med Clin North Am;102(2):399-415, 2018 Mar.
[Is] ISSN:1557-9859
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Men's mental health and how they think about their health are critical to the future of men's health. Poor health choice patterns are established under age 50, when men are twice as likely to die than women. As the future of medicine focuses on quality and value, a better understanding of the social determinants of men's health will identify areas for improvement. The presentation of a man to a clinician's office with a sexual health complaint presents an opportunity for more complete evaluation. The future of men's health will be well served by integrated men's health centers that focus on the entire man.
[Mh] Termos MeSH primário: Medicina Interna
Saúde do Homem
Urologia
[Mh] Termos MeSH secundário: Instituições de Assistência Ambulatorial
Doenças Ósseas
Doenças Cardiovasculares
Seres Humanos
Masculino
Saúde Mental
Educação de Pacientes como Assunto
Medição de Risco
Disfunções Sexuais Fisiológicas
Disfunções Sexuais Psicogênicas
Saúde Sexual
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29176500
[Au] Autor:Gomaa AA; Abdel Aziz NM; Thabet RH; Fouly HA; Altellawy SH; Gomaa GA
[Ti] Título:A Pilot Study of a Topical Intervention for Treatment of Female Sexual Dysfunction.
[So] Source:J Clin Psychopharmacol;38(1):60-67, 2018 Feb.
[Is] ISSN:1533-712X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE/BACKGROUND: Many investigators reported that pharmacological treatment of female sexual dysfunction (FSD) has been a promising field yet to be explored. The purpose of this pilot study was to investigate the efficacy and safety of a topical cream containing small concentrations of three vasodilators with different mechanisms of action in treating FSD. METHODS: In this randomized, controlled pilot trial, premenopausal (n = 30) and postmenopausal (n = 30) cases of 21- to 62-year age range with FSD were allocated randomly into 15 given placebo or 15 given active cream in each group. The women included had FSD for more than a 6-month duration and a total score of Female Sexual Distress Scale-Revised of at least 15. Assessing sexual function by measuring female sexual function index (FSFI) during five clinic visits, one at the end of baseline week and at the end of each week of the 4-week treatment period. The primary end point was changed from baseline FSFI total scores to week 4 treatment. Secondary end point included the changes from baseline arousal, desire, orgasm, and satisfaction scores to week 4 treatment. FINDINGS/RESULTS: The sexual problem reported by patients was orgasmic or/and arousal disorders. In premenopausal cases, active cream led to a high significant increase in mean change FSFI total score from the baseline to week 4 compared with placebo (1.7 ± 1.886 vs 13.35 ± 4.646, respectively; P < 0.0001). Greater improvement of mean change of orgasm and arousal domain score was also observed (0.3 ± 0.45 and 0.35 ± 0.39 vs. 2.66 ± 0.63 and 1.87 ± 0.168, respectively; P < 0.0001). In postmenopausal cases, there were significantly greater improvements with active cream in all sexual functions compared with placebo cream (P < 0.0001). In triple cream, mean change of FSFI total score, orgasm domain score, and arousal score domain were 14.85 ± 6.33, 1.87 ± 0.168 and 2.66 ± 1.182, whereas in the placebo cream, they were 1.54 ± 2.1,0.7 ± 0.76 and 0.22 ± 0.44, respectively. Meanwhile, orgasm scores increased significantly after the use of placebo cream. No serious adverse effects were reported during treatment. IMPLICATIONS/CONCLUSIONS: The results of the pilot trial suggest that topical cream containing small concentrations of three vasodilators may act synergistically, and was effective in improving arousal, orgasmic, and satisfaction disorder with a safer profile for premenopausal and postmenopausal women with FSD. Further studies are recommended to be conducted using a large number of nondepressive and depressive patients.
[Mh] Termos MeSH primário: Pós-Menopausa
Pré-Menopausa
Disfunções Sexuais Fisiológicas/tratamento farmacológico
Vasodilatadores/administração & dosagem
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Método Duplo-Cego
Combinação de Medicamentos
Sinergismo Farmacológico
Feminino
Seres Humanos
Meia-Idade
Orgasmo/efeitos dos fármacos
Satisfação do Paciente
Projetos Piloto
Estudos Prospectivos
Vasodilatadores/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Drug Combinations); 0 (Vasodilator Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/JCP.0000000000000811


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[PMID]:29280868
[Au] Autor:Turini T; Weck Roxo AC; Serra-Guimarães F; Abreu ML; de Castro CC; Aboudib JH; Nahas FX
[Ad] Endereço:Rio de Janeiro and São Paulo, Brazil From the Division of Plastic and Reconstructive Surgery, Pedro Ernesto University Hospital, Rio de Janeiro State University; and the Division of Plastic Surgery, Federal University of São Paulo.
[Ti] Título:The Impact of Labiaplasty on Sexuality.
[So] Source:Plast Reconstr Surg;141(1):87-92, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Labiaplasty is one of the aesthetic procedures that has shown the greatest increase in the number of operations in recent years, although the absolute number of these procedures is still very low. Labia minora hypertrophy causes not only functional discomfort and sexual difficulties, but also embarrassment and aesthetic concern. The aim of this study was to assess the impact of labiaplasty on the patient's quality of life, self-esteem, and sexual function. METHODS: Twenty-four consecutive sexually active patients, who expressed the desire to undergo labiaplasty, were divided into two groups of 12 patients each: the intervention group that underwent labiaplasty immediately after responding the first questionnaires, and the control group that received no intervention during the study period. All patients were assessed for health-related quality of life, self-esteem, and sexual function using the Brazilian Portuguese versions of the Medical Outcomes Study 36-Item Short Form Health Survey, the Brazilian version of the Rosenberg Self-Esteem scale, and the Female Sexual Function Questionnaire, respectively. The questionnaires were administered at inclusion and at 3 and 6 months later in both groups. Comparisons within and between groups were performed. Statistical analysis was performed at a significance level of p < 0.05. RESULTS: No significant differences in Rosenberg Self-Esteem scale or Medical Outcomes Study 36-Item Short Form Health Survey score were found in either group during the study period. However, a significant improvement was found in the Female Sexual Function Questionnaire total score in the pain and enjoyment domains. CONCLUSION: Labiaplasty had a positive impact on sexual functioning of the study population.
[Mh] Termos MeSH primário: Técnicas Cosméticas/psicologia
Qualidade de Vida
Autoimagem
Disfunções Sexuais Fisiológicas/etiologia
Disfunções Sexuais Psicogênicas/etiologia
Sexualidade
Vulva/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seguimentos
Seres Humanos
Hipertrofia/complicações
Hipertrofia/psicologia
Hipertrofia/cirurgia
Meia-Idade
Estudos Prospectivos
Disfunções Sexuais Fisiológicas/diagnóstico
Disfunções Sexuais Fisiológicas/cirurgia
Disfunções Sexuais Psicogênicas/diagnóstico
Disfunções Sexuais Psicogênicas/cirurgia
Resultado do Tratamento
Vulva/patologia
Adulto Jovem
[Pt] Tipo de publicação:CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003921


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[PMID]:28455078
[Au] Autor:Diamond MP; Legro RS; Coutifaris C; Alvero R; Robinson RD; Casson PA; Christman GM; Huang H; Hansen KR; Baker V; Usadi R; Seungdamrong A; Bates GW; Rosen RM; Schlaff W; Haisenleder D; Krawetz SA; Barnhart K; Trussell JC; Santoro N; Eisenberg E; Zhang H; Eunice Kennedy Shriver National Institute of Child Health and Human Development Reproductive Medicine Network
[Ad] Endereço:Department of Obstetrics and Gynecology, Georgia Regents University, Augusta, GA; Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI. Electronic address: michael.diamond@augusta.edu.
[Ti] Título:Sexual function in infertile women with polycystic ovary syndrome and unexplained infertility.
[So] Source:Am J Obstet Gynecol;217(2):191.e1-191.e19, 2017 08.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While female sexual dysfunction is a frequent occurrence, characteristics in infertile women are not well delineated. Furthermore, the impact of infertility etiology on the characteristics in women with differing androgen levels observed in women with polycystic ovary syndrome and unexplained infertility has not been assessed. OBJECTIVE: The objective of the study was to determine the characteristics of sexual dysfunction in women with polycystic ovary syndrome and unexplained infertility. STUDY DESIGN: A secondary data analysis was performed on 2 of Eunice Kennedy Shriver National Institute of Child Health and Human Development Cooperative Reproductive Medicine Networks clinical trials: Pregnancy in Polycystic Ovary Syndrome Study II and Assessment of Multiple Intrauterine Gestations From Ovarian Stimulation. Both protocols assessed female sexual function using the Female Sexual Function Inventory and the Female Sexual Distress Scale. RESULTS: Women with polycystic ovary syndrome had higher weight and body mass index than women with unexplained infertility (each P < .001), greater phenotypic (Ferriman-Gallwey hirsutism score, sebum score, and acne score; each P < .001), and hormonal (testosterone, free testosterone, and dehydroepiandrosterone; each P < .001) evidence of androgen excess. Sexual function scores, as assessed by the Female Sexual Function Inventory, were nearly identical. The Female Sexual Distress Scale total score was higher in women with polycystic ovary syndrome. The mean Female Sexual Function Inventory total score increased slightly as the free androgen index increased, mainly as a result of the desire subscore. This association was more pronounced in the women with unexplained infertility. CONCLUSION: Reproductive-age women with infertility associated with polycystic ovary syndrome and unexplained infertility, despite phenotypic and biochemical differences in androgenic manifestations, do not manifest clinically significant differences in sexual function.
[Mh] Termos MeSH primário: Infertilidade Feminina/complicações
Síndrome do Ovário Policístico/complicações
Disfunções Sexuais Fisiológicas/etiologia
[Mh] Termos MeSH secundário: Adulto
Androgênios/sangue
Estudos Transversais
Feminino
Seres Humanos
Infertilidade Feminina/sangue
Síndrome do Ovário Policístico/sangue
Disfunções Sexuais Fisiológicas/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Androgens)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29202143
[Au] Autor:Dawson ML; Shah NM; Rinko RC; Veselis C; Whitmore KE
[Ad] Endereço:Department of OB/GYN, Drexel University College of Medicine, Philadelphia, PA, USA. Email: Melissa.Dawson.DO@gmail.com.
[Ti] Título:The evaluation and management of female sexual dysfunction.
[So] Source:J Fam Pract;66(12):722-728, 2017 Dec.
[Is] ISSN:1533-7294
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Female sexual dysfunction has complex physiologic and psychological components that require a detailed screening, history, and physical examination. Our goal in this review is to provide family physicians with insights and practical advice to help screen, diagnose, and treat female sexual dysfunction, which can have a profound impact on patients' most intimate relationships.
[Mh] Termos MeSH primário: Disfunções Sexuais Fisiológicas/diagnóstico
Disfunções Sexuais Fisiológicas/terapia
Disfunções Sexuais Psicogênicas/diagnóstico
Disfunções Sexuais Psicogênicas/terapia
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


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[PMID]:28973710
[Au] Autor:Loftus LS; Sokol GH; Laronga C
[Ad] Endereço:From the Department of Breast Oncology, Moffitt Cancer Center and Research Institute, Tampa, Florida, and the Department of Medicine and Clinical Pharmacology, Uniformed Services University of Health Sciences, Bethesda, Maryland.
[Ti] Título:Breast Cancer Survivorship: Patient Characteristics and Plans for High-Quality Care.
[So] Source:South Med J;110(10):673-677, 2017 Oct.
[Is] ISSN:1541-8243
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The number of breast cancer survivors has increased and this increase is expected to continue, likely as a result of population and age growth, the implementation of earlier detection strategies, and the development of more effective therapies. Breast cancer treatment requires a multidisciplinary approach with surgery, radiation, chemotherapy, targeted therapy, and hormonal therapy. Breast cancer survivors may develop various long-term adverse effects from these therapies. Care of the survivor may transition eventually to the primary care physician. Survivorship care plans have been developed to facilitate care transition, guide the content and coordination of posttreatment care, and engender greater self-management of health by cancer survivors. Guidelines for posttreatment follow-up care are discussed in this article, and interventions that patients may practice to promote a healthy lifestyle also are presented.
[Mh] Termos MeSH primário: Assistência ao Convalescente
Neoplasias da Mama/terapia
Doenças Cardiovasculares/terapia
Dor Crônica/terapia
Infertilidade Feminina/terapia
Linfedema/terapia
Complicações Pós-Operatórias/terapia
Disfunções Sexuais Fisiológicas/terapia
Sobreviventes
[Mh] Termos MeSH secundário: Antineoplásicos/efeitos adversos
Doenças Cardiovasculares/induzido quimicamente
Dor Crônica/etiologia
Feminino
Estilo de Vida Saudável
Seres Humanos
Infertilidade Feminina/induzido quimicamente
Excisão de Linfonodo/efeitos adversos
Linfedema/etiologia
Mastectomia/efeitos adversos
Menopausa Precoce
Doenças do Sistema Nervoso Periférico/induzido quimicamente
Doenças do Sistema Nervoso Periférico/terapia
Complicações Pós-Operatórias/etiologia
Guias de Prática Clínica como Assunto
Qualidade da Assistência à Saúde
Disfunções Sexuais Fisiológicas/induzido quimicamente
Transtornos do Sono-Vigília/etiologia
Transtornos do Sono-Vigília/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.14423/SMJ.0000000000000701


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[PMID]:28957928
[Au] Autor:Katz A
[Ad] Endereço:Anne Katz is a clinical nurse specialist at CancerCare Manitoba in Winnipeg, Manitoba, Canada. Contact author: anne.katz@cancercare.mb.ca. The author has disclosed no potential conflicts of interest, financial or otherwise.
[Ti] Título:Obesity and Sexual Dysfunction: Making the Connection.
[So] Source:Am J Nurs;117(10):45-50, 2017 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Understanding the relationship between the two may motivate patients to discuss weight loss.
[Mh] Termos MeSH primário: Papel do Profissional de Enfermagem
Obesidade/enfermagem
Disfunções Sexuais Fisiológicas/enfermagem
Disfunções Sexuais Psicogênicas/enfermagem
[Mh] Termos MeSH secundário: Índice de Massa Corporal
Feminino
Seres Humanos
Masculino
Relações Enfermeiro-Paciente
Obesidade/complicações
Obesidade/prevenção & controle
Disfunções Sexuais Fisiológicas/etiologia
Disfunções Sexuais Fisiológicas/prevenção & controle
Disfunções Sexuais Psicogênicas/etiologia
Disfunções Sexuais Psicogênicas/prevenção & controle
Perda de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000525873.36360.5a


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[PMID]:28854246
[Au] Autor:Lee JY; Shin DW; Oh JW; Kim W; Joo SK; Jeon MJ; Kim SM; Yun JM; Son KY; Park JH; Cho B; Lee SM
[Ad] Endereço:Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
[Ti] Título:Non-alcoholic fatty liver disease as a risk factor for female sexual dysfunction in premenopausal women.
[So] Source:PLoS One;12(8):e0182708, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) has become a common and important chronic liver disease worldwide. Previous studies have indicated that NAFLD has an adverse effect on the quality of life, but information is lacking about the impact of NAFLD on female sexual dysfunction. The aim of this study was to determine the association between NAFLD and female sexual dysfunction in premenopausal women. METHODS: This retrospective study consisted of premenopausal women who were sexually active and visited the outpatient clinic for a routine health check-up between January 2010 and December 2011. Based on the examination of the liver ultrasound scan, the study population was divided into 2 groups: cases with NAFLD and normal controls (cases without NAFLD). The female sexual function was compared between the two groups of cases. For the assessment of sexual function, a female sexual function index (FSFI) questionnaire was used. RESULTS: Four hundred seventy women were included, and the prevalence of NAFLD and female sexual dysfunction were 67/470 (14.3%) and 238/470 (50.6%), respectively. Cases with NAFLD had a lower total FSFI score and higher rate of female sexual dysfunction than the normal control [median score of total FSFI (interquartile range): 24.7 (21.9-27.8) in NAFLD vs. 26.7 (23.7-29.8) in normal control, p<0.005; the female sexual dysfunction: 64.2% in NAFLD vs. 48.4% in normal control, p<0.05]. This difference in female sexual dysfunction between the two groups remained significant after adjustment. CONCLUSION: NAFLD is associated with female sexual dysfunction in premenopausal women.
[Mh] Termos MeSH primário: Hepatopatia Gordurosa não Alcoólica/complicações
Pré-Menopausa
Disfunções Sexuais Fisiológicas/etiologia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Fígado/diagnóstico por imagem
Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem
Qualidade de Vida
Estudos Retrospectivos
Fatores de Risco
Inquéritos e Questionários
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182708


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[PMID]:28846767
[Au] Autor:Taylor HS; Tal A; Pal L; Li F; Black DM; Brinton EA; Budoff MJ; Cedars MI; Du W; Hodis HN; Lobo RA; Manson JE; Merriam GR; Miller VM; Naftolin F; Neal-Perry G; Santoro NF; Harman SM
[Ad] Endereço:Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
[Ti] Título:Effects of Oral vs Transdermal Estrogen Therapy on Sexual Function in Early Postmenopause: Ancillary Study of the Kronos Early Estrogen Prevention Study (KEEPS).
[So] Source:JAMA Intern Med;177(10):1471-1479, 2017 Oct 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Sexual dysfunction, an important determinant of women's health and quality of life, is commonly associated with declining estrogen levels around the menopausal transition. Objective: To determine the effects of oral or transdermal estrogen therapy vs placebo on sexual function in postmenopausal women. Design, Setting, and Participants: Ancillary study of the Kronos Early Estrogen Prevention Study (KEEPS), a 4-year prospective, randomized, double-blinded, placebo-controlled trial of menopausal hormone therapy in healthy, recently menopausal women. Of 727 KEEPS enrollees, 670 agreed to participate in this multicenter ancillary study. Women were 42 to 58 years old, within 36 months from last menstrual period. Data were collected from July 2005 through June 2008 and analyzed from July 2010 through June 2017. Interventions: Women were randomized to either 0.45 mg/d oral conjugated equine estrogens (o-CEE), 50 µg/d transdermal 17ß-estradiol (t-E2), or placebo. Participants also received 200 mg oral micronized progesterone (if randomized to o-CEE or t-E2) or placebo (if randomized to placebo estrogens) for 12 days each month. Main Outcomes and Measures: Aspects of sexual function and experience (desire, arousal, lubrication, orgasm, satisfaction, and pain) were assessed using the Female Sexual Function Inventory (FSFI; range, 0-36 points; higher scores indicate better sexual function). Low sexual function (LSF) was defined as an FSFI overall score of less than 26.55. Distress related to low FSFI score (required for the diagnosis of sexual dysfunction) was not evaluated. Results: The 670 participants had a mean (SD) age of 52.7 (2.6) years. The t-E2 treatment was associated with a significant yet moderate improvement in the FSFI overall score across all time points compared with placebo (average efficacy, 2.6; 95% CI, 1.11-4.10; adjusted P = .002). With o-CEE treatment, there was no significant difference in FSFI overall score compared with placebo (mean efficacy, 1.4; 95% CI, -0.1 to 2.8; adjusted P = .13). There was no difference in FSFI overall score between the t-E2 and o-CEE groups on average across 48 months (adjusted P = .22). In the individual domains of sexual function, t-E2 treatment was associated with a significant increase in mean lubrication (0.61; 95% CI, 0.25-0.97; P = .001) and decreased pain (0.67; 95% CI, 0.25-1.09; P = .002) compared with placebo. Overall, the proportion of women with LSF was significantly lower after t-E2 treatment compared with placebo (67%; 95% CI, 55%-77% vs 76%; 95% CI, 67%-83%; P = .04). For o-CEE there was no significant reduction in the odds of LSF. Conclusions and Relevance: Treatment with t-E2 modestly improved sexual function in early postmenopausal women, but whether it relieved symptoms of distress is not known. Trial Registration: clinicaltrials.gov Identifier: NCT00154180.
[Mh] Termos MeSH primário: Terapia de Reposição de Estrogênios/métodos
Estrogênios Conjugados (USP)/administração & dosagem
Pós-Menopausa
Qualidade de Vida
Disfunções Sexuais Fisiológicas/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Cutânea
Administração Oral
Adulto
Método Duplo-Cego
Estradiol/administração & dosagem
Estradiol/análogos & derivados
Estrogênios/administração & dosagem
Feminino
Seguimentos
Glucuronatos/administração & dosagem
Seres Humanos
Meia-Idade
Progesterona/administração & dosagem
Progestinas/administração & dosagem
Estudos Prospectivos
Escalas de Graduação Psiquiátrica
Fatores de Risco
Disfunções Sexuais Fisiológicas/psicologia
Fatores de Tempo
Saúde da Mulher
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (17-glucuronosylestradiol); 0 (Estrogens); 0 (Estrogens, Conjugated (USP)); 0 (Glucuronates); 0 (Progestins); 4G7DS2Q64Y (Progesterone); 4TI98Z838E (Estradiol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.3877



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