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      Evaluation of sexual function in Brazilian women with and without chronic pelvic pain

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          The aim of this study was to evaluate sexual function in women with chronic pelvic pain (CPP) compared to a control group without CPP and to investigate the factors associated with sexual dysfunction in women with CPP.


          This cross-sectional study included 100 women with CPP and 100 controls. Sexual function was evaluated using the Female Sexual Function Index (FSFI) and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS). A generalized linear model was used to compare the groups with respect to the overall FSFI score and the scores obtained for each FSFI domain. Multiple logistic regression analysis was used to identify the factors associated with sexual dysfunction in the study group.


          Anxiety was present in 66.0% of women with CPP in the study group compared to 49.0% of the controls ( P=0.022). Depression was detected in 63.0% of women with CPP in the study group and in 38.0% of the controls ( P=0.001). Sexual dysfunction was identified in 81.0% of the women with CPP in the study group compared to 58.0% of the controls ( P=0.003). Following adjustment, the women with CPP had significantly lower mean scores compared to the controls in the FSFI domains of desire (3.0±1.3 vs 3.6±1.3; P=0.038), arousal (2.6±1.6 vs 3.4±1.9; P=0.002), lubrication (3.2±1.9 vs 3.7±2.3; P=0.011), orgasm (3.0±1.9 vs 3.6±2.2; P<0.002), and pain (2.5±1.7 vs 3.4±2.2; P<0.001). There was no difference between the groups for the satisfaction domain ( P=0.337) or for the overall score ( P=0.252). A positive and independent association was found between depression and sexual dysfunction in the women with CPP ( P=0.012).


          In the women with CPP, sexual dysfunction was more common, and the scores in most of the sexual function domains were poorer than in the control group. Concurrently, depression was found to be positively associated with sexual dysfunction in the women with CPP.

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          Most cited references 35

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          Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015.

          Definitions of sexual dysfunctions in women and men are critical in facilitating research and enabling clinicians to communicate accurately.
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            Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women--results of the Brazilian study on sexual behavior (BSSB).

            The objective of this study was to assess the prevalence and risk factors of female sexual dysfunctions across a selection of social groups. In all, 1219 women in the community, aged 18 y or older, answered a 38-question self-applicable questionnaire. Statistical analysis was performed using multivariate logistic regression. The average age was 35.6 y (s.d.=12.31) and the average number of sexual intercourses was 2.8 (s.d.=1.94) a week. At least one sexual dysfunction was reported by 49% of the women; lack of sexual desire (LSD) by 26.7%; pain during sexual intercourse (PSI) by 23.1% and orgasmic dysfunction (OD) by 21%. Women aged over 40 y represented an LSD and OD risk factor, whereas women aged over 25 y showed less likelihood of presenting PSI. The educational level was inversely correlated with the risk of LSD, OD and PSI. Depression and cardiopathies increased PSI occurrences and women with diabetes mellitus showed a higher probability of developing LSD and OD. In conclusion, almost half the women had at least one sexual dysfunction, and prevalence increased with age and lower educational levels. Preventive medical care for the female population, mainly for patients with chronic and/or degenerative diseases, considerably reduced the chances of sexual dysfunction.
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              The GRISS: a psychometric instrument for the assessment of sexual dysfunction.

              The Golombok Rust Inventory of Sexual Satisfaction (GRISS) is a short 28-item questionnaire for assessing the existence and severity of sexual problems. The design, construction, and item analysis of the GRISS are described. The two separate male and female scales are shown to have high split-half reliabilities of 0.94 for women and 0.87 for men. Validation of change scores in the GRISS on 30 clinical couples, before and after therapy, showed correlations with therapists' blind ratings of 0.54 (p less than 0.001) for men and 0.43 (p less than 0.01) for women. Discriminatory validity between clinical (n = 69) and nonclinical (n = 59) groups was r = 0.63 for women and r = 0.37 for men. The 12 subscales of impotence, premature ejaculation, anorgasmia, vaginismus, noncommunication, infrequency, male and female avoidance, male and female nonsensuality, and male and female dissatisfaction are also shown to have good reliability and validity.

                Author and article information

                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                08 November 2018
                : 11
                : 2761-2767
                [1 ]Women’s Health Unit, Teaching Hospital, Federal University of Goiás, Goiânia, Goiás, Brazil
                [2 ]Department of Gynecology and Obstetrics, Federal University of Goiás, Goiânia, Goiás, Brazil, delioconde@ 123456gmail.com
                [3 ]Department of Gynecology and Obstetrics, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
                Author notes
                Correspondence: Délio Marques Conde, Department of Gynecology and Obstetrics, Universidade Federal de Goiás, Rua 235, S/N, Setor Leste Universitário, 74605-050, Goiânia, GO, Brazil, Tel +55 62 3209 6151, Email delioconde@ 123456gmail.com
                © 2018 Da Luz et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research

                Anesthesiology & Pain management

                sexuality, depression, sexual dysfunction, orgasm, pain


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