Nuno Monteiro Pereira

Sexuality during pregnancy.

INTRODUCTIONnSexuality is an important part of health and well-being. Sexual behavior modifies as pregnancy progresses, influenced by biological, psychological, and social factors.nnnAIMnTo evaluate changes in sexual perceptions and activities during pregnancy and to determine sexual dysfunctions in that period.nnnMAIN OUTCOME MEASURESnSexual perceptions (desire from the partner, feelings of attractiveness, and fear of sexual intercourse), sexual activities during pregnancy (sexual intercourse frequency, the most frequent sexual intercourse trimester, sexual activity during the birth week, type(s) of sexual intercourse, changes in sexual satisfaction and desire compared with the pre-pregnancy period, and changes in sexual intercourse frequency during each trimester compared with the pre-pregnancy period), and sexual dysfunctions.nnnMETHODSnPuerperal women were asked to anonymously complete a self-administered and structured questionnaire at the day of discharge from hospital.nnnRESULTSnOne hundred and eighty-eight women, aged between 17 years and 40 years with a mean age of 28.9 years, were analyzed. The first trimester was considered the most frequent period of sexual intercourse (44.7%), followed by the second trimester (35.6%). Fifty-five percent reported a decrease of sexual activity during the third trimester. Fear of sexual intercourse was referred by 23.4% of the women questioned. Sexual satisfaction was unchanged in 48.4% of the subjects and decreased in 27.7% (P < 0.0001); sexual desire is reported to be unchanged in 38.8% and decreased in 32.5% (P = 0.196) of the population. Vaginal, oral, anal sex, and masturbation were performed by 98.3%, 38.1%, 6.6%, and 20.4% of the women, respectively.nnnCONCLUSIONSnWe determined in our study that sexual satisfaction do not change in pregnancy compared with the pre-pregnancy patterns despite a decline of sexual activity during the third trimester. A discussion of expected changes in sexuality should be routinely done by the doctor in order to improve couples perception of possible sexual modifications induced by pregnancy.

What is Sexual Satisfaction? Thematic Analysis of Lay People's Definitions

Sexual satisfaction is an important indicator of sexual health and is strongly associated with relationship satisfaction. However, research exploring lay definitions of sexual satisfaction has been scarce. We present thematic analysis of written responses of 449 women and 311 men to the question “How would you define sexual satisfaction?” The participants were heterosexual individuals with a mean age of 36.05 years (SD = 8.34) involved in a committed exclusive relationship. In this exploratory study, two main themes were identified: personal sexual well-being and dyadic processes. The first theme focuses on the positive aspects of individual sexual experience, such as pleasure, positive feelings, arousal, sexual openness, and orgasm. The second theme emphasizes relational dimensions, such as mutuality, romance, expression of feelings, creativity, acting out desires, and frequency of sexual activity. Our results highlight that mutual pleasure is a crucial component of sexual satisfaction and that sexual satisfaction derives from positive sexual experiences and not from the absence of conflict or dysfunction. The findings support definitions and models of sexual satisfaction that focus on positive sexual outcomes and the use of measures that incorporate items linked to personal and dyadic sexual rewards for both men and women.

Predictors of Body Appearance Cognitive Distraction during Sexual Activity in Men and Women

INTRODUCTIONnCognitive distraction is a core concept in cognitive models of sexual dysfunction. Body appearance cognitive distraction during sexual activity (BACDSA) has been mainly studied among female college samples. However, the relative contribution of different indicators of body dissatisfaction among men and women from community samples, including the contribution of relationship variables to BACDSA, has yet to be examined.nnnAIMnThe aim of this study was to examine the extent to which aspects of body dissatisfaction and relationship variables predict BACDSA.nnnMETHODSnA total of 669 cohabitating, heterosexual, Portuguese participants (390 women and 279 men) with no sexual problems completed an anonymous online survey. The survey included a sociodemographic questionnaire and a set of questionnaires assessing body- and relationship-related variables.nnnMAIN OUTCOME MEASURESnWe used a single item measure of the participants satisfaction with the opinion that they perceive their partner has about the participants body (PPO); the Global Body Dissatisfaction Subscale of the Body Attitudes Test (GBD); a version of the Contour Drawing Rating Scale; the Global Measure of Relationship Satisfaction; and the Inclusion of Other in Self Scale. Focus on specific body parts during sexual activity (FBP) and relationship length were assessed with an open-ended question.nnnRESULTSnHierarchical multiple regression indicated that GBD and FBP were the only body dissatisfaction variables that significantly predicted BACDSA in both men and women. The relationship variables significantly increased the amount of variance explained in BACDSA for both men and women. However, PPO was the only significant relationship variable that predicted BACDSA and only in women.nnnCONCLUSIONSnBody and relationship variables are significant factors in body appearance cognitive distraction. They require further research and assessment, particularly for clinical intervention.

Validação de uma versão portuguesa do Índice Internacional de Função Eréctil-5 (IIEF-5

Resumo Objectivos A presente investigacao teve como objectivo proceder a validacao de uma versao portuguesa do Indice Internacional de Funcao Erectil-5 (IIFE-5), instrumento breve que avalia a funcao erectil em homens. Metodos Recorreu-se a 1.417 participantes do sexo masculino subdivididos em tres amostras (nxa0=xa01.250, nxa0=xa0137 e nxa0=xa030), aos quais preencheram o questionario com a traducao para portugues do IIFE-5. Resultados foram demonstradas propriedades psicometricas nomeadamente a nivel de validade factorial, consistencia interna, estabilidade temporal, validade discriminante e validade divergente; o ponto de corte encontrado, todavia, foi mais baixo que o do IIEF-5 original. Discussao As boas propriedades psicometricas encontradas permitem recomendar o uso do IIEF-5 na populacao masculina portuguesa.

Emotional intimacy is the best predictor of sexual satisfaction of men and women with sexual arousal problems

This study investigates the association between variables related to individual body appearance and relationship variables with sexual satisfaction (SS) in a sample of men and women with sexual arousal problems (SAP). An anonymous cross-sectional survey was conducted in a clinical setting with a non-representative sample of people diagnosed (DSP) with SAP and with a sample of people who identified themselves (SISP) as having a SAP. A total of 193 participants was recruited. SS and variables related to body appearance and relationship were measured. Hierarchical regression was used to study the contribution of different sets of variables on SS of men and women. No differences were found in terms of demographic variables, except for gender. Women in the SISP group presented significantly higher levels of SS than women in the DSP group. The predictive models proved to be statistically significant and explained many of the variance of SS in both men (R2=0.44) and women (R2=0.40). In both genders, emotional intimacy was revealed to be the main predictor of SS. Our results support the need to address relationship variables in patients diagnosed with SAP, specifically intimacy. This latter component must be considered for assessment, intervention and referral.

Why are men satisfied or dissatisfied with penile implants? A mixed method study on satisfaction with penile prosthesis implantation

INTRODUCTIONnStudies have demonstrated high levels of satisfaction with penile prosthesis implantation (PPI). However, qualitative research exploring the experience of PPI through mens narratives is scarce.nnnAIMnThe main goals were to analyze (i) the level of sexual satisfaction (quantitatively), and (ii) the reasons for satisfaction and/or dissatisfaction with PPI (qualitatively).nnnMETHODnParticipants were 47 men with erectile dysfunction who underwent surgery between 2003 and 2012, placed by a single surgeon. Structured telephone interviews were carried out.nnnMAIN OUTCOME MEASURESnSatisfaction with PPI was a qualitative and quantitative measure assessed through the following four items: (i) Would you repeat the PPI surgery?; (ii) Would you recommend the PPI surgery?; (iii) How satisfied are you with the PP?; and (iv) Could you explain the motives of your satisfaction/dissatisfaction?.nnnRESULTSnThe majority of men (79%) reported to be satisfied with PPI. Content analysis revealed four main themes for mens satisfaction with the PPI: (i) psychological factors were reported 54 times (nu2009=u200954) and included positive emotions, self-esteem, confidence, enhancement of male identity, major live change, and self-image; (ii) improvement of sexual function was reported 54 times (nu2009=u200954) and referred to achievement of vaginal penetration, increase of sexual desire, sexual satisfaction, penis size, and improvement of erectile function; (iii) relationship factors were reported 11 times (nu2009=u200911) and referred to relationship improvement and the possibility of giving pleasure to the partner; and (iv) improvement in urinary function (nu2009=u20093).nnnCONCLUSIONSnThe level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for erectile dysfunction with a positive impact on the experience of men at sexual, psychological and relational level.

Processo de validação da Global Measure of Sexual Satisfaction em três amostras da população portuguesa

Sexual satisfaction is an important indicator of sexual health, however, its definition is not consensual. Lawrence and Byers (1995) developed a conceptual model of sexual satisfaction for people in committed relationships and, within this model, the authors developed the Global Measure of Sexual Satisfaction (GMSEX) which assesses global sexual satisfaction in the context of an intimate relationship. In the present study we aimed to adapt and assess the psychometric properties of this scale with three distinct samples from the Portuguese population in cohabitation relationships. One was designated as normative group with no diagnosis and perception of sexual problems (n = 291), another called clinical group, whose participants presented sexual problems (n = 84), and an online sample of participants with and without perception of sexual problems (n = 760). The scale proved to have a single factor structure as well as good reliability and validity.

Peripheral Polyneuropathy and Female Sexual Dysfunction—Familial Amyloidotic Polyneuropathy as an Example Besides Diabetes Mellitus

INTRODUCTIONnFemale sexual dysfunction (FSD) in peripheral polyneuropathies besides diabetes mellitus is still a poorly studied subject. Little is known about sexual function in women with amyloidosis, Guillain-Barré syndrome, or porphyria. Even for the worlds most common peripheral polyneuropathies such as diabetes mellitus, knowledge and consensus are still lacking. Familial amyloidotic polyneuropathy (FAP) is the most common cause of genetic systemic amyloidosis, with neurological clinical manifestations similar to diabetes mellitus. Until today, no study on the sexual function of these young female patients has been published.nnnAIMnTo evaluate FSD in female FAP patients and to compare the results with those of healthy, non-FAP females.nnnMETHODSnA questionnaire-based, observational study comprising 94 nonmenopausal women with a sexual partner (51 FAP and 43 non-FAP as the control group) was conducted. The Female Sexual Function Index (FSFI)--Portuguese-validated version was used to assess FSD.nnnMAIN OUTCOME MEASURESnTotal and subscales scores of the FSFI.nnnRESULTSnFSD was reported by 42% (95% confidence intervals [CI] 28.3-55.7) of FAP patients compared to 12% of healthy controls. Of all the FAP patients, 39.2% reported problems with desire (95% CI 25.6-52.4), 72.5% reported problems with arousal (95% CI 60.2-84.8), 68% reported lubrication problems (95% CI 55.1-80.9), 62% reported orgasm problems (95% CI 48.5-75.5), 39.2% experienced pain (95% CI, 25.8-52.6), and 49% experienced sexual dissatisfaction (95% CI, 35.3-62.7). Even after multiple logistic regression analysis, FAP is associated with sexual dysfunction in women (OR 4.3, 95% CI 1.2-15.5, P < 0.03), and the affected domains are desire (OR 5.1, 95% CI 1.3-19.7, P < 0.02), arousal (OR 4.7, 95% CI 1.5-14.1, P < 0.007), orgasm (OR 5, 95% CI 1.6-16, P < 0.007), and sexual satisfaction (OR 4.8, 95% CI 1.4-16.9, P < 0.02). Only the use of medication with potential for sexual dysfunction was found as a significant predictor of orgasm disorder (OR 4.2, 95% CI 1.1-15.6, P < 0.03), as did age for sexual dissatisfaction (OR 1.1, 95% CI 1.0-1.2, P < 0.04).nnnCONCLUSIONSnFAP as a peripheral polyneuropathy results in FSD, presenting a risk factor four times greater and related to disease severity in terms of desire, arousal, and orgasm disorders, as well as sexual dissatisfaction.