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A study of Japanese dyspareunia in patients with endometriosis
THURSDAY,
SEPTEMBER
7
to concentrate (p<.O2), sleep difficulties (p<.O4), headache (p<.O5), increased hair on the face (p<.OOO), loss of fitness (p<.O2), involuntary loss of urine (pc.03); f) increased libido was significantly higher in women who did not suffered from climacteric complaints with the exception of breathlessness, inability to concentrate, bloating of the abdomen, lower abdominal pain, muscular and joint pain, skin dryness. Conclusions A complex interplay of biological, psychological and sociocultural factors decrease the opportunities for a pleasurable perception of sexual intimacy by affecting discrete components of female sexual response.
FC4.23.03 HISTORY OF SEXUAL ABUSE AND GYNECOLOGICAL EXAMINATION IN DANISH PATIENTS VISITING GYNECOLOGICAL IN-AND OUT-PATIENT CLINIC M. Hilden Dept. OB/GYN,Glostrup County Hosp., Uni. of -> Copenhagen, Denmark. K. Sidenius, Dept.OG/GYN,Glostrup County Hosp., Uni. of Copenhagen, Denmark U. Pikarinen, Dept. OBIGYN, Helsinki University Hosp., Finland H. Stoum, Dept.OG/GYN, University Hosp., Trondheim, Norway K. Offerdal, Dept.OB/GYN, University Hosp., Trondheim, Norway T. Steingrimsdottir, Dept OBIGYN, Ladspitalinn,Reykjavik, Iceland K. Svahnberg, Dept.OB/GYN, IHM, LinMping, Sweden Objectives: The aim of the study is to determine how many patients who has been sexually abused and how this influenced the gynecological examination. Study methods: 1000 patients visiting our in-and out-patient clinic accepted to participiate in a mail distributed questionnarie. The response rate was 76 %. The study is the Danish part of the “The Five Country Nordic Study” (Norvold-study). Results: Preliminary analysis of 200 questionnaires demonstrated that 20 % had a history of sexual abuse. 47 % of these women felt “strong discomfort” when being examined by the gynecologist, whereas only 16 % of women who were not sexually abused experienced “strong discomfort”. Yet 89 % of the abused women felt they had positive contact with the gynecologist. There was no difference whether the patient was examined by a male or a female gynecologist. 58 % of the women with a history of sexual abuse reported that they felt violated during contact with the health care system. Less than 5 % reported that they had informed the gynecologist of their history of sexual abuse, and even fewer that they had been asked by the gynecologist. Conclusions: Patients with a history of sexual abuse more often feel “strong discomfort” when being examined. Very few patients report sexual abuse to the gynecologist and gynecologists rarely ask the patients about this issue. This study shows the need to openly discuss issues such as sexual abuse with patients, in order to minimize the risk of retraumatisation.
FC4.23.04 A STUDY OF JAPANESE DYSPAREUNIA IN PATIENTS WITH ENDOMETRIOSIS M.K Seki K. Hamazaki, M. Kashimura, Dept OBIGYN, University of -> Occupational and Environmental Health, Kitakyushu, Japan. Objectives: Dyspareunia is known to be associated with endometriosis. In this study, we focus our interest on physical and psyschological examination in order to manage patients who have hyspareunia with enodmetriosis. Study Methods: 42 Japanese women with endometriosis below the age of 40 years were included in this study. The subjects were divided into 2 groups presenting with dyspareunia (n=20) and in those without dyspareunia (n=22). Results: In comparison with the women without dyspareunia, patients with dyspareunia were noted to have a significant different in terms of the scarring of the uterosacral ligament significant differences between the sate of rAFS. Conclusions: Local lesions of uterosacral ligament may play an important role when associated with dyspareunia especially for patents with endometriosis and could account for the high incidence of psychological conflicts in such patients.
6.5
FC4.23.06 SEXUAL BEHAVIOR IN CLIMATERIC WOMEN Penteado. SRL, Fonseca, AM, Cavalcanti, AM, Parellada, CI; Bagnoli, VR; Pasqualotto, EB & Halbe, HW, Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil Objective: To determine the sexual behavior of a group of climateric women Methods: Thirty-seven sexually active climateric women were interviewed in this study. Patients’ age ranged from 43 to 60 years (mean age 51,8 years). The following parameters were evaluated: sexual desire, masturbation, self - confidence (to feel sexually desirable by her partner), knowledge of her and her partners erotica1 body parts, sexually open dialogues with her partner, and different types of sexual activities. Results: Out of 26 women (70,3%) who reported sexual desire 21 (56,7%) reported decrease of it in the past years. Twenty-eight (76,7%) denied masturbation and most patients felt desired by their partners (22 patients - 59,4%). Most women reported to know their and their partners erotica1 body parts, respectively 26 (70,3%) and 22 (60,5%). Twentytwo women reported an open dialogue with their partners. Finally, 31 women (83,8%) reported to have only vaginal intercourse, 3 (8,2%) vaginal and oral, and the last 3 (8,2%) reported vaginal, oral and anal intercourse. Conclusion: Studies about sexuality and the impact of aging physical changes on performance and behavior of climateric women must continue being carried out.
FC4.23.07 A PILOT STUDY OF THE EFFECT OF VIAGRA’ ON VAGINAL BLOOD FLOW (VBF) IN FEMALE SUBJECTS Ellen Laan MD; Rik HW van Lunsen, MD; Alan Riley, MD; Liz Scott, -> MD; Mitra Boolell, MD Objective: Viagra, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5, is an efficacious and well-tolerated treatment for erectile dysfunction. It has been hypothesised that the nitric oxide (NO)-cGMP pathway may be functionally important in the female sexual arousal response (Burnett et al, 1997). The effects of Viagra on female sexual arousal were investigated in a randomised, double-blind, placebo-controlled, two-way crossover study in 23 healthy female subjects (age range, 18-38 years) conducted at two centres. Methods: VBF, measured by photoplethysmography during visual sexual stimulation (VSS; Laan et al, 1995), and a subjective arousal score (Wincze et al, 1976) were assessed after a single dose of Viagra (50 mg) or placebo. VBF data from one centre were not analysable due to a technical failure. Results: For the 12 subjects at the second centre, there was a statistically significant increase (p value less than 0.05) from baseline in VBF with Viagra treatment (mean 160%; 95% CI, 104%-217%) compared with placebo treatment (mean 112%; 95% CI, 74%-150%). There was no significant difference between the two treatment groups for the mean sexual arousal score, which was 1.8 (range, O-4) for subjects receiving Viagra and 2.0 (range, O-4) for those receiving placebo. The main adverse events reported were headache, flushing, and nasal congestion. Conclusion: Viagra is well tolerated in healthy female subjects and may increase VBF during VSS but does not appear to increase the subjective arousal score.
FC4.23.08 EVALUATION OF THE EFFECTS OF PHENTOLAMINE MESYLATE ON VAGINAL BLOOD FLOW RESPONSE IN POSTMENOPAUSAL WOMEN WITH FEMALE SEXUAL DYSFUNCTION Rubio EA, Lopez M, Lipezeker M, Rampazzo C, Hurtado de Mendoza MT (Mexico City, Mexico), Lowrey F, Loehr LA, Lammers PI (The Woodlands, Texas) Objectives: Studies have shown that Female Sexual Dysfunction (FSD) in postmenopausal women is characterized by weak clitoral erections, vaginal dryness, and diminished vaginal sensations. This study was conducted to collect both physiological and subjective diary information on the effects of phentolamine mesylate, a non-selective alphaadrenergic receptor antagonist, in postmenopausal women with FSD.
SEPTEMBER
7
to concentrate (p<.O2), sleep difficulties (p<.O4), headache (p<.O5), increased hair on the face (p<.OOO), loss of fitness (p<.O2), involuntary loss of urine (pc.03); f) increased libido was significantly higher in women who did not suffered from climacteric complaints with the exception of breathlessness, inability to concentrate, bloating of the abdomen, lower abdominal pain, muscular and joint pain, skin dryness. Conclusions A complex interplay of biological, psychological and sociocultural factors decrease the opportunities for a pleasurable perception of sexual intimacy by affecting discrete components of female sexual response.
FC4.23.03 HISTORY OF SEXUAL ABUSE AND GYNECOLOGICAL EXAMINATION IN DANISH PATIENTS VISITING GYNECOLOGICAL IN-AND OUT-PATIENT CLINIC M. Hilden Dept. OB/GYN,Glostrup County Hosp., Uni. of -> Copenhagen, Denmark. K. Sidenius, Dept.OG/GYN,Glostrup County Hosp., Uni. of Copenhagen, Denmark U. Pikarinen, Dept. OBIGYN, Helsinki University Hosp., Finland H. Stoum, Dept.OG/GYN, University Hosp., Trondheim, Norway K. Offerdal, Dept.OB/GYN, University Hosp., Trondheim, Norway T. Steingrimsdottir, Dept OBIGYN, Ladspitalinn,Reykjavik, Iceland K. Svahnberg, Dept.OB/GYN, IHM, LinMping, Sweden Objectives: The aim of the study is to determine how many patients who has been sexually abused and how this influenced the gynecological examination. Study methods: 1000 patients visiting our in-and out-patient clinic accepted to participiate in a mail distributed questionnarie. The response rate was 76 %. The study is the Danish part of the “The Five Country Nordic Study” (Norvold-study). Results: Preliminary analysis of 200 questionnaires demonstrated that 20 % had a history of sexual abuse. 47 % of these women felt “strong discomfort” when being examined by the gynecologist, whereas only 16 % of women who were not sexually abused experienced “strong discomfort”. Yet 89 % of the abused women felt they had positive contact with the gynecologist. There was no difference whether the patient was examined by a male or a female gynecologist. 58 % of the women with a history of sexual abuse reported that they felt violated during contact with the health care system. Less than 5 % reported that they had informed the gynecologist of their history of sexual abuse, and even fewer that they had been asked by the gynecologist. Conclusions: Patients with a history of sexual abuse more often feel “strong discomfort” when being examined. Very few patients report sexual abuse to the gynecologist and gynecologists rarely ask the patients about this issue. This study shows the need to openly discuss issues such as sexual abuse with patients, in order to minimize the risk of retraumatisation.
FC4.23.04 A STUDY OF JAPANESE DYSPAREUNIA IN PATIENTS WITH ENDOMETRIOSIS M.K Seki K. Hamazaki, M. Kashimura, Dept OBIGYN, University of -> Occupational and Environmental Health, Kitakyushu, Japan. Objectives: Dyspareunia is known to be associated with endometriosis. In this study, we focus our interest on physical and psyschological examination in order to manage patients who have hyspareunia with enodmetriosis. Study Methods: 42 Japanese women with endometriosis below the age of 40 years were included in this study. The subjects were divided into 2 groups presenting with dyspareunia (n=20) and in those without dyspareunia (n=22). Results: In comparison with the women without dyspareunia, patients with dyspareunia were noted to have a significant different in terms of the scarring of the uterosacral ligament significant differences between the sate of rAFS. Conclusions: Local lesions of uterosacral ligament may play an important role when associated with dyspareunia especially for patents with endometriosis and could account for the high incidence of psychological conflicts in such patients.
6.5
FC4.23.06 SEXUAL BEHAVIOR IN CLIMATERIC WOMEN Penteado. SRL, Fonseca, AM, Cavalcanti, AM, Parellada, CI; Bagnoli, VR; Pasqualotto, EB & Halbe, HW, Dept. OBIGYN, SBo Paula University Medical School, SBo Paula, Brazil Objective: To determine the sexual behavior of a group of climateric women Methods: Thirty-seven sexually active climateric women were interviewed in this study. Patients’ age ranged from 43 to 60 years (mean age 51,8 years). The following parameters were evaluated: sexual desire, masturbation, self - confidence (to feel sexually desirable by her partner), knowledge of her and her partners erotica1 body parts, sexually open dialogues with her partner, and different types of sexual activities. Results: Out of 26 women (70,3%) who reported sexual desire 21 (56,7%) reported decrease of it in the past years. Twenty-eight (76,7%) denied masturbation and most patients felt desired by their partners (22 patients - 59,4%). Most women reported to know their and their partners erotica1 body parts, respectively 26 (70,3%) and 22 (60,5%). Twentytwo women reported an open dialogue with their partners. Finally, 31 women (83,8%) reported to have only vaginal intercourse, 3 (8,2%) vaginal and oral, and the last 3 (8,2%) reported vaginal, oral and anal intercourse. Conclusion: Studies about sexuality and the impact of aging physical changes on performance and behavior of climateric women must continue being carried out.
FC4.23.07 A PILOT STUDY OF THE EFFECT OF VIAGRA’ ON VAGINAL BLOOD FLOW (VBF) IN FEMALE SUBJECTS Ellen Laan MD; Rik HW van Lunsen, MD; Alan Riley, MD; Liz Scott, -> MD; Mitra Boolell, MD Objective: Viagra, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5, is an efficacious and well-tolerated treatment for erectile dysfunction. It has been hypothesised that the nitric oxide (NO)-cGMP pathway may be functionally important in the female sexual arousal response (Burnett et al, 1997). The effects of Viagra on female sexual arousal were investigated in a randomised, double-blind, placebo-controlled, two-way crossover study in 23 healthy female subjects (age range, 18-38 years) conducted at two centres. Methods: VBF, measured by photoplethysmography during visual sexual stimulation (VSS; Laan et al, 1995), and a subjective arousal score (Wincze et al, 1976) were assessed after a single dose of Viagra (50 mg) or placebo. VBF data from one centre were not analysable due to a technical failure. Results: For the 12 subjects at the second centre, there was a statistically significant increase (p value less than 0.05) from baseline in VBF with Viagra treatment (mean 160%; 95% CI, 104%-217%) compared with placebo treatment (mean 112%; 95% CI, 74%-150%). There was no significant difference between the two treatment groups for the mean sexual arousal score, which was 1.8 (range, O-4) for subjects receiving Viagra and 2.0 (range, O-4) for those receiving placebo. The main adverse events reported were headache, flushing, and nasal congestion. Conclusion: Viagra is well tolerated in healthy female subjects and may increase VBF during VSS but does not appear to increase the subjective arousal score.
FC4.23.08 EVALUATION OF THE EFFECTS OF PHENTOLAMINE MESYLATE ON VAGINAL BLOOD FLOW RESPONSE IN POSTMENOPAUSAL WOMEN WITH FEMALE SEXUAL DYSFUNCTION Rubio EA, Lopez M, Lipezeker M, Rampazzo C, Hurtado de Mendoza MT (Mexico City, Mexico), Lowrey F, Loehr LA, Lammers PI (The Woodlands, Texas) Objectives: Studies have shown that Female Sexual Dysfunction (FSD) in postmenopausal women is characterized by weak clitoral erections, vaginal dryness, and diminished vaginal sensations. This study was conducted to collect both physiological and subjective diary information on the effects of phentolamine mesylate, a non-selective alphaadrenergic receptor antagonist, in postmenopausal women with FSD.