Diversidade Sexual

As mudanças no campo da sexualidade, durante o século XX, caracterizaram-se pela influência da tecnologia, por progressos na área da Sociologia, Pedagogia e pelo advento da psicanálise. Pesquisas sobre o comportamento sexual representaram ruptura com estudos da sexologia clínica. As palavras sexo e gênero foram, e ainda são, utilizadas como sinônimos, embora pertencer a determinado sexo signifique ser homem ou mulher, biologicamente, enquanto gênero define o masculino e o feminino, do ponto de vista comportamental e psicológico. Por outro lado, o comportamento de gênero assume diferentes significados, conforme a cultura em que se insere. A expressão da sexualidade, mais do que se manifestar por diferentes heranças biológicas, também se constitui num meio de confirmação de regras sociais, o que lhe credita caráter ideológico. Técnicas de imagem cerebral ampliaram o conhecimento das diferenças do cérebro masculino e feminino. Estudos demonstraram que influências associadas ao sexo se dão em vários níveis do sistema nervoso, do genético ao comportamental, resultando em distintas organizações cerebrais, masculina e feminina, dissociadas dos estereótipos. O legado de tais mudanças é sem precedentes para a civilização ocidental. Perplexidade, estigmatização, mapeamentos cerebrais e classificações diagnósticas ainda são as respostas mais frequentes a este turbilhão de orientações, identidades e preferências sexuais. Este artigo se propõe a debater o tema diversidade sexual, provocando uma reflexão sobre a força do sociocultural que se contrapõe às evidências da biotecnologiaThe changes in the field of sexuality during the 20th century are characterized by the influence of technology, progress in the area of Sociology, Teaching and the creation of psychoanalysis. Researches on sexual behavior represented a rupture with clinical sexology studies. The words sex and gender have been and still are used as synonyms, even though belonging to a certain sex means being a man or a woman biologically, whereas gender defines male and female from a behavioral and psychological point of view. On the other hand, gender behavior assumes different meanings in accordance with the culture in which it is inserted. The expression of sexuality, more than being expressed by means of a different biological heritage also constitutes a form of confirmation of social rules, which gives it an ideological character. Brain image techniques extended the knowledge about the male and female brains. Studies show that differences associated with sex happen at different levels of the nervous system, from genetics to behavior, resulting in different male and female brain organization dissociated from stereotypes. The legacy of such changes is unprecedented for the Western civilization. Perplexity, stigmatization, brain mapping and diagnosis classifications are still the most frequent answers to this whirlwind of sexual orientations, identities and preferences. This article proposes to debate the topic of sexual diversity, provoking a reflection on the sociocultural components against the evidences of biotechnolog

Editorial: psychological dimensions in human sexual health and behavior

Human sexuality is still an underexplored world, subjected to great taboos and controversies over the decades, representing one of the most challenging areas of research and facing countless political and social demands. In this sense, leading organizations such as the World Health Organization (WHO, 2014) and the World Association for Sexual Health (WAS, 2014) have established sexual health and well-being as human rights and key goals to be achieved worldwide to improve the health-related quality of life. The newmessage that is being carried out by these entities, is that sexual health not only concerns reproductive issues, sexual problems, sexual violence, and sexually transmitted infections, but also positive aspects related to intimate relationships, pleasure, consenting sexual relationships, gender and sexual orientation variety, and sexual functioning among other aspects

Sexual satisfaction among patients with erectile dysfunction treated with counseling, sildenafil, or both

Introduction. Sexual satisfaction is linked to life satisfaction, and erectile dysfunction (ED) may lead to an impaired quality of life (QOL). Aim. Our goal was to evaluate the QOL among Brazilian patients with ED, before and after three kinds of treatment. Methods. Men aged 25-55 years, with a diagnosis of psychogenic or mixed ED, according to the Classification of Mental and Behavioral Disorders of the International Classification of Diseases, 10th edition, and the Standard Practice in Sexual Medicine, were randomly assigned to three treatment groups: counseling, sildenafil, and sildenafil plus counseling. At baseline each group had 40 patients. Sildenafil was provided in 50 mg that could be adjusted to 100 mg. The patients could initially take one to two tablets per week and the entire treatment lasted for 3 months. Counseling was provided in group sessions that took place once a week. They were evaluated at baseline and after 3 months of treatment with the Male Sexual Quotient (MSQ) and the Sexual Health Inventory for Men (SHIM). Main Outcome Measures. The correlation between the patients` MSQ score and scores on the SHIM. Results. One hundred seventeen patients were enrolled. The three groups were similar according to age, marital status, mean time of ED, and ED severity and etiology. At baseline, MSQ and SHIM total scores were not different among the three groups. MSQ scores increased from 41.2 +/- 15.3, 38.7 +/- 18.0, and 46.8 +/- 17.0 to 48.5 +/- 15.3, 63.8 +/- 21.6, and 70.0 +/- 17.3 after counseling, sildenafil, and sildenafil plus counseling, respectively (P < 0.05). SHIM scores also increased significantly (9.6 +/- 4.1, 9.7 +/- 4.1, and 10.2 +/- 3.9 to 12.1 +/- 3.9, 16.7 +/- 5.6, and 17.7 +/- 4.5 after counseling, sildenafil, and sildenafil plus counseling, respectively) (P < 0.05). There were no serious adverse events related to sildenafil, and no patient was withdrawn from the study because of an adverse event. Conclusions. The three treatments were significantly efficient, and the best treatment was sildenafil associated with counseling

Hypoactive sexual desire disorder in a population-based study of Brazilian women: associated factors classified according to their importance

Objective: The etiology of hypoactive sexual desire disorder (HSDD) is known to be multifactorial, involving biological, psychosexual, and context-related factors. The objective of the present study was to analyze the factors associated with female HSDD and to stratify these factors according to their importance. Methods: This was a population-based, hierarchical study conducted in Brazil, based on data from previous research on the Brazilian Sexual Life Study, conducted between November 2002 and February 2003 in various Brazilian cities. The primary study consisted of a self-administered and anonymous questionnaire, addressing sociodemographic parameters, general health, life habits, behavior, and complaints related to sexual function. The association between HSDD and various other factors was assessed. The data were evaluated by hierarchical multiple regression analysis. Results: The prevalence of HSDD in this sample was 9.5%. Associations were found with cardiovascular disease, breast cancer, posttraumatic stress, poorer education level, being older, being married, a lack of information on sexuality in childhood/adolescence, and a limited sexual repertoire. Women who consumed moderate amounts of alcohol were found to be less likely to have HSDD. Conclusions: Analysis of the associated factors classified in order of importance and analysis of the characteristics of the sexual relationships provide additional information to currently available data on the traditional concepts of HSDD.Eli Lilly Brazi

Timing of Dose Relative to Sexual Intercourse Attempt in Previous Sildenafil Citrate Users Treated with Tadalafil: A Geographical Comparison from a Single Arm, Open-Label Study

Introduction. Previous research has demonstrated that sildenafil citrate users alter dosing-sexual attempt behavior when switched to tadalafil. The impact of geography and culture on sexual behavior with phosphodiesterase type 5 (PDE5) inhibitor treatment has not been fully investigated. Aim. To describe and compare the changes in dosing-sexual attempt behavior with sildenafil citrate vs. tadalafil treatment across four distinct geographies: Asia, Australia/New Zealand (ANZ), Central Eastern Europe/Middle East (CEE/ME), and Latin America (LA). Methods. Data from a single-arm, open-label clinical trial conducted in 21 countries from November 2002 to May 2004 were used in this analysis. Men with erectile dysfunction and a history of >= 6-week prior sildenafil citrate use continued sildenafil citrate treatment for 4 weeks then switched to tadalafil for 8 weeks. Dosing instructions were provided. Main Outcomes Measures. Timing of dose and sexual intercourse was assessed through patient diaries for the final 4 weeks of each treatment period. Results. A total of 2,760 men were enrolled: Asia 15.8%; ANZ 29.4%; CEE/ME 19.7%; LA 35.1%. The median time from dosing to intercourse was significantly increased during tadalafil treatment across all geographical regions; however, the magnitude of increase differed significantly by geography (P < 0.0001). The Asian cohort demonstrated the shortest duration between dosing and sexual intercourse attempts (irrespective of drug), and altered sexual behavior the least upon switching to tadalafil. The ANZ cohort demonstrated the longest duration between dosing and sexual intercourse attempts (irrespective of drug), and altered sexual behavior the most upon switching to tadalafil. Conclusion. Men with a history of established sildenafil citrate use alter their dose-attempt behavior when treated with tadalafil irrespective of geography. However, the extent to which sexual behavior alters is not uniform across geographical regions, suggesting that dosing instructions and duration of drug effectiveness, in combination with personal and cultural preferences, may determine sexual behavior with PDE5 inhibitor use. Rubio-Aurioles E, Glina S, Abdo CHN, Hernandez-Serrano R, Rampazzo C, Sotomayor M, West TM, Gallagher GL, and Lenero E. Timing of dose relative to sexual intercourse attempt in previous sildenafil citrate users treated with tadalafil: A geographical comparison from a single arm, open-label study. J Sex Med 2009;6:2836-2850