La vivencia de la sexualidad en las parejas infértiles/estériles

Antecedentes: La infertilidad supone una crisis vital para la pareja. Son abundantes los estudios sobre su impacto psicológico en la mujer y el varón. Se han descrito también disfunciones sexuales debidas a la infertilidad. Objetivo: Realizar una revisión bibliográfica sobre la vivencia de la sexualidad en las parejas infértiles/estériles y revisar si los protocolos de atención a parejas infértiles incluyen el abordaje de la sexualidad. Métodos: Búsqueda en PubMed de estudios descriptivos, analíticos, revisiones y meta- análisis que evalúen la presencia de disfunciones en personas infértiles. Búsqueda de guías de sociedades científicas sobre el abordaje de la infertilidad. Resultados: En las parejas infértiles se han descrito fundamentalmente disminución del deseo sexual, problemas de excitación y orgasmo en la mujer y disfunción eréctil y trastornos eyaculatorios en el varón. Los estudios revisados tienen importantes limitaciones metodológicas que impiden realizar generalizaciones a la población infértil y determinar si la infertilidad aumenta el riesgo de disfunciones sexuales. Existen guías de atención a las parejas infértiles/estériles que incluyen recomendaciones sobre la evaluación y el abordaje de la vivencia de la sexualidad, aunque la mayoría se dirigen a las parejas que recurren a las terapias de reproducción asistida. Conclusiones: Las parejas infértiles pueden presentar disfunciones sexuales. Son aconsejables más estudios, adecuadamente diseñados, para estimar la prevalencia real de disfunciones sexuales en las parejas fértiles e infértiles y dilucidar si la infertilidad es un factor de riesgo para desarrollar dichas disfunciones. De esta manera se mejoraría la información que se ofrece a las parejas infértiles/estériles

Factores de riesgo relacionados con la salud sexual en los jóvenes europeos

En Europa, seguimos asistiendo a un aumento de la transmisión sexual del virus de la inmunodeficiencia humana (VIH) y otras infecciones de transmisión sexual (ITS). Para priorizar estrategias de salud sexual, resulta importante identificar los factores sexuales de riesgo presentes en los jóvenes europeos. Se realizó una revisión sistemática de artículos científicos y estudios de instituciones oficiales europeas. En total, fueron identificados 21 artículos y 10 estudios. Los datos sugieren un aumento de la iniciación sexual juvenil y del número de parejas sexuales. El 15-20% de los jóvenes usan de forma inconstante el preservativo. Entre los conocimientos y actitudes de riesgo detectadas encontramos: desconocer otras ITS distintas al VIH, tener una actitud favorable a las relaciones sexuales casuales, creer erróneamente que algunas medidas son eficaces para prevenir el VIH, desconocer los riesgos de tener múltiples parejas sexuales y desconocer la transmisión sexual del VIH. Los datos subrayan la necesidad de mejorar los mensajes transmitidos a los jóvenes

Analysis of contents about sexuality and human reproduction in school textbooks in Spain

Objectives: The spread of sexually transmitted infections (STI) in adolescents and teenage pregnancy rates are increasing. A decrease in the average age of youth’s first sexual experience is also being noted. Sexual education programs in schools have an important role to play in addressing these issues. The objective of this study is to analyze the content of textbooks in the area of sexuality and human reproduction in order to evaluate the extent to which these textbooks promote healthy reproductive life styles, as well as risk behavior avoidance among the adolescent students. Study design: Descriptive study of school textbooks content. Methods: The study sample consisted of 12 textbooks (about 80% of all the textbooks) used in Spanish secondary school and edited in 2002. A content analysis evaluated the extent to which these books demonstrated reliable scientific information about: a) condom effectiveness; b) consequences, prevention, and treatment of STI; c) family planning methods; d) Assisted reproductive technologies and e) the promotion of healthy reproductive lifestyles. Results: All textbooks presented inaccurate information in the areas studied. Two hundred and eighty one quotes were identified that facilitated an incomplete perception of sexuality or enabled risky behavior. An average of 12.6 incorrect messages was identified in each textbook. Conclusions: The textbooks examined are neither appropriate nor comprehensive enough for adolescent education on issues of sexuality. Results suggest a need for alternative textbooks based on better scientific evidence. It is essential that textbooks empower adolescents to make healthy decisions through the promotion of useful life skills that provide a more integrated concept of sexuality. In any case, there is a need for approaches to sexual education to integrate values commonly held by parents of the youth that use such texts

The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes

Choice of birth control methods among European women and the role of partners and providers

Background: The choice of a birth control method is influenced by socio-cultural and personal factors. We explored the perceived influences in women’s choice of a birth control method in five European countries (Germany, France, the U.K., Romania and Sweden), where contraception is widely used. Study design: Cross-sectional study of 1137 randomly selected women, aged 18-49 years. An anonymous, 31-item questionnaire related to birth control methods was used. Logistic regression was used to identify variables associated with partner participation in choice of a contraceptive. Results: Oral contraceptives were mainly used in Germany (54.3%), France (50.5%) and Sweden (34.6%) and condoms in the UK (29.6%) and Romania (22.9%). Sweden showed the highest use of intrauterine devices (19%). Romania had the lowest use of contraception. Oral contraceptives and intrauterine devices use were frequently suggested by providers instead of by women. Choosing the method with the partner was associated with age (OR=0.97, 95%CI 0.94-0.99), university graduate (OR=1.59, 95%CI 1.01-2.29), married (OR=1.52, 95%CI 1.01-2.29) and with using a method that requires partner’s cooperation (OR=8.18, 95%CI 5.46-12.27). Conclusions: Hormonal contraceptives and intrauterine devices are commonly recommended by providers rather than requested by women. Partner preferences are taken into account when his cooperation in the use of the method is needed. As fertility care is a male and female issue, there is still more room for actively involving both women and men in choice of a birth control method