PSYCHOSEXUAL FUNCTIONING AFTER TREATMENT FOR CANCER OF THE CERVIX - A COMPARATIVE AND LONGITUDINAL-STUDY

Twenty-six couples participated in a 2-year longitudinal study of sexual functioning before and after treatment for carcinoma of the cervix. Sexual functioning was measured on admission prior to their treatment and at 6, 12 and 24 months follow-up and made operational in terms of current sexual behavior, sexual motivation, sexual (dis)satisfaction, and the perception of genital sensations of sexual arousal. An age-matched nonpatient control group was added to the study. In addition, the results of a 1-year longitudinal assessment of sexual functioning of women diagnosed and treated by means of simple hysterectomy for benign gynecologic disease were used for comparison. The impact of physical variables and participation in the research project was also evaluated. At 1-year follow-up, sexual functioning of the women who had been treated for carcinoma of the cervix was very similar to sexual functioning of the women who underwent simple hysterectomy for benign disease: in both populations the sexual response was significantly disturbed, whereas current sexual behavior and motivation for sexual interaction were within the normal range. The women clearly expressed general satisfaction with their sexual functioning and little relational sexual dissatisfaction. These data demonstrate that woman's motivation for and satisfaction with sexual interaction with the partner is not limited to the experience of sexual arousal and that sexual rehabilitation aimed specifically at the diagnosis of cancer and the associated physical variables is not really justified.</p

THE EFFECT OF 2 DOPAMINERGIC DRUGS ON MENSTRUAL FUNCTION AND PSYCHOLOGICAL STATE IN HYPERPROLACTINEMIA

Objective: To investigate the effect of dopaminergic drugs on the well being in hyperprolactinemic patients. Design: A psychometric test for well being, the SCL-90, was applied at baseline and in the 24th week of a double-blind randomized prospective study comparing the effectiveness and safety of the new dopamine d2 agonist CV 205-502 with bromocriptine. Setting: Outpatient department of a university clinic for obstetrics and gynecology. Patients: Twenty-four women with hyperprolactinemia, 9 of whom had a prolactinoma. Twenty had been treated before, and 11 were known to react unfavorably to bromocriptine. Results: The effectiveness of CV 205-502 was identical to bromocriptine: its tolerability appeared to be better, especially in the initial phase of treatment. At baseline, the mean scores of the SCL-90 were significantly elevated over the reference values. Sixteen patients had normal scores. The elevations were caused by 8 patients with scores in the range found in psychiatric disease (211 +/- 30 [SD] [CV 205-502] and 182 +/- 32 [bromocriptine]). They were depressed, anxious, and hostile. At 24 weeks, the patients treated with CV 205-502 scored better (130 +/- 23.5) in the SCL-90 than the patients treated with bromocriptine (149.5 +/- 20). Conclusion: The markedly increased well being in patients treated with CV 205-502 cannot be explained by its better tolerability and is probably caused by a specific central activity of CV 205-502. Further research into the antidepressive properties of this compound is warranted

SEXUAL CONTACT IN THE DOCTOR-PATIENT-RELATIONSHIP IN THE NETHERLANDS

Objective - To obtain data on sexual contact between doctors and their patients. Design - Anonymous questionnaire with 17 items sent to all working gynaecologists (n=595) and all ear, nose, and throat specialists (n=380) in the Netherlands. Results - Response rate was 74%; a total 64 doctors gave a reason for not completing the questionnaire. 201 (59%) male gynaecologists and 128 (56%) male ear nose, and throat specialists indicated that sexual feelings are acceptable in the doctor-patient relationship; 286 (85%) and 186 (81%), respectively, had felt sexually attracted to a patient at some time, as had 14 (27%) female gynaecologists. More than half (59%) of the doctors who indicated that sexual feelings are unacceptable in the doctor-patient relationship had experienced these feelings, and 91% of this group had a negative attitude towards these feelings. 4% of respondents in each group had had actual sexual contact with patients. Most gynaecologists were in favour of having more attention paid to sexual problems during training; having their professional society take an official viewpoint; subsequent public support of this viewpoint; and taking on an impartial counsellor for the patients as well as the doctors. Conclusion - Sexuality exists in the doctor-patient relationship. Gynaecologists have a higher risk of having sexual contact with their patients than do ear, nose, and throat specialists but compensate for this greater risk by a higher state of recognition and acknowledgement