12 research outputs found

    Hygiene and genital care of menacme women : a population-based study

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    Orientadores: Paulo César Giraldo, Angélica Espinosa Barbosa MirandaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: A higiene é o conjunto de cuidados corporais, do ambiente e de um modo de viver, de se vestir e de habitar para evitar doenças com o objetivo de conservar e fortificar a saúde. Em se tratando de saúde genital, a relação não poderia ser outra, uma vez que esta é parte integrante e inseparável da saúde geral do indivíduo. Estas ações são dependentes da condição social da população e previnem complicações e desconfortos, especialmente na área genital feminina, porém ainda não foram bem estudadas. Objetivo: Avaliar hábitos de higiene e cuidados com a genitália de mulheres no menacme e associá-los com fatores sociodemográficos. Sujeitos e Métodos: Foi realizado um estudo de corte transversal de base populacional, por amostragem, em todas as 28 Unidades de Saúde de Vitória, Espírito Santo, Brasil. Foram incluídas aleatoriamente 474 mulheres, admitidas em seus domicílios, no período de Julho de 2012 a Dezembro 2013. Um questionário auto-respondido foi preenchido de maneira sigilosa contendo 56 perguntas relacionadas ao tema, divididas nos seguintes domínios: I ¿ Limpeza genital; II ¿ Uso de absorventes higiênicos; III ¿ Práticas depilatórias; IV ¿ Uso de piercings e tatuagens genitais; V ¿ Tipo de Indumentária e VI ¿ Práticas sexuais. Além das variáveis relacionadas à higiene, foram considerados fatores sociodemográficos como idade, nível de escolaridade e renda familiar mensal, e algumas variáveis clínicas. A análise dos dados empregou o teste exato de Fisher para averiguar associação entre as variáveis; e regressão múltipla logística para verificar a chance de complicações clínicas e ginecológicas. O nível de significância considerado foi p<0,05. Resultados: A média da idade das participantes foi de 31 anos (± 7,7), 54% eram não caucasianas, casadas ou com parceiros (56,8%), com renda familiar inferior a R1500,00(53,7 1500,00 (53,7%) e 69,6% haviam cursado até o Ensino Médio. As análises sobre os hábitos de higiene demonstraram que 57,4% das mulheres tomavam dois banhos por dia, entretanto 51% lavavam a vulva mais de três vezes ao dia. O uso de lenços umedecidos foi relatado por 13,5% e somente 17,9% das entrevistadas realizavam corretamente a higiene após evacuação. Ducha vaginal foi descrita por 47% dos casos, quase 20% faziam esfoliação na região vulvar e 44,5% relataram corrimento vaginal frequentemente. O uso frequente do protetor diário ocorreu em 38,9% da população, entretanto somente 40,7% destas usavam o protetor sem película plástica. Mulheres mais jovens (p<0,0001) e com maiores níveis de escolaridade (p=0,0390) usavam menos absorventes internos. Observou-se que quanto maior a troca diária do número de absorventes durante o período menstrual, menor foi a chance de aparecimento de fissuras como complicação [OR=0,11 (IC95%:0,02-0,48)]. Quanto ao uso de vestimentas, o tipo de calcinha menos utilizada foi a sintética (5,5%) e os modelos fio dental ou tanga foram os mais relatados (68,6%), principalmente entre as mais jovens (p<0,0001). Cerca de metade da amostra referiu o uso frequente de calças apertadas (51,1%), o que esteve associado às mulheres jovens (p=0,0002) e com maior nível de escolaridade (p=0,0173), além de ser uma variável que identificou uma chance quase duas vezes maior do aparecimento de corrimento vaginal relatado pelas participantes [OR=1,95 (IC95%:1,35-2,81)]. Verificou-se que 97,9% das mulheres realizavam depilação íntima e 65,4% acreditavam ser importante para higiene. Em geral, mulheres com baixa escolaridade e renda utilizavam a lâmina de barbear como principal método. A depilação genital de forma "completa" foi relatada por 52,1% das participantes. Conclusão: Os hábitos de higiene e cuidados com a genitália ainda são inadequados em um percentual muito elevado de mulheres brasileiras. Fatores sociodemográficos como idade, nível de escolaridade e renda familiar mensal associaram-se com diversos aspectos na prática destes hábitosAbstract: Hygiene is the set of body care, of the environment and a way of living, dressing and inhabits to prevent diseases with the goal of preserving and strengthening the health. In terms of genital health, the relation could not be different, since this is an integral and inseparable part of the overall individual health. These actions are dependent on the social status of the population and prevent complications and discomfort, especially in the genital area, but have not been well studied. Objective: To evaluate hygiene and care genitalia among women in menacme and associate them with sociodemographic factors. Subjects and methods: A population-based study was conducted, by sampling at all 28 health units in Vitoria, Espirito Santo, Brazil. Randomized 474 women were included, admitted in their homes between July 2012 to December 2013. A self-administered questionnaire was completed confidentially containing 56 questions related to the subject, divided into the following areas: I - Genital cleaning; II - Use of sanitary pads; III - Depilatory practices; IV - Use of genital piercings and tattoos; V -Clothing type and VI - Sexual practices. Apart from hygiene-related variables were considered sociodemographic factors such as age, education level and monthly family income, and some clinical variables. Fisher Exact Test was used to assess associations between variables; and multiple logistic regression to verify the chance of gynecological and clinical complications. Significance level was set at p <0.05. Results: The average age of participants was 31 years (± 7.7), 54% were not caucasian, married or had partners (56.8%), with family income less than R 1500.00 (53.7%) and 69.6% had attended high school. Analyses of hygiene habits showed that 57.4% of women took two baths per day, however 51% washed the vulva more than three times daily. The use of wet wipes was reported by 13.5% and only 17.9% of respondents performed correctly hygiene after defecation. Vaginal douching was reported by 47% of cases, almost 20% did exfoliation in vulvar region and 44.5% reported vaginal discharge frequently. The frequent use of the panty liners occurred in 38.9% of the population, however only 40.7% of these used without plastic layer. Younger women (p<0.0001) and with higher levels of education (p = 0.0390) used less tampons. It was observed that the greater the number of daily change of the absorbent during the menstrual period, the lower chance of appearance of fissures as genital complication [OR=0.11 (CI95%:0.02-0.48)]. Regarding the use of clothes, the type of underwear was less synthetic (5.5%) and the models thong or string were the most common (68.6%), especially among the youngest (p<0.0001). Approximately half of the sample reported frequent use of tight pants (51.1%) which was associated with young women (p=0.0002) and higher educational level (p=0.0173), as well as being a variable which identified almost twice the chance of appearance of vaginal discharge reported by participants [OR=1.95 (CI95%:1.35-2.81)]. It was verified that 97.9% of women performed pubic hair removal and 65.4% did because they believe it is important for hygiene. Generally, the razor blade was the main method used by women with low education and income. The "complete" genital hair removal was related by 52.1% of participants. Conclusion: Hygiene habits and genitalia care are still inadequate in a very high percentage of Brazilian women. Sociodemographic factors such as age, education level and monthly family income were associated with several aspects in practice of these habitsDoutoradoFisiopatologia GinecológicaDoutora em Ciências da Saúd

    Pelvic floor muscle training in female sexual dysfunctions

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    Orientadores: Ellen Hardy, Maria Jose Duarte OsisDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: Objetivo: avaliar o efeito do treinamento dos músculos do assoalho pélvico (MAP) nas disfunções sexuais femininas. Sujeitos e Métodos: realizou-se um ensaio clínico com 26 mulheres que apresentavam diagnóstico de disfunção sexual (transtorno de desejo sexual, transtorno de excitação, transtorno orgástico e dispareunia) no período de fevereiro de 2008 a maio de 2009. Foi administrado um questionário denominado FSFI (Female Sexual Function Índex) para verificar a função sexual. A contração dos músculos do assoalho pélvico foi avaliada por meio da palpação vaginal (bi-digital) e, em seguida, realizou-se uma eletromiografia de superfície para avaliar amplitudes de contração. Tais procedimentos ocorreram previamente, na metade e após o tratamento. As mulheres realizaram exercícios para os músculos do assoalho pélvico em diferentes posições, uma ou duas vezes por semana, totalizando 10 sessões de tratamento. Na análise das variáveis ao longo do tempo, utilizou-se o teste não-paramétrico e o Anova de Friedman, o teste de Bonferroni e o teste de correlação de Spearman. Adotou-se um nível de significância de p<0,05 para análise dos dados. Resultados: Observou-se uma melhora significativa (p<0,0001) dos escores de todos os domínios e do escore total do FSFI ao final do tratamento quando comparadas a avaliação inicial e intermediária. Em relação a eletromiografia de superfície, as amplitudes das contrações fásicas e tônicas aumentaram significativamente (p<0,0001) ao longo do tratamento. Houve também um aumento na força do assoalho pélvico, com 69% das mulheres apresentando grau 4 ou 5 na avaliação final. Ao final do tratamento, a maioria das participantes (18) recebeu alta por não mais apresentar queixas relativas à função sexual. Conclusão: O treinamento dos MAP resultou em melhora na força e nas amplitudes da eletromiografia, acompanhadas de aumento significativo nos escores de função sexual, o que indica que essa abordagem terapêutica pode ser utilizada com sucesso no tratamento das disfunções sexuais femininasAbstract:Objective: To evaluate the effect of pelvic floor muscle training in female sexual dysfunctions. Subjects and Methods: 26 women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and dyspareunia) were enrolled in a clinical trial, between February 2008 and May 2009. To evaluate the sexual function we used Female Sexual Function Index (FSFI) questionnaire. Bi-digital palpation was applied to assess muscle strength and surface electromyography to contraction amplitudes. The assessment was carried out before, during (after five sessions) and at the end of the treatment (after 10 sessions). The women underwent pelvic floor muscle training, once or twice a week, for 10 sessions in different positions. To analysis during the follow-up period, non parametric's and ANOVA's Friedman test, Bonferroni test and Spearman Correlation test were applied. Results were considered statistically significant if p<0.05. Results: All FSFI scores were higher (p<0.0001) at the end of the treatment in comparison with the values observed before and in the middle of the treatment. Regarding surface electromyography, tonic and phasic contractions amplitudes significantly increased over time (p<0.0001). Pelvic floor strength also increased in 69% of the women who had 4 or 5 grade in final evaluation. Eighteen participants had a total improvement of sexual complaints at the end of the treatment. Conclusions: The pelvic floor muscle training improved strength and surface electromyography amplitudes while the sexual function scores increased. This indicates that physiotherapy approach may be successfully used in the female sexual dysfunctions treatmentMestradoTocoginecologiaMestre em Tocoginecologi

    [pelvic Floor Muscle Training In Female Sexual Dysfunctions].

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    To evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunctions. Twenty-six women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and/or dyspareunia) were included in a clinical trial with a before/after approach . The assessment was carried out before, during (after five sessions) and at the end of the treatment (after ten sessions) by two-digit palpation (assessment of pelvic floor muscle, PFM, strength), intravaginal electromyography (EMG) (capture of PFM contraction amplitudes) and Female Sexual Function Index (FSFI, a questionnaire for the evaluation of sexual function). The women underwent PFMT in different positions for ten sessions (once or twice a week). For statistical analysis, absolute and relative frequencies were used for clinical characteristics and PFM strength. The Friedman test was used to compare the FSFI domain scores and EMG values, the Students t-test was used to determine the association between these values and the characteristics of the women, and the Wilcoxon test for percent modification of the EMG. The Mann-Whitney test permitted us to compare these values with clinical characteristics. The Spearman correlation test was used to correlate the EMG values with mean total score. Results were considered statistically significant if p<0.05. A significant improvement (p<0.0001) of FSFI scores was observed at the end of treatment compared to the values observed before and in the middle of treatment. Regarding the EMG, the amplitudes of tonic and phasic contractions increased significantly during treatment (p<0.0001). Pelvic floor strength increased, which 69% of the women presenting grade 4 or 5 at the end of treatment, with a total improvement of sexual complaints. The PFMT improved muscle strength and electromyography contraction amplitudes, with improved sexual function, indicating that this physiotherapy approach may be successfully used for the treatment of female sexual dysfunctions.32234-4

    Pelvic Floor Muscle Training In Female Sexual Dysfunctions [treinamento Dos Músculos Do Assoalho Pélvico Nas Disfunções Sexuais Femininas]

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    PURPOSE: to evaluate the effect of pelvic floor muscle training (PFMT) on female sexual dysfunctions. METHODS: twentysix women with a diagnosis of sexual dysfunction (sexual desire, arousal, orgasmic disorders and/or dyspareunia) were included in a clinical trial with a before/after approach. The assessment was carried out before, during (after five sessions) and at the end of the treatment (after ten sessions) by two-digit palpation (assessment of pelvic floor muscle, PFM, strength), intravaginal electromyography (EMG) (capture of PFM contraction amplitudes) and Female Sexual Function Index (FSFI, a questionnaire for the evaluation of sexual function). The women underwent PFMT in different positions for ten sessions (once or twice a week). For statistical analysis, absolute and relative frequencies were used for clinical characteristics and PFM strength. The Friedman test was used to compare the FSFI domain scores and EMG values, the Student's t-test was used to determine the association between these values and the characteristics of the women, and the Wilcoxon test for percent modification of the EMG. The Mann-Whitney test permitted us to compare these values with clinical characteristics. The Spearman correlation test was used to correlate the EMG values with mean total score. Results were considered statistically significant if p<0.05. RESULTS: a significant improvement (p<0.0001) of FSFI scores was observed at the end of treatment compared to the values observed before and in the middle of treatment. Regarding the EMG, the amplitudes of tonic and phasic contractions increased significantly during treatment (p<0.0001). Pelvic floor strength increased, which 69% of the women presenting grade 4 or 5 at the end of treatment, with a total improvement of sexual complaints. CONCLUSIONS: the PFMT improved muscle strength and electromyography contraction amplitudes, with improved sexual function, indicating that this physiotherapy approach may be successfully used for the treatment of female sexual dysfunctions.325234240Laumann, E.O., Paik, A., Rosen, R.C., Sexual dysfunction in the United States: Prevalence and predictors (1999) JAMA, 281 (6), pp. 537-544Abdo, C.H., (2004) Estudo da vida sexual do brasileiro, , São Paulo: BregantiniAbdo, C.H., Oliveira Jr., W.M., Moreira Jr., E.D., Fittipaldi, J.A., Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women - results of the Brazilian Study On Sexual Behavior (BSSB) (2004) Int J Impot Res, 16 (2), pp. 160-166Moreira Junior, E.D., Glasser, D., Santos, D.B., Gingell, C., Prevalence of sexual problems and related help-seeking behaviors among mature adults in Brazil: Data from the Global Study of Sexual Attitudes and Behaviors (2005) Sao Paulo Med J, 123 (5), pp. 234-241Weber, A.M., Walters, M.D., Schover, L.R., Mitchinson, A., Vaginal anatomy and sexual function (1995) Obstet Gynecol, 86 (6), pp. 946-949Lemack, G.E., Zimmern, P.E., Sexual function after vaginal surgery for stress incontinence: Results of a mailed questionnaire (2000) Urology, 56 (2), pp. 233-237Artiles Pérez, V., Gutiérrez Sigler, M.D., Sanfélix Genovés, J., Female sexual function and related factors (2006) Aten Primaria, 38 (6), pp. 339-344Masters, W.H., Johnson, V.E., (1979) A Conduta Sexual Humana, , [Costa D, tradutor]. 3a ed. 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