Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which...Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) impossible. In this condition, a woman cannot control these muscle contractions and experiences moderate to intense pain. Objectives: To summarise published evidence on efficacy of physiotherapy for treating female sexual pain disorders, ways to evaluate the condition of a patient and to find the correct treatment. Evidence review: A literature search of Cochrane, PubMed, Journal of Sexual Medicine and Urogynecology Journal databases, SciELO, Google Scholar, Wiley Online Library and University of Barcelona Library was conducted. Findings: Physiotherapy techniques are used to strengthen pelvic floor muscles and relieve pain. Kegel exercises improve the symptoms of sexual pain disorders as they deal with weakened muscles. Vaginal cones exercises are used to strengthen the muscles by means of introduction of gradually increasing weights in the vagina. Biofeedback helps to increase muscle awareness and auto-evaluation of performed exercises. Thermotherapy relaxes muscles and increases elasticity of tissues which helps to reduce pain. Electro-stimulation improves the functionality of muscles. Myofascial therapy consists mainly in manual therapy and in liberating painful trigger points. Conclusions: The role of pelvic physiotherapy is to solve the problems related to sexual pain, recovering the pelvic floor by increasing muscle awareness and proprioception, improving muscle relaxation, toning the muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques, as well as electro-stimulation and thermotherapy are used to achieve positive results.展开更多
Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the en...Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.展开更多
Introduction: Headache associated with sexual activity (HSA) is the painful event of head and neck precipitated only by sexual activity. The negative impact of sexuality is expected to be more severe in HSA patients a...Introduction: Headache associated with sexual activity (HSA) is the painful event of head and neck precipitated only by sexual activity. The negative impact of sexuality is expected to be more severe in HSA patients and their partners than other headache disorder. In addition, social and cultural taboo may conceal sexual problem or hinder seeking counseling for sexual perplexity. A sufficient scientific evidence is therefore needed to clarify the misunderstanding and schedule appropriate education in clinical practice. Methods: A systematic review of literature was completed to elucidate the sexual behavior, function and satisfaction in HSA patients and their partners. Results: A total of 97 publications are eligible after careful screening. However, most of the studies focus on the etiopathogenesis or treatment. Sexual change was mentioned in 23 publications. Orgasmic headache is the most frequent type of HSA. The HSA occurs more frequent in dyadic than extradyadic sexual activity. Intercourse is the leading sexual act for HSA occurrence, following by masturbation. A few patients suffer HSA under specific sexual position, like kneeling, and trigger, such as cannabis. Pain can be rapidly ceased in half of patients when sexual activity was halted. Sexual function and sexual satisfaction may decrease in HSA patient and partner but improve after pain reversal. Conclusions: A shortage of sexuality data of HSA is documented in literature but that still clarifies the extradyadic and masturbatory effect on HSA occurrence. Nevertheless, HSA disturbs sexual function and satisfaction in patients and their partners. The pathogenesis of pain includes two components, the hypersympathetic status and exertional action. Therefore, physician can schedule their education and counseling for HSA according to these findings. Further investigation for sexual function and satisfaction is warranted.展开更多
Fitz-Hugh-Curtis syndrome is a type of perihepatitis that causes liver capsular infection without infecting the hepatic parenchyma or pelvis. Fitz-Hugh-Curtis syndrome is known to occur commonly in women of childbeari...Fitz-Hugh-Curtis syndrome is a type of perihepatitis that causes liver capsular infection without infecting the hepatic parenchyma or pelvis. Fitz-Hugh-Curtis syndrome is known to occur commonly in women of childbearing age who do not use oral contraceptives and have sexual partners older than 25 years of age. However, the syndrome has been reported to occur rarely in males. The clinical symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in male and female. We experienced a case of Fitz-HughCurtis syndrome in a 60-year-old man with the chief complaint of right upper quadrant abdominal pain. Despite a previous history of gonorrhea, we have also described our experiences of improved symptoms and recovery with allopathic medicines and have thereby reported the present case with a literature review.展开更多
目的研究度洛西汀在女性慢性盆腔痛治疗中的作用。方法选取金华市中心医院和金华市妇幼保健院2021年6月至2023年6月盆腔疼痛患者126例,随机分成对照组和观察组,剔除失访及未完成治疗12例,对照组56例,观察组58例,对照组给予盆底电刺激治...目的研究度洛西汀在女性慢性盆腔痛治疗中的作用。方法选取金华市中心医院和金华市妇幼保健院2021年6月至2023年6月盆腔疼痛患者126例,随机分成对照组和观察组,剔除失访及未完成治疗12例,对照组56例,观察组58例,对照组给予盆底电刺激治疗,观察组在对照组治疗基础上应用度洛西汀,两组均治疗3个月,治疗前后应用视觉模拟评分法(Visual analogue scale,VAS)、盆底功能障碍问卷简要版-20(Pelvic floor dysfunction inventory-20,PFDI-20)、盆底器官脱垂/尿失禁性生活问卷-12(Pelvic organ prolapse-urinary incontinence sexual function questionnaire-12,PISQ-12)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)及医院焦虑抑郁量表(Hospital anxiety and depression scale,HAD)观察两组患者治疗前后病情的改善状况。结果治疗前两组VAS、PFDI-20、PISQ-12、PSQI、HAD评分比较,差异无统计学意义(P>0.05),治疗3个月分别对比VAS(观察组:1.20±0.16,对照组:1.51±0.20,P<0.05)、PFDI-20(观察组:5.69±5.4,对照组:8.95±4.27,P<0.05)、PISQ-12(观察组:40.79±3.11,对照组:30.86±5.88,P<0.05)、PSQI(观察组:7.79±1.39,对照组:10.59±1.95,P<0.05)及HAD(观察组:6.21±1.74,对照组:9.29±2.38,P<0.05),差异有统计学意义。结论度洛西汀在女性慢性盆腔痛治疗过程中有助于改善患者疼痛、焦虑、抑郁状态,提高患者生活及睡眠质量,对女性慢性盆腔痛有改善作用,同时对患者性生活质量也有明显改善作用。展开更多
目的观察清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型慢性盆腔炎(Chronic pelvic inflammatory disease,CPID)患者的临床疗效。方法选取2019年1月—2021年8月期间北京市怀柔区中医医院妇科收治的189例湿热瘀结型CPID患者作为研究对...目的观察清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型慢性盆腔炎(Chronic pelvic inflammatory disease,CPID)患者的临床疗效。方法选取2019年1月—2021年8月期间北京市怀柔区中医医院妇科收治的189例湿热瘀结型CPID患者作为研究对象,采用随机数字表法分为对照组、联合1组、联合2组,每组各63例。对照组给予康妇炎胶囊,联合1组给予康妇炎胶囊+红藤方保留灌肠,联合2组给予清热化湿逐瘀汤+红藤方保留灌肠治疗。治疗4周后,观察比较3组患者综合疗效、治疗前后中医证候积分、盆腔疼痛程度[疼痛评分(Visualanaloguescale,VAS)、疼痛等级]、性功能评分(The Female Sexual Function Index,FSFI)、生活质量评分(The World Health Organization’s Quality of Life Questionnaire,WHOQOL-BREF)改善情况及治疗安全性、复发率。结果治疗后联合2组综合疗效总有效率93.65%(59/63)高于对照组76.19%(48/63)与联合1组82.54%(52/63),差异有统计学意义(P<0.05)。治疗后3组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且联合1组中医证候积分低于对照组,联合2组中医证候积分低于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者VAS评分较治疗前降低,疼痛等级较治疗前改善,差异有统计学意义(P<0.05);且联合1组优于对照组,联合2组优于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者FSFI、WHOQOL-BREF评分均较治疗前升高,差异有统计学意义(P<0.05);且联合1组高于对照组,联合2组高于联合1组,差异有统计学意义(P<0.05)。治疗期间,3组患者均无不良反应发生。随访3个月,对照组治愈患者中复发6例,联合1组复发4例,联合2组未见复发病例,3组患者复发率比较,差异有统计学意义(P<0.05)。结论清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型CPID效果显著,有利于缓解盆腔疼痛,改善患者性功能与生活质量,且安全性较高。展开更多
文摘Importance: A lot of women suffer from sexual disfunctions, which most of the times cause pain and discomfort. Many genito-pelvic pain disorders appear in the form of contractions or pelvic floor muscle tension, which makes any type of penetration (sexual, tampons, gynaecological examination tools) impossible. In this condition, a woman cannot control these muscle contractions and experiences moderate to intense pain. Objectives: To summarise published evidence on efficacy of physiotherapy for treating female sexual pain disorders, ways to evaluate the condition of a patient and to find the correct treatment. Evidence review: A literature search of Cochrane, PubMed, Journal of Sexual Medicine and Urogynecology Journal databases, SciELO, Google Scholar, Wiley Online Library and University of Barcelona Library was conducted. Findings: Physiotherapy techniques are used to strengthen pelvic floor muscles and relieve pain. Kegel exercises improve the symptoms of sexual pain disorders as they deal with weakened muscles. Vaginal cones exercises are used to strengthen the muscles by means of introduction of gradually increasing weights in the vagina. Biofeedback helps to increase muscle awareness and auto-evaluation of performed exercises. Thermotherapy relaxes muscles and increases elasticity of tissues which helps to reduce pain. Electro-stimulation improves the functionality of muscles. Myofascial therapy consists mainly in manual therapy and in liberating painful trigger points. Conclusions: The role of pelvic physiotherapy is to solve the problems related to sexual pain, recovering the pelvic floor by increasing muscle awareness and proprioception, improving muscle relaxation, toning the muscles and increasing the elasticity of the tissues in order to eliminate or reduce pain. Different exercise techniques, biofeedback, manual therapy and insertion techniques, as well as electro-stimulation and thermotherapy are used to achieve positive results.
文摘Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.
文摘Introduction: Headache associated with sexual activity (HSA) is the painful event of head and neck precipitated only by sexual activity. The negative impact of sexuality is expected to be more severe in HSA patients and their partners than other headache disorder. In addition, social and cultural taboo may conceal sexual problem or hinder seeking counseling for sexual perplexity. A sufficient scientific evidence is therefore needed to clarify the misunderstanding and schedule appropriate education in clinical practice. Methods: A systematic review of literature was completed to elucidate the sexual behavior, function and satisfaction in HSA patients and their partners. Results: A total of 97 publications are eligible after careful screening. However, most of the studies focus on the etiopathogenesis or treatment. Sexual change was mentioned in 23 publications. Orgasmic headache is the most frequent type of HSA. The HSA occurs more frequent in dyadic than extradyadic sexual activity. Intercourse is the leading sexual act for HSA occurrence, following by masturbation. A few patients suffer HSA under specific sexual position, like kneeling, and trigger, such as cannabis. Pain can be rapidly ceased in half of patients when sexual activity was halted. Sexual function and sexual satisfaction may decrease in HSA patient and partner but improve after pain reversal. Conclusions: A shortage of sexuality data of HSA is documented in literature but that still clarifies the extradyadic and masturbatory effect on HSA occurrence. Nevertheless, HSA disturbs sexual function and satisfaction in patients and their partners. The pathogenesis of pain includes two components, the hypersympathetic status and exertional action. Therefore, physician can schedule their education and counseling for HSA according to these findings. Further investigation for sexual function and satisfaction is warranted.
文摘Fitz-Hugh-Curtis syndrome is a type of perihepatitis that causes liver capsular infection without infecting the hepatic parenchyma or pelvis. Fitz-Hugh-Curtis syndrome is known to occur commonly in women of childbearing age who do not use oral contraceptives and have sexual partners older than 25 years of age. However, the syndrome has been reported to occur rarely in males. The clinical symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in male and female. We experienced a case of Fitz-HughCurtis syndrome in a 60-year-old man with the chief complaint of right upper quadrant abdominal pain. Despite a previous history of gonorrhea, we have also described our experiences of improved symptoms and recovery with allopathic medicines and have thereby reported the present case with a literature review.
文摘目的研究度洛西汀在女性慢性盆腔痛治疗中的作用。方法选取金华市中心医院和金华市妇幼保健院2021年6月至2023年6月盆腔疼痛患者126例,随机分成对照组和观察组,剔除失访及未完成治疗12例,对照组56例,观察组58例,对照组给予盆底电刺激治疗,观察组在对照组治疗基础上应用度洛西汀,两组均治疗3个月,治疗前后应用视觉模拟评分法(Visual analogue scale,VAS)、盆底功能障碍问卷简要版-20(Pelvic floor dysfunction inventory-20,PFDI-20)、盆底器官脱垂/尿失禁性生活问卷-12(Pelvic organ prolapse-urinary incontinence sexual function questionnaire-12,PISQ-12)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)及医院焦虑抑郁量表(Hospital anxiety and depression scale,HAD)观察两组患者治疗前后病情的改善状况。结果治疗前两组VAS、PFDI-20、PISQ-12、PSQI、HAD评分比较,差异无统计学意义(P>0.05),治疗3个月分别对比VAS(观察组:1.20±0.16,对照组:1.51±0.20,P<0.05)、PFDI-20(观察组:5.69±5.4,对照组:8.95±4.27,P<0.05)、PISQ-12(观察组:40.79±3.11,对照组:30.86±5.88,P<0.05)、PSQI(观察组:7.79±1.39,对照组:10.59±1.95,P<0.05)及HAD(观察组:6.21±1.74,对照组:9.29±2.38,P<0.05),差异有统计学意义。结论度洛西汀在女性慢性盆腔痛治疗过程中有助于改善患者疼痛、焦虑、抑郁状态,提高患者生活及睡眠质量,对女性慢性盆腔痛有改善作用,同时对患者性生活质量也有明显改善作用。
文摘目的观察清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型慢性盆腔炎(Chronic pelvic inflammatory disease,CPID)患者的临床疗效。方法选取2019年1月—2021年8月期间北京市怀柔区中医医院妇科收治的189例湿热瘀结型CPID患者作为研究对象,采用随机数字表法分为对照组、联合1组、联合2组,每组各63例。对照组给予康妇炎胶囊,联合1组给予康妇炎胶囊+红藤方保留灌肠,联合2组给予清热化湿逐瘀汤+红藤方保留灌肠治疗。治疗4周后,观察比较3组患者综合疗效、治疗前后中医证候积分、盆腔疼痛程度[疼痛评分(Visualanaloguescale,VAS)、疼痛等级]、性功能评分(The Female Sexual Function Index,FSFI)、生活质量评分(The World Health Organization’s Quality of Life Questionnaire,WHOQOL-BREF)改善情况及治疗安全性、复发率。结果治疗后联合2组综合疗效总有效率93.65%(59/63)高于对照组76.19%(48/63)与联合1组82.54%(52/63),差异有统计学意义(P<0.05)。治疗后3组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且联合1组中医证候积分低于对照组,联合2组中医证候积分低于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者VAS评分较治疗前降低,疼痛等级较治疗前改善,差异有统计学意义(P<0.05);且联合1组优于对照组,联合2组优于联合1组,差异有统计学意义(P<0.05)。治疗后3组患者FSFI、WHOQOL-BREF评分均较治疗前升高,差异有统计学意义(P<0.05);且联合1组高于对照组,联合2组高于联合1组,差异有统计学意义(P<0.05)。治疗期间,3组患者均无不良反应发生。随访3个月,对照组治愈患者中复发6例,联合1组复发4例,联合2组未见复发病例,3组患者复发率比较,差异有统计学意义(P<0.05)。结论清热化湿逐瘀汤联合红藤方保留灌肠治疗湿热瘀结型CPID效果显著,有利于缓解盆腔疼痛,改善患者性功能与生活质量,且安全性较高。
