Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
Intercourse, painful [keywords]
- Decreased concentration of protease inhibitors: possible contributors to allodynia and hyperalgesia in women with vestibulodynia. [JOURNAL ARTICLE]
- Am J Obstet Gynecol 2014 Jul 25.
Women with vestibulodynia exhibit increased pain sensitivity to contact with the vaginal vestibule as well as with vaginal penetration. The mechanism(s) responsible for this effect remains incompletely defined. Based on reports of a possible role for proteases in induction of pain we compared levels of proteases and protease inhibitors in vaginal secretions from women with vestibulodynia and controls.Vaginal secretions from 76 women with vestibulodynia and from 41 control women were assayed by ELISA for the protease inhibitors secretory leukocyte protease inhibitor (SLPI) and human epididymis protein-4 (HE-4) and the proteases kallikrein-5, and cathepsins B and S. Concentrations between subjects and controls were compared and levels related to clinical and demographic variables.Concentrations of HE-4 and SLPI were markedly reduced in vaginal samples from women with vestibulodynia compared to controls (P<0.006). All other compounds were similar in both groups. HE-4 (P=0.0195) and SLPI (P=0.0033) were lower in women with secondary, but not primary, vestibulodynia than in controls. Subjects who had constant vulvar pain had lower levels of HE-4 and SLPI than did healthy control women (p< 0.0.006) or women who experienced vulvar pain only during sexual intercourse (p < 0.0191). There were no associations between HE-4 or SLPI levels and event associated with symptom onset, duration of symptoms, age, number of lifetime sexual partners or age at sex initiation.insufficient vaginal protease inhibitor production may contribute to increased pain sensitivity in an undefined subset of women with secondary vestibulodynia who experience constant vulvar pain.
- Self-Attempted Labioplasty With Elastic Bands Resulting in Severe Necrosis. [JOURNAL ARTICLE]
- J Low Genit Tract Dis 2014 Jul 24.
Labial hypertrophy is protuberant labial tissue extending beyond the labia majora. Self-perception of poor cosmetic appearance is common in young patients and not necessarily pathologic. Labioplasty is indicated for patients with persistent symptoms including entrapment and painful intercourse.A 26-year-old woman presented with genital pain and foul odor after self-applying elastic bands to her labia minora. The bands were applied for a self-perceived abnormal appearance and lack of insurance for medical consultation. Surgical debridement and revision of the labia were performed using a straight vertical approach.Self-attempted labioplasty can result in necrosis and infection. Education and counseling of patients on the normal variants of labial anatomy and the recommended therapeutic methods will lead to better cosmetic results and prevent self-mutilation.
- Health-related quality of life 14years after preoperative short-term radiotherapy and total mesorectal excision for rectal cancer: Report of a multicenter randomised trial. [JOURNAL ARTICLE]
- Eur J Cancer 2014 Jul 21.
Preoperative short-term radiotherapy (PRT) in combination with total mesorectal excision (TME) has shown to improve local control in rectal cancer treatment, however without a survival benefit and at the cost of increased morbidity. The current study investigates the long-term health-related quality of life (HRQL) of patients 14years after treatment in the Dutch TME trial.In the TME trial (1996-1999) 1530 Dutch patients with rectal cancer were treated with TME and randomly assigned to PRT (5×5Gy). In 2012 HRQL was evaluated in surviving patients (n=606) using a questionnaire combining EORTC QLQ-C30, EORTC QLQ-CR29 and additional questions.Results were obtained from 478 patients (82%), with a median follow up of 14years. PRT+TME patients without stoma reported more faecal leakage and higher stool frequency, resulting in increased need of pads. Furthermore, irradiated males reported more erection problems. However, radiotherapy did not have negative effects on overall functioning. Compared with Dutch population, patients in both treatment arms reported a small decrease in overall functioning and males reported less sexual activity, interest and enjoyment and more erection difficulties. Irradiated females reported more vaginal dryness and more pain at intercourse compared with Dutch population.Long-term HRQL evaluation shows that treatment-related symptoms are still present 14years after treatment for rectal cancer. Radiotherapy increased bowel dysfunction in patients without stoma. Compared with the Dutch population, both groups reported increased sexual dysfunction. Despite these treatment-related symptoms, there was no difference in overall functioning and global health between TME and PRT+TME.
- Feasibility and Preliminary Effectiveness of a Novel Cognitive-Behavioral Couple Therapy for Provoked Vestibulodynia: A Pilot Study. [JOURNAL ARTICLE]
- J Sex Med 2014 Jul 24.
Provoked vestibulodynia (PVD), a recurrent, localized vulvovaginal pain problem, carries a significant psychosexual burden for afflicted women, who report impoverished sexual function and decreased frequency of sexual activity and pleasure. Interpersonal factors such as partner responses to pain, partner distress, and attachment style are associated with pain outcomes for women and with sexuality outcomes for both women and partners. Despite these findings, no treatment for PVD has systematically included the partner.This study pilot-tested the feasibility and potential efficacy of a novel cognitive-behavioral couple therapy (CBCT) for couples coping with PVD.Couples (women and their partners) in which the woman was diagnosed with PVD (N = 9) took part in a 12-session manualized CBCT intervention and completed outcome measures pre- and post-treatment.The primary outcome measure was women's pain intensity during intercourse as measured on a numerical rating scale. Secondary outcomes included sexual functioning and satisfaction for both partners. Exploratory outcomes included pain-related cognitions; psychological outcomes; and treatment satisfaction, feasibility, and reliability.One couple separated before the end of therapy. Paired t-test comparisons involving the remaining eight couples demonstrated significant improvements in women's pain and sexuality outcomes for both women and partners. Exploratory analyses indicated improvements in pain-related cognitions, as well as anxiety and depression symptoms, for both members of the couple. Therapists' reported high treatment reliability and participating couples' high participation rates and reported treatment satisfaction indicate adequate feasibility.Treatment outcomes, along with treatment satisfaction ratings, confirm the preliminary success of CBCT in reducing pain and psychosexual burden for women with PVD and their partners. Further large-scale randomized controlled trials are necessary to examine the efficacy of CBCT compared with and in conjunction with first-line biomedical interventions for PVD. Corsini-Munt S, Bergeron S, Rosen NO, Mayrand M-H, and Delisle I. Feasibility and preliminary effectiveness of a novel cognitive-behavioral couple therapy for provoked vestibulodynia: A pilot study. J Sex Med **;**:**-**.
- Congenital vesicovaginal fistula: spontaneous or forced? Two cases and literature review. [JOURNAL ARTICLE]
- Int Urogynecol J 2014 Jul 19.
Congenital vesicovaginal fistula is an exceedingly rare entity. There is no consensus regarding the nature and origin of this condition. We report two cases with congenital vesicovaginal fistula and compile previously reported cases in the English literature. Theories behind the genesis of this anomaly will be briefly presented.We describe the presentation, diagnostic workup, and management of two patients with congenital vesicovaginal fistula. Previously reported cases were retrieved through an extensive English literature review using Medline and PubMed. Cases are tabulated based on the presence or absence of vaginal menstrual outflow obstruction.Two women, aged 23 and 17, had had cyclic hematuria since puberty that was perceived as normal menstruation. One woman presented with an inability to have sexual intercourse, and the other with severe cyclic pelvic pain. Diagnostic workup unveiled congenital vesicovaginal fistula and distal vaginal agenesis in both. One had abnormal ureteric insertion, while the other had a history of anomalies unrelated to the urogenital system. Successful surgical correction of fistula was undertaken in both. An English literature review revealed 23 reported cases of congenital vesicovaginal fistula. While 74 % had concomitant menstrual outflow obstruction, the remaining had normal menstruation per vagina.Congenital vesicovaginal fistula can present as an isolated anomaly, or associated with complex malformations of a wide spectrum. The presenting symptoms as well as the age at diagnosis vary widely. While the term "congenital" implies its genesis before birth, a congenital vesicovaginal fistula can be a manifestation of faulty embryological development, but also the result of outflow obstruction.
- Experiences with nausea and vomiting during pregnancy in Turkish women based on roy adaptation model: a content analysis. [Journal Article]
- Asian Nurs Res (Korean Soc Nurs Sci) 2013 Dec; 7(4):175-81.
This qualitative study aimed to explore how Turkish women experience nausea and vomiting in pregnancy based on the Roy Adaptation Model.To collect data, in-depth interviews were undertaken with 35 pregnant women who had nausea and vomiting. The sample of the study included pregnant women who were in their first 12 weeks of gestation, did not have medical problems and had nausea, retching and/or vomiting for at least the last 3 days. Data were collected in semi-structured interview form based on the Roy Adaptation Model and with a background data sheet. Data were analyzed using direct content analysis.Data were classified into four adaptive modes according to the Roy Adaptation Model. The behaviors in the physiological mode were nausea, vomiting, fatigue, changes in sleep patterns, inadequate nutrition, inguinal pain, burning sensation and irritation in the throat, ketosis, and urinary incontinence. The behaviors in the self-concept mode were feeling weak, crying, inadequate self-care, changes in sexual intercourse, and social isolation. The behaviors in the role function mode were being unable to fulfill the responsibilities at home and work. The behaviors in the interdependence mode were dissatisfaction with relationships.The study findings help nursing staff detect the stimuli and the behaviors of pregnant women with nausea and vomiting. Further research may evaluate the impact of a counseling program prepared under the guidance of a nursing model on nausea and vomiting in pregnancy.
- Sexual activity and functioning in ovarian cancer survivors: an internet-based evaluation. [JOURNAL ARTICLE]
- Climacteric 2014 Jul 16.:1-5.
Objectives Sexual dysfunction is a known complication of treatment for many cancers, but there have been relatively few studies investigating outcomes for ovarian cancer survivors. We have previously reported that women treated for ovarian cancer experience persistent psychological and physical problems. Sexual functioning was highlighted as a significant factor and we sought to investigate this further. Methods Women were invited to complete a questionnaire using both paper and online response formats. A validated tool, the Sexual Activity Questionnaire, was used to obtain information from women following a diagnosis of ovarian cancer. Results Across all responders (n = 102, mean age 51.3 years), 63% of women reported their ovarian cancer diagnosis had negatively changed their sex life. The most common reasons given for an absence of sexual activity were a lack of interest in sex, physical problems that prevented sex or no partner. Of the 46% of responders who stated they were sexually active, 77% reported pain or discomfort during intercourse and 87% described vaginal dryness. Conclusion For the majority of women, treatment for ovarian cancer negatively impacts on their sex lives. Many of the symptoms described by participants are potentially reversible and clinicians should be open to raising the issue of sexual functioning with their patients.
- [Parental attitudes recollected by patients and neurotic disorders picture--sexuality-related and sexuality-unrelated symptoms]. [English Abstract, Journal Article]
- Psychiatr Pol 2013 Sep-Oct; 47(5):827-51.
To evaluate the risks associated with non-optimal characteristics of the picture of parents in the patient's memories, concerning the sexuality-related symptoms and other areas of neurotic disorders.Coexistence of memories of parental attitudes and the current symptoms were analyzed on the basis of KO"0" Checklist and Life Inventory completed prior to treatment in the day hospital for neurotic disorders.In questionnaires, obtained from 2582 females and 1347 males between 1980-2002, there was a significant incidence of memories of adverse parental attitudes, the feeling of not being loved, the parent indifference, rejection. Regression analysis showed a significant relationship between the parental attitudes and symptoms, for instance reluctance of men to sexual contacts coexisted (OR = 3.41) with hostile mother's attitude, the same association in women was weaker (OR = 1.64) but still significant. Also, the absence of mother in childhood was associated with a risk of disruptions in the conduct of intercourse (erectile dysfunction or pain) in women (OR = 2.43) and men (OR = 3.29). Other analyzed symptoms, also sexuality -unrelated, though weaker and less frequently, were associated with non-optimal pictures of parents, e.g. pessimism in women with the hostile mother (OR = 1.97). Higher global severity of symptoms was associated with non-optimal parental attitudes.The type of recollected attitudes of parents was associated with a higher incidence of symptoms, primarily in the field of sexuality, and with other selected symptoms, as well as with higher global symptom level. The results indicate importance of life circumstances in the development of psychopathology and encourage to further research.
- Feasibility of collecting vulvar pain variability and its correlates using prospective collection with smartphones. [Journal Article]
- Pain Res Treat 2014.:659863.
Context. Vulvar pain level may fluctuate in women with vulvodynia even in the absence of therapy; however, there is little evidence suggesting which factors may be associated with variability.
Objective.Determine the feasibility of using smartphones to collect prospective data on vulvar pain and factors that may influence vulvar pain level. Methods. 24 clinically confirmed women were enrolled from a population-based study and asked to answer five questions using their smartphones each week for one month. Questions assessed vulvar pain level (0-10), presence of pain upon wakening, pain elsewhere in their body, treatment use, and intercourse.
Results.Women completed 100% of their scheduled surveys, with acceptability measures highly endorsed. Vulvar pain ratings had a standard deviation within women of 1.6, with greater variation on average among those with higher average pain levels (P < 0.001). On the weeks when a woman reported waking with pain, her vulvar pain level was higher by 1.82 on average (P < 0.001). Overall, average vulvar pain level was not significantly associated with the frequency of reporting other body pains (P = 0.64).
Conclusion.Our smartphone tracking system promoted excellent compliance with weekly tracking of factors that are otherwise difficult to recall, some of which were highly associated with vulvar pain level.
- The impact of vaginal penetration difficulties on the sexual functioning of women and their male partners. [JOURNAL ARTICLE]
- Eur J Contracept Reprod Health Care 2014 Jul 7.:1-7.
Objectives To compare the sexual function of women with and without vaginal penetration difficulties (VPDs) and relate it to the sexual function of their male partners. Methods All consenting women attending a sexual medicine centre during 2005-2007 completed the Female Sexual Function Index (FSFI) and answered questions about five VPDs (placement of a tampon, gynaecological examination, insertion of her or her partner's finger, and penile-vaginal intercourse). Male partners filled the International Index of Erectile Function (IIEF). Results Full data were available for 223 women, and 118 male partners. Male partners of women with VPDs (n = 53) had lower sexual desire (p = 0.0225). The number of VPDs in the women concerned negatively correlated with their partners' desire (r = - 0.18339, p = 0.0468) and erectile function (r = - 0.19848, p = 0.0312). All women with at least one VPD (n = 109) reported significantly more sexual pain (p < 0.0001) and had worse sexual function scores (p = 0.014) than women with no VPDs (n = 114). Women with VPDs other than penile-vaginal penetration had worse orgasmic functioning (p = 0.0119). Conclusions The women's VPDs are correlated with worse sexual functioning for them and for their male partners. The five VPDs are a practical and useful tool for identifying impaired sexual functioning.