CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(04): 184-194
DOI: 10.1055/s-0037-1601435
Original Article
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

A Model for the Management of Female Sexual Dysfunctions

Modelo para abordagem das disfunções sexuais femininas
Lúcia Alves da Silva Lara
1   Human Reproduction Sector, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Sandra Cristina Poerner Scalco
2   Medical Outpatient of Gynecology, Violence and STDs, Sexology Ambulatory, Gynecology Department, Hospital Materno Infantil Presidente Vargas – PMPA, Porto Alegre, Rio Grande do Sul, Brazil
,
Júlia Kefalás Troncon
1   Human Reproduction Sector, Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Gerson Pereira Lopes
3   Department of Sexual Medicine, Hospital Mater Dei, Belo Horizonte, Minas Gerais, Brazil
› Author Affiliations
Further Information

Publication History

15 November 2016

13 January 2017

Publication Date:
03 April 2017 (online)

Abstract

Introduction Sexual pleasure is fundamental for the maintenance of health and well-being, but it may be adversely affected by medical and psychosocial conditions. Many patients only feel that their health is fully restored after they resume normal sexual activities. Any discussion of sexuality in a doctor's office is typically limited, mainly because of a lack of models or protocols available to guide the discussion of the topic.

Objectives To present a model designed to guide gynecologists in the management of female sexual complaints.

Methods This study presents a protocol used to assess women's sexual problems. A semi-structured interview is used to assess sexual function, and the teaching, orienting and permitting (TOP) intervention model that was designed to guide gynecologists in the management of sexual complaints.

Results The use of protocols may facilitate the discussion of sexual issues in gynecological settings, and has the potential to provide an effective approach to the complex aspects of sexual dysfunction in women. The TOP model has three phases: teaching the sexual response, in which the gynecologist explains the physiology of the female sexual response, and focuses on the three main phases thereof (desire, excitement and orgasm); orienting a woman toward sexual health, in which sexual education is used to provide information on the concept and healthy experience of sexuality; and permitting and stimulating sexual pleasure, which is based on the assumption that sexual pleasure is an individual right and is important for the physical and emotional well-being.

Conclusion The use of protocols may provide an effective approach to deal with female sexual dysfunction in gynecological offices.

Resumo

Introdução O prazer sexual é fundamental para a manutenção da saúde e do bem-estar da mulher, mas pode ser afetado negativamente por condições médicas e psicossociais. Em muitos casos, a mulher sente que sua saúde geral é restaurada após retomar sua vida sexual. Porém, a discussão sobre função sexual no consultório do ginecologista é limitada devido à falta de modelos ou protocolos disponíveis para orientar a intervenção neste tema.

Objetivos Apresentar um modelo de intervenção nas disfunções sexuais femininas para ser utilizado pelo ginecologista.

Métodos Foi realizada uma revisão da literatura com levantamento de estudos sobre o manejo das disfunções sexuais femininas nas diferentes culturas. A partir desta revisão, foi elaborado um protocolo que consiste da história clínica e de um modelo de intervenção para orientar os ginecologistas no tratamento das queixas sexuais femininas.

Resultados O uso de protocolos pode facilitar a discussão sobre questões sexuais pelo ginecologista, e pode fornecer uma abordagem eficaz para lidar com os aspectos complexos da disfunção sexual feminina. O modelo proposto, ensinar, orientar e permitir (EOP), tem três fases: ensinar sobre a resposta sexual, na qual o ginecologista explica a fisiologia da resposta sexual feminina, e se concentra nas suas três principais fases (desejo, excitação e orgasmo); orientar sobre saúde sexual para fornecer informações sobre vivência saudável da sexualidade; e permitir a estimulação do prazer sexual, que é um direito individual e importante para o bem-estar físico e emocional do indivíduo.

Conclusão O uso de protocolos pode fornecer uma abordagem eficaz para o ginecologista lidar com a disfunção sexual feminina.

 
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