Objective: To analyse all available evidence to validate the effectiveness of a local intervention in the treatment of dyspareunia in breast cancer survivors (BCS). Methods: We searched the Institute of Scientific Information Web of Knowledge, MEDLINE, PubMed, Scopus, and Cochrane databases for all articles published in peer-reviewed journals up to April 2019. The PICOS standards were: (population) BCS with dyspareunia; (intervention) any type of vulvovaginal treatment; (main outcome) frequency and severity of dyspareunia; (study design) clinical studies. Results: The literature search strategy identified 252 articles, of which 233 were excluded at various stages of the search. Finally, we systematically reviewed 19 studies, 8 with local hormonal therapies, 7 with local non-hormonal therapies, 3 with laser therapy, and 1 with other interventions. Of the studies, 7 were randomized control trials and 11 were prospective observations. Most of the interventions were shown to be effective and safe in the improvement of dyspareunia. Conclusion: In addition to the traditional options already analysed in other current reviews, other interesting options are highlighted (such as laser or local dehydroepiandrosterone [DHEA]). Further work on dyspareunia should make use of high-quality trials with large numbers of samples to obtain evidence that could adequately demonstrate key methodological characteristics and harmful effects.
This review aimed to respond to the question of how a history of violence against women (VAW) influences their health during menopause. Mechanism: We searched all articles (published in peer-reviewed journals up to March 2021) related to menopausal symptoms, sexual dysfunction, and chronic complications in postmenopausal women affected by VAW. Findings in brief : The literature search strategy identified 194 articles, of which 19 were selected for analysis. All articles described cross-sectional or cohort studies concerning menopausal or genitourinary symptoms, psychological health, physical conditions, sexual health, and cardiovascular or metabolic problems. The analyzed data set included 16436 women who reported experiencing violence in the USA, Brazil, and Australia. The combined data on the effect of VAW on menopausal symptoms suggest that the risk of suffering from such effects is 1.51 (95% CI: 1.23-1.86), while for sexual health, the risk was 1.4875 (95% CI: 1.2060-1.8346). Conclusions: A history of VAW increases the symptoms of menopause and worsens the physical conditions and sexual and psychological health after the age of 40. Thus, it is essential to investigate these antecedents in routine clinical practice when treating menopausal women with additional symptoms and to warn of the long-term general health risks for any woman who has experienced an episode of violence.
Female sexual dysfunction (FSD) affects 40% of the world's females, most of which are disorders linked to desire or interest/excitement. Whilst all types of therapy that attempt to improve female sexual desire have long been established, the results are contradictory. Objective: To analyze all available evidence to validate the effectiveness of natural therapies in the treatment of FSD. Method: The study was registered at http://www.prospero.org (CRD42019127700). We searched the Institute for Scientific Information Web of Knowledge, MEDLINE, Pubmed, Scopus and Cochrane databases for all articles published in peerreviewed journals in April 2019 (in any language). The PICOS standard is women with FSD; (intervention) of any type of Natural therapy; (outcome) primary outcome: frequency of changes, severity, and average mean scores on sexual symptoms measured with a validated instrument, secondary outcome: quality of life; (study design) and randomized clinical trial (RCT). Results: The literature search strategy identified 95 articles, 81 of which were excluded at the different search stages. Finally, we systematically reviewed 15 RCTs, 11 of which referred to primary FSD, and four of which analyzed women with drug-induced FSD (DFSD). Most of them analyzed hypoactive sexual desire disorder. Although differences related to placebo were found in most people, the majority of the studies are considered to be of poor quality and low external effectiveness. Conclusion: Although the quality of the evidence is not high, most natural product interventions appear to improve FSD, particularly hypoactive sexual desire disorders including those categorized as primary and drug-induced.
Objectives: Violence against women (VAW) is associated with a deterioration of endocrine function with consequences similar to those of premature ovarian failure in women. The main objective of this study is to evaluate the hormonal repercussions of VAW and, secondly, to analyse the cardio-metabolic, bone, cognitive, psychological, and psychosexual consequences of hypoestrogenism secondary to VAW. Materials and Methods: A cross-sectional study will be conducted on women of any age who have suffered VAW at some point in their lifespan, whether psychological, sexual, or physical. Clinical, hormonal, cardio-metabolic, bone, psychological, and psychosexual parameters will be analysed. Results: The pilot study from the first 23 women show that all of them are suffering from severe sexual dysfunction. In addition, all women reported menstrual irregularity and hypoestrogenism (including two cases of premature ovarian failure) since the VAW episode. Conclusions: VAW is a pandemic that affects all women equally, regardless of their age, status, social background, or education. Despite the claims made by certain groups, VAW does not depend on women, but rather it affects women and is clearly harmful to their sexual, reproductive, and general health.
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