Summaries from the World Congress of Sexology
held in Havana, Cuba, from 10 to 14 March
Chosen by Dr. Carlos Berganza

 

The role of hotlines
in clinical sexology: the Portuguese experience
Dra. Patricia Pascoal, Portugal

The hotlines exist in the United States since the early twentieth century. Initially, they were devoted to the prevention of suicides. Traders were mainly volunteers with human sensitivity, they put their ears in hand, in order to relieve the emotional pain of those who needed someone to talk to in times of great despair. Gradually, its scope was extended, both geographically and thematically. At present, there are hotlines around the world that support in different areas. Sexology, ie, the science that deals with sexual disorders, is an area in which the anonymous help can be especially useful. A helpline in the area of clinical sexology is the first step in the process of change and improvement of sexual life. This type of service can be located between the first two levels of intervention PLISSIT model (Annon, 1976). In Portugal, the helpline for sexual disorders (SOS DIFFICULTIES sexuais) existed for 3.5 years. It is available every working day, from 6 pm until 10 pm and is run by 5 people with specific training in the field of clinical sexology. This is an anonymous, low-cost service that provides a first contact with people in need of information, support and help from professionals in the area of clinical sexology. During all these years, we have been constantly reshaping our work and improving service. In our experience, this service helps to bridge the gap between the general population and specialized face-to-face services that exist in the area of sexuality.
Premature ejaculation: integration of therapeutic techniques.
Dr. Carlos Moreira, Uruguay

The objective was to evaluate the response to medical treatment of premature ejaculation. Since 1994, we have developed a new model of treatment to prevent premature ejaculation. In this research, more than 1,000 patients in our clinic were included, whom underwent electromyography penis and perineum. This allowed us to categorize the level of dysfunction in mild, medium and strong. Subsequently, we started treatment consisting of oral drugs, injections of vasoactive substances and sexual therapy. 8 patients attended medical evaluations in which both control treatment, injecting as work performed. We evaluate the response to treatment based on our observation of the patient and taking into account the delayed ejaculation. Were investigated with particular interest the changes in the erection and sexual desire.
Of the patients studied, we obtained a good response in 49% of cases; and a very good response (achieving the delayed ejaculation sooner than expected) by 37%. Only in 14% of cases, a mediocre response was obtained and patients had to undergo four additional treatments. Of these, 0.8% had a good response to treatment whereas 0.2% had no response whatsoever.
All patients with erectile dysfunction associated with premature ejaculation showed an overall improvement. Or erection or sexual desire deteriorated in either case.
At the end of the study, a positive therapeutic response in 98% of cases showed. After several tracking controls, none again suffered from premature ejaculation. Based on this fact, we believe our model is the best treatment for patients with this type of dysfunction.
Education of young people by young alike
Dra. Stephanie Chase, Canada

The Health Center for Youth (Youth Health Centre [YHC]) provides reproductive health care to youth in Port Alberni. Six years ago, we conducted focus groups to ask young people about the activities of prevention and health promotion with which our organization could help them in making decisions about their sexuality. They identified the need for the information to be delivered to them amicably with the youth environment, and from that concept, was born the project for peer education. This program is entirely driven by young people who are responsible for identifying and assessing needs, investigate, create and deliver presentations on health topics to other young people. Currently we have 40 young educators who make presentations as diverse topics, such as promoting a healthy body image, smoking prevention, alcohol abuse prevention, prevention of AIDS / STDs, birth control, anatomy and physiology, and healthy relationships between them. The program has been well received by students and even when assessing the same peer educators, have shown positive changes in their way of making decisions and the quality of them. Last year, we conducted about 500 hours of presentations and we got to all students in 5th, 6th, 7th, 8th, 9th and 11th grade in our school district.
Transference and countertransference erotic and sexualized
Dra. Ruth Lijtmaer, Argentina

Patients expressing intense erotic attraction to his therapist present a special challenge in the treatment, which could not properly respond to the avoidance of the therapist. The desire on the part of the patient, the therapist show you love and erotic feelings the therapist on these patients, may create misunderstandings and difficult moments from the technical point of view. When sexual feelings predominate, the patient may feel driven by feelings of great intensity that along to demand satisfaction, also it generates feelings of shame and humiliation and rage at the therapist. Unlike other transfer phenomena, the desire for sexual contact, such as repetition of a past trauma, requires the therapist, the rupture area of illusion in the transfer and minimization of fantasy in favor of promoting the formation of limits . and repair deficiencies ego level
Admitting erotic countertransference has been admitted as a professionally acceptable, since only very recently; the fact reveal these feelings to the patient, it is still seen as provocative. The intolerance of erotic countertransference in ourselves, could result in manifestations of the same through maternalists responses or suppression of feelings that are kept out of consciousness, leading to an altered therapeutic process. Feelings of erotic countertransference most powerful are those that have merged with feelings of aggression, since they inhibit the experience of the therapist and can completely change the course of treatment. The purpose of this presentation is to review the literature on this topic and provide clinical examples of the different instances in which the erotic and sexualized transference and countertransference appears. Unless they are explored and understood, these erotic feelings could ori
pages obstacles in treatment, or in the worst case, they may surface in one or both partners.
The education in social communication:
what was missing sex education
Dra. Nasserzadeh Sara, Iran

The emphasis of sex education has been put in the physical part of the relationship, such as anatomy, physiology and sexual positions. There has been little attention to the media before, during and after sexual contact. People, especially young people, learn the communication part of the sexual behavior of their peers and the media, which are not necessarily the best sources of information.
The Hollywood movies and TV series have created tremendous pressure pushing adolescents and young people to premature sex and unprepared (especially from a mental point of view). The content of most porn films is also aimed at achieving maximum carnal satisfaction. Moreover, couples are not properly educated to communicate with each other with their sexual partner and tend to multiply extramarital sexual partners and experiences, in turn increasing the divorce rate. A collegial body of sexologists and specialists in communication, should review the scripts of romantic movies and pornographic videos in order to secure a richly educational message in the film. Educational guidelines should be written so that filmmakers and TV will improve their understanding of what constitutes an appropriate perisexual communication. It should implement a code of healthy sexual relationships to control the quality of porn productions. They should develop special programs for adolescents and young people of school age to educate them properly in the communicative part of sex. They must learn to respect their partners and practice codes of honesty, loyalty and romance. Special programs available to couples who want to improve their sex life as regards proper human communication. They must also create
knowledge, attitudes and sexual behavior
of women with eating disorders
Dr. Maria Lameiras Fernández, Spain

Very few studies have focused on studying multidimensional way the sexuality of young people with eating disorders. The study aimed to identify whether, depending on the type of disorder (restrictive versus purgative anorexia nervosa, bulimia nervosa and eating disorders not specific), differences in knowledge, attitudes and sexual behavior are presented.
We found no significant differences in the knowledge and attitudes regarding the type of eating disorder. 61.3% of young people with restrictive anorexia nervosa, anorexia nervosa 44.2% purgative, 35.4% of girls with bulimia nervosa and 60% of girls with no specific disorders have not kept coital sex. The differences are in the degree in which they have practiced masturbation (Chi 2 = 23.00, p = 0.05), having found that 74.2% of young women with anorexia nervosa restrictive never practice it. No differences between groups regarding age at first intercourse, or frequency with which it has conducted the oral-genital and anal vaginal intercourse. It is proven that girls with restrictive anorexia nervosa have fewer emotional events than those with anorexia nervosa purging (t = -2.42, p <0.05) and that girls with bulimia nervosa (t = -2.73, p <0.01); and girls with restrictive anorexia nervosa are more satisfied with their sexuality than those with bulimia nervosa (t = 2.66, p <0.05); although no differences identified in these variables between the other groups. The findings suggest that different subtypes of anorexia nervosa can be associated with different patterns of sexual behavior, so this should be taken into account when designing programs
of intervention.
Cybersex in chat rooms in Portugal
Dra. Carvalheira Alexandra Ana, Portugal

Sex search the Internet takes a variety of forms, targets and behaviors. This study deals with a particular form of sexual activity on the Internet: in cybersex chat rooms and, more specifically, sex online by Portuguese in sex chat rooms in Portugal. This study sought to identify the reasons and motivations for cybersex chat rooms, gender differences in the time spent on this activity and the consequences in the lives of these users from chat rooms.
To carry out our research, We devised a tool for gathering information in the following areas: 1) the role of anonymity; 2) social skills of individuals; 3) the exclusive online sex preference; 4) sex in chat rooms as a preamble to the actual sex; 5) The role of sexual fantasies; 6) the real impact on relationships in real life; and 7) addictive behaviors.
The sampling was conducted online (N = 400) through a questionnaire of 58 questions in order to collect information regarding the areas already mentioned above, and 4 questions concerning demographic variables and the time spent online. The questionnaire was available on a web site and the field work was the Internet Relay Chat (IRC) of Portugal.
The sample of 400 subjects showed a clear predominance of male involvement in cybersex: 78.3% male, 11.5% female and 10.3 % unresponsive. A factor analysis of the major components followed by a varimax rotation, allowed us to find a solution of 7 factors explaining 58,086% of total variables.
We found a variety of sexual attitudes and connected with cybersex chat rooms behaviors. The analysis of the data suggests the possible existence of two trends pointing in different directions in relation to this type of sexual activity.
The so-called sexual deviations:
¿Perversion or right to difference?
Dr. Maria Cristina Martins, Brazil

Considering the increased use of the Internet as a source of deals on everything related to sex, this study aims to study a group of Brazilian people who describe themselves as practitioners of consensual sadomasochistic sex (S / M) and fetish, to to establish to what extent these deviant behavior should be regarded as a simple variation of the adult should be judged symptomatic or sexuality.
The question, “How does it feel to get pleasure from sexual behavior considered and often diagnosed as a perversion?” is published in several discussion lists and related S / M sites. Potential participants must be over 18, regardless of marital status or sexual orientation. The analysis of the results was a psychosocial perspective. 111 responses of heterosexual men and women, gay men and bisexual men were received: 36% involved in BDSM sex with their partners and 25.2% without the knowledge of their partner; the remaining 38.8% was composed of singles and people looking for sexual partners. All participants reported feeling comfortable with their sexual orientation, they considered pleasurable and claimed the right to choose how, where and who express their sexual fantasies.
People involved in sex consensual S / M have been
discriminated against by society because misconceptions and myths surrounding these types of behaviors that are considered victims and / or perpetrators of violence and coercive sexual abuse. This study suggests that unconventional sexual practices can not be used as diagnostic criteria of any kind, which means that the only aspect that distinguishes these individuals from others is their sexual practices.
Sexual behavior in adolescents
in northern Mexico
Dra. Elba Abril, Mexico

In order to describe and analyze behaviors of adolescents in relation to their sexual practices, we interviewed 668 students between 15 and 19 years old. All attending public schools in Hermosillo, Sonora, located in the northwest of Mexico. Conducted a survey and the instrument was a validated questionnaire composed of 154 questions. 51% was made ​​up of males and 49% for girls.
26% of male respondents and 8% of girls interviewed had sex. Males had done with friends, while girls had sex with love. The average age of first intercourse for both boys and for girls was 15 years. Only 10% of males reported using contraception, like 4% of the girls. 52% of men and 40% of girls accepted premarital sex, a difference that was statistically significant (p <0.05). The results highlight the importance of sex education. The young people of this community are having sex without using any method to avoid sexually transmitted diseases and pregnancy. The information and awareness help teens behave responsibly regarding their sexual practices.
Knowledge of family planning methods
among family medicine residents
Dra. Dr. Ezcurra and Lauren Bardisa. Aissa Dojer I. Naranjo (Cuba)

Family planning is one of the best and most effective investments to improve the health and welfare of women, children and communities. Medical staff plays a crucial role in the provision of high quality family planning but, to do so, they must be well informed about the availability and characteristics of the methods and have the skills required to facilitate a free and informed choice by women and men who require these services.
We designed this study to identify the level of awareness about family planning among family physicians who are residents in the specialty of general medicine. A questionnaire covering the same technical and service delivery points was applied to 39 residents, and 22 of them participated in a discussion with a panel discussion on relevant issues.
In general, the level of knowledge of family planning methods was good, but surprisingly the survey showed that the topic that best students was dominated infertility. The level of knowledge was significantly lower on general issues regarding methods, particularly lactation amenorrhea; almost 60% ignored the concept of emergency contraception.
One of the main results of the discussion groups was that most felt that there was a need to devote more time to these issues during academic activities and practices undertaken by students during their residence. Furthermore, conventional techniques of academic learning, it was also considered that the issue deserved the use of focus groups to discuss aspects of service provision. This would facilitate the provision of family planning services by doctors and paramedical staff, in which the free and informed choice on offer to customers is based on ethical principles and technical incorrect.
Sex therapy in elderly:
experience Cuba
Oscar Diaz, Cuba

This report describes the results of six years of work in a clinic for sexual therapy, with people over 60 years. We have found that most women do not seek help to overcome their sexual problems and when they do, it is almost always because the force your partner. Our experience is that in 6 years, we have seen only 15 women, of which: 2 anorgasmic, 4 with dyspareunia due to vaginal dryness, 3 requesting counseling for different reasons (couples with low sexual desire, Couple 20 years younger requesting information about masturbation in the elderly), 6 with low sexual desire. We think these results are a clear reflection of what is really happening, because, according to the information we have gathered after interviewing more than 1,000 women over 60 years in Havana, they still enjoy sex life (including coital) activity by more than 60% of the total interviewed. And more than 20% of these women reported some degree of sexual dysfunction when asked specifically that. In relation to men, we have seen an average of 72 new cases per year; most of them with complaints about erectile dysfunction. There is a lot of these men (over 40%), whose main cause of dysfunction, psychological or relationship problems, or both. In men with physical problems as the cause of sexual dysfunction and because of the difficulties in the use of sildenafil or other oral therapy in our country, we used alternatives for treatment. Depending on the cause of dysfunction, we used: ozone therapy, nitroglycerin cream, intracavernous injection and magnetic fields. Explain in detail the results on the use of these treatments.
Skills for parents to face possible situations of sexual abuse in their children
Amaia del Campo, Spain

Many studies have confirmed that the reactions of parents to sexual abuse against children has a decisive influence on the subsequent recovery of children. A negative emotional reaction, which is unfortunately very common, only help to aggravate the consequences of abuse. By contrast, emotional support and protection measures can mitigate the onset of symptoms in the victims. The aim of this study was to gain knowledge on parenting skills to deal with sexual abuse in their children and their possible reactions to such cases of abuse. The study included 254 subjects (120 fathers and 132 mothers). The results showed that 62% of parents perceive themselves as capable of acting efficiently in a given case. However, all subjects responded positively, only 15% confirmed that they would report the incident and would offer emotional support to the victim.
The other parents in general, offered courses of action that may be considered inappropriate (for example, aggression against the aggressor) or insufficient. We also explored the knowledge of parents about available community resources to provide support in such cases. Overall, the results suggest that there is a need to engage both mothers and fathers in programs aimed at preventing child sexual abuse.
Intent of adolescents to use condoms
Gabriela Velasquez, Mexico

According to the theory of planned behavior
fied (TPB, for its acronym in English), some predictors were identified with respect to the intention to use condoms in teenagers. Including: knowledge about proper condom use, perceived effectiveness for use, subjective norm, attitude regarding its use, sexual experience, and gender of the subjects. Involved 919 high school students and high school between 14 and 18 years old. The results showed that none of the proposals by the TPB variables influenced the intention to use condoms. Unexpectedly, two demographic variables, “sex” and “sexual experience” showed a clear relationship and influence on the intention to use condoms. The intention to use condoms was important when teenagers did not have sexual experience and decreased when teenagers had had sex. Also it found that adolescent females compared to males, in proportion, showed twice the intention to use condoms consistently.
Similarly, the men had proportionally. twice more than women, lack of intention to use condoms. We also found that women with sexual experience have little information (x = 7.07) and a minimum perception of self-efficacy (x = 32.29), and that women with sexual experience have better information regarding markers (x = 9.02) compared to the whole sample, as well as a stronger sense of self-efficacy (x = 37.54), even on the male average (x = 37.08). Regardless of the amount of information we had and their perception of self-efficacy to use condoms, young adolescents clearly demonstrated their decision to use condoms consistently. The application of these results is discussed in educational campaigns.
Sexual dysfunction among university students
in Concepción, Chile, 2002
Paulina Haemmerli, Chile

Transversal and descriptive study with university students between 18 and 28 years old. The purpose was to determine the existence of any sexual dysfunction.
A voluntary and anonymous questionnaire was administered to 149 young people. 75% between 18 and 21 years of age, and 59.1% is made ​​up of women; most are single with a satisfying emotional relationship up 72.5%. Sexual intercourse in 59.1%, while 36.3% were sexually active. On the other hand, the 1.3% reported having experienced homosexual relations. 76% reported high and very high sexual satisfaction; 24% reported some degree of dissatisfaction arising from: burden of pregnancy, 21.5%; lack of privacy, 16.1%; lack of experience, 10.7%; lack of orgasms, 9.4%; lack of desire, 6.0%; premature ejaculation, 5.4%. Sexual encounters are: at home, 45%; in motels, 18.1%; rented rooms, 15.4%; open spaces, 12.8%. 20% feel guilty because of moral values ​​and religious reasons.
At the end of the study, sexual dysfunction in this group was: anorgasmy, anhedonia and premature ejaculation. Intervention is recommended to achieve sexual satisfaction.
Sexual problems in couples therapy of postmenopausal women with hormone replacement
Jorge Lopez Olmos, Spain

A group of 298 postmenopausal women treated with hormone replacement therapy (acronym, HRT) were interviewed in 1996 to explore their sexual quality of life. There were 143 cases of natural menopause, surgical menopause 122 cases and 33 cases of premature menopause. The average age in this series was 51 to 58 years. The average age of menopause was 45 to 42 years. The average age of the couple was 54 to 39 years. Sexual problems the couple were: premature ejaculation in a 8.72%; ED in 11.07%; lack of sexual desire in 7.71% (no sexual desire in women, 52.68%, p <0.001). No sex in 29 pairs, 9.73%. Factors in men’s sexual problems were depression, hypertension, prostate disease, heart disease and labor problems. The reasons for the absence of sex in women were widowed, lack of partner because of separation, divorce or unmarried; and in the case of the husband. absent, with erectile dysfunction or lack of sexual desire
sexual arousal and orgasm in women
undergoing hysterectomy with estrogen therapy
Ana Lucia Cavalcanti, Brazil

The effects of hormone replacement therapy on sexual desire, arousal and orgasm in women following menopause induced by surgery (hysterectomy) for benign disease were evaluated. 34 women were studied, of which 16 were in the experimental group receiving hormone therapy (GTRE) and 18 were in the experimental group followed up with placebo (GP) in the field of gynecological endocrinology Clinical Hospital of the Medical School University of Sao Paulo, Dr. Aristodemus Pinotti service. The results showed a high frequency of hypoactive sexual desire. There was a significant, but not significant in the frequency of sexual desire and orgasm in both groups of the 2nd to 3rd visit increase. The significant increase in the frequency of arousal and orgasm occurred in both groups: in the group GTRE this increase was observed from the 1st to the 2nd and 3rd visits. In the GP group, there was a significant progressive increase from baseline to 3rd. Our data have also shown an increase in self-esteem and more frequent sexual activity in the GTRE group. The literature is inconclusive about the controversies surrounding the relationship between total and subtotal hysterectomy and sexual dysfunction, nor is it about the information on social, psychological, cultural and organic factors, whose complex interactions must detail best, so that you can determine the liability of such factors of sexual dysfunction.
Usefulness of sildenafil in the treatment of erectile dysfunction secondary to antidepressant
Froilan Sanchez, Spain

The aim was to assess the effectiveness of sildenafil in erectile dysfunction (ED) caused by antidepressant use, its tolerance and its effectiveness after three months of use. This was an open, prospective multicenter study with a treatment arm. 55 male patients (18-70 years) who were taking antidepressants and developed than in relation to such use were included. They must maintain a minimum of 4 sex after taking 50 mg of sildenafil (100 mg from the 6th week if not improves sexual response). The diagnosis of ED was performed using a questionnaire on sexual dysfunction related to psychotropic agent (PRSexDQ) and international index of erectile function (IIEF, acronym in English). The valuation of the clinical course and took PRSexDQ IIEF, Clinical Global Impression Scale (KIMS, acronym in English), patient diary. The descriptive statistical analysis was performed using the Student t test, McNemar and Chi-square test.
At the start of the study included 55 patients, at the end of 54 patients (98.1%). PRSexDQ: Significant improvement at all time points (p <0.0001), IIEF: Significant improvement in the five dimensions were evaluated: p <0.0001, AGCI improvement of the disease; 2.2% (better), p <0.0001, KIMS improving sexual dysfunction: 1.3% (much better), p <0.0001. Success rate of attempts at sexual activity: With measurement: 93%, without medication: 65%, p <0.001. No adverse events declares. The effectiveness in changing the func
erectile ion is maintained (in all categories of IIEF) after 3 months follow-up.
The study concluded that sildenafil is effective in ED caused by antidepressants. During treatment, patients showed a significant improvement in the clinical impression of depression. The drug tolerance is good and keeps improving the DE after 3 months follow up.
Unemployment, age and depression as risk factors for erectile dysfunction in men
and lack of sexual desire in women
Carmita Abdo, Brazil

The study aimed to present the prevalence of erectile dysfunction (ED) in men and lack of sexual desire in women, and to estimate the risk for these disorders when subjects are unemployed and depressed. The sample included 2,835 subjects (47% men and 53% women), aged 18 years, who answered an anonymous questionnaire about general health, habits, practices and sexual difficulties. Chi-square test and multivariate logistic regression were used. 0.05 values ​​were considered significant from a statistical standpoint. It was determined that 22.5% of men and 41.0% of women were unemployed. 14.7% of men had moderate / complete and 34.6% of women had a lack of sexual desire. Depression was mentioned by 16.8% of men and 29.7% women. Unemployed men and women had a higher prevalence of depression and sexual dysfunctions studied. Among men, unemployment increased 1.83-fold (95% CI, 1.22-2.77; p <0.01) the possibility of suffering from, and 1.93-fold (95% CI, 1.25-2.97; p <0.01) depression. Compared to men who are under 25, men between 41 and 60 have 1.86 times greater risk (95% CI, 1.06-3.28; p <0.05). Men over 61 are 4.31 times (95%