Psychosexual aspects of vulvovaginal pain.

Vulvovaginal pain problems are major health concerns in women of childbearing age. Controlled studies have shown that vulvovaginal pain can adversely affect women and their partners’ general psychological well-being, relationship adjustment and overall quality of life. These women have significantly lower levels of sexual desire, arousal, and satisfaction, as well as a lower intercourse frequency than normal controls. They also report more anxiety and depression, in addition to more distress about their body image and genital self-image. Empirical studies indicate that specific psychological and relationship factors may increase vulvovaginal pain intensity and its psychosexual sequelae. Randomized clinical trials have shown that psychosexual interventions, namely cognitive-behavioral therapy (CBT), are efficacious in reducing vulvovaginal pain and improving associated psychosexual outcomes. Women reporting significant psychological, sexual and/or relationship distress should be referred for psychosexual treatment. A multimodal approach to care integrating psychosexual and medical management is thought to be optimal.

Are primary and secondary provoked vestibulodynia two different entities? A comparison of pain, psychosocial and sexual characteristics.

Introduction Provoked vestibulodynia (PVD) is suspected to be the most frequent cause of vulvodynia in premenopausal women. Based on the onset of PVD relative to the start of sexual experience, PVD can be divided into primary (PVD1) and secondary PVD (PVD2). Studies comparing these PVD subgroups are inconclusive as to whether differences exist in sexual and psychosocial functioning. Aim The aim of this study was to compare the pain, sexual and psychosocial functioning of a large clinical and community-based sample of premenopausal women with PVD1 and PVD2. Methods A total of 269 women (n = 94 PVD1; n = 175 PVD2) completed measures on sociodemographics, pain, sexual, and psychosocial functioning. Main Outcome Measures Dependent variables were the 0–10 pain numerical rating scale, McGill–Melzack Pain Questionnaire, Female Sexual Function Index, Global Measure of Sexual Satisfaction, Beck Depression Inventory-II, Painful Intercourse Self-Efficacy Scale, Pain Catastrophizing Scale, State-Trait Anxiety Inventory Trait Subscale, Ambivalence over Emotional Expression Questionnaire, Hurlbert Index of Sexual Assertiveness, Experiences in Close Relationships Scale—Revised, and Dyadic Adjustment Scale-Revised. Results At first sexual relationship, women with PVD2 were significantly younger than women with PVD1 (P < 0.01). The average relationship duration was significantly longer in women with PVD2 compared with women with PVD1 (P < 0.01). Although women with PVD1 described a significantly longer duration of pain compared with women with PVD2 (P < 0.01), no significant subtype differences were found in pain intensity during intercourse. When controlling for the sociodemographics mentioned earlier, no significant differences were found in sexual, psychological, and relational functioning between the PVD subgroups. Nevertheless, on average, both groups were in the clinical range of sexual dysfunction and reported impaired psychological functioning. Conclusions The findings show that there are no significant differences in the sexual and psychosocial profiles of women with PVD1 and PVD2. Results suggest that similar psychosocial and sex therapy interventions should be offered to both subgroups of PVD.

To say or not to say : dyadic ambivalence over emotional expression and its associations with pain, sexuality, and distress in couples coping with provoked vestibulodynia.

Introduction Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD. Aim Ambivalence over emotional expression (AEE) is an emotional regulation variable that quantifies the extent to which a person is comfortable with the way she or he expresses emotions. We examined whether the dyadic AEE of couples in which the woman suffers from PVD was differentially associated with women's pain and couples' psychological, sexual, and relational functioning. Methods Couples (N = 254), in which the woman suffered from PVD, completed the AEE questionnaire. A couple typology of dyadic AEE was created. Main Outcome Measures Dependent measures for both members of the couple were the global measure of sexual satisfaction scale, the Beck depression inventory II, and the revised dyadic adjustment scale. The female sexual function index and the sexual history form were used to assess the sexual function of women and men, respectively. Women also completed the pain rating index of the McGill pain questionnaire. Results Couples, in which both partners were considered low on AEE, had the highest scores on sexual satisfaction (P = 0.02) and function (P < 0.01), the lowest depression scores (P < 0.01), and the best dyadic adjustment (P = 0.02). No difference in pain intensity was found between couples. Conclusions Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD.

A prospective two-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

Note de l'éditeur : This article may not exactly replicate the final version published in the journal. It is not the copy of record. / Cet article ne constitue pas la version officielle, et peut différer de la version publiée dans la revue.

Partner behavioral responses to pain mediate the relationship between partner pain cognitions and pain outcomes in women with provoked vestibulodynia.

Partner behavioral responses to pain can have a significant impact on patient pain and depression, but little is known about why partners respond in specific ways. Using a cognitive-behavioral model, the present study examined whether partner cognitions were associated with partner behavioral responses, which prior work has found to predict patient pain and depressive symptoms. Participants were 354 women with provoked vestibulodynia and their partners. Partner pain-related cognitions were assessed using the partner versions of the Pain Catastrophizing Scale and Extended Attributional Style Questionnaire, whereas their behavioral responses to pain were assessed with the Multidimensional Pain Inventory. Patient pain was measured using a numeric rating scale, and depressive symptoms were assessed using the Beck Depression Inventory–II. Path analysis was used to examine the proposed model. Partner catastrophizing and negative attributions were associated with negative partner responses, which were associated with higher patient pain. It was also found that partner pain catastrophizing was associated with solicitous partner responses, which in turn were associated with higher patient pain and depressive symptoms. The effect of partner cognitions on patient outcomes was partially mediated by partner behavioral responses. Findings highlight the importance of assessing partner cognitions, both in research and as a target for intervention. Perspective The present study presents a cognitive-behavioral model to partially explain how significant others' thoughts about pain have an effect on patient pain and depressive symptoms. Findings may inform cognitive-behavioral therapy for couples coping with PVD.

Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment : results from a 2-year follow up study.

Introduction Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others. Aims The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type. Methods Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later. Main Outcome Measures Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month. Results Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve. Discussion These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in PVD treatment trials, otherwise improvements may simply be the result of natural progression.

Untersuchungen zur Eliminierung und Resorption von Zink aus Säugerspermatozoen während der Nebenhodenpassage

Während der Spermatogenese wird das Element Zink an die Sulfhydrylreste der Cysteine in den Mantelfaserproteinen der Spermienflagellen gebunden. So kann in den noch unreifen Mantelfasern die ungerichtete Ausbildung von Disulfidbrücken verhindert werden. Im Zuge der Spermatozoenreifung während der Nebenhodenpassage wird dieses Zink androgenabhängig zu einem hohen Prozentsatz wieder eliminiert. Die nun gerichtete Ausbildung von Disulfidbrücken ermöglicht die Versteifung der Mantelfasern. Diese Rigidität stellt die Voraussetzung zur progressiven Motilität dar, ohne die eine Fertilisierung der Eizelle im weiblichen Genitaltrakt nicht möglich ist. Da eine negative Korrelation zwischen dem Zinkgehalt von Flagellen und ihrer Motilität besteht (Henkel et al., 1999), hat die Zinkeliminierung während der Nebenhodenpassage eine entscheidende Bedeutung in der Entwicklung der Spermatozoen. Die vorliegende Arbeit untersucht die Mechanismen der epididymalen Zinkeliminierung sowie die an diesem Prozess beteiligten Komponenten und den Verbleib des eliminierten Zinks am System des Bullen, der Ratte und des Menschen. Mittels proteinchemischer Verfahren kann im bovinen System ein zinkbindendes 60 kDa-Protein als Albumin identifiziert werden. Ein 80 kDa-Protein mit zinkbindenden Eigenschaften bleibt unidentifiziert. Die Zinkbindungskapazität der fraktionierten Proteine ist dabei im Caput epididymidis am stärksten ausgeprägt. Atomabsorptionsspektralphotometrische Untersuchungen zeigen die höchsten flagellären Zinkwerte in den Spermien des Rete testis und eine Abnahme des Zinkgehalts zwischen Nebenhodenkopf und -körper. Durch Autometallographie kann eine epitheliale Zinkresorption im Nebenhodenschwanz nachgewiesen werden. Dort erfolgt auch die basale Anreicherung des Zinks. Am Zinkstoffwechsel scheint auch der Macrophage Migration Inhibitory Factor (MIF) beteiligt zu sein. Dieser ist ein Zytokin mit Oxidoreduktasecharakter und kommt unter anderem im Nebenhodenepithel sowie in den Vesikeln des Nebenhoden-Fluids der Ratte vor. MIF zeigt in den hier durchgeführten Untersuchungen sowohl in systemhomologer, als auch in rekombinanter Form in vitro eine Zink-eliminierende Wirkung auf Rattenspermatozoen des Caputs und der Cauda epididymidis und hat somit möglicherweise Einfluss auf den Reifungsprozess der Spermien im Nebenhoden. Lit.: Henkel R, Bittner J, Weber R, Hüther F, Miska W (1999). Relevance of zinc in human sperm flagella and its relation to motility. Fertil Steril 71: 1138-1143

El CEIP Victoria camina hacia la coeducaci??n

Se presenta experiencia educativa que propone la eliminaci??n de los estereotipos sexistas desde las primeras etapas educativas. Se realiza en el CEIP Victoria en Loja, Granada. Los objetivos son: poner de manifiesto los estereotipos existentes a la hora de distribuir las cargas familiares tomando conciencia de la importancia de colaborar en las tareas y valorando el trabajo dom??stico; aprender a resolver los conflictos a trav??s del di??logo; conseguir el desarrollo integral del alumnado partiendo siempre de la existencia de igualdad entre hombres y mujeres; suprimir del lenguaje cotidiano del alumnado las expresiones e insultos de car??cter sexista, para que aprendan otras expresiones que demuestren respeto e igualdad; hacer uso de los juguetes que desarrollen actitudes de respeto a las diferencias, amistad, cooperaci??n, igualdad; afrontar un lenguaje coeducativo; saber valorar las distintas opciones y respetar a los que son diferentes evitando discriminaciones sexistas; construir la identidad sexual de cada persona evitando que lo femenino no quede subordinado a lo masculino; reflexionar sobre el alumnado sobre distintas situaciones y actitudes de violencia, y m??s concretamente contra las mujeres; aprender modos de comportamiento basados en la tolerancia, pac??ficos y de respeto mutuo entre hombres y mujeres.

Coeducar es preparar para la libertad.

Monográfico con el título: 'Educar para la igualdad y la libertad'. Resumen basado en el de la publicación

La mujer a través de la historia.

Se presenta memoria final de proyecto educativo que promueve la organización del currículum de las diversas áreas de la ESO utilizando como eje integrador la historia de la mujer y su desarrollo mediante métodos de investigación y la realización de una representación teatral. Se realiza en el IES Costa del Sol en Torremolinos, Málaga. Los objetivos son: elevar el interés por el estudio de la historia en cuarto de ESO; hacer próximo el proceso de enseñanza-aprendizaje de la historia; motivar y llenar de ilusión el trabajo tanto del colectivo de profesores como de los alumnos a través de esta experiencia educativa; combatir actitudes de no respeto, de no entendimiento de la igualdad en una sociedad cargada de ejemplos violentos o injustos contra la mujer o simplemente el diferente; valorar la música como campo de cultura y de sensibilidad importantes; utilizar con la misma ilusión los medios tecnológicos a nuestro alcance; realizar una experiencia interdisciplinar que de sentido globalizador al proceso de enseñanza-aprendizaje; despertar el interés por el trabajo de investigación bien realizado, manejo de fuentes, técnica y hábitos de trabajo individual y en grupo; elevar el interés por el estudio y la autoestima individual y colectiva; educar para la integración social, el respeto, la tolerancia y la diversidad cultural. El proceso consta de varias fases: manejo de amplia bibliografía; jornadas de concienciación; trabajos de campo; trabajos de investigación sobre personajes femeninos; jornadas interculturales; elaboración de una página web; teatro.

Otros juegos deportivos : aplicaciones para educación primaria.

El libro es el resultado de la experiencia de un equipo de trabajo formado por alumnos y alumnas de Magisterio que cursaron la especialidad de educación física. Libro de sugerencias en los orígenes de los juegos deportivos propuestos, en sus reglamentos y aplicaciones para la educación primaria. Se estructura en 11 capítulos destinados a otros tantos juegos: Rugby, Badminton, Beisbol, Hockey, floorball, lacrosse masculino y femenino, frisbee, indiaca, palas y fun ball.

Hacia una educación no sexista : educación para la igualdad de oportunidades entre mujeres y hombres.

Materiales para formación del profesorado de un curso organizado por el sindicato independiente ANPE titulado: Hacia una educación no sexista, la igualdad de oportunidades entre hombres y mujeres. El curso está dirigido al profesorado de infantil, primaria y secundaria y en él se da a conocer el contexto y la evolución de las ideas con relación a la igualdad de oportunidades y su influencia en la educación, conocimiento que preetende servir para la reflexión sobre la práctica educativa en relación a la coeducación. Se divide en 18 capítulos en los que se abordan, entre otros, los siguientes temas: dicotomía sexo-género, el sexismo en la sociedad actual, evolución histórica del género femenino, el sexismo en la escuela, legislación, la igualdad de oportunidades en la LOGSE, formación del profesorado, coeducación desde la psicopedagogía, etc.

Información para mujeres.

Materiales educativos de educación para la salud dirigidos a población objetivo (mujeres) que forman parte de la campaña anti-tabaco organizada institucionalmente por la Consejería de Sanidad de la Región de Murcia. Este folleto incluye los riesgos del tabaquismo y los problemas de salud a corto y a largo plazo para la mujer fumadora y las consecuencias sobre la maternidad (gestación) y la salud de los hijos. El engaño publicitario sobre el tabaco y los cigarrillos light, así como las ventajas que comporta dejar de fumar.

Materiales para prevenir la violencia contra las mujeres desde el marco educativo : unidad didáctica para Educación Secundaria.

Las ilistraciones son de Carolina Navarro Cámara.- En anexo se incluye 14 textos sobre violencia y sexismo además de un resumen de las actuaciones y servicios prestados por el Instituto de la Mujer en la Región de Murcia

Hacia una educación no sexista : la discriminación sexual a lo largo de la historia y su incidencia en el contexto educativo.

La publicación presenta una sección de enlaces web recomendados y un glosario de términos para favorecer la comprensión de los contenidos. - Parte de la bibliografía está comentada