The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at ... more The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at 9 weeks of gestation by transvaginal two-dimensional color Doppler ultrasonography imaging and its confirmation by hysteroscopic embryoscopy at 12 weeks to further characterize the findings. The embryo showed increased nuchal translucency and fused lower limbs with a large intra-abdominal vessel and two-vessel umbilical cords. The pregnancy was terminated by medical abortion induction after the patient viewed the embryoscopic images. Diagnosis is commonly made later in the second trimester of pregnancy, oligohydramnios being a warning signal, which usually makes the diagnosis difficult. Survival, only possible in the absence of renal agenesis, is extremely rare. In view of the extremely poor prognosis, early diagnosis allows for earlier counseling and less traumatic therapeutic termination of pregnancy.
Chronic endometritis (CE) is a poorly investigated and probably underestimated pathology, which m... more Chronic endometritis (CE) is a poorly investigated and probably underestimated pathology, which may cause abnormal uterine bleeding (AUB), pain, and reproductive failures. Due to undefined symptoms and the normal presence of leukocytes in the endometrial mucosa, diagnosis may be missed. Fluid hysteroscopy is a reliable technique for diagnosing this pathology. Few data exist on the biochemical and paracrine alterations that occur in the endometrium of women diagnosed with CE. The aim of the study was to find molecular modification in endometrium related to CE. Sixteen women with hysteroscopic and histological diagnosis of CE and 10 healthy women as controls were enrolled. We compared the endometrial expression profile of 25 genes encoding proteins involved in the inflammatory response, proliferation, and apoptosis in endometrium during implantation window, using high-throughput real-time RT-PCR. In women with CE, the endometrial expression of some genes was significantly altered. In particular, IGFBP1, BCL2, and BAX were up-regulated, while IL11, CCL4, IGF1, and CASP8 were down-regulated. The altered gene endometrial expression may explain the impaired endometrial receptivity and the finding of endometrial hyperplastic lesions in women affected by CE.
The aim of the study was to determine the changes, if any, on the sexual behavior of women using ... more The aim of the study was to determine the changes, if any, on the sexual behavior of women using an oral contraceptive containing 30 microg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Eighty healthy volunteer women (age range, 19-31 years), with regular menstrual cycle length (mean 27.6+/-3.1) and ovulation, participated in this prospective study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline and at 3, 6 and 9 cycles of pill use. Women reported increased (i) sexual enjoyment (p < .001), (ii) orgasm frequency (p < .05) and (iii) satisfaction with sexual activity (p < .05) during all periods of pill intake with respect to baseline. Both arousal and frequency of sexual activity improved at the sixth and ninth cycle of pill use (p < .05) with respect to baseline. Moreover, women reported decreased genital pain associated with intercourse during pill intake (p < .05). Desire did not change during the use of the pill (p = NS). The mild dose of EE may have improved vaginal lubrication, sexual arousal and decreased dyspareunia. Consequently, women may have experienced increased sexual performance. In addition, improved sexual activity could have been the result of the effects of DRSP, with its antimineralocorticoid effects which could improve pill compliance, with a more satisfied sexual life.
European Journal of Obstetrics and Gynecology and Reproductive Biology, Oct 1, 2003
To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), a... more To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome). Study design: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women. We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients. A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning . Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale. The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups. Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test. Results: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. Sildenafil improved arousal (P < 0:001), orgasm (P < 0:05), and enjoyment (P < 0:001) with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P < 0:01), orgasm (P < 0:001), and sexual enjoyment (P < 0:001). The adverse events were transient and mild or moderate. Conclusions: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience. This study could help to understand the physiologic and pathophysiologic aspects of female sexuality. In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug. Additional studies are required to define the use of sildenafil in a clinical setting. #
The Annals of otology, rhinology, and laryngology, 2004
A prospective study was performed to investigate the changes in nasal cytology that occur in heal... more A prospective study was performed to investigate the changes in nasal cytology that occur in healthy premenopausal women throughout the menstrual cycle. Eighty-eight women with an ovulatory menstrual cycle underwent nasal sampling with a cytobrush by direct vision of the middle and inferior nasal turbinates during the follicular, periovular, and luteal phases of the menstrual cycle, and the specimens were evaluated with the maturation index. Hematoxylin-eosin staining showed the cytologic aspects of the nasal respiratory epithelium and of vaginal smears according to the three different phases of the menstrual cycle. Along with the vaginal cells, the nasal respiratory epithelium is an ovarian steroid target.
Objectives. To evaluate the efficacy of the "daily" use of apomorphine SL compared with the "on d... more Objectives. To evaluate the efficacy of the "daily" use of apomorphine SL compared with the "on demand" administration of the drug in patients with mild to moderate erectile dysfunction (ED) and mild hyperprolactinemia who were nonresponders to apomorphine administered "on demand."
Objectives. To verify whether apomorphine SL is effective in premenopausal women affected by arou... more Objectives. To verify whether apomorphine SL is effective in premenopausal women affected by arousal disorder with hypoactive sexual desire disorder. Methods. Sixty-two volunteer women, aged 26 to 45 years, affected by arousal disorders and hypoactive sexual desire disorder participated in the study, which consisted of two parts. The first was 4 weeks of a taken-as-needed, open-label, dose-escalation regimen starting at 2 or 3 mg of apomorphine SL. The second part of the study was for the nonresponders, who were randomly allocated to treatment in one of six possible sequences of three 2-week double-blind, crossover study periods with apomorphine 2 mg or 3 mg, washout, and placebo. Efficacy was assessed with the Personal Experiences Questionnaire using the 5-point Likert scale. The Personal Experiences Questionnaire quantified subjective arousal, desire, orgasm, enjoyment, and frequency of sexual relationships. Results. Fifty women completed the 4-week "as required" drug regimen, and 6 of them benefited from this treatment regimen (P Ͻ0.05). The 44 women who reported no change with respect to baseline participated in the double-blind crossover part of the study. Six women stopped taking the drug because of a fear of problems (two each during the 2-mg apomorphine, 3-mg apomorphine, and placebo periods). Adverse events were mild or moderate, both occurred during the "as required" part (10 patients) and during daily usage (6 patients) and were mainly nausea, vomiting, dizziness, or headache. However, during the placebo period, 2 women had adverse events, mainly headache. The daily intake of the drug was effective with both the 2-mg and 3-mg dosages compared with placebo for arousal and desire (P Ͻ0.05). The effects of 3 mg of apomorphine were better than those obtained with 2 mg (P Ͻ0.05). The orgasm, enjoyment, and satisfied by frequency scores improved during treatment with daily apomorphine compared with baseline and placebo. Conclusions. The results of our study suggest that daily apomorphine SL may improve the sexual life of women affected by sexual difficulties. Additional studies are needed to define the daily use of apomorphine SL in large subgroups of women on the basis of etiology and the severity of sexual dysfunction. UROLOGY 63: 955-959, 2004.
BACKGROUND: The aim of this prospective study was to evaluate the effects of hormone therapy (HT)... more BACKGROUND: The aim of this prospective study was to evaluate the effects of hormone therapy (HT) on olfactory sensitivity in post-menopausal women. METHODS: Forty-six naturally post-menopausal women underwent rhinomanometric and olfactometric measurements to compare nasal airflow resistance values and olfactometric thresholds during the eighth month of HT treatment with baseline levels prior to starting HT. Eighteen women used an oral HT regimen, and twenty-eight women used transdermal patch HT. RESULTS: Rhinomanometric values during HT were statistically different from those at baseline (P < 0.001). Olfactometric threshold data indicated a higher sensitivity during the HT treatment than at baseline (P < 0.001). Finally, no statistically significant difference was observed among women using oral or patch HT administration on rhinomanometric and olfactometric values. CONCLUSIONS: Our study demonstrates that 8 months of treatment with estrogen and progestogens in HT preparations has an effect on nasal airflow resistance and the olfactory thresholds to odours. We believe that estrogens could influence neuronal plasticity, and the neuronal conduction time into the olfactory system. Our findings confirm that gonadal steroids such as estrogen have an influence on non-genital targets; this relationship might have a beneficial impact on sensorineural communication and emotional behaviour.
BACKGROUND: The aim of this prospective study was to evaluate the effects of the new monophasic o... more BACKGROUND: The aim of this prospective study was to evaluate the effects of the new monophasic oral contraceptives on the audiological system in premenopausal women. METHODS: The auditory brainstem response (ABR) was measured in 94 women during the follicular, periovular and luteal phases of one menstrual cycle in which ovulation was con®rmed using sonography and serum progesterone concentration. The latencies for waves I, III and V were determined, and the inter-peak intervals were calculated for waves I±III, I±V and III±V. All 94 women began taking oral contraceptives: 23 women used 20 mg ethinyl estradiol (EE) plus 150 mg desogestrel, 24 women used 30 mg EE plus 75 mg gestodene, and 47 women used 15 mg EE plus 60 mg gestodene. During the third month of contraceptive intake, each subject was again tested for ABR, as above. RESULTS: The wave latencies and inter-peak intervals showed shorter values during the periovular phase with respect to the luteal phase (P < 0.05), the follicular phase for wave I and for inter-peak interval I±V (P < 0.05) of the menstrual cycle. All of the ABR results in pill users were statistically different from those of the periovular phase (P < 0.05), though similar to those of both the luteal and follicular phases (P = NS). CONCLUSIONS: ABR seems to depend on the variations of ovarian steroids during the menstrual cycle and during oral contraceptive intake.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003
To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), a... more To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome). Study design: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women. We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients. A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning . Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale. The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups. Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test. Results: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. Sildenafil improved arousal (P < 0:001), orgasm (P < 0:05), and enjoyment (P < 0:001) with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P < 0:01), orgasm (P < 0:001), and sexual enjoyment (P < 0:001). The adverse events were transient and mild or moderate. Conclusions: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience. This study could help to understand the physiologic and pathophysiologic aspects of female sexuality. In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug. Additional studies are required to define the use of sildenafil in a clinical setting. #
The aim of the study was to determine the changes, if any, on the sexual behavior of women using ... more The aim of the study was to determine the changes, if any, on the sexual behavior of women using an oral contraceptive containing 30 microg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Eighty healthy volunteer women (age range, 19-31 years), with regular menstrual cycle length (mean 27.6+/-3.1) and ovulation, participated in this prospective study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline and at 3, 6 and 9 cycles of pill use. Women reported increased (i) sexual enjoyment (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), (ii) orgasm frequency (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) and (iii) satisfaction with sexual activity (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) during all periods of pill intake with respect to baseline. Both arousal and frequency of sexual activity improved at the sixth and ninth cycle of pill use (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) with respect to baseline. Moreover, women reported decreased genital pain associated with intercourse during pill intake (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Desire did not change during the use of the pill (p = NS). The mild dose of EE may have improved vaginal lubrication, sexual arousal and decreased dyspareunia. Consequently, women may have experienced increased sexual performance. In addition, improved sexual activity could have been the result of the effects of DRSP, with its antimineralocorticoid effects which could improve pill compliance, with a more satisfied sexual life.
The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at ... more The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at 9 weeks of gestation by transvaginal two-dimensional color Doppler ultrasonography imaging and its confirmation by hysteroscopic embryoscopy at 12 weeks to further characterize the findings. The embryo showed increased nuchal translucency and fused lower limbs with a large intra-abdominal vessel and two-vessel umbilical cords. The pregnancy was terminated by medical abortion induction after the patient viewed the embryoscopic images. Diagnosis is commonly made later in the second trimester of pregnancy, oligohydramnios being a warning signal, which usually makes the diagnosis difficult. Survival, only possible in the absence of renal agenesis, is extremely rare. In view of the extremely poor prognosis, early diagnosis allows for earlier counseling and less traumatic therapeutic termination of pregnancy.
Chronic endometritis (CE) is a poorly investigated and probably underestimated pathology, which m... more Chronic endometritis (CE) is a poorly investigated and probably underestimated pathology, which may cause abnormal uterine bleeding (AUB), pain, and reproductive failures. Due to undefined symptoms and the normal presence of leukocytes in the endometrial mucosa, diagnosis may be missed. Fluid hysteroscopy is a reliable technique for diagnosing this pathology. Few data exist on the biochemical and paracrine alterations that occur in the endometrium of women diagnosed with CE. The aim of the study was to find molecular modification in endometrium related to CE. Sixteen women with hysteroscopic and histological diagnosis of CE and 10 healthy women as controls were enrolled. We compared the endometrial expression profile of 25 genes encoding proteins involved in the inflammatory response, proliferation, and apoptosis in endometrium during implantation window, using high-throughput real-time RT-PCR. In women with CE, the endometrial expression of some genes was significantly altered. In particular, IGFBP1, BCL2, and BAX were up-regulated, while IL11, CCL4, IGF1, and CASP8 were down-regulated. The altered gene endometrial expression may explain the impaired endometrial receptivity and the finding of endometrial hyperplastic lesions in women affected by CE.
The aim of the study was to determine the changes, if any, on the sexual behavior of women using ... more The aim of the study was to determine the changes, if any, on the sexual behavior of women using an oral contraceptive containing 30 microg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Eighty healthy volunteer women (age range, 19-31 years), with regular menstrual cycle length (mean 27.6+/-3.1) and ovulation, participated in this prospective study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline and at 3, 6 and 9 cycles of pill use. Women reported increased (i) sexual enjoyment (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), (ii) orgasm frequency (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) and (iii) satisfaction with sexual activity (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) during all periods of pill intake with respect to baseline. Both arousal and frequency of sexual activity improved at the sixth and ninth cycle of pill use (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) with respect to baseline. Moreover, women reported decreased genital pain associated with intercourse during pill intake (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Desire did not change during the use of the pill (p = NS). The mild dose of EE may have improved vaginal lubrication, sexual arousal and decreased dyspareunia. Consequently, women may have experienced increased sexual performance. In addition, improved sexual activity could have been the result of the effects of DRSP, with its antimineralocorticoid effects which could improve pill compliance, with a more satisfied sexual life.
European Journal of Obstetrics and Gynecology and Reproductive Biology, Oct 1, 2003
To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), a... more To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome). Study design: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women. We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients. A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning . Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale. The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups. Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test. Results: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. Sildenafil improved arousal (P < 0:001), orgasm (P < 0:05), and enjoyment (P < 0:001) with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P < 0:01), orgasm (P < 0:001), and sexual enjoyment (P < 0:001). The adverse events were transient and mild or moderate. Conclusions: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience. This study could help to understand the physiologic and pathophysiologic aspects of female sexuality. In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug. Additional studies are required to define the use of sildenafil in a clinical setting. #
The Annals of otology, rhinology, and laryngology, 2004
A prospective study was performed to investigate the changes in nasal cytology that occur in heal... more A prospective study was performed to investigate the changes in nasal cytology that occur in healthy premenopausal women throughout the menstrual cycle. Eighty-eight women with an ovulatory menstrual cycle underwent nasal sampling with a cytobrush by direct vision of the middle and inferior nasal turbinates during the follicular, periovular, and luteal phases of the menstrual cycle, and the specimens were evaluated with the maturation index. Hematoxylin-eosin staining showed the cytologic aspects of the nasal respiratory epithelium and of vaginal smears according to the three different phases of the menstrual cycle. Along with the vaginal cells, the nasal respiratory epithelium is an ovarian steroid target.
Objectives. To evaluate the efficacy of the "daily" use of apomorphine SL compared with the "on d... more Objectives. To evaluate the efficacy of the "daily" use of apomorphine SL compared with the "on demand" administration of the drug in patients with mild to moderate erectile dysfunction (ED) and mild hyperprolactinemia who were nonresponders to apomorphine administered "on demand."
Objectives. To verify whether apomorphine SL is effective in premenopausal women affected by arou... more Objectives. To verify whether apomorphine SL is effective in premenopausal women affected by arousal disorder with hypoactive sexual desire disorder. Methods. Sixty-two volunteer women, aged 26 to 45 years, affected by arousal disorders and hypoactive sexual desire disorder participated in the study, which consisted of two parts. The first was 4 weeks of a taken-as-needed, open-label, dose-escalation regimen starting at 2 or 3 mg of apomorphine SL. The second part of the study was for the nonresponders, who were randomly allocated to treatment in one of six possible sequences of three 2-week double-blind, crossover study periods with apomorphine 2 mg or 3 mg, washout, and placebo. Efficacy was assessed with the Personal Experiences Questionnaire using the 5-point Likert scale. The Personal Experiences Questionnaire quantified subjective arousal, desire, orgasm, enjoyment, and frequency of sexual relationships. Results. Fifty women completed the 4-week "as required" drug regimen, and 6 of them benefited from this treatment regimen (P Ͻ0.05). The 44 women who reported no change with respect to baseline participated in the double-blind crossover part of the study. Six women stopped taking the drug because of a fear of problems (two each during the 2-mg apomorphine, 3-mg apomorphine, and placebo periods). Adverse events were mild or moderate, both occurred during the "as required" part (10 patients) and during daily usage (6 patients) and were mainly nausea, vomiting, dizziness, or headache. However, during the placebo period, 2 women had adverse events, mainly headache. The daily intake of the drug was effective with both the 2-mg and 3-mg dosages compared with placebo for arousal and desire (P Ͻ0.05). The effects of 3 mg of apomorphine were better than those obtained with 2 mg (P Ͻ0.05). The orgasm, enjoyment, and satisfied by frequency scores improved during treatment with daily apomorphine compared with baseline and placebo. Conclusions. The results of our study suggest that daily apomorphine SL may improve the sexual life of women affected by sexual difficulties. Additional studies are needed to define the daily use of apomorphine SL in large subgroups of women on the basis of etiology and the severity of sexual dysfunction. UROLOGY 63: 955-959, 2004.
BACKGROUND: The aim of this prospective study was to evaluate the effects of hormone therapy (HT)... more BACKGROUND: The aim of this prospective study was to evaluate the effects of hormone therapy (HT) on olfactory sensitivity in post-menopausal women. METHODS: Forty-six naturally post-menopausal women underwent rhinomanometric and olfactometric measurements to compare nasal airflow resistance values and olfactometric thresholds during the eighth month of HT treatment with baseline levels prior to starting HT. Eighteen women used an oral HT regimen, and twenty-eight women used transdermal patch HT. RESULTS: Rhinomanometric values during HT were statistically different from those at baseline (P < 0.001). Olfactometric threshold data indicated a higher sensitivity during the HT treatment than at baseline (P < 0.001). Finally, no statistically significant difference was observed among women using oral or patch HT administration on rhinomanometric and olfactometric values. CONCLUSIONS: Our study demonstrates that 8 months of treatment with estrogen and progestogens in HT preparations has an effect on nasal airflow resistance and the olfactory thresholds to odours. We believe that estrogens could influence neuronal plasticity, and the neuronal conduction time into the olfactory system. Our findings confirm that gonadal steroids such as estrogen have an influence on non-genital targets; this relationship might have a beneficial impact on sensorineural communication and emotional behaviour.
BACKGROUND: The aim of this prospective study was to evaluate the effects of the new monophasic o... more BACKGROUND: The aim of this prospective study was to evaluate the effects of the new monophasic oral contraceptives on the audiological system in premenopausal women. METHODS: The auditory brainstem response (ABR) was measured in 94 women during the follicular, periovular and luteal phases of one menstrual cycle in which ovulation was con®rmed using sonography and serum progesterone concentration. The latencies for waves I, III and V were determined, and the inter-peak intervals were calculated for waves I±III, I±V and III±V. All 94 women began taking oral contraceptives: 23 women used 20 mg ethinyl estradiol (EE) plus 150 mg desogestrel, 24 women used 30 mg EE plus 75 mg gestodene, and 47 women used 15 mg EE plus 60 mg gestodene. During the third month of contraceptive intake, each subject was again tested for ABR, as above. RESULTS: The wave latencies and inter-peak intervals showed shorter values during the periovular phase with respect to the luteal phase (P < 0.05), the follicular phase for wave I and for inter-peak interval I±V (P < 0.05) of the menstrual cycle. All of the ABR results in pill users were statistically different from those of the periovular phase (P < 0.05), though similar to those of both the luteal and follicular phases (P = NS). CONCLUSIONS: ABR seems to depend on the variations of ovarian steroids during the menstrual cycle and during oral contraceptive intake.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003
To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), a... more To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome). Study design: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women. We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients. A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning . Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale. The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups. Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test. Results: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. Sildenafil improved arousal (P < 0:001), orgasm (P < 0:05), and enjoyment (P < 0:001) with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P < 0:01), orgasm (P < 0:001), and sexual enjoyment (P < 0:001). The adverse events were transient and mild or moderate. Conclusions: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience. This study could help to understand the physiologic and pathophysiologic aspects of female sexuality. In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug. Additional studies are required to define the use of sildenafil in a clinical setting. #
The aim of the study was to determine the changes, if any, on the sexual behavior of women using ... more The aim of the study was to determine the changes, if any, on the sexual behavior of women using an oral contraceptive containing 30 microg ethinylestradiol (EE) and 3 mg drospirenone (DRSP). Eighty healthy volunteer women (age range, 19-31 years), with regular menstrual cycle length (mean 27.6+/-3.1) and ovulation, participated in this prospective study. Sexual behavior was assessed using the self-administered Personal Experience Questionnaire, at baseline and at 3, 6 and 9 cycles of pill use. Women reported increased (i) sexual enjoyment (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), (ii) orgasm frequency (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) and (iii) satisfaction with sexual activity (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) during all periods of pill intake with respect to baseline. Both arousal and frequency of sexual activity improved at the sixth and ninth cycle of pill use (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05) with respect to baseline. Moreover, women reported decreased genital pain associated with intercourse during pill intake (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .05). Desire did not change during the use of the pill (p = NS). The mild dose of EE may have improved vaginal lubrication, sexual arousal and decreased dyspareunia. Consequently, women may have experienced increased sexual performance. In addition, improved sexual activity could have been the result of the effects of DRSP, with its antimineralocorticoid effects which could improve pill compliance, with a more satisfied sexual life.
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