Banca de DEFESA: ANTONIO CARLOS QUEIROZ DE AQUINO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ANTONIO CARLOS QUEIROZ DE AQUINO
DATE: 17/03/2025
TIME: 14:00
LOCAL: REMOTA - https://meet.google.com/jhp-kxno-fcu
TITLE:

MANAGEMENT OF SEXUAL DYSFUNCTIONS IN EMOTIONALLY VULNERABLE WOMEN: PREGNANCY, POSTPARTUM, AND DEPRESSION

KEY WORDS:

Women, Pregnancy, Postpartum Period, Antidepressive Agents, Sexual Dysfunction, Therapeutics, Systematic Review, Meta-Analysis

PAGES: 85
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Introduction: Female sexual dysfunction is a multifactorial condition influenced by physiological, psychological, hormonal, and social aspects, significantly impacting quality of life. Specific situations, such as pregnancy, the postpartum period, and antidepressant-induced sexual dysfunction (AISD), present distinct challenges that require different therapeutic approaches. Objectives: To synthesize the available evidence on non-pharmacological and pharmacological interventions for the treatment of female sexual dysfunction in different contexts. Methods: Three systematic reviews and meta-analyses were conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, including only randomized controlled trials (RCTs). Searches were performed in the PubMed, Scopus, Web of Science, Embase, PsycINFO, PEDro, Cochrane Central, and ClinicalTrials.gov databases. The risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool, and the certainty of the evidence was classified according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: For sexual dysfunction during pregnancy, 24 studies (1,557 participants) were included, of which nine were selected for meta-analysis. Cognitive Behavioral Therapy (CBT) increased Female Sexual Function Index (FSFI) scores by 6.82 points (95% CI: 1.63–12.01, p=0.010, I²=73%). The PLISSIT model (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) increased FSFI scores by 6.07 points (95% CI: 3.80–8.35, p=0.00001, I²=80%), while sexual education interventions resulted in an increase of 5.82 points (95% CI: 4.19–7.46, p=0.00001, I²=81%). For postpartum sexual dysfunction, 22 studies (5,390 articles analyzed) were included, with eight (634 participants) incorporated into the meta-analysis. The interventions evaluated included the PLISSIT model (MD: 1.56; 95% CI: 1.27–1.84; I²=0%), pelvic floor exercises (MD: 4.27; 95% CI: 1.23–7.32; I²=99%), and Kegel exercises (MD: 41.54; 95% CI: 33.27–49.80; I²=99%). However, the quality of the evidence was classified as very low due to study heterogeneity. For AISD, 11 RCTs (859 participants) evaluating pharmacological treatments were reviewed. Bupropion SR 150 mg/b.i.d. showed significant improvements in sexual desire (MD: 1.74; 95% CI: 1.03–2.44, p=0.00001), arousal (MD: 1.30; 95% CI: 1.16–1.43, p=0.00001), and orgasm (MD: 1.90; 95% CI: 1.78–2.02, p=0.00001), with no significant impact on depressive symptoms (MD: 0.46; 95% CI: -0.71–1.63, p=0.44). The quality of the evidence was considered low. Conclusions: Non-pharmacological interventions such as CBT, the PLISSIT model, and sexual education are effective for treating female sexual dysfunction during pregnancy and the postpartum period. In AISD, bupropion SR 150 mg/b.i.d. has shown therapeutic potential. Further high-quality RCTs are needed to confirm these findings.

COMMITTEE MEMBERS:
Presidente - 1199080 - ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA
Interno - 346138 - ALDO DA CUNHA MEDEIROS
Externa ao Programa - 3313589 - JANAINA CRISTIANA DE OLIVEIRA CRISPIM FREITAS - UFRNExterno à Instituição - EZEQUIEL BATISTA DO NASCIMENTO - UFSB
Externo à Instituição - KLEYTON SANTOS DE MEDEIROS - LNRCC