Disfunciones sexuales femeninas y masculinas: comparación de género en una muestra de la Ciudad de México
- Autores: Susana Martínez Ramírez, Claudia Sánchez Bravo, Jorge Carreño Meléndez, Maria Eugenia Gómez López
- Localización: Salud mental, ISSN 0185-3325, Vol. 28, Nº. 4, 2005, págs. 74-80
- Idioma: español
- Enlaces
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Resumen
- español
Las disfunciones sexuales constituyen un problema frecuente y que es necesario estudiar por su importancia para la salud de los individuos. Por esto, abordar la sexualidad, conocer su prevalencia en mujeres y en hombres en una muestra de población de la Ciudad de México, y establecer la frecuencia con que se presenta cada una de ellas brindará la posibilidad de proponer estrategias de atención más precisas y focalizadas, además de generar líneas de investigación para estudiar los factores asociados a ellas.
Masters y Jonson estudiaron el comportamiento del ciclo de la respuesta sexual humana, y lo dividieron en cinco fases: deseo, excitación, meseta, orgasmo y resolución. La definición de estas fases los llevó a describir y delimitar las disfunciones sexuales inherentes, aunque no siempre presentes, de la sexualidad humana. A su vez, Rubio las define como ¿una serie de síndromes en los que los procesos eróticos de la respuesta sexual resultan no deseables para el individuo o para el grupo social y que se presentan en forma persistente y recurrente¿.
En el Departamento de Psicología del Instituto Nacional de Perinatología (INPer) de la Ciudad de México, se planteó la necesidad de conocer el comportamiento de los problemas sexuales con el fin de tener un panorama completo y no hipotético de lo que sucede en una población mexicana, con determinadas características, con respecto a su prevalencia, sus tipos y su comparación de género.
Objetivo: Establecer la prevalencia, el porcentaje y la frecuencia de los tipos de disfunción sexual masculina y femenina, así como sus diferencias, en una población de la Ciudad de México. A la vez se analizan algunas variables relacionadas con la vida sexual de la muestra: información sexual recibida, experiencias sexuales traumáticas y trauma infantil.
Material y método: Se utilizaron la Historia clínica de la sexualidad femenina y el Cuestionario de Sexualidad, versión hombres. Estudio de población, exploratorio, descriptivo, transversal, de dos muestras del INPer -una de 384 mujeres y otra de 363 varones (no parejas de las pacientes que se incluyeron en la muestra)- clasificadas cada una en grupo 1 sin disfunción y grupo 2 con disfunción sexual. Los sujetos se seleccionaron y se integraron a los grupos después de ser aceptados en la institución como pacientes y antes de cualquier intervención médica. El tamaño de la muestra fue representativo del número de pacientes que ingresó a la institución ese año. Tanto las mujeres como los hombres debieron cubrir todos los criterios de inclusión.
Los pacientes se incluyeron en el grupo 1 (grupo control) sin disfunciones sexuales, según el resultado de las historias clínicas de mujeres y hombres, cuyo objetivo es determinar la presencia o ausencia de disfunciones sexuales y el tipo de disfunción que se padece. Las diez categorías son las disfunciones sexuales descritas en el DSM-IV-TR.
Resultados: La prevalencia de disfunciones sexuales en mujeres fue de 52% y en hombres, de 38.8%. En promedio, en el grupo de mujeres con disfunción sexual se presentaron 2.52 disfunciones por paciente y en grupo de hombres con disfunción sexual, 1.48 por hombre. Las más frecuentes fueron la disritmia en ambos grupos, el deseo sexual hipoactivo en el grupo femenino y la eyaculación precoz en el grupo masculino. En las variables relacionadas con la vida sexual, el trauma infantil en mujeres se asoció con la presencia de disfunciones sexuales, la práctica masturbatoria en hombres al grupo sin disfunciones sexuales y la falta de información sexual se asoció en ambas poblaciones con el grupo con disfunciones sexuales.
- English
Sexual dysfunctions are a high frequency problem that should be studied because of its significance for individual health. For that reason, approaches to sexuality, sexual dysfunctions prevalence among women and men of a population sample in Mexico City, and the particular frequency of each dysfunction, will convey the possibility of suggesting more precise and focused treatment strategies, as well as the generation of ground lines for the investigation of the specific factors that could be related to them.
Based on researches conducted by many pioneers who have approached the study of human sexuality, Masters and Johnson built up, for the first time during the 1960s, the human sexual response and its dysfunctions. Also, they hold the hypothesis that the way to understand human sexuality must relay on the study of the human sexual response cycle. This consists of five phases: sexual urge phase, excitement phase, plateau phase, orgasmic phase and resolution phase. Masters and Johnson needed to define those phases, so they described and delimited inherent sexual dysfunctions, which may not always be present -but could be- in human sexuality. In order to give a precise and correct diagnosis, researchers have to define and classify sexual dysfunctions. In this sense, Rubio defines them as “a group of syndromes in which the erotical processes of sexual response are undesirable for the individual or for the social group, and occurs persistently and recurrently”. Researchers of the Department of Psychology at the National Institute of Perinatology (Instituto Nacional de Perinatología, INPer) in Mexico City, which is a third level institution (specialties hospital) dedicated to people with reproduction problems, realized that investigation about sexual problems will lead to a broad and objective panorama (not hypothetical) of factors like prevalence, types, and gender comparisons of sexual problems among Mexican population.
Main objective.
This research seeks to state the prevalence, percentage, frequency, and types of both male and female sexual dysfunctions, as well as the differences between them, in a sample of Mexican population living in Mexico City. The research also intends to analyze some variables related to the sexual life of the population under study: sexual information they have previously received, traumatic sexual experiences and childhood trauma.
Method (material and procedures):
Researchers used the Clinical Record of Feminine Sexuality (Historia Clínica de la Sexualidad Femenina) and the Questionnaire of Sexuality, Male Version (Cuestionario de Sexualidad, Versión Hombres), both validated for Mexican population. The type of study that researchers conducted was populational, screening, descriptive, longitudinal, and retrospective. The study was performed using a non-experimental design with two samples drawn from INPer (patients and others); one of the samples consisted of 384 female participants and the other consisted of 363 male individuals (non partners of the patients included in the sample). Each participant was included into one of two groups: Group 1 comprised individuals without dysfunction and Group 2 included participants with sexual dysfunction. This classification was made when individuals were accepted at the INPer as patients, and before they were included in any medical treatment or intervention. Sample size was representative of the number of individuals accepted as patients of INPer that year. Inclusion criteria for men and women consisted of a level of education at least of elementary school -so they could understand the questionnaires- having a sexual partner for a year or more, without previous diagnostic of mental retardation or psychosis, nor medical conditions like neurological or endocrine syndromes, cardiopathies, vascular problems or genital infections, that could influence or determine sexual dysfunctions.
Patients were included in Group 1 (control group) without sexual dysfunctions, or in Group 2 (experimental group) with sexual dysfunctions, based upon the results of the Clinical records in women as well as in men, which is intended to determine presence or absence of sexual dysfunctions and the kind of dysfunction that each individual has. The questionnaire, besides classifying sexual dysfunction, explores sexual life. The 10 types of sexual dysfunctions are: 1. sexual urge disorder (hypoactive sexual desire), 2. aversion to sex disorder, 3. female arousal disorder, 4, male erectile dysfunction, 5. female orgasm disorder, 6. male orgasm disorder, premature ejaculation, pain associated with intercourse disorder (dyspareunia), 9. vaginism (defined and classified following the Diagnostic and Statistical Manual of Mental Disorders-Text Revised (DSM-IV-TR), and 10. dysrythmia (as stated by Alvarez-Gayou, persistent and recurrent inability to obtain satisfaction in one of the partners due to the difference in sexual urge for sexual activity frequency, when conditions are adequate and the problem is not related to physical problems).
Results:
Prevalence in women was 52%; in men it was 38.8%. Mean in women with sexual dysfunctions was 2.52 dysfunctions by patient; mean in men with sexual dysfunctions was 1.48 by patient. Dysrythmia was the most frequent dysfunction both, in males and females. Concerning variables related to sexual activity, childhood trauma for women, masturbation for men and information about sexuality for both men and women, were the main ones.
Conclusion:
Prevalence of sexual dysfunctions and frequency by patient in individuals attending the INPer is lower in men’s population. Having an effective and sound information about sexuality is essential for sexuality development. Another important topic are traumatic sexual experiences that are more frequent in female population and are also associated with sexual dysfunctions; men are less jeopardized for that kind of experiences. Masturbation practice is related to the absence of sexual dysfunctions in men. On the other hand, that practice is not significant for women. Results of this research led us to change attention strategies; this will have a repercussion in the effective treatments and decreased periods of time to solve the problem.
Regarding the possibility to generalize the results, research could be directed to determine prevalence in populations with no reproduction risk and then compare them with the population of the study; hypothetically, results would not have a significant variability given the control of variables.
- español
