Assessment of sexuality among middle-aged women using the Female Sexual Function Index

Abstract

Objective The purpose of the present investigation was to assess sexual function among middle-aged women and determine related risk factors (personal and partner) for sexual dysfunction. MethodsIn this cross-sectional study, women aged 40-59 years were requested to fill out the Female Sexual Function Index (FSFI) and a general demographic questionnaire containing personal and partner data.Results A total of 409 women with a mean age of 47 + 5.3 years were surveyed. Of these, 42.1% were premenopausal, 24.4% perimenopausal and 33.5% postmenopausal. At the time of survey, 10.5% of women were hysterectomized, 1.5% used psychotropic drugs, and 9.8% were on hormone therapy (HT) for the menopause; 28.1% had less than 12 years of schooling and 80.4% had only one partner at the moment of survey. Among their male partners, 7.3% abused alcohol, 10.3% had erectile dysfunction, 11.2% premature ejaculation and 63.83% were faithful partners. Mean (+ standard deviation) scores for the FSFI domains were: desire (3.7 + 1.2), arousal (3.1 + 2.5), lubrication (3.3 + 2.6), orgasm (2.6 + 2.3), satisfaction (4 + 1.7), and pain/dyspareunia (3.2 + 2.6). The mean total FSFI score was 20.1 + 12.4 (median 24.7). In this series, the prevalence of female sexual dysfunction (FSFI score 26.55) was 55.7%, with women presenting difficulties across all domains of female sexual function but mostly in the dyspareunia and lubrication domains. Logistic regression analysis determined that female age (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.6-6.8), p ¼ 0.001), postmenopausal status (OR 2.8, 95% CI 1.3-6.1, p ¼ 0.007), partner's age (OR 2.0, 95% CI 1-4, p ¼ 0.03), educational level (OR 2.7, 95% CI 1.5-5, p ¼ 0.001), and the presence of erectile dysfunction (OR 3.8, 95% CI 1.3-10.9, p ¼ 0.01) and premature ejaculation (OR 4.1, 95% CI 1.4-11.7, p ¼ 0.0001) significantly increased the risk for female sexual dysfunction. Partner faithfulness (OR 0.2, 95% CI 0.1-0.4, p ¼ 0.001) and menopausal HT use (OR 0.4, 95% CI 0.1-1, p ¼ 0.04) decreased this risk.Conclusions In this series, male sexual health and demographic profile and female HT use were relevant determinants for sexual functioning among middle-aged women.

Prevalencia y factores de riesgo de la disfunción sexual femenina: revisión sistemática

“…Tener mayor edad representa un factor de riesgo para presentar una DS, la mayoría de estudios que toman como corte para la edad 40 años, mostraron la existencia de asociación significativa entre tener mayor edad y presentar una DS (1,16,18,19,20), exceptuando el estudio de Hayes y cols (11) en el cual esta variable no es significativa OR 0,4 (0,1-1,9) (Tabla IV). En el estudio de Song y cols (17), se observó que tener entre 20-29 años representa un factor de riesgo de presentar una disfunción sexual (OR 3,49; IC95% 1,48-8,41).…”

“…En el estudio realizado por Choi y cols (1), la presencia de una actitud negativa por parte de la mujer hacia el sexo, no constituye una variable significativa para presentar una DS (OR 1,26; IC95% 0,780-2,062), en caso contrario, Song y cols (17) identificaron que el factor de riesgo más fuerte para el desarrollo de una DS es la actitud negativa de la mujer hacia el sexo (OR 19,06; IC95% 5,67-64,06). La menopausia demostró ser un factor de riesgo en todos los estudios en los cuales se evaluó esta variable (18,19,20), excepto en el de Hayes y cols (11) (OR 0,9; IC95% 0,1-5,6). Se encontró en dos de los estudios de la revisión (13,20), que el uso de terapia de reemplazo hormonal constituye un factor protector para la presencia de DSF, pero Hayes y cols (11) no observó una asociación significativa (OR 3.4; IC95% 0,5-20,7) (Tabla V).…”

“…La menopausia demostró ser un factor de riesgo en todos los estudios en los cuales se evaluó esta variable (18,19,20), excepto en el de Hayes y cols (11) (OR 0,9; IC95% 0,1-5,6). Se encontró en dos de los estudios de la revisión (13,20), que el uso de terapia de reemplazo hormonal constituye un factor protector para la presencia de DSF, pero Hayes y cols (11) no observó una asociación significativa (OR 3.4; IC95% 0,5-20,7) (Tabla V).…”

“…La presencia de disfunción eréctil en la pareja según Grewal y cols (14) se constituye como unas de las variables más significativas de la revisión (OR 27,36; IC95% 4,71-159,08), encontrándose también como significativa para la presencia de DSF en otros artículos en los cuales se evaluó (14,19,20,22).…”

The Female Sexual Function Index (FSFI): Translation, Validation, and Cross-Cultural Adaptation of an Urdu Version “FSFI–U”

“…This questionnaire has been successfully translated and psychometrically validated in other languages, including Chinese, Arabic, Persian, Malay, Turkish, Korean, and Japanese [18, 19, 20, 21, 22, 23]. It has also been used to evaluate sexual problems in adolescence, pregnancy, middle and menopausal ages [5, 6, 24, 25]. It has been used to evaluate sexual problems in various clinical conditions, like women with diabetes mellitus, hypertension, female genital mutilation, obstructive sleep apnea, medical tinnitus, spinal cord injury, pelvic surgery, elective aortic surgery, and women from a medical clinic [7, 26, 27, 28, 29, 30, 31, 32, 33, 34].…”