Subscribe to RSS
DOI: 10.1055/s-0041-1735128
Sexual Function and Associated Factors in Postmenopausal Women
Função sexual e fatores associados em mulheres na pós-menopausa
Abstract
Objective To assess the sexual function and associated factors in postmenopausal women.
Methods This a descriptive, cross-sectional study with 380 women aged 40 to 65 years, users of public health services in 2019. Questionnaires were applied on demographic characteristics, on climacteric symptoms (menopause rating scale) and on sexual function (sexual quotient, female version). Bivariate and multiple analyses by logistic regression were performed, with adjusted odds ratios (ORad) and 95% confidence intervals (95%CIs).
Results More than half (243/64%) of the participating women were at risk of sexual dysfunction, with lower scores in the domains of sexual desire and interest, comfort, orgasm, and satisfaction. Women with a partner (ORad 2.07; 95%CI 1.03–4.17) and those who reported sleep problems (ORad 2.72; 95%CI 1.77–4.19), depressed mood (ORad 2.03; 95%CI 1.32–3.10), sexual complaints (ORad 8.16; 95%CI 5.06–13.15), and vaginal dryness (ORad 3.44; 95%CI 2.22–5.32) showed greater chance of sexual dysfunction.
Conclusion There was a high prevalence of sexual dysfunction, with the influence of conjugality and climacteric symptoms on sexual function.
Resumo
Objetivo Avaliar a função sexual e fatores associados em mulheres na pós-menopausa.
Métodos Este é um estudo descritivo, transversal, com 380 mulheres de 40 a 65 anos, usuárias de serviços de saúde públicos em 2019. Foram aplicados questionários sobre características demográficas, sobre sintomas climatéricos (menopause rating scale) e sobre a função sexual (Quociente Sexual, versão feminina). Análises bivariada e múltipla por regressão logística foram realizadas, com cálculo de odds ratio ajustado (ORaj) e intervalos de confiança de 95% (ICs95%).
Resultados Mais da metade (243/64%) das mulheres participantes no estudo apresentou risco de disfunção sexual, com escores mais baixos dos domínios desejo e interesse sexual, conforto, orgasmo e satisfação. Mulheres com companheiro (ORaj 2,07; IC95% 1,03–4,17) e aquelas que relataram problemas de sono (ORaj 2,72; IC95% 1,77–4,19), ânimo depressivo (ORaj 2,03; IC95% 1,32–3,10), queixas sexuais (ORaj 8,16; IC95% 5,06–13,15) e ressecamento vaginal (ORaj 3,44; IC95% 2,22–5,32) apresentaram maior chance de disfunção sexual.
Conclusão Houve prevalência elevada de disfunção sexual, com influência da conjugalidade e dos sintomas climatéricos sobre a função sexual.
Keywords
sexuality - sexual dysfunctions - psychological - climateric - women's health - postmenopausePalavras-chave
sexualidade - disfunções sexuais psicogênicas - climatério - saúde da mulher - pós-menopausaContributions
All authors participated in the concept and design of the present study; analysis and interpretation of data; draft or revision of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.
Publication History
Received: 24 August 2020
Accepted: 21 July 2021
Article published online:
30 August 2021
© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 World Health Organization. Sexual health and its linkages to reproductive health: an operational approach [Internet]. Geneva: WHO; 2017. [cited 2020 Nov 14]. Available from: https://apps.who.int/iris/bitstream/handle/10665/258738/9789241512886-eng.pdf?sequence=1&isAllowed=y
- 2 World Health Organization. Measuring sexual health: conceptual and practical considerations and related indicators [Internet]. 2010 [cited 2020 Jun 18]. Available from: whqlibdoc.who.int/hq/2010/who_rhr_10.12_eng.pdf
- 3 Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Saúde sexual e saúde reprodutiva [Internet]. Brasília, DF: Ministério da Saúde; 2013. [cited 2020 Jun 19]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/saude_sexual_saude_reprodutiva.pdf
- 4 Basson R. Human sexual response. Handb Clin Neurol 2015; 130: 11-18 DOI: 10.1016/B978-0-444-63247-0.00002-X.
- 5 Masters WH, Johnson VE. A resposta sexual humana. São Paulo: Roca; 1984
- 6 Calabrò RS, Cacciola A, Bruschetta D. et al. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue?. Brain Behav 2019; 9 (12) e01389 DOI: 10.1002/brb3.1389.
- 7 Basson R. The female sexual response: a different model. J Sex Marital Ther 2000; 26 (01) 51-65 DOI: 10.1080/009262300278641.
- 8 Abdo CH, Oliveira Jr WM, Moreira Jr ED, Fittipaldi JA. Perfil sexual da população brasileira: resultados do Estudo do Comportamento Sexual (ECOS) do Brasileiro. Rev Bras Med 2002; 59 (04) 250-257
- 9 Valadares AL, Pinto-Neto AM, Osis MJ, Sousa MH, Costa-Paiva L, Conde DM. Prevalence of sexual dysfunction and its associated factors in women aged 40-65 years with 11 years or more of formal education: a population-based household survey. Clinics (São Paulo) 2008; 63 (06) 775-782 DOI: 10.1590/S1807-59322008000600012.
- 10 Cabral PU, Canário AC, Spyrides MH. et al. [Influence of menopausal symptoms on sexual function in middle-aged women]. Rev Bras Ginecol Obstet 2012; 34 (07) 329-334 DOI: 10.1590/S0100-72032012000700007. Portuguese
- 11 Valadares AL, Lui-Filho JF, Costa-Paiva L, Pinto-Neto AM. Middle-aged female sexual dysfunction and multimorbidity: a population-based study. Menopause 2016; 23 (03) 304-310 DOI: 10.1097/GME.000000000000053.
- 12 De Jesus Aquino KS, Prado DS, Santos BR, Carvalho Barreto ID. Fatores associados a disfunções sexuais no climatério. Rev Bras Sex Hum. 2019; 29 (02) 36-46 DOI: 10.35919/rbsh.v29i2.57.
- 13 Thornton K, Chervenak J, Neal-Perry G. Menopause and Sexuality. Endocrinol Metab Clin North Am 2015; 44 (03) 649-661 DOI: 10.1016/j.ecl.2015.05.009.
- 14 Santos JL, Leão AP, Gardenghi G. Disfunções sexuais no climatério. Reprod Clim. 2016; 31 (02) 86-92 DOI: 10.1016/j.recli.2016.08.001.
- 15 Thomas HN, Neal-Perry GS, Hess R. Female sexual function at midlife and beyond. Obstet Gynecol Clin North Am 2018; 45 (04) 709-722 DOI: 10.1016/j.ogc.2018.07.013.
- 16 Simon JA, Davis SR, Althof SE. et al. Sexual well-being after menopause: An International Menopause Society White Paper. Climacteric 2018; 21 (05) 415-427 DOI: 10.1080/13697137.2018.1482647.
- 17 Santoro N, Worsley R, Miller KK, Parish SJ, Davis SR. Role of estrogens and estrogen-like compounds in female sexual function and dysfunction. J Sex Med 2016; 13 (03) 305-316 DOI: 10.1016/j.jsxm.2015.11.015.
- 18 Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The physiology of female sexual function and the pathophysiology of female sexual dysfunction (Committee 13A). J Sex Med 2016; 13 (05) 733-759 DOI: 10.1016/j.jsxm.2016.02.172.
- 19 Rindner L, Strömme G, Nordeman L. et al. Prevalence of somatic and urogenital symptoms as well as psychological health in women aged 45 to 55 attending primary health care: a cross-sectional study. BMC Womens Health 2017; 17 (01) 128 DOI: 10.1186/s12905-017-048-1.
- 20 Wong ELY, Huang F, Cheung AWL, Wong CKM. The impact of menopause on the sexual health of Chinese Cantonese women: A mixed methods study. J Adv Nurs 2018; 74 (07) 1672-1684 DOI: 10.1111/jan.13568.
- 21 Heinemann LA, Potthoff P, Schneider HP. International versions of the Menopause Rating Scale (MRS). Health Qual Life Outcomes 2003; 1: 28-34 DOI: 10.1186/1477-7525-1-28.
- 22 Abdo CH. Elaboração e validação do quociente sexual – versão feminina: uma escala para avaliar a função sexual da mulher. Rev Bras Med 2006; 63 (09) 477-482
- 23 Malheiros ES, Chein MB, da Silva DS. et al. [Climacteric syndrome in a Northeastern Brazilian city: a household survey]. Rev Bras Ginecol Obstet 2014; 36 (04) 163-169 DOI: 10.1590/S0100-7203201400040002. Portuguese
- 24 Cavalcanti IF, Farias PD, Ithamar L, Silva VM, Lemos A. [Sexual function and factors associated with sexual dysfunction in climacteric women]. Rev Bras Ginecol Obstet 2014; 36 (11) 497-502 DOI: 10.1590/S0100-720320140004985. Portuguese
- 25 Dąbrowska-Galas M, Dąbrowska J, Michalski B. Sexual dysfunction in menopausal women. Sex Med 2019; 7 (04) 472-479 DOI: 10.1016/j.esxm.2019.06.010.
- 26 Chedraui P, Pérez-López FR, Sánchez H. et al. Assessment of sexual function of mid-aged Ecuadorian women with the 6-item Female Sexual Function Index. Maturitas 2012; 71 (04) 407-412 DOI: 10.1016/j.maturitas.2012.01.013.
- 27 Cabral PU, Canário AC, Spyrides MH, Uchôa SA, Eleutério Jr J, Gonçalves AK. Determinants of sexual dysfunction among middle-aged women. Int J Gynaecol Obstet 2013; 120 (03) 271-274 DOI: 10.1016/j.ijgo.2012.09.023.
- 28 Rosen R, Brown C, Heiman J. et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26 (02) 191-208 DOI: 10.1080/009262300278597.
- 29 Leite AP, Moura EA, Campos AA, Mattar R, Souza E, Camano L. [Validation of the Female Sexual Function Index in Brazilian pregnant women]. Rev Bras Ginecol Obstet 2007; 29 (08) 396-401 DOI: 10.1590/S0100-72032007000800003. Portuguese
- 30 Giraldi A, Rellini A, Pfaus JG. et al. Questionnaires for assessment of female sexual dysfunction: a review and proposal for a standardized screener. J Sex Med 2011; 8 (10) 2681-2706 DOI: 10.1111/j.1743-6109.2011.02395.x.
- 31 Crema IL, De Tilio R, Campos MT. Repercussões da menopausa para a sexualidade de idosas: revisão integrativa da literatura. Psicologia (Cons Fed Psicol) 2017; 37 (03) 753-769 DOI: 10.1590/1982-3703003422016.
- 32 Burri A, Hilpert P, Spector T. Longitudinal evaluation of sexual function in a cohort of pre- and postmenopausal women. J Sex Med 2015; 12 (06) 1427-1435 DOI: 10.1111/jsm.12893.
- 33 Senturk Erenel A, Golbasi Z, Kavlak T, Dilbaz S. Relationship between menopausal symptoms and sexual dysfunction among married Turkish women in 40-65 age group. Int J Nurs Pract 2015; 21 (05) 575-583 DOI: 10.1111/ijn.12309.
- 34 Parish SJ, Meston CM, Althof SE. et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions. J Sex Med 2019; 16 (03) 452-462 DOI: 10.1016/j.jsxm.2019.01.010.
- 35 Monterrosa-Castro A, Márquez-Vega J, Arteta-Acosta C. Disfunción sexual en mujeres climatéricas afrodescendientes del Caribe Colombiano. Iatreia. 2014; 27 (01) 31-41
- 36 Figueroa J R, Jara A D, Fuenzalida P A, Del Prado A M, Flores D, Blumel JE. Prevalencia de disfunción sexual en mujeres climatéricas. Rev Med Chil 2009; 137 (03) 345-350 DOI: 10.4067/S0034-98872009000300004.
- 37 Mark KP, Lasslo JA. Maintaining sexual desire in long-term relationships: a systematic review and conceptual model. J Sex Res 2018; 55 (4-5): 563-581 DOI: 10.1080/00224499.2018.1437592.