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King EM, Carter A, Loutfy M, Webster K, Muchenje M, Murray MCM, de Pokomandy A, Ding E, Li J, Kaida A. Sexual Satisfaction of Midlife Women Living With HIV in Canada: A Prospective Cohort Analysis. J Acquir Immune Defic Syndr 2023; 93:272-281. [PMID: 37019076 DOI: 10.1097/qai.0000000000003204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated the prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and sociostructural experiences. SETTING We studied women in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) over 3 survey waves (2013-2018). METHODS We included women living with HIV aged ≥45 years who reported ever having consensual sex. Sexual satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women and was dichotomized into satisfactory ("completely/very/reasonably satisfactory") and not satisfactory ("not very/not at all satisfactory"). Probable depression was based on CES-D ≥10. Multivariable logistic regression and fixed effects models determined correlates of sexual satisfaction. Reasons for sexual inactivity and alternate forms of sexual expression were also explored. RESULTS Among 508 midlife women, 61% were satisfied with their sexual lives at baseline. Women with probable depression had lower odds of sexual satisfaction than those without (aOR: 0.44; 95% CI: 0.27 to 0.71) and worsening depressive symptoms over time were associated with poorer sexual satisfaction ( P = 0.001). Increased sexual activity was associated with higher sexual satisfaction (aOR: 2.75; 95% CI: 1.54 to 4.91); however, 51% of women reporting sexual satisfaction were sexually inactive. Sexually inactive women engaged in alternate forms of sexual expression such as self-pleasure (37%) and intimate relationships without sex (13%). CONCLUSION Midlife women with HIV have high rates of sexual satisfaction, even in the absence of sexual activity. Depressive symptoms were closely associated with sexual dissatisfaction, alerting providers to the importance of screening for depression and sexual health together.
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Affiliation(s)
- Elizabeth M King
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
| | - Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Webster
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law, UNSW Sydney, Sydney, Australia
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
- McGill University Health Center, Montreal, Quebec, Canada; and
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Marvelous Muchenje
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law, UNSW Sydney, Sydney, Australia
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
- McGill University Health Center, Montreal, Quebec, Canada; and
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | | | - Erin Ding
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jenny Li
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
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Shreffler KM, Gibbs L, Tiemeyer S, McQuillan J, Greil AL. Is Reproductive Orientation Associated with Sexual Satisfaction Among Partnered U.S. Women? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2459-2469. [PMID: 34346003 PMCID: PMC8515561 DOI: 10.1007/s10508-021-01984-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 06/13/2023]
Abstract
Little is known about how "reproductive orientation" (i.e., trying to get pregnant, ambivalent about pregnancy, trying to avoid pregnancy, or having had a sterilization surgery) is associated with sexual satisfaction among women of childbearing age. Using data from the National Survey of Fertility Barriers (N = 2811), we examined the association of reproductive orientation with sexual satisfaction, adjusting for relationship characteristics including union type (cohabitation versus marriage), quality, and length; infertility history; and demographic characteristics including age, parity, and race/ethnicity. Results indicated that women who were ambivalent or trying to get pregnant reported significantly higher levels of sexual satisfaction than women who were sterile in the unadjusted model, but not in the models that included relationship quality. The association of reproductive orientation and sexual satisfaction depended upon relationship quality; among women with lower relationship quality, "trying" was associated with higher, and among those with higher relationship quality, with lower sexual satisfaction.
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Affiliation(s)
- Karina M Shreffler
- College of Nursing, University of Oklahoma Health Sciences Center, 1100 N. Stonewall Ave., Oklahoma City, OK, 73117, USA.
| | - Larry Gibbs
- Department of Sociology and Anthropology, Southern Oregon University, Ashland, OR, USA
| | - Stacy Tiemeyer
- Center for Integrative Research on Childhood Adversity, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Julia McQuillan
- Department of Sociology, The University of Nebraska at Lincoln, Lincoln, NE, USA
| | - Arthur L Greil
- Department of Sociology, Alfred University, Alfred, NY, USA
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Heidari M, Ghodusi M, Rezaei P, Kabirian Abyaneh S, Sureshjani EH, Sheikhi RA. Sexual Function and Factors Affecting Menopause: A Systematic Review. J Menopausal Med 2019; 25:15-27. [PMID: 31080785 PMCID: PMC6487288 DOI: 10.6118/jmm.2019.25.1.15] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/01/2018] [Accepted: 11/16/2018] [Indexed: 12/17/2022] Open
Abstract
The purpose of this review study is to evaluate sexual function and its effective factors in menopause. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of “menopause,” “postmenopause,” “postmenopausal,” “premenopause,” “pre-menopausal period,” “sexual function,” “sexual health,” “sexuality,” “sexual and gender disorders,” “sexual development,” “sexual dysfunction,” “sexual disorders,” “sexual behavior and “sexual activity” were used in combination with the Boolean operators OR and AND. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set. The results of the reviewed articles showed that, in the physical domain, the factors affecting sexual function can be mentioned, age, hormonal changes, medical problems and reproductive history. Sexual disorders in menopause can be affected by some of the individual and social characteristics and psychological problems. Considering the fact that many psychological and social injuries occur in this period following sexual disorders; therefore, policies and programs for improving the quality of life of women in menopause should be aimed at eliminating sexual dysfunction, correcting attitudes and negative emotions and help to women for more comfortable in menopause.
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Affiliation(s)
- Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mansureh Ghodusi
- Young Researchers and Elite Club, Abadeh Branch, Islamic Azad University, Abadeh, Iran
| | - Parvin Rezaei
- Department of Infectious Disease and Tropical Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Heidari Sureshjani
- Prehospital Emergency Care, Disaster and Emergency Medical Management Center, ShahreKord University of Medical Sciences, Shahrekord, Iran
| | - Rahim Ali Sheikhi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tabatabaeichehr M, Mortazavi H, Abadi MH, Moayed L. Sexual Desire and Related Factors in Middle-Aged and Elderly Married Women: A Cross-Sectional Study in Iran. Open Access Maced J Med Sci 2018; 6:1906-1911. [PMID: 30455772 PMCID: PMC6236044 DOI: 10.3889/oamjms.2018.383] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/09/2018] [Accepted: 09/10/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The sexual desire in the middle-aged and senior women is one of the factors affecting their quality of life and psychological well-being. AIM The present study was aimed to assess the sexual desire and related factors among married women aged 50-70 years. MATERIALS AND METHODS In this descriptive-analytical study, 210 married menopausal women aged 50-70 years were selected by cluster sampling method. Data were collected using a demographic profile questionnaire and Sexual Desire Inventory (SDI), and analysed by SPSS version 22 software using descriptive statistics and independent t-test, ANOVA and Pearson correlation coefficient tests. RESULTS The mean age of women was 59.40 ± 5.93 years, and the mean sexual desire score was 22.66 ± 17.78 (out of 112). There was a significant relationship between sexual desire score and age, educational level, occupation of women and spouses, age of menopause, marital history, number of pregnancies and children, individual health and pain level (P < 0.001). The sexual desire score had a significant association with diabetes, hypertension, heart disease, high cholesterol, chronic pain, gastrointestinal problems, chronic ulcers, bladder and intestinal problems, joint and bone disorders, taking cardiac medications, antihypertensive, anticoagulant, insulin, cholesterol-lowering drugs (P < 0.001). CONCLUSION The low sexual desire score and its reduction with age and the presence of various diseases and factors affecting sexual desire highlight the importance of diagnostic screening, family related educational planning and the role of health care providers in the health status of the older adults.
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Affiliation(s)
- Mahbubeh Tabatabaeichehr
- Geriatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Geriatric Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mahdi Hares Abadi
- Geriatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Leili Moayed
- Student Research Committee, Gerontological Care Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Merghati Khoei E, Alavi T, Maasoumi R, Sheikhan F. Elements associated with Iranian women's sexual behaviours: A cross-sectional study. Int J Reprod Biomed 2018. [DOI: 10.29252/ijrm.16.5.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Ghazanfarpour M, Khadivzadeh T, Roudsari RL. Sexual Disharmony in Menopausal Women and Their Husband: A Qualitative Study of Reasons, Strategies, and Ramifications. J Menopausal Med 2018; 24:41-49. [PMID: 29765926 PMCID: PMC5949307 DOI: 10.6118/jmm.2018.24.1.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 08/27/2017] [Accepted: 09/06/2017] [Indexed: 01/14/2023] Open
Abstract
Objectives The goal of this study was to explore perceptions and experiences of general practitioners and midwives during sexual dialogue with menopausal women. Methods In a descriptive exploratory qualitative study, 13 midwives and 12 general practitioners were selected using a semi-structured interview and purposive sampling method. Data analysis was conducted using qualitative content analysis adopted by Graneheim and Lundman. Results Through data analysis “sexual disharmony” emerged as a central theme, which included three categories of reasons, strategies, and ramifications of sexual disharmony. Reasons for sexual disharmony included subcategories of aging and health related-problems, marital problems, and stereotypical perceptions regarding menopause and sexuality and daily concerns. Strategies used by couples to address sexual disharmony consisted of changing roles and values, pretending to reach orgasm, suppressing sexual desire, meeting sexual needs of husbands in accordance with religious rules, seeking help of peers, seeking friends or traditional medicine and health providers, seeking a help charmer, engaging in sex with other women to fulfill sexual needs, pretending to be moody to alleviate sexual tension. Sexual disharmony may lead to spending money on a prostitute instead of engaging in sex out of wedlock or a surge in social pathologies such as sexually transmitted disease. Conclusions Healthcare providers must be aware of various sexual behavior of menopausal women and their husbands when they detect sexual disharmony in their patients. Results of this study can facilitate development of restricted guidelines for sexual discussion with menopausal women.
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Affiliation(s)
- Masumeh Ghazanfarpour
- Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Robab Latifnejad Roudsari
- Evidence-Based Care Research Centre, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Cranney S. Sex Life Satisfaction in Sub-Saharan Africa: A Descriptive and Exploratory Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1961-1972. [PMID: 28484861 DOI: 10.1007/s10508-017-0984-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/06/2017] [Accepted: 03/25/2017] [Indexed: 06/07/2023]
Abstract
Nearly all of the sex life satisfaction literature has dealt with developed-country settings, and nothing has been published on sex life satisfaction in sub-Saharan Africa. Not only is sub-Saharan African a substantively relevant area in its own right, but it also provides a useful point of comparison for patterns and relations found in developed-world contexts. A brief descriptive and exploratory study of sex life satisfaction in sub-Saharan Africa was conducted using the World Gallup Poll, a dataset with representative sex life satisfaction data for 31 countries and 25,483 cases. In general, there was little variation in weighted averages across countries, and most of the samples surveyed were satisfied with their sex lives, with the modal score being a perfect 10. Furthermore, what variation did exist could not be attributed to level of economic development or gender inequality. Within countries, sociodemographic associations generally comported with patterns found in other contexts: income, education, and being partnered were generally associated with sex life satisfaction, and for two of the four UN subregions (West Africa and East Africa), males were significantly more satisfied with their sex lives than women. The relationship with age demonstrated a curvilinear relationship, with the peak age of sexual satisfaction in the late 20s to early 30s depending on the geographic region. The age pattern was not due to health differences, but combining estimators after a seemingly unrelated regression suggests that 4-12% of the effect of income on sex life satisfaction was attributable to better health. In general, religiosity and perceived gravity of the HIV/AIDS problem in one's country were not significantly related to sexual satisfaction.
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Affiliation(s)
- Stephen Cranney
- Institute for the Studies of Religion, Baylor University, One Bear Place, #97236, Waco, TX, 76798, USA.
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8
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Smith RL, Gallicchio L, Flaws JA. Factors Affecting Sexual Function in Midlife Women: Results from the Midlife Women's Health Study. J Womens Health (Larchmt) 2017; 26:923-932. [PMID: 28437219 PMCID: PMC5646747 DOI: 10.1089/jwh.2016.6135] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The objective of this study was to estimate the importance of risk factors affecting sexual function in sexually active midlife women. MATERIALS AND METHODS A cohort of 780 women undergoing the menopausal transition was surveyed each year for up to 7 years. Data were collected from sexually active women on sexual function, including frequencies of enjoyment, arousal, orgasm, passion for partner, satisfaction with partner, pain, lack of lubrication, fantasizing, and sexual activity. Data were also collected on a large number of potential risk factors for sexual dysfunction, including behaviors (smoking and alcohol use), health status (overall and frequency of different disorders), and demographic information (race, education, income, etc.). Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data on individual outcomes were examined with ordinal logistic regression models using individual as a random effect. An overall sexual function score was constructed from individual outcome responses, and this score was examined with linear regression. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition. RESULTS A total of 1,927 women-years were included in the analysis. Women with much more physical work than average had higher sexual function scores and higher rates of enjoyment, passion, and satisfaction. Higher family income was associated with lower sexual function score and more frequent dry sex. Married women had significantly lower sexual function scores, as did those with frequent irritability or vaginal dryness. A higher step on the Ladder of Life was associated with a higher sexual function score and higher frequency of sexual activity. CONCLUSIONS The factors associated with sexual outcome in menopausal women are complex and vary depending on the sexual outcome.
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Affiliation(s)
- Rebecca L. Smith
- Department of Pathobiology, University of Illinois College of Veterinary Medicine, Urbana, Illinois
| | - Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Jodi A. Flaws
- Department of Comparative Biomedicine, University of Illinois College of Veterinary Medicine, Urbana, Illinois
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Smith RL, Gallicchio L, Flaws JA. Factors Affecting Sexual Activity in Midlife Women: Results from the Midlife Health Study. J Womens Health (Larchmt) 2016; 26:103-108. [PMID: 27653205 DOI: 10.1089/jwh.2016.5881] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The objective of this study was to identify (1) the importance of a number of potential factors affecting the likelihood of sexual activity in perimenopausal women and (2) the likelihood of a number of barriers to sexual activity. METHODS A cohort of 780 women undergoing menopausal transition was surveyed annually for up to 7 years. Data were collected on sexual activity and, if not sexually active, reasons for no sexual activity, as well as a number of potential risk factors. Height and weight were measured at an annual clinic visit; serum hormone concentrations were assayed using blood samples donated annually. Data were examined with logistic regression models using the individual as a random effect, with subset analysis of nonsexually active women to determine the likelihood of each barrier. All factors with univariate associations of p < 0.1 were considered in multivariate model building with stepwise addition. RESULTS A total of 2440 woman-years were included in the analysis of sexual activity. The likelihood of sexual activity increased for women living with a partner, with perceived quality of life, and with less frequent hot flashes. Among 513 woman-years reporting no sexual activity, women living with a partner and women reporting frequent fatigue were less likely to lack a sexual partner, but were more likely to have sexual difficulties. Women with more physical work than average and women with higher serum estradiol levels were less likely to have sexual difficulties. CONCLUSIONS The factors associated with sexual activity in menopausal women are complex, indicating that an individualized approach to improving sexual activity is required.
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Affiliation(s)
- Rebecca L Smith
- 1 Department of Pathobiology, University of Illinois College of Veterinary Medicine , Urbana, Illinois
| | - Lisa Gallicchio
- 2 Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute , Bethesda, Maryland
| | - Jodi A Flaws
- 3 Department of Comparative Biomedicine, University of Illinois College of Veterinary Medicine , Urbana, Illinois
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Associations between body mass index and sexual functioning in midlife women: the Study of Women's Health Across the Nation. Menopause 2016; 22:1175-81. [PMID: 25803669 DOI: 10.1097/gme.0000000000000452] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aims to examine baseline and longitudinal associations between body mass index (BMI) and sexual functioning in midlife women. METHODS Midlife women (N = 2,528) from the Study of Women's Health Across the Nation reported on sexual functioning and underwent measurements of BMI annually beginning in 1995-1997, with follow-up spanning 13.8 years. Associations between baseline levels and longitudinal changes in BMI and sexual desire, arousal, intercourse frequency, and ability to climax were assessed with generalized linear mixed-effects models. Models were adjusted for demographic variables, depressive symptoms, hormone therapy use, alcohol intake, menopause status, smoking status, and health status. RESULTS Mean BMI increased from 27.7 to 29.1 kg/m2, whereas all sexual functioning variables declined across time (P values ≤ 0.001). Higher baseline BMI was associated with less frequent intercourse (P = 0.003; 95% CI, -0.059 to -0.012). Although overall change in BMI was not associated with changes in sexual functioning, years of greater-than-expected BMI increases relative to women's overall BMI change trajectory were characterized by less frequent intercourse (P < 0.001; 95% CI, -0.106 to -0.029) and reduced sexual desire (P = 0.020; 95% CI, -0.078 to -0.007). CONCLUSIONS Although women's overall BMI change across 13.8 years of follow-up was not associated with overall changes in sexual functioning, sexual desire and intercourse frequency diminished with years of greater-than-expected weight gain. Results suggest that adiposity and sexual functioning change concurrently from year to year. Further research should explore the impact of weight management interventions as a strategy for preserving sexual functioning in midlife women.
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Jee Y, Kim Y. Factors influencing sexual function of middle-aged married Korean women. J Phys Ther Sci 2015; 27:819-23. [PMID: 25931738 PMCID: PMC4395722 DOI: 10.1589/jpts.27.819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/24/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the status of women's sexual function and relevant factors given the fact that women's health is crucial to the national health, and in particular that women's sexual health has a significant impact on their overall health. [Subjects and Methods] This study surveyed 353 women living in South Korea's P and K metropolitan regions from July 2012 to August 10, 2013. The Female Sexual Functional Index (FSFI), the Sexual Attitude Scale (SAS), sexual knowledge and questionnaires were used. [Results] Two groups based on FSFI scores above and below a cutoff value of 25 were compared with each other, and significant differences were found in age, male friends, menstrual status, sex status, and frequency of sex, experience of forced sex, personal health, husband's health and sexual knowledge. Male friends, sex status, experience of forced sex, husband's healths and sexual knowledge explained women's sexual function. [Conclusion] The finding that women's sexual function is associated with multiple factors suggests an intervention program for improving women's sexual function should be developed to reflect the factors influencing the target groups' sexual function.
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Affiliation(s)
- YoungJu Jee
- College of Nursing, Kyungnam University, Republic of Korea
| | - YoungHae Kim
- College of Nursing, Pusan National University, Republic of Korea
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Senturk Erenel A, Golbasi Z, Kavlak T, Dilbaz S. Relationship between menopausal symptoms and sexual dysfunction among married
T
urkish women in 40–65 age group. Int J Nurs Pract 2014; 21:575-83. [DOI: 10.1111/ijn.12309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Zehra Golbasi
- Department of NursingFaculty of Health ScienceCumhuriyet University Sivas Turkey
| | - Tulay Kavlak
- Gulhane Military Medical Academy Hospital Ankara Turkey
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Merghati-Khoei E, Sheikhan F, Shamsalizadeh N, Haghani H, Yousofnia Pasha YR, Killeen T. Menopause negatively impacts sexual lives of middle-aged Iranian women: a cross-sectional study. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:552-560. [PMID: 24308863 DOI: 10.1080/0092623x.2013.796577] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The study aimed to explore associations between sexual function, demographic variables, health and menopausal status among middle-aged Iranian women. Participants were 200 Iranian middle-aged women (40-65 years). All women completed the Female Sexual Function Index and the Brief Profile of Female Sexual Function. Data were analyzed using a Pearson correlation statistical test, a one-way analysis of variance, an independent t test, and a linear regression analysis. Advanced age, lower education, and socioeconomic status were significantly correlated with the lower scores on the Female Sexual Function Index. Lower scores on the Female Sexual Function Index were associated with being retired; having a hysterectomy or oophorectomy; and presence of hot flashes, vaginal dryness, health problems, prescription drug use, and cold sweats. There were no significant associations between middle-aged women's sexual function and ethnicity, body mass index, alcohol consumption, severity of hot flashes, and hot flash frequency. Sexual desire was decreased or absent in 94.5% of the postmenopausal respondents. Our findings appear that sexual function is associated with sociodemographic characteristics of Iranian middle-aged women. Gender-sensitive counseling and medical services for aging Iranian women can improve the quality of women's sexual lives.
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Affiliation(s)
- Effat Merghati-Khoei
- a Iranian National Center of Addiction Studies, Risk Behavior Institution , Tehran University of Medical Sciences , Tehran , Iran
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Alexander JL, Dennerstein L, Burger H, Graziottin A. Testosterone and libido in surgically and naturally menopausal women. ACTA ACUST UNITED AC 2012; 2:459-77. [PMID: 19803917 DOI: 10.2217/17455057.2.3.459] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The assessment and then treatment of a change in libido, or a change in the desire to partake in sexual activity, during the menopausal transition and beyond has been a challenging and elusive area of clinical research. This is partly due to the multidimensional nature of female sexuality, the difficulties of measuring testosterone in women in a reliable and accurate manner, and the complexity of the neurobiology and neurobehavior of female sexual desire. In addition, there is a lack of evidence for diagnostic specificity of low free testosterone levels for the symptom of low libido in women for whom there are no confounding interpersonal or psychological factors; although, in the symptomatic population of surgically or naturally menopausal women, a low level of free testosterone often accompanies a complaint of reduced desire/libido. The randomized clinical trial research on testosterone replacement for naturally and/or surgically menopausal women with sexual dysfunction has been criticized for a high placebo response rate, supraphysiological replacement levels of testosterone, the perception of modest clinical outcome when measuring objective data such as the frequency of sexual intercourse relative to placebo, and the unknown safety of long-term testosterone replacement in the estrogen-replete surgically or naturally menopausal woman. A careful review of current evidence from randomized, controlled trials lends support to the value of the replacement of testosterone in the estrogen-replete menopausal woman for whom libido and desire has declined. The issue of long-term safety remains to be answered.
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Affiliation(s)
- Jeanne L Alexander
- Kaiser Permanente Medical Group of Northern California Psychiatry Women's Health, Kaiser Permanente Medical Group, 1700 Shattuck Avenue, Suite 329, Berkeley, CA 94709, USA.
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Trompeter SE, Bettencourt R, Barrett-Connor E. Sexual activity and satisfaction in healthy community-dwelling older women. Am J Med 2012; 125:37-43.e1. [PMID: 22195529 PMCID: PMC3246190 DOI: 10.1016/j.amjmed.2011.07.036] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 07/27/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Female sexual dysfunction is a focus of medical research, but few studies describe the prevalence and covariates of recent sexual activity and satisfaction in older community-dwelling women. METHODS A total of 1303 older women from the Rancho Bernardo Study were mailed a questionnaire on general health, recent sexual activity, sexual satisfaction, and the Female Sexual Function Index. RESULTS A total of 806 of 921 respondents (87.5%) aged 40 years or more answered questions about recent sexual activity. Their median age was 67 years; mean years since menopause was 25; most were upper-middle class; 57% had attended at least 1 year of college; and 90% reported good to excellent health. Half (49.8%) reported sexual activity within the past month with or without a partner, the majority of whom reported arousal (64.5%), lubrication (69%), and orgasm (67.1%) at least most of the time, although one third reported low, very low, or no sexual desire. Although frequency of arousal, lubrication, and orgasm decreased with age, the youngest (<55 years) and oldest (>80 years) women reported a higher frequency of orgasm satisfaction. Emotional closeness during sex was associated with more frequent arousal, lubrication, and orgasm; estrogen therapy was not. Overall, two thirds of sexually active women were moderately or very satisfied with their sex life, as were almost half of sexually inactive women. CONCLUSION Half these women were sexually active, with arousal, lubrication, and orgasm maintained into old age, despite low libido in one third. Sexual satisfaction increased with age and did not require sexual activity.
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Affiliation(s)
- Susan E. Trompeter
- Division of General Internal Medicine, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California
- Veterans Affairs San Diego Health Care System, San Diego, CA
| | - Ricki Bettencourt
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego School of Medicine, La Jolla, California
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Fahs B, Swank E. Social identities as predictors of women's sexual satisfaction and sexual activity. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:903-914. [PMID: 20878224 DOI: 10.1007/s10508-010-9681-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 07/09/2010] [Accepted: 07/09/2010] [Indexed: 05/29/2023]
Abstract
While much research has examined sexual problems and dysfunction, far less research has examined intersections between sexual satisfaction and sexual activity, particularly as it relates to social identities. This study utilized secondary analysis of 1,473 women from the National Health and Social Life Survey to examine the way sexual satisfaction and sexual activity are at times misaligned. Using factor and cluster analyses, four groups of women defined by being high or low on satisfaction and activity were predicted by nine demographic variables, including socioeconomic class, racial/ethnic identity, age, marital status, education, sexual identity, geographical "coming of age" location, employment status, and number of children. Results showed that lower status women (women of color, working-class women, younger women, less educated women, women who worked full-time) reported low satisfaction and high activity. Women who reported high satisfaction and low activity represented the largest cluster of women, indicating that more women reported a disjuncture between satisfaction and activity than did those reporting a match between satisfaction and activity. Implications for clinical, sexuality, and social identity literatures are discussed.
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Affiliation(s)
- Breanne Fahs
- Women and Gender Studies Program, Arizona State University at the West Campus, 4701 W. Thunderbird Road, Mail Code 2151, Glendale, AZ 85306, USA.
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Dundon CM, Rellini AH. More than Sexual Function: Predictors of Sexual Satisfaction in a Sample of Women Age 40–70. J Sex Med 2010; 7:896-904. [DOI: 10.1111/j.1743-6109.2009.01557.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Chedraui P, Pérez-López FR, San Miguel G, Avila C. Assessment of sexuality among middle-aged women using the Female Sexual Function Index. Climacteric 2009; 12:213-21. [DOI: 10.1080/13697130802607727] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Gallicchio L, Schilling C, Tomic D, Miller SR, Zacur H, Flaws JA. Correlates of sexual functioning among mid-life women. Climacteric 2009; 10:132-42. [PMID: 17453861 DOI: 10.1080/13697130601167956] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Studies have reported a decline in sexual functioning among women undergoing the menopausal transition. Few studies, however, have examined the associations between hormones and sexual dysfunction during this time period. Therefore, the purpose of this study was to examine the associations between participant characteristics and endogenous hormones with sexual functioning in mid-life women. METHODS Data were analyzed from a community-based sample of 441 women aged 45-54 years who stated that they were sexually active at the time of the study. Each participant completed a survey that included questions pertaining to sexual functioning and provided a blood sample that was used to measure estrogen and androgen concentrations. RESULTS Among women who reported being sexually active, poorer self-reported health and the experiencing of depressive symptoms were significantly associated with not being satisfied with sexual relations after adjustment for other covariates. None of the hormones examined were significantly associated with overall sexual satisfaction. However, statistically significant associations between both total testosterone levels and the free testosterone index with satisfaction with the frequency of sexual relations were observed. CONCLUSIONS Our findings indicate that the experiencing of depressive symptoms and the reporting of poor overall health are important correlates of sexual dysfunction. Further, our results suggest that higher total and free testosterone levels are significantly associated with a desire for increased frequency of sexual relations among mid-life women.
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Affiliation(s)
- L Gallicchio
- Prevention and Research Center, Weinberg Center for Women's Health & Medicine, Mercy Medical Center, Baltimore, Maryland, USA
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Ayaz S, Kubilay G. Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. J Clin Nurs 2009; 18:89-98. [DOI: 10.1111/j.1365-2702.2008.02282.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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