Sexual Health of Postmenopausal Women in North India

Socioeconomics and Erotic Inequity: A Theoretical Overview and Narrative Review of Associations Between Poverty, Socioeconomic Conditions, and Sexual Wellbeing

Sexual health includes positive aspects of sexuality and the possibility of having pleasurable sexual experiences. However, few researchers examine how socioeconomic conditions shape sexual wellbeing. This paper presents the concept of "erotic equity," which refers to how social and structural systems enable, or fail to enable, positive aspects of sexuality. In part one, we use this concept to consider potential pathways through which socioeconomic conditions, especially poverty, may shape sexuality. Part two builds from this theoretical framework to review the empirical literature that documents associations between socioeconomics and sexual wellbeing. This narrative review process located 47 studies from more than 22 countries. Forty-four studies indicated that individuals who reported more constrained socioeconomic conditions, primarily along the lines of income, education, and occupation, also reported poorer indicators of sexual wellbeing, especially satisfaction and overall functioning. Most studies used unidimensional measures of socioeconomic status, treating them as individual-level control variables; few documented socioeconomics as structural pathways through which erotic inequities may arise. Based on these limitations, in part three we make calls for the integration of socioeconomic conditions into sexuality researchers' paradigms of multi-level influences on sexuality.

The association between sexual function and body image among postmenopausal women: a cross-sectional study

BACKGROUND

Postmenopause physiological changes may alter body image (BI) during the postmenopausal period of life. Body image dissatisfaction may have negative effects on the sexual function of women. The present study aims to assess the relationship between body image and sexual function during the postmenopausal period.

METHODS

This cross-sectional study was performed on 231 postmenopausal women who were menopausal during the recent 5 years, aged > 40 years old, and referring to health centers in Tehran-Iran. The participants were recruited using a multi-stage sampling method. Data were collected using 3 questionnaires including socio-demographic, Fisher's Body Image, and female sexual function index (FSFI). Data were analyzed using SPSS 24 and multiple regression, Mann-Whitey, Pearson, and Spearman correlation tests.

RESULTS

Two hundred thirty-one postmenopausal women aged 52.53 ± 5.32 (mean ± SD) years old participated in the study. The mean and standard deviation of FSFI and BI of the women were respectively 19.59 ± 11.11(ranges 1.2-36) and 155.43 ± 37.09 (ranges from 46 to 230). According to FSFI, 62.8% of female sexual dysfunction (FSD) was reported. There were significant correlations between scores of total and all domains of FSFI with scores of total and all dimensions of BI. There was also a positive correlation between education and family income of the women and a negative correlation between age of husband and duration of menopause with their sexual function. Significant relationships were also shown between the women's and the husbands' jobs with the total score of women's sexual function. According to the multiple linear regression model, BI was a significant predictor of sexual function in postmenopausal women.

CONCLUSION

Body image is effective on the sexual function of postmenopausal women. Therefore, body image is necessary to be considered in future postmenopausal health promotion programs.

Effects of Menopause on Sexual Function in Indian Women: A McCoy's Questionnaire-Based Assessment

Background:

Menopause is associated with physical, physiological, psychological changes and may lead to sexual dysfunction (SD) effecting woman's health and well-being. Scientific research in the area of female sexuality in India is scant. Therefore, this study aimed to investigate female sexual function at perimenopause and menopause and determine the association between sociodemographic and physiological factors with sexual function.

Materials and Methods:

This was a cross-sectional hospital-based study carried out in perimenopausal and menopausal women. Study participant's details were collected by gynecologists and clinical research professionals following the participant's informed consent. The case report and McCoy female sexuality questionnaire were used. The association between sociodemographic status and sexual function was determined. Data were summarized using descriptive statistics for portraying profile of the participants and t-test for comparison.

Results:

A total of 129 women in the menopausal (SD − 3.26) and 112 in the premenopausal group (SD − 6.01) were enrolled. The sociodemographic parameters did not significantly affect the sexual function scores in both groups. In terms of vaginal atrophy, a significant increase in urgency was noted in the postmenopause group. The general domain of sexual function was significantly lower in menopausal than and perimenopausal with a P < 0.001. Looking at individual domains of sexual function, for sexual interest, satisfaction, vaginal lubrication, and orgasm, the mean value of perimenopausal participants was significantly higher when compared to menopausal women; for a primary partner domain, no significant differences between the two groups were noted.

Conclusion:

Overall, the sociodemographic profile did not impact sexual function in this study. Compared with menopausal women, perimenopausal women showed better, more complete sexual function based on McCoy's score except partner-related domain that is constant from perimenopause to menopause in a monogamous relationship.

Sexual dysfunction in women with interstitial cystitis/bladder pain syndrome: A case-control study

Introduction:

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating illness characterized by urinary frequency, urgency, and pelvic pain. IC/BPS adversely affects the sexual well-being of the patients. We used the Female Sexual Function Index (FSFI) to compare sexual dysfunction (FSD) in women with IC/BPS versus controls in an Indian cohort where such data is lacking.

Materials and Methods:

This case–control study was designed to compare the FSDs in patients with IC/BPS to that of asymptomatic controls. Pelvic Pain and Urgency/Frequency (PUF) Questionnaire scores and FSFI scores were used as tools for this study.

Results:

Thirty-two patients were recruited in each group. Patients with IC/BPS had a significantly higher PUF score as compared to the control group (7.843 vs. 3.656). These patients also scored worse on the total adjusted FSFI score (18.678 ± 4.531 vs. 28.05 ± 4.318; P < 0.05) and individually in all domains of sexual function. Twenty-nine (90.62%) patients of the IC/BPS group had FSD as compared to 12 (37.5%) of patients in the control group. Pain was the most common presenting complaint and was seen in 65.25% of patients in the IC/BPS group as compared to only 31.25% of patients in the control group.

Conclusion:

The results of our study show that women with IC/BPS have more pain and sexual dysfunction than controls.

Female Sexual Function and Its Association with the Severity of Menopause-Related Symptoms

The aim of this study was to examine female sexual functioning and its association with the impact of the symptoms of menopause among Spanish postmenopausal women. A total of 182 postmenopausal women (65.59 ± 7.93 years) participated in this cross-sectional study. The female sexual function index (FSFI) and the menopause rating scale (MRS) were used to analyze sexual function and severity of menopausal symptoms, respectively. Age, education, area of residence, occupation, and depression (Hospital Anxiety and Depression Scale) were considered as possible confounders. The results of a linear multivariate regression analysis showed that the severity of urogenital menopause-related symptoms was associated with lower values in the FSFI total score and the lubrication, satisfaction, arousal, and orgasm domains. These last three subscales were also linked to severe psychological impact, while the MRS total score was only related to the desire domain. Regarding confounders, being younger, working, and residing in a rural area were all linked to better sexual function. All effect sizes were large (adjusted R² > 0.35). In conclusion, after controlling for possible confounders, postmenopausal women who experience a severe impact of menopausal symptoms endure poorer sexual function, particularly when said symptoms are urogenital or psychological in nature.

The Effect of a Midwife-Based Group Discussion Education on Sexual Dysfunction Beliefs in Rural Postmenopausal Women

Introduction

Correcting sexual beliefs can affect women's sexual function. There are very limited interventional studies on correcting the sexual dysfunction beliefs in postmenopausal women living in rural areas. Therefore, the present study was carried out with the aim of investigating the effect of a midwife-based group education on sexual dysfunction beliefs in one group of rural postmenopausal women.

Methods

The present study was a quasi-experimental pre-post design without a control group. The study population included rural menopausal women who referred to rural health centers. The study sample consisted of 50 participants who have all received education program. The education was held in six group discussion sessions. The data gathering tool used in this study was the Sexual Dysfunctional Beliefs Questionnaire which was completed before and after the education. This questionnaire consists of 33 items and includes 6 subscales.

Results

The mean age of participants was 53.26 years. Approximately half of the participants (48%) had primary education. The mean scores of sexual dysfunction beliefs before and after education were 114.58 and 58.56, respectively (p-value<0.001). The mean scores of sexual conersations, affection primacy, motherhood-related beliefs, sexual desire and pleasure as sin beliefs, age-related beliefs, and body image beliefs before intervention were 14.38, 21.38, 13.9, 23.64, 20.74, 17.04, respectively, and after intervention were 6.9, 11.80, 8.64, 12.48, 7.7, 9.40, respectively.

Conclusion

Rural postmenopausal women had problems with sexual dysfunction beliefs. A midwife-based group discussion education on this matter had significantly improved the sexual dysfunction beliefs in them. Further studies are needed in this regard.