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Saleh SA, Almadani N, Mahfouz R, Nofal HA, El-Rafey DS, Seleem DA. Exploring the Intersection of Depression, Anxiety, and Sexual Health in Perimenopausal Women. Int J Womens Health 2024; 16:1315-1327. [PMID: 39100112 PMCID: PMC11298183 DOI: 10.2147/ijwh.s464129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose The perimenopausal period is marked by hormonal fluctuations that trigger a complex interplay between estrogen levels and neurotransmitters' function, contributing to increased susceptibility to depression and anxiety in women. Concurrently, hormonal changes, coupled with alterations in vaginal tissue, lead to sexual dysfunction during this transitional phase. This study aimed at evaluating the association between menopausal symptoms and sexual dysfunction among perimenopausal women and identifying the mediating effects of depression and anxiety on this association. Patients and Methods Data for the present cross-sectional study were collected from participants via Arabic versions of three questionnaires; the modified Menopausal Rating Scale (MRS), the Female Sexual Functioning Index (FSFI) and the Hospital Anxiety and Depression scale (HADS). Results Our study was conducted on 149 females with age ranged from 45 to 55 years. On studying the relation between modified MRS and HADS, the menopausal symptoms were significantly high among female with high anxiety scores. Regarding the relationship between MRS and FSFI, women with anxiety and physical and mental exhaustion had significantly lower FSFI scores than women without such symptoms (19.2 [2-31.4] vs 21.7 [3.8-30.9], p = 0.04, respectively). Furthermore, there were statistically significant negative correlations between depression scores and sexual desire (r = -0.32, p < 0.001), arousal (r = -0.25, p = 0.003), and total FSFI scores (r = -0.27, p = 0.04). Conclusion Perimenopausal women experience a confluence of challenges related to depression, anxiety, and sexual dysfunction. Understanding the interconnectedness of hormonal and psychosocial factors is essential for tailored interventions aimed at improving mental health and sexual well-being during this transitional phase.
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Affiliation(s)
- Shahenda A Saleh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Noura Almadani
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Rasha Mahfouz
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Hanaa A Nofal
- Community, Environmental, and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dina S El-Rafey
- Community, Environmental, and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dina A Seleem
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Moniri R, Gharraee B, Zahedi Tajrishi K. Modeling the relationship between depression in people with cancer and perceived stress, with the mediating role of eating problems, sexual satisfaction, emotion regulation and self-compassion. Front Psychol 2024; 15:1281347. [PMID: 38659675 PMCID: PMC11040260 DOI: 10.3389/fpsyg.2024.1281347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
Aim With the rising prevalence of cancer and the adverse physical and psychological experiences endured by affected individuals, this study aims to establish a model illustrating the relationship between depression in people with cancer and perceived stress. Additionally, it examines the mediating influence of eating problems, sexual satisfaction, emotional regulation, and self-compassion. Method This study employs a descriptive-correlational research method, utilizing structural equation analysis (modeling) to explore the role of mediators. The research sample comprised 200 individuals diagnosed with cancer, selected based on predetermined inclusion and exclusion criteria. Participants completed Beck's 13-item depression questionnaire, a 10-item perceived stress questionnaire, an 8-item appetite measurement questionnaire, a 25-item sexual satisfaction questionnaire, a 10-item emotion regulation questionnaire, and a 12-item compassion questionnaire. The data were subsequently analyzed using SPSS-24 and Lisrel 80/8 software. Findings The research findings indicate a significant positive relationship between perceived stress and depression in people with cancer. Furthermore, eating problems exhibited a mediating role in the relationship between perceived stress and depression, with a direct effect coefficient of (t = 0.28, ß = 0.02). However, the path from perceived stress to depression, mediated by sexual satisfaction, was found to be statistically insignificant, with a standard coefficient of 0.01 at the p < 0.05 level. Emotion regulation demonstrated a direct effect coefficient of (t = -3.52, ß = -0.33) on depression. Likewise, self-compassion exhibited a direct effect coefficient of (t = -3.08, ß = -0.28) on depression, while the path from perceived stress to depression was mediated by self-compassion, with a standard coefficient of 0.12 at the p < 0.05 level. Conclusion In conclusion, this study sheds light on the interplay between depression and perceived stress in individuals with cancer, revealing a significant positive association. Eating problems emerged as a mediating factor, directly influencing the manifestation of depressive symptoms. However, the mediation pathway through sexual satisfaction was found to be statistically insignificant. Emotion regulation and self-compassion were identified as influential factors, with direct effects on depression and self-compassion also serving as a mediator in the relationship between perceived stress and depression. The findings emphasize the importance of targeted interventions addressing eating problems, enhancing emotion regulation, and fostering self-compassion to alleviate the impact of depression and perceived stress in individuals facing cancer-related challenges. Further research is encouraged to refine and expand upon these insights, advancing holistic care for this population.
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Affiliation(s)
| | - Banafsheh Gharraee
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
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Galati MCR, Hollist CS, do Egito JHT, Osório AAC, Parra GR, Neu C, de Moraes Horta AL. Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples. J Sex Med 2023; 20:260-268. [PMID: 36763940 DOI: 10.1093/jsxmed/qdac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 09/13/2022] [Accepted: 09/17/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Health professionals treating sexual dysfunction and relational dissatisfaction recognize that they are multifactorial phenomena, and depression can be bidirectionally associated with both. AIM The purpose of this study was to investigate sexual dysfunction in heterosexual couples in relation to the quality of their marital relationship and depression symptoms. METHODS The sample consisted of 100 heterosexual couples recruited in Brazil. Both partners of each couple completed the Golombok-Rust Inventory of Sexual Satisfaction and the Golombok-Rust Inventory of Marital Satisfaction, which were translated and adapted, and the Beck Depression Inventory, which was validated for the Brazilian population. Both partners completed their questionnaires separately, and the couple's surveys were linked to preserve conjugal data for dyadic analysis. The Actor-Partner Interdependence Model was used to understand how sexual dysfunction in couples is related to depression and relationship quality among and between partners. RESULTS Sexual dysfunction was found to be strongly associated with dissatisfaction in the relationship (husbands, β = 0.57, P < 0.001; wives, β = 0.60, P < 0.001), and a positive association was found between depressive symptoms and marital dissatisfaction (husbands, β = .32, P < .001; wives β = .40, P < .001). CLINICAL IMPLICATION The results suggest that it is important for health professionals to be aware of the dyadic impact of struggles with both sex and the relationship and the presence of depression symptoms in patients who seek care for sexual complaints or depression and who are in a marital relationship. STRENGTHS AND LIMITATIONS The different results found for men and women may shed light on the biopsychosocial dimensions of human sexuality. When treated as a purely physical experience, sex is myopic. In this study we demonstrated psychosocial aspects associated with gender and sexuality, and the partner's variables were found to have a greater impact on women than they did on the men. A limitation of this study is that the sample is not generalizable as it is not demographically representative of all socioeconomic groups in Brazil. Furthermore, the participants in this sample did not have clinical levels of depression, so the results cannot be extended to couples in which one or both spouses have depressive disorder. CONCLUSION It was found that sexual dysfunction is strongly associated with the quality of the couple relationship, and that the quality of relationship plays a mediating role between depression and marital quality, especially for the women.
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Affiliation(s)
| | - Cody S Hollist
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Nebraska, United States
| | | | - Ana Alexandra Caldas Osório
- Developmental Disorders Program and Mackenzie Center for Research in Childhood and Adolescence, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Gilbert R Parra
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Nebraska, United States
| | - Christopher Neu
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Nebraska, United States
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Roman Lay AA, de Oliveira Duarte YA, Duarte LS, Vilela Borges AL. Sexual activity and satisfaction in older adults from a Brazilian cohort study. Aging Ment Health 2023; 27:417-424. [PMID: 35023418 DOI: 10.1080/13607863.2021.2025338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objectives: Although the majority of older adults experience sexual satisfaction regardless of their sexual activity, there are few studies that address sexuality in aging, especially in Latin America. The objective of this study was to assess the prevalence of sexual activity and satisfaction among older adults in two time-points, as well as their sociodemographic and health predictors.Method: We analyze data from 1,464 older adults aged 60 years or over from the Health, Well-Being, and Aging (SABE) cohort study conducted in Brazil. Multivariable regression models were used to determinate the factors associated with sexual activity and sexual satisfaction, stratified by gender. Results: Among older adults, the prevalence of sexual activity was 48%, while the vast majority reported feeling sexually satisfied (80%). Men had more sexual activity than women, while women presented greater sexual satisfaction than men. After the follow-up, older adults that were married were more likely to have sexual activity. In women, being older than 71 years was associated with lower sexual activity. In men, those with mobility problems and depression were less likely to have sexual activity. Regarding sexual satisfaction, having depression remained a leading factor for lower sexual satisfaction in men.Conclusion: Despite beliefs, a high percentage of older adults reported being sexually active and feeling sexually satisfied. Our results highlight the gender difference in the predictors of sexual activity and sexual satisfaction. Since sexuality is important for well-being throughout life, preventing factors that decrease sexual activity and sexual satisfaction in aging could help improve the quality of life of older adults.
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Affiliation(s)
| | | | - Luciane Simões Duarte
- Chronic Noncommunicable Diseases Division, Disease Control Coordination, São Paulo State Health Department, São Paulo, Brazil
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Karakose S, Urs M, Marshall JE, Ledermann T. Depression, Anxiety, Stress, and Sexual Satisfaction in Couples. JOURNAL OF SEX & MARITAL THERAPY 2023:1-14. [PMID: 36688349 DOI: 10.1080/0092623x.2023.2166637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Sexual satisfaction is an important concept in relationships contributing to psychological general well-being. The present study examined dyadic associations between mental health variables, particularly depression, anxiety, and stress, and sexual satisfaction. Using data of 102 heterosexual married couples from Turkey (mean age = 30.06 years), we sought to investigate whether a person's depression, anxiety, and stress were associated with his or her own as well as the partner's sexual satisfaction. Actor-Partner Independence Model (APIM) analysis revealed that husbands' anxiety and stress were associated with their own sexual satisfaction and husbands' depression was associated with both their own and the wives' sexual satisfaction. Wives' depression and stress were associated with their own sexual satisfaction but not with the satisfaction of their husbands. Additionally, wives' anxiety was not neither associated with their own nor their husbands' sexual satisfaction.
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Affiliation(s)
- Selin Karakose
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
| | | | - Jordan E Marshall
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
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Bahrami N, Peixoto MM, Griffiths MD, Alimoradi Z. Sexual Satisfaction and Cognitive Schemas Activated in a Sexual Context among Iranian Married Women of Reproductive Age. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:251-262. [PMID: 34668845 DOI: 10.1080/0092623x.2021.1986185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The present study examined the relationship between sexual satisfaction (SS) and cognitive schemas activated in sexual context. In a cross-sectional study, the participants comprised 313 Iranian married women (mean age of 36.7 years and mean marriage duration of 12.4 years). Data were collected utilizing an online survey comprising the Index of Sexual Satisfaction, the Cognitive Schema Activated in Sexual Context Questionnaire, and a number of sociodemographic questions. A linear regression model utilizing the stepwise method was performed. The mean score of cognitive schemas relating to sexual problems was 35.56 (out of 140; SD = 14.68) with the highest mean in the Difference/Loneliness subscale (higher scores indicating greater negative schema activation). The mean score of sexual satisfaction on the ISS was 96.80 (out of 125; SD = 16.77). The highest scores of cognitive schemas relating to sexual problems were observed among individuals with low sexual satisfaction. Based on a multivariable linear regression model, age (β = 0.33), spouse social support (β = 0.23), and spouse job (β = 0.21) had the highest regression coefficients in relation to sexual satisfaction among Iranian married women. Cognitive schemas activated in a sexual context were strongly and significantly associated with sexual satisfaction among Iranian married women of reproductive age. The findings suggest that schema therapy techniques be used alongside initiatives to promote spouse social support to help prevent problematic sexual cognitive schemas.
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Affiliation(s)
- Nasim Bahrami
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maria Manuela Peixoto
- The Psychology for Positive Development Research Center, Lusíada University, Porto, Portugal
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Folayan MO, Arowolo O, Mapayi B, Chukwumah NM, Alade MA, Yassin RH, El Tantawi M. Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria. BMC Oral Health 2021; 21:401. [PMID: 34399740 PMCID: PMC8365974 DOI: 10.1186/s12903-021-01768-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study determined the association between mental health and risky oral health and sexual health behaviours. METHODS A household cross-sectional survey was conducted in Ile-Ife, Nigeria between December 2019 and January 2020. Data were collected from 10 to 19-year-old on the sociodemographic profile (age, sex at birth and socioeconomic status); mental health problems (psychological distress, depressive symptoms and suicidal ideation); and mental (smoking habit, consumption of alcohol, use of psychoactive substances), sexual (history of vaginal or anal sexual intercourse; transactional sex, multiple sex partners, use of condom at last sexual intercourse) and oral (frequency of daily tooth brushing, daily frequency of consumption of refined carbohydrate in-between-meals, frequency of use of dental floss, history of dental service utilization in the last 12 months and dental anxiety) health risk factors. Binary logistic regression analysis was conducted to determine the association between risky oral (neglecting to brush twice daily and frequent consumption of refined carbohydrates in-between-meals), and sexual (neglecting to use condoms during the last sex act and having multiple sex partners) health behaviours as outcome variables, and mental health status as the explanatory variables. An ordinal logistic regression model was also developed where the outcome variable was the number of risky health behaviours. The models were adjusted for the socio-demographic variables and history of dental service utilisation in the last 12 months of the survey. RESULTS High psychological distress was significantly associated with lower odds of frequent consumption of refined carbohydrates in-between-meals (AOR = 0.32; 95%CI 0.23, 0.47), and having multiple sex partners (AOR = 0.10; 95%CI 0.02, 0.57); but higher odds of having a higher number of risky behaviours (AOR = 3.04; 95%CI 2.13, 4.33). Having depressive symptoms was significantly associated with higher odds of neglecting to use condom at the last sexual intercourse (AOR = 7.20; 95%CI 1.94, 26.76) and having multiple partners (AOR = 95.43; 95%CI 24.55, 370.90). Suicidal ideation was significantly associated with lower odds of neglecting to use condom at the last sexual intercourse (AOR = 0.00; 95%CI 0.00, 0.00) and having multiple sex partners (AOR = 0.00; 95%CI 0.00, 0.00). CONCLUSION The associations between psychological distress and oral and sexual health risk behaviours in adolescents seem complex and need to be studied further.
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Affiliation(s)
| | - Olaniyi Arowolo
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Boladale Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Nneka Maureen Chukwumah
- Department of Preventive Dentistry, School of Dentistry, University of Benin, Benin City, Nigeria
| | - Michael A Alade
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Randa H Yassin
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Hamid TA, Din HM, Bagat MF, Ibrahim R. Do Living Arrangements and Social Network Influence the Mental Health Status of Older Adults in Malaysia? Front Public Health 2021; 9:624394. [PMID: 34026706 PMCID: PMC8131656 DOI: 10.3389/fpubh.2021.624394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/15/2021] [Indexed: 01/07/2023] Open
Abstract
Living arrangement has been reported to have a significant influence on several mental health statuses of older adults, but their social network may confound this association. This study is aimed at examining the interactive effect of living arrangements and social network on the mental health status among older adults in Malaysia. A total of 2,188 Malaysian older adults living nationwide were included in this cross-sectional study. Participants were classified into four groups according to their living arrangements (living alone or not living alone) and social network size (assessed using Lubben's Social Network Scale-6). Poor social network was defined as the lowest quartile (fourth quartile) of the score. Mental health statuses, which include flourishing in life, life satisfaction, cognitive functions, loneliness, depression, and perceived stress, were measured. Multiple linear regression models, adjusted for age, gender, education, and comorbidities, revealed that a good social network was significantly associated with an increase on the flourishing scale scores, regardless of living arrangements. Not living alone and having good social network was significantly associated with increased Montreal Cognitive Assessment scores and decreased loneliness scores. This study found that living arrangements are not always a risk factor for the mental health status of older adults. However, it may be confounded by the level of their social networks. The results suggested that the effects of social network may exceed the impact of living arrangements. It is recommended that health professionals pay more attention to the social networks of older Malaysians to harness its benefits in improving their mental health status.
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Affiliation(s)
- Tengku Aizan Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | - Hazwan Mat Din
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Rahimah Ibrahim
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia.,Department of Human Development and Family Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang, Malaysia
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Zegeye B, Woldeamanuel GG, Negash W, Shibre G. Sexual Satisfaction and Its Associated Factors among Married Women in Northern Ethiopia. Ethiop J Health Sci 2020; 30:169-178. [PMID: 32165806 PMCID: PMC7060387 DOI: 10.4314/ejhs.v30i2.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Sexual satisfaction is an essential component of overall health related quality of life. However, the epidemiology of sexual satisfaction among Ethiopian women is largely unknown. Hence, the present study was undertaken to investigate the sexual satisfaction and its associated factors among married women. Methods Community-based cross-sectional study with mixed approach was conducted from March 1 to April 30, 2019 in Kewot District, Northern Ethiopia on a sample of 397 married women. Quantitative data was collected on a face-to-face interview using a pre-tested questionnaire while qualitative data was collected using in-depth interviews. The new sexual satisfaction scale was used to assess sexual satisfaction of the women. Descriptive statistics and ordinal logistic regression analysis were performed using SPSS version 23. Results The findings showed that half of the participants (50.4%) expressed moderate sexual satisfaction, and only 39% of the participants reported greatest sexual satisfaction. Poor partner communication (AOR = 0.30, 95% CI; 0.11–0.79], poor sexual self-esteem (AOR = 0.17, 95% CI; 0.08 – 0.36), absence of social responsibility (AOR = 6.52, 95% CI; 3.32 – 12.80), poor sexual function (AOR = 0.36, 95% CI; 0.21 – 0.61), no previous information about sexuality (AOR = 0.06, 95% CI; 0.00 – 0.62) and perception of sexual talk as taboo (AOR = 7.15, 95% CI; 3.86 – 13.26) were significantly associated with sexual satisfaction. Conclusion Several factors could affect sexual satisfaction of married women. Therefore, development of educational programs, pre-marriage counseling and continuous education should be conducted.
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Affiliation(s)
- Betregiorgis Zegeye
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Wassie Negash
- Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Gebretsadik Shibre
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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