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Bulut H, Hinchliff S, Ali P, Piercy H. Women's Experiences of Intimate and Sexual Relationships During Menopause: A Qualitative Synthesis. J Clin Nurs 2024. [PMID: 39334554 DOI: 10.1111/jocn.17436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 07/07/2024] [Accepted: 09/01/2024] [Indexed: 09/30/2024]
Abstract
AIM The aim of this literature review was to explore women's experiences of their intimate and sexual relationships during menopause. BACKGROUND Evidence shows that the menopause transition can be a difficult time for women due to symptoms of menopause. There is little research evidence about how menopause-related symptoms impact women's intimate and sexual relationships. METHOD A qualitative synthesis was carried out on research published between May 2005 and July 2023 using five electronic databases: ASSIA, CINAHL, PubMed, PsycINFO and Web of Science. We also searched Google Scholar and used backward and forward chaining methods to identify results not listed in the databases and ensure that no relevant literature was omitted. RESULTS Eighteen qualitative studies were included in this review. Six main themes were identified: the meaning of menopause to women in different cultures; factors affecting women's sexual lives; changes in sexual desire and orgasm; talking about sexual issues; women's attempts to overcome the impact of ageing and menopause on their sexual lives; and concerns about partner sexual satisfaction during the menopause. CONCLUSION During the menopause transition, women can experience sexual difficulties that have an impact on their lives and intimate relationships. Qualitative studies showed that sexual changes associated with menopause can be difficult to manage and must be viewed in the social and cultural contexts of the women's lives. RELEVANCE TO CLINICAL PRACTICE The results of this review will be of interest to nurses to assess patient needs while offering health services to women in menopause. In addition, the results can be used to inform education and support programmes for women. REPORTING METHOD We have adhered to relevant EQUATOR guidelines and used the PRISMA-ScR reporting method. No patient or public contribution was required for this study.
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Affiliation(s)
- Hatice Bulut
- Division of Obstetrics and Gynaecologic Nursing, Department of Nursing, Süleyman Demirel University Faculty of Health Science, Isparta, Turkey
| | - Sharron Hinchliff
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Parveen Ali
- School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, Sheffield, UK
- Doncaster and Bassetlaw Teaching Hospitals, Doncaster, UK
| | - Hilary Piercy
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
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Gewirtz-Meydan A, Levkovich I, Pinto G, Ayalon L. Discomfort in Discussing Sexual Issues: Developing a New Scale for Staff at Long-Term Care Facilities for Older Adults. J Gerontol Nurs 2022; 48:27-37. [PMID: 36007217 DOI: 10.3928/00989134-20220808-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Interviews reveal that many health professionals working with older adults are uncomfortable discussing sexual issues with those under their care. Nevertheless, to date, discomfort in discussing sexual issues with older adults has not been empirically investigated. To facilitate exploration of this subject, the current study evaluated the psychometric properties of a new measure: The Discomfort in Discussing Sexual Issues (DDSI) with Older Adults scale. The study was conducted via online survey among 127 long-term care staff (e.g., nurses, physicians, physical therapists, social workers, speech therapists, occupational therapists) serving older adults. A confirmatory factor analysis confirmed the DDSI scale's structure as a single, four-item construct. More conservative attitudes regarding sexuality in later life were associated with higher DDSI scores. In addition, DDSI scale scores were negatively correlated with knowledge about sexuality in later life and educational level. Findings indicate that the DDSI has good psychometric properties, as reflected by its high reliability and adequate validity, making it a useful assessment tool for future research. [Journal of Gerontological Nursing, 48(9), 27-37.].
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Tavoli A, Tavoli Z, Effatpanah M, Montazeri A. Prevalence and associated risk factors for sexual dysfunction among postmenopausal women: a study from Iran. Womens Midlife Health 2021; 7:10. [PMID: 34838138 PMCID: PMC8626990 DOI: 10.1186/s40695-021-00069-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Female Sexual Dysfunction (FSD) is a distressing condition linked to menopause. This study aimed to determine the prevalence and contributing factors for FSD among postmenopausal women. METHODS This was a cross-sectional study. A convenience sample of postmenopausal women attending a gynecology clinic in a teaching hospital affiliated with Tehran University of Medical Sciences was enrolled into the study. The Female Sexual Function Index (FSFI) was used to assess sexual function. In addition, demographic and psychosocial information were recorded. The association between sexual function and anxiety and depression were examined to explore the data. RESULTS In all 162 postmenopausal women were studied. We performed general linear regression analysis to assess the relationship between sexual function and anxiety while including demographic variables in the model. The results showed that the model could explain about 46% of the variance observed in sexual function (adjusted R2 = 0.467). The analysis indicated that among independent variables, age (p < 0.001), sexual frequency (p < 0.001), and anxiety (p = 0.003) were significant contributing factors associated with sexual function. A similar analysis evaluating the relationship between sexual function and depression in menopausal women found that age (p < 0.001), sexual frequency (p < 0.001), and depression (p = 0.003), were significant contributing factors associated with sexual function; explaining about 46% of the variance observed (adjusted R2 = 0.466). CONCLUSION The findings showed that nearly half of menopausal women had sexual dysfunction in this convenience sample of women seeking gynecologic care. Women reporting sexual dysfunction also reported a higher prevalence of anxiety and depression. Indeed, recognition of such factors requires a holistic therapeutic approach to sexual dysfunction among postmenopausal women.
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Affiliation(s)
- Azadeh Tavoli
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Zahra Tavoli
- Department of Obstetrics and Gynecology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Effatpanah
- Department of Psychiatry, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran
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Azar M, Azar N, Kroll T, Bradbury-Jones C. Should I Seek Help for Sexual Difficulties? Middle-Aged Lebanese Women's Views. JOURNAL OF SEX & MARITAL THERAPY 2021; 47:635-655. [PMID: 34154514 DOI: 10.1080/0092623x.2021.1934208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This qualitative study explored the way middle-aged Lebanese women address their sexual difficulties. Data analysis revealed three overarching themes and subthemes. From these we developed a help-seeking behavior framework for sexual difficulties. The framework focuses on: the perception of the problem, the beliefs about help-seeking and the sources of help. This framework can be used to facilitate access to personalized sexuality-related care based on a better understanding of the complex interplay of personal, socio-cultural and service-related factors that influence help-seeking behavior for sexual problems.
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Affiliation(s)
- Mathilde Azar
- Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
| | - Nagham Azar
- Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Thilo Kroll
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
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Mohamad Ishak NN, Jamani NA, Mohd Arifin SR, Abdul Hadi A, Abd Aziz KH. Exploring women's perceptions and experiences of menopause among East Coast Malaysian women. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2021; 16:84-92. [PMID: 33948146 PMCID: PMC8088743 DOI: 10.51866/oa1098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Menopause signifies the beginning of a non-reproductive phase from the reproductive period. Although it is considered a natural life transition, recent studies have indicated that a woman's menopausal experience may impact her quality of life. While studies have examined Malaysian women's knowledge and awareness of menopause, they have focused on the prevalence of menopausal symptoms and sociocultural aspects. These investigations also used a quantitative design that may have limited the information regarding the nature and experience of menopause. Objectives: This study explores women's perceptions and understanding of their menopausal experience. METHODS A total of 20 menopausal women were recruited using purposive sampling through social media in the state of Pahang, Malaysia. In-depth semi-structured interviews were used to explore how they perceived their menopausal experience. The data were then analyzed using thematic analysis. RESULTS Three themes that emerged from the findings included perceptions of menopause, biopsychosocial changes and help-seeking behavior. For many Muslim women, menopause was perceived as a time for them to engage in religious commitment more than they had before. CONCLUSION The study findings uncovered a knowledge gap and a lack of support for women impacted by menopause. Muslim women regarded their menopause phase as a time for them to engage in religious duty fully. These results indicate the need for a psychosocial intervention and educational program to ensure women a better transition throughout their menopausal phase.
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Affiliation(s)
- Nurul Najmi Mohamad Ishak
- MBBS, Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Nurjasmine Aida Jamani
- MD, M. Med (Fam Med), IBCLC, Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia Pahang, Malaysia,
| | - Siti Roshaidai Mohd Arifin
- PhD (Midwifery), MNSc, BHSc, RN, RM, Department of Special Care Nursing, Kulliyyah of Nursing International Islamic University Malaysia, Pahang, Malaysia
| | - Azwanis Abdul Hadi
- MBChB, M.Med (Fam Med), Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
| | - Karimah Hanim Abd Aziz
- MPH, DrPH, Department of Community Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Pahang, Malaysia
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El-Sakka AI. Middle East Cultural Challenges and the Treatment of Sexual Problems in Men. TRENDS IN ANDROLOGY AND SEXUAL MEDICINE 2020. [DOI: 10.1007/978-3-030-36222-5_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Dąbrowska-Galas M, Dąbrowska J, Michalski B. Sexual Dysfunction in Menopausal Women. Sex Med 2019; 7:472-479. [PMID: 31371259 PMCID: PMC6963159 DOI: 10.1016/j.esxm.2019.06.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Hormone-related changes in menopause may negatively affect sexual function. AIM The primary aim of this study was to evaluate sexual functioning in Polish women with the Female Sexual Function Index (FSFI). The secondary aim was to evaluate the major factors affecting sexual functions in middle-aged Polish women. METHODS The Menopause Rating Scale was used to assess the menopausal symptoms. The Polish translation of the FSFI was used to assess sexual function. OUTCOMES 69.73% of respondents had sexual dysfunction according to FSFI (FSFI score ≤ 26.55). RESULTS 80.61% of women experienced menopausal symptoms during the 4-week period of study. Psychological and urogenital symptoms were the most frequently reported among all the women enrolled in the study (78.23% and 77.21%). Sexual problems were observed in women who did not use hormone therapy (β = 0.09, t = -1.97, P = .048) and showed no somatic symptoms (β = 0.03, t = 2.95, P = .002). CLINICAL IMPLICATIONS It is important for health care providers to ask women about this problem and understand the factors that may influence sexual problems in menopause. STRENGTHS & LIMITATIONS A validated survey tool was used. The limitation was selection of participants in the clinical setting and sample population size. CONCLUSION Sexual problems were much more common in women who did not use hormone therapy and showed no somatic symptoms. Dąbrowska-Galas M, Dąbrowska J, Michalski B. Prevalence and Associated Risk Factors of Sexual Problems Among Polish Middle-Aged Women. Sex Med 2019;7:472-479.
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Affiliation(s)
- Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
| | - Jolanta Dąbrowska
- Department of Kinesitherapy and Special Methods, Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogdan Michalski
- Department of Nursing in Gynaecology and Obstetrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Khadivzadeh T, Ghazanfarpour M, Latifnejad Roudsari R. Cultural Barriers Influencing Midwives' Sexual Conversation with Menopausal Women. J Menopausal Med 2019; 24:210-216. [PMID: 30671415 PMCID: PMC6336569 DOI: 10.6118/jmm.2018.24.3.210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/28/2018] [Accepted: 09/09/2018] [Indexed: 12/05/2022] Open
Abstract
Objectives The present study aimed to determine the barriers influencing the sexual conversation. Methods In this descriptive cross-sectional study, 200 midwives were selected through convenience sampling method from private and public clinics in Mashhad, North East of Iran. A self-structured questionnaire was used to collect the study data. Results The mean age of subjects was 39.58 ± 8.12 years with 13.49 ± 7.59 years of work experience. A number of cultural conditions act as an inhibitory force for the midwives to address sexual issues with menopausal women. Menopausal women visit a doctor at the acute stage when emotional and physical problems make sexual discussion difficult for the midwives (86.5%). Other related causes for not having proper sexual conversation were insufficient knowledge (51.4%), inadequate education provided via public media through health providers (83.5%), midwives or their patient's shame (51.5%), and attempt to get help from traditional healers, friends, relatives and supplicants instead of midwifery staff (78.5%). Also, we found that sexual workshops, communication workshops, and work experiences had a significant influence in changing the views of midwives. Conclusions Cultural barriers prevent the patients and providers from communicating effectively with each other, thus highlighting the need for sexual and communication workshops for the health care providers.
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Affiliation(s)
- Talat Khadivzadeh
- Evidence-Based Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masumeh Ghazanfarpour
- Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Robab Latifnejad Roudsari
- Evidence-Based Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Najaf Najafi M, Ghazanfarpour M. Effect of phytoestrogens on sexual function in menopausal women: a systematic review and meta-analysis. Climacteric 2018; 21:437-445. [DOI: 10.1080/13697137.2018.1472566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- M. Najaf Najafi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M. Ghazanfarpour
- Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Babakhanian M, Ghazanfarpour M, Najafi MN, Dizavandi FR, Khadivzadeh T, Safaei M, Nooghabi MJ. Psychometric properties of the Persian language version of the Female Sexual Function index among postmenopausal women. J Turk Ger Gynecol Assoc 2018; 19:187-192. [PMID: 29865776 PMCID: PMC6250082 DOI: 10.4274/jtgga.2017.0131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective The present research aimed to evaluate the psychometric properties of the Persian language version of the Female Sexual Function Index (FSFI) among postmenopausal women. Material and Methods This secondary analysis examined 402 healthy postmenopausal Iranian women presenting to healthcare centers across Iran. The sampling method was convenience sampling. The translation of the FSFI and its cross-cultural adaptation were conducted under the guidelines proposed by Beaton. The reliability (Cronbach’s alpha coefficient and test-rest reliability) and construct validity confirmatory factor analysis) were assessed. Model fitting index [such as the root mean square error of approximation (RMSEA), the Goodness of Fit Index (GFI) and the Comparative Fit Index (CFI)] was calculated. Results The mean age of the study participants was 53.63±7.8 years. Test-retest reliability was high for both the entire scale (r=0.964; p<0.001) and its six dimensions (0.76-0.94; p<0.001). The Cronbach’s alpha of the entire scale and its dimensions was greater than 0.80. The original six-factor was used, which showed a relatively poor fit (χ2=667.054; p<0.001; χ2/df=4.86; GFI=0.92; RMSEA=0.098; GFI=0.85). After adding three correlated error terms to the six-factor model, an acceptable fit was obtained (χ2=470.542; p<0.001; χ2/df=3.51; CFI=0.95; RMSEA=0.079; GFI=0.89). Conclusion According to our results, the FSFI tool indicated a satisfactory fit for a six-factor model, as similar to the original English version, for use in clinical practice and research regarding healthy postmenopausal Iranian women. More research needs to be conducted on this scale to assess all of its psychometric properties.
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Affiliation(s)
- Masaudeh Babakhanian
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Masumeh Ghazanfarpour
- Department of Midwifery, Kerman University of Medical Sciences School of Nursing and Midwifery, Kerman, Iran
| | - Mona Najaf Najafi
- Department of Community Medicine, Imam Reza Clinical Research Units, Faculty of Medicine Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Rajab Dizavandi
- Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Department of Midwifery, Kerman University of Medical Sciences School of Nursing and Midwifery, Kerman, Iran
| | - Minoo Safaei
- Department of Midwifery, Kerman University of Medical Sciences School of Nursing and Midwifery, Kerman, Iran
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