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Pio J, Valadares AL, Costa Paiva L. Female and male factors that impact on frequency of sexual intercourse in aging couples: a cross-sectional study. Menopause 2024:00042192-990000000-00373. [PMID: 39190363 DOI: 10.1097/gme.0000000000002409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
OBJECTIVES To assess the prevalence and factors associated with dyspareunia and the lack of sexual intercourse in women between 50 and 70 years cohabiting with their partners. METHODS This is a descriptive and exploratory cross-sectional study using the snowball technique with prospective data collection using a structured questionnaire to describe multiple aspects of health and sexuality among 266 cohabiting Brazilian couples aged 50 to 70. RESULTS The prevalence of lack of sexual activity was 20%. Factors associated with sexual inactivity were female sexual dysfunction (OR: 9.87, 95% CI: 3.24-30.10, P < 0.001), female dissatisfaction with the partner as a lover (OR: 5.86, 95% CI: 2.03-16.88, P = 0.001), male sexual dysfunction (OR: 4.51, 95% CI: 1.60-12.70, P = 0.004), and poor self-rated male health (OR: 3.66, 95% CI: 1.29-10.40, P = 0.015). The prevalence of dyspareunia was 42.3% in the sample of sexually active women. Factors associated with dyspareunia were female sexual dysfunction (OR: 2.7, 95%, CI: 1.26-5.77, P = 0.010), moderate/severe vaginal dryness (OR: 4.67, 95% CI: 2.21-9.87, P < 0.001), and vaginal discomfort (OR: 4.03, 95% CI: 1.77-9.17, P < 0.001). CONCLUSIONS The results showed that male, female, and dyadic factors were associated with a lack of sexual activity. On the other hand, only female factors were associated with dyspareunia among sexually active couples.
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Affiliation(s)
- Janaina Pio
- From the Department of Obstetrics and Gynecology, School of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil
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Shahrahmani N, Babazadeh R, Ebadi A. Sexual satisfaction of postmenopausal women: An integrative review. PLoS One 2024; 19:e0306207. [PMID: 39078815 PMCID: PMC11288452 DOI: 10.1371/journal.pone.0306207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/12/2024] [Indexed: 08/02/2024] Open
Abstract
A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.
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Affiliation(s)
- Nasim Shahrahmani
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Raheleh Babazadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Giraldi A, Nappi RE, Palacios S, Reisman Y, Jannini EA. From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples. Sex Med Rev 2024; 12:346-354. [PMID: 38515320 DOI: 10.1093/sxmrev/qeae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/12/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Midlife men and women are facing frequent sexual problems that affect not only individuals' sexual health but also the sexual health of aging couples. OBJECTIVES To review the main sexual life challenges faced by midlife couples, to present the concepts of couplepause and doublepause as 2 new paradigms to address the sexual health needs of aging couples, and to discuss key aspects in couple-focused care. METHODS An online meeting attended by 5 European experts in sexual health was carried out in June 2023 to discuss the topic. The conversation centered on their clinical experience and expert opinion. Additionally, the indexed literature was reviewed to endorse and complement the expert opinions obtained in the aforementioned meeting. RESULTS Midlife men and women face physical, psychological, and sociocultural changes that affect their sexual activity. These changes may be experienced differently between genders. Both members of a couple may experience age-related changes concurrently or in an unsynchronized manner affecting their sexual health. Communication, sharing expectations, defining sexual dynamics, and couple goals are determinant for the sexual health of a midlife couple. Couplepause and doublepause are 2 new complementary paradigms that effectively address the sexual health needs of aging couples as a unit, considering physical, psychological, cultural, social, and dyadic-related factors. Couple-centered strategies should promote open communication about couple intimacy issues, understanding the diverse expectations according to gender and orientation, communication styles, and goals. The following are identified as crucial aspects to promote couple-focused care: education and training of health care professionals, the provision of information to aging couples, physician involvement in addressing sexual problems, the need for collaboration across medical specialties, and the development of effective tools and strategies. CONCLUSIONS The sexual problems of aging couples should be managed following couple-centered strategies that effectively address their sexual health needs as a couple.
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Affiliation(s)
- Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, 27100, Italy
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, 27100, Italy
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Adedeji AO, Olajubu AO, Aladegboye MK, Olowokere AE. Determinants of Sexual Health Status of Menopausal Women in Osun State, Nigeria. J Menopausal Med 2024; 30:44-53. [PMID: 38714493 PMCID: PMC11103074 DOI: 10.6118/jmm.22028] [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: 07/25/2022] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 05/10/2024] Open
Abstract
OBJECTIVES This study aimed to assess sexual health status and associated factors in menopausal women. METHODS The study employed a descriptive, cross-sectional design. It included 420 menopausal women aged 40-65 years from Ilesa West Local Government Area of Osun State. A structured questionnaire was used, and the data were analyzed using descriptive and inferential statistics. RESULTS The mean age of the study respondents was 54.74 ± 5.49 years. A little over half (52.4%) of the respondents exhibited good sexual health status, whereas 47.6% had poor sexual health status. Logistic regression analysis revealed that lack of financial resources (P = 0.01; odds ratio [OR], 4.00; 95% confidence interval [95% CI], 1.45-11.02), loss of partner (P = 0.01; OR, 9.18; 95% CI, 2.89-29.09), and limited communication with partner (P = 0.01; OR, 3.12; 95% CI, 1.51-6.46) were predictors of poor sexual health status. CONCLUSIONS This study provides insight into the determinants of the sexual health status of menopausal women, which may help health care providers and policymakers develop effective strategies to improve the sexual health of menopausal women.
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Affiliation(s)
| | | | - Mercy Kikelomo Aladegboye
- Department of Community Health Nursing, Faculty of Nursing Sciences, University of Medical Sciences, Ondo, Nigeria
| | - Adekemi Eunice Olowokere
- Department of Nursing Science, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Wellings K, Gibson L, Lewis R, Datta J, Macdowall W, Mitchell K. "We're Just Tired": Influences on Sexual Activity Among Male-Partnered Women in Midlife; A Mixed Method Study. JOURNAL OF SEX RESEARCH 2023; 60:1304-1317. [PMID: 36757684 DOI: 10.1080/00224499.2023.2165613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Studies into decline in sexual activity among women in midlife produce equivocal findings, some implicating hormonal and physiological changes, others psycho-social and environmental factors. Women's perspectives rarely inform interpretation of the data. Associations between sexual satisfaction, activity and function, and health and lifestyle factors were explored using data from 2133 female participants in the third British National Survey of Sexual Attitudes and Lifestyles (2010-2012). Semi-structured interviews (2012-2015) with 23 women aged 45-59 reporting sexual dissatisfaction in Natsal-3 explored their perceptions of the influences on their sexual activity. Analysis of the survey data showed sexual dissatisfaction to be less common than low frequency and function. Neither menopausal stage nor age was independently associated with any of the dimensions of sexual experience. Only relationship unhappiness was independently associated with all three and communicational difficulty with two (dissatisfaction and lower function). In-depth interviews identified influences on sexual activity not captured in the survey. Tiredness attributed to contemporary challenges of midlife was a dominant theme. Relationship quality mediated its adverse impact. Sexual experience in midlife must be interpreted in light of both life-stage and era, notably, the increasing demands on women in contemporary society and their impact on vitality. Efforts to address sexual wellbeing should take account of the wider social context.
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Affiliation(s)
- Kaye Wellings
- Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Lorna Gibson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Ruth Lewis
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jessica Datta
- Social and Environmental Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Wendy Macdowall
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Kirstin Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Carmen A, Anne O, Monika S, Daniel E, Johannes G, Verena M, Michael H, Christine B. Does the toxicity of endocrine therapy persist into long-term survivorship?: Patient-reported outcome results from a follow-up study beyond a 10-year-survival. Breast Cancer Res Treat 2023; 198:475-485. [PMID: 36418518 PMCID: PMC10036266 DOI: 10.1007/s10549-022-06808-9] [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: 04/09/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Endocrine treatment (ET) is a highly effective breast cancer treatment but can distinctly impair breast cancer patients' quality of life (QOL). In a patient-reported outcome (PROs) study conducted by the authors in 2011, patients reported higher ET-induced symptom levels than known from the registration trials, and was underestimated. Based on these study results, we investigated the long-term sequelae of ET reported by breast cancer survivors (BCS) in a follow-up study conducted 5-10 years after an earlier assessment. METHODS BCS who had participated in the earlier study (n = 436) were approached for study participation either at one of their routine follow-up appointments or via mail; consenting patients were asked to completed the same PRO assessment used in the original study (FACT-B + ES). BCS with relapse/ progressive disease were excluded from the analysis. We compared long-term endocrine symptomatology and overall QOL outcome (i.e. FACT-G and -ES sum score). RESULTS A final sample of 268 BCS was included in the analysis. BCS reported a significant improvement of the overall endocrine symptomatology (baseline mean = 59 vs. follow-up mean = 62, p < 0.001), physical (baseline = 23.9 mean vs. follow-up mean = 24.8, p < 0.01) and functional well-being (baseline mean = 21.7 vs. follow-up mean = 22.7, p = 0.013) and overall QOL (mean baseline = 88.3 vs. mean follow-up = 90.9, p = 0.011). However, the prevalence of particular symptoms, well-known to be ET induced, did not change over time such as joint pain (baseline = 45.5% vs. 44.2%, n.s. difference), lack of energy (36.4% vs 33.8%, n.s. difference), weight gain (36.8% vs. 33.9%, n.s. difference) or vaginal dryness (30.2% vs. 33%, n.s. difference) and the proportion reporting lack of interest in sex increased (40.4% vs. 48.7%, p < 0.05). CONCLUSION Presented results indicate that BCS recover well in terms of overall endocrine symptomatology and quality of life but experience some clinically relevant and unfavorable ET-related long-term effects.
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Affiliation(s)
- Albertini Carmen
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Oberguggenberger Anne
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria.
| | - Sztankay Monika
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Egle Daniel
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Giesinger Johannes
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Meraner Verena
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, CL Service, University Hospital of Psychiatry II, Medical University of Innsbruck, Innrain 52, A-6020, Innsbruck, Austria
| | - Hubalek Michael
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
| | - Brunner Christine
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria
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Rostami-Moez M, Masoumi SZ, Otogara M, Farahani F, Alimohammadi S, Oshvandi K. Examining the Health-Related Needs of Females during Menopause: A Systematic Review Study. J Menopausal Med 2023; 29:1-20. [PMID: 37160298 PMCID: PMC10183767 DOI: 10.6118/jmm.22033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/19/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023] Open
Abstract
Menopause is one the most crucial stages in a female's life. Identifying the education gaps regarding menopause is important, thus this study aims to explain the health-related needs of females during menopause. Scopus, PubMed, Scientific Information Database, and Web of Science databases were searched for the available observational (cohort, case-control, and cross-sectional), systematic review, meta-analysis, and clinical trial studies (2007-2021) using keywords, such as 'Educational Needs Assessment,' 'Assessment of Healthcare Needs,' 'menopause,' 'climacteric,' 'premenopause,' and 'postmenopause.' A total of 180 out of 5,705 papers were evaluated after considering the inclusion and exclusion criteria. The educational needs of females during menopause in the reviewed studies include osteoporosis, oral and dental problems, metabolic disorders, cardiovascular diseases, hypertension, lung diseases, infectious diseases, musculoskeletal problems, urinary problems, breast cancer, defecation problems, genital disorders, special diseases such as eye diseases and hypothyroidism and hormone therapy, mental disorders, cognitive function, sleep disorders, sexual disorders, physical activity, supplement consumption, public health issues, health education, fall, and nutrition. The study results reveal that females during postmenopause require training, counseling, and support in all aspects to get through this challenging time, and providing these services, infrastructure, appropriate policy, and the use and support of the medical team's capacity are all required.
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Affiliation(s)
- Masoumeh Rostami-Moez
- Research Center for Health Sciences, Education Development Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Marzieh Otogara
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farhad Farahani
- Department of Ear, Nose and Throat, School of Medicine, Hearing Disorder Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shohreh Alimohammadi
- Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Obalowu IA, Odeigah LO, Mohammed A, Ademola CO, Yusuf AR. Pattern and Predictors of Sexual Activity among Postmenopausal Women Attending a Family Medicine Clinic in Ilorin, North-Central Nigeria. J Menopausal Med 2022; 28:121-127. [PMID: 36647275 PMCID: PMC9843035 DOI: 10.6118/jmm.22015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/03/2022] [Accepted: 12/22/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Sexual activity tends to decline with age and is greatly impacted in postmenopausal women. This study aimed to describe the sexual activity pattern among postmenopausal Nigerian women and also detect socio-demographic and menopause-related predictors of their sexual activity. METHODS In this hospital-based cross-sectional study, 357 postmenopausal women between 45-60 years participated. Data was collected using the sexual activity questionnaire and a socio-demographic questionnaire developed by the authors. RESULTS The prevalence of sexual inactivity among the participants was 60%. This was attributed mainly to the unavailability of male partners (50.5%) and negative menopause-related sociocultural beliefs (23.8%). Among sexually active participants, 83.2% of them reported having pleasurable experiences and 53.8% of them reported no associated sexual discomfort. Only being in a marital relationship was found to be a statistically significant predictor of sexual activity among the participants (regression coefficient = 3.125, degree of freedom = 1, P < 0.0001). CONCLUSIONS We reported a high prevalence of sexual inactivity among the participants; the most important reasons given were the unavailability of their husbands and the belief that sexual intercourse was taboo during the postmenopausal period. The study also provided positive evidence for the importance of marriage for sexual activity among the participants.
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Affiliation(s)
| | | | | | | | - Adebayo Ramat Yusuf
- Department of Family Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Sung ML, Black AC, Blevins D, Henry BF, Cates-Wessel K, Dawes MA, Drexler K, Hagle H, Molfenter T, Levin FR, Becker WC, Edelman EJ. Adaptations to Opioid Use Disorder Care During the COVID-19 Pandemic: A National Survey of Prescribers. J Addict Med 2022; 16:505-513. [PMID: 35020698 PMCID: PMC9271533 DOI: 10.1097/adm.0000000000000948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Among opioid use disorder (OUD)-treating providers, to characterize adaptations used to provide medications for OUD (MOUD) and factors associated with desire to continue virtual visits post-COVID-19 pandemic. METHODS In a national electronic survey of OUD-treating prescribers (July-August 2020), analyses restricted to X-waivered buprenorphine prescribers providing outpatient, longitudinal care for adults with OUD, quantitative and qualitative analyses of survey items and free text responses were conducted. RESULTS Among 797 respondents, 49% were men, 57% ≥50 years, 76% White, 68% physicians. Respondents widely used virtual visits to continue prescribing existing MOUD regimens (79%), provide behavioral healthcare (71%), and initiate new MOUD prescriptions (49%). Most prescribers preferred to continue/expand use of virtual visits after COVID-19. In multivariable models, factors associated with preference to continue/expand virtual visits to initiate MOUD postpandemic were treating a moderate number of patients prepandemic (aOR = 1.67; 95%[CI] = 1.06,2.62) and practicing in an urban setting (aOR = 2.17; 95%[CI] = 1.48,3.18). Prescribing buprenorphine prepandemic (aOR = 2.06; 95%[CI] = 1.11,3.82) and working in an academic medical center (aOR = 2.47; 95%[CI] = 1.30,4.68) were associated with preference to continue/expand use of virtual visits to continue MOUD postpandemic. Prescribing naltrexone extended-release injection prepandemic was associated with preference to continue/expand virtual visits to initiate and continue MOUD (aOR = 1.51; 95%[CI] = 1.10,2.07; aOR = 1.74; 95%[CI] = 1.19,2.54). Qualitative findings suggest that providers appreciated virtual visits due to convenience and patient accessibility, but were concerned about liability and technological barriers. CONCLUSIONS Surveyed prescribers widely used virtual visits to provide MOUD with overall positive experiences. Future studies should evaluate the impact of virtual visits on MOUD access and retention and clinical outcomes.
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Affiliation(s)
- Minhee L. Sung
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Anne C. Black
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Derek Blevins
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Brandy F. Henry
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Kathryn Cates-Wessel
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Michael A. Dawes
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Karen Drexler
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Holly Hagle
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Todd Molfenter
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - Frances R. Levin
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - William C. Becker
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
| | - E. Jennifer Edelman
- From the VA Health Services Research & Development, West Haven, CT (MLS); VA Connecticut Healthcare System, West Haven, CT (MLS, ACB, WCB); Yale School of Medicine, New Haven, CT (MLS, ACB, WCB, EJE); Columbia University Vagelos College of Physicians and Surgeons; New York State Psychiatric Institute, Division on Substance Use Disorders, New York City, NY (DB, FRL); School of Social Work, Columbia University, New York, NY (BFH); College of Education, Pennsylvania State University, University Park, PA (BFH); American Academy of Addiction Psychiatry, East Providence, RI (KC-W); Boston University Medical Center, Boston, MA (MAD); Emory University, Atlanta, GA (KD); Addiction Technology Transfer Center Network Coordinating Office, University of Missouri, Kansas City, Kansas City, MO(HH); Center for Health Enhancement Systems Studies, University of Wisconsin, Madison WI (TM); Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT (EJE)
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10
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Khosravi A, Riazi H, Simbar M, Montazeri A. Effectiveness of Kegel exercise and lubricant gel for improving sexual function in menopausal women: A randomized trial. Eur J Obstet Gynecol Reprod Biol 2022; 274:106-112. [PMID: 35640438 DOI: 10.1016/j.ejogrb.2022.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/07/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are different approaches to improving sexual function among menopausal women including Kegel exercise and using lubricant gel. However, it is not clear which of these methods could be more effective. This study aimed to compare the effectiveness of these two methods on sexual function in menopausal women. METHODS The present randomized trial was conducted on 150 menopausal women in Dezful, Iran. Eligible women were randomly assigned to two interventions (Kegel exercise and lubricating gel) and one control groups. The Kegel exercise group received training on the exercise method; the lubricant gel group was given the lubricating gel and taught how it should be used, while the control group received no intervention. The interventions continued for 12 weeks, and sexual function was assessed at four times: baseline, one month, two months, and three-months follow-up. Chi-square test, one-way analysis of variance, repeated measures, analysis of covariance, and logistic regression analyses were applied. RESULTS No significant difference was found between groups regarding demographic and obstetrics variables. After adjusting for the baseline sexual function score, covariate analysis showed a significant improvement in sexual function in Kegel and gel groups as compared to the control group. Similarly, within-group comparison using repeated measures analysis showed that sexual function in both Kegel and gel groups improved during the study follow-up periods while women in the control group showed no changes in their sexual function. Finally, logistic regression analysis indicated a significantly higher odds ratio for better sexual function in both Kegel and gel groups. However, the odds of better sexual function for the Kegel group (OR = 4.19, 95% CI: 1.81-9.72, P = 0.001) was higher than the gel group (OR = 3.7, 95% CI: 1.42-7.52, P = 0.005). CONCLUSION Both Kegel exercise and gel were effectively improved sexual function in menopausal women. However, the findings indicated that sexual function was more likely to be improved after using Kegel exercise than using lubricant gel. TRIAL REGISTRATION IRCT20150128020854N7. Registered 30 September 2019, https://fa.irct.ir/user/trial/40878/view.
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Affiliation(s)
- Atefeh Khosravi
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedyeh Riazi
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Masoumeh Simbar
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran; Faculty of Humanity Sciences, University of Science and Culture, Tehran, Iran.
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11
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Predictors of Sexual Function and Performance in Young- and Middle-Old Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074207. [PMID: 35409888 PMCID: PMC8999058 DOI: 10.3390/ijerph19074207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022]
Abstract
Background: Maintaining sexual life in older women might be perceived as a measure of healthy and successful aging. This study aimed to establish the prevalence of female sexual dysfunction (FSD) based on the DSM-5 criteria and predictors of sexual performance in older women. Methods: A total of 185 women between 55 and 79 years old were included in the study. Validated scales were used to assess sexual function (Changes in Sexual Function Questionnaire (CSFQ)), the propensity for sexual excitation/inhibition (Sexual Excitation/Sexual Inhibition Inventory for Women), and sexual anxiety/avoidance (Body Exposure during Sexual Activity Questionnaire (BESAQ)). Multiple regression was used to assess the factors affecting sexual function and the prevalence of FDS. Results: Sexual distress was diagnosed in 14.1% of women, and FSD in 16.2% (n = 53), whereas sexual problems (CSFQ) were diagnosed in 33.3% of women, and distressing sexual concerns in 35.1%. Women with a lower number of male sexual partners (β = −0.22), a better attitude toward sex (β = 0.25), higher importance of sex (β = 0.31), a higher level of sexual excitation (β = 0.34), and that were sexually active (β = 0.39) had better sexual function, as evaluated by CSFQ. Conclusions: Most older women remain sexually active. The diversity of sexual activity in later life should be affirmed to encourage women to be sexually active and to strengthen the response to sexual stimuli.
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12
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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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13
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Wolfman W, Krakowsky Y, Fortier M. Guideline No. 422d: Menopause and Sexuality. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2021; 43:1334-1341.e1. [PMID: 34537418 DOI: 10.1016/j.jogc.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Provide strategies for improving the care of perimenopausal and postmenopausal women based on the most recent published evidence. TARGET POPULATION Perimenopausal and postmenopausal women. BENEFITS, HARMS, AND COSTS Target population will benefit from the most recent published scientific evidence provided via the information from their health care provider. No harms or costs are involved with this information since women will have the opportunity to choose among the different therapeutic options for the management of the symptoms and morbidities associated with menopause, including the option to choose no treatment. EVIDENCE Databases consulted were PubMed, MEDLINE, and the Cochrane Library for the years 2002-2020, and MeSH search terms were specific for each topic developed through the 7 chapters. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE: physicians, including gynaecologists, obstetricians, family physicians, internists, emergency medicine specialists; nurses, including registered nurses and nurse practitioners; pharmacists; medical trainees, including medical students, residents, fellows; and other providers of health care for the target population. SUMMARY STATEMENTS RECOMMENDATIONS.
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14
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Wolfman W, Krakowsky Y, Fortier M. Directive clinique n o 422d : Ménopause et sexualité. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2021; 43:1342-1351.e1. [PMID: 34555546 DOI: 10.1016/j.jogc.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Brennan-Ing M, Kaufman JE, Larson B, Gamarel KE, Seidel L, Karpiak SE. Sexual Health Among Lesbian, Gay, Bisexual, and Heterosexual Older Adults: An Exploratory Analysis. Clin Gerontol 2021; 44:222-234. [PMID: 33203315 DOI: 10.1080/07317115.2020.1846103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: A significant gap in our knowledge concerns sexual health among the older lesbian, gay, and bisexual (LGB) population.Methods: We compared a community-based sample of self-identified LGB older adults (n = 128) with population-based samples of behaviorally-defined LGB older adults (i.e., reporting same-sex experiences) (n = 112) and behaviorally-defined older heterosexuals (i.e., reporting no same-sex experiences) (n = 2,893) from the National Social Life, Health and Aging Project (NSHAP). Differences in sexual activity and sexual problems were examined.Results: Older LGB adults were as likely to remain sexually active as older heterosexuals. Gay and bisexual men were more likely than heterosexual men to report some sexual problems. Regardless of sexual orientation, older adults rarely had their sexual health needs addressed in healthcare settings.Conclusions: Results highlight the need for more research on LGB older adult sexual health.Clinical Implications: The lack of attention to LGB older adults' sexual health in healthcare settings may be exacerbated by ageism and heterosexism, leading these individuals to avoid disclosing their sexual orientations and avoid conversations about sexuality. Mental health practitioners require education on associations between sexual health and mental health, and how sexual health problems may contribute to mental health concerns in vulnerable populations like older LGB adults.
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Affiliation(s)
- Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | - Jennifer E Kaufman
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | | | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Liz Seidel
- Hartford Institute of Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Stephen E Karpiak
- ACRIA Center on HIV and Aging at GMHC, New York, New York, USA
- New York University Rory Meyers College of Nursing, New York, New York, USA
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Bourchier L, Malta S, Temple-Smith M, Hocking J. Do we need to worry about sexually transmissible infections (STIs) in older women in Australia? An investigation of STI trends between 2000 and 2018. Sex Health 2020; 17:517-524. [PMID: 33334416 DOI: 10.1071/sh20130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022]
Abstract
Background This study examined trends in chlamydia, gonorrhoea and syphilis diagnosis, and chlamydia testing and positivity, among older women in Australia between 2000 and 2018. METHODS Using national notifiable disease data and Medicare data, diagnosis rates were calculated for each sexually transmissible infection (STI), as well as testing and positivity rates for chlamydia. Data were compared between two older groups (55-64 and 65-74 years) and two younger groups (15-24 and 25-34 years). Poisson regression examined trends for 2000-18 and 2014-18 separately. RESULTS Rates for all STIs increased across all age groups and were highest in the two youngest age groups. From 2014 to 2018, chlamydia rates increased the most among those aged 55-64 years [incidence rate ratio (IRR) = 1.06; 95%CI: 1.02-1.10] and declined in those aged 15-24 years (IRR = 0.99; 95%CI: 0.99-0.99). Gonorrhoea rates increased the most among those aged 65-74 years (IRR = 1.47; 95%CI: 1.23-1.77) and least in those aged 15-24 years (IRR = 1.12; 95%CI: 1.10-1.13). Syphilis rates increased the most among those aged 55-64 years (IRR = 1.58; 95%CI: 1.25-1.99) and least in those aged 15-24 years (IRR = 1.29; 95%CI: 1.23-1.35). Chlamydia test positivity declined among younger women but remained stable in older women. CONCLUSIONS In general, STIs are increasing among older women in Australia at a faster rate than among younger women. Although the greatest burden is among younger women, STIs need to be considered and monitored among older women.
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Affiliation(s)
- Louise Bourchier
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and Corresponding author.
| | - Sue Malta
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and National Ageing Research Institute, Poplar Road, Parkville, Vic. 3052, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia
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Faubion SS, Fairbanks F, Kuhle CL, Sood R, Kling JM, Vencill JA, Mara KC, Kapoor E. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020; 17:1971-1980. [PMID: 32771351 DOI: 10.1016/j.jsxm.2020.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/24/2020] [Accepted: 07/02/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Obesity and female sexual dysfunction (FSD) are prevalent conditions, and both are associated with significant adverse effects on health and well-being. AIM To investigate the association between body mass index and FSD, as well as potential moderators. METHODS This cross-sectional study was performed by analyzing medical records of 6,688 women seeking consultation for menopause-related or sexual health-related concerns at women's health clinics at Mayo Clinic Rochester, MN, and Scottsdale, AZ, between May 1, 2015, and September 15, 2019. OUTCOMES Female sexual function was assessed by the Female Sexual Function Index, and sexual distress was assessed by the Female Sexual Distress Scale-Revised. RESULTS Being overweight or obese was associated with a lack of sexual activity. Among sexually active women, those who were overweight or obese had lower Female Sexual Function Index total scores and sexual function domain scores (indicating worse sexual function), including sexual arousal, lubrication, satisfaction, orgasm, and pain, and higher levels of sexual distress than those with normal weight. However, on multivariable analysis, these associations were found to be mediated by other factors, including age, level of education, reproductive stage, medication use, and mood disturbances, which are known to impact body weight and sexual function in women. CLINICAL IMPLICATIONS Overweight and obesity were associated with sexual inactivity and greater odds of having FSD, which should prompt proactive assessment of sexual function. STRENGTHS AND LIMITATIONS The strengths of this study include the large cohort size and assessment of sexual problems in addition to sexual distress, a key component of the definition of sexual dysfunction. This study also took into account multiple potential moderating factors. Limitations include the cross-sectional design, which precludes determination of causality as well as lack of diversity in the cohort, potentially limiting generalizability of results. In addition, sexual function was not assessed in women reporting no recent sexual activity, which may confound results. CONCLUSION Overweight/obesity and FSD are highly prevalent conditions, which appear to be indirectly associated. These results highlight the need to identify and address FSD in all overweight and obese women, with particular attention to potential contributing factors. Faubion SS, Fairbanks F, Kuhle CL, et al. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020;17:1971-1980.
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Affiliation(s)
- Stephanie S Faubion
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
| | - Flavia Fairbanks
- Department of Obstetrics and Gynecology and PROSEX, University of Sāo Paulo School of Medicine, Sao Paulo, Brazil
| | - Carol L Kuhle
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Richa Sood
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juliana M Kling
- Division of Women's Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Jennifer A Vencill
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Ekta Kapoor
- Center for Women's Health, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA
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Lonza A, Štulhofer A, Graham C. Emotional Intimacy and Distress About Sexual Difficulties in Partnered Older European Men and Women: A Network Analysis. JOURNAL OF SEX & MARITAL THERAPY 2020; 46:474-490. [PMID: 32370627 DOI: 10.1080/0092623x.2020.1760979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Although research in older individuals' sexual health is steadily increasing, the nature of, and predictors related to, their distress about changes in sexual function have not been well-studied. Using data from sexually active and partnered 1,047 Norwegian and Danish women and men aged 60-75 years, this study employed network analysis to explore the structure of older individuals' sexual distress and the role of emotional intimacy. Men's network of sexual distress facets was more densely interconnected than women's network. Higher emotional intimacy was associated with lower sexual distress levels across gender. The findings have implications for sexual health interventions targeting older people.
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Affiliation(s)
- Anamarija Lonza
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Cynthia Graham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, England
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Shifren JL. Midlife sexuality in women's words. Menopause 2019; 26:1088-1089. [PMID: 31567870 DOI: 10.1097/gme.0000000000001408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jan L Shifren
- Department of Obstetrics and Gynecology, Midlife Women's Health Center, Massachusetts General Hospital, Boston, MA
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