1
|
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.
Collapse
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
| |
Collapse
|
2
|
Rasmussen EB, Camp L, Lawyer SR. The Use of Nonmonetary Outcomes in Health-Related Delay Discounting Research: Review and Recommendations. Perspect Behav Sci 2024; 47:523-558. [PMID: 39099748 PMCID: PMC11294320 DOI: 10.1007/s40614-024-00403-7] [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] [Accepted: 03/06/2024] [Indexed: 08/06/2024] Open
Abstract
Delay discounting (DD) refers to the tendency to devalue an outcome as a function of its delay. Most contemporary human DD research uses hypothetical money to assess individual rates of DD. However, nonmonetary outcomes such as food, substances of misuse, and sexual outcomes have been used as well, and have advantages because of their connections to health. This article reviews the literature on the use of nonmonetary outcomes of food, drugs, and sexual outcomes in relation to health and reinforcer pathologies such as substance use disorders, obesity, and sexual risk behaviors, respectively, and makes a case for their use in discounting research. First, food, substances, and sex may be more ecologically valid outcomes than money in terms of their connections to health problems and reinforcer pathologies. Second, consistent trends in commodity-specific (i.e., domain) effects, in which nonmonetary outcomes are discounted more steeply than money, enhance variation in discounting values. Third, commodity-specific changes in discounting with treatments designed to change health choices are described. Finally, methodological trends such as test-retest reliability, magnitude effects, the use of hypothetical versus real outcomes, and age-related effects are discussed in relation to the three outcome types and compared to trends with monetary discounting. Limitations that center around individual preferences, nonsystematic data, and deprivation are discussed. We argue that researchers can enhance their DD research, especially those related to health problems and reinforcer pathologies, with the use of nonmonetary outcomes. Recommendations for future directions of research are delineated.
Collapse
Affiliation(s)
- Erin B. Rasmussen
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| | - Lillith Camp
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| | - Steven R. Lawyer
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| |
Collapse
|
3
|
Cameron J, Santos-Iglesias P. Sexual Activity of Older Adults: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:145-166. [PMID: 38616794 PMCID: PMC11008554 DOI: 10.1080/19317611.2024.2318388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/07/2024] [Indexed: 04/16/2024]
Abstract
Objective: The goal was to conduct a literature review of studies that examined sexual activity in older adults. Method: A systematic search was conducted to identify studies that had examined sexual activity in adults aged 60 years and older. The main characteristics of each study and results were examined and reported according to PRISMA guidelines. Results: Sixty-three articles were found. These articles were classified into three main groups based on the results they presented: percentage of older adults that were sexually active; frequency of sexual activity; and type of sexual activities. The results show that older adults are sexually active, engage in frequent sexual activity, and participate in a wide variety of activities. Conclusions: Although older adults remain sexually active, differences in the way sexual activity is assessed limit the drawing of firm conclusions and our understanding of the sexual activity of older adults. We propose a series of recommendations to gain a better understanding of this topic.
Collapse
Affiliation(s)
- Joshua Cameron
- Department of Psychology, Cape Breton University, Sydney, Nova Scotia, Canada
| | | |
Collapse
|
4
|
Gupta N, Zebib L, Wittmann D, Nelson CJ, Salter CA, Mulhall JP, Byrne N, Nolasco TS, Loeb S. Understanding the sexual health perceptions, concerns, and needs of female partners of prostate cancer survivors. J Sex Med 2023; 20:651-660. [PMID: 36941211 PMCID: PMC10149377 DOI: 10.1093/jsxmed/qdad027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/25/2023] [Accepted: 02/10/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Prostate cancer (PCa) and its treatments can have a significant negative impact on the sexual health of survivors and couples, but few studies have specifically examined the impact of PCa-related sexual dysfunction on female partners of survivors. AIM Our objective was to perform a qualitative study to comprehensively characterize female partners' perceptions of the implications of PCa on their sex lives, as well as partners' sexual health concerns and unmet needs. METHODS We conducted semi-structured telephone interviews about sexual health and unmet needs with female partners of PCa survivors recruited from multiple clinical locations and support groups for PCa caregivers from September 2021 to March 2022. Interviews were audio-recorded, transcribed verbatim, and independently coded. Participants were recruited until thematic saturation was achieved. OUTCOMES Outcomes of this study were female partner sexual health concerns and unmet needs. RESULTS Among 12 participants, the median age was 65 (range 53 to 81) years, 9 were White, the median time since their partner's PCa diagnosis was 2.25 years (range 11 months to 20 years), and a majority reported that their partner had undergone radical prostatectomy, radiation, and/or hormonal therapy. Major emergent themes pertained to the significant impact of age- and PCa-related sexual dysfunction on female sexual quality of life, the dyadic nature of sexual dysfunction and recovery, the role of the partner in coping with and adjusting to sexual dysfunction, difficulties communicating about sexual dysfunction in an intimate relationship, a lack of physician-led sexual health counseling and support, and the benefit of peer interactions and proactive information seeking in addressing unmet sexual health needs. CLINICAL IMPLICATIONS Future efforts should continue to explore the impact of PCa on partner sexual health and address unmet needs through sexual health education and support. STRENGTHS AND LIMITATIONS In this study, we identified female partners' sexual health concerns both related to and independent of PCa survivor sexual health. Limitations include exclusion of male partners of survivors and potential responder bias, as partners who agreed to participate may have experienced more sexual health concerns. CONCLUSION We found that female partners experience PCa-related sexual dysfunction as a couple's disease, grief due to age- and PCa-related sexual losses, and a lack of physician-led sexual health counseling and information. Our results highlight the importance of including partners of PCa survivors in the sexual recovery process and of developing sexual care programs to address partners' unmet sexual health needs.
Collapse
Affiliation(s)
- Natasha Gupta
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, MI 48109, United States
| | - Christian J Nelson
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Carolyn A Salter
- Department of Urology, Madigan Army Medical Center, Tacoma, WA 98431, United States
| | - John P Mulhall
- Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Nataliya Byrne
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Tatiana Sanchez Nolasco
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| | - Stacy Loeb
- Department of Urology, New York University, New York, NY 10016, United States
- Department of Population Health, New York University, New York, NY 10016, United States
- Manhattan Veteran Affairs, New York, NY 10010, United States
| |
Collapse
|
5
|
Radnia N, Hosseini ST, Vafaei SY, Pirdehghan A, Mehrabadi NL. The effect of conjugated estrogens vaginal cream and a combined vaginal cream of vitamins D and E in the treatment of genitourinary syndrome. J Family Med Prim Care 2023; 12:507-516. [PMID: 37122641 PMCID: PMC10131947 DOI: 10.4103/jfmpc.jfmpc_1364_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/24/2022] [Accepted: 11/14/2022] [Indexed: 05/02/2023] Open
Abstract
Background and Aim Genitourinary syndrome occurs due to a decrease in ovarian hormones; this can have a significant negative impact on women's interpersonal relationships and sexual function. The present study aimed at comparing the therapeutic effect of conjugated estrogens vaginal cream and a combined vaginal cream of vitamins D and E in the treatment of genitourinary syndrome in postmenopausal women. Methods This study was conducted as a double-blind randomized clinical trial (RCT). As many as 64 postmenopausal women suffering from genitourinary syndrome were randomly divided into study and control groups. The study group was treated with a combined vaginal cream of vitamins D and E, and the control group was treated with conjugated estrogens vaginal creams for 12 weeks. The patients were visited at the beginning of being admitted, the fourth week, the 12th week, and four weeks after the treatment and their information was recorded by checklists and a sexual function questionnaire. The data were finally analyzed by SPSS-25 at a significant level of 0.05. Result At four visits, libido, orgasm, and frequency of sexual intercourses, as well as vaginal symptoms such as burning, itching, dryness, and dyspareunia were improved in both groups (P <.05). However, there was no difference between the two groups in terms of the frequency of severity of these symptoms during the four visits (P >.05). Investigating the female sexual function index showed that using vitamin D and E vaginal creams, like the use of conjugated estrogens vaginal creams, improves sexual function in women (P <.01). Conclusion According to the results, it can be concluded that the combined vaginal cream of vitamins D and E is a suitable alternative to vaginal estrogens in relieving the symptoms of genitourinary syndrome in postmenopausal women, especially those who are unable to use hormone therapy or have little compatibility with this therapy.
Collapse
Affiliation(s)
- Nahid Radnia
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Tahereh Hosseini
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Address for correspondence: Dr. Seyedeh Tahereh Hosseini, Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. E-mail:
| | - Seyed Yaser Vafaei
- Department of Pharmaceutics, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azar Pirdehghan
- Department of Community Medicine, School of Public Health and Research Center for Health Science, Hamadan University of Medical Sciences, Hamadan, Iran
| | | |
Collapse
|
6
|
Henning G, Segel-Karpas D, Praetorius Björk M, Bjälkebring P, Berg AI. Retirement and Sexual Satisfaction. THE GERONTOLOGIST 2023; 63:274-284. [PMID: 35876786 DOI: 10.1093/geront/gnac102] [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: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner. RESEARCH DESIGN AND METHODS Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years. RESULTS On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction. DISCUSSION AND IMPLICATIONS Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted.
Collapse
Affiliation(s)
| | | | - Marcus Praetorius Björk
- Department of Research, Education and Innovation, Region Västra Götaland, South Älvsborg Hospital, Borås, Sweden.,Research, Development, Education and Innovation, Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
| | - Pär Bjälkebring
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | | |
Collapse
|
7
|
Sexual activity and successful aging. Eur Geriatr Med 2022; 13:1235-1238. [PMID: 36068402 DOI: 10.1007/s41999-022-00694-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
8
|
Vasconcelos P, Paúl C, Serruya SJ, Ponce de León RG, Nobre P. A systematic review of sexual health and subjective well-being in older age groups. Rev Panam Salud Publica 2022; 46:e179. [PMID: 36320206 PMCID: PMC9595221 DOI: 10.26633/rpsp.2022.179] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives. This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods. A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as “sexual health” or “sexuality” and “well-being” and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results. A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dissertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions. This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.
Collapse
Affiliation(s)
- Priscila Vasconcelos
- Center for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Constança Paúl
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Suzanne J. Serruya
- Latin American Center of Perinatology, Women and Reproductive Health (CLAP/WR), Montevideo, Uruguay
| | | | - Pedro Nobre
- Center for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| |
Collapse
|
9
|
Beerepoot S, Luesken SWM, Huisman M, Deeg DJH. Enjoyment of Sexuality and Longevity in Late Midlife and Older Adults: The Longitudinal Ageing Study Amsterdam. J Appl Gerontol 2022; 41:1615-1624. [PMID: 35324364 PMCID: PMC9082964 DOI: 10.1177/07334648221078852] [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] [Indexed: 11/23/2022] Open
Abstract
Sexual well-being refers to the evaluation of one’s sexuality. We examined the association of enjoyment of sexuality with longevity and the moderating role of perceived importance of sexuality in this association. In the population-based Longitudinal Ageing Study Amsterdam, the survival of initially 55–84-year-olds was followed during 27 years. Complete data were available for 1042 participants (45.3%). Analyses were adjusted for health-related and psychosocial covariates. 60% of the participants experienced their sexuality as enjoyable and 44% as important. Enjoyment of sexuality was weakly, positively associated with longevity (B[CI] = 0.29[-0.004;0.58]). Perceived importance modified this association: only in those who perceived sexuality as important, the association between enjoyment and longevity was statistically significant (B[CI] = 0.78[0.29;1.27]). Positive affect, functional limitations, emotional loneliness, self-rated health, sense of mastery and alcohol consumption accounted for 35% of the latter association. Interventions may target older adults who perceive sexuality as important but not enjoyable.
Collapse
Affiliation(s)
- Shanice Beerepoot
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Suzanne W M Luesken
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology & Data Science and the Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| |
Collapse
|
10
|
Rossin B. Les maux cachés, sexualité de la femme en post-ménopause. Ou, comment, révéler les secrets des fonctions sexuelles à la ménopause. SEXOLOGIES 2022. [DOI: 10.1016/j.sexol.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Carter A, Gormley B, Muchenje M, Zhu D, Patterson S, Kestler M, Hankins C, Logie CH, Brotto LA, Tharao W, Lee M, Li J, Ding E, de Pokomandy A, Loutfy M, Kaida A. Prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. WOMEN'S HEALTH 2022; 18:17455065221074877. [PMID: 35088623 PMCID: PMC8801632 DOI: 10.1177/17455065221074877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. Methods: We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV diagnosis and associated distress (none, mild, moderate, severe). Five areas of concern were assessed, including difficulties related to sexual self-esteem, sexual function, relationships, and emotional and behavioral aspects of sex. Logistic regression analyses identified correlates of reporting any sexual concerns and severe distress about these concerns. Results: Of 906 participants (median age 48, Q1–Q3 = 41–55), 596 (65.8%) reported sexual concerns post-HIV diagnosis. We found a high prevalence of concerns related to relationships (43.3%), sexual self-esteem (49.4%), and emotional aspects of sex (45.4%), relative to sexual functioning (38.4%) and behavioral aspects (33.7%). Of those with sexual concerns, 36.7% reported severe distress. Reports of severe distress were the highest for relationship difficulties (32.5%), relative to other areas of concern (21.4%–22.8%). In adjusted analyses, women reporting sexual dissatisfaction and high HIV-related stigma had significantly higher odds of reporting sexual concerns. Conversely, those reporting higher resilience, better mental health, African, Caribbean, and Black identity, and sex as somewhat unimportant, not at all important, or neutral to their lives had lower adjusted odds. Factors associated with severe distress about sexual concerns included older age, body dissatisfaction, sexual dissatisfaction, and high HIV-related stigma, while better mental health and getting support from someone living with HIV were protective. While 84.4% of women had discussed with a provider how viral load impacts transmission risk, only 40.6% had conversations about sexual wellbeing. Conclusion: More attention to women’s sexual wellbeing within social and relational contexts is critical to ensure the sexual rights of women living with HIV are upheld.
Collapse
Affiliation(s)
- Allison Carter
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- Australian Human Rights Institute, UNSW Sydney, Sydney, NSW, Australia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Becky Gormley
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Marvelous Muchenje
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Denise Zhu
- Faculty of Science, The University of British Columbia, Vancouver, BC, Canada
| | - Sophie Patterson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Mary Kestler
- Division of Infectious Diseases, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Oak Tree Clinic, British Columbia Women’s Hospital and Healthcare Centre, Vancouver, BC, Canada
| | - Catherine Hankins
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- Women’s Health Research Institute, Vancouver, BC, Canada
| | | | - Melanie Lee
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Jenny Li
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Erin Ding
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, BC, Canada
| | | | - Mona Loutfy
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Women’s Health Research Institute, Vancouver, BC, Canada
| |
Collapse
|
12
|
Khani S, Azizi M, Elyasi F, Kamali M, Moosazadeh M. The Prevalence of Sexual Dysfunction in the Different Menopausal Stages: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 33:439-472. [PMID: 38595744 PMCID: PMC10903585 DOI: 10.1080/19317611.2021.1926039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 04/17/2021] [Accepted: 04/25/2021] [Indexed: 04/11/2024]
Abstract
Objectives: Despite the noticeable advances in sexual dysfunction (SD) research in the menopausal period, scientific literature showed different reports on the prevalence of SD in the menopausal stages. The primary objective of this study was to systematically review and meta-analysis the prevalence of SD in the different menopausal stages and then meta-analysis the included studies in domains of SD separately. Methods: In this systematic review and meta-analysis, keywords were retrieved through MeSH strategy and databases such as PubMed/MEDLINE, PsycINFO, Web of Science (ISI), Scopus, ScienceDirect, SID (Scientific Information Database), Magiran, and Google scholar were searched. Manual review of retrieved citations identified additional citations. The quality of the included studies was assessed using The Newcastle-Ottawa Scale. The main outcome measure in this study was the prevalence of SD in three stages of menopause such as pre, peri, and postmenopause. Results: Of 54 included studies 81,227 menopausal aged women from different menopause stages participated and the sample sizes varied from 49 to 31,581 individuals. The articles from 17 countries worldwide were included in this study. The prevalence of SD in premenopausal aged women was ranged between 22.7% and 72.2%, in perimenopausal aged women, was 37.3-78.2% and also in postmenopausal aged women was extremely reported a wide variety of prevalence ranges and was estimated between 8.7% and 89.01%. The premenopausal women had a lower prevalence of SD compared to other stages of the menopausal period. Conclusion: The results indicated that the prevalence of SD and also domains of SD in different studies were reported much widely. This study can be used as a good resource for obstetricians to understand the high possibility of recurrence of SD and assess the sexual activity of menopausal aged women in the menopause clinic. However, based on the systematic review, more standard and high-quality studies are needed to perform regarding the prevalence of SD in menopausal periods.
Collapse
Affiliation(s)
- Soghra Khani
- Sexual and Reproductive Health Research Centre, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marzieh Azizi
- Sexual and Reproductive Health Research Centre, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Department of Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahsa Kamali
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
13
|
Vasconcelos PA, Ramos C, Paúl C, Nobre PJ. Sexual Conservatism and Sexual Satisfaction in Older Women: A Cross-Sectional Mediation Analysis. Clin Gerontol 2021; 44:249-258. [PMID: 33478374 DOI: 10.1080/07317115.2021.1872755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objectives: The present study aims to assess the relationship between age and sexual satisfaction in older women and testing the potential mediating role of conservative sexual beliefs on this association.Methods: A total of 106 women (Mage = 68.71; SD = 6.31) completed measures of sexual beliefs (SDBQ), sexual functioning (FSFI), and sexual satisfaction (GMSEX). Bivariate correlation analyses were performed to assess the association between age, sexual conservatism, sexual satisfaction, and sexual function. Mediation analysis with bootstrap samples was performed to test the mediating effect of sexual conservatism.Results: Findings suggest a mediating effect of conservative sexual beliefs on the relationship between age and sexual satisfaction in a community-based sample of older women (F(3,102) = 9.31, p <.001, R2 = .215).Conclusions: The negative association between sexual conservatism and sexual satisfaction of the participants, and the non-significance of the direct effect of age in sexual satisfaction when including sexual conservatism in the mediation model, highlight the relevance of cognitive factors in sexual health in later life.Clinical Implications: Results such as the mediating role of sexual conservatism on the relationship between age and sexual satisfaction provide opportunities for developing and testing sexual health programs based on the demystification of sexual beliefs.
Collapse
Affiliation(s)
- Priscila A Vasconcelos
- Faculty of Psychology and Education Sciences, Center for Psychology at University of Porto, Porto, Portugal
| | - Catarina Ramos
- Faculty of Psychology and Education Sciences, Center for Psychology at University of Porto, Porto, Portugal
| | | | - Pedro J Nobre
- Faculty of Psychology and Education Sciences, Center for Psychology at University of Porto, Porto, Portugal
| |
Collapse
|
14
|
Graham CA, Štulhofer A, Lange T, Hald GM, Carvalheira AA, Enzlin P, Træen B. Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2951-2961. [PMID: 32533517 PMCID: PMC7641931 DOI: 10.1007/s10508-020-01742-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 05/07/2023]
Abstract
There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.
Collapse
Affiliation(s)
- Cynthia A Graham
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Shackleton Building (B44), Room 44/3073, Southampton, SO17 1BJ, UK.
| | | | - Theis Lange
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Paul Enzlin
- Department of Neurosciences, KU Leuven, Institute for Family and Sexuality Studies, Leuven, Belgium
| | - Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
15
|
Long-Term Clinical Outcomes, Recurrence, Satisfaction, and Regret After Total Colpocleisis With Concomitant Vaginal Hysterectomy: A Retrospective Single-Center Study. Female Pelvic Med Reconstr Surg 2020; 27:e510-e515. [PMID: 32618601 PMCID: PMC8016512 DOI: 10.1097/spv.0000000000000900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental digital content is available in the text. Objective This study aimed to investigate long-term study outcomes of colpocleisis along with concomitant vaginal hysterectomy for pelvic organ prolapse (POP). Methods A retrospective cohort study was conducted in elderly women with advanced POP who underwent total colpocleisis with or without hysterectomy from 2012 to 2017. Results A total of 242 elderly women were included in this study, of which 172 underwent total colpocleisis along with concomitant vaginal hysterectomy (CH group) and 70 underwent partial colpocleisis-retained uterus (LeFort group). More than one comorbidity was observed among 154 (85.9%) patients in the CH group and 56 (81.4%) patients in the LeFort group. The difference between 2 groups (CH and LeFort) in mean length of hospital staying, mean day of removing urinary catheter, mean day of farting time after operation, and postoperative complications was not statistically significant. In total colpocleisis along with hysterectomy group, a case (0.6%) of early asymptomatic endometrial cancer was diagnosed unexpectedly by pathology after hysterectomy. Median follow-up was 43.0 (19.0–85.0) months in the CH group and 45.0 (26.0–79.0) months in the LeFort group. Only one patient reported recurrence. Subjective satisfaction rate was 98.8% (CH group) versus 98.6% (LeFort group). Regret rate was 0.58% (CH group) versus 0% (LeFort group). No significant difference was observed between the 2 groups. Conclusions Both colpocleisis along with hysterectomy and partial colpocleisis-retained uterus are safe, with fewer complications and high long-term satisfaction. Colpocleisis along with hysterectomy is more conducive to discovery of early asymptomatic malignant tumors of the uterus, which is a suitable alternative for elderly frail women with severe POP.
Collapse
|
16
|
Rahn A, Bennett C, Jones T, Lykins A. Happily partnered older adults’ relationship‐enhancing behaviours. Australas J Ageing 2020; 39 Suppl 1:30-39. [DOI: 10.1111/ajag.12731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/24/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Alison Rahn
- Sociology Department School of Social Sciences Western Sydney University Penrith New South Wales Australia
- Sociology Department Faculty of Humanities, Arts, Social Sciences and Education School of Humanities, Arts and Social Sciences University of New England Armidale New South Wales Australia
| | - Cary Bennett
- Sociology Department Faculty of Humanities, Arts, Social Sciences and Education School of Humanities, Arts and Social Sciences University of New England Armidale New South Wales Australia
| | - Tiffany Jones
- Faculty of Human Sciences Department of Educational Studies Macquarie University Sydney New South Wales Australia
- School of Psychology and Public Health College of Science, Health and Engineering Australian Research Centre in Sex Health and Society La Trobe University Bundoora Victoria Australia
| | - Amy Lykins
- Faculty of Medicine and Health School of Psychology University of New England Armidale New South Wales Australia
| |
Collapse
|
17
|
Fischer N, Træen B, Štulhofer A, Hald GM. Mechanisms underlying the association between perceived discrepancy in sexual interest and sexual satisfaction among partnered older adults in four European countries. Eur J Ageing 2020; 17:151-162. [PMID: 32549870 DOI: 10.1007/s10433-019-00541-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The ways in which the discrepancy between one's own interest in sex and that of one's partner may affect personal sexual satisfaction has rarely been systematically studied, especially among older adults. Previous research among younger adults indicates that a discrepancy in sexual desire can be detrimental in terms of several relationship outcomes, including sexual satisfaction. This study aimed to investigate a conceptual model of sexual satisfaction among coupled older adults which posits that the association between perceived discrepancy in sexual interest and sexual satisfaction is mediated by the frequency of sexual activity and emotional closeness during sex. Data from a probability-based postal survey that included 2695 partnered heterosexual adults aged 60-75 years from four European countries (Norway, Denmark, Belgium, and Portugal) were used to test the mediation model. Due to expected gender differences in the two mediators, all analyses were carried out separately for men and women. The findings supported the proposed model, suggesting that as an individual's perception of a discrepancy in sexual interest increases, his or her levels of sexual frequency and perceived closeness during sex decrease-which in turn diminishes sexual satisfaction. The results of this study provide insights into links among sexual interest, sexual frequency, emotional closeness, and sexual satisfaction in older adults, and point to substantial similarities in the sexuality of aging men and women in this regard.
Collapse
Affiliation(s)
- N Fischer
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
| | - B Træen
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
| | - A Štulhofer
- Department of Sociology, University of Zagreb, Zagreb, Croatia
| | - G M Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
18
|
Pozza A, Veale D, Marazziti D, Delgadillo J, Albert U, Grassi G, Prestia D, Dèttore D. Sexual dysfunction and satisfaction in obsessive compulsive disorder: protocol for a systematic review and meta-analysis. Syst Rev 2020; 9:8. [PMID: 31918750 PMCID: PMC6953228 DOI: 10.1186/s13643-019-1262-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/20/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a chronic mental health condition recognized as one of the most serious causes of disability and impaired quality of life. In the literature, there is no review about sexual dysfunction and satisfaction in OCD. The current paper presents the protocol for a systematic review and meta-analysis aimed to summarize data (1) comparing the presence of sexual dysfunction between groups with OCD and non-clinical groups, (2) investigating prevalence of each one of the sexual dysfunctions in patients with OCD, (3) comparing risk for sexual dysfunction in OCD groups with the prevalence in control groups, (4) comparing sexual satisfaction between OCD groups and non-clinical groups, and (5) investigating moderators of sexual dysfunction in OCD groups as compared with control groups. Gender, age, marital status, OCD symptom severity and subtypes, comorbid depressive disorders, comorbid anxiety disorders, concurrent psychiatric medications, comorbid general medical disease, and study quality will be investigated as moderators. METHODS The protocol is reported according to PRISMA-P guidelines. The search will be conducted by independent reviewers during the second week of December 2019 by using electronic databases (Scopus, PubMed, EMBASE, PsycINFO, CINAHL, and the Cochrane Library), by contacting the authors of the included studies to identify further data, by examining the references of the included studies, and by handsearching conference proceedings and theses/doctoral dissertations. The study quality will be independently evaluated using the Newcastle-Ottawa Quality Assessment Scale. Random-effect meta-analyses will be computed. If there is insufficient data for a specific outcome, only a systematic review will be performed. DISCUSSION This review may support clinical practice highlighting the importance of the assessment of sexuality in patients with OCD and suggesting the use of therapeutic strategies dedicated to sexuality in this clinical population with the aim of improving patients' quality of life. Potential limitations will regard the heterogeneity of the studies in terms of the instruments used to assess sexual dysfunction/satisfaction and of the definitions used to conceptualize sexual dysfunction. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42019132264.
Collapse
Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - David Veale
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
- South London and Maudsley, NHS Trust, London, UK
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Jaime Delgadillo
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Opthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa IRCCS San Martino, Genoa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| |
Collapse
|
19
|
NeJhaddadgar N, Ziapour A, Abbas J, Mardi A, Zare M. Correlation between general health and sexual function in older women in an Iranian setting. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:300. [PMID: 33426104 PMCID: PMC7774623 DOI: 10.4103/jehp.jehp_316_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/23/2020] [Indexed: 05/10/2023]
Abstract
INTRODUCTION The world's population is aging and this trend continues. Older adults are living healthier and longer than in the last decades and their sexual function should also be considered along with their general health. This study aimed to examine the correlation between general health and sexual function in elderly women. MATERIALS AND METHODS In this cross-sectional correlation study, 1245 women over 60 years old were selected in Ardabil health-care centers by a convenient sampling method. Demographic data of all participants were noted and general health and sexual function were evaluated by the Goldberg General Health Questionnaire and Female Sexual Function Index (FSFI) Questionnaire. RESULTS The participants' mean ± standard deviation age was 75.1 ± 7.2 years, most of the women (40.08%) were illiterate, and the majority of them were living with their married (44.81%) or single children (27.14%). The general health score for 380 older women (30.52%) was under 22 (healthy). About 60% of the women had engaged in sexual activity during the past 4 weeks, and the total mean score of FSFI was 17.36 ± 1.44. In addition, 84.33% of the women had sexual dysfunction (FSFI < 26.55). The age (P < 0.05), educational level (P < 0.001), living with children (P < 0.01), and general health status (P < 0.01) were found to be significantly related to sexual function. The total scores for FSFI and the scores for all domains except for satisfaction were in positive correlation with the score for the total and all domains of general health (P < 0.001). CONCLUSION Sexual function in elderly women is affected by several factors, such as general health. Therefore, to promote successful aging in women, sexual function and general health require more attention when implementing women's health initiatives.
Collapse
Affiliation(s)
- Nazila NeJhaddadgar
- Department of Health Promotion and Education, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Arash Ziapour
- PhD Student of Health Education and Health Promotion, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jaffar Abbas
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
| | - Afrouz Mardi
- Department of Public Health, School of Health, Ardabil University of Medical Science, Ardabil, Iran
- Address for correspondence: Dr. Afrouz Mardi, Department of Public Health, School of Health, Ardabil University of Medical Science, Ardabil, Iran. E-mail:
| | - Maryam Zare
- Department of Nutrition, Khalkhal University of Medical Sciences, Khalkhal, Iran
| |
Collapse
|
20
|
Estebsari F, Dastoorpoor M, Khalifehkandi ZR, Nouri A, Mostafaei D, Hosseini M, Esmaeili R, Aghababaeian H. The Concept of Successful Aging: A Review Article. Curr Aging Sci 2019; 13:4-10. [PMID: 31657693 PMCID: PMC7403646 DOI: 10.2174/1874609812666191023130117] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 08/20/2019] [Accepted: 08/26/2019] [Indexed: 11/24/2022]
Abstract
Background With the increasing number of elderly people in the world, usage of concepts and terminology related to this phenomenon has substantially increased. One concept in this context is successful aging. The purpose of the present study is to extract and introduce a common concept to be used in studies on measuring successful aging. Methods This is a review study. First, by searching the databases of Magiran, Noormags, Medlib, Irandoc, Iranmedex, Barakat Knowledge Network System, Civilica, SID, ISI Web Of Science, PubMed, Scopus, Science Direct and search engines, Google Scholar and Elmnet as well as using standard keywords such as elder, elderly, aging, and successful aging, all related published articles during the period 1995 to 2017 were retrieved. A total of 3417 documents were retrieved. By removing 3390 unrelated, duplicate and unusable documents, 27 articles were included in the study after quality control. Results The findings of the study were categorized in three areas: “defining successful aging by focusing on dimensions”, “successful aging principles” and “factors influencing successful aging”. Reviewing various studies, we found that the definition of successful aging deals with cognitive action, perception, control, life satisfaction, and ethics. Successful aging is also defined as having inner feelings of happiness and satisfaction with life for the present and the past. Sometimes successful aging is also considered to be survival with health. Conclusion Health care professionals as community health supporters can use the results from the present study for providing the grounds for successful aging. Then, they can use the designed successful aging program for preserving and promoting active and healthy aging for every elderly person in old age.
Collapse
Affiliation(s)
- Fatemeh Estebsari
- Department of Community Health Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Dastoorpoor
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi Khalifehkandi
- Department of Health Education & Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Nouri
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davoud Mostafaei
- Department of Nursing Management, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roghayeh Esmaeili
- Department of Nursing, School of Nursing & Midwifery, Shahid Beheshti, University of Medical Sciences, Tehran, Iran
| | - Hamidreza Aghababaeian
- Department of Nursing and Emergency, Dezful University of Medical Sciences, Dezful, Iran
| |
Collapse
|
21
|
Lahav Y, Price N, Crompton L, Laufer A, Solomon Z. Sexual Satisfaction in Spouses of Ex-POWs: The Role of PTSD Symptoms and Self-Differentiation. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:755-766. [PMID: 30924723 DOI: 10.1080/0092623x.2019.1594478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Spouses of former prisoners-of-war (ex-POWs) are at risk for posttraumatic stress symptoms (PTSS) and marital distress. This study assessed the implications of PTSS and self-differentiation for sexual satisfaction among 90 ex-POWs' spouses and 75 matched combatants' spouses from the 1973 Yom Kippur War. Standardized questionnaires were used. Ex-POWs' spouses had elevated PTSS and imbalanced self-differentiation. PTSS were associated with poorer self-differentiation and lower sexual satisfaction. Imbalanced self-differentiation mediated the association between PTSS and sexual satisfaction. The findings imply that PTSS and imbalanced self-differentiation contribute to low sexual satisfaction among spouses of primary trauma survivors.
Collapse
Affiliation(s)
- Yael Lahav
- Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv, Israel
- I-CORE Research Center for Mass Trauma, Tel Aviv University , Tel Aviv, Israel
| | - Naomi Price
- Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv, Israel
| | - Laura Crompton
- Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv, Israel
- I-CORE Research Center for Mass Trauma, Tel Aviv University , Tel Aviv, Israel
| | - Avital Laufer
- School of Behavioral Sciences, Netanya Academic College , Netanya, Israel
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv, Israel
- I-CORE Research Center for Mass Trauma, Tel Aviv University , Tel Aviv, Israel
| |
Collapse
|
22
|
Bazi T. The underutilization of obliterative and constrictive surgery in the surgical treatment of pelvic organ prolapse. Int Urogynecol J 2019; 30:1221-1224. [PMID: 31183534 DOI: 10.1007/s00192-019-03994-x] [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: 03/27/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
Vaginal length and caliber are necessary for satisfactory vaginal coitus. Surgical treatment of pelvic organ prolapse (POP) can include preservation of vaginal length and caliber, or shortening and narrowing of the vagina (constrictive and obliterative surgery). The latter option is proven to have fewer complications and a lower risk of recurrence of POP. Women undergoing surgical intervention for POP who are not coitally active and choose not to be coitally active for the rest of their lives should be offered constrictive and obliterative surgery.
Collapse
Affiliation(s)
- Tony Bazi
- American University of Beirut Medical Center, PO box 11-0236, Riyad El-Solh, Beirut, 11072020, Lebanon.
| |
Collapse
|
23
|
Heidari M, Ghodusi M, Rezaei P, Kabirian Abyaneh S, Sureshjani EH, Sheikhi RA. Sexual Function and Factors Affecting Menopause: A Systematic Review. J Menopausal Med 2019; 25:15-27. [PMID: 31080785 PMCID: PMC6487288 DOI: 10.6118/jmm.2019.25.1.15] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/01/2018] [Accepted: 11/16/2018] [Indexed: 12/17/2022] Open
Abstract
The purpose of this review study is to evaluate sexual function and its effective factors in menopause. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The key words of “menopause,” “postmenopause,” “postmenopausal,” “premenopause,” “pre-menopausal period,” “sexual function,” “sexual health,” “sexuality,” “sexual and gender disorders,” “sexual development,” “sexual dysfunction,” “sexual disorders,” “sexual behavior and “sexual activity” were used in combination with the Boolean operators OR and AND. After reviewing the selected articles, 27 papers were selected based on the criteria for entering the study and the goals set. The results of the reviewed articles showed that, in the physical domain, the factors affecting sexual function can be mentioned, age, hormonal changes, medical problems and reproductive history. Sexual disorders in menopause can be affected by some of the individual and social characteristics and psychological problems. Considering the fact that many psychological and social injuries occur in this period following sexual disorders; therefore, policies and programs for improving the quality of life of women in menopause should be aimed at eliminating sexual dysfunction, correcting attitudes and negative emotions and help to women for more comfortable in menopause.
Collapse
Affiliation(s)
- Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mansureh Ghodusi
- Young Researchers and Elite Club, Abadeh Branch, Islamic Azad University, Abadeh, Iran
| | - Parvin Rezaei
- Department of Infectious Disease and Tropical Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ehsan Heidari Sureshjani
- Prehospital Emergency Care, Disaster and Emergency Medical Management Center, ShahreKord University of Medical Sciences, Shahrekord, Iran
| | - Rahim Ali Sheikhi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
24
|
Træen B, Štulhofer A, Janssen E, Carvalheira AA, Hald GM, Lange T, Graham C. Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:815-829. [PMID: 29987546 DOI: 10.1007/s10508-018-1256-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/19/2018] [Accepted: 06/07/2018] [Indexed: 05/12/2023]
Abstract
The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe.
Collapse
Affiliation(s)
- Bente Træen
- Department of Psychology, University of Oslo, Box 1094 Blindern, 0317, Oslo, Norway.
| | | | - Erick Janssen
- Institute for Family and Sexuality Studies, University of Leuven, Louvain, Belgium
| | | | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Statistical Science, Peking University, Peking, China
| | - Cynthia Graham
- Department of Psychology, University of Southampton, Southampton, UK
| |
Collapse
|
25
|
Kingsberg SA, Schaffir J, Faught BM, Pinkerton JV, Parish SJ, Iglesia CB, Gudeman J, Krop J, Simon JA. Female Sexual Health: Barriers to Optimal Outcomes and a Roadmap for Improved Patient-Clinician Communications. J Womens Health (Larchmt) 2019; 28:432-443. [PMID: 30714849 PMCID: PMC6482896 DOI: 10.1089/jwh.2018.7352] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although sexual health can be considered a vital sign for overall health, several barriers prevent women from receiving proper medical counseling, support, and/or care for their sexual health needs and concerns. METHODS Experts in sexual health compiled research and experience on the impediments to women receiving adequate assessment and treatment for their sexual health. Specific solutions and a roadmap for overcoming such barriers and improving patient-clinician communication are presented. RESULTS Social stigma around female sexuality remains in Western culture and as a result, women often avoid and/or are embarrassed to discuss their sexual health with their health care professionals (HCPs). Moreover, midlife women are typically unaware or have misconceptions about conditions that may adversely impact their sexual life, such as genitourinary syndrome of menopause and hypoactive sexual desire disorder. Without understanding there may be underlying medical conditions, there is also a lack of awareness that safe and effective treatments are available. Lack of training, tools, time, and limited treatment options impede HCPs from providing women with necessary sexual health support. Educating women, training HCPs, and providing communication tools to HCPs can facilitate effective dialog between patients and HCPs. More specifically, HCPs can be trained to initiate and maintain a sexual health conversation in a manner that is comfortable for women to convey sexual health needs and concerns, and for HCPs to correctly identify, diagnose, and treat the sexual problems of their female patients. CONCLUSIONS Solutions exist to address the barriers currently impeding patient-clinician interactions around sexual health.
Collapse
Affiliation(s)
- Sheryl A Kingsberg
- 1 MacDonald Women's Hospital, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | | | | | | | - Cheryl B Iglesia
- 6 MedStar Washington Hospital Center, Washington, District of Columbia
| | | | - Julie Krop
- 7 AMAG Pharmaceuticals, Waltham, Massachusetts
| | - James A Simon
- 8 George Washington University, School of Medicine, IntimMedicine Specialists, Washington, District of Columbia
| |
Collapse
|
26
|
Lund JI, Kleinplatz PJ, Charest M, Huber JD. The Relationship Between the Sexual Self and the Experience of Pregnancy. J Perinat Educ 2019; 28:43-50. [PMID: 31086474 DOI: 10.1891/1058-1243.28.1.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Studies reveal that prenatal health-care providers and educators often refrain from discussing sexuality with their patients. The present study explored the relationship between sexuality and pregnancy by considering whether the way in which women view themselves sexually is associated with their experience of pregnancy. Findings revealed that a positive sexual self was significantly related to a positive experience of pregnancy and that particular experiences of pregnancy were more significantly related to how women viewed themselves sexually than others. The findings encourage further discussion regarding the role that comprehensive sex education and training of prenatal health-care providers might play in ultimately establishing open, honest, and nonjudgmental discussions about sexuality between providers and their pregnant patients and partners.
Collapse
|
27
|
Štulhofer A, Hinchliff S, Jurin T, Carvalheira A, Træen B. Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries. Eur J Ageing 2018; 16:155-165. [PMID: 31139030 DOI: 10.1007/s10433-018-0492-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Although the importance of sexuality and physical intimacy for well-being of older adults has been recognized, the role of sexuality in successful aging (SA) has been largely neglected. Building on our previous work, here we further validated a three-dimensional model of SA and examined its associations with sexual satisfaction and change in sexual interest among older heterosexual couples (aged 60-75 years). Participants were recruited in a probability-based survey, which was carried out in 2016-2017 in four European countries. Using structural equation modeling of the Actor-Partner Interdependence, we observed significant relationships between SA and sexual satisfaction for both male and female partners across countries. Among women, their retrospectively assessed change in sexual interest over the past 10 years was consistently associated with sexual satisfaction. Partner effects were gender-specific: male partners' SA was significantly related to their female partners' change in sexual interest, which in turn was linked to male partners' sexual satisfaction. The findings point to substantial ties between successful aging and sexuality in older European couples. Taking into account the prevalent stereotypes about old age and sexuality, this study's findings can assist professionals working with aging couples.
Collapse
Affiliation(s)
- Aleksandar Štulhofer
- 1Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lučića 3, 10000 Zagreb, Croatia
| | - Sharron Hinchliff
- 2School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Tanja Jurin
- 3Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Ana Carvalheira
- 4Department of Clinical Psychology, William James Center for Research, ISPA-University Institute, Lisbon, Portugal
| | - Bente Træen
- 5Department of Psychology, University of Oslo, Oslo, Norway
| |
Collapse
|
28
|
Štulhofer A, Hinchliff S, Jurin T, Hald GM, Træen B. Successful Aging and Changes in Sexual Interest and Enjoyment Among Older European Men and Women. J Sex Med 2018; 15:1393-1402. [DOI: 10.1016/j.jsxm.2018.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/13/2018] [Accepted: 08/20/2018] [Indexed: 01/07/2023]
|
29
|
Vitamin E as alternative local treatment in genitourinary syndrome of menopause: a randomized controlled trial. Int Urogynecol J 2018; 30:831-837. [PMID: 29971469 DOI: 10.1007/s00192-018-3698-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Genitourinary syndrome of menopause is a major health concern in postmenopausal women. This study was aimed at comparing the effect of a vitamin E vaginal suppository with that of conjugated estrogen vaginal cream on sexual function in postmenopausal women with genitourinary syndrome of menopause. METHODS This survey was carried out on 52 postmenopausal women aged 40-65 years who had been referred to gynecology clinics in Mashhad city, during 2013-2014. Keeping β = 0.1, the power was calculated to be 90%. The patients were randomly divided into two groups: vitamin E vaginal suppository and conjugated estrogen vaginal cream. Participants used the medications for 12 weeks. They were visited at the 4th, 8th, and 12th weeks. Validated Abbreviated Sexual Function Questionnaire (ASFQ), as the primary outcome measure, and a demographic information questionnaire, were used to collect data at each visit. Data were analyzed using SPSS and p < 0.05 was considered statistically significant. RESULTS Mean overall scores of the ASFQ were increased significantly in both groups during the course of the study, compared with baseline (p < 0.001). However, the mean ASFQ scores of the two treatments did not differ significantly. CONCLUSION Improved scores of ASFQ after the 12th week showed that the treatment was successful in both groups. Therefore, a vitamin E vaginal suppository may be an alternative to vaginal estrogen in relieving the symptoms of vaginal atrophy in postmenopausal women, especially those not able to use hormone therapy or have low compliance.
Collapse
|
30
|
Heidari M, Shahbazi S, Ghafourifard M, Ali Sheikhi R. Prediction of Marital Satisfaction Based on Emotional Intelligence in Postmenopausal Women. J Menopausal Med 2017; 23:196-201. [PMID: 29354620 PMCID: PMC5770530 DOI: 10.6118/jmm.2017.23.3.196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 08/22/2017] [Accepted: 09/06/2017] [Indexed: 01/19/2023] Open
Abstract
Objectives This study was coperinducted with the aim of prediction of marital satisfaction based on emotional intelligence for postmenopausal women. Methods This cross-sectional study was the descriptive-correlation and with a sample size of 134 people to predict marital satisfaction based on emotional intelligence for postmenopausal women was conducted in the Borujen city. The subjects were selected by convenience sampling. Data collection tools included an emotional intelligence questionnaire (Bar-on) and Enrich marital satisfaction questionnaire. Results The results of this study showed a significant positive relationship between marital satisfaction and emotional intelligence (P < 0.05, r = 0.25). Also, regression analysis showed that emotional intelligence (β = 0.31) can predict positively and significantly marital satisfaction. Conclusions Due to the positive relationship between emotional intelligence and marital satisfaction, adequacy of emotional intelligence is improved as important structural in marital satisfaction. So it seems that can with measuring emotional intelligence in reinforced marital satisfaction during menopause, done appropriate action.
Collapse
Affiliation(s)
- Mohammad Heidari
- Departments of Medical and Surgical, School of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Sara Shahbazi
- Department of Nursing, Borujen Nursing School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mansour Ghafourifard
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Ali Sheikhi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health in Emergency and Disaster, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
31
|
Abstract
PURPOSE OF REVIEW To provide an update of recent studies on factors associated with sexual well being in older people with a special focus on sexual activity, satisfaction and function. RECENT FINDINGS Most recent studies confirmed the relationship between mental health status, especially negative affect and depressive symptoms, and sexual health in older adulthood. However, when this relationship is investigated more deeply, it seems that in fact positive psychological well being (positive affect and quality of life) accounts for sexual activity rather than the lack of depressive symptoms. Moreover, recent studies provided more insight into the relationship between marital characteristics, religion, cognitive functioning and sleeping difficulties and different dimensions of sexual health in older adulthood. SUMMARY In summary, there is substantial previous research revealing associations between various psychosocial, health-related and demographic variables and sexual health in older adulthood. Most considered variables are, for example, age, sex, general physical and mental health. For future research, it is important to consider that relationships between specific variables and sexual health in higher age are usually more complex than they are expected to be and factors differ between different dimensions of sexual health. Communication about sexuality between health-care providers and older patients still implies a lot of barriers and lack of knowledge. Therefore, the provision of communication training for health-care providers to older people in which knowledge is gained about correlates of sexual health in older adulthood should be implemented.
Collapse
|
32
|
Crema IL, Tilio RD, Campos MTDA. Repercussões da Menopausa para a Sexualidade de Idosas: Revisão Integrativa da Literatura. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2017. [DOI: 10.1590/1982-3703003422016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo A menopausa representa transformações hormonais significativas que podem ser acompanhadas de mudanças sociais e emocionais. Além disso, a população idosa feminina tem apresentado maiores comprometimentos em relação à sexualidade do que os homens. Este estudo teve por objetivo apresentar uma revisão integrativa da literatura científica nacional e internacional sobre as possíveis repercussões da menopausa para a sexualidade de idosas. As buscas foram realizadas nas bases Lilacs, SciELO, PePSIC e PsycINFO com análise da produção científica nacional e internacional relativa ao período de janeiro de 2006 a março de 2016. Foram analisadas 36 produções na íntegra cujo perfil predominante é de estudos quantitativos, descritivos e transversais, desenvolvidos com mulheres de diferentes faixas etárias na pós-menopausa, incluindo idosas. Todavia, estudos com amostras compostas exclusivamente por idosas são minoria. Entre os resultados houve predominância de pesquisas voltadas para a avaliação e quantificação das possíveis patologias e sintomas biológicos que afetam a sexualidade (redução da libido, de lubrificação e de orgasmos, por exemplo). A maioria das pesquisas aponta para a importância da análise conjunta de aspectos biológicos, psicológicos, sociais, culturais e individuais para a compreensão das suas distintas influências na sexualidade das idosas. Destaca-se a necessidade de realização de pesquisas com abordagem mista e voltadas apenas para mulheres idosas a fim de ampliar a compreensão acerca das suas perspectivas sobre as repercussões da menopausa para a sexualidade pretendendo respaldar práticas clínicas e políticas sociais destinadas a essa população.
Collapse
|
33
|
Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. AIM To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. CONCLUSION Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
Collapse
Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
| |
Collapse
|
34
|
Factors associated with sexual quality of life among midlife women in Serbia. Qual Life Res 2017; 26:2793-2804. [PMID: 28580495 DOI: 10.1007/s11136-017-1608-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. METHODS Participants were 500 women aged 40-65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. RESULTS Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3-15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. CONCLUSIONS Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL.
Collapse
|
35
|
Yelland EL, Cless AW, Mallory AB, Cless JD. Public Perspectives Toward the Sexual Behavior of an Individual With Dementia Residing in Long-Term Care. J Aging Health 2017; 30:800-815. [PMID: 28553809 DOI: 10.1177/0898264317696774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examines public perspectives toward sexual behavior within a heterosexually married couple in which one individual has dementia and resides in a long-term care facility. METHOD Respondents included 318 adults in the Southern United States. Paired sample t tests were used to understand how the diagnosis of dementia statistically influenced participants' responses, and a logistic regression model was used to understand how a vignette character's sex and respondent characteristics influenced attitudes. RESULTS Fifty-eight percent of respondents believed that a sexual relationship should be permitted for an adult with dementia, and t tests revealed that dementia had a statistical effect on participants' responses. Sex of the vignette character was not a predictor of attitudes. Participant's qualitative rationales are offered for additional insight. DISCUSSION Respondents who felt that a couple should not engage in a sexual relationship commonly cited consent-related issues as their primary concern. Implications for policy development are discussed.
Collapse
|
36
|
Long-term follow-up after LeFort colpocleisis: patient satisfaction, regret rate, and pelvic symptoms. Menopause 2016; 23:621-5. [DOI: 10.1097/gme.0000000000000604] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Abstract
OBJECTIVES Stigma related to later life sexuality could produce detrimental effects for older adults, through individual concerns and limited sexual health care for older adults. Identifying groups at risk for aging sexual stigma will help to focus interventions to reduce it. Accordingly, the purpose of this study was to examine cross-sectional trends in aging sexual stigma attitudes by age group, generational status, and gender. METHOD An online survey was administered to a national sample of adults via a crowdsourcing tool, in order to examine aging sexual stigma across age groups, generational status, and gender (N = 962; 47.0% male, 52.5% female, and .5% other; mean age = 45 years). An aging sexual stigma index was formulated from the attitudinal items of the Aging Sexual Knowledge and Attitudes Scale. RESULTS This sample reported moderately permissive attitudes toward aging sexuality, indicating a low level of aging sexual stigma. Though descriptive data showed trends of stigma attitudes increasing with age and later generations, there were no significant differences between age groups or generations in terms of aging sexual stigma beliefs. Men, regardless of age and/or generation, were found to espouse significantly higher stigmatic beliefs than women or those reporting 'other' gender. CONCLUSIONS Aging sexual stigma beliefs may not be prevalent among the general population as cohorts become more sexually liberal over time, though men appear more susceptible to these beliefs. However, in order to more comprehensively assess aging sexual stigma, future research may benefit from measuring explicit and implicit aging sexual stigma beliefs.
Collapse
Affiliation(s)
- Maggie L. Syme
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Tracy J. Cohn
- Department of Psychology, Radford University, Radford, VA, USA
| |
Collapse
|
38
|
Yelland E, Hosier A. Public Attitudes Toward Sexual Expression in Long-Term Care: Does Context Matter? J Appl Gerontol 2015; 36:1016-1031. [PMID: 26316266 DOI: 10.1177/0733464815602113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to (a) examine how age and sex of long-term care (LTC) residents influence public attitudes toward sexuality in LTC and (b) understand how, in the absence of cognitive decline, residing in LTC influences the perception of sexuality as a basic human right. Attitudes were examined using a factorial vignette with a probability sample of 325 respondents from a southern state. Results indicate that attitudes were not statistically affected by a vignette character's age or sex; but respondent education level, parenthood status, and religious affiliation did have direct bearing on attitudes. The notion of sexuality as a basic human right for residents of LTC was ultimately challenged as 19% of respondents said that LTC residents should not be permitted to have sexual relations with their spouse in the facility.
Collapse
Affiliation(s)
- Erin Yelland
- 1 Kansas State University, Manhattan, Kansas, USA
| | - Amy Hosier
- 2 University of Kentucky, Lexington, USA
| |
Collapse
|
39
|
Roney L, Kazer MW. Geriatric sexual experiences: The seniors tell all. Appl Nurs Res 2015; 28:254-6. [DOI: 10.1016/j.apnr.2015.04.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/15/2015] [Indexed: 11/30/2022]
|
40
|
Rozanova J, Noulas P, Southwick SM, Pietrzak RH. Perceptions of Determinants of Successful Aging Among Older U.S. Veterans: Results from the National Health and Resilience in Veterans Study. Am J Geriatr Psychiatry 2015; 23:744-53. [PMID: 25488494 DOI: 10.1016/j.jagp.2014.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 08/26/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To conduct a qualitative study of older American veterans' subjective perceptions of factors that contribute to successful physical, emotional, and cognitive aging. METHODS A nationally representative sample of 2,025 veterans aged 60 or older (range: 60-96; 96.9% male, 39.4% combat veterans) participated in the National Health and Resilience in Veterans Study. Using qualitative analysis software, the authors coded responses to three open-ended questions, inductively developed categories, aggregated similar categories into factors, and grouped factors into broader themes. RESULTS A total of 53, 56, and 61 categories of responses was identified in response to questions about successful physical, cognitive, and emotional aging, respectively, with 10 aggregate factors linking these categories. The most prominent theme overall was "What you do," which received 2,295, 2,210, and 1,247 mentions for each of these domains of successful aging, with health behaviors the most common factor for both successful physical and cognitive aging and social engagement the most common for successful emotional aging. The theme "Who you are" was the second-most common factor (discerned from 376, 247, and 943 total mentions, respectively), with the factors that comprise this theme-personality and explanatory style, moral compass, and emotional dispositions-more commonly endorsed for successful emotional aging. External factors such as healthcare were least commonly endorsed across all domains. CONCLUSION Older U.S. Veterans emphasize health behaviors, social engagement, and dispositional characteristics as key determinants of successful aging. Prevention and treatment initiatives that target these potentially modifiable factors may help promote successful aging in this growing segment of the population.
Collapse
Affiliation(s)
- Julia Rozanova
- Department of Sociology, Yale University, New Haven, CT.
| | - Paraskevi Noulas
- VA Connecticut Healthcare System and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Steven M Southwick
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder and Department of Psychiatry, Yale School of Medicine, New Haven, CT
| |
Collapse
|
41
|
Hughes AK, Rostant OS, Pelon S. Sexual Problems Among Older Women by Age and Race. J Womens Health (Larchmt) 2015; 24:663-9. [PMID: 26061291 DOI: 10.1089/jwh.2014.5010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The purpose of our study was to examine the prevalence of sexual problems by age and race among older women in the United States and to examine quality of life correlates to sexual dysfunction among non-Hispanic white and African American older women. METHODS A cross-sectional study using self-report surveys was conducted among community-dwelling U.S. women, aged 60 years and over. A total of 807 women aged 61-89 years were included. Self-administered questionnaires assessed sexual dysfunction, satisfaction with life, depressive symptomatology, and self-rated health. Analyses included multivariate logistic regression. RESULTS The mean age of the sample was 66 years. Two-thirds of the sample had at least one sexual dysfunction; the most common for both African American and non-Hispanic white women were lack of interest in sex and vaginal dryness. Prevalence varied by age for each of the sexual dysfunctions. The odds of experiencing sexual dysfunction varied with age and race. Compared with non-Hispanic white women, African American women had lower odds of reporting lack of interest in sex or vaginal dryness. Poor self-rated health, depressive symptomatology, and lower satisfaction with life were associated with higher odds of having some sexual dysfunction. CONCLUSIONS Improved understanding of how sexual dysfunction affects women across multiple age ranges and racial/ethnic groups can assist providers in making recommendations for care that are patient centered. The associations that we identified with quality of life factors highlight the need to assess sexual health care in the aging female population.
Collapse
Affiliation(s)
- Anne K Hughes
- 1 School of Social Work, Michigan State University , East Lansing, Michigan
| | - Ola S Rostant
- 2 The National Institute on Aging Intramural Research Program, National Institutes of Health , Baltimore, Maryland
| | - Sally Pelon
- 1 School of Social Work, Michigan State University , East Lansing, Michigan
| |
Collapse
|
42
|
Sex and the (older) single girl: Experiences of sex and dating in later life. J Aging Stud 2015; 33:67-75. [DOI: 10.1016/j.jaging.2015.02.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/13/2015] [Accepted: 02/13/2015] [Indexed: 01/17/2023]
|
43
|
Sexual Orientation, Body Image, and Age as Predictors of Sexual Self-Schema for Women with Physical Disabilities. SEXUALITY AND DISABILITY 2015. [DOI: 10.1007/s11195-015-9399-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
44
|
Wang V, Depp CA, Ceglowski J, Thompson WK, Rock D, Jeste DV. Sexual health and function in later life: a population-based study of 606 older adults with a partner. Am J Geriatr Psychiatry 2015; 23:227-33. [PMID: 24840610 DOI: 10.1016/j.jagp.2014.03.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 03/05/2014] [Accepted: 03/12/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexual health and function is an important yet understudied aspect of overall health and well-being in older adults. There are limited data on the relative strength of associations between various aspects of sexual health with the physical, emotional, and cognitive function in older adults. Additionally, there is little information on how these associations differ by age and sex. METHODS In this Successful Aging Evaluation (SAGE) study, 606 community-dwelling adults in San Diego County, aged 50-99 years and who had a partner, were included in the analysis. Evaluations included a phone-based cognitive screening followed by a comprehensive mail-in survey including rating scales of sexual health, depression, anxiety, and physical function. RESULTS The mean age of the sample was 75.2 years. Over 80% of respondents had engaged in sexual activity in the past year, over 70% engaged in sexual activity weekly or more than once a week, and over 60% were somewhat or very satisfied with their sex lives. No sex differences were evident on dimensions of sexual health except for a higher rate of rejection of sexual overtures by women. Depressive symptoms were negatively associated with all assessed aspects of sexual health, even after adjusting for age, physical functioning, anxiety, cognitive ability, or perceived stress in both men and women. CONCLUSIONS In this population-based study older men and women who had a partner reported frequent engagement in and satisfaction with sexual activity. Depressive symptoms were broadly associated with worse sexual health, more so than physical function, anxiety or stress, or age itself.
Collapse
Affiliation(s)
- Vicki Wang
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, La Jolla, CA; Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA; San Diego Veterans Affairs Healthcare System, San Diego, CA.
| | - Jennifer Ceglowski
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Wesley K Thompson
- Department of Psychiatry, University of California San Diego, La Jolla, CA; Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - David Rock
- Department of Psychiatry, University of California San Diego, La Jolla, CA; Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA; Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA; San Diego Veterans Affairs Healthcare System, San Diego, CA
| |
Collapse
|
45
|
Sánchez-Fuentes MDM, Santos-Iglesias P. Sexual Satisfaction in Spanish Heterosexual Couples: Testing the Interpersonal Exchange Model of Sexual Satisfaction. JOURNAL OF SEX & MARITAL THERAPY 2015; 42:223-242. [PMID: 25629546 DOI: 10.1080/0092623x.2015.1010675] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The study of sexual satisfaction in Spain is scarce and has proceeded atheoretically. This study aimed at examining sexual satisfaction in 197 Spanish heterosexual couples based on the Interpersonal Exchange Model of Sexual Satisfaction. Men and women reported equal satisfaction. Men's sexual satisfaction was predicted by their own relationship satisfaction, balance of sexual rewards and costs, and comparison level of sexual rewards and costs. Women's sexual satisfaction was predicted by their own relationship satisfaction, balance of sexual rewards and costs, comparison level of sexual rewards and costs, equality of sexual costs, and their partner's balance of sexual rewards and costs. These results provide with a better understanding of the mechanisms that explain sexual satisfaction in Spanish couples. Implications for research and therapy are discussed.
Collapse
Affiliation(s)
| | - Pablo Santos-Iglesias
- b Department of Psychology , University of New Brunswick , Fredericton , New Brunswick , Canada
| |
Collapse
|
46
|
Stephenson KR, Meston CM. The conditional importance of sex: exploring the association between sexual well-being and life satisfaction. JOURNAL OF SEX & MARITAL THERAPY 2015; 41:25-38. [PMID: 24308354 DOI: 10.1080/0092623x.2013.811450] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Leaders in the field of sexuality have called for additional research examining the link between sexual well-being and life satisfaction in women in order to expand knowledge regarding the important consequences of a satisfying sex life. Participants in the present study were sexually active women reporting a wide range of sexual difficulties who completed an in-person interview, validated self-report measures, and daily online assessments for 4 weeks. Sexual well-being was related to life satisfaction both cross-sectionally and within individuals over time. In addition, high relational satisfaction and low attachment anxiety served as protective factors, decreasing the degree to which unsatisfying sexual experiences were associated with decreases in life satisfaction. These results extend previous findings by confirming a strong association between sexual well-being and overall life satisfaction within individuals over time. The strength of this association is moderated by a number of intra- and interpersonal factors. Implications for healthcare providers are discussed.
Collapse
Affiliation(s)
- Kyle R Stephenson
- a Department of Psychology , University of Texas at Austin , Austin , Texas , USA
| | | |
Collapse
|
47
|
Constructions of sexuality in later life: Analyses of Canadian magazine and newspaper portrayals of online dating. J Aging Stud 2015; 32:40-9. [DOI: 10.1016/j.jaging.2014.12.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 12/01/2014] [Accepted: 12/29/2014] [Indexed: 11/22/2022]
|
48
|
Müller B, Nienaber CA, Reis O, Kropp P, Meyer W. Sexuality and affection among elderly German men and women in long-term relationships: results of a prospective population-based study. PLoS One 2014; 9:e111404. [PMID: 25369193 PMCID: PMC4219747 DOI: 10.1371/journal.pone.0111404] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 09/29/2014] [Indexed: 11/29/2022] Open
Abstract
Satisfaction with sexual activity i.e. sexual satisfaction and the importance of sexuality and affection were analysed using data from the German “Interdisciplinary Longitudinal Study of Adult Development” (ILSE). At three measurement points, 1993–1995, 1997–1998, and 2004–2006 i.e. subjects' ages of 63, 67, and 74 years, participants' reports about their affection and sexual activity were collected. The sample of completed records used for this study consisted of 194 urban non-institutionalised participants, 68% male, all living with partners. Median levels of sexual satisfaction were reported, fluctuating between the measurement points of ages 63 to 74. Between baseline, first and second follow-up no differences were found in levels of sexual satisfaction, though at measurement points age 63 and 67 women were more satisfied than men. When measured at age 74, affection was given a higher priority than sexual activity. Although men and women reported similar priorities, sexual activity and affection were more important for men than for women. Satisfaction within the relationship can be predicted by the importance of affection, but not by that of sexual activity. Our results confirm the thesis of the ‘second language of sexuality’: for humans in their later years affection seems to be more important than for younger individuals.
Collapse
Affiliation(s)
- Britta Müller
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
- * E-mail:
| | - Christoph A. Nienaber
- Medical Center Rostock, Department of Cardiology and Angiology, Rostock University Hospital, University of Rostock, Rostock, Germany
| | - Olaf Reis
- Clinic for Child and Adolescent Psychiatry, Rostock University Hospital, University of Rostock, Rostock, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
| | - Wolfgang Meyer
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, United Kingdom
| |
Collapse
|
49
|
Bossio JA, Pukall CF, Steele S. A review of the current state of the male circumcision literature. J Sex Med 2014; 11:2847-64. [PMID: 25284631 DOI: 10.1111/jsm.12703] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Male circumcision is one of the most commonly performed surgical procedures worldwide and a subject that has been the center of considerable debate. Recently, the American Association of Pediatrics released a statement affirming that the medical benefits of neonatal circumcision outweigh the risks. At present, however, the majority of the literature on circumcision is based on research that is not necessarily applicable to North American populations, as it fails to take into account factors likely to influence the interpretability and applicability of the results. AIMS The purpose of this review is to draw attention to the gaps within the circumcision literature that need to be addressed before significant changes to public policy regarding neonatal circumcision are made within North America. METHODS A literature review of peer-reviewed journal articles was performed. MAIN OUTCOME MEASURES The main outcome measure was the state of circumcision research, especially with regard to new developments in the field, as it applies to North American populations. RESULTS This review highlights considerable gaps within the current literature on circumcision. The emphasis is on factors that should be addressed in order to influence research in becoming more applicable to North American populations. Such gaps include a need for rigorous, empirically based methodologies to address questions about circumcision and sexual functioning, penile sensitivity, the effect of circumcision on men's sexual partners, and reasons for circumcision. Additional factors that should be addressed in future research include the effects of age at circumcision (with an emphasis on neonatal circumcision) and the need for objective research outcomes. CONCLUSION Further research is needed to inform policy makers, health-care professionals, and stakeholders (parents and individuals invested in this debate) with regard to the decision to perform routine circumcision on male neonates in North America.
Collapse
|
50
|
Graf AS, Patrick JH. The Influence of Sexual Attitudes on Mid-to Late-Life Sexual Well-Being: Age, Not Gender, as a Salient Factor. Int J Aging Hum Dev 2014. [DOI: 10.2190/ag.79.1.c] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The influence of sexual attitudes on sexual activity and expression has been relatively understudied in older populations. In the current study, we sought to understand the role sexual attitudes have on sexual well-being among middle-aged and young-old adults. Using a diverse sample of participants over the age of 45 ( N = 384), a path model was analyzed to determine whether sexual attitudes contributed to sexual well-being. The model was then compared by gender. Results indicated: a) only age-relative sexual attitudes significantly contributed to sexual well-being; and b) the model was equally robust for both men and women, even though women held slightly more positive age-relative sexual attitudes than men. Therefore, among middle-aged and young-old adults, sexual well-being may be reduced by harboring negative ageist sexual attitudes. Efforts should be made to reduce stigma surrounding continued sexual activity and expression among the aged.
Collapse
|