Sexual dysfunction in the climacteric period and associated factors

cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period.

Results:

among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance.

Conclusion:

the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Key words
Climacteric; Physiological sexual dysfunction; Psychogenetic sexual dysfunctions; Woman’s health; Sexuality

Variables	n	%
Sociodemographic
Age (years)
40 - 45	65	25.7
46 - 50	64	25.3
51 - 55	65	25.7
56 - 60	59	23.3
Skin color
White	52	20.6
Non-white	200	79.1
Occupation
Paid work	139	54.9
Unpaid work	113	44.7
Home ownership
Yes	201	79.4
No	52	20.6
Schooling
High school/ Higher Education	109	43.1
Elementary school- No schooling	144	56.9
Behavioral
Smoking
No	177	70.0
Yesformer smoker	76	30.0
Alcohol consumption
No	173	68.4
Yes	80	31.6
Satisfied with body
Yes	105	41.5
No	148	58.5
Anthropometric
Body Mass Index
< 25	86	34.0
≥ 25	167	66.0
Waist circumference
No risk	84	33.2
Metabolic risk	35	13.8
Increased metabolic risk	134	53.0
Gynecological
Climacteric symptoms
Asymptomatic-Mild	67	26.5
Moderate-Severe	185	73.1
Climacteric stages
Premenopause	117	46.2
Post menopause	134	53.0
Type of menopause
Did not have menopause yet	118	46.6
Spontaneous	103	40.7
Hysterectomized	29	11.5
Age of Menopause
Did not have menopause yet	117	46.2
< 50 years	99	39.1
≥ 50 years	35	13.8
Age of Menarche
≥ 12 years	208	82.2
< 12 years	44	17.4
Sexual performance
Sexual performance
Satisfactory performance	120	47.4
Unsatisfactory performance	75	29.6

Variables	Unsatisfactory performance	Satisfactory performance	OR (CI95%)	p
Variables	%	%	Crude	p
Sociodemographics
Age (years)				0.009
40 - 45	23.3	76.7	1.00
46 - 50	37.0	63.0	1.93 (0.86 - 4.36)
51 - 55	54.3	45.7	3.91 (1.70 - 9.00)
56 - 60	45.7	54.3	2.77 (1.13 - 6.77)
Skin color				0.014
White	54.8	45.2	1.00
Non-white	34.0	66.0	0.43 (0.21 - 0.85)
Occupation				0.179
Paid work	34.3	65.7
Unpaid work	43.7	56.3	1.49 (0.83 - 2.67)
Home ownership				0.189
Yes	40.5	59.5	1.00
No	28.1	71.9	0.58 (0.25 - 1.32)
Schooling				0.017
High School-Higher Education	29.1	70.9	1.00
Elementary-No schooling	45.9	54.1	2.07 (1.14 - 3.76)
Behavioral
Smoking				0.183
No	41.3	58.7	1.00
Yesformer smoker	30.8	69.2	0.63 (0.32 - 1.5)
Alcohol consumption				0.074
No	43.0	57.0	1.00
Yes	29.9	70.1	0.57 (0.30 - 1.07)
Satisfied with body				0.119
Yes	45.3	54.7	1.00
No	34.2	65.8	0.63 (0.35 - 1.13)
Anthropometric
Body Mass Index				0.250
< 25	43.8	56.2	1.00
≥ 25	35.9	64.1	0.72 (0.39 - 1.32)
Waist circumference				0.228
No risk	42.4	57.6	1.00
Metabolic risk	50.0	50.0	1.36 (0.53 - 3.47)
Increased metabolic risk	33.3	66.7	0.68 (0.36 - 1.28)
Gynecological factors
Climacteric symptoms				0.019
Asymptomatic-Mild	25.5	74.5	1.00
Moderate-Severe	43.6	56.4	2.26 (1.13 - 4.52)
Climacteric stages				0.019
Premenopause	30.8	69.2	1.00
Post menopause	47.2	52.8	2.01 (1.12 - 3.62)
Type of menopause				0.002
Did not have menopause yet	30.5	69.5	1.00
Spontaneous	56.2	43.8	2.93 (1.54 - 5.59)
Hysterectomized	26.1	73.9	0.81 (0.29 - 2.23)
Age of Menopause				0.027
Did not have menopause yet	30.8	69.2	1.00
< 50 years	43.3	56.7	1.72 (0.91 - 3.25)
≥ 50 years	59.1	40.9	3.25 (1.26 - 8.37)
Age of Menarche				0.094
≥ 12 years	40.9	59.1	1.00
< 12 years	25.7	74.3	0.51 (0.22 - 1.14)

Variables	OR (CI95%)	p	OR (CI95%)	p
Variables	Crude	p	Ajusted	p
Climacteric symptoms		0.019		0.015
Asymptomatic-Mild	1.00		1.00
Moderate-Severe	2.26 (1.13 - 4.52)		2.47 (1.19 - 5.12)
Age of Menarche		0.094		0.056
≥ 12 years	1.00		1.00
< 12 years	0.51 (0.22 - 1.14)		0.43 (0.18 - 1.02)
Schooling		0.017		0.036
High School - Higher Education	1.00		1.00
Elementary - no Schooling	2.07 (1.14 - 3.76)		1.95 (1.04 - 3.65)
Skin color		0.014		0.007
White	1.00		1.00
Non-white	0.43 (0.21 - 0.85)		0.36 (0.17 - 0.76)

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

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[1] Associated Editor: Melânia Amorim