@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2020;7(1):5-12

Background
... [1-5]. Sexual function can be impaired by several factors, such as menopause [6].
Previous Studies
... [7-26]. Since the systematic study of human sexual behaviors has been studied, it has become clear that sexual dysfunction is more common than was expected [27]. According to community-based studies conducted in different countries, the prevalence of sexual dysfunction in women is estimated to be between 25 and 63%, which is higher in postmenopausal women and ranges from 68 to 86.5% [28]. In many cases, sexual dysfunction can cause severe discomfort and problems in interpersonal communication and affect women's self-esteem [29, 30]. On the importance of interpersonal relationships, studies have shown that women who do not have a good relationship with their husbands and are unable to express their sexual needs are more likely to have sexual dysfunction than other women [31]. This problem can be seen in couples as social and family conflicts [32]. Many factors can affect the sexual function of postmenopausal women, which have been investigated in numerous studies [21, 27, 33, 34].
Aim(s)
The aim of this study was to investigate the relationship between sexual dysfunction and demographic factors in postmenopausal women.
Research type
This research was a cross-sectional descriptive-analytical study.
Research society, place and time
This study was performed on postmenopausal women referred to comprehensive health centers in Hamadan from October to March 2018.
Sampling method and number
SAVE13: Stata module 13 was used to determine sample size. According to previous studies [35] and considering 18 predictive and tested variables, alpha value of 0.05, power of 0.8 and attrition of 10%, sample size was finally calculated 315 people.
Used devices&materials
Demographic characteristics questionnaire and Female Sexual Function Index (FSFI) questionnaire were used to collect data. Data were finally entered into Stata 13 software. The Kolmogorov-Smirnov test was used to examine the distribution of sexual function scores. Univariate and multivariate linear regression analysis were used to examine the relationship between sexual function scores of postmenopausal women and the independent variables studied.
Findings by Text
The mean age of participants was 54.12±4.25 years and the mean duration of menopause was 65.82±47.55 months. The majority of participants had a below diploma degree and the majority were housewives (Table 1).The mean scores of all domains of FSFI were lower than the cut-off point for each domain. Also, the highest dysfunction was in arousal and the least was in satisfaction and there was no dysfunction in pain. The mean score of sexual functioning in postmenopausal women was 18.92±4.25, indicating poor sexual functioning in this group of women (Table 2).In univariate analysis, age, spouse's age, spouse's unemployment, duration of menopause, number of marriages, and dissatisfaction with marriage had a significant negative relationship with sexual function score (p <0.05). In multivariate analysis, age, spouse's age, spouse's education, spouse's occupation, duration of marriage, duration of menopause, number of single children, spouse’s number of marriages, monthly income, and marriage satisfaction explained 25% of the variance in the model (R2 = 0.25 and Adjusted R2 = 0.22). By adjusting the effect of other potential confounding variables, marital satisfaction and marital satisfaction were significantly correlated with sexual function score. As the number of marriages increased, the score of sexual function decreased to 2.45 (p = 0.006). Also, sexual function score was 5.58 lower in those who were not satisfied with their marital status (p <0.001) and this variable was more strongly correlated with decreased sexual function scores than spouses’ number of marriages (Table 3).
Main comparison to the similar studies
In a systematic review by Nazarpour et al., a review of 46 studies on menopause and sexual function from 15 countries showed that in some studies, menopause had a negative effect on sexual function as a transition period and had negative effects on some dimensions of sexual function. However, other studies have suggested that the effect of interpersonal variables, such as satisfaction with marriage, may be more important than the effect of aging or decreasing hormones on sexual function in menopause [21], which is to some extent consistent with our results. Also, in the study by Biotel et al., the results showed that the contribution of psychosocial factors, such as satisfaction with sexual partner is effective in sexual function [37], which is in line with the results of the present study and confirms the importance of interpersonal relationships [38-40]. In Hashmi et al. study on the sexual function of 225 postmenopausal women, the results showed that postmenopausal women's attitudes toward sexual function had a significant effect on their sexual activity [41].
Suggestions
Regarding the high prevalence of sexual dysfunction in postmenopausal women, it is suggested that interventional studies be performed to investigate the effect of different therapeutic methods on improvement of sexual dysfunction in menopausal period.
Limitations
One of the limitations of the study is that sexual function is considered taboo in Iran and it may be difficult for women to respond to the questionnaire.
Conclusions
The sexual function of studied postmenopausal women was undesirable and they had problem in all dimensions, except for sexual pain. Marital satisfaction and number of marriages were associated with sexual dysfunction in postmenopausal women.
Acknowledgments
The authors are grateful to the Ibn Sina University of Medical Sciences, the Hamadan Health Center, and the women participating in the research.
Conflict of interest
None
Ethical Permissions
This research was approved by the Hamadan University of Medical Sciences (ethics code: IR.UMSHA.REC.1397.399).
Funding Sources
This research was extracted from a Master's thesis in midwifery counseling (9708224837), approved by the Research Council of Hamadan University of Medical Sciences.

TABLES and CHARTS

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