Determinants of sexual dysfunction among middle‐aged women

Cabral, Patrícia Uchõa Leitão; Canário, Ana Carla Gomes; Spyrides, Maria Helena Constantino; Uchôa, Severina Alice da Costa; Eleutério, José; Gonçalves, Ana Katherine

doi:10.1016/j.ijgo.2012.09.023

Cited by 59 publications

(72 citation statements)

References 23 publications

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“…Diversos estudos realizados com mulheres de faixa etária próxima à da atual pesquisa e utilizando outros instrumentos de avaliação da função sexual mostraram que a idade mais elevada, maior que 48 anos 15 , igual ou maior que 50 9 e igual ou maior que 55 6,14 , estava associada à disfunção sexual. Ainda, estudos realizados na Espanha 19 , na China 20 , na Rússia 21 , no Equador 10 e na Turquia 22,23 também confirmaram o achado de que a idade mais avançada associa-se à disfunção sexual.…”

Section: Discussionunclassified

“…Todavia, não há consenso na literatura. Estudos mostram que mulheres casadas apresentaram mais chances de terem disfunção sexual 10,14,23,24 , enquanto outro evidenciou que as divorciadas ou separadas tiveram maior frequência de disfunção 6 .…”

Section: Discussionunclassified

“…No Brasil, a prevalência de disfunção sexual chega a atingir 49% das mulheres com 18 anos ou mais 5 e 67% daquelas na meia-idade (40 a 65 anos) 6 . Além disso, 60% das brasileiras referem ter diminuição da atividade sexual após a menopausa 7 .…”

Section: Introductionunclassified

“…No entanto, são escassos os estudos que avaliam a sexualidade das brasileiras no climatério 2,6,7,9 . Isso se deve, provavelmente, às questões culturais envolvendo o tema.…”

Section: Introductionunclassified

“…Isso se deve, provavelmente, às questões culturais envolvendo o tema. Embora exista uma maior quantidade de estudos internacionais quanto à sexualidade de mulheres no climatério, não há consenso na literatura sobre os fatores que influenciam a vida sexual nessa fase da vida da mulher 6,[10][11][12] .…”

Section: Introductionunclassified

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Função sexual e fatores associados à disfunção sexual em mulheres no climatério

Cavalcanti¹,

Farias²,

Ithamar³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar a função sexual e os fatores associados à disfunção sexual de mulheres no período do climatério. MÉTODOS: Foi realizado um estudo de corte transversal incluindo 173 mulheres, na faixa etária de 35 a 65 anos, com parceiro fixo nos últimos 6 meses, alfabetizadas, sem comprometimento cognitivo e com atividade sexual há pelo menos 6 meses. O instrumento utilizado para avaliar o desempenho sexual foi o Quociente Sexual, versão feminina. A associação entre disfunção sexual e dados sociodemográficos, antecedentes pessoais e obstétricos e história sexual foi realizada por meio do teste do χ 2 de Pearson e da força de associação, por meio do odds ratio (OR) com intervalo de confiança de 95% (IC95%). RESULTADOS: Neste estudo, 46,2% das mulheres apresentaram disfunção sexual. Houve uma diminuição da chance de disfunção sexual para a faixa etária entre 35 e 49 anos (OR=0,3; IC95% 0,2-0,6) e para as mulheres que se sentiam à vontade para falar sobre sexo (OR=0,5; IC95% 0,2-0,8). Entretanto, presença de osteoporose (OR=3,3; IC95% 1,5-7,6), incontinência urinária (OR=2,0; IC95% 1,1-3,7) e correções cirúrgicas do assoalho pélvico (OR=2,2; IC95% 1,1-4,5) elevaram essa chance. CONCLUSÕES: A frequência de disfunção sexual em mulheres na faixa etária entre 35 e 65 anos foi 46,2% e fatores como osteoporose, incontinência urinária e correções cirúrgicas do assoalho pélvico aumentaram a chance de disfunção sexual. Abstract PURPOSE:To evaluate the sexual function and factors associated with sexual dysfunction in climacteric women. METHODS: A cross-sectional study was conducted on 173 women aged 35 to 65 years old, with a steady partner during the last 6 months, who are literate, without cognitive impairment, and with sexual activity for at least 6 months. The instrument used to assess sexual performance was the Sexual Quotient, female version. The association between sexual dysfunction and sociodemographic data, personal, obstetric and sexual history was determined by Pearson's χ 2 test and strength of association by the odds ratio (OR) with a 95% confidence interval (95%CI). RESULTS: In this study, 46.2% of the women reported sexual dysfunction. There was a decrease in the chance of sexual dysfunction for the age group between 35 and 49 years old (OR=0.3; 95%CI 0.2-0.6) and for women who felt comfortable talking about sex (OR=0.5; 95%CI 0.2-0.8). However, the presence of osteoporosis (OR=3.3; 95%CI 1.5-7.6), urinary incontinence (OR=2.0; 95%CI 1.1-3.7), and surgical corrections of the pelvic floor (OR=2.2; 95%CI 1.1-4.5) increased this chance. CONCLUSIONS: The frequency of sexual dysfunction in women aged 35 to 65 years old was 46.2% and factors such as osteoporosis, urinary incontinence and surgical corrections of the pelvic floor increased the chance of sexual dysfunction.

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Section: Discussionunclassified

Section: Introductionunclassified

“…No entanto, são escassos os estudos que avaliam a sexualidade das brasileiras no climatério 2,6,7,9 . Isso se deve, provavelmente, às questões culturais envolvendo o tema.…”

Section: Introductionunclassified

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Função sexual e fatores associados à disfunção sexual em mulheres no climatério

Cavalcanti¹,

Farias²,

Ithamar³

et al. 2014

Rev. Bras. Ginecol. Obstet.

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Pelvic Organ Prolapse

Costantini

Natale²,

Carbone

et al. 2016

Practical Functional Urology

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Pelvic organ prolapse (POP) is one of the most common problems faced by every gynecologist. Understandably, terminology is very important when describing vaginal or uterine descent, for two reasons. First, the physician's notes must represent the clinical problem and be able to communicate it to another colleague exactly as it has been seen. The second reason is quality assurance in research, where exact terminology is needed to accurately describe changes in pelvic organ prolapse and to allow comparisons between institutions and studies.Urogenital prolapse has traditionally been classifi ed according to the degree of anatomical descent, the site of the defect and the presumably involved pelvic viscera. The large number of different grading systems that have been used refl ects the diffi culty in designing an objective, reproducible system for grading prolapse. Intraand interobserver variability is often of importance and may lead to confusion. This makes diffi cult comparing successive examinations over time in the same woman or between different women. The Baden-Walker halfway system is one of the most used for POP classifi cation. It consists of a simple 0-4 grading scale which classifi es prolapse according to the defect site (urethra, bladder, cervix, or cuff, pouch of Douglas, rectum, and perineum) and descent above or below the vaginal introitus. For its simplicity, the Baden-Walker system has maintained considerable popularity among gynecologists in their daily clinical practice.In 1996 Bump et al. published a new classifi cation: the POP-Q system that has been widely accepted and has become the de facto standard in clinical medicine and research.It has been adopted by major organizations including the International Continence Society (ICS), the Society of Gynecologic Surgeons, the American Urogynecologic Society, and the National Institute of Health (NIH) as an accepted method of describing pelvic support and comparing exams over time or before and after interventions. The POP-Q has been shown to have reproducibility in several centers when the exam is conducted in a standardized fashion. The clinical description of pelvic fl oor anatomy is determined during the physical examination of the external genitalia and vaginal canal. It is critical that the examiner sees and describes the maximum protrusion noted by the individual during her daily activities and during physical examination in gynecological position (better on 45° angle) at maximum effort or Valsalva maneuver. The system relies on specifi c measurements of six defi ned points in the midline of the vaginal wall: Aa, Ba, C, D, Ap, Bp, and three other landmarks: GH (genital hiatus), TVL (total vaginal length), and PB (perineal body). Each of the six points is measured in centimeters above or proximal to the hymen (negative number) or in centimeters below or distal to the hymen (positive number) with the plane of the hymen being defi ned as zero (0). The hymen was selected as the reference point rather the introitus because it is more precisely iden...

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