Abstract
To examine women with pelvic floor dysfunction (PFDs) and identify factors associated with sexual activity (SA) status that impacts quality of life (QoL). We conducted a cross-sectional study that included women > 18 years old who presented with at least one PFD symptom (urinary incontinence [UI] and/or pelvic organ prolapse [POP]), in outpatient clinics specializing in urogynecology and PFD in Fortaleza, state of Ceará, Brazil, using a service evaluation form and QoL questionnaires. The analysis of 659 women with PFD included 286 SA (43.4%) women and 373 non-sexually active (NSA) (56.6%) women, with a mean age of 54.7 (±12) years old. The results revealed that age (odds ratio [OR] = 1.07, 95% confidence interval [CI] 1.03-1.12) and post-menopausal status (OR = 2.28, 95% CI 1.08-4.8) were negatively associated with SA. Being married (OR = 0.43, 95% CI 0.21-0.88) was associated with SA. Pelvic organ prolapse (OR = 1.16, 95% CI 0.81-1.68) and UI (OR = 0.17, 95% CI 0.08-0.36) did not prevent SA. SF-36 Health Survey results indicated that only the domain functional capacity was significantly worse in NSA women (p = 0.012). Two King's Health Questionnaire domains in NSA women, impact of UI (p = 0.005) and personal relationships (p < 0.001), were significantly associated factors. Data from the Prolapse Quality-of-life Questionnaire indicated that NSA women exhibited compromised QoL. Postmenopausal status and age negatively affected SA. Being married facilitated SA. Presence of POP and UI did not affect SA. However, NSA women with POP exhibited compromised QoL.
Highlights
The results revealed that age and post-menopausal status were negatively associated with sexually active (SA)
The results were organized into blocks of data from women with SA and non-sexually active (NSA) status with pelvic floor dysfunction (PFD) regarding: a) clinical and demographic characteristics (►Table 1); b) characteristics according to the type of PFD (►Table 2); c) characteristics according to the physical examination (►Table 3); d) logistic regression analyses related to the association between clinical, demographic and PFD characteristics (►Table 4); and e) to quality of life (QoL) scores (►Table 5)
The results revealed that age (p < 0.001), marital status (p < 0.001), education (p < 0.001), number of births (p < 0.001), obesity (p 1⁄4 0.004), body mass index (BMI) (p 1⁄4 0.007), menopause (p < 0.001) and smoking (p < 0.001) were significantly different between the SA and NSA groups, while family income, diabetes (p 1⁄4 0.967) and systemic arterial hypertension (SAH) (p 1⁄4 0.021) were not significantly different between groups
Summary
In the context of clinical practice, women who are sexually active (SA) and those who are non-sexually active (NSA) with satisfactory self-perception of their sexual function (SF) may experience sexual problems related to pelvic floor dysfunction (PFD).1The reported prevalence of sexual activity in middle-aged and older women ranges from 53 to 79%, depending on the population studied. Panman et al reported that, among older women with PFD, increased age and lower levels of education were predictors of sexual inactivity.Sexual activity and SF rates have not been found to exhibit any differences between women with and without PFD, and women with PFD are as likely to be SA as those without PFD. women with pelvic organ prolapse (POP) are reported to be more likely to avoid sexual activity compared with women with urinary incontinence (UI). Previous studies have reported that PFD strongly affects perimenopausal and postmenopausal women. The reported prevalence of sexual activity in middle-aged and older women ranges from 53 to 79%, depending on the population studied.. Panman et al reported that, among older women with PFD, increased age and lower levels of education were predictors of sexual inactivity. Sexual activity and SF rates have not been found to exhibit any differences between women with and without PFD, and women with PFD are as likely to be SA as those without PFD.. Women with pelvic organ prolapse (POP) are reported to be more likely to avoid sexual activity compared with women with urinary incontinence (UI).. Previous studies have reported that PFD strongly affects perimenopausal and postmenopausal women. The current study sought to identify factors that affect sexual activity in women with PFD, and the impacts of QoL, according to sexual activity status The demand for evaluation and treatment of these conditions has steadily increased in recent years, with increased life expectancy and efforts to promote quality of life (QoL). Sexuality is a fundamental part of human life, and is an important parameter for health and QoL. the current study sought to identify factors that affect sexual activity in women with PFD, and the impacts of QoL, according to sexual activity status
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