Assessment of sexuality among middle-aged women using the Female Sexual Function Index.

OBJECTIVE: The purpose of the present investigation was to assess sexual function among middle-aged women and determine related risk factors (personal and partner) for sexual dysfunction.

METHODS: In this cross-sectional study, women aged 40-59 years were requested to fill out the Female Sexual Function Index (FSFI) and a general demographic questionnaire containing personal and partner data.

RESULTS: A total of 409 women with a mean age of 47 +/- 5.3 years were surveyed. Of these, 42.1% were premenopausal, 24.4% perimenopausal and 33.5% postmenopausal. At the time of survey, 10.5% of women were hysterectomized, 1.5% used psychotropic drugs, and 9.8% were on hormone therapy (HT) for the menopause; 28.1% had less than 12 years of schooling and 80.4% had only one partner at the moment of survey. Among their male partners, 7.3% abused alcohol, 10.3% had erectile dysfunction, 11.2% premature ejaculation and 63.83% were faithful partners. Mean (+/- standard deviation) scores for the FSFI domains were: desire (3.7 +/- 1.2), arousal (3.1 +/- 2.5), lubrication (3.3 +/- 2.6), orgasm (2.6 +/- 2.3), satisfaction (4 +/- 1.7), and pain/dyspareunia (3.2 +/- 2.6). The mean total FSFI score was 20.1 +/- 12.4 (median 24.7). In this series, the prevalence of female sexual dysfunction (FSFI score <or=26.55) was 55.7%, with women presenting difficulties across all domains of female sexual function but mostly in the dyspareunia and lubrication domains. Logistic regression analysis determined that female age (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.6-6.8), p = 0.001), postmenopausal status (OR 2.8, 95% CI 1.3-6.1, p = 0.007), partner's age (OR 2.0, 95% CI 1-4, p = 0.03), educational level (OR 2.7, 95% CI 1.5-5, p = 0.001), and the presence of erectile dysfunction (OR 3.8, 95% CI 1.3-10.9, p = 0.01) and premature ejaculation (OR 4.1, 95% CI 1.4-11.7, p = 0.0001) significantly increased the risk for female sexual dysfunction. Partner faithfulness (OR 0.2, 95% CI 0.1-0.4, p = 0.001) and menopausal HT use (OR 0.4, 95% CI 0.1-1, p = 0.04) decreased this risk.

CONCLUSIONS: In this series, male sexual health and demographic profile and female HT use were relevant determinants for sexual functioning among middle-aged women.