Função sexual e fatores associados em mulheres na pós-menopausa

Este é umestudo descritivo, transversal, com380 mulheres de 40 a 65 anos, usuárias de serviços de saúde públicos em 2019. Foram aplicados questionários sobre características demográficas, sobre sintomas climatéricos (menopause rating scale) e sobre a função sexual (Quociente Sexual, versão feminina). Análises bivariada e múltipla por regressão logística foram realizadas, com cálculo de odds ratio ajustado (OR_aj) e intervalos de confiança de 95% (ICs95%).

Resultados

Mais da metade (243/64%) das mulheres participantes no estudo apresentou risco de disfunção sexual, com escores mais baixos dos domínios desejo e interesse sexual, conforto, orgasmo e satisfação. Mulheres com companheiro (OR_aj 2,07; IC95% 1,03-4,17) e aquelas que relataram problemas de sono (OR_aj 2,72; IC95% 1,77-4,19), ânimo depressivo (OR_aj 2,03; IC95% 1,32-3,10), queixas sexuais (OR_aj 8,16; IC95% 5,06-13,15) e ressecamento vaginal (OR_aj 3,44; IC95% 2,22-5,32) apresentaram maior chance de disfunção sexual.

Conclusão

Houve prevalência elevada de disfunção sexual, com influência da conjugalidade e dos sintomas climatéricos sobre a função sexual.

Palavras-chave:
sexualidade; disfunções sexuais psicogênicas; climatério; saúde da mulher; pós-menopausa

Characteristics	n	%
Age range (years)
40–49	48	12.6
50–59	260	68.4
60–65	72	18.9
Skin color
Yellow/indigenous	8	2.1
White	48	12.6
Black/brown	324	85.3
Education (years)
No	18	4.7
Up to 11	339	89.2
> 11	23	6.1
Professional occupation
With occupation	192	50.5
With no occupation	188	49.5
Family income (wages)
No	14	3.7
Up to 2	294	77.4
> 2	71	18.7
Do not know how to inform	1	0.3
Conjugality
No	37	9.7
Yes	343	90.3
Use of hormone therapy
No	358	94.2
Yes	22	5.8

Variables	Present symptoms	Risk of sexual dysfunction (SQ-F ≤ 60)	Absence of sexual dysfunction (SQ-F ≥ 62)	p-value^* * Pearson's chi-square test.
Variables	n (%)	n (%)	n (%)
Domains
Psychological	271 (71.3)	191 (70.5)	80 (29.5)	< 0.001
Somatic	295 (77.6)	209 (70.8)	86 (29.2)	< 0.001
Urogenital	300 (78.9)	218 (72.7)	82 (27.3)	< 0.001
Symptoms
Hot flashes	221 (58.2)	157 (71.0)	64 (29.0)	< 0.001
Cardiac malaise	175 (46.0)	125 (71.4)	50 (28.6)	< 0.001
Sleeping problems	212 (55.8)	157 (74.1)	55 (25.9)	< 0.001
Depressed mood	195 (51.3)	140 (71.8)	55 (28.2)	< 0.001
Irritability	222 (58.4)	159 (71.6)	63 (28.4)	< 0.001
Anxiety	255 (67.1)	177 (69.4)	78 (30.6)	< 0.001
Physical and mental exhaustion	212 (55.8)	157 (74.1)	55 (25.9)	< 0.001
Sexual problems	246 (64.7)	198 (80.5)	48 (19.5)	< 0.001
Bladder problems	69 (18.2)	50 (72.5)	19 (27.5)	< 0.001
Vaginal dryness	214 (56.3)	163 (76.2)	51 (23.8)	< 0.001
Muscle/joint problems	286 (75.3)	186 (65.0)	100 (35.0)	< 0.001

Characteristics	Risk of sexual dysfunction (SQ-F ≤ 60)	Absence of sexual dysfunction (SQ-F ≥ 62)	p-value^* * Pearson chi-square test.
Characteristics	n (%)	n (%)	p-value^* * Pearson chi-square test.
Age range (years)
40–49	28 (58.3)	20 (41.7)	0.620
50–59	170 (65.4)	90 (34.6)
60–65	45 (62.5)	27 (37.5)
Skin color
Yellow/indigenous	6 (75.0)	2 (25.0)	0.725
White	32 (66.7)	16 (33.3)
Black/brown	205 (63.3)	119 (36.7)
Education (years)
No	11 (61.1)	7 (38.9)	0.916
Up to 11	14 (60.9)	9 (39.1)
> 11	218 (64.3)	121 (35.7)
Professional occupation
With occupation	162 (66.9)	80 (33.1)	0.108
With no occupation	81 (58.7)	57 (41.3)	0.108
Family income (wages)^a a Do not know how to answer: 1 (0.3%).
Up to 2	194 (63.0)	114 (37.0)	0.048
> 2	61 (85.9)	10 (14.1)	0.048
Conjugality
No	18 (48.6)	19 (51.4)	0.041
Yes	225 (65.6)	118 (34.4)	0.041
Use of hormone therapy
No	229 (64.0)	129 (36.0)	0.975
Yes	14 (63.6)	8 (36.4)	0.975
Total	243 (63.9)	137 (36.1)

Variables	OR_ad¹	95% CI²		p-value^* * Multivariable logistic regression model.
Sociodemographic characteristics
Professional occupation	0.73	0.47	1.14	0.169
Family income	0.26	0.05	1.20	0.084
Conjugality	2.07	1.03	4.17	< 0.001
Symptoms
Hot flashes	1.12	0.658	1.910	0.674
Cardiac malaise	1.15	0.68	1.96	0.598
Sleeping problems	2.72	1.77	4.19	0.001
Depressed mood	2.03	1.32	3.10	0.041
Irritability	1.20	0.66	2.17	0.556
Anxiety	0.86	0.47	1.58	0.623
Physical and mental exhaustion	1.38	0.77	2.47	0.274
Sexual problems	8.16	5.06	13.15	< 0.001
Bladder problems	0.97	0.49	1.92	0.931
Vaginal dryness	3.44	2.22	5.32	< 0.001
Muscle/joint problems	0.69	0.39	1.23	0.204

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Sexual performance and satisfaction	Points	n	%
Good to excellent	82–100	45	11.8
Regular to good	62–80	92	24.2
Unfavorable to regular	42–60	110	29.0
Bad to unfavorable	22–40	105	27.6
Null to bad	0–20	28	7.4
Total	–	380	100.0
Domains	Scores	Average	Level (%)
Sexual desire and interest	0–15	6.47	43.1
Foreplay	0–5	2.92	58.3
Personal excitement/alignment with partnership	0–10	5.27	52.7
Comfort	0–10	4.34	43.4
Orgasm and satisfaction	0–10	4.66	46.6
Total score	0–100	52.12	–