A cross-sectional study of female sexual dysfunction among Turkish pregnant and nonpregnant women: correlation with hormone profile

Year 2019, Volume: 5 Issue: 2, 258 - 267, 04.03.2019

Bahar Sarıibrahim Astepe İşıl Köleli

https://doi.org/10.18621/eurj.432490

Cited By: 2

Abstract

Objectives:
To determine the
prevalence of female sexual dysfunction (FSD) and its correlation with the
androgenic hormones among pregnant and nonpregnant Turkish women.

Methods: This was a cross-sectional study
of 251 women, including 137 healthy pregnant and 114 healthy nonpregnant
Turkish women. Assessment of female sexual function index (FSFI), sociodemographic
characteristics, serum androgen levels, including the total testosterone,
dehydroepiandrosterone sulfate (DHEAS), 1-4 delta androstenedione.

Results: There was a 65.7 % incidence of
FSD in all of the participants, with an incidence of 58.8% in the pregnant and
41.2% in the nonpregnant women. There
was no significant difference in the FSFI total scores between the pregnant and
nonpregnant women (p > 0.05).
Moreover, the androgen levels were not different
between the women with sexual dysfunction and those without. The Spearman
correlation test results were significant between the total testosterone level and
the FSFI arousal domain (r=0.167, p <
0.05), FSFI lubrication domain (r=0.264, p
< 0.01), and FSFI total score (r=0.212, p
< 0.01)., as well as between the androstenedione level and FSFI lubrication
domain (r=0.211, p < 0.01), FSFI
orgasm domain (r=0.156, p < 0.05),
and FSFI total score (r=0.174, p <
0.05). In the logistic regression analysis for sexual dysfunction, an increase in the DHEAS level increased the
sexual dysfunction by 0.996-fold. Women with one pregnancy had 3.312-fold
greater sexual dysfunction than those with no pregnancies. Moreover, the women
with more than eight years of education had 0.358 times more sexual dysfunction
than those with eight years of education and less.

Conclusion: The FSFI total scores were not significantly
different between the pregnant and nonpregnant women. However, there were
significant correlations between the total testosterone and androstenedione
levels and the FSFI total scores. Any increases in the DHEAS level and
educational level in women decrease the chance of developing sexual
dysfunction. 

Keywords

Female sexual function index, androgens, pregnancy

References

• [1] Sexual dysfunctions. In: Diagnostic and Statistical Manual of Mental Disorders. American. Psychiatric Association. 5th ed., 2013.
• [2] Garcia S, Moreno S, Aponte H. Prevalence of sexual dysfunction in female outpatients and personnel at a Colombian hospital: correlation with hormonal profile. J Sex Med 2008;5:1208-13.
• [3] Laumann EO, Nicolosi A, Glasser DB, Paik A, GingellC, Moreira, et al; Gssab Investigators' Group. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005;17:39-57.
• [4] Cayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E. The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women. Urol Int 2004;72:52-7.
• [5] Aslan E, Beji NK, Gungor I, Kadioglu A, Dikencik BK. Prevalence and risk factors for low sexual function in women: a study of 1,009 women in an outpatient clinic of a university hospital in Istanbul. J Sex Med 2008;5:2044-52.
• [6] Oruç S, Esen A, Laçin S, Adigüzel H, Uyar Y, Koyuncu F. Sexual behaviour during pregnancy. Aust NZ J Obstet Gynaecol 1999;39:48-50.
• [7] Lee JT. The meaning of sexual satisfaction in pregnant Taiwanese women. J Midwifery Womens Heal 2002;47:278-86.
• [8] von Sydow K. Sexuality during pregnancy and after childbirth: a meta content analysis of 59 studies. J Psychosom Res 1999;47:27-49.
• [9] Orji EO, Ogunlola IO, Fasubaa OB. Sexuality among pregnant women in South West Nigeria. J Obstet Gynaecol 2002;22:166-8.
• [10] Sayle AE, Savitz DA, Thorp JM Jr, Hertz-Picciotto I, Wilcox AJ. Sexual activity during late pregnancy and risk of preterm delivery. Obstet Gynecol 2001;97:283-9.
• [11] Read JS Klebanoff MA. Sexual intercourse during pregnancy and preterm delivery:effects of vaginal microorganisms. The Vaginal Infections and Prematurity Study Group. Am J Obstet Gynecol 1993;168:514-9.
• [12] Heinig L, Engfer A. Schwangerschaft und Partnerschaft. Rep Psychol 1988;13:56-9.
• [13] Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, Undavalli C, et al. The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab 2014;99:3536-42.
• [14] Dennerstein L, Dudley EC, Hopper JL, Burger H. Sexuality, hormones and the menopausal transition. Maturitas 1997;26:83-93.
• [15] Baulieu EE, Thomas G, Legrain S, Lahlou N, Roger M, Debuire B, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci U S A 2000;97:4279-84.
• [16] Panjari M, Bell RJ, Jane F, Wolfe R, Adams J, Morrow C, et al. A randomized trial of oral DHEA treatment for sexual function, well-being, and menopausal symptoms in postmenopausal women with low libido. J Sex Med 2009;6:2579-90.
• [17] Hackbert L, Heiman JR. Acute dehydroepiandrosterone (DHEA) effects on sexual arousal in postmenopausal women. J Womens Health Gend Based Med 2002;11:155-162.
• [18] Schmidt PJ, Daly RC, Bloch M, Smith MJ, Danaceau MA, St Clair LS, et al. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Arch Gen Psychiatry 2005;62:154-62.
• [19] Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assesment of female sexual function. J Sex Marital Ther 2000;26:191-208.
• [20] Öksüz E, Malhan S. [Reliability and validity of the female sexual function index in Turkish population]. Sendrom 2005;17:54-9. [Article in Turkish]
• [21] Oksuz E, Malhan S. Prevalence and risk factors for female sexual dysfunction in Turkish women. J Urol 2006;175:654-8.
• [22] McCool ME, Zuelke A, Theurich MA, Knuettel H, Ricci C, Apfelbacher C. Prevalence of female sexual dysfunction among premenopausal women: a systematic review and meta-analysis of observational studies. Sex Med Rev 2016;4:197-212.
• [23] Ninivaggio C, Rogers RG, Leeman L, Migliaccio L, Teaf D, Qualls C. Sexual function changes during pregnancy. Int Urogynecol J 2017;28:923-9.
• [24]. Seven M, Akyüz A, Güngör S. Predictors of sexual function during pregnancy. J Obstet Gynaecol 2015;35:691-5.
• [25] Eryılmaz G, Ege E, Zincir H. Factors affecting sexual life during pregnancy in eastern Turkey. Gynecl Obs Invest 2004;57:103-8.
• [26] Erol B, Sanli O, Korkmaz D, Seyhan A, Akman T, Kadioglu A. A cross-sectional study of female sexual function and dysfunction during pregnancy. J Sex Med 2007;4:1381-7.
• [27] Corbacıoğlu Esmer A, Akca A, Akbayir O, Goksedef BP, Bakir VL. Female sexual function and associated factors during pregnancy. J Obstet Gynaecol Res 2013;39:1165-72.
• [28] Davis SR, Davison SL Donath S, Bell RJ. Circulating androgen levels and self-reported sexual function in women. JAMA 2005;294:91-6.
• [29] von Sydow K. Sexuality during pregnancy and after childbirth: a metacontent analysis of 59 studies. J Psychosom Res 1999;47:27-49.
• [30] Morel Y, Roucher F, Plotton I, Goursaud C, Tardy D. Evolution of steroids during pregnancy: maternal, placental and fetal synthesis. Ann Endocrinol (Paris) 2016;77:82-9.
• [31] Hill M, Pašková A, Kančeva R, Velíková M, Kubátová J, Kancheva L, et al. Steroid profiling in pregnancy: a focus on the human fetus. J Steroid Biochem Mol Biol 2014;139:201-22.
• [32] Wåhlin-Jacobsen S, Pedersen AT, Kristensen E, Læssøe NC, Lundqvist M, Cohen AS, et al. Is there a correlation between androgens and sexual desire in women? J Sex Med 2015;12:358-73.
• [33] Fourcroy JL. Customs, culture, and tradition - what role do they play in a woman’s sexuality? J Sex Med 2006;3:954-9.
• [34] Pauleta J, Pereira NM GL. Sexuality during pregnancy. J Sex Med. 2010;7:136–42.
• [35] Fok W, Chan LY, Yuen PM. Sexual behavior and activity in Chinese pregnant women. Acta Obstet Gynecol Scand 2005;84:934-8.
• [36] Laumann EO, Paik A Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537-44.