Effect of Menopause on Sexual Dysfunction and Depression: A Case-Control Study

Öz

Objective: This study aimed to compare the sexual function and depression levels of women between the ages of 45-55 who have and have not entered menopause. Methods: This cross-sectional and case-control study was completed with a total of 176 married women, aged 45-55, who applied to the Gynecology and Obstetrics Polyclinic in a hospital in the Central Black Sea region, 88 of whom had entered menopause and 88 of whom had not entered menopause, and who met the inclusion criteria for the study. The data of the research was collected using face-to-face interview technique between August 2020 and February 2021. Personal Information Form, Arizona Sexual Experiences Scale (ASEX) and Beck Depression Scale (BDI) were used to collect data. Results: In our study, women in the case and control groups were found to be similar in terms of sociodemographic and some characteristics (p>0.05), but were statistically different in terms of body mass index (p<0.05). Sexual dysfunction was detected in 88.6% of the women in the case group and 51.1% of the women in the control group, and the difference between the groups was found to be statistically significant (p<0.05). The difference between the BDI, ASEX total and sub-score averages of women in the case and control groups was found to be statistically significant (p<0.05). Conclusion: The incidence of sexual dysfunction and depression in women who have gone through menopause is higher than in women who have not gone through menopause.

Anahtar Kelimeler

• Sexual dysfunction
• depression
• menopause

Menopozun Cinsel İşlev Bozukluğuna ve Depresyona Etkisi: Vaka-Kontrol Çalışması

Öz

Amaç: Bu çalışmada 45-55 yaş arası menopoza girmiş ve girmemiş kadınların cinsel işlev ve depresyon düzeylerinin karşılaştırılması amaçlanmıştır. Yöntemler: Kesitsel ve vaka kontrol tipte olan bu çalışma Orta Karadeniz bölgesinde bir hastanede Kadın Hastalıkları ve Doğum Polikliniğine başvuran 45-55 yaş arası, 88’i menopoza girmiş ve 88’i menopoza girmemiş olan, araştırmaya dahil edilme kriterlerini karşılayan toplam 176 evli kadınla tamamlanmıştır. Araştırmanın verileri yüz yüze görüşme tekniği ile Ağustos 2018-Mart 2019 tarihleri arasında toplanmıştır. Verilerin toplanmasında Kişisel Bilgi Formu, Arizona Cinsel Yaşantılar Ölçeği (ACYÖ) ve Beck Depresyon Ölçeği (BDÖ) kullanılmıştır. Bulgular: Çalışmamızda vaka ve kontrol grubundaki kadınlar sosyodemografik ve bazı özelliklerine göre benzer bulunmuş olup (p>0,05), beden kitle indeksi açısından istatistiksel olarak farklı bulunmuştur (p<0,05). Vaka grubundaki kadınların %88,6’sında, kontrol grubundaki kadınların %51,1’inde cinsel işlev bozukluğu tespit edilmiş olup, gruplar arasındaki fark istatistiksel olarak anlamlı bulunmuştur (p<0,05). Vaka ve kontrol grubundaki kadınların BDÖ, ACYÖ toplam ve alt puan ortalamaları arasındaki fark istatistiksel olarak anlamlı bulunmuştur (p<0,05). Sonuç: Menopoza girmiş olan kadınlarda cinsel işlev bozukluğu ve depresyon görülme düzeyi menopoza girmemiş kadınlara göre daha yüksektir.

Anahtar Kelimeler

• depresyon
• cinsel fonksiyon bozukluğu
• menopoz

Kaynakça

1. Gozuyesil E, Avcıbay Vurgec B, Gokyildiz Surucu S, Onat Koroglu C. The relationship between the attitudes towards menopause and SFs among women in the climacteric period, Turkey. Journal of Midwifery and Reproductive Health. 2021;9(3):1-10. doi: 10.22038/jmrh.2021.57544.1698
2. Bülbül T, Mucuk S, Dolanbay M, Turhan İ. Do complaints related to menopause affect sexuality and marital adjustment? Sex Relat Ther. 2020;36(4):1–15. https://doi.org/10.1080/14681994.2020.1813886
3. Erbaş N, Demirel G. Klimakterik dönemdeki kadınların menopoza ilişkin yakınmalarının ve menopozal tutumlarının cinsel yaşam kalitesi üzerine etkisinin değerlendirilmesi. ACU Sağlık Bil Derg. 2017;(4):220–5.
4. Heidari M, Ghodusi M, Rezaei P, Abyaneh SK, Sureshjani EH, Sheikhi RA. Sexual function and factors affecting menopause: A systematic review. Journal of Menopausal Medicine. 2019;25(1):15-27. https://doi.org/10.6118/jmm.2019.25.1.15
5. Nazarpour S, Simbar M, Khorrami M, Jafari Torkamani Z, Saghafi R, Alavi-Majd H. The association between sexual function and body image among postmenopausal women: A cross-sectional study. BMC Women’s Health, 2021;21:1-9. https://doi.org/10.1186/s12905-021-01549-1
6. Nazarpour S, Simbar M, Khorrami M, Jafari Torkamani Z, Saghafi R, Alavi-Majd H. The association between sexual function and body image among postmenopausal women: A cross-sectional study. BMC Women’s Health, 2021;21:1-9.
7. Karimi FZ, Pourali L, Hasanzadeh E, Nosrati SF, Pouresmaeili N, Abdollahi M. Sexual dysfunction in postmenopausal women. Acta Medica Iranica. 2021;59(12):720-725. https://doi.org/10.18502/acta.v59i12.8060
8. Khalesi ZB, Jafarzadeh-Kenarsari F, Mobarrez YD, Abedinzade M. The impact of menopause on sexual function in women and their spouses. African Health Sciences. 2020;20(4):1979-84. Doi: 10.4314/ahs.v20i4.56

9. Lundberg G, Wu P, Wenger N. Menopausal hormone therapy: A comprehensive review, women and ischemic heart diseas. Current Atherosclerosis Reports. 2020;22:33.
10. Yadav V, Jain A, Dabar D, Goel AD, Sood A, Joshi A, Andeshwar S. A meta-analysis on the prevalence of depression in perimenopausal and postmenopausal women in India. Asian Journal of Psychiatry. 2021;57:102581. https://doi.org/10.1016/j.ajp.2021.102581
11. Logan S, Anazodo A. The psychological importance of fertility preservation counseling and support for cancer patients. Acta Obstetricia et Gynecologica Scandinavica. 2019;98:583–97. https://doi.org/10.1111/aogs.13562
12. Düzgün AA, Kök G, Şahin S, Güvenç G. Assessment of depression and sexual quality of life in postmenopausal women. Perspectives in Psychiatric Care. 2022;58(4):2029-36. https://doi.org/10.1111/ppc.13024
13. Senturk Erenel A, Golbasi Z, Kavlak T, Dilbaz S. Relationship between menopausal symptoms and sexual dysfunction among married T urkish women in 40–65 age group. International Journal of Nursing Practice. 2015;21(5):575-83. https://doi.org/10.1111/ijn.12309
14. Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. Beck depression inventory (BDI). Archives of General Psychiatry 1961;4(6):561-71.
15. Hisli N. A study on the validity of Beck Depression Inventory. Journal of Psychology 1988;6:118-22.
16. McGahuey A, Alan J, Gelenberg Cindi A, Laukes, Francisco A, Moreno Pedro L, Delgado, Kathy M, McKnight, Rachel Manber C. The Arizona sexual experience scale (ASEX): reliability and validity. Journal of Sex &Marital Therapy. 2000;26(1):25-40.
17. Soykan A. The reliability and validity of Arizona sexual experiences scale in Turkish ESRD patients undergoing hemodialysis. International Journal of Impotence Research. 2004;16(6):531.
18. Nasreen SZA, Shahreen S, Huq S, Huq S. Genito urinary syndrome of menopause (GSM) or vulvo-vaginal atrophy (VVA): An unspoken sorrow. American Journal of Internal Medicine. 2019;7(6):154-162.
19. Phillips NA, Bachmann GA. The genitourinary syndrome of menopause. Menopause. 2021;28(5):579-88. doi: 10.1097/GME.0000000000001728
20. Cagnacc A, Xholli A, Venier M. Ospemifene in the management of vulvar and vaginal atrophy: focus on the assessment of patient acceptability and ease of use. Patient Prefer Adherence. 2020;14:55–62.
21. Khani S, Azizi M, Elyasi F, Kamali M, Moosazadeh M. The prevalence of sexual dysfunction in the different menopausal stages: A systematic review and meta-analysis. International Journal of Sexual Health. 2021;33(3):439-72. https://doi.org/10.1080/19317611.2021.1926039
22. Rouhbakhsh M, Kermansaravi F, Shakiba M, Navidian A. The effect of couples education on marital satisfaction in menopausal women. Journal of Women & Aging. 2019;31(5): 432-45. doi.org/10.1080/08952841.2018.1510244
23. Meeta M, Majumdar S, Tanvir T, Sharma S, Shah J, Aggarwal N, Joshi SA. Effects of menopause on sexual function in Indian women: A McCoy’s Questionnaire-Based Assessment. Journal of Mid-life Health. 2021;12(2):144. DOI: 10.4103/jmh.jmh_95_21
24. Logan S, Thu WPP, Ho K, Cauley JA, Kramer MS, Yong EL. Sexual inactivity and sexual dysfunction in midlife Singaporean women: A prospective cross-sectional study of prevalence and risk factors. Maturitas. 2021;152:1-9. https://doi.org/10.1016/j.maturitas.2021.07.002
25. Duran AD, Sinan Ö. Doğal ve cerrahi menopoza giren kadınlarda cinsel fonksiyon bozukluklarının ve depresyon durumlarının belirlenmesi. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2020;6(2):150-6. https://doi.org/10.30934/kusbed.633350
26. Trento SRSS, Madeiro A, Rufino AC. Sexual function and associated factors in postmenopausal women. Revista Brasileira de Ginecologia e Obstetrícia. 2021;43:522-9. https://doi.org/10.1016/j.fertnstert.2019.08.005
27. Alblooshi S, Taylor M, Gill N. Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review. Australasian Psychiatry, 2023;31(2):165-73. https://doi.org/10.1177/10398562231165439
28. ACOG. Practice Bulletin No. 141: Management of menopausal symptoms. Erratum in: Obstet Gynecol. 2018;131(3):604. doi: 10.1097/01.Aog.0000441353.20693.78.
29. Zeng LN, Yang Y, Feng Y, Cui X, Wang R, Hall BJ, Xiang YT. The prevalence of depression in menopausal women in China: A meta-analysis of observational studies. Journal of Affective Disorders. 2019;256:337-43. https://doi.org/10.1016/j.jad.2019.06.017
30. Sohn JN. Factors influencing depression in middle aged women: Focused on quality of life on menopause. Journal of Health Informatics and Statistics. 2018;43(2):148-57. https://doi.org/10.21032/jhis.2018.43.2.148
31. Mulhall S, Andel R, Anstey KJ. Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas. 2018;108:7-12. https://doi.org/10.1016/j.maturitas.2017.11.005
32. Tang R, Luo M, Li J, Peng Y, Wang Y, Liu B, Chen R. Symptoms of anxiety and depression among Chinese women transitioning through menopause: Findings from a prospective community-based cohort study. Fertility and Sterility. 2019;112(6):1160-71. https://doi.org/10.1016/j.fertnstert.2019.08.005
33. Padda J, Khalid K, Hitawala G, Batra N, Pokhriyal S, Mohan A, Zubair U. Depression and its effect on the menstrual cycle. Cureus. 2021;13(7):e16532. doi: 10.7759/cureus.16532
34. Sydora BC, Yuksel N, Veltri NL, Marillier J, Sydora CP, Yaskina M, Ross S. Patient characteristics, menopause symptoms, and care provided at an interdisciplinary menopause clinic: Retrospective chart review. Menopause, 2018:25(1):102-5. DOI: 10.1097/GME.0000000000000942