OJOG  Vol.5 No.4 , April 2015
Socioeconomic Variables Effecting Female Sexual Function in an Urban, Community Setting
ABSTRACT

Introduction: Female sexual dysfunction is a common problem affecting 12% - 63% of the population, and its relationship with demographic factors, depression, and urinary incontinence needs to be more clearly identified. Aims: To determine demographic and clinical conditions associated with female sexual dysfunction in an urban population of women seeking routine gynecologic care. Methods: A cross-sectional, IRB approved study with a convenience sample was performed of 238 sexually-active, non-pregnant women reporting to two urban gynecology clinics: a private practice (n = 168) and a publicly funded ambulatory clinic (n = 70). Main Outcome Measures: The participants completed informed consent and a demographic questionnaire, plus validated questionnaires that measured sexual function with the Female Sexual Function Index (FSFI), depression with the Center for Epidemiologic Studies Depression Scale (CES-D), and urinary incontinence with the Questionnaire for Urinary Incontinence Diagnosis (QUID). Results: The mean FSFI score for those with public insurance and private insurance was 29.5 ± 4.2 and 27.8 ± 5.1 (OR 0.746, p = 0.0005, 95% CI 0.633, 0.881) respectively. In comparing “private” and “public” patient groups, age, weight, race, education, employment, exercise, household income, smoking, alcohol frequency, and sex frequency were all significantly different (p < 0.05). Multivariate logistic regression analysis found that female sexual dysfunction correlated with less education (OR 1.379, p = 0.0346, 95% CI 1.024, 1.858), and worsening depression identified by CES-D score (OR 1.088, p < 0.0001, 95% CI 1.043, 1.135). Conclusions: Female sexual dysfunction was associated with decreased household income, urinary incontinence, less education, and depression.


Cite this paper
Neal, K. , Teng, S. , Nyamukapa, M. , Greenberg, V. , Braverman, A. and Worly, B. (2015) Socioeconomic Variables Effecting Female Sexual Function in an Urban, Community Setting. Open Journal of Obstetrics and Gynecology, 5, 195-202. doi: 10.4236/ojog.2015.54028.
References
[1]   Worly, B., Gopal, M. and Arya, L. (2010) Sexual Dysfunction among Women of Low-Income Status in an Urban-Setting. International Journal of Gynecology & Obstetrics, 111, 241-244.
http://dx.doi.org/10.1016/j.ijgo.2010.06.019

[2]   Laumann, E.O., Paik, A. and Rosen, R. (1999) Sexual Dysfunction in the United States: Prevalence and Predictors. JAMA, 281, 537-544.
http://dx.doi.org/10.1001/jama.281.6.537

[3]   Shifren, J., Monz, B., Russo, P., Segreti, A. and Johannes, C. (2008) Sexual Problems and Distress in United States Women: Prevalence and Correlates. Obstetrics & Gynecology, 112, 970-978.
http://dx.doi.org/10.1097/AOG.0b013e3181898cdb

[4]   Jiann, B.P., Su, C.C., Yu, C.C., Wu, T. and Huang, J.K. (1999) Risk Factors for Individual Domains of Sexual Function. The Journal of Sexual Medicine, 6, 3364-3375.
http://dx.doi.org/10.1111/j.1743-6109.2009.01494.x

[5]   Frank, E., Anderson, C. and Rubinstein, D. (1978) Frequency of Sexual Dysfunction in “Normal” Couples. The New England Journal of Medicine, 299, 111-115.
http://dx.doi.org/10.1056/NEJM197807202990302

[6]   Masters, W. and Johnson, V. (1966) Human Sexual Response. Little, Brown, Boston.

[7]   American Psychiatric Assoc. (2000) Diagnostic and Statistical Manual of Mental Disorders. 4th Edition, Text Revision. Washington DC, 535 p.

[8]   Bancroft, J., Loftus, J. and Long, J. (2003) Distress about Sex: A National Survey of Women in Heterosexual Relationships. Archives of Sexual Behavior, 32, 193-208.
http://dx.doi.org/10.1023/A:1023420431760

[9]   Kaplan, H. (1979) Disorders of Sexual Desire and Other New Concepts and Techniques in Sex Therapy. Brunner/ Hazel Publications, New York.

[10]   Berman, J. and Bassuk, J. (2002) Physiology and Pathophysiology of Female Sexual Function and Dysfunction. World Journal of Urology, 20, 111-118.
http://dx.doi.org/10.1007/s00345-002-0281-4

[11]   Working Group on a New View of Women’s Sexual Problems (2000) A New View of Women’s Sexual Problems. Electronic Journal of Human Sexuality, 3.
www.ejhs.org/volume3/newview.htm

[12]   Whipple, B. (2002) Women’s Sexual Pleasure and Satisfaction. A New View of Female Sexual Function. The Female Patient, 27, 39-44.

[13]   Basson, R. (2001) Female Sexual Response: The Role of Drugs in the Management of Sexual Dysfunction. Obstetrics & Gynecology, 98, 350-353.
http://dx.doi.org/10.1016/S0029-7844(01)01452-1

[14]   Whipple, B. and Brash-McGreer, K. (1997) Management of Female Sexual Dysfunction. In: Sipski, M.L. and Alexander, C.J., Eds., Sexual Function in People with Disability and Chronic Illness. A Health Professional’s Guide, Aspen Publishers, Inc., Gaithersburg, 509-534.

[15]   Sand, M. and Fisher, W.A. (2007) Women’s Endorsement of Models of Female Sexual Response: The Nurses’ Sexuality Study. The Journal of Sexual Medicine, 4, 708-719.
http://dx.doi.org/10.1111/j.1743-6109.2007.00496.x

[16]   World Health Organization (2012) Sexual Health.
http://www.who.int/topics/sexual_health/en/

[17]   Marwick, C. (1999) Survey Says Patients Expect Little Physician Help on Sex. JAMA, 281, 2173-2174.
http://dx.doi.org/10.1001/jama.281.23.2173

[18]   Avis, N., Zhao, X., Johannes, C., Ory, M., Brockwell, S. and Greendale, G. (2005) Correlates of Sexual Function among Multi-Ethnic Middle-Aged Women: Results from the Study of Women’s Health Across the Nation (SWAN). Menopause, 12, 385-398.
http://dx.doi.org/10.1097/01.GME.0000151656.92317.A9

[19]   Rogers, R.G., Kammerer-Doak, D., Villarreal, A., Coates, K. and Qualls, C. (2001) A New Instrument to Measure Sexual Function in Women with Urinary Incontinence or Pelvic Organ Prolapse. American Journal of Obstetrics and Gynecology, 184, 552-558.
http://dx.doi.org/10.1067/mob.2001.111100

[20]   Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D. and D’agostino, R. (2000) The Female Sexual Function Index (FSFI): A Multi-Dimensional Self-Report for the Assessment of Female Sexual Function. Journal of Sex & Marital Therapy, 26, 191-208.
http://dx.doi.org/10.1080/009262300278597

[21]   Wiegel, M., Meston, C. and Rosen, R. (2005) The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores. Journal of Sex & Marital Therapy, 31, 1-20.
http://dx.doi.org/10.1080/00926230590475206

[22]   Eaton, W., Muntaner, C., Smith, C., Tien, A. and Ybarra, M. (2004) Center for Epidemiologic Studies Depression Scale: Review and Revision (CESD and CESD-R). In: Maruish, M.E., Ed., The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, 3rd Edition, Lawrence Erlbaum, Mahwah, 363-377.

[23]   Bradley, C.S., Rahn, D.D., Nygaard, I.E., Barber, M.D., Nager, C.W., Kenton, K.S., Siddiqui, N.Y., Abel, R.B., Spino, C. and Richter, H.E. (2010) The Questionnaire for Urinary Incontinence Diagnosis (QUID): Validity and Responsiveness to Change in Women Undergoing Non-Surgical Therapies for Treatment of Stress Predominant Urinary Incontinence. Neurourology and Urodynamics, 29, 727-734.
http://dx.doi.org/10.1002/nau.20818

 
 
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