Influence of Sexual Function on the Social Relations and Quality of Life of Women with Premature Ovarian Insufficiency

 

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Abstract

Objective To evaluate the impact of sexual function (SF) in the quality of life (QoL) of women with premature ovarian insufficiency (POI).

Methods Case-control study in which 80 women with POI were evaluated using estrogen plus progestogen therapy, compared with 80 women matched by age (±2 years) and presenting preserved gonadal function. Sexual function was evaluated using the Female Sexual Function Index (FSFI), and the QoL was evaluated using the World Health Organization's (WHO) QoL assessment instrument (WHOQoL-BREF).

Results The mean age of the women with POI and of the control group was 38.4 ± 7.3 years and 38.1 ± 7.3 years respectively. The QoL, was worse among the POI group, and there were significant differences in the physical (63.4 ± 17.4 and 72.7 ± 15.2 respectively, p = 0.0004) and psychological (63.2 ± 14.6 and 69.3 ± 13.9 respectively, p = 0.0075) domains among this group when compared with the control group. Women with POI presented significantly lower arousal, lubrication, orgasm and satisfaction, more dyspareunia and a worse FSFI scores when compared with the control group. All aspects of SF correlate directly with the worsening of the QoL regarding social relationships.

Conclusion Women with POI showed worse QoL and SF than the control group. The psychological aspects (desire, excitement, orgasm and sexual satisfaction) of SF had greater influence on the parameters of the QoL, while the physical aspects (pain and lubrication) had a low impact on the QoL. The poor SF in women with POI is directly correlated with a worsening across multiple domains of the QoL; however, the negative impact is particularly important in the social domain. These results suggest that the improvement in sexuality can improve the social interactions of women with POI.

Resumo

Objetivo Avaliar o impacto da função sexual na qualidade de vida (QV) de mulheres com insuficiência ovariana prematura (IOP).

Métodos Estudo de caso-controle que avaliou 80 mulheres com IOP usando terapia hormonal combinada (progestagênio e estrogênio), em comparação com 80 mulheres com função gonadal preservada pareadas por idade (±2 anos). A função sexual (FS) foi avaliada por meio do índice de função sexual feminina (IFSF) e a QV, por meio do instrumento da Organização Mundial de Saúde (OMS) para avaliação da QV (WHOQoL-BREF, na sigla em inglês).

Resultados A média etária das mulheres com IOP e do grupo controle foi de 38,4 ± 7,3 e 38,1 ± 7,3 anos, respectivamente. A QV do grupo com IOP foi pior, e verificou-se uma diferença significativa nos domínios físico (63,4 ± 17,4 e 72,7 ± 15,2, respectivamente, p = 0,0004) e psicológico (63,2 ± 14,6 e 69,3 ± 13,9, respectivamente, p = 0,0075) para as mulheres com IOP quando comparadas com o grupo de controle. Mulheres com IOP apresentaram pior pontuação para excitação, lubrificação, orgasmo, satisfação, dispareunia, e pior índice de FS em comparação ao grupo controle. A piora em todos os aspectos da FS foi diretamente correlacionada com a piora no domínio das relações sociais da QV.

Conclusão Mulheres com IOP apresentaram pior QV e FS do que o grupo controle. Os aspectos psicológicos (desejo, excitação, orgasmo e satisfação sexual) da FS exerceram grande influência na QV, enquanto os físicos (dor e lubrificação) exerceram pouca influência. A má função sexual em mulheres com IOP está diretamente correlacionada com uma piora em vários domínios da QV; porém, o impacto negativo é particularmente importante no domínio social, sugerindo que a melhora da sexualidade pode auxiliar na melhor integração social das mulheres com IOP.

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