CC BY
19
Section 11. Medicine
Khaidarova Feruza Alimovna, Chief physician of the Center's clinic, doctor, of Medical Sciences, Republican Specialized Scientific Practical Medical Center of Endocrinology, Tashkent, Uzbekistan Fakhrutdinova Sevara Srazhitdinovna, basic doctorate, Republican Specialized Scientific Practical Medical Center
of Endocrinology, Tashkent, Uzbekistan E-mail: mbshakur@mail.ru
SEXUAL DYSFUNCTIONS AMONG THE WOMEN WITH PRETERM OVARIAN FAILURE
Abstract: In 77.1% of the women with POF psychopathological and subjective significant sexual dysfunctions tended for mutual intensification with formation of "vicious circle" generally negatively effecting either progression of neurotic disorders or satisfaction by intimate relationships and marriage, as a whole, producing pessimistic attitude to the perspectives.
Keywords: preterm ovarian failure, sexual dysfunctions, women.
Preterm ovarian failure (POF) is a complex of symp- Inclusion criteria: absence of menstruation for more than
toms characterized by secondary amenorrhea, hypoestro- one year; 2-4 folds increase of the FSH basal level compared
genia symptoms, and rise of gonadotropins' (FSH, LH) rate in women under 40 [4, 6]. The performed epidemiological studies indicate a close link of the pathology with age. The frequency of POF among women under 20 is 1:10000, while in the age from 30 to 40 years old 1:1000 [3]. POF is observed in 10-28% of the patients with primary amenorrhea, and 4-18% of women with the secondary amenorrhea [2]. Prevalence of POF in the population is equal to 1% [3, 4].
Sexual health is one of important aspects of the quality of life. In spite of the fact, that sexual problems are relevant to both genders, in literature there is prevailing opinion that sexual dysfunctions are more often met among women; approximately 95% of women have one or several dysfunctions [1, 7, 8]. Detection of specific risk factors provides a possibility of early diagnostics and treatment of sexual dysfunctions, by these means improving the quality of life. It is very important to take into account stresses, especially those linked with pathologies and interrelationships in the assessment of the status ofwomen with sexual dysfunctions [5, 10, 11].
In the modern time there are multiple researches performed in the whole world [1, 9], for the study of the prevalence of sexual dysfunctions among women.
The objective of this study was determination of the prevalence of sexual dysfunctions among women with POF with the help of based questionnaires.
Materials and research methods: the study was done at the consultancy polyclinic of the RSSPMC of Endocrinology. We questioned 175 women, among them 105 women with natural menopause composed the first group, and 70 women with POF were included to the second one.
to the normal value; women's age from 35 to 55 years old; the women sexually active within the last 4 weeks.
Exclusion criteria: prolapsus of genitals; superior sexual tract abnormality; urinary infection; intake ofdrugs (antidepressants, anti-epileptic drugs, anti-cholinergic agents, due to their side-effects on sexual function); absence ofsexual activity for 4 weeks.
The questionary for independent fulfillment was divided to three parts. The first part was developed for the achievement of data about social-demographic parameters of women. The second part included a poll named "Female Sexual Function Index" (FSFI) including 19 questions with answers. FSFI involved six parameters such as desire, excitement, lubrication, orgasm, satisfaction, and pain. Total FSFI score was from 2 to 36 points. Total score < 25 was considered to be female sexual dysfunction. [4]. The third part of the questionary consisted of the "Bek's Depression Scale" (BDS) including 24 questions focused on the symptoms relevant to depression. BDS score gradation was from 0 to 63. The presence of depressive disorders was stated at total score > 17 BDS [5].
For the definition of sexual dysfunction risk factors we used logistic regression model. We performed double and multiple logistic regression. In the regression analysis there were seven parameters: group (natural and surgical menopause), age, partner's age, BMI, depression, duration of the marriage, education level were considered to be possible predictors of sexual dysfunction.
Statistical processing of the actual material and graphical images was performed with the help of IBM using SPSS software. Reliability of the data was assessed with the help of reliability criterion.
SEXUAL DYSFUNCTIONS AMONG THE WOMEN WITH PRETERM OVARIAN FAILURE
Results of the study: Average age of the women in the first group was 51 ± 3.4 years old (from 47 to 55), average age in the second group was 40.0 ± 3.3 years old (from 35 to 40). Women in the first group were married for 25.0 ± 3.7 years average, while in the second one 19.0 ± 2.1 years (P < 0.05).
The prevalence of sexual dysfunctions in the first group was 64.8% (68/105) and 77.1% (54/70) among the women of the second group, respectively. There were statistically reliable differences in the prevalence of sexual dysfunctions between the groups (p0.01).
In the analysis of the final score and FSFI parameters we observed statistical differences in the parameters such as desire, excitement (P < 0.05), orgasm (p < 0.05), dysparenuria (p < 0.01) between the first and the second groups. The total average FSFI score was reliably less in women with POF and was equal to 22.2 ± 0.47 points versus 24.1 ± 0.5 (P < 0.01).
The prevalence of depression in these groups was 40.9% (43/105) and 50.0% (35/70) in the first and second groups, respectively. The analysis of the average BDS scores showed statistical differences between the groups (p < 0.01).
After double logistic regression we revealed the basic predictors of sexual dysfunction, such as partner's age (p < 0.01), depression (p < 0.01), and social status (p < 0.05).
Women with POF had risk of development of sexual dysfunctions 9.5 folds higher than the women with natural menopause.
Thus, the analysis of typical profile of the questionary reflecting the most important parameters of female sexuality
allowed us to reveal quite predictable differences in common (prognostic) parameters among the women with POF and natural menopause. The analysis of typical profile of the questionary showed that the lowest values in all three parts were registered in the women with POF, and that indicated negative or indifferent attitude of the greater part of these women to sexual activity. In the same group we noted the lowest ability to sexual excitement and the greatest problems with orgasm occurence.
Dominance of more expressed anxious-depressive symptoms and asthenia in the women with POF testified both severity of psychopathological manifestations, negatively effecting sexual sphere, and intensification of neurotic symptoms in several cases with growing sexual dysadaptation. In 77.1% of the women with POF psychopathological and subjective significant sexual dysfunctions tended for mutual intensification with formation of "vicious circle" generally negatively effecting either progression of neurotic disorders or satisfaction by intimate relationships and marriage, as a whole, producing pessimistic attitude to the perspectives.
Conclusions
1. Women with POF have a risk of sexual dysfunctions development high than women with natural menopause.
2. Depressive disorders are more often observed in the women with POF.
3. Parameters such as excitement, orgasm, and satisfaction are the most significant aspects of sexual function in women during menopause.
References:
1. Alekseyev B. E. Gender-relevant behavior and its accents. SPb.: Speech, - 2006. - 144 p.
2. Poznyakova A. A., Volodina M. A., Pyatayeva S. V Misbalance of antioxidant protection system in the patients with preterm ovarian failure // Obstetrics and gynecology. - 2016. - No. 2. - P. 99-107.
3. Poznyakova A. A., Marchenko L. A., Rukhina N. K. Preterm ovarian failure and cardiac vascular diseases // Obstetrics and gynecology. - 2015. - No. 8. - P. 47-52.
4. Radzinski V.E., Ordiyantz I. M., Pobedinskaya O. S. Modern technologies in the treatment of the patients with ovarian exhaustion syndrome // Obstetrics and gynecology: news, opinions, training. - 2015. - No. 3. - P. 126-136.
5. Basson R. Androgen 'deficiency' in women is problematic // Med Aspects Hum Sex. - 2001. - Sep; 1 (6). - P. 41-3.
6. DSS Research. Researcher's toolkit. Available at: http://www.dssresearch.com. Accessed July 19, - 2010.
7. Garcia S. Prevalence of Sexual Dysfunction in Female Outpatients and Personnel at a Colombian Hospital: Correlation with Hormonal Profile // The J Sex Med. - 2008. - 5: - P. 1209-1214.
8. Hentschel H., Alberton D. L., Sawdy R. J. Sexual function in women from infertile couples and in women seeking surgical sterilization // J Sex Marital Ther.- 2008. - 34. - P. 107-14.
9. Nusbaum M., Gamble G., Skinner B., Heiman J. The high prevalence of sexual concerns among women seeking routine gynecological care // J Fam Pract.- 2000. - 49(3). - P. 229-32.
10. Pauls R.N., Kleeman S. D., Karram M. M. Female sexual dysfunction: principles of diagnosis and therapy. Obstet Gynecol Surv - 2005. - 60. - P. 196-205.
11. Rosen R., Brown C., Heiman J., et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther - 2000. - 26 p.
