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Assessment of sexual function and related factors in mid-aged sexually active Spanish women with the six-item Female Sex Function Index

Pérez-López, Faustino R. MD, PhD1; Fernández-Alonso, Ana M. MD, PhD2; Trabalón-Pastor, Martina MD2; Vara, Carmen MD2; Chedraui, Peter MD, MSc3for The MenopAuse RIsk Assessment (MARIA) Research Group

doi: 10.1097/gme.0b013e3182546242
Original Articles

Objective The aim of this study was to assess sexual function and related factors (menopause-related quality of life and mood included) in mid-aged Spanish women.

Methods This was a cross-sectional study in which 179 sexually active women (40-65 y old) completed the six-item Female Sexual Function Index (FSFI-6), the Menopause Rating Scale (MRS), the Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire containing personal and partner data.

Results Median age was 51 years; 55.3% of the women were naturally postmenopausal, 47.5% had increased body mass index, and 6.7% had hypertension. Currently, 4.5% and 19.6% of the women used hormone therapy and psychotropic drugs, respectively. A total of 87.7% had a stable partner; 1.3% of partners abused alcohol and 8.3% had erectile dysfunction. Of the surveyed women, 36.9% displayed total FSFI-6 scores of 19 or less (lower sexual function); 40.2%, mood morbidity (total HADS scores ≥11); and 23.5%, impaired quality of life (severe total MRS scores ≥17). Cronbach α for the FSFI-6 was 0.91. Total FSFI-6 scores positively correlated with female and partner education and inversely with female age and scores on the MRS and the HADS (total and subscale values). Multiple linear regression analysis found that total FSFI-6 scores positively correlated with partner educational level and inversely (worse sexual function) with female age, partner issues (alcohol abuse and erectile dysfunction), and total HADS and urogenital and somatic MRS scores.

Conclusions In this mid-aged Spanish sample, as assessed with a short and consistent tool, lower sexual function was related to menopausal and mood symptoms and several women and partner factors. Further research using this instrument is warranted.

From the 1Department of Obstetrics and Gynecology, Universidad de Zaragoza Hospital Clínico Lozano Blesa, Zaragoza, Spain; 2Department of Obstetrics and Gynecology, Hospital Torrecárdenas, Almería, Spain; and 3Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.

Received February 6, 2012; revised and accepted March 6, 2012.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Faustino R. Pérez-López, MD, PhD, Department of Obstetrics and Gynecology, University of Zaragoza Hospital Clínico, Domingo Miral s/n, Zaragoza 50009, Spain. E-mail:

©2012The North American Menopause Society