Department of Reproductive Biology, Case Western Reserve University, Cleveland, Ohio; University Hospitals Cleveland Medical Center, MacDonald Women's Hospital, Cleveland, Ohio.
Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health - Dallas Campus, Dallas, Texas.
Womens Health Issues. 2019 Jul-Aug;29(4):299-307. doi: 10.1016/j.whi.2019.05.009. Epub 2019 Jul 2.
To investigate associations between past-year verbal and/or physical abuse (VA/PA) and sexual (dis)satisfaction, that is, global or frequency-related (dis)satisfactions with sexual activity, among postmenopausal women in the Women's Health Initiative.
A cross-sectional analysis of archival data was performed from the subset of 83,329 Women's Health Initiative participants (clinical trial and/or observational study components) who reported sexual activity in the year before baseline. Associations between VA/PA and global frequency (dis)satisfactions were modeled using logistic regression.
Most participants reported sexual satisfaction (global, 77%; frequency related, 66%). Disappointment with sexual frequency, specifically a desire for more frequent sex, was the most common dissatisfaction expressed. Past-year VA/PA exposure was reported by 9,410 participants (11%). In regression models adjusted for sociodemographic, health and health risk, and menopausal symptom variables, VA/PA was associated with higher rates of global (35% VA/PA exposed vs. 22% non-exposed; adjusted odds ratio, 1.66; 95% confidence interval, 1.53-1.80) and frequency-related dissatisfactions (50% of VA/PA exposed vs. 32% of non-exposed; adjusted odds ratio, 1.73; 95% confidence interval, 1.57-1.90).
Sexual satisfaction was common, but not universally reported by study participants. Sexual dissatisfactions were overrepresented in VA/PA-exposed participants and associated with a desire for more frequent sexual activity. Opportunities for postmenopausal women to receive clinician-led education about safe and healthy ways to increase sexual activity are needed. Further research on this topic, particularly efforts to characterize safety concerns as well as modifiable barriers to satisfying sexual activity among postmenopausal women with recent VA/PA, would ensure that these interventions are evidence based.
调查绝经后妇女过去一年言语和/或身体虐待(VA/PA)与性(不)满意度之间的关联,即对性行为的整体或与频率相关的(不)满意度,这是在妇女健康倡议中进行的。
对来自妇女健康倡议参与者(临床试验和/或观察性研究部分)的 83329 名报告基线前一年有性行为的亚组的档案数据进行了横断面分析。使用逻辑回归模型对 VA/PA 与整体频率(不)满意度之间的关系进行建模。
大多数参与者报告了性满意度(整体,77%;与频率相关,66%)。对性频率感到失望,特别是渴望更频繁的性行为,是最常见的不满。有 9410 名参与者(11%)报告了过去一年的 VA/PA 暴露。在调整了社会人口统计学、健康和健康风险以及绝经症状变量的回归模型中,VA/PA 与更高的整体(暴露于 VA/PA 的 35%与未暴露的 22%;调整后的优势比,1.66;95%置信区间,1.53-1.80)和与频率相关的不满(暴露于 VA/PA 的 50%与未暴露的 32%;调整后的优势比,1.73;95%置信区间,1.57-1.90)相关。
性满意度是常见的,但并不是所有研究参与者都普遍报告。性不满意度在 VA/PA 暴露的参与者中更为突出,并与对更频繁的性活动的渴望有关。绝经后妇女需要有机会接受临床医生主导的关于安全和健康增加性活动的教育。需要对这一主题进行进一步的研究,特别是努力描述安全问题,以及最近经历 VA/PA 的绝经后妇女满足性活动的可改变障碍,以确保这些干预措施是基于证据的。