Função sexual de mulheres com infertilidade

Mulheres inférteis (grupo infértil, GI) em idade reprodutiva foram convidadas a participar deste estudo. Um grupo controle (GC) de mulheres foi recrutado da população geral da mesma cidade. A função sexual foi avaliada pelo Índice de Função Sexual Feminina (FSFI, na sigla eminglês), e ansiedade e depressão foram medidas pela Escala Hospitalar de Ansiedade e Depressão (HADS, na sigla em inglês).

Resultados

Um total de 280 mulheres participaram deste estudo, sendo 140 no GI e 140 no GC. A análise dos escores do FSFI mostrou que 47 mulheres (33,57%) no GI e 49 mulheres (35%) no GC apresentaram disfunção sexual (FSFI≤ 26,55; p = 0,90). Mulheres com ansiedade ou depressão tiveram um risco maior de disfunção sexual e a disfunção sexual aumentava o risco de ansiedade e depressão. Asmulheres casadas tiveram um risco menor de depressão do que as mulheres amasiadas.

Conclusão

As mulheres inférteis não apresentaram risco aumentado de disfunção sexual em relação aos controles. Ansiedade e depressão aumentaram o risco de disfunção sexual na população estudada.

Palavras-chave:
infertilidade conjugal; sexualidade; disfunção sexual feminina; ansiedade; depressão; reprodução assistida

Variable		IGn (%)	CGn (%)	p-value
Age (years)	< 40	130 (92.86)	125 (89.29)	0.40
Age (years)	≥40	10 (7.14)	15 (10.71)	0.40
Marital status	Living together	34 (24.29)	46 (32.86)	0.15
Marital status	Married	106 (75.71)	94 (67.14)	0.15
Partner's age (years)	< 40	99 (70.71)	100 (71.43)	0.99
Partner's age (years)	≥40	41 (29.29)	40 (28.57)	0.99
Time of relationship(years)	< 5	10 (7.14)	27 (19.29)	< 0.01
Time of relationship(years)	≥5	130 (92.86)	113 (80.71)	< 0.01
Schooling	Elementary	19 (16.38)	16 (11.43)	0.29
	High school	46 (39.66)	50 (35.72)
	Higher education	51 (43.97)	74 (52.85)
BMI (kg/m2)*	Low weight	2 (1.44)	2 (1.43)	0.72
	Normal weight	63 (45.32)	72 (51.43)
	Overweight	44 (31.65)	42 (30)
	Obese	30 (21.58)	24 (17.14)
Sexarche	< 18 years	70 (50)	64 (45.71)	0.35
Sexarche	≥18 years	70 (50)	76 (54.28)	0.35
Frequency of intercourse	Every 2 months	1 (0.71)	1 (0.71)	0.41
	Once a month	0	3 (2.14)
	Twice a month	4 (2.86)	1 (0.71)
	Three times a month	3 (2.14)	2 (1.43)
	1–3 days a week	111 (79.29)	108 (77.14)
	4–6 days a week	21 (15)	24 (17.14)
	Every day	0	1 (0.71)
Number of partners	< 5	118 (84.28)	106 (75.71)	0.71
	≥5	16 (11.43)	33 (23.57)
	Doesn't know	6 (4.28)	1 (0.71)

Variable	Group	Median (Q1-Q3)	p-value*
Desire	IG	3.60 (3.00–4.20)	0.51
Desire	CG	3.60 (3.00–4.20)	0.51
Excitation	IG	4.20 (3.60–4.80)	0.04
Excitation	CG	4.50 (3.60–5.10)	0.04
Lubrication	IG	5.40 (4.20–6.00)	0.94
Lubrication	CG	5.40 (4.20–6.00)	0.94
Orgasm	IG	4.80 (4.00–5.60)	0.58
Orgasm	CG	4.80 (4.00–5.60)	0.58
Satisfaction	IG	5.20 (4.80–6.00)	0.52
Satisfaction	CG	5.60 (4.00–6.00)	0.52
Pain	IG	5.60 (4.40–6.00)	0.90
Pain	CG	5.60 (4.40–6.00)	0.90

Variable	Sexual dysfunction		p-value
Variable	Yes, n (%)	No, n (%)	p-value
Anxiety (n= 107)	52 (54.2)	55 (29.9)	< 0.01
Depression (n= 34)	24 (25)	10 (5.4)	< 0.01

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs< 40 years old)	1.03	0.40–2.67	0.95	1.09	0.37–3.21	0.88
BMI* (OW vs UW + N)	0.91	0.49–1.71	0.77	0.90	0.44–1.86	0.78
BMI* (O vs UW + N)	0.77	0.37–1.63	0.50	0.66	0.27–1.64	0.37
Marital status (married vs unmarried)	1.66	0.89–3.09	0.11	1.84	0.83–4.05	0.13
Time of relationship, years ( ≥5 vs< 5 years)	2.06	0.86–4.98	0.11	1.36	0.47–3.96	0.57
Schooling (high school vs elementary)	1.98	0.82–4.78	0.13	2.49	0.91–6.83	0.08
Schooling (complete high school vs complete elementary)	0.88	0.37–2.12	0.78	0.96	0.35–2.61	0.94
Pregnancy (yes vs no)	2.01	1.14–3.54	0.02	0.89	0.26–3.02	0.85
Contraception (yes vs no)	1.23	0.71–2.13	0.46	0.84	0.40–1.76	0.65
Parity (yes vs no)	1.82	1.05–3.17	0.03	1.79	0.46–6.98	0.40
Psychotherapy (yes vs no)	1.03	0.34–3.12	0.96	1.96	0.56–6.78	0.29
Cigarette smoking (yes vs no)	0.66	0.23–1.90	0.44	0.54	0.14–2.10	0.37
Alcohol (yes vs no)	2.04	0.40–10.47	0.39	3.31	0.45–24.23	0.24
Alcohol (social vs no)	0.92	0.51–1.67	0.78	1.08	0.52–2.22	0.84
Partner's age (≥40 vs< 40 years)	1.11	0.61–2.02	0.75	1.20	0.60–2.43	0.61
Risk of anxiety (yes vs no)	2.87	1.63–5.05	< 0.01	2.53	1.34–4.81	< 0.01
Risk of depression (yes vs no)	7.10	2.83–17.78	< 0.01	6.85	2.37–19.75	< 0.01
Group (case vs control)	0.77	0.44–1.36	0.37	0.86	0.35–2.09	0.73

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs< 40 years old)	0.79	0.31–2.03	0.62	0.81	0.29–2.27	0.68
BMI* (OW vs UW + N)	0.91	0.50–1.68	0.77	0.98	0.49–1.93	0.95
BMI* (O vs UW + N)	1.05	0.52–2.13	0.89	1.19	0.53–2.66	0.68
Marital Status (married vs unmarried)	1.33	0.74–2.38	0.34	1.47	0.72–3.00	0.29
Time of relationship years (5 or more vs <5)	1.59	0.72–3.51	0.25	1.25	0.50–3.11	0.63
Schooling (high school vs elementary)	1.02	0.44–2.35	0.97	0.90	0.35–2.30	0.82
Schooling (complete high scholl vs complete elementary)	1.06	0.47–2.39	0.88	1.17	0.47–2.91	0.73
Pregnancy (yes vs no)	1.06	0.62–1.80	0.83	1.62	0.51–5.13	0.41
Contraception (yes vs no)	0.82	0.48–1.39	0.46	0.85	0.43–1.68	0.64
Parity (yes vs no)	0.85	0.50–1.44	0.54	0.41	0.12–1.46	0.17
Psychotherapy (yes vs no)	0.79	0.26–2.40	0.68	0.81	0.24–2.73	0.73
Cigarette smoking (yes vs no)	1.08	0.42–2.75	0.87	1.05	0.35–3.16	0.93
Alcohol (yes vs no)	3.53	0.63–19.88	0.15	5.23	0.75–36.43	0.10
Alcohol (social vs no)	1.20	0.68–2.13	0.53	1.41	0.74–2.69	0.30
Partner's age (≥40 years old vs< 40 years old)	1.03	0.57–1.84	0.93	1.00	0.52–1.94	0.99
Sexual Dysfunction (yes vs no)	2.86	1.63–5.05	< 001	2.44	1.29–4.62	< 0.01
Risk of depression (yes vs no)	4.28	1.77–10.32	< 0.01	3.60	1.35–9.61	0.01
Group (case vs control)	1.23	0.72–2.11	0.46	1.01	0.45–2.27	0.98

Variable	OR crude	95% CI crude	p-value	OR adjusted	95% CI adjusted	p-value
Age (≥40 years old vs < 40 years old)	0.33	0.04–2.55	0.29	0.27	0.03–2.62	0.26
BMI* (OW vs UW + N)	0.88	0.37–2.10	0.77	0.69	0.23–2.09	0.52
BMI* (O vs UW + N)	0.63	0.20–1.99	0.43	0.44	0.11–1.73	0.24
Marital Status (married vs unmarried)	0.52	0.24–1.16	0.11	0.21	0.07–0.60	< 0.01
Time of relationship, years (5 or more vs< 5)	2.31	0.52–10.17	0.27	2.37	0.43–12.97	0.32
Schooling (high school vs elementary)	1.02	0.34–3.09	0.97	0.53	0.14–1.96	0.34
Schooling (complete high scholl vs complete elementary)	0.53	0.17–1.66	0.27	0.53	0.13–2.09	0.36
Pregnancy (yes vs no)	2.82	1.20–6.63	0.02	4.61	0.87–24.36	0.07
Contraception (yes vs no)	1.50	0.69–3.26	0.31	1.31	0.46–3.67	0.61
Parity (yes vs No)	2.10	0.96–4.61	0.06	0.63	0.09–4.28	0.64
Cigarette smoking (yes vs no)	1.42	0.39–5.17	0.60	1.24	0.23–6.74	0.80
Partner's age (≥40 years old vs< 40 years old)	0.74	0.30–1.81	0.51	0.51	0.17–1.54	0.23
Sexual dysfunction (yes vs no)	7.62	3.11–18.69	< 0.01	7.59	2.72–21.14	< 0.01
Risk of anxiety (yes vs no)	4.14	1.80–9.51	< 0.01	3.51	1.36–9.06	< 0.01
Group (case vs control)	0.72	0.32–1.59	0.41	0.93	0.23–3.72	0.91

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[1] Address for correspondence Priscilla Bianchini Salomão, Master, Faculdade de Medicina, Universidade de São Paulo de Ribeirão Preto, Av. Bandeirantes, 3900, Monte Alegre, 14040-900, Ribeirão Preto, SP, Brazil (e-mail: pri_salomao@hotmail.com).