FEMALE SEXUAL DYSFUNCTION IN LOWER EGYPT

1,264 views

Published on

FEMALE SEXUAL DYSFUNCTION IN LOWER EGYPT

Published in: Health & Medicine
1 Comment
8 Likes
Statistics
Notes
No Downloads
Views
Total views
1,264
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
58
Comments
1
Likes
8
Embeds 0
No embeds

No notes for slide

FEMALE SEXUAL DYSFUNCTION IN LOWER EGYPT

  1. 1. A ELNashar M Hassan M Ibrahim M Eldosoky O Ali Benha University Hospital, Egypt Aboubakr Elnashar
  2. 2. • Sexuality is an important part of health, quality of life and general wellbeing. • Sexual dysfunction is more prevalent in women than in men and is associated with various demographic characteristics. Women of different racial groups show different patterns of sexual dysfunction. • Epidemiological data on FSD are relatively scanty and vary widely. Epidemiological data are important: Assess the magnitude of the problem Develop appropriate service delivery and resource allocation models (Edward et al., 1999). Aboubakr Elnashar
  3. 3. • Female circumcision is one of the traditional practices that is still performed in Egypt and is a possible cause of FSD. • To the best of our knowledge, there is no Egyptian epidemiological study on FSD. This fact stimulated the present study. Aboubakr Elnashar
  4. 4. Aim of the work To assess the prevalence & associated factors of female sexual dysfunction in lower Egypt Aboubakr Elnashar
  5. 5. • A cross-sectional clinic-/hospital-based survey was designed for implementation in married women between 16 and 49 years. • Sample size: The following formula was used to estimate the minimum sample size using Epi-Info version 5.01, 1990. If the approximate prevalence of the problem is 34% (0.34) (Spector & Carey, 1990) and the magnitude of the absolute sampling error that can be tolerated "d" is 0.04 . N= z2 pq /d2 N= (1.96)2 x 0.34 x 0.66/(0.04)2 N= 538.78 Subjects Aboubakr Elnashar
  6. 6. • Thus, at least 539 individuals should be surveyed to achieve the study objective. • A total of 1000 women were chosen to increase the statistical reliability of the study. • The study sample were selected from women in Dakahlia governorate as representative of lower Egypt: {according to Egyptian Demographic Health Survey, 2000, the demographic & cultural characteristics in most governorates of lower Egypt are similar} Aboubakr Elnashar
  7. 7. Aboubakr Elnashar
  8. 8. •936 women complied with the study, while 64 refused to participate, giving a response rate of 93.6%. Aboubakr Elnashar
  9. 9. • The questionnaire used to measure sexual dysfunction comprised 6 response items, each assessing the presence of a critical symptom or a sexual problem. Method Aboubakr Elnashar
  10. 10. Response items included • Lacking or having reduced sexual desire • Frequency of sexual activity • Arousal difficulty i.e. erection problem, ejaculating too rapidly in men and lubrication difficulties in women • Inability in achieving orgasm; • Physical pain during intercourse • Forced to have sex Aboubakr Elnashar
  11. 11. • Demographic characteristics: Age. Duration of marriage. Other wives. Residence status. Level of education. Work & other source of income. • Reproductive features: Number of children Mode of delivery Method of birth control . • Health and lifestyle: Emotional and psychological causes or stress-related problems e.g. potentially traumatic events such as sexual harassment or termination of pregnancy, circumcision, health status and husband travelling abroad. Aboubakr Elnashar
  12. 12. Reason (s) of attending medical service Total Variable No % 936 100 239 (25.5)Accompany a patient 40 (4.3)Sex problems 180 (19.2)Obstetric reason (s) 334 (35.7)Gynecological reason (s) 143 (15.3)Family planning The low rate of overt complaints regarding sexual problems among Egyptian women does not indicate lack of sexual interest but rather reflects cultural factors such as shyness, embarrassment and reluctances of the women and lack of physicians’ awareness and training, which lead to inadequate identification and management of such problemsAboubakr Elnashar
  13. 13. Frequency, satisfaction of current frequency, and satisfying frequency of sexual intercourse among women (No = 936) %No Intercourse frequency 12.6118Once/day 2.725>1/day 12.2114Once/week 58.55472-4/week 14132<1-2 / month %NoSatisfaction prevalence 63.8597Satisfied 36.2339Not satisfied %NoSatisfying frequency 100339Total unsatisfied women 34.21161 / week 25.7872 / week 17.1583 / week 23.078Others (>3 / week and <1/ week) Aboubakr Elnashar
  14. 14. Prevalence of sexual problems among studied women according to women's perceptions %NoGroups 31.1291No apparent sex problems 68.9645Women with sex problems 45.9430• Distressed by them*. 23.0215• Not distressed by them 100936Total *One hundred and eight (11.5%) women suffered from FSD & sexual abuse Aboubakr Elnashar
  15. 15. Types of sexual problems among women (No = 936). %NoType Desire problem 49.6464Decrease or loss of desire 3.634Increase desire 53.2498Total Arousal problem 24.8232Occasional difficulty 11.2105Always difficult 36.0337Total Orgasmic problem 10.598Primary anorgasmia 6.460Secondary total anorgasmia 26.1244Occasional anorgasmia 43.0402Total Dyspareunia 4.643Superficial 12.5117Deep 14.4135All through 31.5295Total Aboubakr Elnashar
  16. 16. Female sexual problems relative to socio- demographic characteristics of women Test of significance p= Women with sex problems Women without sex problems Variable No % 645 100 No % 291 100 0.57 0.031 0.99 0.017 Age 57 (8.8)29 (10.0)< 20 years 302 (46.8)156 (53.6)20-29 years 203 (31.5)86 (29.6)30-39 years 83 (12.9)20 (6.9)40-49 years 0.72 Residency 378 (58.6)178 (61.1)Rural 267 (41.4)113 (38.8)Urban 0.94 0.83 Type of family 114 (17.8)52 (17.9)Extended Family 531 (82.3)239 (82.1)Nuclear Family 0.28 0.31 0.001 0.80 Education 179 (27.8)89 (30.6)Illiterate 98 (15.2)37 (12.7)Primary 409 (63.4)140 (48.1)Secondary 59 (9.1)25 (8.6)University 0.77 0.55 0.31 0.25 Work status 119 (18.4)56 (19.2)Professional 36 (5.6)12 (4.2)Farmer 40 (6.2)14 (4.8)Laborer 450 (69.8)209 (71.8)House wife 0.049 Circumcision status 58 (9)33 (11.3)No 587 (91)258 (88.7)Yes Aboubakr Elnashar
  17. 17. Female sexual abuse among participants according to statistically significant variables of wives Test of significance p= Women with sexual abuse Women without sexual abuseTotal Variable No 108 (100%)No 828 (100%)No 936 (100%) 0.69 0.45 0.72 0.23 Age 11 (10.2)75 (9.1)86 (9.2)< 20 years 50 (46.3)408 (49.3)458 (48.9)20-29 years 32 (29.6)257 (31.0)289 (30.9)30-39 years 15 (13.9)88 (10.6)103 (11.0)40-49 years 0.002 0.014 0.009 0.015 Education 40 (37.0)228 (27.5)268 (28.6)Illiterate 23 (21.2)112 (13.2)135 (14.4)Primary school attainment 41 (38.0)408 (49.3)449 (48)Secondary school attainment 4 (3.8)80 (9.7)84 (9.0)University graduated 0.026 0.80 0.99 0.0001 0.99 Reasons of attendance 22 (20.3)217 (26.2)239 (25.5)Accompany a patient 5 (4.6)35 (4.2)40 (4.3)Sex problems 16 (14.8)164 (19.8)180 (19.2)Obstetric reasons 52 (48.1)283 (34.2)333 (35.8)Gynaecological reasons 13 (12.0)129 (15.6)142 (15.2)Family planning 0.16 Menstrual pattern 64 (59.3)563 (68.0)627 (67.0)Normal 44 (40.7)265 (32.0)309 (33.0)Abnormal 0.40 0.001 0.002 0.001 Parity 16 (14.8)110 (13.3)126 (13.5)Nullipara 26 (24.1)408 (49.3)434 (46.4)1-2 deliveries 11 (10.2)290 (35.0)301 (32.2)3-5 deliveries 55 (50.9)20 (2.4)75 (8.1)> 5 deliveries 0.024 Circumcision status 4 (3.7)87 (10.5)91 (9.7)No 104 (96.3)741 (89.5)845 (90.3)Yes - 0.0001 0.76 0.089 Surgical procedures 59 (54.6)572 (69.1)631 (67.4)Non 27 (25.0)110 (13.3)137 (14.6)Gynecological 16 (14.8)125 (15.1)141 (15.1)Non gynecological 6 (5.6)21 (2.5)27 (2.9)Spine and traumatic accidents Aboubakr Elnashar
  18. 18. Female sexual abuse among participants according to statistically significant variables of husbands Test of significance p= Women with sexual Women without sexual abuseTotal Variable No % 108 11.5 No % 828 88.5 No % 936 100 Age 24 (22.2)195 (23.6)219 (23.4)20-29 35 (32.4)369 (44.0)399 (42.6)30-39 19 (17.6)178 (21.4)197 (21.1)40-49 30 (27.8)91 (11.0)121 (12.9)> 50 0.001 0.014 0.003 0.008 Education 50 (46.3)221 (26.7)271 (29.0)Illiterate 23 (21.3)128 (15.5)151 (16.1)Primary school attainment 30 (27.8)341 (41.1)371 (39.6)Secondary school attainment 5 (4.6)138 (16.7)143 (15.3)University graduated 0.001 Smoking 37 (34.3)415 (50.1)452 (48.3)No 71 (65.7)413 (49.9)484 (51.7)Yes 0.967 Medical disorders* 101 (93.5)751 (90.7)852 (91.0)No 7 (6.5)77 (9.3)84 (9.0)Yes 0.001 Drugs usage** 79 (73.1)732 (88.4)811 (86.6)Non users 29 (26.9)96 (11.6)125 (13.4)Users - 0.58 0.92 Surgical procedures 99 (91.2)732 (88.4)831 (88.8)Absent 4 (3.7)51 (6.2)55 (5.9)Varicocele & hernia repair operation 5 (4.6)45 (5.4)50 (5.3)Spine & trauma operation Aboubakr Elnashar
  19. 19. Aggravating factors in relation to female sexual problems (No = 645) %NoFactors 28.1181No aggravating factors 28.1181Unfavorable socioeconomic 16.0103Marital disharmony & hate 15.7101Pregnancy related 3.120Delivery related 3.120Contraception related 2.315Infertility related 3.724Combined factors and male or female health problems. Aboubakr Elnashar
  20. 20. Ameliorating factors in relation to female sexual problems (No = 645) %NoFactors 84.5545No ameliorating factors 10.368Marital adjustment 5.232 Medical consultation & treatment Most women reported receiving no assistance for their sexual problems. Only 5.2% (32 of the 645) with sexual problems had received treatment Aboubakr Elnashar
  21. 21. Conclusion In Lower Egypt: • FSD is a highly prevalent problem with a low reporting and very low treatment rates. • The most prevalent types of FSD: Decreased desire (49.6%), Anorgasmia (43.0%) Difficult arousal (36.0%) Aboubakr Elnashar
  22. 22. • The commonest predictors of FSD: Unfavorable socioeconomic circumstances Marital disharmony Pregnancy related events. Aboubakr Elnashar
  23. 23. Recommendation • The high prevalence of FSD among apparently healthy individuals emphasises the importance of direct questioning about sexual function as part of the routine checklist in gynaecology and family planning clinics • FSD is under- researched & therefore warrants recognition as a significant public health concern with a need for further epidemiological research. • Most physicians receive little or no formal training in this critical area. Studies of physician awareness and competency in FSD are urgently needed. Aboubakr Elnashar
  24. 24. Aboubakr Elnashar

×