Elsevier

Maturitas

Volume 126, August 2019, Pages 45-50
Maturitas

Relationships between body image, sexual dysfunction, and health-related quality of life among middle-aged women: A cross-sectional study

https://doi.org/10.1016/j.maturitas.2019.04.218Get rights and content

Highlights

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    Validated measures have not previously been used to evaluate the relationship between sexual function, body image, relationship with partner, and health-related quality of life (HRQoL) among middle-aged women.

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    Negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Sexual dysfunction tended to be a negative predictor of the mental component summary (MCS) of HRQoL.

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    A higher frequency of orgasm predicted a better physical component summary (PCS) of HRQoL; sexual satisfaction and relationship satisfaction with partner predicted better MCS.

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    These findings will be useful in health education and health promotion for middle-aged women, and help health providers to focus on these predictors when caring for middle-aged women.

Abstract

Objectives

To examine whether body image, sexual function, and relationship with a partner influence health-related quality of life (HRQoL) among middle-aged women, as well as to identify the association with menopausal symptoms.

Main outcome measures

Physical component summary and mental component summary of HRQoL.

Methods

This was an analysis of 1026 women (2013–2014); data regarding demographic characteristics, sexual function, body image, relationship with partner, menopausal symptoms and HRQoL during middle age were collected. HRQoL, sexual function, body image, relationship with partner, and menopausal symptoms were measured using the Medical Outcomes Study SF-12, Female Sexual Function Index (FSFI), Multidimensional Body-Self Relations Questionnaire-Appearance Scale, the Relationship Assessment Scale, and the Greene Climacteric Scale, respectively. A multivariate regression was used to examine factors influencing HRQoL.

Results

After adjusting for covariates, significant factors predicting the physical component summary (PCS) of HRQoL among middle-aged women included the orgasm domain of the FSFI (β = 0.69; p =  0.023), appearance evaluation (β = 0.93; p =  0.037), and menopausal symptoms (β = −0.25; p <  0.001). The factors predicting the mental component summary (MCS) of HRQoL included the satisfaction domain of the FSFI (β = 0.70; p =  0.014), appearance evaluation (β = 2.09; p < 0.001), self-classified weight (β = 1.21; p <  0.001), relationship with partner (β = 0.16; p =  0.034), and menopausal symptoms (β = −0.36; p <  0.001).

Conclusion

The results indicated that negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Higher frequency of orgasm predicted better PCS; sexual satisfaction and satisfaction with relationship with a partner predicted better MCS of HRQoL.

Introduction

Health-related quality of life (HRQoL) is used to assess subjects’ perceived health status, and is a significant health outcome measurement for adults including midlife women [1]. The majority of middle-aged women may experience menopause [2], which is a complex and personal body transition and a psychological change that may affect women’s health [3]. During menopause, the bodily changes in appearance such as weight, shape, skin, hair change, physical menopausal symptoms, and sexual function, can change a woman’s perceptions about her body [4]. Loss of fitness, urogenital symptoms, depressive symptoms and negative self-image were common among women with sexual displeasure [5]. A woman’s bodily perceptions in later life are important, as body image has a significant effect on self-esteem and self-confidence [6].

Lower sexual function of middle-aged women can negatively affect sexual health [7,8]. Menopause-related physical changes, such as vaginal atrophy and a lack of lubrication, often make sexual intercourse difficult [9,10]. Women have less intimate contact and less coitus as menopause progresses [10], but their response to the change varies [11]. A poor relationship with a partner is related to low sexual satisfaction in midlife and older women [12]. Study reported that taking a couple-oriented approach to the evaluation and management of couplepause can help the older couples to improve close relationhip and sexual health [13].

Previous studies have found that socioeconomic and lifestyle factors associated with quality of life in middle-aged women [14]. Studies reported that menopausal symptoms [15], or menopause status are associated with quality of life [16], whereas others found no such association [17].

Until now, less is known about the relationships between sexual function, body image, relationship with a partner, and HRQoL in middle-aged women using validated and reliable measures. The aims of this study were to examine whether sexual dysfunction, sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain), body image (appearance evaluation, appearance orientation, body area satisfaction, and self-classified weight), and relationship with partner influence HRQoL in middle-aged women, as well as to identify the association with menopause.

Section snippets

Study design

In this cross-sectional study, convenient sampling was used to select middle-aged women from three communities in cities in northern Taiwan between 2013 and 2014. This study was approved by the Research Ethics Committee of our institution. The inclusion criteria were women 40–65 years old who were able to read traditional Chinese and complete a questionnaire. We approached and explained the research purpose to undergraduate students at three universities, and asked them to invite their mothers.

Sample characteristics

The subject’s characteristics are shown in Table 1. The mean age (± SE) of the participants was 48.51 ± 0.17 years. The educational status responses of the women indicating middle school and below, high school and undergraduate, or graduate and above were 20.20%, 76.00%, and 3.80%, respectively; 4.39% were single, 95.61% were married, 57.85% were full-time workers, and 42.15% were part-time workers.

Based on univariate regression, we examined the relationship between the participants’

Discussion

The results of this study using reliable measurements show that sexual function, body image, and relationship with a partner were significantly associated with HRQoL in middle-aged women.

In our study, a higher orgasm domain of the FSFI was a positive predictor of PCS among middle-aged women, which is the first finding identifying the relationship between a specific orgasm domain of female sexual function and physical quality of life. Orgasm is a sensation and a cerebral event, which help the

Conclusion

The results of this study identified the impact of sexual function, body image, and relationship with partner on HRQoL among middle-aged women in Taiwan. A high orgasm score and satisfaction with appearance were positive significant factors predicting better PCS of HRQoL. Sexual satisfaction, appearance satisfaction, satisfied with self-classified weight and relationship satisfaction with partner were positive factors predicting a better MCS of HRQoL. These findings will be useful in health

Contributors

Shiow-Ru Chang designed and obtained funding for the study, and contributed to data interpretation and manuscript writing.

Cheng Fang Yang contributed to data collection and manuscript preparation.

Kuang-Ho Chen contributed to data analysis and interpretation.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This study was supported by a grant from the Ministry of Science and Technology of Taiwan (Grant ID MOST 105-2629-B-002-004).

Ethical approval

This research project was reviewed and approved by the Research Ethics Committee of the National Taiwan University Hospital (Number: 201212045RINC).

Provenance and peer review

This article has undergone peer review.

Research data (data sharing and collaboration)

There are no linked research data sets for this paper. Data will be made available on request.

Acknowledgment

This study was supported by a grant from the Ministry of Science and Technology of Taiwan.

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