Prevalence and risk factors of female sexual dysfunction among healthcare personnel in malaysia
Introduction
Female sexual dysfunction (FSD) is a highly prevalent disorder, which affects 11%–43% of women [1], [2], [3], [4] and has a profound negative impact on a woman's self esteem, her relationships and overall quality of life [5]. The mechanisms underlying FSD are complex and multi-factorial. It is also dynamic, that at different stages in a woman's life, the reasons underlying sexual problems may vary, taking into account the physiological changes related to aging as well as psychosocial circumstances. An interaction of biological, psychosexual and contextual factors is frequently implicated, and this makes a thorough assessment of FSD imperative [6].
FSD is associated with poor perception of personal health status, lower education level, depression, anxiety, thyroid conditions, urinary incontinence and older age [7]. The effect of drugs like antidepressants on FSD is also significant [8]. Other associated factors for FSD are economic hardship, being unmarried, and having had early traumatic sexual experience [1], [2]. The association between a woman's age and her academic status has been inconsistent, with difference in the opinion of various researchers [2], [4], [9].
In a conservative society like Malaysia, matters pertaining to sexuality are not discussed openly and neither it is frequently a focus of clinical attention. Indeed, the influence of cultural attitudes and beliefs does play a major role in determining the help seeking behavior of women with sexual difficulties and influence the way physicians approach the problem [10]. Nevertheless, during recent years, there has been an interest to study FSD in Malaysia. Cross sectional surveys have found rates of FSD in primary care populations ranging between 18.2% and 29.6% [11], [12], [13], [14]. These studies have found FSD to be associated with older age and menopause, a higher academic status, being married longer, having more children and an older husband as well as a lower frequency of sexual intercourse.
The present study was conducted with the aim of determining the prevalence and risk factors of FSD among female healthcare personnel from selected tertiary government hospitals in Malaysia. Female healthcare personnel were chosen as the study sample because it was postulated that they would have a good perception of personal health status and furthermore, studies of sexual health among healthcare personnel have never been done in Malaysia.
Section snippets
Study design, sample size and sampling
This cross-sectional study was conducted between August 2010 and September 2011 in three large tertiary government hospitals in Malaysia, whose locations were in urban and rural areas. The selection of the three sites was done by means of convenience sampling and essentially they were chosen for logistical reason. The principal investigator was working in two of the sites, and at the third site the data were collected by another investigator. At each center, the female healthcare personnel were
Results
A total of 266 women who fulfilled the inclusion criteria were randomly selected, of which 43 did not give their consent to participate in the study. A further 22 women were excluded from the study due to incomplete or incorrectly answered questionnaires; hence the final number and response rate of female subjects were 201 and 75.6%, respectively. The corresponding partners of the respondents were lower (n = 163), as 38 partners of the respondents refused to give the consent. The mean age (years)
Discussion
Epidemiological surveys pertaining to sexual problems in Malaysian women have only begun to surface, in the last few years [13], [14]. The prevalence of FSD in this study was 5.5%. This was markedly lower than other studies done in Malaysia, which showed rates of 18.2% to 29.6% [14]. This discrepancy, while significant, is not surprising in view of the differences in the study populations and methodology. Having been conducted in primary care settings and amongst women with medical problems
Conclusion
Approximately 1 in 18 healthy female healthcare personnel suffers from FSD. Within specific domains of female sexual function, low sexual desire was the most prevalent, affecting 18.9% of the women. Duration of marriage, frequency of sexual intercourse and ED in the male partner were significantly associated with FSD, with ED being the strongest predictor. This highlights the importance of including partner variables in future studies on FSD, especially in an Asian region like Malaysia.
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Publication of this supplement was supported by Universiti Kebangsaan Malaysian Medical Centre, Kuala Lumpur, Malaysia.
Conflict of interest: The authors have no conflict of interest to declare.
Source of funding: None.