title: Determinants of sexual dysfunction among middle-aged women.
abstract: OBJECTIVE
  To assess the determinants of sexual dysfunction among middle-aged women.
  
  
  METHODS
  In a cross-sectional, questionnaire-based study of middle-aged women (aged 40-65 years) attending a public healthcare facility in Natal, Brazil, data on sociodemographic, clinical, and behavioral characteristics were collected between May and October 2011. The Female Sexual Function Index (FSFI), Blatt-Kupperman Menopausal Index (BKMI), International Physical Activity Questionnaire (IPAQ), and WHO quality of life questionnaire (WHOQOL-Bref) were used to collect data, which were analyzed by relative frequency and percentage of variables, followed by Pearson χ(2) test and logistic regression analysis.
  
  
  RESULTS
  Among 370 study participants, 67% exhibited sexual dysfunction (FSFI ≤ 26.55). Women who were in the oldest age group (56-65 years) (P<0.001), were divorced or separated (P<0.001), were sedentary (P=0.006), had undergone a hysterectomy (P=0.016), had strong climacteric symptoms (P<0.001), or had low quality of life (P<0.001) had a significantly higher incidence of sexual dysfunction. Logistic regression showed that the eldest group of women (55-65 years) (95% CI, 3.4-15.7; P<0.001), with the strongest climacteric manifestations (95% CI, 3.4-15.7; P<0.001) and lowest quality of life (95% CI, 3.2-13.8; P<0.001), were most likely to develop sexual dysfunction.
  
  
  CONCLUSIONS
  Sexual dysfunction was found to be substantially influenced by sociodemographic, biologic, and behavioral variables.
authors.affiliation: Department of Gynecology and Obstetrics, Federal University of Rio Grande do Norte, Natal, Brazil.
authors.forename: Patrícia U L
authors.initials: PU
authors.lastname: Cabral
authors.forename: Ana C G
authors.initials: AC
authors.lastname: Canário
authors.forename: Maria H C
authors.initials: MH
authors.lastname: Spyrides
authors.forename: Severina A C
authors.initials: SA
authors.lastname: Uchôa
authors.forename: José
authors.initials: J
authors.lastname: Eleutério
authors.forename: Ana K
authors.initials: AK
authors.lastname: Gonçalves
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D015444:Exercise; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D016015:Logistic Models; D017533:Marital Status; D008593:Menopause; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D016387:Women's Health