title: Sexual function in older women with pelvic floor symptoms: a cross-sectional study in general practice.
abstract: BACKGROUND
  Pelvic floor symptoms are common and are negatively associated with sexual function which, in turn, is an important aspect of quality of life. The majority of older women with pelvic floor symptoms are treated in general practice but evidence from studies in general practice on the sexual functioning of these women is scarce.
  
  
  OBJECTIVE
  This study examined predictors of sexual inactivity in older women with pelvic floor symptoms in general practice and of sexual functioning in those women who are sexually active.
  
  
  METHODS
  Cross-sectional study in women (aged ≥55 years) from 20 general practices who screened positive on a pelvic floor symptom questionnaire.
  
  
  METHODS
  Logistic and linear regression analyses were used to determine predictors of sexual inactivity and sexual functioning (PISQ-12) by assessing their association with patient characteristics, symptoms (PFDI-20) and degree of prolapse (POP-Q).
  
  
  RESULTS
  A total of 639 women were included (sexually active n = 393, sexually inactive n = 246). Predictors of sexual inactivity were increasing age (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10 to 1.17) and lower education (OR = 2.31; 95% CI = 1.50 to 3.54; Nagelkerke R(2) = 0.208). In sexually active women, sexual functioning was associated with pelvic floor symptom distress (P<0.001) and pelvic floor surgery (P = 0.018; R(2) = 0.138).
  
  
  CONCLUSIONS
  In older women with pelvic floor symptoms, increasing age and lower educational level are predictors of sexual inactivity. Many of these older women are sexually active and pelvic floor symptom distress is negatively associated with sexual functioning. These results may encourage GPs to ask about sexual problems in women with pelvic floor symptoms.
authors.affiliation: University of Groningen, University Medical Centre Groningen, Department of General Practice, Groningen, The Netherlands.
authors.forename: Chantal McR
authors.initials: CM
authors.lastname: Panman
authors.forename: Marian
authors.initials: M
authors.lastname: Wiegersma
authors.forename: Marrit N
authors.initials: MN
authors.lastname: Talsma
authors.forename: Boudewijn J
authors.initials: BJ
authors.lastname: Kollen
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Lisman-Van Leeuwen
authors.forename: Janny H
authors.initials: JH
authors.lastname: Dekker
mesh_terms: D000367:Age Factors; D000368:Aged; D003075:Coitus / Q000523:psychology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D058006:General Practice; D006801:Humans; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D059952:Pelvic Floor Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D010549:Personal Satisfaction; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology / Q000503:physiopathology*; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology
keywords: general practice; pelvic floor disorders; pelvic organ prolapse; postmenopause; psychological; sexual activity; sexual dysfunctions