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Wrong diagnosis: sexual dysfunction

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A new study has found that many women who were diagnosed with sexual dysfunction when they were younger actually had a healthy sex life when they entered middle age. The study was published on February 10 in the journal JAMA Internal Medicine by researchers at the University of Pittsburgh in Pittsburgh, Pennsylvania.

The researchers noted that sexual function is associated with health-related quality of life; thus, understanding the dynamics that affect aging women’s sexual activity can affect the maintenance of health-related quality of life among these women. The study group comprised 354 middle-aged and older Pittsburgh women. After an initial evaluation, they were studied again four years later in regard to sexual activity. The investigators theorized that higher sexual function and higher importance of sex at the initial evaluation could predict maintenance of sexual activity at the second evaluation.

The investigators used a test known as the Female Sexual Function Index to diagnose the subjects’ sexual problems. The index includes 19 questions pertaining to arousal, orgasm, vaginal lubrication, and pain during intercourse. More than 85% of women reported that they remained sexually active when they took the test the second time; at the second testing, the women were between the ages of 48 and 73. The researchers were surprised to find that most of these women generally scored low when they took the sexual-function test; they had an average score of 22.3, which was below the cutoff of 26.55 considered sexually dysfunctional. Thus, the index failed to predict whether the women continued to have sex. The investigators suggested that the index was labeling women as dysfunctional when they actually were not. They wrote that the index’s “focus on intercourse may not accurately reflect what constitutes satisfying sex in this population, yielding falsely low scores.”

Although, the index did not predict sexual activity as a woman aged, the researchers did find factors that were predictors of continued sexual satisfaction; race, weight, relationship status, and how important a women deemed sex to be. Caucasian women were more likely to remain sexually active. Thinner women were also more likely to continue sex relations as they aged. In addition, previous studies have found that women who undergo bariatric (weight loss surgery) often resume sexual activity. Women who rated sex as important were three times more likely to remain sexually active as women who rated it as unimportant.

The researchers noted that a woman and her physician should not focus narrowly on the physical symptoms, rather, they should take a holistic approach that includes emotional and relationship factors. Dealing with sexual problems can affect overall quality of life. The researchers note that other studies have reported that a healthy sex life is a predictor of longevity; thus, understanding sex might have broader implications for overall health.

Take home message:
This study suggests that a number of factors are involved in a satisfying sex life and that a satisfying sex life can benefit a woman’s overall health. Addressing relationship and weight problems can improve the situation. Lubricants or hormone replacement therapy can resolve vaginal dryness issues. Although Caucasian women tended to have a more satisfying sex life than minorities, race itself was probably not at the root of the problem. The minority women in the study may have endured poverty or poor/absent relationships. A gynecologist can often aid women with sexual problems; in addition, sex therapists can aid a women who is interested in improving her sex life.

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