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Sexual Dysfunction, Depression, and Anxiety in Young Women According to Relationship Status: an Online Survey

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Sexual Dysfunction, Depression, and Anxiety in Young Women According to Relationship Status: an Online Survey Tin Psychiatryrends and Psychotherapy Original Article Sexual dysfunction, depression, and anxiety in young women according to relationship status: an online survey Disfunção sexual, depressão e ansiedade em mulheres jovens de acordo com o status de relacionamento: uma pesquisa on-line Valeska Martinho Pereira,1 Antonio Egidio Nardi,2 Adriana Cardoso Silva3 Abstract Resumo Background: Sexual dysfunction is a common, still poorly un- Contexto: Disfunção sexual é um problema comum e ainda pou- derstood problem among women. Being or not in a relationship co compreendido entre mulheres. Estar ou não em um relaciona- seems to be a risk factor for sexual dysfunction. mento parece ser um fator de risco para disfunção sexual. Objectives: To evaluate the presence of sexual problems, an- Objetivo: Avaliar a presença de problemas sexuais, ansiedade xiety, and depression in young women and to correlate findings e depressão em jovens mulheres e correlacionar os achados ao with current relationship status (single, in a committed rela- estado de relacionamento atual (solteiras, em relacionamento tionship, or married). sério ou casadas). Methods: Data were collected trough an online survey from a Métodos: Dados foram coletados através de pesquisa on-line total of 155 women aged between 20 and 29 years. Sociodemo- de um total de 155 mulheres com idade entre 20 e 29 anos. graphic data were collected, and both the Hospital Anxiety and Foram coletados dados sociodemográficos, e a Escala Hospitalar Depression scale and the Female Sexual Function Index were de Ansiedade e Depressão e o Índice de Função Sexual Feminina applied. Data were statistically analyzed using the chi-square foram aplicados. Os dados foram analisados através dos testes and Kruskal-Wallis tests, and groups were compared in 2 x 2 qui-quadrado e Kruskal-Wallis, e os grupos foram comparados matrices using the Mann-Whitney test. dois a dois através do teste Mann-Whitney. Results: Single women showed a significantly higher prevalence Resultados: Mulheres solteiras apresentaram uma prevalência of problems in the lubrication (45.3%), orgasm (53.1%), satis- significativamente maior de problemas nos domínios lubrificação faction (67.2%), and pain (50%) domains and also in total Fe- (45,3%), orgasmo (53,1%), satisfação (67,2%) e dor (50%), e male Sexual Function Index scores (60.9%) in comparison with também no escore total do Índice de Função Sexual Feminina the other groups. Additionally, significantly higher depression (60,9%), em comparação aos outros grupos. Além disso, foram scores were found among single women (5.89±3.3) in compa- observados escores estatisticamente superiores para depressão rison to those in a committed relationship (4.05±2.83). Anxiety em mulheres solteiras (5,89±3,3) quando comparadas ao grupo scores were similar in all groups. relacionamento sério (4,05±2,83). Os escores de ansiedade fo- Conclusion: Our findings suggest that single women have a po- ram similares em todos os grupos. orer sexual function and are more likely to have mood disorders Conclusão: Nossos resultados sugerem que mulheres solteiras in comparison to their peers involved in stable relationships. têm um pior funcionamento sexual quando comparadas a seus Keywords: Prevalence, sexual dysfunction, anxiety, depression, pares envolvidos em relacionamentos estáveis e são mais pro- female. pensas a apresentar transtornos de humor. Descritores: Prevalência, disfunção sexual, ansiedade, depres- são, mulheres. 1 MSc, Graduate Program in Psychiatry and Mental Health, Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil. Investigator, Laboratório de Pânico e Respiração, IPUB, UFRJ. National Science and Technology Institute for Translational Medicine (INCT-TM). 2 PhD. Full professor, Graduate Program in Psychiatry and Mental Health, IPUB, UFRJ. Coordinator, Laboratório de Pânico e Respiração, IPUB, UFRJ. INCT-TM. 3 PhD. Adjunct professor, Universidade Federal Fluminense (UFF), Niterói, RJ. Coordinator, Laboratório de Tanatologia e Psicometria, UFF. Vice coordinator, Laboratório de Pânico e Respiração, IPUB, UFRJ. INCT-TM. Financial support: none. Submitted May 16 2012, accepted for publication Aug 09 2012. No conflicts of interest declared concerning the publication of this article. Suggested citation: Pereira VM, Nardi AE, Silva AC. Sexual dysfunction, depression, and anxiety in young women according to relationship status: an online survey. Trends Psychiatry Psychother. 2013;35(1):55-61. © APRS Trends Psychiatry Psychother. 2013;35(1) – 55-61 Sexual dysfunction in young women – Pereira et al. Introduction The objective of the present study was to evaluate the presence of sexual problems, anxiety and depression The first model proposed to explain the human sexual in young women aged 20 to 29 years and to correlate response cycle comprised four distinct phases: excitement, results with different relationship statuses (single, in plateau, orgasm, and resolution.1 Years later, another model a committed relationship/dating, or married), so as to emphasized the importance of desire in the human sexual identify possible differences in sexual functioning. response cycle.2 This current model is a combination of previous models and comprises the following four phases: desire, arousal, orgasm, and resolution.3 Method Sexual dysfunctions are impairments in the sexual response cycle or the presence of pain associated Participants and procedures with sexual intercourse.3 Female sexual dysfunctions (FSD) can take the form of hypoactive sexual desire This study used an online questionnaire to collect disorder, sexual aversion disorder, female sexual arousal data. An advertise describing study aims and researcher disorder, female orgasmic disorder, dyspareunia, and information was posted on social networks and sexuality vaginismus. In addition to these disorders, recently a forums and discussion groups. An internet link was provided, new dysfunction called the persistent genital arousal and any woman could access and answer the survey. Data disorder has also been described.4 Some risk factors for were collected for 2 months (May and June 2011). sexual dysfunction cited in the current literature include Inclusion criteria were being female and aged 20 to 29 age, level of education, emotional problems, stress, and years. Questionnaires with missing data and women who a history of sexual abuse.5 did not match the age criterion were excluded. A total of Anxiety seems to play an important role in FSD, 169 questionnaires were completed, and 155 were included but the relationship between both conditions is not in the analysis after application of exclusion criteria. completely clear. For instance, sexual worries and fears The study was approved by the Research Ethics seem to impair sexual arousal,6 and nonsexual worries Committee of Universidade Federal do Rio de Janeiro have been shown to affect sexual response.7 One (protocol no. 20-02/07). Participation was voluntary and study also found that women presenting complaints of anonymous, and all participants were informed of the vaginismus showed higher anxiety scores than controls.8 objectives of the study before starting to answer the The literature suggests that depression has a close questionnaire. relationship with FSD, increasing the risk for development of the latter. In depressed women, hypoactive sexual desire Measures disorder seems to be the most frequent dysfunction.9 Two studies conducted in Brazil reported the prevalence Social demographics of any type of sexual dysfunction to be 28 and 49%, Sociodemographic data were collected using the respectively.10,11 Female orgasmic disorder presented rates standardized questionnaire Hospital Anxiety and between 18 and 29.3%,10,12,13 and a prevalence of 26.7% Depression (HAD) scale and covered sexual orientation, was observed for hypoactive sexual desire disorder.11 marital status, religion, education level, having children, Moreover, it has been reported that only 18.8% of women practice of physical activities, use of alcohol and tobacco, seek professional help for sexual disturbances.14 and psychiatric treatment. During pregnancy, the sexual functioning of women The HAD scale is a self-reported instrument was found to be reduced in the third trimester.15 Women comprising 14 items divided into two subscales: HAD-A, aged 40 to 65 years with at least 11 years of formal which evaluates anxiety symptoms, and HAD-D, for education showed the highest rates of sexual dysfunction depressive symptoms.13 Each subscale yields a separate among middle-aged women.16 The risk factors cited were score obtained by summing its items. The total HAD scale lower socioeconomic and educational levels, whereas the score is obtained by summing the final scores of each predictors of good sexual functioning were having a sex subscale. A cutoff point of 8 was used in each subscale partner and general well-being. to determine the presence or absence of depressive or Most studies evaluating sexual dysfunction focus on anxiety disorder. The HAD scale has been translated to differences across ages groups, while other suggested risk and validated in Brazilian Portuguese.17-19 factors remain inconsistently studied. In this sense, studying women with similar sociodemographic characteristics Female Sexual Function Index (FSFI) provides a possibility to understand how other factors The FSFI is a 19-item scale that comprises six domains: possibly interact and influence sexual function. desire, arousal,
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