Influência da terapia de reposição hormonal e da vinculação afetiva sobre a função sexual de mulheres nas fases reprodutivas, peri e pós-menopausa

Abstract

During the transitional period between the reproductive and non-reproductive life, biological and psychological changes can interfere with sexual response. During climacteric the hormone production (e.g. estradiol) declines progressively and it may affect female sexual response, but other factors such as emotional attachment, the length of relationship and body mass index, are also relevant to understand the changes in female sexual response. This study aimed to investigate the relation of female sexual function in the reproductive stages, peri and post-menopausal women with biological and psychosocial factors. 411 women aged 18 to 70 made part of the survey, grouped by age composing three sub-groups: a) reproductive age; b) perimenopause; c) post-menopause. The instruments used were the FSFI (Female Sexual Function Index); the MARQ scale (Marriage and Relationship Questionnaire) in the subscale specific issues related to affectional bonds (love); an instrument with sociodemographic questions (including the length of relationship and BMI calculation). The results show higher FSFI scores in reproductive age women, followed by the group in perimenopausal and postmenopausal women, suggesting a decline in sexual function in postmenopausal women, and the domains of desire and excitement had the smallest scores in the whole sample. Both peri and post-menopausal women who were on hormone therapy had higher FSFI scores than those who did not. However these differences were not statistically significant. BMI, the length of relationship and hormone replacement therapy did not have positive effects on sexual function, but the bonding is revealed as an important variable in predicting better sexual function. Although the length of relationship has not presented statistical significance, some women in shorter relationships had higher sexual function. The results of this study indicate that the desire did not precede sexual arousal in most women, suggesting that involvement in sexual activity is attributed to many reasons, keeping the relationship would be one of them, reinforcing the female strategy of forming bonds with the partner.