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Relationships between body image, sexual dysfunction, and health-related quality of life among middle-aged women: A cross-sectional study

      Highlights

      • Validated measures have not previously been used to evaluate the relationship between sexual function, body image, relationship with partner, and health-related quality of life (HRQoL) among middle-aged women.
      • Negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Sexual dysfunction tended to be a negative predictor of the mental component summary (MCS) of HRQoL.
      • A higher frequency of orgasm predicted a better physical component summary (PCS) of HRQoL; sexual satisfaction and relationship satisfaction with partner predicted better MCS.
      • These findings will be useful in health education and health promotion for middle-aged women, and help health providers to focus on these predictors when caring for middle-aged women.

      Abstract

      Objectives

      To examine whether body image, sexual function, and relationship with a partner influence health-related quality of life (HRQoL) among middle-aged women, as well as to identify the association with menopausal symptoms.

      Main outcome measures

      Physical component summary and mental component summary of HRQoL.

      Methods

      This was an analysis of 1026 women (2013–2014); data regarding demographic characteristics, sexual function, body image, relationship with partner, menopausal symptoms and HRQoL during middle age were collected. HRQoL, sexual function, body image, relationship with partner, and menopausal symptoms were measured using the Medical Outcomes Study SF-12, Female Sexual Function Index (FSFI), Multidimensional Body-Self Relations Questionnaire-Appearance Scale, the Relationship Assessment Scale, and the Greene Climacteric Scale, respectively. A multivariate regression was used to examine factors influencing HRQoL.

      Results

      After adjusting for covariates, significant factors predicting the physical component summary (PCS) of HRQoL among middle-aged women included the orgasm domain of the FSFI (β = 0.69; p =  0.023), appearance evaluation (β = 0.93; p =  0.037), and menopausal symptoms (β = −0.25; p <  0.001). The factors predicting the mental component summary (MCS) of HRQoL included the satisfaction domain of the FSFI (β = 0.70; p =  0.014), appearance evaluation (β = 2.09; p < 0.001), self-classified weight (β = 1.21; p <  0.001), relationship with partner (β = 0.16; p =  0.034), and menopausal symptoms (β = −0.36; p <  0.001).

      Conclusion

      The results indicated that negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Higher frequency of orgasm predicted better PCS; sexual satisfaction and satisfaction with relationship with a partner predicted better MCS of HRQoL.

      Keywords

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      References

        • Huang Y.
        • Chatooah N.D.
        • Qi T.
        • Wang G.
        • Ma L.
        • Ying Q.
        • et al.
        Health-related quality of life and its associated factors in Chinese middle-aged women.
        Climacteric. 2018; 21: 483-490
        • El Shafie K.
        • Al Farsi Y.
        • Al Zadjali N.
        • Al Adawi S.
        • Al Busaidi Z.
        • Al Shafaee M.
        Menopausal symptoms among healthy, middle-aged Omani women as assessed with the Menopause Rating Scale.
        Menopause. 2011; 18: 1113-1119
        • Pearce G.
        • Thogersen-Ntoumani C.
        • Duda J.
        Body image during the menopausal transition: a systematic scoping review.
        Health Psychol. Rev. 2014; 8: 473-489
        • Chrisler J.C.
        • Ghiz L.
        Body image issues of older women.
        Women Ther. 1993; 14: 67-75
        • Nappi R.E.
        • Verde J.B.
        • Polatti F.
        • Genazzani A.R.
        • Zara C.
        Self-reported sexual symptoms in women attending menopause clinics.
        Gynecol. Obstet. Invest. 2002; 53: 181-187
        • Polivy J.
        • Herman C.P.
        • Trottier K.
        • Sidhu R.
        Who are you trying to fool: does weight underreporting by dieters reflect self-protection or self-presentation?.
        Health Psychol. Rev. 2014; 8: 319-338
        • Wong E.L.
        • Huang F.
        • Cheung A.W.
        • Wong C.K.
        The impact of menopause on the sexual health of Chinese cantonese women: a mixed methods study.
        J. Adv. Nurs. 2018; 74: 1672-1684
        • Liu J.
        • Eden J.
        Experience and attitudes toward menopause in Chinese women living in Sydney-a cross sectional survey.
        Maturitas. 2007; 58: 359-365
        • Nappi R.E.
        • Kokot-Kierepa M.
        Women’s voices in the menopause results from an international survey on vaginal atrophy.
        Maturitas. 2010; 67: 223-238
        • Lo S.S.
        • Kok W.M.
        Sexuality of Chinese women around menopause.
        Maturitas. 2013; 74: 190-195
        • Yang C.F.
        • Kenney N.J.
        • Chang T.C.
        • Chang S.R.
        Sex life and role identity in Taiwanese women during menopause: a qualitative study.
        J. Adv. Nurs. 2016; 72: 770-781
        • Thomas H.N.
        • Hess R.
        • Thurston R.C.
        Correlates of sexual activity and satisfaction in midlife and older women.
        Ann. Fam. Med. 2015; 13: 336-342
        • Jannini E.A.
        • Nappi R.E.
        Couplepause: a new paradigm in treating sexual dysfunction during menopause and andropause.
        Sex. Med. Rev. 2018; 6: 384-395
        • Katainen R.E.
        • Siirtola T.J.
        • Engblom J.R.
        • Erkkola R.U.
        • Polo-Kantola P.
        A population-based survey of quality of life in middle-aged Finnish women.
        Menopause. 2015; 22: 402-413
        • Karacam Z.
        • Seker S.E.
        Factors associated with menopausal symptoms and their relationship with the quality of life among Turkish women.
        Maturitas. 2007; 58: 75-82
        • Hess R.
        • Thurston R.C.
        • Hays R.D.
        • Chang C.C.
        • Dillon S.N.
        • Ness R.B.
        • et al.
        The impact of menopause on health-related quality of life: results from the STRIDE longitudinal study.
        Qual. Life Res. 2012; 21: 535-544
        • Li S.
        • Ho S.C.
        • Sham A.
        Relationship between menopause status, attitude toward menopause, and quality of life in Chinese midlife women in Hong Kong.
        Menopause. 2016; 23: 67-73
        • Ware J.E.
        • Kosinski M.M.A.
        • Turner-Bowker D.M.
        • Sundaram M.
        • Gandek B.
        • Maruish M.E.
        SF-12v2 Health Survey: Administration Guide for Clinical Trial Investigators.
        Quality Metric Incorporated, 1996 (ISBN 1-891810-24-3)
        • Ware J.E.
        • Kosinski M.M.A.
        • Keller S.A.
        12-Item Short Form Health Survey: construction of scales and preliminary tests of reliability and validity.
        Med. Care. 1996; 34: 220-233
        • Chang S.R.
        • Chang T.C.
        • Chen K.H.
        • Lin H.H.
        Developing and validating a Taiwan version of the Female Sexual Function Index for pregnant women.
        J. Sex. Med. 2009; 6: 1609-1616
        • Rosen R.
        • Brown C.
        • Heiman J.
        • Leiblum S.
        • Meston C.
        • Shabsigh R.
        • et al.
        The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.
        J. Sex Marital Ther. 2000; 26: 191-208
        • Wiegel M.
        • Meston C.
        • Rosen R.
        The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores.
        J. Sex Marital Ther. 2005; 31: 1-20
        • Cash T.F.
        The Multidimensional Body-self Relations Questionnaire, MBSRQ Users’ Manual.
        3rd rev. 2000
        • Hendrick S.S.
        A generic measure of relationship satisfaction.
        J. Marriage Fam. 1988; 50: 93-98
        • Greene J.G.
        Constructing a standard climacteric scale.
        Maturitas. 1998; 29: 25-31
        • Schiavi R.C.
        • Segraves R.T.
        The biology of sexual function.
        Psychiatr. Clin. North Am. 1995; 18: 7-23
        • Basson R.
        • Schultz W.W.
        Sexual sequelae of general medical disorders.
        Lancet. 2007; 369: 409-424
        • Woloski-Wruble A.C.
        • Oliel Y.
        • Leefsma M.
        • Hochner-Celnikier D.
        Sexual activities, sexual and life satisfaction, and successful aging in women.
        J. Sex. Med. 2010; 7: 2401-2410
        • Ornat L.
        • Martinez-Dearth R.
        • Munoz A.
        • Franco P.
        • Alonso B.
        • Tajada M.
        • et al.
        Sexual function, satisfaction with life and menopausal symptoms in middle-aged women.
        Maturitas. 2013; 75: 261-269
        • Santosa A.
        • Ohman A.
        • Hogberg U.
        • Stenlund H.
        • Hakimi M.
        • Ng N.
        Cross-sectional survey of sexual dysfunction and quality of life among older people in Indonesia.
        J. Sex. Med. 2011; 8: 1594-1602
        • Zhang H.
        • Fan S.
        • Yip P.S.
        Sexual dysfunction among reproductive-aged Chinese married women in Hong Kong: prevalence, risk factors, and associated consequences.
        J. Sex. Med. 2015; 12: 738-745
        • Jafary F.
        • Farahbakhsh K.
        • Shafiabadi A.
        • Delavar A.
        Quality of life and menopause: developing a theoretical model based on meaning in life, self-efficacy beliefs, and body image.
        Aging Ment. Health. 2011; 15: 630-637
        • Lindau S.T.
        • Gavrilova N.
        Sex, health, and years of sexually active life gained due to good health evidence from two US population based cross sectional surveys of ageing.
        BMJ. 2010; 340: c810
        • Cheng M.H.
        • Lee S.J.
        • Wang S.J.
        • Wang P.H.
        • Fuh J.L.
        Does menopausal transition affect the quality of life? A longitudinal study of middle-aged women in Kinmen.
        Menopause. 2007; 14: 885-890