Middle-aged female sexual dysfunction and multimorbidity: a population-based study.

Objectives: The aim of the study was to evaluate the association between multimorbidity and sexual dysfunction in women aged 45 to 60 years in a cross-sectional population-based study in a specific Brazilian city. It was also to evaluate the main factors associated with sexual dysfunction in the group with multimorbidity.

Methods: Cross-sectional population-based study conducted with 736 women (household survey), representative of a population of 257,434 women, to obtain data on multimorbidity and sexual dysfunction, as part of a broader study on women's health. The instrument used to evaluate sexual dysfunction was the Short Personal Experiences Questionnaire. Associations were determined between multimorbidity and sexual dysfunction and sexual dysfunction and demographic, behavioral, and medical characteristics.

Results: 53% of the women reported multimorbidity and 49.6% of them reported sexual dysfunction. Multiple regression analysis showed no association between sexual dysfunction and multimorbidity. Sexual dysfunction in the whole sample (with and without multimorbidity) was associated with sexual activity in the last month (prevalence ratio [PR] = 0.27, 95% CI 0.22-0.33, P < 0.001), having physical activity greater than or equal to 2 times a week (PR = 0.70, 95% CI 0.58-0.84, P < 0.001), menopause rating symptoms greater than 8 (PR = 1.25, 95% CI 1.09-1.43, P = 0.002), perimenopausal or postmenopausal status (PR = 1.57, 95% CI 1.13-2.17, P = 0.007), alcohol use greater than or equal to 1 drink/week (PR = 0.81, 95% CI 0.67-0.97, P = 0.025), and anxiety (PR = 1.15, 95% CI 1.01-1.31, P = 0.039). In the group with multimorbidity, the main factors associated with sexual dysfunction were sexual activity in the last month (PR = 0.31, 95% CI 0.25-0.39, P < 0.001), anxiety (PR = 1.33, 95% CI 1.15-1.53, P < 0.001), and physical activity (PR = 0.70, 95% CI 0.56-0.87, P = 0.002).

Conclusions: There was no evidence that multimorbidity was associated with sexual dysfunction in this sample of middle-aged women. The main factors associated with sexual dysfunction in women with multimorbidity in this sample were lack of sexual activity in the last month, physical inactivity, and anxiety. This highlights the importance of sexual activity, psychological health, and physical activity for a satisfactory sexual life in the case of women with multimorbidity.