An examination of the association of abuse (physical, sexual, or emotional) and female sexual dysfunction: results from the Boston Area Community Health Survey.

摘要

OBJECTIVE: To examine associations between abuse (physical, sexual, and emotional) in childhood and adolescence/adulthood and sexual activity and dysfunction in women. DESIGN: We analyzed data from the Boston Area Community Health Survey, a community-based epidemiologic study of urologic and sexual symptoms and risk factors in a racially and ethnically diverse random sample of women aged 30-79 years (N = 3,205 women). SETTING: Boston area community. PATIENT(S): Participants were community residents. INTERVENTION(S): Data were observational; no interventions were made. MAIN OUTCOME MEASURE(S): Sexual activity and dysfunction rates were assessed by means of a validated questionnaire (the Female Sexual Function Index). RESULT(S): Abuse history was not significantly associated with likelihood of sexual activity. Among those who were sexually active with a partner, a history of each of three types of abuse approximately doubles the odds of female sexual dysfunction. Specifically, childhood emotional (odds ratio [OR] 2.13, 95% confidence interval [CI] 1.28-3.56), adult sexual (OR 1.94, 95% CI 1.23-3.08), and adult emotional abuse (OR 1.86, 95% CI 1.15-3.01) were all significantly and positively associated with sexual dysfunction after adjusting for covariates (including depression). Analyses of the six female sexual dysfunction domains showed that the relationships were strongest for pain and satisfaction. CONCLUSION(S): These findings extend those from previous studies by identifying an association between female sexual dysfunction and multiple types of abuse, even after adjusting for depression.