Abstract
Purpose
To investigate associations between past-year verbal and/or physical abuse (VA/PA)
and sexual (dis)satisfaction, that is, global or frequency-related (dis)satisfactions
with sexual activity, among postmenopausal women in the Women's Health Initiative.
Procedures
A cross-sectional analysis of archival data was performed from the subset of 83,329
Women's Health Initiative participants (clinical trial and/or observational study
components) who reported sexual activity in the year before baseline. Associations
between VA/PA and global frequency (dis)satisfactions were modeled using logistic
regression.
Main Findings
Most participants reported sexual satisfaction (global, 77%; frequency related, 66%).
Disappointment with sexual frequency, specifically a desire for more frequent sex,
was the most common dissatisfaction expressed. Past-year VA/PA exposure was reported
by 9,410 participants (11%). In regression models adjusted for sociodemographic, health
and health risk, and menopausal symptom variables, VA/PA was associated with higher
rates of global (35% VA/PA exposed vs. 22% non-exposed; adjusted odds ratio, 1.66;
95% confidence interval, 1.53–1.80) and frequency-related dissatisfactions (50% of
VA/PA exposed vs. 32% of non-exposed; adjusted odds ratio, 1.73; 95% confidence interval,
1.57–1.90).
Conclusions
Sexual satisfaction was common, but not universally reported by study participants.
Sexual dissatisfactions were overrepresented in VA/PA-exposed participants and associated
with a desire for more frequent sexual activity. Opportunities for postmenopausal
women to receive clinician-led education about safe and healthy ways to increase sexual
activity are needed. Further research on this topic, particularly efforts to characterize
safety concerns as well as modifiable barriers to satisfying sexual activity among
postmenopausal women with recent VA/PA, would ensure that these interventions are
evidence based.
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Biography
Erika L. Kelley, PhD, is a clinical psychologist at University Hospitals Cleveland Medical Center and an Assistant Professor of Reproductive Biology at Case Western Reserve University. Her clinical/research focus is on intersections of interpersonal violence and women's sexual/reproductive health.
Biography
M. Brad Cannell, PhD, is an Associate Professor of Epidemiology, Human Genetics, and Environmental Sciences at the University of Texas Health Science Center. He has expertise in epidemiologic methods/analytics and publishes widely on disability, preservation of function, and elder abuse prevention.
Biography
Margery S. Gass, MD, is Executive Director Emerita of The North American Menopause Society, formerly Professor of Obstetrics & Gynecology at the University of Cincinnati College of Medicine. Her research interests include menopausal hormone therapy, postmenopausal female sexual function, and osteoporosis.
Biography
Shawnita Sealy-Jefferson, PhD, MPH, is a Social Epidemiologist and Assistant Professor in the Division of Epidemiology in the College of Public Health at Ohio State University. Her research expertise includes birth outcomes, neighborhood effects, minority health, and chronic disease epidemiology.
Biography
Nancy Fugate Woods, PhD, RN, FAAN, is Professor and Dean Emerita of the University of Washington School of Nursing and past director of the NIH-funded UW Center for Women's Health Research.
Biography
Chloe E. Bird, PhD, is a Senior Sociologist at RAND and a Professor within the Pardee RAND Graduate School, with expertise in women's cardiovascular health. She is also working to build a Women's Health Research and Policy Center at RAND.
Biography
Marcia L. Stefanick, PhD, is a Professor of Medicine (Stanford Prevention Research Center) and Obstetrics & Gynecology, at Stanford School of Medicine. She is the founding Director of the Stanford Women's Health and Sex Differences in Medicine (WHSDM) Center.
Biography
Julie C. Weitlauf, PhD, is a clinical psychologist at the VA Palo Alto Health Care System, and a Clinical Professor of Psychiatry and Behavioral Sciences at Stanford School of Medicine. Her research examines the lifelong physical/mental health consequences of women's abuse exposure.
Article info
Publication history
Published online: July 02, 2019
Accepted:
May 28,
2019
Received in revised form:
May 22,
2019
Received:
September 15,
2018
Footnotes
The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. Dr. Cannell had full access to the data used for this manuscript and takes full responsibility for the integrity of the data and the accuracy of the data analyses. Dr. Weitlauf served as Dr. Kelley's research mentor throughout her 2-year fellowship at the Sierra Pacific MIRECC where she completed this project.
The Women's Health Initiative (WHI) program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C.
Dr. Kelley's time and work on this article was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Medical Research Service of the Veterans Affairs Palo Alto Health Care System and the Department of Veterans Affairs Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC). An earlier version of this manuscript was presented at a conference as an oral paper, as follows: Kelley, E. L., Cannell, M. B., Gass, M., Sealy-Jefferson, S., Woods, N. F., … Weitlauf, J. C. (2018). Association between verbal/physical abuse and sexual dissatisfaction among postmenopausal women in the Women's Health Initiative (WHI). Oral paper presentation at the annual meeting of the International Society for the Study of Women's Sexual Health (ISSWSH), February 8–11, 2018, San Diego, California.
Identification
Copyright
Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.
