Spinal cord injury and women's sexual life: case-control study.

Study design :This is a case-control study. OBJECTIVE: The objective of this study was to estimate the magnitude of association between spinal cord injury (SCI) and women's quality of sexual life and sexual function. SETTING: This study was conducted in the Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: From the referral university-based clinics, we used simple random sampling to recruit 62 women: 31 women with SCI and 31 women without SCI. Socio-demographic and reproductive traits questionnaire, Sexual Quality of life-Female (SQOL-F), Female Sexual Function Index (FSFI) and Spinal Cord Independence Measure (SCIM) were completed using telephone and face-to-face interviews in the cases and controls. After univariate analyses, multivariate linear and proportional odds regression models were conducted to investigate the relation between SCI and women's quality of sexual life, as well as sexual function. RESULTS: The mean age of cases and controls was 35.42±6.51 and 33.77±4.02 years. Most women were high school-educated and housewives. Adjusting for probable confounders, the proportional odds regression model showed a significant relationship between the spinal cord injury (AOR=4.2, 95% CI: 1.8-9.2), non-college-educated (AOR=3.1, 95% CI: 1.2-5.9) and employed (AOR=1.8, 95% CI: 1.1-1.8) variables and being in one of the moderate or poor quality of life classes. Scores of SQOL-F and FSFI domains, except satisfaction, were significantly worse in cases versus controls (P<0.001). CONCLUSION: Although our participants showed low sexual dysfunction, they tended to report moderate to poor quality of sexual life. Our findings support the implication that sexual rehabilitation must be provided for women with SCI soon after injury.

Psychometric properties of the Sexual Adjustment Questionnaire (SAQ) in the Iranian population with spinal cord injury.

STUDY DESIGN: This is a cross-sectional study. OBJECTIVES: The objective of this study was to examine the psychometric properties of the Sexual Adjustment Questionnaire (SAQ) for Iranian people with spinal cord injury. SETTING: This study was conducted in the brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: We assessed the psychometric properties of the SAQ, with 200 participants (men=146, women=54) completing the scale. An evaluation of its test-retest reliability was performed over a 2-weeks period, on a subsample of 30 patients recruited from the overall group. Cronbach's α-coefficient was computed for assessment of internal consistency reliability. In addition, content and face validity were examined by an expert committee. Construct validity was assessed by examining convergent and discriminant validity. Finally, exploratory factor analysis was used to extract the factor structure of the questionnaire. RESULTS: The Cronbach's α and intraclass correlation coefficient were 0.77 and 0.72 retrospectively. With regard to construct validity, there was a significant (P=0.009) negative correlation (r=-0.28) between the SAQ score and age. Those with lower levels of educations scored significantly lower on the SAQ (P=0.04). The exploratory factor analysis indicated a four-factor structure for the questionnaire, accounting for 68.9% of the observed variance. The expert committee approved the face and content validity of the developed measure. CONCLUSION: The SAQ is a valid measure for assessing sexual adjustment in people with spinal cord injury. The evaluation of sexual well-being may be useful in clinical trials and practical settings.

Vaginismus and its correlates in an Iranian clinical sample.

Although vaginismus is a relatively common female sexual dysfunction in Iran, there are scant studies reporting on its clinical and social features. The aim of the present study was to compare the social and clinical characteristics of women with vaginismus with those of healthy women. The study comprises 22 patients with vaginismus and 22 healthy controls who presented to the health clinics of Tehran University of Medical Sciences, Iran. We used three assessment tools: interview, a (34-item) questionnaire for demographic and clinical characteristics of vaginismus and a 13-item questionnaire of Female Sexual Distress Scale-Revised (FSDS-R) for sexual distress. The majority (73%) of women with vaginismus had primary vaginismus (unconsummated marriage). These women demonstrated significant higher phobia than healthy women, including fear of genital pain and penetration, fear of bleeding during intercourse, height phobia, aversion to looking or touching the genitalia, fear of vaginal disproportion and also disgust of semen. Compared with the healthy women, these women displayed a significantly higher sexual distress score, defecation or urination problems, general anxiety, higher education levels and lower self-esteem. Our findings suggest that there is a strong correlation between vaginismus, phobia and anxiety.