The sexuality of middle-aged women with a sexual partner: a population-based study.

OBJECTIVE: To evaluate the factors associated with the sexuality of middle-aged women with sexual partners. DESIGN: A cross-sectional, population-based study was carried out using an anonymous, self-response questionnaire completed by Brazilian-born women 40 to 65 years old with 11 years or more of formal education who had a sexual partner. Of the 378 women who agreed to participate in the study, 219 answered all the questions used for calculation of the sexuality score and reported having a sexual partner. The instrument was based on the Short Personal Experiences Questionnaire. Seven components were analyzed: satisfaction in sexual activities, orgasm, intensity of desire, self-classification of sexual life, and frequency of arousal, sexual activity, and sexual fantasies. Sociodemographic, clinical, behavioral, reproductive, and partner-related factors were evaluated. Poisson multiple regression analysis was performed, and prevalence ratios (PRs) with their 95% CIs were estimated. RESULTS: The median sexuality score was 9 (range, 2.45-13.77). The prevalence of below-median scores was higher in women who lived with their sexual partner (PR = 2.07; 95% CI: 1.17-3.69), who were in the menopausal transition or were postmenopausal (PR = 1.69; 95% CI: 1.08-2.65), and who were hypertensive (PR = 1.65; 95% CI: 1.19-2.30). Sexual activities involving penetration (PR = 0.48; 95% CI: 0.31-0.73) and a score of 6 for satisfaction with partner as a lover (PR = 0.34; 95% CI: 0.20-0.60) were indicative of a protective effect against poor sexuality. CONCLUSIONS: In this cohort, the sexuality of women in midlife was negatively associated with the factors of living with a sexual partner, being in the menopausal transition or postmenopausal, and being hypertensive. Therefore, greater attention should be paid to identifying these factors, and measures should be adopted to minimize their repercussions on the sexuality of middle-aged women.

Conhecimento sobre métodos anticoncepcionais por estudantes adolescentes / Knowledge of contraceptive methods among adolescent students

OBJETIVO: Comparar o conhecimento sobre métodos anticoncepcionais e identificar os fatores associados ao conhecimento adequado dos adolescentes de escolas públicas e privadas. MÉTODOS: Realizou-se estudo transversal, do qual participaram 1.594 adolescentes entre 12 e 19 anos, de 13 escolas públicas e cinco privadas do Município de São Paulo entre junho e dezembro de 2003. As escolas foram selecionadas aleatoriamente e os alunos responderam um questionário sobre características sociodemográficas, reprodutivas e métodos anticoncepcionais. As razões de prevalência foram calculadas com intervalo de confiança de 95 por cento para cada questão sobre conhecimento de métodos e o tipo de escola. Atribuiu-se meio ponto para cada questão correta sobre conhecimento de anticoncepcionais, o ponto de corte foi 50 por cento de acerto. Os testes estatísticos utilizados foram o qui-quadrado, o Wilcoxon-Gehan e a regressão múltipla de Poisson. RESULTADOS: Dentre os adolescentes, 61 por cento eram do sexo feminino nos dois grupos de escolas. Predominou nível socioeconômico baixo nas escolas públicas e alto nas privadas (p<0,001). Cerca de 18,6 por cento dos adolescentes nas escolas privadas e 28,6 por cento nas públicas tinham atividade sexual (p<0,002). Quanto ao conhecimento, 25,7 por cento dos adolescentes das escolas públicas e 40,8 por cento das privadas apresentaram escore superior ou igual a cinco. Os fatores associados ao maior conhecimento foram ser do sexo feminino, estudar em escola privada, estar no ensino médio, ter nível socioeconômico alto, ter relação sexual e ter maior idade. CONCLUSÕES: O nível de conhecimento adequado sobre métodos anticoncepcionais foi baixo para os adolescentes de ambos os tipos de escolas. Os resultados revelam que, assim como os mais desfavorecidos, os adolescentes de maior nível socioeconômico necessitam de informações adequadas sobre planejamento familiar, visando a melhorar esse conhecimento para mudança seu comportamento.

[Knowledge of contraceptive methods among adolescent students]. / Conhecimento sobre métodos anticoncepcionais por estudantes adolescentes.

OBJECTIVE: To compare the knowledge of contraceptive methods as well as to identify factors associated with adequate knowledge among public and private school adolescents. METHODS: A cross-sectional study comprising 1,594 adolescents aged between 12 and 19 years old from 13 public and five private schools in the city of São Paulo city, Brazil, was carried out from June to December 2003. Schools were randomly selected and students filled out a questionnaire about sociodemographic, reproductive and contraceptive methods. The prevalence ratios were estimated with a 95% confidence interval for each question on their knowledge of contraceptive methods and by school group. Each question correctly answered received a half score, and the cut-off value was 50% of correct answers. Statistical tests utilized were Chi-square and Wilcoxon-Gehan tests and Poisson multiple regression model. RESULTS: Of all respondents, 61% were of females in both school groups. Most students had low socioeconomic condition in public schools while they had mostly high socioeconomic condition in private schools (p<0.001). Nearly 18.6% private and 28.6% public school students were sexually active (p<0.002). In regard to their knowledge, 25.7% of public and 40.8% of private school students had a score equal to or above five. Factors associated with higher knowledge were: being female, at high school of a private school, having high socioeconomic condition, having had sexual intercourse and being older. CONCLUSIONS: Knowledge of contraceptive methods was low in both public and private school students. The study results show that both underprivileged as well as high socioeconomic adolescents need to have adequate information about family planning to improve their knowledge and change their behavior.

[Quality of life in users and non-users of hormone replacement therapy]. / Qualidade de vida em usuárias e não usuárias de terapia de reposição hormonal.

OBJECTIVE: To compare the quality of life in postmenopausal women who were users and non-users of hormone replacement therapy (HRT). METHODS: A cross-sectional study was conducted on postmenopausal women aged between 40 and 65 years, who had been menopausal for up to 15 years. Women considered HRT users were those who had undergone this type of treatment for at least six months. Non-users of HRT were those who had not received this type of treatment during the last six months. Two hundred and seven women were included in the study: 106 users and 101 non-users of HRT. Sociodemographic, clinical and behavioral characteristics were assessed. The Kupperman Menopausal Index was applied to rate the intensity of climacteric symptoms and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was applied to assess women's quality of life. For data analysis, a Student's t test, a chi-square analysis, a Fisher's exact test and a Mann-Whitney test were used. RESULTS: The mean age of HRT users was 52.6 +/- 4.9 years and the mean age of non-users of HRT was 54.3 +/- 4.7 years (p=0.01). There was a statistically significant difference regarding marital status (p=0.04). HRT users reported a lower frequency of moderate and severe climacteric symptoms (p=0.001). Of the eight quality of life domains evaluated, only vitality scored below 50 (45) in both groups. There were no differences between groups regarding the SF-36 components. CONCLUSIONS: Postmenopausal women who were users and non-users of HRT presented a good quality of life. There were no differences between users and non-users of hormone therapy.

Qualidade de vida em usuárias e não usuárias de terapia de reposição hormonal / Quality of life in users and non-users of hormone replacement therapy

OBJETIVO: Comparar a qualidade de vida de mulheres após a menopausa usuárias e não usuárias de terapia de reposição hormonal (TRH). MÉTODOS: Realizou-se um estudo de corte transversal com mulheres na pós-menopausa, com idade entre 40 e 65 anos, menopausadas há no máximo 15 anos. Consideraram-se como usuárias de TRH aquelas que faziam uso dessa terapia há pelo menos seis meses, e não usuárias aquelas que não fizeram uso dessa terapia nos últimos seis meses. Foram incluídas no estudo 207 mulheres: 106 usuárias e 101 não usuárias de TRH. Avaliaram-se as características sociodemográficas, clínicas e comportamentais. Aplicou-se o índice de Kupperman para avaliar a intensidade dos sintomas climatéricos, e o questionário Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) para avaliação da qualidade de vida. Na análise dos dados utilizaram-se os testes t de student, Qui-quadrado, exato de Fisher e Mann-Whitney. RESULTADOS: As usuárias de TRH apresentaram média etária de 52,6±4,9 anos e as não usuárias de 54,3±4,7 anos (p=0,01). Houve diferença estatisticamente significativa em relação ao estado marital (p=0,04). As usuárias relataram menor freqüência de sintomas climatéricos de intensidade moderada e acentuada (p=0,001). Dos oito domínios de qualidade de vida avaliados, apenas a vitalidade apresentou escore abaixo de 50 (45) para os dois grupos. Não houve diferenças entre os grupos em relação aos componentes do SF-36. CONCLUSÕES: As mulheres na pós-menopausa usuárias e não usuárias de TRH apresentaram boa qualidade de vida. Não houve diferenças entre usuárias e não usuárias de terapia hormonal.