Prevalence and Factors associated with Female Sexual Dysfunction amongst Women using Hormonal and Non-Hormonal Contraception at The Aga Khan University Hospital Nairobi Clinics
Date of Award
Master of Medicine (MMed)
Prof. Valentino M. Lema
Dr. Abraham Mukaindo
Dr. Gulnaz Mohamoud
Family Medicine (East Africa)
Background: Female sexual function is a complex phenomenon. It integrates all the body systems and is influenced by a variety of factors. Contraceptives have been shown to have variable effects on female sexual function, but there have not been adequately powered studies on this in our setting.
Justification: The prevalence of female sexual dysfunction (FSD) has been shown to vary among different population subsets globally. The associations of different factors with FSD have also shown variable conclusions that are not generalizable to our setting. In Kenya there is a high discontinuation rate of contraception and this is mainly attributed to its related side effects. This has created a need to study the prevalence of, and the significant factors affecting FSD among those using contraception in our setting.
Objectives and methods: The aim of the study was to determine the prevalence of FSD among women using hormonal and those using non-hormonal contraception and to examine the factors associated with it. A cross-sectional study was conducted at clinics within AKUHN. Consecutive sampling of women of reproductive age using either hormonal or non-hormonal contraception was done. Two questionnaires, one on demographic profiles and the other on the female sexual function index (FSFI) were completed.
Independent associations of the factors with the outcome variables were assessed using Chi square test of association and variables with a P< 0.25 used in the multivariate analysis. Factors associated with FSD were determined using binary logistic regression.
Results: A total of 566 participants were included. The prevalence of FSD among those using hormonal and those using non-hormonal contraception was 51.5% and 29.6% respectively (P<0.0001). Using logistic regression we found that the factors that were associated with FSD were presence of chronic illness and use of chronic medication, self-employment and unemployment statuses, alcohol intake and history of miscarriage(s).
Conclusions and recommendations: There was a high prevalence of FSD in our setting. There was a strong association between hormonal contraception and FSD amongst those using it. More studies on this topic in different settings are recommended to investigate effect of each type of hormonal method on FSD.
Butt, M. (2018). Prevalence and Factors associated with Female Sexual Dysfunction amongst Women using Hormonal and Non-Hormonal Contraception at The Aga Khan University Hospital Nairobi Clinics (Unpublished master's dissertation). Aga Khan University, East Africa.