Sexual function and quality of life of women using Medroxyprogesterone Acetate contraceptive in Nakuru County Referral Hospital

Abstract

Introduction: Sexual function is in the centre of women’s quality of life. Depot medroxyprogesterone acetate (DMPA) contraceptive has a high discontinuation rate for reasons other than conception. Menstrual irregularities and reduced libido are the most cited reasons. Knowing the sexual function and quality of life of DMPA users enables healthcare providers to serve clients well. Objective: To assess the sexual function, quality of life and describe the relationship between sexual function and quality of life among women using DMPA contraceptive. Methodology: A cross sectional descriptive study was conducted in Nakuru County referral Hospital. A total of 130 DMPA users visiting family planning clinic were selected using systematic sampling technique. Questionnaires on demographic, female sexual function index and the short form 36 health survey were used for data collection. Data was analysed using SPSS version 23.0. Descriptive statistics used included frequencies, percentage, minimum, maximum, mean and standard deviation. The relationship between dependent and independent variables was tested using chi square. Logistic regression used to check for linear relationship and possible confounders. The p-value of less than 0.05 was considered statistically significant. Data were presented as figures such as bar graphs, histograms and tables. Results: About half of participants 46% (52) had sexual dysfunction having scored below the cut off points of 26.5. A number of participants, 21% (23) never experience sexual desire. Sexual desire domain had the least mean, 3.27(±1.52) while sexual satisfaction domain had the highest mean of 5.12(±1.35). A significant relationship was seen between age and sexual arousal (χ2 =9.419, df=2 and sig = 0.009). On Quality of life, majority, 96.4% (108) scored above average (50%) with physical functioning having the highest mean of 95.80 (±14.41) and energy/fatigue having the lowest mean of 77.95 (±18.28). There was a significant relationship between DMPA contraceptive use and female sexual function (r=0.253, ρ<0.05). Conclusion: Female sexual function among DMPA users was found to be low. The most affected domain was sexual desire followed by sexual arousal. Participants enjoyed a favourable quality of life despite the sexual dysfunction. Recommendations: Assessing of Female sexual function should be incorporated as part of comprehensive and holistic health care given to women of reproductive age using DMPA. Sexuality counselling by service providers should be done in order for the women to make informed choice when opting for DMPA as a contraceptive method. Sexual concerns should be addressed routinely by service providers as part of care given to women using DMPA to enhance method continuation.