Perbandingan Kualitas Fungsi Seksual Antara Wanita Perimenopause dengan Wanita Pascamenopause di Kecamatan Ngaglik, Kabupaten Sleman, Daerah Istimewa Yogyakarta

Nathina Finiasana Widiarti, Dr. dr. Shofwal Widad, Sp. OG., Subsp. FER; dr. Muhammad Nurhadi Rahman, Sp. OG

2023 | Tesis-Spesialis | S2 Ilmu Kebidanan dan Penyakit Kandungan

Latar Belakang: Menopause dan fungsi seksual merupakan dua hal yang masih sangat jarang dibicarakan. Fungsi seksual merupakan salah satu aspek kesehatan yang seringkali terabaikan terutama pada fase menopause. Nyatanya fungsi seksual merupakan salah satu faktor yang mempengaruhi kualitas hidup seseorang. Status menopause dikatakan menjadi salah satu faktor terjadinya disfungsi seksual, namun wanita menopause juga masih memiliki hak untuk menjalani hidup yang berkualitas dengan fungsi seksual yang baik.

Tujuan: Penelitian ini bertujuan untuk mengetahui adanya hubungan antara status menopause dengan kejadian disfungsi seksual.

Metode: Studi ini merupakan studi potong lintang yang dilakukan di Kecamatan Ngaglik, Kabupaten Sleman, Yogyakarta. Penelitian ini merupakan penelitian dengan data tersarang dimana daftar sampel awal didapatkan dari Health and Demographic Surveillance System (HDSS) Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan (FKKMK) UGM. Sebanyak 338 subjek wanita berusia >40 tahun dengan status menikah kemudian diwawancara dan akhirnya sebanyak 37 subjek wanita perimenopause dan 52 subjek wanita pascamenopause masuk dalam kriteria inklusi yang diwawancara dengan kuesioner Female Sexual Function Index (FSFI) versi Indonesia yang telah dilakukan uji validasi sebelumnya.  Analisis statistik dilakukan dengan SPSS versi 26 dengan uji univariat untuk melihat karakteristik sampel, uji bivariat dengan chi square, fisher exact, dan Mann Whitney untuk melihat hubungan antara dua variabel, kemudian dilakukan uji multivariat dengan regresi logistik.

Hasil: Didapatkan dari kelompok perimenopause yang mengalami disfungsi seksual sebanyak 19 (51,4%) dan kelompok pascamenopause sebanyak 44 subjek (84,6%) dengan adanya hubungan yang signifikan secara statistik (p=0,001 95% [0,071 – 0,517]). Terdapat hubungan yang signifikan antara status menopause dengan gangguan pada domain hasrat (p=0,001), keterangsangan (p=0,000), lubrikasi (p=0,001), orgasme (p=0,006), kepuasan (p=0,003), namun tidak ada hubungan yang signifikan pada domain nyeri (0,710). Lama menopause tidak memiliki pengaruh terhadap fungsi seksual (p= 0,308; PR= 1,11 CI 95% [0,857 ; 1,360]). Tidak didapatkan adanya hubungan signifikan antara variabel pengganggu (IMT, Pendidikan, pekerjaan, riwayat persalinan normal, riwayat trauma jalan lahir, riwayat penyakit saraf, riwayat penyakit metabolik).

Kesimpulan: Terdapat perbedaan kualitas fungsi seksual antara wanita perimenopause dengan wanita pascamenopause di Kecamatan Ngaglik, Kabupaten Sleman, Daerah Istimewa Yogyakarta dimana kejadian disfungsi seksual lebih banyak terjadi pada wanita pascamenopause dibandingkan dengan wanita perimenopause.

Background: Menopause and sexual function are two things that are still rarely discussed. Sexual function is one aspect of health that is often overlooked, especially during the menopausal phase. In reality, sexual function is one of the factors that affect a person's quality of life. Menopausal status is said to be one of the factors in the occurrence of sexual dysfunction, but menopausal women still have the right to live a quality life with good sexual function.

Objective: This study aims to determine the relationship between menopausal status and the occurrence of sexual dysfunction.

Method: This study is a cross-sectional study involving 37 perimenopausal subjects and 52 postmenopausal subjects residing in the Ngaglik Sub-district, Sleman Regency, Yogyakarta. The research employed a nested data, where the initial sample list was obtained from the Health and Demographic Surveillance System (HDSS) of the Faculty of Medicine, Public Health, and Nursing at Gadjah Mada University (FKKMK UGM). A total of 338 female subjects aged >40 years with married status were interviewed, resulting in 37 perimenopausal female subjects and 52 postmenopausal female subjects meeting the inclusion criteria. These subjects were then interviewed to gather basic data and assess their sexual function using the Indonesian version of the Female Sexual Function Index (FSFI) questionnaire, which had undergone prior validation testing. Statistical analysis was conducted through univariate tests to examine sample characteristics, bivariate tests including chi-square, Fisher's exact test, and Mann-Whitney to explore relationships between variables, followed by multivariate analysis using logistic regression.

Results: Obtained from a perimenopausal group experiencing sexual dysfunction were 19 subjects (51.4%), and from a postmenopausal group were 44 subjects (84.6%), with a statistically significant relationship (p=0.001, 95% CI [0.071 – 0.517]). There was a significant relationship between menopause status and disturbances in desire domain (p=0.001), arousal (p=0.000), lubrication (p=0.001), orgasm (p=0.006), satisfaction (p=0.003), but there was no significant relationship in the pain (0.710). The duration of menopause did not have an influence on sexual function (p=0.397; PR=1.08, 95% CI [0.857; 1.360]). No significant relationships were found between sexual function and BMI, education, occupation, history of normal childbirth, history of birth canal trauma, history of neurological disease, and history of metabolic disease.

Conclusion: There is a difference in the quality of sexual function between perimenopausal and postmenopausal women in the Ngaglik District, Sleman Regency, Yogyakarta Special Region, where the occurrence of sexual dysfunction is more common in postmenopausal women compared to perimenopausal women.

Kata Kunci : Fungsi seksual, status menopause, perimenopause, pascamenopause, FSFI