Female sexual function is known to be impacted by the presence of pelvic floor disorders (PFDs). Racial disparities exist in the relationship between PFDs and sexual function among racial/ethnic minority women. Little is understood regarding the factors that influence these disparities. We evaluated the demographic, sociocultural, and psychosocial factors, namely stress and discrimination, associated with sexual function among Latina women in a clinical setting.

We conducted a prospective cross-sectional study of Spanish and English-speaking Latina women with and without PFDs recruited from Urology and Urogynecology clinics at a large private or public hospital. Presence of PFDs was determined by the Pelvic Floor Disorders Inventory (PFDI-20) questionnaire. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12) is validated for use in women with PFDs to assess sexual function. As such we performed a subset analysis on women with PFDs who were also sexually active. Self-reported psychosocial stress was assessed with the 10-item Perceived Stress Scale (PSS), including protective and negative domains, and the Everyday Discrimination Scale (EDS). We performed linear regression analysis to assess the relationship between PISQ-12 score and demographic, cultural and psychosocial metrics, significant at a value of p-value < 0.05.

Of the 153 total study participants, 53 (34.6 %) completed the PISQ-12 questionnaire. The mean PISQ-12 score was 29.9 with 8.0, 8.6 and 13.2 on the partner, behavior, and physical domains, respectively. Compared to non-sexually active women who completed the PISQ-12, our cohort of sexually active women were slightly older (50.1 vs 47.9, p = 0.34), with significantly worse bowel (27.3 vs 15.2, p = 0.005), urinary (67.3 vs 31.8, p < 0.001), and prolapse symptoms (45.9 vs 20.8, p < 0.001). On linear regression analysis, positive association was seen with higher PISQ-12 score (better sexual function) and the Mexican-American values of familism (p = 0.05), respect (p = 0.04), religion (p = 0.02), and being employed (p = 0.05), with a trend towards significance for the PSS negative subscore (p = 0.06). A negative correlation was observed for Mainstream values of independence (p = 0.05), age (p = 0.05).

Among Latina women who presented to clinic for management of their PFDs, better sexual function was more associated with Mexican-American values as compared to Mainstream values. The specific domains of the Mexican-American values scale highlight areas of importance for maintaining sexual function despite PFDs for Latina women

These results suggest sociocultural drivers of disparities in sexual function among racial/ethnic minority women with PFDs.