Women on the Other Side of War and Poverty : Its Effect on the Health of Reproduction

The word “sexual satisfaction” means a person’s pleasant feelings towards sexual intercourse (1) and includes the individual’s satisfaction from sexual activity until reaching orgasm (2). According to the World Health Organization (WHO) definition, sexual health is the integration and coordination of the mind, the senses and the individual’s body that leads to putting one’s social and rational efforts in the direction of personality promotion, and ultimately leads to communication and love among individuals. Therefore, any disorder that leads to the elimination of this coordination and integration results in sexual dysfunction and, as a result, dissatisfaction with sex (3). The latest theory on sexual function includes 6 components for female sexual function. The sexual desire component is an individual’s desire to engage in sexual activity. The sexual arousal component is stimulation of physiological responses in sexual organs, which includes swelling of the vagina, labia and clitoris in women. The slippery or moisture component is vaginal secretions that increase due to arousal and lead to slipping. The orgasm component is characterized by rhythmic contractions of the uterine muscle and external one third of the vagina and anal sphincter. The satisfaction component is the sexual satisfaction from intercourse with the spouse, satisfaction with sexual relations and satisfaction with the whole marital life. The pain component is the amount of vaginal pain during sexual intercourse and postpartum (4). Various studies have investigated the prevalence of sexual dysfunction. For example, the prevalence of sexual dysfunction in Iranian studies includes Birjand’s finding of 60.3% (5), Yazd’s finding of 73.2% (6), and Sabzevar’s finding of 63.21% (7). In non-Iranian studies, the prevalence of sexual dysfunction is 40% in the United States and Sweden, 29.6% in Malaysia and Turkey (8), 69% in Egypt (9), and 35% in China (10). Optimal sexual function and sexual satisfaction results in warmth and passion in couples. It would protect them against many diseases and mental and physical disorders. For example, there is a relationship between sexual satisfaction and reducing heart attacks in men and reducing incidence of migraine headaches, symptoms of premenstrual syndrome and chronic arthritis in women (11). In contrast, people who have Abstract Objectives: Sexual decency is one of the false beliefs among women about sexual function, and women who have this belief choose an inactive and passive sexual role. The present study aimed to investigate the effect of decisiveness-based sexuality counselling on sexual function among married female students at the University of Sistan and Baluchestan. Materials and Methods: This quasi-experimental study used a pre-test-post-test design and was conducted on 80 married female students who were selected and randomly assigned to the intervention (n = 40) or control (n = 40) groups. The data collection tool was Rosen’s Sexual Function questionnaire. The intervention group, after the pre-test, took part in four sessions of assertivenessbased sexual counselling weekly across 2 sessions of 90 to 120 minutes. Both groups filled out the questionnaires after the end of the waiting period (2 months) (post-test). Chi-square, covariance and independent paired t tests were used to compare the means of the quantitative variables in the 2 groups. Results: The results showed that the mean score on the sexual function index increased in the intervention group after sexual counselling and decreased in the control group. An independent t test also showed that the difference in mean scores on the sexual function index after sexual counselling in the intervention and control groups was not significant. However, the mean change in the total index score was significantly different in the 2 groups (P = 0.0001). Conclusions: The assertiveness-based sexual counselling method significantly influenced sexual function and expression of sexual rights and reduced the shame and contempt that women in the study felt. It is safe to admit that this method can be used as a way to promote sexuality and to establish a more intimate relationship in marital life.