بررسی تأثیر ژل پوست انار بر ارگاسم و رضایت‌مندی جنسی زنان در سنین باروری: یک کارآزمایی بالینی تصادفی کنترل شده

نوع مقاله: اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 استادیار گروه مامایی، مرکز تحقیقات مراقبت‌های پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دکترای تخصصی کنترل دارو، گروه علوم دارویی در طب ایرانی، دانشکده طب ایرانی و مکمل، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

4 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

5 استادیار گروه آمار و اپیدمیولوژی، مرکز تحقیقات مدیریت و تعیین کننده‌های اجتماعی سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: از جمله عوامل فیزیولوژیک تأثیرگذار بر ارگاسم و به دنبال آن رضایت جنسی، قدرت عضلات کف لگن می‌باشد. ضعف این عضلات می‌تواند سبب ایجاد اختلال در رسیدن زنان به ارگاسم و در نهایت آنورگاسمی گردد و به‌دنبال آن رضایت جنسی را کاهش دهد. مطالعه حاضر با هدف تعیین تأثیر ژل پوست انار بر ارگاسم و رضایت‌مندی جنسی زنان در سنین باروری انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی دو گروهه سه‌سوکور در سال 1397 بر روی110 نفر از زنان 45-18 ساله مراجعه کننده به درمانگاه زنان بیمارستان امام رضا (ع) مشهد انجام شد. واحدهای پژوهش به صورت تصادفی در دو گروه ژل پوست انار و دارونما قرار گرفته و به آنها توصیه شد که به مدت 8 هفته از ژل استفاده نمایند. ارگاسم و رضایت‌مندی جنسی زنان قبل، 4 و 8 هفته بعد از مداخله در دو گروه بررسی شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار Stata و آزمون­های آماری تی مستقل، من‌ویتنی، تی زوجی، ویلکاکسون و فریدمن انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: در ابتدای مطالعه در میانگین نمره حیطه­های ارگاسم (748/0=p) و رضایت‌مندی جنسی (922/0=p) عملکرد جنسی زنان در دو گروه مداخله و دارونما تفاوت آماری معناداری وجود نداشت، اما بعد از 4 و 8 هفته مداخله، میانگین نمره این دو حیطه نسبت به گروه دارونما افزایش آماری معناداری یافته بود (001/0p<).
نتیجه‌گیری: استفاده از ژل پوست انار به‌طور مؤثری می‌تواند از طریق بهبود ارگاسم، باعث افزایش رضایت‌مندی جنسی زنان شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of pomegranate peel gel on orgasm and sexual satisfaction of women in reproductive age: A triple-blind، randomized, controlled clinical trial

نویسندگان [English]

  • Fatemeh Mohammadzadeh 1
  • Raheleh Babazadeh 2
  • Roshanak Salari 3
  • Maliheh Afiat 4
  • Hamid Heidarian Miri 5
1 M.Sc. student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Midwifery, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Ph.D. of Drug Control, Department of Pharmaceutical Sciences in Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5 Assistant Professor, Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, School of Public Health, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: One of the physiologic factors affecting orgasms and sexual satisfaction is the strength of the pelvic floor muscles. The weakness of these muscles may lead to female orgasmic disruption, anorgasmia, and, in turn, to decreased sexual satisfaction. This study aimed to determine the effect of pomegranate peel gel on women's orgasm and sexual satisfaction during their reproductive age.
Methods: This randomized triple blind clinical trial was conducted on 110 women aged 18-45 years old admitted to the women's clinic of Imam Reza Hospital in Mashhad in 2018. The participants were randomly assigned to two groups of control and intervention. The subjects in intervention and control group were recommended to use peel gel and placebo, respectively for 8 weeks. The orgasms and sexual satisfaction of the women in both groups were evaluated at the baseline, as well as 4 and 8 weeks after the intervention. The data were analyzed in Stata software, using T_test, Mann_whitney, T_paird, Wilcoxom & Friedman. P<0.05 was considered statistically significant.
Result: At the beginning of the study, the two groups were not different in terms of orgasms (p=0/748), sexual satisfaction (p=0/922), and sexual function. However, the mean scores of these two domains were significantly higher in study group after 4 and 8 weeks of intervention (p<0.001).
Conclusion: The use of pomegranate peel gel can effectively increase women's sexual satisfaction by improving orgasms.

کلیدواژه‌ها [English]

  • Orgasm
  • Sexual satisfaction
  • Sexual dysfunctions
  • pomegranate peel
  1. Byers ES. Relationship satisfaction and sexual satisfaction: a longitudinal study of individuals in long‐term relationships. J Sex Res 2005; 42(2):113-8.
  2. Babazadeh R, Mirzaei Najmabadi K, Masoumi Z, Raei M. Investigating effect of teaching on sexual-activity changes during pregnancy. Iran J Obstet Gynecol Infertil 2012; 15(12):18-26. (Persian).
  3. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26(2):191-208.
  4. Karimi F, Bababzadeh R, Latifnejad-Roudsari R, Esmaily H. The Relationship between sexual function and sexual self-disclosure in women after childbirth. J Isfahan Med Sch 2019; 36(502):1321-8. (Persian).
  5. Berek JS. Berek & Novak's gynecology. 15th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. BMC Med 2013; 17:133-7.
  7. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008; 112(5):970-8.
  8. Najafabady MT, Salmani Z, Abedi P. Prevalence and related factors for anorgasmia among reproductive aged women in Hesarak, Iran. Clinics 2011; 66(1):83-6.
  9. Ghiasi A, Keramat A. Prevalence of sexual dysfunction among reproductive-age women in Iran: a systematic review and meta-analysis. J Midwifery Reprod Health 2018; 6(3):1390-8.
  10. Ahrold TK, Farmer M, Trapnell PD, Meston CM. The relationship among sexual attitudes, sexual fantasy, and religiosity. Arch Sex Behav 2011; 40(3):619-30.
  11. Meston CM, Levin RJ, Sipski ML, Hull EM, Heiman JR. Women's orgasm. Ann Rev Sex Res 2004; 15:173-257.
  12. Mah K, Binik YM. The nature of human orgasm: a critical review of major trends. Clin Psychol Rev 2001; 21(6):823-56.
  13. Kontula O, Miettinen A. Determinants of female sexual orgasms. Socioaffect Neurosc Psychol 2016; 6:31624.
  14. Kelly MP, Strassberg DS, Turner CM. Behavioral assessment of couples' communication in female orgasmic disorder. J Sex Marital Ther 2006; 32(2):81-95.
  15. Kelly MP, Strassberg DS, Turner CM. Communication and associated relationship issues in female anorgasmia. J Sex Marital Ther 2004; 30(4):263-76.
  16. Schover LR. Sexuality and chronic illness: a comprehensive approach. New York: Guilford Press; 1988.
  17. Artibani W, Haab F, Hilton P. Pelvic floor reconstruction. Eur Urol 2002; 42(1):1-11.
  18. Berman JR, Berman LA, Kanaly KA. Female sexual dysfunction: new perspectives on anatomy, physiology, evaluation and treatment. EAU Update Ser 2003; 1(3):166-77.
  19. Patel DA, Xu X, Thomason AD, Ransom SB, Ivy JS, DeLancey JO. Childbirth and pelvic floor dysfunction: an epidemiologic approach to the assessment of prevention opportunities at delivery. Am J Obstet Gynecol 2006; 195(1):23-8.
  20. Vergeldt TF, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J 2015; 26(11):1559-73.
  21. Aydın S, Aydın ÇA, Batmaz G, Dansuk R. Effect of vaginal electrical stimulation on female sexual functions: a randomized study. J Sex Med 2015; 12(2):463-9.
  22. Brækken IH, Majida M, Engh ME, Bø K. Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial. J Sex Med 2015; 12(2):470-80.
  23. Meriwether KV, Komesu YM, Craig E, Qualls C, Davis H, Rogers RG. Sexual function and pessary management among women using a pessary for pelvic floor disorders. J Sex Med 2015; 12(12):2339-49.
  24. Namvar F, Golmakani N, Khadem N. A comparative study of the effects of vaginal cones and pelvic floor muscles exercises in women with pelvic floor muscles atony. J Sabzevar Univ Med Sci 2002; 8(4):16-22. (Persian).
  25. Jafarnejad F, Kazemeini H, Mazloum R, Emami Moghadam Z, Sefidgaran A. Study on the effect of colporrhaphy on women’s sexual function and satisfaction. Iran J Obstet Gynecol Infertil 2013; 16(59):14-23. (Persian).
  26. Goudarzi F, Rad P, Hekmatzadeh F, Taj Aramesh S. Sexual function in women with genital prolapse before and after Anterior posterior Colporrhaphy (APR). Iran J Obstet Gynecol Infertil 2016; 19(34):1-9. (Persian).
  27. Komesu YM, Rogers RG, Kammerer-Doak DN, Barber MD, Olsen AL. Posterior repair and sexual function. Am J Obstet Gynecol 2007; 197(1):101.e1-6.
  28. Mahajan ST. Pelvic organ prolapse in women: surgical repair of anterior vaginal wall prolapse. Massachusetts: UpToDate; 2015.
  29. Walters M. Surgical correction of anterior vaginal wall prolapse. Walters MD, Karram MM, editors. Urogynecology and reconstructive pelvic surgery. 3rd ed. Philadelphia: Mosby; 2007. P. 234-45.
  30. Yosefzadeh S, Sadeghi S, Rakhshandeh H, Dadghar S, Mazloum SR. The effect of date palm pollen capsule on orgasm and sexual satisfaction in menopausal women: a double-blind controlled clinical trial. Iran J Obstet Gynecol Infertil 2017; 20(10):43-51. (Persian).
  31. Akhtari E, Raisi F, Keshavarz M, Hosseini H, Sohrabvand F, Bioos S, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo-controlled study. Daru 2014; 22(1):40.
  32. Akbarzadeh M, Zeinalzadeh S, Zolghadri J, Mohagheghzadeh A, Faridi P, Sayadi M. Comparison of Elaeagnus angustifolia extract and sildenafil citrate on female orgasmic disorders: a randomized clinical trial. J Reprod Infertil 2014; 15(4):190-8.
  33. Modabbernia A, Sohrabi H, Nasehi AA, Raisi F, Saroukhani S, Jamshidi A, et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology 2012; 223(4):381-8.
  34. Abbasi Pirouz M, Zojaji A, Shakeri MT, Mirzaei K. Effect of Squill on the sexual function among women of reproductive age. Iran J Obstet Gynecol Infertil 2018; 21(10):57-65. (Persian).
  35. Zamani Z. Characteristics of pomegranate cultivars grown in Saveh of Iran. [Doctoral Dissertation]. Tehran: University of Tehran; 1990. (Persian).
  36. Prakash CV, Prakash I. Bioactive chemical constituents from pomegranate (Punica granatum) juice, seed and peel-a review. Int J Res Chem Environ 2011; 1(1):1-18.
  37. Kim ND, Mehta R, Yu W, Neeman I, Livney T, Amichay A, et al. Chemopreventive and adjuvant therapeutic potential of pomegranate (Punica granatum) for human breast cancer. Breast Cancer Res Treat 2002; 71(3):203-17.
  38. Viuda‐Martos M, Fernández‐López J, Pérez‐Álvarez J. Pomegranate and its many functional components as related to human health: a review. Compr Rev Food Sci Food Saf 2010; 9(6):635-54.
  39. Khorasani MA. Makhzan al Advieh. Tehran, Iran: Bavardaran Press Research institute for Islamic and Complementary Medicine, Iran University of Medical Sciences; 2001.
  40. Tonkaboni MM. Tohfeh al-momenin. Tehran: Shahid Beheshti University of Medical Sciences; 2007.
  41. Seeram NP, Adams LS, Henning SM, Niu Y, Zhang Y, Nair MG, et al. In vitro antiproliferative, apoptotic and antioxidant activities of punicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice. J Nutr Biochem 2005; 16(6):360-7.
  42. Ashok PK, Upadhyaya K. Tannins are astringent. J Pharm Phytochem 2012; 1(3):45-50.
  43. Lorzadeh N, Sepavand F, Soleimaninezhad M, Kazami RN. The effect of extract of internal layer of quercus (OAK GAL) in contraction of vaginal smooth muscles in women with vaginal relaxation. J Med Plants 2016; 15(60):173-81.
  44. World Health Organization. Calcium and magnesium in drinking-water: public health significance. Geneva: World Health Organization; 2009.
  45. Negi PS, Jayaprakasha GK, Jena BS. Antioxidant and antimutagenic activities of pomegranate peel extracts. Food Chem 2003; 80(3):393-7.
  46. Sabbah A, Nasser M, As-sadi F, Hijazi A, Rammal H, Nasser G. Chemical composition and antioxidant activity of lebanese punica granatum peels. Int J Pharma Res Health Sci 2017; 5(1):1552-7.
  47. Jahromi SB, Pourshafie MR, Mirabzadeh E, Tavasoli A, Katiraee F, Mostafavi E, et al. Punica granatum peel extract toxicity in mice. Jundishapur J Natural Pharm Prod 2015; 10(4):e23770.
  48. Mohammadi KH, Heydari M, Faghihzadeh S. The female sexual function index (FSFI): validation of the Iranian version. Payesh 2008; 7(3):269-78. (Persian).
  49. Abedi P, Jamali S, Tadayon M, Parhizkar S, Mogharab F. Effectiveness of selective vaginal tightening on sexual function among reproductive aged women in Iran with vaginal laxity: a quasi‐experimental study. J Obstet Gynaecol Res 2014; 40(2):526-31.
  50. Coad J, Dunstall M. Anatomy and physiology for midwives e-book. New York: Elsevier Health Sciences; 2011.
  51. Danforth DN. Danforth's obstetrics and gynecology. Philadelphia: Lippincott williams & Wilkins; 2008.
  52. Zahariou AG, Karamouti MV, Papaioannou PD. Pelvic floor muscle training improves sexual function of women with stress urinary incontinence. Int Urogynecol J 2008; 19(3):401-6.
  53. Topuz Ş, Seviğ EÜ. Effects of kegel exercises applied to urinary ıncontinence on sexual satisfaction. Int J Clin Exp Med 2016; 9(6):12365-74.
  54. Nazarpour S, Simbar M, Majd HA, Tehrani FR. Beneficial effects of pelvic floor muscle exercises on sexual function among postmenopausal women: a randomised clinical trial. Sex Health 2018; 15(5):396-402.
  55. Serati M, Braga A, Di Dedda MC, Sorice P, Peano E, Biroli A, et al. Benefit of pelvic floor muscle therapy in improving sexual function in women with stress urinary incontinence: a pretest-posttest intervention study. J Sex Marital Ther 2015; 41(3):254-61.
  56. Bastani P, Hajebrahimi S, Ghaderi F, Vakilazad Z, Ghojazadeh M. The effect of pelvic floor physical therapy on sexual function in women complaining dyspareunia. Tehran Univ Med J 2016; 74(7):500-8. (Persian).
  57. Lara LA, Montenegro ML, Franco MM, Abreu DC, Rosa e Silva AC, Ferreira CH. Is the sexual satisfaction of postmenopausal women enhanced by physical exercise and pelvic floor muscle training? J Sex Med 2012; 9(1):218-23.
  58. Citak N, Cam C, Arslan H, Karateke A, Tug N, Ayaz R, et al. Postpartum sexual function of women and the effects of early pelvic floor muscle exercises. Acta Obstet Gynecol Scand 2010; 89(6):817-22.