Association between air pollution and female sexual function among Chinese women in a nationwide observation study

Abstract

Previous studies have suggested the negative impacts of air pollution on female reproductive health, yet its effect on female sexual function remains unexplored. We conducted a nationwide cross-sectional study involving 4859 sexually active women to investigate the potential association between exposure to six air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, O₃ and CO) and female sexual function. Female sexual function was evaluated using the Female Sexual Function Index (FSFI). Individual exposure levels to the six air pollutants over the past 1, 3, 6, and 12 months were determined using the inverse distance weighting (IDW) model. And the general linear model and restricted spline function were utilized for data analysis. Significant negative associations were found between NO₂ exposure and CO exposure in the past 1, 3, and 6 months with FSFI total score (NO₂ (1m): β = - 0.029, 95% CI - 0.052 to - 0.006; NO₂ (3m): β = - 0.029, 95% CI - 0.051 to - 0.007; NO₂ (6m): β = - 0.023, 95% CI - 0.042 to - 0.003; CO (1m): β = - 0.002, 95% CI - 0.003 to - 0.0004; CO (3m): β = - 0.002, 95% CI - 0.003 to - 0.001; CO (6m): β = - 0.002, 95% CI - 0.003 to - 0.0004), primarily impacting desire, arousal, orgasm, and satisfaction. There were positive associations between PM₁₀ and O₃ exposure and the FSFI total score, while PM_2.5 and SO₂ showed no significant association with the FSFI total score. Our findings indicated that NO₂ and CO may serve as risk factors affecting sexual function in sexually active women. Furthermore, even women with currently normal sexual function scores may suffer from such adverse effects.

Keywords: Air pollution; FSD; FSFI; Female sexual function; Sexually active women.

Fig. 1

Flowchart of the exclusion criteria for participants in this study.

Fig. 2

The forest plot of the correlation between exposure to six air pollutants in the past 1, 3, 6, and 12 months and FSFI total score. The multivariable linear regression models were adjusted for age, BMI, smoking status, drinking status, education level, income, underlying disease, resident, depression score, and daily average temperature during exposure period. The units of all the above ambient air pollutants were converted to μg/m³.

Fig. 3

Linear and non-linear fitted curves between exposure to the six air pollutants and FSFI total score in the past 1, 3, 6, and 12 months. The multivariable linear regression models with restricted cubic spline functions of air pollutant exposure were adjusted for age, BMI, smoking status, drinking status, education level, income, underlying disease, resident, depression score, and daily average temperature during exposure period, with 4, 3, 3, 3, 3, 3, 3, 3, 3, 3, 3, 3, 3, 3, 3, 4, 4, 4, 4, 3, 3, 3, 3 and 3 degrees of freedom, respectively. The units of all the above ambient air pollutants were converted to μg/m³.

Fig. 4

The forest plots of the correlation between exposure to NO₂(A) and CO(B) in the past 1, 3 and 6 months and FSFI 6-dimension scores (desire, arousal, lubrication, orgasm, satisfaction and pain). The ordered multivariable logistic regression models were adjusted for age, BMI, smoking status, drinking status, education level, income, underlying disease, resident, depression score, and daily average temperature during exposure period. The units of all the above ambient air pollutants were converted to μg/m³.