Cyclical Mastalgia and Sexual Satisfaction: A Descriptive Analytical Study

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This study aimed to determine the predictors of sexual satisfaction among women diagnosed with cyclical mastalgia. Methods This cross-sectional study was conducted from April to August 2021. A total of 204 married women diagnosed with cyclical mastalgia were included. The study used a cluster random sampling method from 4 comprehensive health centers and Kousar hospital clinics in Qazvin, Iran. Sexual Satisfaction Index (SSI) scores were assessed. The obtained data were analyzed using SPSS version 26 with a significance level of p < 0.05. Results The participants’ ages ranged from 21 to 47 years; the mean ages of the participants and their spouses were 33.05 (SD = 6.14) and 36.21 (5.97) years, respectively. The mean sexual satisfaction was 80.93 (14). Examining the level of sexual satisfaction of the participants showed that most of the participants in the study (63.7%) had moderate sexual satisfaction, and the least number of participants (2%) reported a lack of sexual satisfaction. The results of multivariate linear regression analysis to determine the predictors of sexual satisfaction showed that the couple’s education, spouse’s occupation, location, wife’s interest in her spouse, and spouse’s greater interest in touching the wife’s breast were predictors of sexual satisfaction. Conclusion Cyclical mastalgia did not affect sexual satisfaction. mastodynia orgasm Introduction Mastalgia is a common form of breast pain among fertile women (1). Pain is often described as a dull ache, although some women may experience sensations of heaviness, tightness, discomfort, or burning sensation in the breast tissue(2). Approximately 65–70% of women will suffer from this condition at least once in their lifetime(3). Despite its frequency, mastalgia is difficult to manage well because of its subjective nature and unclear etiology(4). The etiology of mastalgia, which is a factor contributing to its poor management, remains unclear(5). High levels of endogenous estrogen can cause cyclical mastalgia (perimenstrual breast pain) (6), which is a common type of mastalgia that lasts for five days or more each month(7) and can be severe enough to interfere with usual activities(7). Studies have shown that cyclical breast pain in 20–30% of women resolves spontaneously within 3 months after onset(8). An experience of intense stress, daily coffee, and chocolate consumption, a history of breast surgery, and menstruation patterns were risk factors associated with mastalgia. Some domains of quality of life are negatively affected in women with mastalgia(9). Mastalgia is also associated with anxiety, stress, and other psychological factors(10). In approximately 8% of these women, severe pain interferes with their normal activities(11) and disturbs their normal sexual function(12). Breasts are among the most important sexual organs in women (13) and are known as a symbol of beauty, motherhood, and sexual attractiveness (14). In some sources, the breast is considered the second most important sexual organ in women. Pain can affect sexual performance and satisfaction. Disturbance during breast st. stimulation can cause sexual dysfunction(15), which can also lead to decreased sexual satisfaction(16). Sexual pleasure is one of the most important pleasures that a person can enjoy throughout his or her life and creates difficulties and problems for couples (17). Sexual satisfaction plays an important role in relationships, mental health, and even physical health(18). Studies have shown that approximately 80% of marital disputes occur due to sexual dissatisfaction (19). Identifying predictors of sexual satisfaction, especially in women, is useful for preventing these problems(19). Therefore, this study aimed to determine the predictors of sexual satisfaction among women diagnosed with cyclical mastalgia. Methods Study Design and Population This descriptive-analytical study was conducted on women who were referred to comprehensive health centers and Kausar Hospital clinics in Qazvin City, Iran. Enrollment began in April and continued until August 2021. In this study. The cluster random sampling method was used. In this way, a list of comprehensive health centers in Qazvin city was prepared, and the city was divided into 5 regions: northwest, northeast, southwest, southeast, and central. From each region, a comprehensive urban health center representative of that region in terms of society and number of patients was selected randomly. The samples were then included in the study according to the available methods and inclusion criteria. The inclusion criteria were willingness to participate in the study, reproductive age, regular menstruation, and involvement with cyclical mastalgia. To diagnose cyclical mastalgia, the participants were asked to determine their daily pain severity using a visual analog scale (VAS) over two menstrual cycles and to mark the obtained score on the Cardiff breast pain chart for the same day. Cyclical mastalgia was defined as breast pain severity equal to or greater than four according to the VAS score and a pain duration of more than five days per month according to the Cardiff Breast Pain Chart. The exclusion criteria included pregnancy, breastfeeding, physical or mental illness (self-reported), a history of breast cancer in the participant or her family, medication use in the past three months to reduce breast pain, and the use of hormonal contraceptive methods. The sample size was calculated based on the study by Afzali et al., considering α = 0.05 and d = 8, 177 people, and considering a sample loss rate of 20%, 195 people(20). Measures Demographic and Reproductive Characteristics Checklist This checklist included 23 questions that examined demographic characteristics and the status of breast pain and sex. To verify the content, the opinions of five expert members of the midwifery department of Qazvin University of Medical Sciences were obtained and approved. Cardiff Clinic Breast Pain Chart This chart was developed to determine the duration of pain based on the definition of cyclical mastalgia. This table has 31 houses, which are graded from 1 to 31, meaning that each number represents the same day of the month. In the house corresponding to the day when the person feels pain, moderate pain is indicated by a cross sign, severe pain is indicated by a solid sign, and menstrual days are indicated by a dot sign(21). Visual Analog Scale (VAS) This tool contains a horizontal line that is used in physiotherapy and is rated from 0 to 10, where 0 indicates absolute painlessness and 10 indicates unbearable pain; this tool is used to assess the severity of pain in people(16). Sexual Satisfaction Index The sexual satisfaction index was first designed and psychometrically evaluated by Hodson in 1981(22). Larson et al. (1998) widely used the sexual satisfaction index in 70 couples to examine empathy, friendly communication, balance in relationships, and self-esteem one year after marriage. In this study, to facilitate the comparison of these results with those of other studies, they positively reversed the scoring of this questionnaire. This index has 25 questions, 13 negative questions (4-5-6-7-8-9-11-14-15-18-20-24-25), and 12 positive questions (1-2-3-10-12-13-16-17-19-21-22-23). For each question, 5 options were included based on a Likert scale (never, rarely, sometimes, most of the time, and always), and each question was given a score ranging from 1 to 5 (23). In this index, a higher score is equivalent to greater sexual satisfaction(24). The Cronbach’s alpha values for all the positive and negative items were greater than 0.7. This index in Iran also has acceptable validity and reliability for use in studies (24, 25). Procedure Sampling was performed in two stages. In the first stage, the researcher identified women who were within the reproductive age range and who had regular menstruation. The Cardiff breast pain chart and visual analog scale were available for the samples for two months. After 2 months, in the case of cyclical mastalgia, the sexual satisfaction index was completed. Statistical analysis The results of the descriptive statistics are expressed as the mean ± standard deviation for continuous variables and as frequencies and percentages for categorical variables. The data were analyzed using SPSS software version 26. To determine the demographic, gender, and mastalgia-related variables affecting sexual satisfaction, each of the variables was entered into univariate linear regression separately, and the significant variables were then entered into multivariate linear regression. In this study, a linear regression model was used in the Enter method. In all analyses, a P value less than 0.05 was considered to indicate statistical significance. Ethics Statement This study was approved by the Institutional Review Board and Regional Ethics Committee of Biomedical Research (Qazvin University of Medical Sciences, Qazvin, Iran, decree code: IR.QUMS.REC.1400.479). All the methods were performed in accordance with the relevant guidelines and regulations. When conducting the research, the necessary permits were obtained to attend comprehensive health centers. The design, objectives, and research methods were fully explained to the participants, and informed consent was obtained from all participants. Individuals were assured that their information would remain confidential. Voluntary participation in the study and having the full authority of the participants to continue or withdraw from the study were observed. Results In this study, 204 questionnaires were completed. The participants’ ages ranged from 21 to 47 years; the mean ages of the participants and their spouses were 33.05 (SD = 6.14) and 36.21 (5.97) years, respectively. Among the qualified individuals, 47.5% were housewives and 52.5% were employed. Among the spouses, 2.9% were jobless, and 97.1% were employed. Family income status was self-rated by the participants; in 75% of the samples, it was reported to be sufficient, and in 25%, it was considered insufficient. Of these, 83.3% had a diploma or an academic degree, and 16.7% had an under diploma academic degree. Most of the spouses (86.3%) had a diploma or an academic degree, and 13.7% had an upper diploma academic degree. Among those who had experienced cyclical mastalgia, 90.7% were city dwellers, and 9.3% lived in villages. Our participants had been married for an average of 8.56 years. (Table 1) Table 1–Distribution of sociodemographic variables Variable classes N (%) Education Upper Diploma 170 (83.3) Under Diploma 34 (16.7) Spouse's education Upper Diploma 176(86.3) Under Diploma 28(13.7) Occupation Housewife 97 (47.5) Employed 107 (52.5) Spouse's occupation Jobless 6 (2.9) Employed 198 (97.1) Family income status Under sufficient 51 (25) Sufficient 153 (75) Location Town 185 (90.7) Village 19 (9.3) Mean (SD) Age 33.05 (6.14) Spouse's age 36.21(5.97) Duration of marriage (in years) 8.56 (6.50) Regarding cyclical mastalgia, breast pain was reported in 82.8% of patients bilaterally, 9.3% in the left breast, and 7.8% in the right breast. Among the patients, 91.17% had breast pain for more than 1 year, and 8.8% had breast pain for less than 1 year. The mean breast pain severity, number of breast pain days per month, and number of sexual interactions per week were 6.00 (1.07), 6.01(0.87), and 1.61 (0.74), respectively. Among our participants, 71.6% were highly interested in their spouses, and among the spouses 57.8% were highly interested in touching the wife’s breast during sexual relations. (Table 2 ) Table 2 Distribution of mastalgia-related variables Variable classes N (%) Breast pain location Right 16 (7/8) Left 19 (9/3) Bilateral 169 (82/8) Breast pain duration < 1 year 18 (8.82) 1 year< 186 (91.17) Spouses' interest in touching wife's breast Low 25 (16.8) Moderate 57 (27.9) High 122 (57.8) Wife's interest in her spouse Low 16 (7.8) Moderate 42 (20.6) High 146 (71.6) Mean (SD) Severity of breast pain 6.00(1.07) Number of days a woman has breast pain each month 6.01(0.87) Number of sexual interactions per week 1.61(0.74) The mean sexual satisfaction was 80.93 (14). Examining the level of sexual satisfaction of the samples showed that most of the participants (63.7%) had moderate sexual satisfaction, the least number of participants (2%) reported a lack of sexual satisfaction, 29/9% reported low sexual satisfaction, and 4/4% reported high sexual satisfaction. The results of univariate linear regression analysis to determine the predictors of sexual satisfaction according to all sociodemographic variables showed that the severity of breast pain, breast pain location, and the number of days a woman experienced breast pain each month were not significant (p > 0.05). According to the multivariate linear regression, the couple’s education, spouse's occupation, location, wife’s interest in her spouse, spouse’s greater interest in touching the wife’s breast, and number of sexual relations per week were determined to be predictors of sexual satisfaction. (p < 0.05). (Table 3) Table 3- Linear regression analysis for prediction of sexual satisfaction according to sociodemographic factors Variable Unadjusted Adjusted B Beta P value B Beta P value Age -1.259 -0.552 < 0.001 0.025 0.011 0.923 Spouse's age -1.119 -0.477 < 0.001 -0.113 -0.048 0.543 Education 10.805 0.556 < 0.001 2.542 0.131 0.045 * Spouse's education 9.310 0.473 < 0.001 -2.550 -0.130 0.042 * Occupation 3.201 0.291 < 0.001 0.171 0.016 0.734 Spouse's occupation 7.830 0.421 < 0.001 2.137 0.115 0.017 * Duration of marriage -1.379 -0.640 < 0.001 -0.278 -0.129 0.214 Family income status 11.880 0.454 < 0.001 -0.167 -0.006 0.903 Location -18.612 -0.387 < 0.001 -4.646 -0.097 0.048 * Breast pain duration -4.009 -0.180 < 0.001 0.481 0.022 .0625 wife's interest in her spouse 15.475 0.690 < 0.001 8.043 0.359 0.000 * Spouses' interest in touching wife's breast 15.475 0.690 < 0.001 4.263 0.264 0.000 * Number of sexual interactions per week 10.686 0.568 < 0.001 2.736 0.145 0.006 * Discussion This is the first study to examine the sexual satisfaction of women diagnosed with cyclical mastalgia. In Iran and other countries around the world, a limited number of studies have been conducted on cyclical mastalgia, most of which are devoted to the treatment of breast pain. Few studies have investigated the effect of cyclical mastalgia on different aspects of a woman’s life. The results of a systematic review of predictors of sexual satisfaction by Diana Rausch (2021) showed that relationship satisfaction and the frequency of sexual interactions were identified as the most frequently confirmed predictors of sexual satisfaction across all evaluated studies(26). However, the results showed that the number of sexual interactions was not a predictor of sexual satisfaction among patients with cyclical mastalgia. The findings showed that most women diagnosed with cyclical mastalgia had average sexual satisfaction (63.7%), and a minority of participants reported a lack of sexual satisfaction (2%). Among the remaining participants, 29.9% had low sexual satisfaction, and 4.4% had high sexual satisfaction. Molavi et al. (2015) conducted a study to investigate the performance and sexual satisfaction of couples after mastectomy. They concluded that mastectomy surgery has a significant negative effect on women’s sexual satisfaction (27). This study is similar to ours because it investigated sexual satisfaction in another group of women with breast-related problems. Because breasts are the second most important sexual organ in women(15), the results of both studies can be justified to some extent. In both studies, Larson’s evaluation index was used to evaluate sexual satisfaction. The results demonstrated that occupation can affect sexual satisfaction. A comparative study conducted by Khaneghahi et al (2019) on illness anxiety and marital sexual satisfaction in employed and housewife-married women illustrated that women who were housewives had greater sexual satisfaction than women who were employed(28). This study is not in line with our study. The presence of cyclical mastalgia may result in different outcomes. The results of another study conducted by Bahrami (2010) and colleagues on the relationship between infertility and the sexual satisfaction of couples indicate that age, level of education, and job status have no significant relationship with sexual satisfaction(29). The results of this part of Bahrami’s study are not in line with this study. Considering the conflicting results of the aforementioned studies with those of this study, the reason for this difference is probably the cyclical mastalgia of our samples. The results of a study conducted by Gheisari and Karimian (2013) with the aim of developing a causal model based on the variables of relationship satisfaction, marital quality, sexual relationship anxiety, sexual entitlement, and frequency of sexual interactions among married female students showed that the number of sexual interactions could predict women’s sexual satisfaction(30). In the present study, the number of sexual interactions also significantly predicted sexual satisfaction. Thus, cyclical mastalgia does not affect the number of sexual interactions. Based on the results of our study, the level of a woman’s interest in her husband was significantly related to sexual satisfaction. Interest and love between couples satisfy sexual needs, and despite the observation of those who are not satisfied with their sexual relationship despite reaching the peak of sexual pleasure, we may be able to justify the relationship between interest in a spouse and sexual satisfaction. Our results showed that the more women with cyclical mastalgia were interested in their husbands, the greater their sexual satisfaction. Our study conformed to the study of Salemi and his colleagues (2022) on the prediction of the sexual satisfaction of married women based on marital commitment and marital intimacy during the COVID-19 era and showed that the level of love and affection for the spouse is a predictor of sexual satisfaction(31). The results show that features associated with cyclical mastalgia, such as the number of days a woman experiences breast pain each month, breast pain location, and the severity of breast pain, do not influence sexual satisfaction. In other published studies, the associations between the features or complications of cyclical mastalgia and sexual problems and its etiology have not been investigated. Therefore, cyclical mastalgia does not affect women’s sexual satisfaction. Limitations The cross-sectional nature of the study, the use of self-reports to complete the scales, and the lack of simultaneous assessment of spouses were the main limitations of the present study. In addition, the participants in the study were only sampled from one urban area. While the study setting (Qazvin city) is one of the main cites in Iran with cultural diversity within the population, the results cannot necessarily be generalized to the Iranian population. Further studies using a longitudinal design with the participation of couples from other countries and cultures are recommended. Conclusion None of the features related to cyclical mastalgia affected sexual satisfaction. An association between cyclical mastalgia and sexual satisfaction has not been previously reported. Prospective research is needed to determine the factors affecting sexual satisfaction among women diagnosed with this disorder. Declarations Acknowledgment Not applicable Ethics approval : The ethics committee of Qazvin University of Medical Sciences approved the study( IR.QUMS.REC.1400.479). All the methods were performed in accordance with the relevant guidelines and regulations. When conducting the research, the necessary permits were obtained to attend comprehensive health centers. The design, objectives, and research methods were fully explained to the participants, and informed consent was obtained from all participants. Individuals were assured that their information would remain confidential. Voluntary participation in the study and having the full authority of the participants to continue or withdraw from the study were observed. Consent for publication: Not applicable. Competing interest: The authors declare no competing interests. Author contribution : F.O. and F.M. contributed to the conception and design of this research M.H and M.M contributed to the acquisition and analysis of the data; M.H. and M.M contributed to the interpretation of the data; M.H. drafted the preliminary manuscript. M.H. contributed in extensive literature review and preparing the final version of the manuscript. M.H. re-edited the manuscript completely and prepared the final version of the manuscript for submission . All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript to be published. All authors met the criteria for authorship and all entitled to authorship were listed as authors in the title page. Data availability: Data and materials will be available upon email to the corresponding author. 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Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4131266","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":282440612,"identity":"9982212f-deb0-4531-8e69-9c5dc190d605","order_by":0,"name":"Forouzan olfati","email":"","orcid":"","institution":"Qazvin University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Forouzan","middleName":"","lastName":"olfati","suffix":""},{"id":282440613,"identity":"7cd245ee-93ff-46da-aee8-74986137d9bd","order_by":1,"name":"Monirsadat Mirzadeh","email":"","orcid":"","institution":"Qazvin University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Monirsadat","middleName":"","lastName":"Mirzadeh","suffix":""},{"id":282440614,"identity":"75fb418a-21d2-4509-a199-4ffd5604e7d8","order_by":2,"name":"Farnoush Moafi","email":"","orcid":"","institution":"Qazvin University of Medical Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Farnoush","middleName":"","lastName":"Moafi","suffix":""},{"id":282440615,"identity":"3e1fe36d-4001-4a52-95e2-aa7b1305ac9d","order_by":3,"name":"Mobina Hosseini","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYBACAxCRwCDBwCDB2MDAUFHDw8/AwEaKljPHZCQbiNECBkBdDIxtzDYGBwhoMWdvf/jg4Q6LaH7p5rYHP9jYeIxvJD978KGCQZ5f7ABWLZY9Z4wNEs9I5M6cc7DdsIdHhsfsRpq54YwzDIYzZydgd9iNHDaJxDaJ3A03gCSPBBtQS4KZNG8bQ4LBbVxa0p//gGmR/GPAzGM8I/0bAS0JZgwwLdI8Ccw8BhI5BGw5c8YY7DCgX9qkZQ4c45E486ZMcsYZCdx+Od7+8OPPtrrcfun2Z5Jv/9XY87enb5P4UGEjzy+NXQsWIABWKUGschDgP0CK6lEwCkbBKBgBAAAnSF9CkwVVpwAAAABJRU5ErkJggg==","orcid":"","institution":"Qazvin University of Medical Sciences","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Mobina","middleName":"","lastName":"Hosseini","suffix":""}],"badges":[],"createdAt":"2024-03-19 14:46:48","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4131266/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4131266/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":112408522,"identity":"61c308c3-b723-442c-9277-f3518284862c","added_by":"auto","created_at":"2026-06-18 08:07:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":225682,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4131266/v1/b4fa4bc5-a500-4512-9b32-3c4c6dc9d2b4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cyclical Mastalgia and Sexual Satisfaction: A Descriptive Analytical Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMastalgia is a common form of breast pain among fertile women (1). Pain is often described as a dull ache, although some women may experience sensations of heaviness, tightness, discomfort, or burning sensation in the breast tissue(2). Approximately 65\u0026ndash;70% of women will suffer from this condition at least once in their lifetime(3). Despite its frequency, mastalgia is difficult to manage well because of its subjective nature and unclear etiology(4).\u003c/p\u003e \u003cp\u003eThe etiology of mastalgia, which is a factor contributing to its poor management, remains unclear(5). High levels of endogenous estrogen can cause cyclical mastalgia (perimenstrual breast pain) (6), which is a common type of mastalgia that lasts for five days or more each month(7) and can be severe enough to interfere with usual activities(7). Studies have shown that cyclical breast pain in 20\u0026ndash;30% of women resolves spontaneously within 3 months after onset(8).\u003c/p\u003e \u003cp\u003eAn experience of intense stress, daily coffee, and chocolate consumption, a history of breast surgery, and menstruation patterns were risk factors associated with mastalgia. Some domains of quality of life are negatively affected in women with mastalgia(9). Mastalgia is also associated with anxiety, stress, and other psychological factors(10). In approximately 8% of these women, severe pain interferes with their normal activities(11) and disturbs their normal sexual function(12).\u003c/p\u003e \u003cp\u003eBreasts are among the most important sexual organs in women (13) and are known as a symbol of beauty, motherhood, and sexual attractiveness (14). In some sources, the breast is considered the second most important sexual organ in women. Pain can affect sexual performance and satisfaction. Disturbance during breast st. stimulation can cause sexual dysfunction(15), which can also lead to decreased sexual satisfaction(16).\u003c/p\u003e \u003cp\u003eSexual pleasure is one of the most important pleasures that a person can enjoy throughout his or her life and creates difficulties and problems for couples (17). Sexual satisfaction plays an important role in relationships, mental health, and even physical health(18). Studies have shown that approximately 80% of marital disputes occur due to sexual dissatisfaction (19).\u003c/p\u003e \u003cp\u003eIdentifying predictors of sexual satisfaction, especially in women, is useful for preventing these problems(19). Therefore, this study aimed to determine the predictors of sexual satisfaction among women diagnosed with cyclical mastalgia.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Population\u003c/h2\u003e \u003cp\u003eThis descriptive-analytical study was conducted on women who were referred to comprehensive health centers and Kausar Hospital clinics in Qazvin City, Iran. Enrollment began in April and continued until August 2021. In this study. The cluster random sampling method was used. In this way, a list of comprehensive health centers in Qazvin city was prepared, and the city was divided into 5 regions: northwest, northeast, southwest, southeast, and central. From each region, a comprehensive urban health center representative of that region in terms of society and number of patients was selected randomly. The samples were then included in the study according to the available methods and inclusion criteria.\u003c/p\u003e \u003cp\u003eThe inclusion criteria were willingness to participate in the study, reproductive age, regular menstruation, and involvement with cyclical mastalgia. To diagnose cyclical mastalgia, the participants were asked to determine their daily pain severity using a visual analog scale (VAS) over two menstrual cycles and to mark the obtained score on the Cardiff breast pain chart for the same day. Cyclical mastalgia was defined as breast pain severity equal to or greater than four according to the VAS score and a pain duration of more than five days per month according to the Cardiff Breast Pain Chart.\u003c/p\u003e \u003cp\u003eThe exclusion criteria included pregnancy, breastfeeding, physical or mental illness (self-reported), a history of breast cancer in the participant or her family, medication use in the past three months to reduce breast pain, and the use of hormonal contraceptive methods. The sample size was calculated based on the study by Afzali et al., considering α\u0026thinsp;=\u0026thinsp;0.05 and d\u0026thinsp;=\u0026thinsp;8, 177 people, and considering a sample loss rate of 20%, 195 people(20).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eDemographic and Reproductive Characteristics Checklist\u003c/strong\u003e \u003cp\u003eThis checklist included 23 questions that examined demographic characteristics and the status of breast pain and sex. To verify the content, the opinions of five expert members of the midwifery department of Qazvin University of Medical Sciences were obtained and approved.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCardiff Clinic Breast Pain Chart\u003c/strong\u003e \u003cp\u003eThis chart was developed to determine the duration of pain based on the definition of cyclical mastalgia. This table has 31 houses, which are graded from 1 to 31, meaning that each number represents the same day of the month. In the house corresponding to the day when the person feels pain, moderate pain is indicated by a cross sign, severe pain is indicated by a solid sign, and menstrual days are indicated by a dot sign(21).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eVisual Analog Scale (VAS)\u003c/strong\u003e \u003cp\u003eThis tool contains a horizontal line that is used in physiotherapy and is rated from 0 to 10, where 0 indicates absolute painlessness and 10 indicates unbearable pain; this tool is used to assess the severity of pain in people(16).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSexual Satisfaction Index\u003c/strong\u003e \u003cp\u003eThe sexual satisfaction index was first designed and psychometrically evaluated by Hodson in 1981(22). Larson et al. (1998) widely used the sexual satisfaction index in 70 couples to examine empathy, friendly communication, balance in relationships, and self-esteem one year after marriage. In this study, to facilitate the comparison of these results with those of other studies, they positively reversed the scoring of this questionnaire. This index has 25 questions, 13 negative questions (4-5-6-7-8-9-11-14-15-18-20-24-25), and 12 positive questions (1-2-3-10-12-13-16-17-19-21-22-23). For each question, 5 options were included based on a Likert scale (never, rarely, sometimes, most of the time, and always), and each question was given a score ranging from 1 to 5 (23). In this index, a higher score is equivalent to greater sexual satisfaction(24). The Cronbach\u0026rsquo;s alpha values for all the positive and negative items were greater than 0.7. This index in Iran also has acceptable validity and reliability for use in studies (24, 25).\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eProcedure\u003c/h2\u003e \u003cp\u003eSampling was performed in two stages. In the first stage, the researcher identified women who were within the reproductive age range and who had regular menstruation. The Cardiff breast pain chart and visual analog scale were available for the samples for two months. After 2 months, in the case of cyclical mastalgia, the sexual satisfaction index was completed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe results of the descriptive statistics are expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation for continuous variables and as frequencies and percentages for categorical variables. The data were analyzed using SPSS software version 26. To determine the demographic, gender, and mastalgia-related variables affecting sexual satisfaction, each of the variables was entered into univariate linear regression separately, and the significant variables were then entered into multivariate linear regression. In this study, a linear regression model was used in the Enter method. In all analyses, a P value less than 0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eEthics Statement\u003c/h2\u003e \u003cp\u003e This study was approved by the Institutional Review Board and Regional Ethics Committee of Biomedical Research (Qazvin University of Medical Sciences, Qazvin, Iran, decree code: IR.QUMS.REC.1400.479). All the methods were performed in accordance with the relevant guidelines and regulations. When conducting the research, the necessary permits were obtained to attend comprehensive health centers. The design, objectives, and research methods were fully explained to the participants, and informed consent was obtained from all participants. Individuals were assured that their information would remain confidential. Voluntary participation in the study and having the full authority of the participants to continue or withdraw from the study were observed.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, 204 questionnaires were completed. The participants\u0026rsquo; ages ranged from 21 to 47 years; the mean ages of the participants and their spouses were 33.05 (SD\u0026thinsp;=\u0026thinsp;6.14) and 36.21 (5.97) years, respectively. Among the qualified individuals, 47.5% were housewives and 52.5% were employed. Among the spouses, 2.9% were jobless, and 97.1% were employed. Family income status was self-rated by the participants; in 75% of the samples, it was reported to be sufficient, and in 25%, it was considered insufficient. Of these, 83.3% had a diploma or an academic degree, and 16.7% had an under diploma academic degree. Most of the spouses (86.3%) had a diploma or an academic degree, and 13.7% had an upper diploma academic degree. Among those who had experienced cyclical mastalgia, 90.7% were city dwellers, and 9.3% lived in villages. Our participants had been married for an average of 8.56 years. (Table\u0026nbsp;1)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;1\u0026ndash;Distribution of sociodemographic variables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable classes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUpper Diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e170 (83.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder Diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (16.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSpouse's education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUpper Diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176(86.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder Diploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28(13.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97 (47.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107 (52.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSpouse's occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJobless\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (2.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e198 (97.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFamily income status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder sufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 (25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSufficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e153 (75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e185 (90.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVillage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (9.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eMean (SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.05 (6.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSpouse's age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.21(5.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDuration of marriage (in years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.56 (6.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding cyclical mastalgia, breast pain was reported in 82.8% of patients bilaterally, 9.3% in the left breast, and 7.8% in the right breast. Among the patients, 91.17% had breast pain for more than 1 year, and 8.8% had breast pain for less than 1 year. The mean breast pain severity, number of breast pain days per month, and number of sexual interactions per week were 6.00 (1.07), 6.01(0.87), and 1.61 (0.74), respectively.\u003c/p\u003e \u003cp\u003e Among our participants, 71.6% were highly interested in their spouses, and among the spouses 57.8% were highly interested in touching the wife\u0026rsquo;s breast during sexual relations. (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of mastalgia-related variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eVariable classes N (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eBreast pain location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (7/8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (9/3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBilateral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e169 (82/8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBreast pain duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (8.82)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 year\u0026lt;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e186 (91.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSpouses' interest in touching wife's breast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (16.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (27.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e122 (57.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWife's interest in her spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (7.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (20.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e146 (71.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMean (SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eSeverity of breast pain 6.00(1.07)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eNumber of days a woman has breast pain each month 6.01(0.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eNumber of sexual interactions per week 1.61(0.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mean sexual satisfaction was 80.93 (14). Examining the level of sexual satisfaction of the samples showed that most of the participants (63.7%) had moderate sexual satisfaction, the least number of participants (2%) reported a lack of sexual satisfaction, 29/9% reported low sexual satisfaction, and 4/4% reported high sexual satisfaction.\u003c/p\u003e \u003cp\u003eThe results of univariate linear regression analysis to determine the predictors of sexual satisfaction according to all sociodemographic variables showed that the severity of breast pain, breast pain location, and the number of days a woman experienced breast pain each month were not significant (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). According to the multivariate linear regression, the couple\u0026rsquo;s education, spouse's occupation, location, wife\u0026rsquo;s interest in her spouse, spouse\u0026rsquo;s greater interest in touching the wife\u0026rsquo;s breast, and number of sexual relations per week were determined to be predictors of sexual satisfaction. (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). (Table\u0026nbsp;3)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;3- Linear regression analysis for prediction of sexual satisfaction according to sociodemographic factors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eUnadjusted\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAdjusted\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.923\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse's age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.477\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.543\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.805\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.556\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.045 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse's education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.473\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.042 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.734\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse's occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.830\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.421\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.017 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDuration of marriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.640\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily income status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.880\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.903\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-18.612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.387\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-4.646\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.097\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.048 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreast pain duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-4.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e.0625\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ewife's interest in her spouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.690\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.000 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouses' interest in touching wife's breast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.690\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.263\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.000 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of sexual interactions per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.686\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.006 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is the first study to examine the sexual satisfaction of women diagnosed with cyclical mastalgia. In Iran and other countries around the world, a limited number of studies have been conducted on cyclical mastalgia, most of which are devoted to the treatment of breast pain. Few studies have investigated the effect of cyclical mastalgia on different aspects of a woman\u0026rsquo;s life.\u003c/p\u003e \u003cp\u003e The results of a systematic review of predictors of sexual satisfaction by Diana Rausch (2021) showed that relationship satisfaction and the frequency of sexual interactions were identified as the most frequently confirmed predictors of sexual satisfaction across all evaluated studies(26). However, the results showed that the number of sexual interactions was not a predictor of sexual satisfaction among patients with cyclical mastalgia.\u003c/p\u003e \u003cp\u003eThe findings showed that most women diagnosed with cyclical mastalgia had average sexual satisfaction (63.7%), and a minority of participants reported a lack of sexual satisfaction (2%). Among the remaining participants, 29.9% had low sexual satisfaction, and 4.4% had high sexual satisfaction. Molavi et al. (2015) conducted a study to investigate the performance and sexual satisfaction of couples after mastectomy. They concluded that mastectomy surgery has a significant negative effect on women\u0026rsquo;s sexual satisfaction (27). This study is similar to ours because it investigated sexual satisfaction in another group of women with breast-related problems. Because breasts are the second most important sexual organ in women(15), the results of both studies can be justified to some extent. In both studies, Larson\u0026rsquo;s evaluation index was used to evaluate sexual satisfaction.\u003c/p\u003e \u003cp\u003eThe results demonstrated that occupation can affect sexual satisfaction. A comparative study conducted by Khaneghahi et al (2019) on illness anxiety and marital sexual satisfaction in employed and housewife-married women illustrated that women who were housewives had greater sexual satisfaction than women who were employed(28). This study is not in line with our study. The presence of cyclical mastalgia may result in different outcomes.\u003c/p\u003e \u003cp\u003eThe results of another study conducted by Bahrami (2010) and colleagues on the relationship between infertility and the sexual satisfaction of couples indicate that age, level of education, and job status have no significant relationship with sexual satisfaction(29). The results of this part of Bahrami\u0026rsquo;s study are not in line with this study. Considering the conflicting results of the aforementioned studies with those of this study, the reason for this difference is probably the cyclical mastalgia of our samples.\u003c/p\u003e \u003cp\u003eThe results of a study conducted by Gheisari and Karimian (2013) with the aim of developing a causal model based on the variables of relationship satisfaction, marital quality, sexual relationship anxiety, sexual entitlement, and frequency of sexual interactions among married female students showed that the number of sexual interactions could predict women\u0026rsquo;s sexual satisfaction(30). In the present study, the number of sexual interactions also significantly predicted sexual satisfaction. Thus, cyclical mastalgia does not affect the number of sexual interactions.\u003c/p\u003e \u003cp\u003eBased on the results of our study, the level of a woman\u0026rsquo;s interest in her husband was significantly related to sexual satisfaction. Interest and love between couples satisfy sexual needs, and despite the observation of those who are not satisfied with their sexual relationship despite reaching the peak of sexual pleasure, we may be able to justify the relationship between interest in a spouse and sexual satisfaction. Our results showed that the more women with cyclical mastalgia were interested in their husbands, the greater their sexual satisfaction. Our study conformed to the study of Salemi and his colleagues (2022) on the prediction of the sexual satisfaction of married women based on marital commitment and marital intimacy during the COVID-19 era and showed that the level of love and affection for the spouse is a predictor of sexual satisfaction(31).\u003c/p\u003e \u003cp\u003eThe results show that features associated with cyclical mastalgia, such as the number of days a woman experiences breast pain each month, breast pain location, and the severity of breast pain, do not influence sexual satisfaction. In other published studies, the associations between the features or complications of cyclical mastalgia and sexual problems and its etiology have not been investigated. Therefore, cyclical mastalgia does not affect women\u0026rsquo;s sexual satisfaction.\u003c/p\u003e"},{"header":"Limitations","content":"\u003cp\u003eThe cross-sectional nature of the study, the use of self-reports to complete the scales, and the lack of simultaneous assessment of spouses were the main limitations of the present study. In addition, the participants in the study were only sampled from one urban area. While the study setting (Qazvin city) is one of the main cites in Iran with cultural diversity within the population, the results cannot necessarily be generalized to the Iranian population. Further studies using a longitudinal design with the participation of couples from other countries and cultures are recommended.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eNone of the features related to cyclical mastalgia affected sexual satisfaction. An association between cyclical mastalgia and sexual satisfaction has not been previously reported. Prospective research is needed to determine the factors affecting sexual satisfaction among women diagnosed with this disorder.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval :\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethics committee of Qazvin University of Medical Sciences approved the study( IR.QUMS.REC.1400.479). All the methods were performed in accordance with the relevant guidelines and regulations. When conducting the research, the necessary permits were obtained to attend comprehensive health centers. The design, objectives, and research methods were fully explained to the participants, and informed consent was obtained from all participants. Individuals were assured that their information would remain confidential. Voluntary participation in the study and having the full authority of the participants to continue or withdraw from the study were observed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interest:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor contribution\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u003cspan dir=\"RTL\"\u003e:\u0026nbsp;\u003c/span\u003e\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan dir=\"LTR\"\u003eF.O. and F.M. contributed to the conception and design of this research\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan dir=\"LTR\"\u003eM.H and M.M contributed to the acquisition and analysis of the data;\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan dir=\"LTR\"\u003eM.H. and M.M contributed to the interpretation of the data; M.H. drafted the preliminary\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan dir=\"LTR\"\u003emanuscript.\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003eM.H. contributed in extensive literature review and preparing the final version of the manuscript. M.H. re-edited the manuscript completely and prepared the final version of the manuscript for submission\u003c/span\u003e.\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003eAll authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript to be published. All authors met the criteria for authorship and all entitled to authorship were listed as authors in the title page.\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData availability:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData and materials will be available upon email to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research deputy of Qazvin University of Medical Sciences financially supported the project\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDavies EL, Gateley CA, Miers M, Mansel RE. The long-term course of mastalgia. Journal of the Royal Society of Medicine. 1998;91(9):462-4.\u003c/li\u003e\n\u003cli\u003eOlawaiye A, Withiam-Leitch M, Danakas G, Kahn K. Mastalgia: a review of management. 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The effect of healthy lifestyle promotion intervention on quality of life in cyclic mastalgia via individual counseling: A randomized controlled clinical trial. International Journal of Community Based Nursing and Midwifery. 2021;9(1):55.\u003c/li\u003e\n\u003cli\u003eHudson WW, Harrison DF, Crosscup PC. A short‐form scale to measure sexual discord in dyadic relationships. Journal of Sex Research. 1981;17(2):157-74.\u003c/li\u003e\n\u003cli\u003eLarson JH, Anderson SM, Holman TB, Niemann BK. A longitudinal study of the effects of premarital communication, relationship stability, and self-esteem on sexual satisfaction in the first year of marriage. Journal of sex \u0026amp; marital therapy. 1998;24(3):193-206.\u003c/li\u003e\n\u003cli\u003eBahrami N. Yaghoob zadeh A, Sharif Nia H, Soliemani MA, Haghdoost AA.[Validity and reliability of the persian version of Larson sexual Satisfaction Questionnaire in couples.]. J Kerman Univ Med Sci. 2016;23:344-56.\u003c/li\u003e\n\u003cli\u003eBahrami N, Yaghoobzadeh A, Sharif Nia H, Soliemani M, Haghdoost A. Psychometric properties of the Persian version of Larsons sexual satisfaction questionnaire in a sample of Iranian infertile couples. Iranian Journal of Epidemiology. 2016;12(2):18-31.\u003c/li\u003e\n\u003cli\u003eRausch D, Rettenberger M. Predictors of Sexual Satisfaction in Women: A Systematic Review. Sexual medicine reviews. 2021;9(3):365-80.\u003c/li\u003e\n\u003cli\u003eMolavi A, Hekmat K, Afshari P, Hoseini M. Evaluation of couples' sexual function and satisfaction after mastectomy. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2015;17(134):17-24.\u003c/li\u003e\n\u003cli\u003eKhaneghahi S, Bamadi N, Khoshdel daryasari S. A Comparative Study of Illness Anxiety and Marital Sexual Satisfaction in Employed and Housewife Married Women. Quarterly Journal of Woman and Society. 2019;10(39):99-114.\u003c/li\u003e\n\u003cli\u003eBahrami N, Sattarzadeh N, Ghojazadeh M, Soleymani M, Sadeghi T, Kazemi H. Relation between infertility and sexual satisfaction in couples. Journal of Inflammatory Diseases. 2010;14(2):5-11.\u003c/li\u003e\n\u003cli\u003eGheisari S, Karimian N. A causal model based on relationship satisfaction, sexual satisfaction, marital quality, anxiety of sexual relationship, sexual assertiveness, and the frequency of intercourse in female maried students of Bandarabbas. Counseling Culture and Psycotherapy. 2013;4(16):85-106.\u003c/li\u003e\n\u003cli\u003eSalemi Y, Abooei A, Saeidmanesh M. Predicting Sexual Satisfaction of Married Women in Yazd City during Coronavirus disease Epidemic Based on Marital Commitment, Marital Intimacy and Attachment Styles. Journal of Applied Family Therapy. 2022;2(Covid-19 articles collection)):94-115.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"mastodynia, orgasm","lastPublishedDoi":"10.21203/rs.3.rs-4131266/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4131266/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim\u003c/h2\u003e \u003cp\u003eMastalgia is a common form of breast pain among fertile women; the presence of pain in the aforementioned organs can affect sexual performance and sexual satisfaction. This study aimed to determine the predictors of sexual satisfaction among women diagnosed with cyclical mastalgia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was conducted from April to August 2021. A total of 204 married women diagnosed with cyclical mastalgia were included. The study used a cluster random sampling method from 4 comprehensive health centers and Kousar hospital clinics in Qazvin, Iran. Sexual Satisfaction Index (SSI) scores were assessed. The obtained data were analyzed using SPSS version 26 with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe participants\u0026rsquo; ages ranged from 21 to 47 years; the mean ages of the participants and their spouses were 33.05 (SD\u0026thinsp;=\u0026thinsp;6.14) and 36.21 (5.97) years, respectively. The mean sexual satisfaction was 80.93 (14). Examining the level of sexual satisfaction of the participants showed that most of the participants in the study (63.7%) had moderate sexual satisfaction, and the least number of participants (2%) reported a lack of sexual satisfaction. The results of multivariate linear regression analysis to determine the predictors of sexual satisfaction showed that the couple\u0026rsquo;s education, spouse\u0026rsquo;s occupation, location, wife\u0026rsquo;s interest in her spouse, and spouse\u0026rsquo;s greater interest in touching the wife\u0026rsquo;s breast were predictors of sexual satisfaction.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eCyclical mastalgia did not affect sexual satisfaction.\u003c/p\u003e","manuscriptTitle":"Cyclical Mastalgia and Sexual Satisfaction: A Descriptive Analytical Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-25 21:22:04","doi":"10.21203/rs.3.rs-4131266/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8ee7a6bc-c8ee-42eb-acf5-d595e3faee1d","owner":[],"postedDate":"March 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-06-18T07:57:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-25 21:22:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4131266","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4131266","identity":"rs-4131266","version":["v1"]},"buildId":"CiT4i_kKBbxQbnFL0ufpk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}