Sexual Dysfunction Affects Almost Half of American Women

Sexual dysfunction (SD) refers to a problem that makes sex less satisfying for either party. In the U.S., some 31 percent of men suffer from problems such as erectile dysfunction, premature ejaculation, delayed ejaculation and impotency, while 43 percent of women report problems like loss of libido or desire, decreased sexual arousal, lack of orgasm and painful intercourse. Surprisingly, however, only 12 percent of women say they are distressed about it.

So says a recent study led by researchers from Massachusetts General Hospital that surveyed 32,000 women across the U.S., aged 18 to older than 100. In addition to asking the women standardized questions about their sexual health, the researchers used a Female Sexual Distress Scale to measure the women’s levels of personal distress related to their sex lives, such as feeling of unhappiness, anger, guilt, frustration, embarrassment, and worry.

Some level of SD was reported by 43 percent of respondents; 39 percent reported low levels of desire, 26 percent had arousal problems and 21 percent had problems with achieving orgasm. But only 12 percent reported distress related to any of these problems. “Sexual problems are common in women, but problems associated with personal distress, those which are truly bothersome and affect a woman’s quality of life, are much less frequent,” said study leader, Dr. Jan Shifren, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and director of the Vincent Menopause Program at Massachusetts General Hospital, both in Boston, in a news release. “For a sexual concern to be considered a medical problem, it must be associated with distress, so it’s important to assess this in both research studies and patient care.”

There were age differences. Women over 65 had the highest prevalence of SD, but reported the lowest levels of distress. Distress was reported most frequently in women aged 45 to 64, while the youngest group—aged 18 to 44—had the lowest levels of both SD and distress. Women with depression were more than twice as likely to report distress over any type of SD compared to those not suffering from depression. Although the researchers did not look at the specific reasons why older women had more problems but less distress about them, they speculate the reasons could include partner changes, other medical conditions, or problems with their partner’s health. While conditions such as high blood pressure, diabetes, heart disease, nerve disorders and hormone problems are known to affect sexual health, none of these issues impacted women’s sexual health in this study. “I think the most important finding is that the overall prevalence of women with distressing sexual problems is 12 percent,” Dr. Shifren said.

These findings coincide with previous studies that evaluated the prevalence of SD among American women. A study published in the Journal of the American Medical Association in February 1999 also found that about 43 percent of women reported having SD. But in an editorial accompanying the new study, Igrid Nygaard, a doctor at the University of Utah School of Medicine in Salt Lake City, points out that the 1999 survey may have caused some people to exaggerate the extent of the dysfunction and regard it as a disease. “What’s to be gained by over inflating rates and turning symptoms into disease?” Nygaard wrote. “Lots—market shares, provider income, grant support and so on—that is, fame and fortune.”

“Actually, what the study says is that bothersome sexual dysfunction is rarer than previously thought,” said Dr. Lisa Jones, an obstetrician-gynecologist at the Greater New Bedford Community Health Center in New Bedford, Massachusetts. She added that women should remember that what is “normal” for one person may be a serious problem for another—sexual function and dysfunction is all relative. “Sexuality is a spectrum and just because someone does not conform to a ‘norm’ doesn’t mean they are abnormal unless they perceive a problem.”

Although it’s reassuring that fewer women are distressed by sexual problems, they still affect approximately one in eight adult women, Dr. Shifren said. “As part of a thorough health assessment, it’s important that health care providers ask their female patients if they have sexual concerns and if those problems are associated with distress. Although this study did not examine treatments for sexual problems, effective options are available—including relationship counseling, treatment of associated medical conditions and sex therapy.”

Shifren’s research was sponsored by Boehringer Ingelheim Gmb H, a German company with an experimental medicine for pre-menopausal women with low sexual desire not caused by a medical condition or drug. According to Boehringer’s Web site, the product, flibanserin, is in final-stage studies.

Shifren’s study was published in the November issue of Obstetrics and Gynecology.