Female Sexual Function and the Pelvic Floor

Sarit O. Aschkenazi;   Roger P. Goldberg

Disclosures

Expert Rev of Obstet Gynecol. 2009;4(2):165-178. 

In This Article

Prevalence of Female Sexual Dysfunction

Prevalence and incidence studies of FSD are confounded by a lack of consistent methodology. Variability in levels of normal sexual function and the importance of sexual function to individuals and cultural beliefs also complicate the classification and determination of FSDs. Community studies indicate that the prevalence of female sexual dysfunction ranges from 25 to 63%[23]. An important population-based study, a substudy of the National Health and Social Life Survey, was conducted in 1992. It provides a probability sample among 1749 women and 1410 men living in the USA, aged 18 -59 years, and is based on face-to-face interviews conducted by trained interviewers. The population is similar to the US Census Bureau Current Population Survey, representative for age, education level and marital status. Following are the ranges of dysfunctions across the age groups:

  • Lack of interest in sex: 27-32%

  • Unable to achieve orgasm: 22-28%

  • Pain during sex: 8-21%

  • Sex not pleasurable: 17-27%

The study found that sexual dysfunction is more prevalent in women than men (43 vs 31%). Lack of interest was the most frequently reported female sexual complaint.

The prevalence of HSDD was recently investigated in a population-based telephone survey of women aged 30-70 years in the USA[24]. Sexual desire and personal distress were assessed using the validated Profile of Female Sexual Function and Personal Distress Scale instruments, respectively. Low sexual desire increased with age; the prevalence was highest in women aged 60-70 years (61%). Conversely, the overall prevalence of HSDD (low sexual desire with personal distress) was similar across all age groups, ranging from 5.8 to 9.4%. The prevalence of low sexual desire was approximately three-times greater than the prevalence of HSDD, suggesting that many women may not experience personal distress associated with their lack of desire.

Hayes et al. calculated prevalence rates from published prevalence studies that included assessment of all FSDs, were based on convenience sampling, had a response rate of more than 50% and included more than 100 participants[25]. A total of 11 studies were included. As in other studies of FSD, desire disorders were the most prevalent, with an average of 64% (range: 16-75%). Orgasmic difficulties were reported by 35% of women with a range of 16-48%. Arousal and pain disorders had an average prevalence of 31 and 26% with ranges of 12-64% and 7-58%, respectively. Interestingly, only two studies included in the analysis reported on the presence of personal distress with FSD. These studies reported a range of 21-67%.

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