Sexual Problems: How Distressing? - Diabetes and Sexual Problems for Health Providers

Sexual Problems: How Distressing?
November 5, 2008
By Andrew M. Kaunitz, MD, and Sandra Ann Carson, MD
Published in Journal Watch Women's Health

U.S. survey results show that sexual problems in women are common but often are not distressing.

Female sexual dysfunction has received renewed interest among healthcare providers as women have become more comfortable discussing their sexual difficulties and requesting therapy. Sexual problems — low desire or arousal, orgasmic dysfunction, and painful intercourse — collectively affect more than 40% of U.S. women. How often sexual problems are accompanied by distress, however, is unclear. In an industry-funded survey sent to 50,000 households constituting a demographically balanced research panel, investigators evaluated prevalence of self-reported sexual problems and related personal distress in more than 31,000 female respondents 18 or older (mean age, 49; 81% white; 70% currently with partner; 62% premenopausal). Sexual problems were assessed with the validated Changes in Sexual Functioning Questionnaire (CSFQ-14) and the Female Sexual Distress Scale (FSDS) to measure sexually related distress.

The prevalence of any sexual problem was 44%, with the most common problem being low desire (39%), followed by low arousal (26%) and orgasmic dysfunction (21%). Overall, 22% of participants reported sexually related personal distress (FSDS scores ≥15), and the prevalence of distress associated with any of the three problems was 12%. Although the likelihood of sexual problems rose with age, distress related to any of these problems was more common in women who were aged 45 to 64 (15%) than in younger (11%) or older (9%) women. Medical conditions associated with higher prevalence of any distressing sexual problem were depression, thyroid problems, anxiety, and urinary incontinence; diabetes, hypertension, and heart disease were not associated with distressing sexual problems.

Comment: The results of this large survey confirm that sexual problems are common among U.S. women; however, distress caused by these problems is considerably less common. These findings should be interpreted with caution: Sexual problems associated with distress were related statistically to demographic variables, and no direct physiologic associations could be made; moreover, participants were not interviewed in person. Therefore, the true clinical relevance of the findings is unclear, and part of their value might lie in what was found not to be statistically significant (i.e., lack of association between distressing sexual problems and hypertension, heart disease, or diabetes). Nonetheless, when a clinician elicits a history indicating sexual difficulties, he or she should ascertain the degree of related distress before determining how best to address the problem.

Citation(s):

Shifren JL et al. Sexual problems and distress in United States women: Prevalence and correlates. Obstet Gynecol 2008 Nov; 112:970.