November 3, 2008
The largest such study ever published finds that, while about 40 percent of
women surveyed report having sexual problems, only 12 percent indicate that
those issues are a source of significant personal distress. The report led
by a Massachusetts General Hospital (MGH) physician appears in the November
issue of Obstetrics & Gynecology.
"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." says Jan Shifren, MD, of the MGH Obstetrics
and Gynecology Service, who led the study. "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."
Several studies and surveys of sexual problems in women have found problems
with low desire, diminished arousal or difficulties with orgasm in
approximately 40 percent of women, but few of those have asked about levels
of distress associated with those problems. The current study surveyed
32,000 women aged 18 to over 100 from across the U.S. using a
well-established survey of sexual function supplemented by a validated
measure of a woman's distress related to her sex life - including feelings
of anger, guilt, frustration, and worry.
Some level of sexual problem was reported in 43 percent of the female
respondents - with 39 percent reporting low levels of desire, 26 percent
problems with arousal and 21 percent difficulties with orgasm. But distress
related to any of these problems was reported by only 12 percent of study
participants. Although the prevalence of sexual problems was highest in
women over 65, that group reported the lowest levels of distress, while
distress was reported most frequently in women aged 45 to 64. The youngest
group - those from 18 to 44 - had lower levels of both problems and
distress. Women with depression were more than twice as likely to report
distress over any type of sexual problem as those not suffering from
depression.
"Although sexual problems were very common in women over age 65, these
problems often weren't associated with distress," Shifren says. "Several
factors could be behind the lower levels of distress in the oldest group. If
their partners also have low desire, it may not be looked on as a problem,
or additional health issues could be of greater concern.
"While distressing sexual problems are much less common in women than sexual
problems overall, they still affect approximately one in eight adult women,"
she adds. "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 is an associate professor of
Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.
