prevalence of and factors associated with low desire, sexually related personal distress, and (HSDD)
Low desire is the most common sexual problem in women at midlife. Prevalence data are limited by lack of validated instruments or exclusion of unpartnered or sexually inactive women.
The prevalence of distressing sexual problems has been reported to peak in women during midlife, with low desire being the most common concern Hypoactive sexual desire dysfunction (HSDD) is the clinical manifestation of low sexual desire and is characterized by persistently low or absent desire that causes significant distress. Although the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition has replaced HSDD with “female sexual interest/arousal disorder,” the International Society of Sexual Medicine consensus was to retain the diagnosis of HSDD. Because there are no validated epidemiologic tools for assessing the prevalence of female sexual interest/arousal disorder.
The degree to which HSDD adversely affects women is demonstrated in epidemiologic studies of the psychological well being of women in the general community. Women who report having sexual dysfunction have similar decreases in well being as women with chronic back pain or urinary incontinence.
Although there have been several studies of female sexual function and HSDD in women at midlife, our current knowledge has been limited by highly selected small samples, the lack of use of validated instruments with validated cutoff points, and a focus on women who are sexually active and in long term partnerships. Multiple factors have been found to contribute to female sexual dysfunction. These factors are generally considered in the context of a biopsychosocial model. Social factors, such as relationship difficulties and low education level, and psychological factors, such as depression, anxiety, and the perceived importance of sex, are consistently found to be strong predictors of poor sexual function. Biological factors that influence women’s sexual health are not limited to hormonal status but include urinary in continence and a range of acute or chronic medical conditions. However, past studies have not included factors known to affect desire such as sexual pain and use of psychotropic medications, which are highly prevalent in community settings.
Prevalence and Predictors of Low Sexual Desire, Sexually Related Personal Distress, and Hypoactive Sexual Desire Dysfunction in a Community-Based Sample of Midlife Women by Roisin Worsley FRACP, Robin J., Bell, Pragya Gartoulla, Susan R., Davis.