While prevalent, sexual problems in women not always associated with distress

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 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.