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Epidemiolgy of Female Sexual Dysfunction
There has been much interest and exposure in the past in male sexual dysfunction, especially male erectile dysfunction. However, little attention has been placed on female sexual dysfunction (FSD). FSD includes desire, arousal, orgasmic and sex pain disorders. The epidemiological data on incidence and prevalence of FSD is sparse. In addition, available treatment for this medical condition is scant. Consequently, with increased awareness of women's health issues and the negative impact on the quality of life, FSD is being discussed more openly. In addition, the availability of both old and new treatments for male erectile dysfunction has prompted women to demand effective solutions for their own sexual concerns. This is further heightened by the recent increased media coverage about female sexual dysfunction. Numerous therapies are now available for FSD including, Prosensual, a topical lubricant with stimulating properties that has achieved great success in pilot studies. These exciting advances in the field bring us to ask many questions about the epidemiology of this condition. The following is a review of the literature on the epidemilogy of female sexual dysfunctions.
According to the American Urological Association, approximately 43% (40 million) of American women experience some form of sexual dysfunction. Data from Women's Sexual Health clinic in Boston reported the mean age at time of presentation to be 42 years including 21% who underwent natural or surgical menopause. A study performed by Laumann et al. found sexual dysfunction to be more prevalent among women (43%) as compared to men (31%). Hence, this is an important medical condition affecting nearly half of all American women today. In addition, a study surveying women seeking routine gynecological care found a total of 98.8% of these women reporting one or more sexual concerns. The top 4 most commonly reported concerns were lack of interest (87.2%), difficulties with orgasm (83.3%), inadequate lubrication (74.7%) and dypareunia (71.7%). Other studies have found similar results with the most common sexual dysfunctions to include any of the four previously mentioned. Sexual dysfunction is universal that if asked, nearly all women convey at least one sexual concern.
FSD has been shown to have trends and associated demographic factors. Studies show that with increasing age, the prevalence of sexual disorders decreases. Additionally single women have more sexual symptoms than their married counter part. These two statistics can be psychosocial disturbances such as emotional and stress related problems. According to Laumann et al., because young women are likely to be single, they have sexual activities with many different partners and have periodic sexual inactivity.
Hence, with this instability along with inexperience, they tend to have more stressful sexual encounters. Osborn, M. et al. found the contrary to be true. In their study, sexual dysfunction among women increased with age. Other studies have reported that once a woman reaches perimenopause and postmenopause, sexual desire decreases and there is more vaginal dryness and discomfort with intercourse. One study attempted to find associations among each type of dysfunction, specifically orgasmic dysfunction, inhibited enjoyment, vaginal dryness and dyspareunia. The main link to orgasmic dysfunction and inhibited enjoyment was self-reported marital difficulties. Vaginal dryness was strongly associated with age and psychological status, in particular depression. Anxiety and depression were also significantly related to orgasmic dysfunction and inhibited enjoyment.
The literature shows some variability when comparing ethnicity and sexual problems. One study found African American women to have higher rates of low sexual desire and experience less pleasure in comparison to white women. On the other hand, white women are more likely to have sexual pain than African American women. And surprisingly, Hispanic women report lower rates in all categories of sexual problems. In regards to exposure history, one study found that among women who had symptoms of sexual dysfunction, 4% of patients had hypertension, 4% diabetes mellitus, 10% hypercholesterolemia and 8% cigarette smokers. There appears to be a high prevalence of sexual disorders in the diabetic population with the literature underestimating this association.
Risk factors for FSD are important in the assessment of patients, as there could be potential interventions. Laumann et al. found that poor health had an elevated risk for sexual pain. In addition, the presence of irritative voiding (urinary) symptoms appears to also have an increased risk for arousal and pain disorders. Social status based on household income was evaluated, too. The study found that with deteriorating economic position, measured by a decline in household income, there was a moderate risk for all sexual dysfunction categories (low desire, arousal disorder and sexual pain). There appears to be a high association with arousal disorders and having experienced sexual victimization through adult-child contact or being forced into sexual contact.
An important question that should be answered is that if females have a sexual dysfunction, do they in turn desire professional help for it? The answer appears to be yes. Dunn, K. et al. did an anonymous postal questionnaire survey in which 39% of female responders who had a sexual problem reported that they would like to receive help for it. However, out of those wishing for help, only 4% actually received it.
We hope that this overview answered some of your questions about the epidemiology of female sexual dysfunction. This is a truly fascinating condition and can be treated. In addition, we hope that you consult the web site Always For Me for more information about Prosensual, which has shown a great deal of promise in the management of FSD. You may also contact Dr. Zaslau for further information about FSD at 718-265-5300. The office is located at 2940 Ocean Parkway in the Brighton Beach section of Brooklyn. Office hours are 9am to 5pm Monday, Wednesday and Friday. In addition, you may e-mail questions to Dr. Zaslau at the following address: Zaslau@pol.net. He is a sensitive and caring physician who receives many accolades from his patients.
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