BEST SEX DOCTOR MUMBAI: female-sexual-problem-causing-distress

40% U.S. Women have Sexual Dysfunction

Sexual problems associated with PERSONAL DISTRESS were much less common, although reported by approximately 12% of women.

TOTAL U.S. WOMEN HAVING SEX PROBLEMS ARE 40 %
of these
PERSONAL DISTRESS IS REPORTED BY 12 %

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Personal distress
The age-adjusted prevalence of sexually related personal distress (22.2%) was comparable to the prevalence of marked sexual distress of 22.8% from a U.S. national sample. ^[5]

This is a review of a new study published in November 2008 in the Journal of Obstetrics and Gynecology, Dr. Jan Shifren,MD Reproductive Endocrinologist of Massachusetts General Hosptial

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WHAT ARE
FEMALE SEXUAL DYSFUNCTIONS

Female sexual dysfunction is a term used to describe various sexual problems, such as

low desire or interest,
diminished arousal,
orgasmic difficulties, and
dyspareunia.

Female sexual dysfunction is considered common, with a widely quoted prevalence estimate of 43% from the U.S. National Health and Social Life Survey [4] and similar estimates from other large, population-based surveys in the United States[5] [6] and the United Kingdom[7] [8].

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In elderly men as age increases distress associated with sexual problem is high. In contrast to this, the research team found that though sexual problems were greatest in elderly women, consequent distress due to the problems was least prevalent in the elderly women.

LIMITATIONS OF THE STUDY

on Female sexual Dysfunctions associated with female distress
1
One important factor to be noted is that sexual problems and distress were based on self-reported information without any clinical evaluation.
2
Only 63% women chose to respond. They may be more conscious about their problems.
37% did not participate in the study about whom nothing can be said.
3
Data provided by this survey are unable to address the reason for this finding.

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FEMALE SEXUAL PROBLEMS
CAUSING DISTRESS
WHAT DOES THE RESEARCH CONCLUDE

The results of this study show that sexual problems associated with personal distress occur in about 12% of adult U.S. women, which is much less common than previously published and widely quoted prevalence estimates of about 40% for sexual problems (with unknown presence of distress).

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Still, the proportion of women with distressing sexual problems is not trivial, particularly for women at mid life, because
one in eight women aged 45-64 years had distress associated with desire problems and about
one in 15 with arousal and orgasm problems.
An accurate estimate of prevalence and identification of correlates of distressing female sexual problems has important implications for the care of women. Clinicians assessing women with sexual problems should be certain to evaluate the level of distress associated with such problems.

50 - 60 yrs distress 13%

13 % of women between 50 years and 60 years of age have desire problems causing distress in the present study. This is found to be same as in another study (WISHes)[12] where the distress is 13% in U.S. women as well as 13% in European women.

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Desire Dysfunction Causing Distress

Distressing desire problem highest in 35-64 years.
In married women it is two times more than in single women, but higher in women without a current partner.
Post menopausal women have 20% more problems than pre menopausal women.

Distressing problems of desire were definitely more in women who had the following medical conditions:

Current Depression
Thyroid Problems
Anxiety
Urinary Incontinence

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Arousal Dysfunction Causing Distress

Medical conditions related to increased odds of arousal problems were

thyroid problems,
arthritis,
anxiety,
urinary incontinence, and
inflammatory or irritable bowel disease.

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Orgasm Dysfunction Causing Distress

Medical conditions related to a higher odds of orgasm problems with associated distress included

depression ^[13]
worsening health status
thyroid problems,
arthritis,
anxiety, and
urinary incontinence.

Orgasm problems were 40 % more likely in women with lower education
and also in single (never married) women
compared with divorced, widowed, or separated women.
Unlike desire and arousal problems, distressing orgasm problems were less likely in married women and women without a current partner

Compared with premenopause, only surgical postmenopause was associated with orgasm problems (odds ratio 1.34).

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No Distress

Distress causing problems were not correlated with

number of children,
taking contraceptives or hormone therapy, and
taking medication to lower high blood pressure or high cholesterol
heart disease
diabetes ^{[14], [15]}

Lubrication Problem causing Distress

Lubrication Problem
Comparing with other studies it can be said that age-related increase in lubrication problems is well documented.

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Women with depression are twice more likely to have distress compared to women without depression. ^[13]

Jan Shifren's survey is remarkable for three reasons,
1. Large total number of females and wide age range of women.
2. Personal Distress due to Female sexual dysfunctions are covered
3. Most recent among similar studies.

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Current diagnostic guidelines from the American Psychiatric Association^[9] and Food and Drug Administration^[10] require personal distress as part of the diagnostic criteria for dysfunction.
Even the American Urological Association Foundation emphasizes the clinical importance of distress in its revised definitions of sexual disorders.^[11]

METHODS:
The 31,581 female respondents aged 18 years and older were from 50,002 households sampled from a national research panel representative of U.S. women. Correlates of each distressing sexual problem were evaluated using multiple logistic regression techniques.

Reference:
STUDY AUTHOR
Jan L. Shifren, MD, is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School in Boston, Massachusetts. She is a reproductive endocrinologist and director of the Menopause Program at the Vincent Obstetrics and Gynecology Service of the Massachusetts General Hospital.

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[1]
© 2008 The American College of Obstetricians and Gynecologists
Shifren, Jan L.; Monz, Brigitta U.; Russo, Patricia A.; Segreti, Anthony; Johannes, Catherine B.
Obstetrics & Gynecology:
November 2008 - Volume 112 - Issue 5 - pp 970-978
doi: 10.1097/AOG.0b013e3181898cdb
Original Research
Sexual Problems and Distress in United States Women: Prevalence and Correlates
Corresponding author: Dr. Jan L. Shifren, Vincent OB/GYN Service, Massachusetts General Hospital, 55 Fruit Street, Yawkey 10-A, Boston, MA 02114; e-mail: jshifren@partners.org

[2]
Jan L. Shifren, MD, is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School in Boston, Massachusetts. She is a reproductive endocrinologist and director of the Menopause Program at the Vincent Obstetrics and Gynecology Service of the Massachusetts General Hospital.
http://www.femalesexualdysfunctiononline.org/meetings/asrm-menopause/index.cfm?&cmepage=cme_presenters

Faculty Biographies and Disclosures
This continuing medical education activity is sponsored by
the American Society for Reproductive Medicine.
Supported by unrestricted educational grants from Boehringer Ingelheim and Procter & Gamble.

© 2009 Baylor College of Medicine. All rights reserved.

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[3]
The Journal of Sexual Medicine
Basic Research and Clinical Studies in Male and Female Sexual Function and Dysfunction

The Official Journal of the International Society for Sexual Medicine and the International Society for the Study of Women's Sexual Health
Editor-in-Chief
Irwin Goldstein, MD
Director, Sexual Medicine
Alvarado Hospital
University of California
San Diego, CA USA
[4]
Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors [published erratum appears in JAMA 1999;281:1174]. JAMA 1999;281:537-44.
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[5]
Bancroft J, Loftus J, Long JS. Distress about sex: a national survey of women in heterosexual relationships. Arch Sex Behav 2003;32:193-208.
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[6]
Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstet Gynecol 2006;107:755-64.
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[7]
Dunn KM, Croft PR, Hackett GI. Sexual problems: a study of the prevalence and need for health care in the general population. Fam Pract 1998;15:519-24.
Cited Here... | PubMed | CrossRef

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[8]
Nazareth I, Boynton P, King M. Problems with sexual function in people attending London general practitioners: cross sectional study. BMJ 2003;327:423.
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[9]

6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): American Psychiatric Association; 1994.

Cited Here...

[10]

7. US Department of Health and Human Services. Food and Drug Administration Center for Drug Evaluation and Research. Guidance for Industry. Female Sexual Dysfunction 2000. Available at: http://www.fda.gov/cder/guidance/3312dft.htm. Retrieved November 2, 2007.

Cited Here...

[11]

8. Basson R, Althof S, Davis S, Fugl-Meyer K, Goldstein I, Leiblum S, et al. Summary of the recommendations on sexual dysfunctions in women. J Sex Med 2004;1:24-34.

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[12]

Hayes RD, Dennerstein L, Bennett CM, Koochaki PE, Leiblum SR, Graziottin A. Relationship between hypoactive sexual desire disorder and aging. Fertil Steril 2007;87:107-12.

Cited Here... | PubMed | CrossRef

^[13]
^{[14],
[15]}

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