Ethnic Underrepresentation in Validation of Female Sexual Dysfunction Questionnaires

Abstract

ABSTRACT Introduction Female sexual dysfunction (FSD) is a significant cause of morbidity that affects an estimated 30-50% of women. FSD is characterized by conditions which cause distress in at least one area – desire, arousal, orgasm, or pain – and can be challenging to diagnose depending on the patient-provider relationship and/or individual levels of comfort in having such discussions. Several questionnaires have been developed over the past four decades to assess FSD. This repertoire of tools includes assessments of overall sexual function, quality of life, and specific dysfunctions (i.e., hypoactive sexual desire disorder). Objective The purpose of this review is to evaluate the ethnic representation of sample populations used in the studies to validate questionnaires used to assess FSD. Methods A literature search was performed to gather information on questionnaires that have been developed to assess FSD. Subsequent searches were targeted to obtain the published studies used to validate each tool. Collective averages from the combined ethnic data were compared to population data from US census data and healthcare workforce reports to evaluate epidemiologic diversity. Ethnicity data from each questionnaire were investigated longitudinally to evaluate trends in representation of these sample populations over the past 40 years. Results Nineteen questionnaires were evaluated for ethnic representation based on published validation studies. Each questionnaire was tabulated to include the domain(s) assessed, number of items in each questionnaire, validation sample population size and description, and available ethnicity breakdown for each questionnaire. The average ethnic representation of the questionnaires relative to the US general population and US female health care workforce, respectively, was: Caucasian (78.3% vs. 62.7% and 68.5%), African American (3.3% vs. 13.3% and 8.3%), Hispanic (2.3% vs. 16.0% and 9.6%), American Indian (0.0% vs. 0.8% and 0.3%), Asian (0.6% vs. 6.4% and 6.2%), and Other (0.7% vs. 0.7% and 1.4%). Conclusions FSD is a common condition affecting women and causes significant impacts on quality of life. Review of the sample populations used to validate the questionnaires used to evaluate FSD in routine practice shows underrepresentation of ethnic minorities when compared to general population demographics. FSD questionnaire is an important research tool, helps increase health care providers and patients awareness of FSD, in addition, eventually improving access to care for ethnic minority women. Disclosure No