Hypoactive sexual desire disorder in menopausal women in the US

Abstract

(1) Determine the proportion of menopausal women with Hypoactive Sexual Desire Disorder (HSDD); (2) Assess the degree and nature of the distress associated with HSDD; (3) Determine the relationship between desire, arousal, and orgasm; (4) Assess the relationship between sexual desire and sexual activity, and; (5) Study the relationship between sexual desire and overall relationship and sexual satisfaction. The Women’s International Study of Health and Sexuality (WISHeS) was conducted by mail among US women, aged 20–70 yrs. 85% of women who agreed to participate in the study completed and returned the survey. The survey included: (1) questions on women’s sexual activity and behavior, sexual and marital or relationship satisfaction, (2) the Profile of Female Sexual Function (PFSF), a validated instrument designed to assess sexual desire in women, and, (3) the Personal Distress Scale (PDS), a validated scale used to assess distress associated with low sexual desire in women. The following populations of women (n=1235) were compared: (1) premenopausal (PreM) women (20–49 yrs) were compared to surgically menopausal (SM) women (20–49 yrs), and (2) surgically menopausal women (50–70 yrs) were compared with naturally menopausal (NM) women (50–70 yrs). Cut-off scores on the Desire Domain of the PFSF and the PDS were used, respectively, to classify women with low sexual desire and women with low desire who were distressed by it. About 1 in 4 PreM women and 1 in 3 SM or NM women were classified as having low sexual desire. Younger SM women were significantly more likely to be distressed about their low sexual desire and to be classified as having HSDD than PreM, older SM, or NM women. About 1 in 4 younger SM women, 1 in 6 PreM and older SM, and 1 in 10 NM women were classified as having HSDD. Women in all populations with low sexual desire were found to have co-morbid low sexual arousal. These women also initiated sexual activity, had intercourse, experienced orgasm and sexual pleasure significantly less often than women without low sexual desire. Low sexual desire was significantly correlated with decreased feelings of being sexually desirable (r=0.58) and lower satisfaction with sex life (r=0.49). Low satisfaction with sex life was significantly correlated with lower overall relationship satisfaction (r=0.56). HSDD is prevalent and distressing to many menopausal women. It is associated with reduced sexual and overall relationship satisfaction. The sexual experience and behavior of women with low sexual desire is different than women without low desire, i.e., they initiate sex less frequently, experience fewer orgasms and report diminished sexual pleasure. These results demonstrate that HSDD is a clinically relevant condition that warrants clinical attention.