Sexual Inactivity in Japan: A Scoping Review

ObjectivesTo examine how prevalence and context of sexual inactivity varies across the life-course, assess dissatisfaction with sex life among those who are sexually inactive and identify associations with factors that...

Sexual dysfunctions are common experiences that often impact negatively on the health and well-being of affected individuals. We used baseline questionnaire data from 62,675 Danes aged 15-89years, who participated in the cohort study Project SEXUS 2017-2018, to yield nationally representative estimates of the prevalence of sexual inactivity and dysfunction and to identify their sociodemographic correlates. Overall, we found that 23.0% of sexually experienced men and 28.8% of sexually experienced women had not been sexually active with another person within the last year. Sexual inactivity with another person was associated with both young and old age, single status, less favorable socioeconomic conditions, underweight and obesity, indicators of poor health, no use of alcohol, and physical inactivity. Among sexually active respondents, 18.0% of men had experienced any dysfunction within the last year, including erectile dysfunction (7.4%), premature ejaculation dysfunction (10.0%), orgasmic dysfunction (4.0%), and/or genital pain dysfunction (0.7%). Among women, 20.4% had experienced any dysfunction within the last year, including lubrication dysfunction (9.1%), orgasmic dysfunction (12.2%), genital pain dysfunction (5.0%), and/or vaginal cramp dysfunction (vaginismus) (0.8%). Additionally, 3.4% of men and 9.9% of women with a spouse/partner had experienced hypoactive sexual desire disorder within the last four weeks. Using the 5-item International Index of Erectile Function (IIEF-5) and the 6-item Female Sexual Function Index (FSFI-6) among respondents with a spouse/partner who had attempted sexual intercourse within the last four weeks, we found that 3.8% of men had experienced moderate or severe erectile dysfunction (IIEF-5 score ≤ 11) and 20.8% of women had experienced any sexual dysfunction (FSFI-6 score ≤ 19) during that period. Single status, difficulties paying bills and, among men, unemployment were positively associated with sexual dysfunction. In conclusion, we document several sociodemographic disparities in the prevalence of sexual inactivity and dysfunction in Denmark. In particular, both sexual inactivity and dysfunction were more common among singles and those reporting financial difficulties.

Sexual Inactivity During the Last 4 Weeks in Long-Term Cervical Cancer Survivors: Prevalence and Associated Factors

Sexual dysfunction has been extensively studied in methadone maintenance treatment (MMT) patients. However, little data is available regarding sexual inactivity in the MMT patient population. The objectives of this study were to determine the prevalence and putative risk factors for sexual inactivity in the MMT patient population. This cross-sectional study involved 25–71 year old MMT patients recruited from six methadone clinics. Two hundred and seventy-one patients were interviewed for demographic characteristics, comorbidities, concurrent medications used, and sexual activity. The prevalence of sexual inactivity in the MMT population was found to be 47.6%. Increasing age (p < 0.01) and being single/divorced (p < 0.01) were significantly associated with sexual inactivity. In subgroup analysis, increasing age was significantly associated with sexual inactivity in both single/divorced (p < 0.05) and married (p < 0.05) subgroups, while unemployment (p < 0.05) was only significantly associated with sexual inactivity in the earlier subgroup. Our results suggest that sexual inactivity is common in the MMT patient population. The putative risk factors are related to biological and sociocultural factors. Having specific comorbidities or being on certain medications were not correlated with sexual inactivity in the MMT population. Routine assessment of sexual problems is essential, and proper management should be performed for MMT patients.

Associations of Unhealthy Lifestyle Factors with Sexual Inactivity and Sexual Dysfunctions in Denmark

Assessment of sexual activity and dysfunction in medically underserved women with gynecologic cancers

Sensory Dysfunction and Sexuality in the U.S. Population of Older Adults

12132 Background: Sexual dysfunction is common among breast cancer survivors, but poorly characterized in sexually inactive women. We aim to better understand sexual desire in sexually inactive breast cancer survivors. Methods: We performed a cross-sectional survey of breast cancer survivors between 2014 and 2016. Women with a history of breast cancer were approached at a surveillance visit, offered enrollment, and signed consent. They completed the validated 19-question Female Sexual Function Index (FSFI) survey. The FSFI defines sexual inactivity as no sexual activity in the four weeks prior to survey completion. Fisher’s exact test was used for categorical data analysis. Firth’s bias-reduced logistic regression adjusted for age and menopausal status. Results: Of 585 respondents, 305 (53.1%) were age 40 to 59 and 241 (42.0%) were age 60 to 79 when surveyed. Four hundred and twenty-seven (73.0%) were post-menopausal and 285 (48.7%) were sexually inactive. Sexual inactivity was positively correlated with increasing age (p &lt; 0.001) and not being in a current relationship (p &lt; 0.0001). Four hundred and six (69.4%) respondents underwent lumpectomy and 179 (30.6%) underwent mastectomy with most having reconstruction, n = 129 (72.1%). Neither type of surgery or receipt of chemotherapy, endocrine therapy, or radiation were significantly different for sexually inactive and active respondents after controlling for age and menopausal status. 23.6% of sexually inactive respondents reported sexual desire half the time or more. 32.4% of sexually inactive respondents reported feeling sexual desire “a few times (less than half the time)” (versus 28.8% of sexually active respondents, p = 0.005) and 44% reported feeling sexual desire “almost never or never” (versus 8.0% of sexually active respondents, p &lt; 0.001). 31.7% of sexually inactive respondents rated their degree of sexual desire as “low” (versus 25.0% of sexually active respondents, p = 0.04) and 40.9% rated it as “very low or none at all” (versus 7.0% of sexually active respondents, p &lt; 0.001). 27.5% of sexually inactive respondents experienced moderately high sexual desire. Sexually inactive respondents were more likely to report being dissatisfied with their overall sexual life with 23.5% choosing the rating “moderately dissatisfied” (versus 8.8% of sexually active respondents, p &lt; 0.001) and 28.1% choosing “very dissatisfied” (versus 5.8% of sexually active respondents, p &lt; 0.001). Conclusions: Sexual inactivity is associated with lower rates of self-reported sexual desire and lower satisfaction with overall sexual life. However, nearly a quarter of sexually inactive respondents still reported significant sexual desire. This suggests patients classified as sexually inactive may not be content or indifferent to this lack of sexual activity or desire. Sexual inactivity in breast cancer survivors warrants intervention studies to improve sexual satisfaction.

Introduction Benign prostatic hyperplasia is a common pathology in patients over 40 years of age, with an important role in male sexual health due to its association with sexual dysfunction, with an elevated proportion of patients with sexual inactivity. Objective The objective of this study is to evaluate the factors associated with sexual activity in patients over 40 years of age with a diagnosis of benign prostatic hyperplasia Methods A retrospective cross-sectional study of 331 patients with a confirmed diagnosis of benign prostatic hyperplasia between January 2021 and November 2021. Both sociodemographic and clinical data were evaluated to associate them to the IIEF questionnaire15 Results Of the 331 patients diagnosed with BPH, 68.5% had erectile dysfunction: severe ED 119 (36%) moderate ED 14.2%, Mild/moderate ED 10.6% andMild in 7.9%. Of the 226 patients with ED, only 50 patients (22.1%) treated their erectile dysfunction. In addition, 33.2% had low sexual desire and the overall prevalence of sexual inactivity in more than 1 month was 43%. Sexual inactivity was classified: in 1-3 months: 29, 5%, 3-6 months 15.4%, 12% more than 6 months and 42.9% more than 12 months. The independent predictors related variables of sexual inactivity were: age over 60 years (PR 1.5), not having a sexual partner (PR 3.2), IEEF-15 (Erectile dysfunction RP 9.2) dissatisfaction with the partner (PR 4.9), low sexual desire (PR 2.9), and lack of confidence (PR 2.5), Severity of IPSS (RP 1.7) and urethral catheter carrier (RP 2.4) Conclusions Sexual inactivity is common in patients diagnosed with BPH and is associated with age and sexual desire. Independently lack of confidence, erectile dysfunction, not having a sexual partner or dissatisfaction with the partner. Of the specific variables related to prostatic hyperplasia, the only ones related were being a carrier of urethral catheter and IPSS severity, the latter associated with decreased sexual frequency and erectile dysfunction. Cardiovascular risk factors had no independent association unlike what was found in other studies. Disclosure No

Physical and mental health are important to sexual function and wellbeing. Yet, associations of ill-health with sexual inactivity and dysfunctions are scarcely researched at population level. To explore and document associations of self-rated health and physical and mental health problems with inter-personal sexual inactivity and sexual dysfunctions. We used data from a probability-based, nationally representative sample of 60,958 sexually experienced Danes aged 15-89 years who participated in the 2017-18 Project SEXUS cohort study. Logistic regression analyses provided demographically weighted odds ratios for associations between health measures and sexual outcomes adjusted for partner status and other potential confounders. Inter-personal sexual inactivity and a range of male and female sexual dysfunctions. Inter-personal sexual inactivity was more common among individuals with bad or very bad self-rated health compared to peers rating their health as good or very good (men: adjusted odds ratio 1.93, 95% confidence interval 1.66-2.25; women: 1.66, 1.42-1.94). Individuals rating their health as bad or very bad were also consistently more likely to report sexual dysfunctions, with associated statistically significant adjusted odds ratios ranging from 1.66 to 6.38 in men and from 2.25 to 3.20 in women. Patient groups at high risk of sexual dysfunctions comprised individuals afflicted by cardiovascular diseases, pain conditions, diabetes, gastrointestinal and liver diseases, cancer, skin diseases, nervous system diseases, gynecological diseases, benign prostatic hyperplasia, other physical health problems, stress, anxiety, affective disorders, self-injury or suicide ideation and attempts, posttraumatic stress disorder, personality disorders, eating disorders, psychoses and other mental health problems. These findings warrant heightened awareness among healthcare professionals, public health promoters and researchers concerning insufficiently appreciated sexual challenges among individuals with poor health. The major strengths of our investigation include the large size of the study cohort, the detailed assessment of health-related variables, potential confounders and sexual outcomes, and the fact that we provide new population-based knowledge about less common and sparsely researched sexual dysfunctions and diseases. Limitations of our study include its cross-sectional nature and its modest response rate (35%). Findings from our large and nationally representative cohort study provide evidence that poor self-rated health and a range of specific physical and mental health problems are associated with statistically significantly increased rates of inter-personal sexual inactivity and sexual dysfunctions.

Background Hypertension (HTN) and its treatment are commonly associated with sexual problems; yet, data are discordant in men and lacking in women. We investigated the association of HTN and its treatment with sexual health in older adults, and whether the association varied by gender and medication class. Methods Data are from the NSHAP, a nationally-representative observational study of men and women aged 57-85 yrs. Adults were stratified by HTN status: No HTN; HTN-Treated; and HTN-Untreated. HTN was defined by self-report or a mean blood pressure ≥140/90mmHg. HTN-Treated adults reported taking ≥1 of the following medications: diuretics, beta-blockers, calcium-channel blocker, ACE inhibitors or angiotensin receptor blockers, and alpha blockers. We report the prevalence of partnered sexual activity and problems by HTN status. Models testing the association of medication class were examined, stratified by gender, and adjusted for other antihypertensive medication classes (Model 1), and Model 1 plus age, partner status, insurance, diabetes, heart disease, smoking, and functional status (Model 2). Results Comparing HTN-treated to HTN-Untreated and No HTN, the prevalence of sexual activity in men was 60.7% v. 74.3% v. 71.5% (p=.002) and in women 35.4% v. 38.3% v. 58.0% (p&lt;.001). The prevalence of sexual problems in men was 69.3% v. 53.8% v. 51.4% (p=.005) and in women 73.9% v. 66.7% v. 71.7% (p=.367). Most commonly cited were erectile problems (41%) in men with HTN. Diuretics (unadjusted: OR=0.68, p 0.02; Model 1: OR=0.69, p=.03; Model 2: OR=0.72, p=.17) and beta blockers (unadjusted: OR=0.69, p 0.02; Model 1: OR=0.67, p=.03; Model 2: OR=0.79, p=.33) were associated with sexual inactivity in men with treated HTN; diuretics, only, were associated with sexual inactivity in women (unadjusted: OR=0.81, p 0.25; Model 1: OR=0.76, p=.14; Model 2: OR=0.58, p=.02). There were no significant associations with sexual problems. Discussion HTN and its treatment are associated with sexual inactivity; diuretics more than other medication classes. In men but not women, treatment is also associated with sexual problems but medication class has no effect. More research investigating gender-specific mechanisms linking HTN and its treatment with sexual health is needed.

Sexual inactivity and sexual dysfunction in midlife Singaporean women: A prospective cross-sectional study of prevalence and risk factors

The advances on HIV/AIDS diagnosis and treatment have enabled people living with HIV/AIDS (PLHA) better quality of life. However, the persistence of HIV-related stigma and discrimination, and the risks triggered by HIV disclosure, may be a barrier to the sexual exercise of PLHA. We investigated the prevalence of sexual inactivity and the reasons given for it among a representative sample of women of reproductive age living with HIV/AIDS (WLWHA) in the municipality of São Paulo, Brazil. We surveyed 918 WLWHA with probability proportional to average number of visits in each of the 18 referral HIV/AIDS services. Sexual inactivity was defined as not having had vaginal sexual intercourse in the year prior to research. Statistical modeling of the factors associated with sexual inactivity was carried out by way of bivariate and multivariate analysis. In all, 22.2% (n=200) of the women did not have sexual relations in the year prior to the interview. The majority reported a reduction in desire (64.5%) and sexual activity (68%). Among the women not in a relationship, the predictors of sexual inactivity were: being older (35-49) (ORa=2.25); not being Catholic (ORa=2.91); having kept the diagnosis secret from their partner (ORa=2.45); having had up to five sexual partners throughout life (ORa=3.81). The diagnosis of HIV seems to have more of an effect on the desire for and frequency of sexual activity than on its interruption. Sexual inactivity was influenced by the stigma of HIV/AIDS, by age, and by moral-religious values.

Past studies that demonstrated that sexual dysfunction is common among women receiving chronic hemodialysis did not distinguish sexual dysfunction/difficulty from sexual inactivity. This study sought to differentiate these in order to elucidate the prevalence of true "sexual dysfunction" in this population. As part of a clinical trial of symptom management strategies in patients receiving chronic hemodialysis, female sexual function was prospectively assessed monthly for 6 months and quarterly thereafter using the Female Sexual Function Index, to which questions were added differentiating sexual dysfunction/difficulty from sexual inactivity. Beginning in month 7, patients were asked three questions about sexual activity, difficulty, and satisfaction monthly. Of the women enrolled in the clinical trial,125 participants completed 1721 assessments between 2009 and 2011. Scores on 574 of 643 (89%) quarterly Female Sexual Function Index assessments were consistent with sexual dysfunction, due largely to sexual inactivity, which was reported on 525 (82%) quarterly assessments. When reported (n=1663), the most frequently described reasons for sexual inactivity were lack of interest in sex (n=715; 43%) and lack of a partner (n=647; 39%), but rarely sexual difficulty (n=36; 2%). When reported (n=1582), women were moderately to very satisfied with their sexual life on 1020 (64%) assessments and on 513 of 671 (76%) assessments in which lack of interest was cited as a reason for sexual inactivity. Women indicated an interest in learning about the causes of and treatment for sexual dysfunction on just 5% of all assessments. Although many women receiving chronic hemodialysis are sexually inactive, few describe sexual difficulty. Most, including those with a lack of interest in sex, are satisfied with their sexual life and few wish to learn about treatment options. These findings suggest that true sexual dysfunction is uncommon in this population and that treatment opportunities are rare.

Sexual dysfunction in women with epilepsy