Background: Female sexual dysfunction (FSD) is a health issue that affects life satisfaction, relationship satisfaction, and behavioral health. Primary care is an ideal setting to screen for sexual health concerns. However, FSD is often underdetected and undertreated in this setting, which may be due to the limited dissemination of prevalence information about FSD to providers. This meta-analysis aimed to identify the prevalence of the most common forms of FSD in primary care settings. Materials and Methods: A search was conducted in electronic databases from inception to July 2020, identifying 48 included studies. Eligible studies had longitudinal, cross-sectional, retrospective, or cohort designs that reported the prevalence of FSD domains using screening tools, diagnostic interviews, or data extracted from clinical records of adult female participants in primary care settings. Results: Among the studies examining overall FSD (n = 16), a random-effects meta-analysis revealed that the prevalence of overall FSD was 39%. The prevalence of FSD ranged from 24% to 29% for the following domains: desire (29%), arousal (28%), lubrication (29%), orgasm (26%), pain (24%), and satisfaction (27%). The test of moderators was not significant, suggesting that the sample type examined across studies (e.g., patients with depression versus diabetes) was not associated with the magnitude of prevalence estimates. The results showed considerable variability in the specific clinical and demographic subpopulations examined (e.g., participants with diabetes versus pregnant women) and measurement methods across studies. Conclusions: Findings indicate that FSD is a significant public health concern. Patients with diverse presenting concerns in primary care would benefit from regular screening for FSD.

Assisted reproductive technology (ART) represents a significant life challenge that can impact psychological well-being and intimate relationships. This cross-sectional study examined whether psychological resilience mediates the association between adult attachment insecurity (anxiety and avoidance) and sexual dysfunction in 198 Italian individuals (99 heterosexual couples) undergoing ART. Path analyses were conducted separately by gender. Results showed that attachment anxiety (βmen = −.35, p < .001; βwomen= −.34, p < .001) and avoidance (βmen = −.48, p < .001; βwomen = −.57, p < .001) were significantly and negatively associated with resilience, which in turn was strongly linked to sexual dysfunction (βmen = −.66, p < .001; βwomen = −.74, p < .001). The indirect effects of anxious attachment (women: estimate = 0.127, p < .001, 95% CI [0.063, 0.192], men: estimate = 0.233, p < .001, 95% CI [0.189, 0.562]), and avoidant attachment (women: estimate = 0.273, p < .001, 95% CI [0.171, 0.376], men: estimate = 0.375, p = .015, 95% CI [0.046, 0.420]) on sexual functioning via resilience were significant. The models explained 53% of the variance in female sexual dysfunction and 44% in male sexual dysfunction. These findings highlight the role of psychological resilience as a key mechanism linking insecure attachment to sexual difficulties during ART and support its potential as a target for couple-based interventions.

(016) Impact of Cystectomy on Pelvic Organ Prolapse and Sexual Function of Women: An Exploration of Patient Centered Outcomes

The effect of inflammation on sexual desire and sexual function in pre- and post-menopausal women is moderated by sexual violence history.

ABSTRACT Background: Antiretroviral therapy has markedly increased life expectancy among people living with human immunodeficiency virus (HIV), yet the long-term impact of chronic HIV infection on women’s quality of life (QoL) and sexual functioning remains poorly understood. Female sexual dysfunction (FSD) is common in women and may impair psychological well-being and social relationships. Understanding how HIV infection intersects with FSD and QoL could inform holistic care for women in resource-limited settings. Objective: To compare QoL and FSD between women living with HIV and HIV-negative women and to identify socio-demographic predictors of poor QoL. Methods: We conducted a hospital-based cross-sectional study in 2024 among 200 women on antiretroviral therapy and 200 age-matched HIV-negative women attending the general outpatient clinic at Aminu Kano Teaching Hospital, Kano, Nigeria. Participants were recruited through systematic sampling; research assistants provided study information and obtained written informed consent. Quality of life was assessed with the World Health Organization Quality of Life 26-item Brief questionnaire (WHOQOL-BREF). Female sexual function was screened with the 19-item Female Sexual Function Index (FSFI); a total score ≤26.55 denoted FSD. Data were analyzed using chi-square tests, independent t-tests and multivariable logistic regression. Results: The mean (±SD) age of participants was 37.1 ± 9.4 years. Overall QoL was significantly worse among women with HIV than HIV-negative women (53% vs 63% reporting good QoL, p = 0.043). Mean QoL scores were lower in the HIV-positive group for the psychological (61 ± 18 vs 54 ± 14; p < 0.001) and environmental domains (69 ± 20 vs 65 ± 16; p < 0.001), while physical and social domain scores were comparable. FSD was highly prevalent in both groups (96% in HIV-positive and 98% in HIV-negative participants; p = 0.40), and FSFI scores were not associated with QoL. In multivariable analysis, rural residence (adjusted odds ratio 3.30, 95% CI 1.31–8.98) and primary-level education (aOR 3.06, 95% CI 1.50–6.38) independently predicted poor QoL. Conclusions: Women living with HIV experience poorer overall QoL than HIV-negative peers, particularly in psychological and environmental domains. Interventions that improve living conditions, strengthen psychosocial support and integrate sexual and mental health services into HIV care, are needed to improve the well-being of women in North-western Nigeria.

Female sexual dysfunction (FSD) refers to problems with desire, arousal, orgasm, or pain, affecting approximately 12% of US women. Although FSD can be managed in primary care, most primary care clinicians do not regularly treat it. This survey of primary care clinicians practicing at a large US health system assessed perspectives on managing sexual dysfunction compared with other conditions, knowledge of prevalence of sexual dysfunction, and which specialty should be responsible for treating FSD. We described the distribution of clinicians' survey responses. Of the 527 invited, 80 completed the survey (response rate: 15%). Most were women (68%), physicians (52%), and had >15 years of experience (43%). The majority (88%) reported treating FSD is as important as treating other conditions that affect quality of life. Two-thirds reported disorders of desire, arousal, and orgasm could be managed in primary care, and 64% believed that pain with intercourse, typically addressed by Obstetrics/Gynecology, should be handled in primary care. Most primary care clinicians believed that treating FSD was at least as important as treating other conditions, yet up to one-third believed this responsibility should be left to a different specialty. Educational interventions targeting primary care clinicians may increase the number who take on FSD management.

Endocrine disrupting chemicals and female sexual health: An emerging research priority.

Prevalence of female sexual dysfunction in Africa: A systematic review and meta-analysis

Abstract Purpose of Review This review aims to synthesize current evidence on female sexual dysfunction following traumatic brain injury (TBI), a complication often overlooked in clinical practice and underrepresented in research. We sought to clarify prevalence, pathophysiology, clinical presentation, and gaps in healthcare and research, while highlighting implications for evaluation and treatment. Recent Findings Emerging studies demonstrate that women with TBI report significantly greater sexual dysfunction than men with TBI and women without TBI, including decreased desire, arousal, orgasm, and satisfaction. Pathophysiologic contributors include hypothalamic-pituitary-gonadal axis dysfunction, neuroanatomical disruption, and secondary sequelae such as spasticity and pain. Psychological and cognitive changes, including depression, anxiety, and body image concerns, further exacerbate dysfunction. Despite this, women remain underrepresented in studies, and providers rarely address sexual health after TBI. Summary Female sexual dysfunction after TBI is prevalent, multifactorial, and often neglected. Greater awareness, sex-specific research, and culturally sensitive interventions are needed to improve recognition, care, and outcomes.

BackgroundData regarding associations between polycystic ovary syndrome (PCOS) and female sexual function are limited.ObjectiveTo evaluate the association between a self-reported diagnosis of PCOS and female sexual dysfunction (FSD).MethodsThis cross-sectional study was performed in sexually active women, aged ≥ 20 years, who sought care at Mayo Clinic Women’s Health specialty clinics between May 1, 2015, to December 31, 2019. Participants’ sexual function was assessed with the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R) questionnaires. Multivariable logistic regression was used to assess the association between a self-reported diagnosis of PCOS and FSD (defined by the combined diagnostic thresholds for the FSFI and FSDS-R), after adjusting for participant demographics and potential mediators known to impact female sexual function including age, BMI, hormone therapy use, anxiety, depression and relationship satisfaction.ResultsResponses from 4,405 sexually active women were analyzed including 1,481 pre/perimenopausal women and 2,924 postmenopausal women. History of PCOS was reported by 6.1% of pre/perimenopausal women and 3.9% of postmenopausal women. FSD was frequently reported in women with and without PCOS (52.7% among pre/perimenopausal; 64.6% among postmenopausal and 50.6% among pre/perimenopausal; 58.5% among postmenopausal, respectively). Independent of the reproductive stage, PCOS was not associated with FSD, but when adjusted for PCOS, FSD was associated with age less than 40 years, anxiety, depression, and relationship dissatisfaction.ConclusionIn this large cross-sectional study, a self-reported history of PCOS was not independently associated with FSD after adjusting for key psychosocial and health-related factors.

Background and Objectives: Sexual function often fluctuates during pregnancy, yet the contributions of body image-related quality of life (BI-QoL)—operationalized via body image instruments such as the Body Exposure during Sexual Activities Questionnaire (BESAQ) and pregnancy-specific body image scales—and relationship satisfaction remain inconsistently quantified. This systematic review aimed to synthesize evidence on the associations between BI-QoL, relationship satisfaction, and female sexual function in pregnant women. Methods: Following PRISMA 2020, PubMed/MEDLINE, Scopus, and Web of Science were searched up to 23 August 2025. Eligible studies enrolled pregnant women and reported quantitative data on BI-QoL and/or relationship satisfaction alongside sexual outcomes. Risk-of-bias used design-appropriate tools; findings were narratively synthesized due to heterogeneity. Results: Thirteen studies met criteria (predominantly cross-sectional; sample sizes 107–472; one RCT; several couples/longitudinal cohorts). Female Sexual Function Index (FSFI) means clustered in the mid-20s; in a randomized trial, the intervention arm improved FSFI by +1.76 points (22.95 → 24.71; p = 0.002). Overall female sexual dysfunction reached 54.7% in the largest cross-sectional sample. Higher body exposure anxiety was associated with ~4.24-fold greater odds of dysfunction across trimesters. Marital satisfaction explained ≈36% of FSFI variance in multivariable models. Pregnancy context factors related to BI-QoL included planned pregnancy (β = −0.273) and third trimester (β = −0.280) indicating better BI-QoL, while more children predicted worse BI-QoL (β = +0.317). In one cohort, BI during sexual activity worsened postpartum versus pregnancy (p = 0.01). Conclusions: Across diverse settings, poorer BI-QoL and lower relationship satisfaction were consistently linked to reduced sexual function during pregnancy, with desire/arousal most affected. Routine screening and couple-sensitive counseling should be considered as promising, yet still under-tested, strategies that warrant further evaluation in intervention studies.

(P24) a new era in female sexual health: pilot study on regenerative Gynecology and its impact on sexual function and quality of life

The prevalence of female sexual dysfunction was analyzed in sexually active women attending Hospital de Clínicas “José de San Martín” between November 2023 and January 2025. The FSFI questionnaire was applied to 241 valid surveys grouped by age. Overall sexual dysfunction was found in 29.9%, with greater impairment of lubrication, pain, and satisfaction after age 40. Results highlight the influence of hormonal and psychosocial factors and emphasize the need for early diagnosis and interdisciplinary management.

Impact of female sexual dysfunction on assisted reproductive technology outcome.

To correlate genitourinary exam (GU) findings to patient-reported sexual dysfunction in female cancer survivors. This retrospective cohort study included female cancer patients seen at a South Florida sexual health after cancer program. GU anatomy abnormalities and patient-reported sexual dysfunction were evaluated by Adapted Vulvovaginal Exam Score (AVES) and theFemale Sexual Function Index (FSFI), respectively. Multivariate analyses compared, FSFI scores between patients with AVES > 3 vs. 0-3, (AVES > 3 corresponds to more abnormal GU exam). Adjusted odds ratio (aOR) and 95% confidence intervals (95% CI) were calculated. AVES was calculated for 162 female patients treated between 2020-2022. Median age was 46; 57% were Hispanic, and 79% had breast cancer. Common symptoms included vaginal dryness (55%) and dyspareunia (45%). Of 108 women with FSFI scores, 97% met criteria for female sexual dysfunction (FSD). 23% were found to have vaginal stenosis, and 42% had a narrowed vaginal introitus. Those with AVES > 3 had significantly lower FSFI lubrication, orgasm, satisfaction, and pain domain scores. Any endocrine therapy use was associated with worse AVES scores (aOR 0.20, 95% CI 0.05-0.80, p = 0.024), an association strongest with aromatase inhibitor (AIs) use. Low satisfaction scores < 3.6 were nearly three times more likely to have abnormal GU exams (aOR = 2.81; 95% CI: 1.03-7.65; p = 0.044). FSD in female cancer survivors is associated with previously unreported GU exam changes that can limit or prevent sexual activity through pain and worsened sexual satisfaction. Ongoing work evaluates targeted interventions to improve symptoms and quality of life for this growing survivor population.

BackgroundFemale sexual dysfunction is one of the most common public health problems in developed and developing countries, however little is expressed and need medical care due to cultural barriers and female were shameful.Even though sexual dysfunction has harmful effects on women's life, little is known about the prevalence and its associated factors in this study area.ObjectiveTo assess the prevalence of Sexual Dysfunction and Associated Factors among human immunodeficiency virus positive Women attending on antiretroviral therapy in South Gondar Hospital, North West, Ethiopia.MethodsInstitutional based Cross-sectional study was conducted among 623 sexual active HIV Positive women. Participants in the sample size estimation process were chosen through a systematic sampling procedure and information was gathered through document review and interview methods. Then data were entered by Epi-data version 4.6.0.2 and exported to SPSS Version 20 for analysis. Descriptive statistics such as frequency distribution tables and figures were used to describe the study participants. Bi-variable logistic regression model, adjusted odds ratios with 95% confidence level was used to show the strength of association. Variables with a p-value less than 0.05 in the multi-variable model were considered statistically significant. The necessary assumption of model fitness of the regression was checked by Hosmer Lemeshow test.ResultsThe prevalence of sexual dysfunction was 58.8 % (95% CI: 54.8- 62.7). Age above 50 (AOR=3.16, 95% CI: 1.48, 6.72), Episiotomy (AOR=4.41, 95% CI: 2.51, 6.81), Medical disease (AOR=3.45, 95%CI: 1.79, 6.68), ART started duration ≥8 years ago (AOR=2.24, 95%CI: 1.38, 3.66) and Clinical stage of HIV (AOR=5.29, 95% CI: 3.13, 8.96) were associated with sexual dysfunction.Conclusion and recommendation The prevalence of sexual dysfunction was high as compare to other previous studies. Sexual dysfunction was influenced by age, episiotomy, medical disease; antiretroviral therapy started duration and Clinical stage HIV. As a result recognizing female sexual dysfunction as a significant public health problem is essential.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12879-025-11879-2.

Pulmonary arterial hypertension increases the risk of female sexual dysfunction: a systematic review and meta-analysis.

Female sexual dysfunction (FSD) is common in women with urinary incontinence (UI), and pelvic floor exercises (PFEs) are a well-established treatment. Vaginal spheres, designed to stimulate pelvic floor muscle engagement, may offer additional benefits in improving sexual function. To assess the efficacy of a regimen of PFEs combined with vaginal spheres with the same exercises performed without any device to improve sexual function. This randomized, single-blind trial conducted at the RAPbarcelona Center enrolled 71 adult women with sexual dysfunction symptoms. Participants were assigned to either PFEs alone or combined with vaginal Enna Balls. The intervention lasted 4 months, with initial assessments at baseline and follow-ups at 8 and 16 weeks. The Female Sexual Function Index assessed sexual function. Adverse events and treatment adherence were monitored at weeks 4, 8, 12, and 16, and follow-ups. The mean age of participants was 46.85±1.58. After treatment, no significant changes were observed in the overall Female Sexual Function Index score (≥0.05), except for an increase in desire, showing statistical differences between groups at the end of treatment (p = 0.041). Tolerance and safety did not significantly differ between groups. Adding vaginal spheres to PFEs may offer specific benefits in enhancing aspects of sexual function, particularly desire and lubrication, though overall outcomes were similar to PFEs alone. These findings support the potential role of vaginal spheres as an adjunctive therapy in personalized pelvic floor rehabilitation strategies for women with FSD.

Sexual health and behaviors in homosexual, bisexual and heterosexual Danes: baseline findings in the Project SEXUS cohort study.

Female sexual function and dysfunction is an often-overlooked component within clinical visits. Female sexual disorders are classified by the International Society for the Study of Women's Sexual Health and Fourth International Consultation on Sexual Medicine along the following categories: hypoactive sexual desire disorder, female sexual arousal disorder, female orgasm disorder, and genitopelvic pain disorder. Although more attention has been given to sexual health and developing options for treating dysfunction in recent years, significant knowledge gaps remain in addressing sexual health concerns as part of patient-centered care. Assessing female sexual function consists of obtaining a comprehensive clinical history and performing a thorough physical examination of the pelvic floor and vulvovaginal anatomy. Causes of sexual dysfunction include biologic, psychologic, interpersonal, and sociocultural risk factors. A nuanced approach incorporating evidence-based guidelines and tailored treatment plans that align with the patient's personal goals helps optimize patient sexual health outcomes.