Findings from the Journal of Sexual Medicine suggest that low sexual desire accompanied by distress is most common among women reaching midlife. Having a partner, being sexually inactive, and taking psychotropic medication was also associated with a higher likelihood of such distress.
When low sexual desire is accompanied by feelings of distress, it is referred to as hypoactive sexual desire dysfunction (HSDD). The condition has been shown to negatively impact other parts of life, affecting a person’s psychological health, well-being, and relationships.
The authors of the study were motivated to explore the pervasiveness of HSDD among Australian women and to uncover factors that might predict its occurrence.
“There has been a substantial focus on sexual function in post menopausal women,” said lead researcher Susan Davis, a professor and director of the Women’s Health Research Program at Monash University. “The few studies that have looked at sexual desire across the lifespan have not taken into account whether a low desire is or is not associated with distress. Having conducted studies in representative samples of Australian women, we were in a unique position to explore the prevalence of low desire and sexually related personal distress in women aged 18 to 79 years.”
The researchers analyzed survey data from three separate community samples of Australian women. In total, the surveys polled 10,544 women. The questionnaires included items concerning respondents’ medical history, smoking and alcohol habits, and sociodemographic characteristics.
Each questionnaire also asked respondents how often they had felt sexual desire in the past month and had them complete a 13-item measure of sexually related personal distress. Since an in-person assessment would be necessary for a diagnosis of HSDD, the researchers note that their study instead assesses the presence of epidemiological HSDD (eHSDD).
“A diagnosis of hypoactive sexual desire disorder requires a clinical assessment and exclusion of factors that could be interfering with sexual function such as a fundamentally poor relationship, medication and other biological or sociological factors,” Davis explained. “We are not reporting the prevalence of a clinical diagnosis of hypoactive sexual desire disorder, but rather the prevalence of low sexual desire, related distress and the coexistence of these two without specifying a confirmed diagnosis.”
In their analysis, Davis and team found that younger women, aged 25-29, showed the highest scores for sexually related personal distress. The prevalence of eHSDD, however, was highest at midlife, peaking between 40 and 44 years old at around 33%. Rates of eHSDD then began to decline after age 64. Women between the ages of 18-24 showed low rates of 12%, and older women of 75-79 years old had the lowest rates of 7%.
“Our study demonstrates that, when no women are excluded, young women are most likely to experience sexually related distress without low desire, whereas for women at midlife who have sexually related distress, for most this is associated with low desire. Hence the peak prevalence of eHSDD occurs at midlife,” the researchers report.
As far as related factors, the likelihood of eHSDD was higher among women who were sexually inactive, but only after taking into account all confounding variables. “This shows that the context in which a woman is sexually inactive, such as being partnered or not, is a critical determinant of the presence of sexually related personal distress,” Davis and colleagues note.
Importantly, women in partnerships were three times more likely to demonstrate signs of eHSDD. The researchers suggest this might be due to strain caused by misaligned expectations between partners. Women who were more educated or using psychotropic medications were also more likely to present with eHSDD.
As the authors say, their findings revealed a prevalence of eHSDD across all age groups, which is troubling considering its association with reduced quality of life. “A greater understanding of the prevalence of, and risk factors for, low sexual desire with associated distress is an important step toward destigmatizing this condition and aiding the identification of affected women so they can be appropriately supported,” the researchers emphasize.
The authors further express that their findings can help guide clinicians when it comes to pinpointing women who are at risk of HSDD. The study should also convey to women with HSDD that they are not alone.
“More research into sexual wellbeing of younger and older women is needed as these are surprisingly neglected areas,” Davis said.
The study, “Prevalence of Low Sexual Desire With Associated Distress Across the Adult Life Span: An Australian Cross-Sectional Study”, was authored by Jia Zheng, Rakibul M. Islam, Robin J. Bell, Marina A. Skiba, and Susan R. Davis.