Sex Difficulties in Women Not Distressing to Most (Update1)
By Elizabeth Lopatto
Oct. 31 (Bloomberg) -- Sex is painful, uninteresting or unsatisfying for four of every 10 U.S. women, yet just 12 percent say they feel distress because of their difficulties, a survey by a Harvard University researcher found.
Women ages 45 to 64 were more likely to be distressed than older or younger females, said the report in the November issue of Obstetrics & Gynecology. In the 45-to-64 group, one in eight was unhappy because of a lack of desire and one in 15 was upset over their difficulties with arousal or orgasm.
The research mirrors a 1999 survey's conclusion that 43 percent of women from age 18 to 59 had sexual dysfunction. It adds that most aren't ``distressed,'' a word the authors relate to unhappiness, guilt, worry, frustration, embarrassment or anger. Because most women aren't distressed by sexual activity, there probably should be less focus on pharmaceutical solutions and more emphasis on counseling that considers a woman's entire life experience, according to an accompanying editorial.
``We thought it would be important to have an accurate statistic for distressing sexual problems,'' said Jan Shifren, the lead author and an assistant professor of obstetrics and gynecology at Harvard Medical School in Boston, in an Oct. 30 telephone interview. ``If it's not associated with distress, then it's probably not affecting a woman's quality of life.''
Shifren's research, based on self-reporting by more than 31,000 respondents, was sponsored by Boehringer Ingelheim GmbH, the German company with an experimental medicine for pre- menopausal women with low sexual desire not caused by a medical condition or drug. The product, flibanserin, is in final-stage studies, according to Boehringer's Web site.
`Normal Dysfunction'
``We're used to hearing statistics like 30 to 40 percent of women have sexual dysfunction,'' Shifren said. ``That number seems very high, which suggests it may be normal. To determine the true prevalence, it has to be associated with distress.''
``The question is, if it's not a problem for the person who's got low desire, is it a problem?'' said Katherine Rachlin, a clinical psychologist and sex therapist in New York City. She wasn't affiliated with the study. ``I know one person who thought he had a problem because it took him so long to have an orgasm, and the woman he was with said that was one of the best things about their sex life.''
Women's sexuality is complicated, Rachlin said. It has been her experience that some women don't mind that they don't always orgasm, because they may value the intimacy and closeness sex brings, she said.
`Optional Orgasm'
``Enjoying sex might rate very high, but having an orgasm may be more optional,'' Rachlin said.
About 38 percent of U.S. women have low sexual desire; about a quarter experience low arousal, and a fifth rarely or never achieve orgasm, if the findings are extrapolated through the U.S. population, the authors wrote.
The 1999 survey may have caused some people to exaggerate the extent of the dysfunction and regard it as a disease, wrote Ingrid Nygaard, a doctor at the University of Utah School of Medicine, in Salt Lake City, in the accompany editorial.
``What's to be gained by over inflating rates and turning symptoms into disease?'' Nygaard wrote. ``Lots -- market shares, provider income, grant support and so on -- that is, fame and fortune.''
Depression
Women who were depressed had twice the odds of reporting each type of distressing sexual problem, compared with women who weren't depressed. Urinary incontinence was also associated with a slightly higher risk of distress. Neither heart disease nor diabetes were examined as contributing to sexual dysfunction.
``We're trying to find predictors of distress in the data,'' said Shifren. ``The only factor we have is age.''
While elderly women experienced the most sexual problems, they were least troubled. The authors suggested this may be due to other medical problems, changes in their partners' sexual function, or increased importance of other relationship factors.
Though it's reassuring that fewer than 43 percent of women are distressed by sexual problems, the 1 of 8 who reported distress in today's study is high, Shifren said.
``We need to do more to identify these women and provide them with care,'' Shifren said.