Estimating the Prevalence of Sexual Function Problems: The Impact of Morbidity Criteria

Abstract

Establishing the clinical significance of symptoms of sexual dysfunction is challenging. To address this, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced two new morbidity criteria (duration and symptom severity) to the existing criteria of distress. This study sought to establish the impact of these three criteria on the population prevalence of sexual function problems. The data come from a national probability survey (Natsal-3) and are based on 11,509 male and female participants aged 16–74, reporting at least one sexual partner in the past year. The key outcomes were: proportion of individuals reporting proxy measures of DSM-5 problems, and the proportion of those meeting morbidity criteria. We found that among sexually active men, the prevalence of reporting one or more of four specific sexual problems was 38.2%, but 4.2% after applying the three morbidity criteria; corresponding figures for women reporting one or more of three specific sexual problems, were 22.8% and 3.6%. Just over a third of men and women reporting a problem meeting all three morbidity criteria had sought help in the last year. We conclude that the DSM-5 morbidity criteria impose a focus on clinically significant symptoms.

Painful sex (dyspareunia) in women: prevalence and associated factors in a British population probability survey

“…27 Our estimates were slightly lower than this, and decreased further when stricter morbidity criteria were used (see also ref. 28 ), and this effect has also been found in other population surveys. 24,29 Other studies do not measure dyspareunia per se, but report estimates of genital pain disorders such as vulvodynia.…”

“…7,8,38 Only a fraction of women affected by genital pain disorders ever receive an official diagnosis: 1.4% in a study of women meeting criteria for vulvodynia. 30 In a previous paper from Natsal-3 28 we reported that less than half of women with morbid symptoms of sexual pain had sought professional help in the last year. Among those who do seek treatment, negative experiences are common, including invalidated concerns, not receiving a formal diagnosis, and being given treatment perceived as ineffective.…”

“…15,31 Although painful sex is less commonly reported by women than lacking interest in sex and difficulty reaching climax, 39 it is the sexual function problem most commonly experienced as distressing. 28 It can lead to feelings of isolation, shame, sexual inadequacy, loss of confidence and feeling out of control. 7,8,38 Only a fraction of women affected by genital pain disorders ever receive an official diagnosis: 1.4% in a study of women meeting criteria for vulvodynia.…”

Help-Seeking for Sexual Difficulties and the Potential Role of Interactive Digital Interventions: Findings From the Third British National Survey of Sexual Attitudes and Lifestyles

“…In this large, national probability survey of the British population aged 16 to 74 years, fewer than half of women and men with distressing sexual difficulties in the past year reported that they had sought help/advice for their sex lives during this time. This leaves the majority of those with a distressing sexual difficulty reporting that they had not sought help, demonstrating a large unmet need (Mitchell et al, 2016). Overall, there were few sociodemographic differences between those who did and did not report seeking help, particularly after taking account of age.…”

“…Preferences differed according to age, with age-35-and-over participants preferring to seek help from a general practitioner/family doctor and under-age-35 participants preferring to seek help from family/friends. This finding may reflect the types of sexual difficulties that people tend to experience at different ages (Mitchell et al, 2016), as well as younger generations being more comfortable accessing information from the Internet.…”