Female Sexual Dysfunction as Measured by Low Sexual Frequency is Associated with Lower Socioeconomic Status: An Analysis of the National Health and Nutrition Examination Survey (NHANES), 2007-2016

Abstract

Background Female sexual dysfunction (FSD) is a complex disorder of biopsychosocial etiology, and FSD symptoms affect more than 40% of adult women worldwide. Aim In this cross-sectional study, we sought to investigate the association between FSD and socioeconomic status (SES) in a nationally representative female adult population. Methods Economic and sexual data for women aged 20–59 from the 2007–2016 National Health and Nutrition Examination Survey, a United States nationwide representative database, was analyzed. Poverty income ratio (PIR), a ratio of family income to poverty threshold, was used as a measure of SES, and low sexual frequency was used as a measure of FSD. The association between FSD and SES was analyzed using survey-weighted logistic regression after adjusting for relevant social and gynecologic covariates, such as marital status and history of pregnancy, as well as significant medical comorbidities. Outcomes We found that FSD, as measured by low sexual frequency, was associated with lower SES. Results Among the 7,348 women of mean age 38.4 (IQR 29–47) included in the final analysis, 26.3% of participants reported sexual frequency of 0–11 times/year and 73.7% participants reported sexual frequency >11 times/year. Participants of PIR <2 were 92% more likely to report sexual frequency ≤11 times/year than those of PIR ≥2 after adjusting for demographics, social history, gynecologic history and significant medical conditions (OR = 1.92; 95% CI = 1.21–3.05; P < .006). Clinical Implications The evaluation and treatment of FSD may benefit from a comprehensive approach that takes SES into account. Strengths & Limitations This study is limited by its cross-sectional design, but it is strengthened by a large, nationally representative sample with extensive, standardized data ascertainment. Conclusion Lower SES and lower sexual frequency are directly correlated among female adults in the United States; future studies should focus on social determinants of health as risk factors for FSD.

Sexual Activity Rates Are Declining Both Before and During the COVID-19 Tragedy

“…A nationally representative US study, adjusted for many relationship, health, and socioeconomic factors, reported that, of 7348 women aged 20 to 59 years, the risk of having no sex or sex less than 11 times a year was almost twice as likely among economically poor women (odds ratio, 1.92; 95% confidence interval, 1.21-3.05; P < 0.006). 6 A study of 2109 California insured women aged 40 to 69 years reported that among women making $100,000+ a year, only 8.2% did not have sex in the past year as compared with 49.5% of the women making $40,000 or less ( P < 0.001). 7 It seems remarkable to me that in the socially liberal state of California, almost half of the lower-income middle-aged women reported no sexual activity at all in the past year.…”

“…Other studies have reported that rates of partnered sexual activity are especially low among certain populations such as low-income women. A nationally representative US study, adjusted for many relationship, health, and socioeconomic factors, reported that, of 7348 women aged 20 to 59 years, the risk of having no sex or sex less than 11 times a year was almost twice as likely among economically poor women (odds ratio, 1.92; 95% confidence interval, 1.21–3.05; P < 0.006) 6 . A study of 2109 California insured women aged 40 to 69 years reported that among women making $100,000+ a year, only 8.2% did not have sex in the past year as compared with 49.5% of the women making $40,000 or less ( P < 0.001) 7 .…”

The global prevalence of sexual dysfunction in obese and overweight women: a systematic review and meta-analysis

“…Sexual dysfunction refers to any condition that hinders a person's ability to derive satisfaction from sexual activity [ 9 ]. In particular, female sexual dysfunction (FSD) is a complex disorder with multi-faceted causes rooted in biological and psychosocial factors [ 11 ]. FSD can have detrimental effects on an individual’s self-esteem, sense of wholeness, and interpersonal relationships, often leading to emotional discomfort [ 12 ].…”

Magnitude of Symptomatic Pelvic Floor Dysfunction and Associated Factors Amongst Women in Western Ethiopia: A Cross-Sectional Study

“…11 Due to a lack of underwear, disposable pads, and washing facilities, women in rural areas unable to control urinary leakage, exposing them to poor hygiene and odor issues. 12 Various studies have linked increasing age, increasing parity, and lifting heavy objects to pelvic floor dysfunction. Furthermore, anatomical prolapse and, more importantly, older age at last delivery were linked to pelvic floor dysfunction.…”

“… 11 Due to a lack of underwear, disposable pads, and washing facilities, women in rural areas unable to control urinary leakage, exposing them to poor hygiene and odor issues. 12 …”