(062) Associations Between Female Sexual Distress, Genitourinary Diagnoses, and Mental Health in a Clinical Population

Abstract Introduction Historically, female sexual health has been under-studied, especially in regard to female sexual experiences and sexual distress. Previous studies have investigated treatment options such as physical therapy, steroid or lubricant use for dyspareunia while other studies have related female sexual dissatisfaction to mental health disorders and perceptions about sex. However, studies investigating the relationship between feelings of sexual distress in females and diagnoses related to the female genitourinary system or psychiatric diagnoses are few. Objective This study aims to expand our understanding of the effects of mental health or genitourinary conditions on Female Sexual Distress Scale- Revised (FSDS-R) scores. Methods Investigators completed a chart review of 515 patients who were seen in a local female sexual health clinic between January 2019 and July 2025. Data gathered included age at the time of appointment, race, ethnicity, sexual orientation, diagnoses related to the female genitourinary system (dyspareunia, vulvar vestibulitis, pelvic floor dysfunction, urinary incontinence, etc.), mental health conditions (depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder), menopausal status (pre-menopause or post-menopause), use of hormone replacement therapy (HRT) prior to the appointment, hysterectomy status, and scores on the female sexual distress scale-revised (FSDS-R), urinary distress index-6 (UDI-6), female sexual function index (FSFI), and sexual experience survey (SES). Following data collection, thirty-one charts were excluded due to lack of scores reported on the FSDS-R, FSFI, SES, and UDI-6 surveys or incorrect patient medical record numbers, leaving a total of 484 charts included in the data analysis. Data analysis included analysis of variance (ANOVA) and chi-squared testing using a p-value of ≤0.05 as the statistical threshold. Results Of the 484 patients included, 97.31% identified as White and 96.49% identified as non-Hispanic with a mean age of 45.84 +/- 13.67. “Straight” sexuality accounted for 57.44% of patients and “unknown” sexuality accounted for 40.91% of patients. FSDS-R score did not significantly relate to patient age (p = 0.45). Menopausal status and FSDS-R scores were not statistically significantly related (p = 0.12). Additionally, diagnoses of dyspareunia, vulvar vestibulitis, and genitourinary symptoms of menopause were not significantly associated with changes in FSDS scores. Diagnoses that did significantly relate to FSDS-R scores included history of sexual abuse (p 0.00), other forms of abuse (emotional, physical, verbal) (p = 0.01), hypoactive sexual desire disorder (p 0.00), anxiety (p 0.00), depression (p 0.00), and post-traumatic stress disorder (p 0.00). Conclusions Female sexual distress can be a difficult topic to address and is often multifactorial. Conditions such as hypoactive sexual desire disorder, anxiety, depression, post-traumatic stress disorder, and history of abuse (physical, emotional, verbal, or sexual) are important factors associated with increased sexual distress in female patients regardless of age or menopausal status. Of note, diagnoses of dyspareunia or genitourinary symptoms of menopause were not associated with a significant change in FSDS-R scores. Disclosure No.