A Population-Based Epidemiologic Study of Female Sexual Dysfunction Risk in Mainland China: Prevalence and Predictors

BACKGROUND: Epidemiologic data on female sexual dysfunction in China are sparse. AIM: To assess the prevalence of risk of female sexual dysfunction in mainland China and its regional and sociodemographic variations and physiologic, pathologic, and behavioral risk factors. METHODS: A survey of the general female population was conducted in mainland China from February 2014 through January 2016. Women were randomly selected using multistage, stratified, cluster sampling. The prevalence rate of sexual dysfunction, as measured by the Female Sexual Function Index and a score lower than 23.45 as the cutoff threshold, was determined. Multivariate logistical regression models were used to examine the effects of sociodemographic, physiologic, pathologic, and behavioral factors on women's risk of experiencing sexual dysfunction and domain-specific sexual problems. OUTCOMES: The questionnaire on sexual dysfunction was completed by 25,446 women 20 to 70 years old. RESULTS: The prevalence of sexual dysfunction in women 20 to 70 years old in mainland China was estimated at 29.7% (99% CI = 28.9-30.4), with large regional variations. The prevalence rates of potential domain-specific sexual problems were 21.6% (99% CI = 20.9-22.2) for low desire, 21.5 (99% CI = 20.8-22.2) for arousal disorder, 18.9% (99% CI = 18.3-19.6) for lubrication disorder, 27.9% (99% CI = 27.2-28.7) for orgasm disorder, and 14.1% (99% CI = 13.6-14.7) for sexual pain. Higher educational attainment and urban residency were associated with a decreased risk of sexual dysfunction. Women of ethnic minorities (or non-Han ethnicity) had fewer reports of sexual dysfunction than women of Han ethnicity (odds ratio = 0.67, 99% CI = 0.47-0.97). Diabetes, cancers, pelvic inflammatory disease, and pelvic organ prolapse significantly increased the reports of sexual dysfunction. CLINICAL TRANSLATION: This survey provided the prevalence and risk factors of female sexual dysfunction in China, information that could be useful for potential prevention and clinical treatment. STRENGTHS AND LIMITATIONS: This is the first large-scale, nationally based epidemiologic study of female sexual dysfunction in mainland China. The limitations of the study design included an overpowered study caused by the large sample, the under-representation of younger and unmarried women, and no information on the women's partners, their values and knowledge, and detailed medical conditions. CONCLUSIONS: The prevalence rate of female sexual dysfunction in mainland China was modest overall, although variations existed across regions and social groups. Zhang C, Tong J, Zhu L, et al. A Population-Based Epidemiologic Study of Female Sexual Dysfunction Risk in Mainland China: Prevalence and Predictors. J Sex Med 2017;14:1348-1356.