Background: Female sexual dysfunction is a prevalent medical condition defined as a distressing problem with sexual pain, desire, arousal, or orgasm; however, little epidemiological research on dysfunction accounts for participants' distress. Our objective was to evaluate associations between potential risk factors and sexual dysfunction among women, in order to inform clinical care. Methods: This cross-sectional survey of women in Ohio, Michigan, and Pennsylvania screened for sexual dysfunction using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale (FSDS). Respondents' perceived cause of decreased desire was evaluated using the Decreased Sexual Desire Screener. Multivariable logistic regression was used to identify factors (i.e., chronic medical conditions, life changes, or gynecological conditions) associated with sexual activity in the past 6 months, sexual problems, sexual distress, sexual dysfunction, and decreased desire. Results: Among the 1,390 respondents, the median age was 48, 49% (693) were sexually active in the past 6 months, and 622 completed the FSFI and FSDS. Of these 622, 49% (306) were experiencing sexually-related distress (FSDS ≥ 11), 50% (311) were experiencing sexual problems (FSFI ≤ 26.55), 39% (242) met criteria for sexual dysfunction (FSFI ≤ 26.55 and FSDS ≥ 11), and 27% (166) had experienced a decrease in desire. Having at least one medical condition was associated with experiencing sexual dysfunction (aOR = 2.50, 95% CI: 1.60-3.97), sexually related distress (aOR = 2.74, 95% CI: 1.80-4.23), and decreased desire (aOR = 2.54, 95% CI: 1.52-4.41). Having at least one gynecological condition was associated with experiencing sexual dysfunction (aOR = 1.81, 95% CI: 1.27-2.59), sexually-related distress (aOR = 1.94, 95% CI: 1.37-2.77), and decreased desire (aOR = 2.18, 95% CI: 1.48-3.25). Conclusions: Chronic medical conditions and gynecological conditions are associated with sexual dysfunction, sexually related personal distress, and decreased desire. When a new condition is diagnosed, health care professionals should inquire about the patient's sexual concerns.
Ahrendt et al. (2025) studied this question.