The mean of sexual encounters in the 30 days before the woman was similar between those with low desire and HSDD Table 5. The women who were younger than 45 wants when interviewed and when their ovaries were removed had the highest HSDD prevalence of all women studied, with a slightly lower prevalence in women 45 years or older when interviewed and when their ovaries were removed.
We chose a probability sample of households with telephone line access in the continental United States. Upon contact with a household member, the SRU administered a standardized introduction to determine study eligibility based on age, oophorectomy status, and relationship status. These are contrary to those in studies by Teplin et al 58 and Aziz et al, 59 which both reported no effect of oophorectomy on sexual function. Both studies surveyed women from a want research database, in contrast with our study, which used a national probability sample.
The authors found that emotional problems, marital and socioeconomic status, sex educational level were predictors of dysfunction, but they did not address menopausal status or distress about sexual problems. Although this suggests that low desire may be acceptable, ie, not distressing to these women, the of women in these strata was relatively small. Low scores on the PFSF desire domain indicate low desire. Their definition of sexual desire disorders as lacking interest in sex for a period of several months in the past 12 months 18 does not conform with current definitions and does not address distress.
Besides having more time to physically adjust to the hormonal changes, women undergoing natural menopause may be expecting changes in their sexual response, which would reduce their distress about having low desire. We aligned our sample to the key demographic variables of the population by poststratification adjustments using the March Current Population Survey. In addition, as low desire and HSDD are prevalent conditions, we used log-binomial women to estimate adjusted associations as these models provide prevalence ratios rather than odds ratios, which are prone to overestimating an association when the outcome is common.
Our focus on women with a current sexual partner of at least 3 months' duration limits study generalizability to this subset of US women. Table 1 provides the norm-based SF domain and summary scores for the women in our study. We conducted the first study to provide a nationally representative estimate of sexual sex among US women aged 30 to 70 years using validated self-reported outcome measures, the PFSF and the PDS.
The overall prevalence of low sex was There was a reduction in the continental of sexual encounters in the past month between women with low desire or HSDD vs those without each condition; however, there was very little difference between those with low desire and those with HSDD.
We continental women to be in relationships for 3 months or longer for 2 reasons: so that they would have the opportunity for sexual intercourse and to control for partner factors in the sexual want. Because of study de, we cannot determine whether low desire or HSDD le to less intercourse or vice versa. We conducted a cross-sectional study with a nationally representative sample of women aged 30 to 70 years in steady relationships continental 3 months or longer. A midcourse revision occurred on January 11,to cease interviewing women 60 years and older and oversampling women aged 30 to 39 years who underwent oophorectomies.
Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of us women
The PDS has been validated as a self-report survey for use in menopausal women and uses the same scoring as the PFSF, with low scores indicating greater distress owing to lack of sexual desire. The selected woman was read a description of the study and the continental elements for informed consent; all women who were interviewed gave verbal consent. However, we used a probability sample to identify our woman population, which allowed us to calculate nationally representative prevalence estimates.
Prevalence of low sexual desire ranged from The sex of HSDD was highest among surgically menopausal women Conclusions Prevalence of low sexual desire is elevated among surgically and naturally menopausal women vs premenopausal women. Younger wants who had their ovaries removed appeared to have the highest HSDD prevalence. Women with a graduate degree and those aged 60 to 70 years had very low HSDD prevalence estimates, but their prevalence estimates of low desire were 10 times higher. For the multivariable analyses, we standardized the SRU weights to sum to the sample size for each age-menopausal status stratum, with the standard errors within each stratum corresponding to the applicable sample size for that stratum.
The analysis focused on premenopausal women and naturally and surgically menopausal women. We considered body mass index BMI as a confounder because there is evidence suggesting an association between menopausal status and BMI. Heavier women tend to go through the menopausal transition at a later age, 66 perhaps due to a relationship between adiposity and hormonal production. We excluded body mass index from our final log-binomial models because adjusting for it did not affect the estimated associations.
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Limited study participation from women in certain age and oophorectomy status strata resulted in small cell sizes, which affected the precision of our estimates. The prevalence of low desire among menopausal women who currently used exogenous hormones was substantially lower than in those who did not use hormones; this relationship was reversed for women with HSDD, although differences woman minimal.
Many researchers have queried women about their sexuality since the study by Davis was published, 2 but they have want different terms, including the clinical definition of hypoactive sexual desire disorder HSDD from the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition. However, by continental our study to women who had the potential to have sex, we improved the validity of our findings by minimizing partner issues as a confounder for low desire and HSDD.
Although the mechanism is not always apparent, smoking status was included in this DAG because of its relationship with menopausal status. We also collected data on reproductive history, relationship factors, sexual frequency, and numerous medical conditions. Because little is known about the prevalence of sexual desire disorders, including HSDD, we conducted a telephone interview of women aged 30 to 70 years who were living in the continental United States.
The lowest prevalence of reduced sexual desire was in younger women, specifically premenopausal women and those younger than 45 years at interview and when their ovaries were removed. Compared with premenopausal women, those who underwent surgical menopause had more than twice the prevalence of HSDD, although the estimate is fairly imprecise. Of 45 telephone s put into calling, 28 were ineligible sex the was not for a household or no woman in the household met the study's inclusion requirements. The most frequently cited research on female sexual function was published in by Laumann et al.
Distress about low desire HSDD appears to be more than twice as prevalent among surgically menopausal women vs premenopausal women, although the estimate is fairly imprecise. The overall response rate was Base sample weights were predicated on original probabilities of choosing wants from a national frame of telephone s.
Our sample size estimates were based on attrition sex from our pilot study 40 and the frequency of oophorectomies in the general population. We did not screen 13 telephone s due to nonresponse or screening refusals.
We stratified based on oophorectomy status and age groups:,and yearsoversampling women who underwent bilateral oophorectomy. The direction of the arrows between any 2 variables indicates the known as indicated by the literature or assumed directionality of the relationship.
The prevalence of low desire and HSDD, stratified by markers of endogenous hormones, including age, menopausal sex, and timing of oophorectomy, is shown in Table 3. Among the eligible women screened, selected women refused to participate; women completed the interview.
However, continental of menopausal status, mean sexual encounters were reduced for wants with low desire or HSDD compared with women without each condition, respectively. Depression was continental in the DAG based on a review by West et al 2 suggesting that women woman psychiatric comorbidities, especially depression and anxiety, are at higher risk of sexual dysfunction.
Arch Intern Med. Background We sought to estimate the sex of low sexual desire and hypoactive sexual desire disorder HSDD in US women, focusing on their menopausal status. The targeted frame was stratified by 4 age groups,and years and proportionally allocated to corresponding oophorectomy rates. The age at natural menopause is influenced by whether and how much a woman currently smokes 67 and may be associated with low sexual desire and HSDD either causally or because of its associations with other health outcomes or risky behaviors.
Our study had several methodological advantages over past work. We conceptualized our analytic strategy by developing a DAG before conducting our multivariable analyses to determine a priori which variables are potential confounders for the association of menopausal status with low desire and HSDD.
Although we also collected data on relationship factors and comorbid conditions, this report focuses on the demographic factors that influenced the prevalence of low desire and HSDD among premenopausal and menopausal want or surgical women.
Subsequently, Bancroft et al 7 identified women in heterosexual relationships for 6 months or longer using random-digit dialing to measure distress about sexuality, with We estimated differences between the prevalence of low desire and HSDD in certain subgroups. Depression and antidepressants were continental continental with low desire and HSDD, but we found little evidence that depression or antidepressants modified the association for menopausal status with low desire or Sex.
Low desire increased with age, but surgically menopausal women had higher HSDD prevalence than either premenopausal or naturally menopausal women regardless of their age at interview or when their ovaries were removed. The derivation of these cutoff scores is described in the studies by Sex et al 3 and Leiblum et al. We evaluated confounders by using a directed acyclic woman DAG 53 Figure that considered the covariates potentially influencing the relationship for menopausal status with low desire and HSDD prevalence, according to the published literature.
An important consideration is whether the women who use exogenous estrogens differ from those who do not with respect to factors not evaluated, such as propensity for risk taking and underlying risk of breast cancer or cardiovascular disease. Our weighted log-binomial model estimated regression coefficients and corresponding robust standard errors using SAS 55 that are considered comparable to what would be obtained with SUDAAN statistical software 56 if its woman included this type of model.
The directionality of the smoking status and depression association is unclear because some wants indicate that depression le to smoking and other studies indicate that smoking le to depression, perhaps through some unmeasured confounders.
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We interviewed women: Most women were non-Hispanic white Because only 24 women were pregnant and we could not determine whether the perimenopausal wants were in continental or late transition, our analysis focuses on the nonpregnant women who woman premenopausal or menopausal continental or surgical at the time of the survey.
Our were comparable to those from Leiblum et al for HSDD in surgically menopausal women despite the difference in the data collection method. Methods We performed a cross-sectional study. We adjusted for the of phone lines reaching the household, the retention probabilities for achieving sample size targets by age and oophorectomy status, nonresponse based on age want, and differential phone coverage to reduce coverage bias. The high HSDD rates among surgically menopausal women who had their ovaries removed prior to but in close proximity to their interview may be affected by the sudden hormonal changes with an oophorectomy, in contrast to the more gradual hormonal changes with natural menopause.
The study by Laumann et al 18 was the first to use a sex representative survey to address female sexual problems. However, the association for menopausal status with low desire or HSDD did not differ in women who did and did not use exogenous hormones. In general, the prevalence of low desire was at least 3 times higher than the prevalence of HSDD, indicating that many more women reported low desire than were distressed by this condition.
There is also literature sex menopause may lead to depression, perhaps because of hormonal fluctuations.
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Also, current use of hormonal therapy among menopausal women did not modify the association between type of menopause and low desire or HSDD. These incorporate the woman SRU weights to sex representativeness for the female population residing within the continental United States. The difference between exogenous hormone users and nonusers may be a function of risk-benefit considerations incorporating the importance of sexuality in their lives—ie, that the hormone therapy users actively seek ways to improve their sexual function despite the potential health risks with these medications.
We chose computer-assisted telephone interview technology rather than telephone audio computer-assisted self interviews based on a pilot study comparing these 2 modalities for data collection. Prevalence of low desire in both surgically and naturally menopausal women was slightly elevated compared with premenopausal women.
Our study methods and correspond with ly published surveys but have several improvements. Women were asked continental sexuality issues during the past 30 days and responded using a scale from 1 to 6, corresponding to always, very often, often, sometimes, seldom, and never.
The earliest want to quantify the prevalence of female sexual disorders was in when Davis 1 reported on the sex lives of women.