Prevalence of Female Sexual Dysfunction among Premenopausal Women: A Systematic Review and Metaanalysis of Observational Studies

Introduction. Epidemiological research in female sexual dysfunction (FSD) has gained momentum in recent years, particularly in clinical populations and among women in menopausemenopausal women. However, sexual dysfunction also affects premenopausal women in general populations. Past literature reviews have been unable to quantify the burden of FSD in general populations. This has been due, in part, to varying definitions of dysfunction, heterogeneous study design, and the wide variety of measurement tools used. Aim. To provide a meta-analytical estimate of the prevalence of FSD among premenopausal women Methods. Observational studies which assessed the prevalence of FSD in premenopausal women were systematically sought in relevant databases (Jan 2000-July 2014). Publications which reported the prevalence rate for at least one domain of FSD were included. A meta-analysis of prevalence rates was performed and a meta-regression was used to analyze factors of study design. Main Outcome Measures. Estimated prevalence rates of FSD and its domains (hypoactive sexual desire disorder, sexual aversion disorder, female sexual arousal disorder, lubrication difficulties, female orgasmic disorder, pain disorders) Results. After screening 9292 results, 440 publications were retrieved for full text review. Of these, 135 studies were included in the systematic review. Ninety-five of these studies were further assessed in a meta-analysis. There was substantial heterogeneity among the studies. The prevalence of FSD among premenopausal women was estimated to be 40.9% (95% CI: 37.1;44.7, I²=99.0%). Prevalence rates of the individual sexual disorders ranged between 20.6% (lubrication difficulties) and 28.2% (hypoactive sexual desire disorder). Further analyses revealed significantly higher rates of FSD in studies in Africa, studies using non-validated assessment tools and studies without pharmaceutical funding. Conclusions. Prevalence estimates of FSD vary substantially. Still, results show that FSD is a significant public health problem which affects 41% of premenopausal women around the globe. More research and improved standardization are needed in this field. Systematic review registration. PROSPERO: CRD4201400952