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Hypoactive sexual desire dysfunction in community-dwelling older women

Zeleke, Berihun M. MD, MPH; Bell, Robin J. MBBS, MPH, PhD, FAFPHM; Billah, Baki BSc(Hons), MSc, MAS, PhD; Davis, Susan R. MBBS, PhD, FRACP

doi: 10.1097/GME.0000000000000767
Original Articles

Objective: To determine the prevalence of hypoactive sexual desire dysfunction (HSDD) and its associated factors in women aged 65 to 79 years.

Methods: A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on electoral rolls. Sexual function and sexual distress were assessed by the Female Sexual Function Index and the Female Sexual Distress Scale-Revised, respectively. HSDD was defined as the presence of both low sexual desire and sexually related personal distress.

Results: The mean ± SD age of the 1,548 women was 71 ± 3.4 years and 52.6% were partnered. Among the participants, 88.0% (95% confidence interval [CI], 86.3%-89.6%) had low sexual desire, 15.5% (95% CI, 13.8%-17.4%) had sexually related personal distress, and 13.6% (95% CI, 11.9%-15.4%) had HSDD. The HSDD was more common among partnered than among unpartnered women (23.7% vs 5.9%; P < 0.001). Being partnered (adjusted odds ratio [AOR] = 4.21; 95% CI, 2.50-7.07), having vaginal dryness during intercourse (AOR = 2.37; 95% CI, 1.58-3.55), having symptomatic pelvic floor dysfunction (AOR = 1.92; 95% CI, 1.29-2.92), and having moderate-to-severe depressive symptoms (AOR = 4.15; 95% CI, 2.16-7.96) were independently associated with having HSDD. In a subanalysis, HSDD was more common among sexually active than sexually inactive women (31.5% vs 17.3%; P < 0.001). Furthermore, 32% (95% CI, 27.7%-38.3%) of partnered sexually active women had HSDD, as did 22% (95% CI, 11.5%-37.8%) of unpartnered sexually active women.

Conclusions: HSDD is common and associated with potentially modifiable risk factors in older women. It should not be assumed that unpartnered older women are sexually inactive or are not distressed by low sexual desire.

1Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

2Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

3Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Address correspondence to: Susan R. Davis, MBBS, FRACP, PhD, Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia. E-mail:

Received 10 July, 2016

Revised 29 August, 2016

Accepted 29 August, 2016

Funding/support: The study was supported by an International Menopause Society Research Bursary.

Financial disclosure/conflicts of interest: S.R.D. has received honoraria from Abbott and Pfizer Pharmaceuticals and has research support from Lawley Pharmaceuticals. B.M.Z. is supported by a Monash University Postgraduate Research Scholarship and S.R.D. is an Australian National Health and Medical Research Council (NHMRC) Principal Research Fellow (Grant no. 1041853). The remaining authors have no disclosures.

© 2017 by The North American Menopause Society.