Do Sexual Desire Problems Cause Distress?

October 16, 2014

Sexual desire problems in midlife women are common, but of key importance is determining whether they cause distress, says Raymond Rosen, PhD.

[[{"type":"media","view_mode":"media_crop","fid":"28522","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_7450073414947","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2904","media_crop_rotate":"0","media_crop_scale_h":"104","media_crop_scale_w":"75","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; float: right;","title":"Raymond C. Rosen, PhD","typeof":"foaf:Image"}}]]In the initial plenary session of the 25th Annual Meeting of The North American Menopause Society, the topic of focus was low libido in midlife women. The first speaker was Raymond Rosen, PhD, chief scientist of the New England Research Institutes, Inc, in Watertown, Mass, who is an expert of sexual dysfunction in men and women. Today, Rosen discussed the epidemiology of sexual problems at midlife.

He emphasized that sexual problems are widespread among aging women, but of key importance is whether women experience distress because of this sexual dysfunction.

6 Concepts to Consider

1. Sexual desire problems are the most frequent sexual dysfunction, with no distinction for age or socioeconomic status.

2. Lubrication and arousal difficulties are common and distressing in estrogen-deficient women. Many women want to remain sexually active, and their level of distress tends to vary with age and relationship status.

3. Lubrication and arousal difficulties are common in estrogen-deficient women. This can be extremely distressing for women, especially when pain or bleeding accompanies penetration.

4. Only a small minority of women seek help for sexual problems. Rosen suggested that this may be because of a lack of approved treatments. There is also probably embarrassment and a stigma associated with this as well.

5 Long-term sexual problems are associated with a loss of well-being, relationship dissatisfaction, and lower health-related quality of life, Rosen said.

6. Unmet medical need is persistent and noteworthy. In this aspect, sexual problems in women are under-recognized and widely underserved.

What the Data Show

Rosen pointed out that data show that women generally don't discuss sexual problems with their clinician (22% of women older than 50 vs 38% of men). And just 1% of women reported receiving treatment for sexual dysfunction (vs 14% of men). Considering that 43% of women report having low desire, this is startling. 

Research has also taught us that of self-reported sexual problems, low desire is the most prevalent. And it's a problem that women of all races experience, said Rosen, with about 10% of women across all races experiencing both low desire and distress. 

VVA Makes Things Worse

Women with sexual dysfunction were nearly 4 times more likely to report vulvovaginal atrophy than women without sexual dysfunction. Also, arousal difficulties and a lack of lubrication occurred nearly 8 times more often in women with VVA, cited Rosen.

VVA is strongly and reliably associated with all components of sexual response, said Rosen. He pointed out that more than 50% of postmenopausal women have dyspareunia related to vaginal dryness, which often leads to loss of arousal and desire that becomes a long-term problem with multiple adverse consequences. For example, more than 80% of women with VVA report lubrication difficulties with intercourse. And in a study that included 1000 couples, 78% of male partners cited VVA as the cause for loss of intimacy with their partners.

Together, these findings reveal an urgent need for a validated symptom measure for VVA and a standardized diagnostic assessment tool, said Rosen. He did say that he anticipates that more women will begin discussing these issues, since Baby Boomers in general care about quality of life, which includes a healthy sex life.