06 Dec Sexual function problems are common but distress about them much less so
MedicalResearch.com Interview with:
Dr Kirstin R Mitchell PhD
Lecturer in Sexual and Reproductive Health
Dept of Social and Environmental Health Research
Faculty of Public Health & Policy
London School of Hygiene and Tropical Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Mitchell: We explored the distribution of sexual function in the British population using a probability sample survey (the third National Survey of Sexual Attitudes and Lifestyles [Natsal-3]) of 15 162 individuals aged 16–74 years. We measured sexual function using the Natsal-SF, a novel validated measure, which assessed problems with individual sexual response, sexual function in a relationship context, and self-appraisal of sex life.
Men and women in the oldest age groups surveyed (55 – 74) were more likely to have low overall sexual function than those in the youngest age group (16 – 24). After taking account of age differences, low sexual function was associated in both men and women with being unemployed, with current depression, and with poor general health. It was also associated with higher numbers of lifetime partners (women only), paying for sex (men only), and reporting same-sex partners, as well as with other aspects of sexual health, such as being diagnosed with an STI and experiencing sex against their will.
Low sexual function was associated with relationship breakdown, and with people not being happy with their relationship. Within relationships, the most common problem was an imbalance in level of interest in sex between partners, which affected around a quarter of both men and women. Just under one in five men and women said their partner had experienced sexual difficulties in the last year, and this proportion increased with age, particularly among women.
Lack of interest in sex was one of the most commonly reported problems for both men and women, affecting three in every twenty (15%) men, and with women twice as likely as men to say that this had been an issue in the last year. Difficulty reaching climax (16%) and vaginal dryness (13%) were among common problems for women; and reaching a climax more quickly than desired (15%), and difficulty getting or keeping an erection (13%) among men.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Mitchell: Sexual dissatisfaction and avoidance of sex were higher among those who did not have sex in the past year than among those who did, but we were surprised to find that the majority of individuals who had not had sex in the past year reported no distress or dissatisfaction and had not avoided sex because of sexual difficulties. This cautions against assuming that sexual inactivity is necessarily problematic.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Mitchell: Sexual function is closely linked with other aspects of sexual health and with aspects of life stage and life events. It deserves to be given greater priority in sexual health policy.
Sexual function problems are common but distress about them is much less so. Although 42% of men and 51% of women report one or more problem with sexual function lasting three months or more in the last year, only about 10% report being distressed about their sex life.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Mitchell: In public health research and policy, sexual function tends to be overlooked as a component of sexual health. In future, we recommend greater efforts to include sexual function as an explanatory or outcome variable in epidemiological research. Sexual function could be included in quality of life measures or as an endpoint in studies assessing the success of sexual health interventions.
Our data highlight the fact that we need to take account of the personal significance of sexual problems for men and women, and their partners. We hope that this study will encourage a move away from ways of measuring sexual function that over-medicalise sexual problems, towards one that takes into account the relationship in which they occur, and the level of personal dissatisfaction and distress they cause.
Dr Kirstin R Mitchell PhD,Catherine H Mercer PhD,George B Ploubidis PhD,Kyle G Jones MSc,Jessica Datta MSc,Nigel Field MBPhD,Andrew J Copas PhD,Clare Tanton PhD,Bob Erens MA,Pam Sonnenberg PhD,Soazig Clifton BSc,Wendy Macdowall MSc,Andrew Phelps BA,Prof Anne M Johnson MD,Prof Kaye Wellings FRCOG
The Lancet – 30 November 2013 ( Vol. 382, Issue 9907, Pages 1817-1829 )