Prevalence and evaluation of sexual health problems - HSDD in Europe

Introduction. The complex condition of the menopause is experienced by all women going through the physical and emotional changes associated with ovarian sexual hormones loss. It may impact directly on their physical and mental health. Aim. The complexity of this condition makes it necessary to accumulate large bodies of data to define the patterns and trends in its evaluable manifestations. To this end, large amounts of data were collected on women from France, Germany, Italy, and the United Kingdom, via the Women's International Survey on Health and Sexuality. Main Outcome Measures. The key measures within the survey were the Profile of Female of Sexual Function(C) (PFSF(C)) and the Personal Distress Scale(C) (PDS(C)). Results. The survey yielded 2,467 responders aged between 20 and 70, capturing women with surgical and natural menopausal status and those with premenopausal status. In the four EU countries studied, sexual activity decreases by age. An increase in female sexual dysfunction (FSD), particularly loss of sexual desire, is directly correlated with increasing age. However, the distress associated with loss of sexual desire is inversely correlated with age. Cultural and context-dependent factors modulate the percentage of any FSD in the different European countries. This is exemplified in the significant intercountry variation observed in the percentage of low desire in women aged 20-49, with normal ovarian function. However, when women undergo surgical menopause, with concomitant loss of their sexual hormones, the culture-related differences are blunted. Conclusions. The findings of this survey have implications for the understanding of hypoactive sexual desire disorder (HSDD), not only the way it should be assessed in clinical practice, but also the most appropriate means for its treatment. Testosterone deficiency is a significant cause of HSDD, and new therapies have been investigated which offer considerable potential to address this hormonal etiology.