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

摘要

Introduction. Epidemiological research in female sexual dysfunction (FSD) has gained momentum in recent years,\udparticularly in clinical populations and among women in menopausemenopausal women. However, sexual dysfunction\udalso affects premenopausal women in general populations. Past literature reviews have been unable to quantify the\udburden of FSD in general populations. This has been due, in part, to varying definitions of dysfunction, heterogeneous\udstudy design, and the wide variety of measurement tools used.\ud\udAim. To provide a meta-analytical estimate of the prevalence of FSD among premenopausal women\udMethods. Observational studies which assessed the prevalence of FSD in premenopausal women were systematically\udsought in relevant databases (Jan 2000-July 2014). Publications which reported the prevalence rate for at least one\uddomain of FSD were included. A meta-analysis of prevalence rates was performed and a meta-regression was used to\udanalyze factors of study design.\ud\udMain Outcome Measures. Estimated prevalence rates of FSD and its domains (hypoactive sexual desire disorder,\udsexual aversion disorder, female sexual arousal disorder, lubrication difficulties, female orgasmic disorder, pain\uddisorders)\ud\udResults. After screening 9292 results, 440 publications were retrieved for full text review. Of these, 135 studies were\udincluded in the systematic review. Ninety-five of these studies were further assessed in a meta-analysis. There was\udsubstantial heterogeneity among the studies. The prevalence of FSD among premenopausal women was estimated to be\ud40.9% (95% CI: 37.1;44.7, I²=99.0%). Prevalence rates of the individual sexual disorders ranged between 20.6%\ud(lubrication difficulties) and 28.2% (hypoactive sexual desire disorder). Further analyses revealed significantly higher\udrates of FSD in studies in Africa, studies using non-validated assessment tools and studies without pharmaceutical\udfunding.\ud\udConclusions. Prevalence estimates of FSD vary substantially. Still, results show that FSD is a significant public health\udproblem which affects 41% of premenopausal women around the globe. More research and improved standardization\udare needed in this field.\ud\udSystematic review registration. PROSPERO: CRD42014009526