Almost 50% of Australian women in midlife have poor sexual wellbeing, including a doubling of the likelihood of desire and arousal dysfunction in early perimenopause.

There has been substantial uncertainty regarding the prevalence of female sexual dysfunction (FSD) at midlife in women aged 40-69 years.  

A Monash University-led study believed to be the largest of its kind, has explored the prevalence of sexual difficulties and sexually related personal distress experienced in midlife women. 

The study involved 5,468 Australian women aged 40-69 years. Of the 5,468 participants, 2,583 had sexually related personal distress. Of these, one in four had a sexual dysfunction and one in four had sexually related distress without an identified sexual dysfunction. 

The study identified early perimenopause as a time of change in sexual wellbeing, highlighting the need for therapeutic options and best practice guidelines. 

“The importance of sexual wellbeing to overall health is often overlooked. One cannot dismiss the impact that sexual health has, not only on a woman’s intimate relationship, but most importantly on a woman’s general wellbeing,” said senior author Professor Susan Davis, head of the Monash University Women’s Health Research Program in the School of Public Health and Preventive Medicine.

FSD is associated with impaired wellbeing and quality of life, such that affected women are more likely to be depressed, and to report emotional and relationship stress and breakdown. 

In the study low sexual desire (13.3%), impaired arousal (13.1%), and poor sexual self-image (12.8%) were the most prevalent sexual dysfunctions. 

“Although our study revealed low desire and arousal to be the most prevalent sexual difficulties, participants with poor sexual self-image had the greatest likelihood of having associated distress,” said Professor Davis.

The greatest likelihood of estimated FSD was in participants aged 55-59 years, suggesting increasing age could be a key contributing factor to these associations, said Dr Yuanyuan Wan, first author on the study, also from the School of Public Health and Preventive Medicine

“The two-fold increase in the prevalence of desire, arousal and sexual self-image dysfunction among early perimenopausal participants, compared with premenopausal participants, highlights early perimenopause as a vulnerable period for the development of FSD,” said Professor Davis.

However, best practice guidelines for FSD in perimenopause were scarce, she said. Additionally, regulator-approved treatments for FSD are restricted to desire dysfunction and confined to either premenopausal or postmenopausal women.

“Given the observed prevalence of FSD in perimenopausal women, best practice guidelines and treatment options for perimenopausal women are much needed,” said Professor Davis.

The paper was published in The Lancet Obstetrics, Gynaecology, & Women’s Health, access here