Results of May survey 2006

The hypoactive sexual desire disorder is probably the most frequently observed female sexual dysfunction in the clinical practice. It is:

1) most frequent in postmenopausal women (>50 y.o.), where organic factors (e.g. hormonal factors, hysterectomy) may often be present: Percentage of answers: 50,0%
2) most frequent in younger patients, due mainly to interpersonal problems: Percentage of answers: 0,0%
3) most frequent just in the menopausal years, but far less prevalent in the decades before and after menopause: Percentage of answers: 33,4%
4) almost equally frequent in all age groups, although probably caused by different aetiologies in different decades: Percentage of answers: 16,6%

Comments

In contrast with the common belief (answer 1) that the lack of sexual interest is a quite exclusive problem of the post menopausal woman, due to physiological and hormonal changes, some studies support a high prevalence of hypoactive sexual desire also in younger decades. Laumann et al. showed that the prevalence of this dysfunction is almost constant during all the life, being as high as 32% in women aged 18-29, and slightly declining to 27% in those aged 50-59 [1]. Furthermore, the lack of sexual desire has been reported as the most frequent sexual concern, together with orgasm difficulty, not only in > 65 y.o but also in <65 y.o. women [2].
Of course, different causes are expected to support this hypoactive desire in the different decades, and probably in younger women a lot more interpersonal factors are present , whereas physical/hormonal changes linked to the menopause play the main role in the older decades.
Definitely, menopause is a “high risk” phase for the development of hypoactive sexual desire, and the loss of libido is reported, together with vaginal dyspareunia, as the most frequent menopause-related change in sexual functioning [3]. However, a worsening of sexual function is not consistently observed, and while 45% of women report a decrease of sexual desire with the onset of menopause, 37% are unchanged and 10% report an increase of libido.

References

1. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. Jama 1999;281: 537-44.

2. Nusbaum MR, Singh AR, Pyles AA. Sexual healthcare needs of women aged 65 and older. J Am Geriatr Soc 2004;52: 117-22.

3. Dennerstein L, Dudley E, Burger H. Are changes in sexual functioning during midlife due to aging or menopause? Fertil Steril 2001;76:456-60.