Women’s Sexual Desire and Arousal Disorders

Lori A. Brotto, PhD, Johannes Bitzer, MD, PhD, Ellen Laan, PhD, Sandra Leiblum, PhD, and Mijal Luria, MD

Correction for The Journal of Sexual Medicine2008;7(1):586–614.

The last entry on Table 2 on page 590 was formatted incorrectly. Below is the table as it should have appeared:

Table 2

Prevalence of sexual desire and arousal difficulties in cross-sectional representative studies

StudySample characteristicsAgeIn a sexual relationshipDistress measuredPrevalence of desire difficultiesPrevalence of arousal difficulties
Laumann et al. [36]1,749 American women (NHSLS)18–59Had to be sexually active over the past 12 monthsNo27–32% Critical symptom for diagnosis had to be present in the past 12 months20.6% trouble lubricating
Fugl-Meyer and Fugl-Meyer [37]1,335 Swedish women18–74Not necessaryIndirectly with the question: “Has this been a problem in your sexual life during the last year?”Sexual disability was defined as having low desire quite often/nearly all the time/all the time=34%. Among these, 43% viewed it as a problem. Symptom had to have occurred in the past 12 monthsSexual disability was defined as having insufficient vaginal lubrication during intercourse quite often/nearly all the time/all the time=12%. Among these, 63% viewed it as a problem.
Mercer et al. [38]11,161 British men and women (NATSAL)16–44Must have had at least one partner in past yearNoLow desire lasting 1 month: 40%; lasting 6 months: 10%Lubrication problems lasting 1 month: 9.2%; lasting 6 months: 2.6%
Bancroft et al. [28]987 American women; half were African-American20–65Not necessaryAssessed distress over the relationship and distress to one’s own sexualityLow desire: 7.2%
Sexual experiences over the preceding month were assessed
Lubrication problems: 31.2%; Impaired arousal: 12.2%
Oberg et al. [26]1,056 Swedish women recruited in 199619–65Must have had sexual intercourse once in past yearManifest distress: experienced quite often, nearly all the time, or all of the timeLow desire: Manifest—29%; Mild—60%
Symptoms were assessed over the previous 12 months
Insufficient lubrication: Manifest—12%; Mild—50%
Laumann et al. [39]13,882 women recruited internationally. Analyses based on 9,000 sexually active women (GSSAB)40–80Must have had sexual intercourse once in past yearNo26–43% across countries reported a lack of interest in sex lasting for a period of 2 months or more16.1–37.9% across countries
Leiblum et al. [40]952 American surgically or naturally women (WISHeS)20–70Currently sexually activePersonal Distress Scale24–36% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 9% to 26%. Symptoms occurring in the past 30 days were assessedn/a
Dennerstein et al. [41]2,467 European women from France, Germany, Italy, UK, and United States (WISHeS)20–70Currently sexually activePersonal Distress Scale16–46% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 7% to 16%. Symptoms occurring in the past 30 days were assessedn/a
West et al. [42]755 American premenopausal, 552 naturally menopausal, and 637 surgically menopausal women30–70In stable relationships for at least 3 monthsPersonal Distress ScaleOverall rate of low desire 36.2%. Overall rate of HSDD 8.3%. Symptoms in the past 30 days were assessedn/a
Witting et al. [43]5,463 Finnish women18–49Must have engaged in sexual activity with a partner over the past 4 weeks.Female Sexual Distress Scale (FSDS)Using FSFI cut-off score of 3.16, 55% had low desire. Using FSDS cut-off score of 8.75, 23% had low desire and distress. Symptoms were assessed in the past 4 weeksUsing FSFI cut-off score of 4.31, 10.9% had lubrication difficulties. Using FSDS cut-off score, 7% had lubrication problem plus distress.
Shifren et al. [27]13,581 women United States18–102Not necessarySexual desire assessed with one question: “How often do you desire to engage in sexual activity?” Distress assessed by FSDS38.7% had low desire, overall. Between 7.4%–12.3%, across ages, had low desire and distress.26.1% had low arousal, overall. Between 3.3%–7.5%, across ages, had low arousal and distress.
StudySample characteristicsAgeIn a sexual relationshipDistress measuredPrevalence of desire difficultiesPrevalence of arousal difficulties
Laumann et al. [36]1,749 American women (NHSLS)18–59Had to be sexually active over the past 12 monthsNo27–32% Critical symptom for diagnosis had to be present in the past 12 months20.6% trouble lubricating
Fugl-Meyer and Fugl-Meyer [37]1,335 Swedish women18–74Not necessaryIndirectly with the question: “Has this been a problem in your sexual life during the last year?”Sexual disability was defined as having low desire quite often/nearly all the time/all the time=34%. Among these, 43% viewed it as a problem. Symptom had to have occurred in the past 12 monthsSexual disability was defined as having insufficient vaginal lubrication during intercourse quite often/nearly all the time/all the time=12%. Among these, 63% viewed it as a problem.
Mercer et al. [38]11,161 British men and women (NATSAL)16–44Must have had at least one partner in past yearNoLow desire lasting 1 month: 40%; lasting 6 months: 10%Lubrication problems lasting 1 month: 9.2%; lasting 6 months: 2.6%
Bancroft et al. [28]987 American women; half were African-American20–65Not necessaryAssessed distress over the relationship and distress to one’s own sexualityLow desire: 7.2%
Sexual experiences over the preceding month were assessed
Lubrication problems: 31.2%; Impaired arousal: 12.2%
Oberg et al. [26]1,056 Swedish women recruited in 199619–65Must have had sexual intercourse once in past yearManifest distress: experienced quite often, nearly all the time, or all of the timeLow desire: Manifest—29%; Mild—60%
Symptoms were assessed over the previous 12 months
Insufficient lubrication: Manifest—12%; Mild—50%
Laumann et al. [39]13,882 women recruited internationally. Analyses based on 9,000 sexually active women (GSSAB)40–80Must have had sexual intercourse once in past yearNo26–43% across countries reported a lack of interest in sex lasting for a period of 2 months or more16.1–37.9% across countries
Leiblum et al. [40]952 American surgically or naturally women (WISHeS)20–70Currently sexually activePersonal Distress Scale24–36% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 9% to 26%. Symptoms occurring in the past 30 days were assessedn/a
Dennerstein et al. [41]2,467 European women from France, Germany, Italy, UK, and United States (WISHeS)20–70Currently sexually activePersonal Distress Scale16–46% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 7% to 16%. Symptoms occurring in the past 30 days were assessedn/a
West et al. [42]755 American premenopausal, 552 naturally menopausal, and 637 surgically menopausal women30–70In stable relationships for at least 3 monthsPersonal Distress ScaleOverall rate of low desire 36.2%. Overall rate of HSDD 8.3%. Symptoms in the past 30 days were assessedn/a
Witting et al. [43]5,463 Finnish women18–49Must have engaged in sexual activity with a partner over the past 4 weeks.Female Sexual Distress Scale (FSDS)Using FSFI cut-off score of 3.16, 55% had low desire. Using FSDS cut-off score of 8.75, 23% had low desire and distress. Symptoms were assessed in the past 4 weeksUsing FSFI cut-off score of 4.31, 10.9% had lubrication difficulties. Using FSDS cut-off score, 7% had lubrication problem plus distress.
Shifren et al. [27]13,581 women United States18–102Not necessarySexual desire assessed with one question: “How often do you desire to engage in sexual activity?” Distress assessed by FSDS38.7% had low desire, overall. Between 7.4%–12.3%, across ages, had low desire and distress.26.1% had low arousal, overall. Between 3.3%–7.5%, across ages, had low arousal and distress.

NHSLS=National Health and Social Life Survey; NATSAL=National Survey of Sexual Attitudes and Lifestyle; n/a=not applicable; GSSAB=Global Study of Sexual Attitudes and Behaviors; WISHeS=Women’s International Study of Health and Sexuality; HSDD=hypoactive sexual desire disorder.

Table 2

Prevalence of sexual desire and arousal difficulties in cross-sectional representative studies

StudySample characteristicsAgeIn a sexual relationshipDistress measuredPrevalence of desire difficultiesPrevalence of arousal difficulties
Laumann et al. [36]1,749 American women (NHSLS)18–59Had to be sexually active over the past 12 monthsNo27–32% Critical symptom for diagnosis had to be present in the past 12 months20.6% trouble lubricating
Fugl-Meyer and Fugl-Meyer [37]1,335 Swedish women18–74Not necessaryIndirectly with the question: “Has this been a problem in your sexual life during the last year?”Sexual disability was defined as having low desire quite often/nearly all the time/all the time=34%. Among these, 43% viewed it as a problem. Symptom had to have occurred in the past 12 monthsSexual disability was defined as having insufficient vaginal lubrication during intercourse quite often/nearly all the time/all the time=12%. Among these, 63% viewed it as a problem.
Mercer et al. [38]11,161 British men and women (NATSAL)16–44Must have had at least one partner in past yearNoLow desire lasting 1 month: 40%; lasting 6 months: 10%Lubrication problems lasting 1 month: 9.2%; lasting 6 months: 2.6%
Bancroft et al. [28]987 American women; half were African-American20–65Not necessaryAssessed distress over the relationship and distress to one’s own sexualityLow desire: 7.2%
Sexual experiences over the preceding month were assessed
Lubrication problems: 31.2%; Impaired arousal: 12.2%
Oberg et al. [26]1,056 Swedish women recruited in 199619–65Must have had sexual intercourse once in past yearManifest distress: experienced quite often, nearly all the time, or all of the timeLow desire: Manifest—29%; Mild—60%
Symptoms were assessed over the previous 12 months
Insufficient lubrication: Manifest—12%; Mild—50%
Laumann et al. [39]13,882 women recruited internationally. Analyses based on 9,000 sexually active women (GSSAB)40–80Must have had sexual intercourse once in past yearNo26–43% across countries reported a lack of interest in sex lasting for a period of 2 months or more16.1–37.9% across countries
Leiblum et al. [40]952 American surgically or naturally women (WISHeS)20–70Currently sexually activePersonal Distress Scale24–36% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 9% to 26%. Symptoms occurring in the past 30 days were assessedn/a
Dennerstein et al. [41]2,467 European women from France, Germany, Italy, UK, and United States (WISHeS)20–70Currently sexually activePersonal Distress Scale16–46% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 7% to 16%. Symptoms occurring in the past 30 days were assessedn/a
West et al. [42]755 American premenopausal, 552 naturally menopausal, and 637 surgically menopausal women30–70In stable relationships for at least 3 monthsPersonal Distress ScaleOverall rate of low desire 36.2%. Overall rate of HSDD 8.3%. Symptoms in the past 30 days were assessedn/a
Witting et al. [43]5,463 Finnish women18–49Must have engaged in sexual activity with a partner over the past 4 weeks.Female Sexual Distress Scale (FSDS)Using FSFI cut-off score of 3.16, 55% had low desire. Using FSDS cut-off score of 8.75, 23% had low desire and distress. Symptoms were assessed in the past 4 weeksUsing FSFI cut-off score of 4.31, 10.9% had lubrication difficulties. Using FSDS cut-off score, 7% had lubrication problem plus distress.
Shifren et al. [27]13,581 women United States18–102Not necessarySexual desire assessed with one question: “How often do you desire to engage in sexual activity?” Distress assessed by FSDS38.7% had low desire, overall. Between 7.4%–12.3%, across ages, had low desire and distress.26.1% had low arousal, overall. Between 3.3%–7.5%, across ages, had low arousal and distress.
StudySample characteristicsAgeIn a sexual relationshipDistress measuredPrevalence of desire difficultiesPrevalence of arousal difficulties
Laumann et al. [36]1,749 American women (NHSLS)18–59Had to be sexually active over the past 12 monthsNo27–32% Critical symptom for diagnosis had to be present in the past 12 months20.6% trouble lubricating
Fugl-Meyer and Fugl-Meyer [37]1,335 Swedish women18–74Not necessaryIndirectly with the question: “Has this been a problem in your sexual life during the last year?”Sexual disability was defined as having low desire quite often/nearly all the time/all the time=34%. Among these, 43% viewed it as a problem. Symptom had to have occurred in the past 12 monthsSexual disability was defined as having insufficient vaginal lubrication during intercourse quite often/nearly all the time/all the time=12%. Among these, 63% viewed it as a problem.
Mercer et al. [38]11,161 British men and women (NATSAL)16–44Must have had at least one partner in past yearNoLow desire lasting 1 month: 40%; lasting 6 months: 10%Lubrication problems lasting 1 month: 9.2%; lasting 6 months: 2.6%
Bancroft et al. [28]987 American women; half were African-American20–65Not necessaryAssessed distress over the relationship and distress to one’s own sexualityLow desire: 7.2%
Sexual experiences over the preceding month were assessed
Lubrication problems: 31.2%; Impaired arousal: 12.2%
Oberg et al. [26]1,056 Swedish women recruited in 199619–65Must have had sexual intercourse once in past yearManifest distress: experienced quite often, nearly all the time, or all of the timeLow desire: Manifest—29%; Mild—60%
Symptoms were assessed over the previous 12 months
Insufficient lubrication: Manifest—12%; Mild—50%
Laumann et al. [39]13,882 women recruited internationally. Analyses based on 9,000 sexually active women (GSSAB)40–80Must have had sexual intercourse once in past yearNo26–43% across countries reported a lack of interest in sex lasting for a period of 2 months or more16.1–37.9% across countries
Leiblum et al. [40]952 American surgically or naturally women (WISHeS)20–70Currently sexually activePersonal Distress Scale24–36% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 9% to 26%. Symptoms occurring in the past 30 days were assessedn/a
Dennerstein et al. [41]2,467 European women from France, Germany, Italy, UK, and United States (WISHeS)20–70Currently sexually activePersonal Distress Scale16–46% depending on age and menopausal status. Among those who also had distress, rates of HSDD ranged from 7% to 16%. Symptoms occurring in the past 30 days were assessedn/a
West et al. [42]755 American premenopausal, 552 naturally menopausal, and 637 surgically menopausal women30–70In stable relationships for at least 3 monthsPersonal Distress ScaleOverall rate of low desire 36.2%. Overall rate of HSDD 8.3%. Symptoms in the past 30 days were assessedn/a
Witting et al. [43]5,463 Finnish women18–49Must have engaged in sexual activity with a partner over the past 4 weeks.Female Sexual Distress Scale (FSDS)Using FSFI cut-off score of 3.16, 55% had low desire. Using FSDS cut-off score of 8.75, 23% had low desire and distress. Symptoms were assessed in the past 4 weeksUsing FSFI cut-off score of 4.31, 10.9% had lubrication difficulties. Using FSDS cut-off score, 7% had lubrication problem plus distress.
Shifren et al. [27]13,581 women United States18–102Not necessarySexual desire assessed with one question: “How often do you desire to engage in sexual activity?” Distress assessed by FSDS38.7% had low desire, overall. Between 7.4%–12.3%, across ages, had low desire and distress.26.1% had low arousal, overall. Between 3.3%–7.5%, across ages, had low arousal and distress.

NHSLS=National Health and Social Life Survey; NATSAL=National Survey of Sexual Attitudes and Lifestyle; n/a=not applicable; GSSAB=Global Study of Sexual Attitudes and Behaviors; WISHeS=Women’s International Study of Health and Sexuality; HSDD=hypoactive sexual desire disorder.