Document Type : Original Article
Authors
Abstract
INTRODUCTION: Sexual dysfunctions are considered as the most prevalent problems in the general
population and their prevalence is so dispersed depending on different cultures and living conditions.
This research investigates the prevalence of sexual dysfunctions and their relevant factors in Tehran.
MATERIALS AND METHODS: In this cross-sectional questionnaire-based study, 1129 women and
men referring to health centers in 22 Districts of Tehran were selected using quota, stratified and
cluster sampling. Demographic questionnaire, female sexual function index (FSFI), and Brief Sexual
Function Inventory (BSFI) were used to collecting data.
DATA ANALYSIS: The data were analyzed using descriptive methods, and the findings were
compared using the Chi-square, analysis of variance, and independent t-tests.
RESULTS: Totally 561 women and 568 men with the average ages of 33/06 and 34/98 participated
in this study. In general, 77/6% of women and 35/6% of men complained about sexual problems.
The most prevalent problems in women were sexual desire dysfunction (45/3%) and arousal
dysfunction (38/85%), and the most prevalent problems in men were erection dysfunction (40/4%)
and then ejaculation dysfunction (32/5%). Prevalence rates of dysfunctions of orgasm, dyspareunia,
and vaginal dryness were, respectively, 9/2%, 9/0%, and 7/0%, and prevalence of sexual drive
dysfunction in men was 10/6%.
CONCLUSION: The prevalence of sexual problems in Iranian women is so much higher than the
global findings, and in men, this rate is somewhat higher than global prevalence. This difference can
be due to the culture and the chosen silence about sexuality and specially women’s sexuality in the
Iranian culture that requires extra attention to this area.
Keywords
- Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United
States: Prevalence and predictors. JAMA 1999;281:537‑44.
2. Moreira ED Jr., Brock G, Glasser DB, Nicolosi A, Laumann EO,
Paik A, et al. Help‑seeking behaviour for sexual problems: The
global study of sexual attitudes and behaviors. Int J Clin Pract
2005;59:6‑16.
3. Moreira ED, Glasser DB, Nicolosi A, Duarte FG, Gingell C;
GSSAB Investigators’ Group. Sexual problems and help‑seeking
behaviour in adults in the United Kingdom and continental
Europe. BJU Int 2008;101:1005‑11.
4. IsHak WW. The Textbook of Clinical Sexual Medicine. Cham:
Springer International Publishing; 2017.
5. Ishak IH, Low WY, Othman S. Prevalence, risk factors, and
predictors of female sexual dysfunction in a primary care setting:
A survey finding. J Sex Med 2010;7:3080‑7.
6. Aslan E, Beji NK, GungorI, Kadioglu A, Dikencik BK. Prevalence
and risk factors for low sexual function in women: A study of
1,009 women in an outpatient clinic of a university hospital in
Istanbul. J Sex Med 2008;5:2044‑52.
7. Basirnia A, Sahimi-Izadian E, Arbabi M, Bayay Z, Vahid-Vahdat S,
Noorbala AA, et al. Systematic review of prevalence of sexual
disorders in Iran. Iran J Psychiatry 2007;2:151-6.
8. Fourcroy JL. Female sexual dysfunction: Potential for
pharmacotherapy. Drugs 2003;63:1445‑57.
9. Mykletun A, Dahl AA, O’Leary MP, Fosså SD. Assessment of
male sexual function by the brief sexual function inventory. BJU
Int 2006;97:316‑23.
10. American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders (DSM-5®). US: American Psychiatric
Association Publishing; 2013.
11. Holmberg D, Blair KL, Phillips M. Women’s sexual satisfaction as a predictor of well‑being in same‑sex versus mixed‑sex
relationships. J Sex Res 2010;47:1‑1.
12. Laumann EO, Paik A, Glasser DB, Kang JH, Wang T, Levinson B,
et al. A cross‑national study of subjective sexual well‑being among
older women and men: Findings from the global study of sexual
attitudes and behaviors. Arch Sex Behav 2006;35:145‑61.
13. Lau JT, Kim JH, Tsui HY. Mental health and lifestyle correlates
of sexual problems and sexual satisfaction in heterosexual Hong
Kong Chinese population. Urology 2005;66:1271‑81.
14. Tiefer L. Beyond the medical model of women’s sexual problems:
A campaign to resist the promotion of female sexual dysfunction.
Sex Relation Ther 2002;17:127‑35.
15. McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD,
et al. Incidence and prevalence of sexual dysfunction in women
and men: A consensus statement from the fourth international
consultation on sexual medicine 2015. J Sex Med 2016;13:144‑52.
16. Fugl‑Meyer K, Fugl‑Meyer AR. Sexual disabilities are not
singularities. Int J Impot Res 2002;14:487‑93.
17. World Health Organization. Defining Sexual Health: Report of
a Technical Consultation on Sexual Health, 28‑31 January 2002.
Geneva: World Health Organization; 2006.
18. Goldstein I, Meston CM, Davis S, Traish A. Women’s Sexual
Function and Dysfunction: Study, Diagnosis and Treatment. US:
CRC Press; 2005.
19. Nasehi AA, Raisi F, Ghaeli P, Amini M, Yahyavi ST,
Arabkheradmand J, et al. Prevalence of sexual dysfunction among
general population of Iran: A systematic review. Iran J Psychiatry
Behav Sci 2017;11:e7643.
20. Lammerink EA, de Bock GH, Pascal A, van Beek AP, van den
Bergh AC, Sattler MG, et al. A survey of female sexual functioning
in the general Dutch population. J Sex Med 2017;14:937‑49.
21. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C,
Moreira E, et al. Sexual problems among women and men aged
40‑80 y: Prevalence and correlates identified in the global study
of sexual attitudes and behaviors. Int J Impot Res 2005;17:39‑57.
22. Nicolosi A, Laumann EO, Glasser DB, Moreira ED Jr., Paik A,
Gingell C. Sexual behavior and sexual dysfunctions after age
40: The global study of sexual attitudes and behaviors. Urology
2004;64:991‑7.
23. Moreira ED, Glasser DB, King R, Duarte FG, Gingell C; GSSAB
Investigators’ Group. Sexual difficulties and help‑seeking among
mature adults in Australia: Results from the global study of sexual
attitudes and behaviours. Sex Health 2008;5:227‑34.
24. Bancroft J, Loftus J, Long JS. Distress about sex: A national
survey of women in heterosexual relationships. Arch Sex Behav
2003;32:193‑208.
25. Lutfey KE, Link CL, RosenRC, Wiegel M, McKinlay JB. Prevalence
and correlates of sexual activity and function in women: Results
from the Boston Area Community Health (BACH) survey. Arch
Sex Behav 2009;38:514‑27.
26. Fajewonyomi BA, Orji EO, Adeyemo AO. Sexual dysfunction
among female patients of reproductive age in a hospital setting
in Nigeria. J Health Popul Nutr 2007;25:101‑6.
27. Nwagha UI, Oguanuo TC, Ekwuazi K, Olubobokun TO,
Nwagha TU, Onyebuchi AK, et al. Prevalence of sexual
dysfunction among females in a university community in Enugu,
Nigeria. Niger J Clin Pract 2014;17:791‑6.
28. Najman JM, Dunne MP, Boyle FM, Cook MD, Purdie DM. Sexual
dysfunction in the Australian population. Aust Fam Physician
2003;32:951‑4.
29. Richters J, Grulich AE, de Visser RO, Smith AM, Rissel CE. Sex in
Australia: Sexual difficulties in a representative sample of adults.
Aust N Z J Public Health 2003;27:164‑70.
30. Sidi H, Puteh SE, Abdullah N, Midin M. The prevalence of sexual
dysfunction and potential risk factors that may impair sexual
function in Malaysian women. J Sex Med 2007;4:311‑21.
31. Alimohammadi L, Mirghafourvand M, Zarei F, Pirzeh R. The
effectiveness of group counseling based on Bandura’s self‑efficacy
theory on sexual function and sexual satisfaction in Iranian
newlywed women: A randomized controlled trial. Appl Nurs
Res 2018;42:62‑9.
32. Mohammad‑Alizadeh‑Charandabi S, Mirghafourvand M,
Asghari‑Jafarabadi M, Tavananezhad N, Karkhaneh M.
Modeling of socio‑demographic predictors of sexual function
in women of reproductive age. J Mazandaran Univ Med Sci
2014;23:238‑42.
33. Ramezani MA, Ahmadi K, Ghaemmaghami A, Marzabadi EA,
Pardakhti F. Epidemiology of sexual dysfunction in Iran:
A systematic review and meta‑analysis. Int J Prev Med 2015;6:43.
34. Bolourian Z, Ganjloo J. Evaluating sexual dysfunction and some
related factors in women attending Sabzevar Health Care Centers.
J Reprod Infertil 2007;8:163-70. [Persian].
35. Bakouei F, Omidvar S, Nasiri F. Prevalence of female sexual
dysfunction in married women and its related factors (Babol
2006). J Babol Univ Med Sci 2007;9:59‑64.
36. Gashtasbi A, Rahimi Forooshani A, Mohamadi A. Sexual
dysfunction and its association with reproductive variables in
the Kohgiluye and Boyer Ahmad province. Payesh 2008;7:67‑73.
37. Safarinejad MR. Female sexual dysfunction in a population‑based
study in Iran: Prevalence and associated risk factors. Int J Impot
Res 2006;18:382‑95.
38. Avellanet YR, Ortiz AP, Pando JR, Romaguera J. Relationship
between loss of libido and signs and symptoms of depression in
a sample of Puerto Rican middle‑aged women. P R Health Sci J
2008;27:85‑91.
39. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual
problems and distress in United States women: Prevalence and
correlates. Obstet Gynecol 2008;112:970‑8.
40. Laumann EO, Glasser DB, Neves RC, Moreira ED Jr.; GSSAB
Investigators’ Group. A population‑based survey of sexual
activity, sexual problems and associated help‑seeking behavior
patterns in mature adults in the United States of America. Int J
Impot Res 2009;21:171‑8.
41. Osborn M, Hawton K, Gath D. Sexual dysfunction among
middle aged women in the community. Br Med J (Clin Res Ed)
1988;296:959‑62.
42. Melin R, Fugl‑Meyer KS, Fugl‑Meyer AR. Life satisfaction in
18‑ to 64‑year‑old Swedes: In relation to education, employment
situation, health and physical activity. JRehabil Med 2003;35:84‑90.
43. Kontula O, Haavio-Mannila E. Sexual Pleasures: Enhancement
of Sex Life in Finland, 1971-1992. US: Dartmouth Pub., Co.; 1995.
44. Eplov L, Giraldi A, Davidsen M, Garde K, Kamper‑Jørgensen F.
Sexual desire in a nationally representative Danish population.
J Sex Med 2007;4:47‑56.
45. Colson MH, Lemaire A, Pinton P, Hamidi K, Klein P. Sexual
behaviors and mental perception, satisfaction and expectations
of sex life in men and women in France. J Sex Med 2006;3:121‑31.
46. Amidu N, Owiredu WK, Woode E, Addai‑Mensah O, Quaye L,
Alhassan A, et al. Incidence of sexual dysfunction: A prospective
survey in Ghanaian females. Reprod Biol Endocrinol 2010;8:106.
47. Hayes RD, Dennerstein L, Bennett CM, Fairley CK. What is
the “true” prevalence of female sexual dysfunctions and does
the way we assess these conditions have an impact? J Sex Med
2008;5:777‑87.
48. KhazaeiM, RostamiR, ZaryabiA. The relationship between sexual
dysfunctions and marital satisfaction in Iranian married students.
Procedia Soc Behav Sci 2011;30:783‑5.
49. Jafarzadeh Esfehani R, Fazel N, Dashti S, Moshkani S, Haghighi
Hasanabad F, Foji S, et al. Female sexual dysfunction and
its associated risk factors: An epidemiological study in the
North‑East of Iran. J Midwifery Reprod Health 2016;4:498‑505.
50. Oberg K, Fugl‑Meyer AR, Fugl‑Meyer KS. On categorization
and quantification of women’s sexual dysfunctions: An
epidemiological approach. Int J Impot Res 2004;16:261‑9.
[Downloaded free from http://www.jehp.net on Sunday, February 26, 2023, IP: 69.194.69.84]
51. Attaky A. The prevalence of sexual dysfunction among Arab
female living in Saudi Arabia. J Sex Med 2017;14:e328.
52. Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social
Organization of Sexuality: Sexual Practices in the United States.
US: University of Chicago Press; 1994.
53. Fugl‑Meyer A, Sjogren K. Sexual disabilities, problems and
satisfaction in 18‑74 year old Swedes. Scand J Sexol 1999;2:79.
54. Barlow DH, Cardozo LD, Francis RM, Griffin M, Hart DM,
Stephens E, et al. Urogenital ageing and its effect on sexual health
in older British women. Br J Obstet Gynaecol 1997;104:87‑91.
55. Kadri N, McHichi Alami KH, McHakra Tahiri S. Sexual
dysfunction in women: Population based epidemiological study.
Arch Womens Ment Health 2002;5:59‑63.
56. Smith AM, Rissel CE, Richters J, Grulich AE, de Visser RO.
Sex in Australia: The rationale and methods of the Australian
study of health and relationships. Aust N Z J Public Health
2003;27:106‑17.
57. Pacik PT, Geletta S. Vaginismus treatment: Clinical trials follow
up 241 patients. Sex Med 2017;5:e114‑e123.
58. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ,
McKinlay JB. Impotence and its medical and psychosocial
correlates: Results of the Massachusetts male aging study. J Urol
1994;151:54‑61.
59. Nicolosi A, Moreira ED Jr., Shirai M, Bin Mohd Tambi MI,
Glasser DB. Epidemiology of erectile dysfunction in four
countries: Cross‑national study of the prevalence and correlates
of erectile dysfunction. Urology 2003;61:201‑6.
60. Tleyjeh IM, Abdel‑Latif A, Rahbi H, Scott CG, Bailey KR,
Steckelberg JM, et al. A systematic review of population‑based
studies of infective endocarditis. Chest 2007;132:1025‑35.
61. Shabsigh R, Perelman MA, Lockhart DC, Lue TF, Broderick GA.
Health issues of men: Prevalence and correlates of erectile
dysfunction. J Urol 2005;174:662‑7.
62. Lockhat Y, Ross A, Ramlachan P, Rangiah C. The prevalence of
erectile dysfunction at a primary healthcare clinic in Durban,
KwaZulu‑Natal. South Afr Fam Pract 2013;55:289‑93.
63. Yovwin D, Imarhiagbe F, Obazee E, Oguike T. Erectile dysfunction
in a sub‑Saharan African population: Profile and correlates in a
tertiary care hospital. Sahel Med J 2015;18:116.
64. Weber MF, Smith DP, O’Connell DL, Patel MI, de Souza PL,
Sitas F, et al. Risk factors for erectile dysfunction in a cohort of
108 477 Australian men. Med J Aust 2013;199:107‑11.
65. Martin SA, Atlantis E, Lange K, Taylor AW, O’Loughlin P,
Wittert GA. Predictors of sexual dysfunction incidence and
remission in men. J Sex Med 2014;11:1136‑47.
66. Masumori N, Tsukamoto T, Kumamoto Y, Panser LA, Rhodes T,
Girman CJ, et al. Decline of sexual function with age in
Japanese men compared with American men – Results of two
community‑based studies. Urology 1999;54:335‑44.
67. Kongkanand A. Prevalence of erectile dysfunction in Thailand.
Thai erectile dysfunction epidemiological study group. Int J
Androl 2000;23 Suppl 2:77‑80.
68. Shaeer O, Shaeer K. The Global Online Sexuality Survey (GOSS):
Erectile dysfunction among Arabic‑speaking internet users in the
Middle East. J Sex Med 2011;8:2152‑60.
69. Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM. The triad of erectile
dysfunction, testosterone deficiency syndrome and metabolic
syndrome: Findings from a multi‑ethnic Asian men study (The
subang men’s health study). Aging Male 2011;14:231‑6.
70. Khoo EM, Tan HM, Low WY. Erectile dysfunction and
comorbidities in aging men: An urban cross‑sectional study in
Malaysia. J Sex Med 2008;5:2925‑34.
71. Low WY, Khoo EM, Tan HM, Hew FL, Teoh SH. Depression,
hormonal status and erectile dysfunction in the aging male:
Results from a community study in Malaysia. J Mens Health
Gender 2006;3:263‑70.
72. Bai Q, Xu QQ, Jiang H, Zhang WL, Wang XH, Zhu JC. Prevalence
and risk factors of erectile dysfunction in three cities of China:
A community‑based study. Asian J Androl 2004;6:343‑8.
73. Cho BL, Kim YS, Choi YS, Hong MH, Seo HG, Lee SY, et al.
Prevalence and risk factors for erectile dysfunction in primary
care: Results of a Korean study. Int J Impot Res 2003;15:323‑8.
74. Li MK, Garcia LA, Rosen R. Lower urinary tract symptoms and
male sexual dysfunction in Asia: A survey of ageing men from
five Asian countries. BJU Int 2005;96:1339‑54.
75. Ho CC, Singam P, Hong GE, Zainuddin ZM. Male sexual
dysfunction in Asia. Asian J Androl 2011;13:537.
76. Reza KB, Safarinezhad M. A survey of prevalence of sexual
disorders and risk factors in patient who referred in urology ward
in 501 hospital 2004-05. Annals of Military and Health Sciences
Research 2007;4:1041-45.
77. Yekeh FL, Goudarzi MR. Prevalence of sexual dysfunction and
related factors among married couples in Qazvin. J Qazvin Univ
Med Sci 2009;13:10. [Persian].
78. Safarinejad MR. Prevalence and risk factors for erectile
dysfunction in a population‑based study in Iran. Int J Impot Res
2003;15:246‑52.
79. Ahn TY, Park JK, Lee SW, Hong JH, Park NC, Kim JJ, et al.
Prevalence and risk factors for erectile dysfunction in Korean men:
Results of an epidemiological study. J Sex Med 2007;4:1269‑76.
80. McMahon CG, Lee G, Park JK, Adaikan PG. Premature
ejaculation and erectile dysfunction prevalence and attitudes in
the Asia‑Pacific region. J Sex Med 2012;9:454‑65.
81. Rahman S. Female sexual dysfunction among muslim women:
Increasing awareness to improve overall evaluation and
treatment. Sex Med Rev 2018;6:535‑47.
82. Petersen M, Kristensen E, Berg S, Midgren B. Sexual function
in male patients with obstructive sleep apnoea. Clin Respir J
2009;173:186-191.
83. Dennerstein L, Guthrie JR, Hayes RD, DeRogatis LR, Lehert P.
Sexual function, dysfunction, and sexual distress in a prospective,
population‑based sample of mid‑aged, Australian‑born women.
J Sex Med 2008;5:2291‑9.
84. JohannesCB, Avis NE. Gender differences in sexual activity among
mid‑aged adults in Massachusetts. Maturitas 1997;26:175‑84.
85. Ghanbarzadeh N, Nadjafi‑Semnani M, Ghanbarzadeh MR,
Nadjfai‑Semnani A, Nadjfai‑Semnani F. Female sexual
dysfunction in Iran: Study of prevalence and risk factors. Arch
Gynecol Obstet 2013;287:533‑9.
86. Lewis RW. Epidemiology of erectile dysfunction. Urol Clin North
Am 2001;28:209‑16, vii.
87. Clayton AH. Female sexual dysfunction related to depression and
antidepressant medications. Curr Womens Health Rep 2002;2:182‑7.
88. Valenzuela‑Peters R, Contreras‑García Y, Manriquez‑Vidal C.
Influence of the type of work shift in female sexual function index
of healthcare sector female workers. Eur J Obstet Gynecol Reprod
Biol 2017;210:39‑44.
89. Ramezani Tehrani F, Farahmand M, Simbar M, Malek Afzali H.
Factors associated with sexual dysfunction; a population based
study in Iranian reproductive age women. Arch Iran Med
2014;17:679‑84.
90. O’Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP,
Guess HA, et al. A brief male sexual function inventory for
urology. Urology 1995;46:697‑706.
91. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R,
et al. The Female Sexual Function Index (FSFI): Amultidimensional
self‑report instrument for the assessment of female sexual
function. J Sex Marital Ther 2000;26:191‑208.
92. Wiegel M, Meston C, Rosen R. The Female Sexual Function
Index (FSFI): Cross‑validation and development of clinical cutoff
scores. J Sex Marital Ther 2005;31:1‑20.
93. Mohammadi KH, Heydari M, Faghihzadeh S. The Female Sexual
Function Index (FSFI): Validation of the Iranian version. Health
Monitor J Iran Instit Health Sci Res 2008;7:269-278. - 94. Mohammadi K, Rahnama P, Mohseni SM, Sahraian MA,
Montazeri A. Determinants of sexual dysfunction in women with
multiple sclerosis. BMC Neurol 2013;13:83.
95. Bolhari J, Ramezanzadeh F, Abedininia N, Naghizadeh MM,
Pahlavani H, Saberi M. The survey of divorce incidence in divorce
applicants in Tehran. J Fam Reprod Health 2012;6:129-37.
96. McCool ME, Zuelke A, Theurich MA, Knuettel H, Ricci C,
Apfelbacher C. Prevalence of female sexual dysfunction among
premenopausal women: A systematic review and meta‑analysis
of observational studies. Sex Med Rev 2016;4:197‑212.
97. Heiman JR, Meston CM. Evaluating sexual dysfunction in women.
Clin Obstet Gynecol 1997;40:616‑29.
98. Nappi RE, Cucinella L, Martella S, Rossi M, Tiranini L, Martini E.
Female sexual dysfunction (FSD): Prevalence and impact on
Quality of Life (QoL). Maturitas 2016;94:87‑91.
99. Montorsi F, Adaikan G, Becher E, Giuliano F, Khoury S, Lue TF,
et al. Summary of the recommendations on sexual dysfunctions
in men. J Sex Med 2010;7:3572‑88.