title: Sexual complaints, pelvic floor symptoms, and sexual distress in women over forty.
abstract: BACKGROUND
  The American Psychiatric Association recommends considering sexually related personal distress when assessing female sexual dysfunction. Currently, there is little data regarding the impact of sexual complaints on sexual distress.
  
  
  OBJECTIVE
  To investigate the association between sexual complaints and perceived sexual distress in a population of ambulatory adult women.
  
  
  METHODS
  Using the short forms of the Personal Experiences Questionnaire and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire, we assessed sexual complaints among 305 women seeking outpatient gynecologic care. Depressive symptoms were quantified using the Center for Epidemiologic Studies Depression (CESD) score. Sexual distress was measured using the Female Sexual Distress Scale (FSDS). Using multivariable logistic regression, we compared sexual complaints between distressed and nondistressed women.
  
  
  METHODS
  Sexual distress, defined by FSDS score ≥15.
  
  
  RESULTS
  FSDS scores were available for 292/305 participants. Seventy-six (26%) scores reflected distress. Distressed women were more likely to be younger (55.2±1.0 years vs. 56.7±0.8 years, P=0.017); have higher CESD scores (16.6 vs. 9.5, P=0.001); and report decreased arousal (56.8% vs. 25.1%, P=0.001), infrequent orgasm (54% vs. 28.8%, P=0.001), and dyspareunia (39.7% vs. 10.6%, P=0.001). Women with sexual distress were also more likely to report sexual difficulty related to pelvic floor symptoms, including urinary incontinence with sexual activity (9% vs. 1.3%, P=0.005), sexual avoidance due to vaginal prolapse (13.9% vs. 1%, P=0.001), or sexual activity restriction due to fear of urinary incontinence (14.9% vs. 0.5%, P=0.001). After multivariate analysis, sexual distress was significantly associated with dyspareunia (odds ratio [OR] 3.11, P=0.008) and depression score (OR 1.05, P=0.006), and inversely associated with feelings of arousal during sex (OR 0.19, P=0.001).
  
  
  CONCLUSIONS
  Our results indicate that sexually related personal distress is significantly associated with dyspareunia, depressive symptoms, and decreased arousal during sexual activity. This contributes to our understanding of how sexual complaints may adversely affect women's quality of life.
authors: Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. lknoepp@gmail.com
authors: Leise R
authors: LR
authors: Knoepp
authors: Stuart H
authors: SH
authors: Shippey
authors: Chi Chiung Grace
authors: CC
authors: Chen
authors: Geoffrey W
authors: GW
authors: Cundiff
authors: Leonard R
authors: LR
authors: Derogatis
authors: Victoria L
authors: VL
authors: Handa
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004414:Dyspareunia / Q000473:pathology / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007989:Libido; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D017773:Pelvic Floor / Q000473:pathology*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology*; D019529:Sexuality / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires