title: An Internet survey of demographic and health factors associated with risk of sexual dysfunction in women who have sex with women.
abstract: BACKGROUND
  There has been scant attention to predictors of sexual dysfunction in women who have sex with women (WSW).
  
  
  OBJECTIVE
  To investigate the associations of high risk for sexual dysfunction in an Internet cohort of WSW.
  
  
  METHODS
  A modified version of the Female Sexual Function Index (FSFI) was used to quantify each subject's sexual function.
  
  
  METHODS
  Women who have sex with women were invited to participate in an Internet-based survey by invitations posted on e-mail listservs and on social media sites catering to WSW. Ethnodemographic, health status, and sexual/relationship data were collected.
  
  
  RESULTS
  The study was completed by 2,433 adult women. Of these, 1,566 participants had complete data on the FSFI and comprised the study cohort; 388 (24.8%) met the FSFI criteria for high risk of female sexual dysfunction (HRFSD). On multivariable analysis, the following variables were found to be independently associated with the HRFSD; moderate or severe subjective bother regarding sexual function (OR 4.8, 95% CI 3.0-7.9 and 13.7, 95% CI 7.5-25.1, respectively), overactive bladder (OAB) (OR 2.1, 95% CI 1.0-4.5), having a nonfemale or no partner (OR 2.3, 95% CI 1.1-4.7 and 3.2, 95% CI 2.0-5.2, respectively). A history of pregnancy was associated with lower odds of HRFSD (OR 0.567, 95% CI 0.37-0.87). Mean FSFI domain scores for all domains except desire were negatively impacted by partner factors and OAB.
  
  
  CONCLUSIONS
  A single-item question on sexual bother is strongly predictive of potentially distressing sexual problems in the WSW. A number of health and social factors are associated with risk of sexual problems in the WSW. Assessment of sexual well-being in the WSW is a priority for practicing healthcare providers.
authors.affiliation: Department of Urology, University of California at Davis, Sacramento, CA 95816, USA. alan.shindel@ucdmc.ucdavis.edu
authors.forename: Alan W
authors.initials: AW
authors.lastname: Shindel
authors.forename: Tami S
authors.initials: TS
authors.lastname: Rowen
authors.forename: Tzu-Chun
authors.initials: TC
authors.lastname: Lin
authors.forename: Chin-Shang
authors.initials: CS
authors.lastname: Li
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Robertson
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006304:Health Status; D006306:Health Surveys; D018452:Homosexuality, Female / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008875:Middle Aged; D060728:Reproductive Health / Q000706:statistics & numerical data; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D055815:Young Adult