Journal of Sexual Medicine vol:13 issue:4 pages:650-668
Introduction: Because severity and duration of sexual impairment and any distress caused by the sexual
impairment are not assessed in most epidemiologic studies on sexual dysfunction, the available prevalence rates
are probably an overestimation.
Aims: To provide prevalence estimates of severe and persistent sexual difficulties that cause personal distress and
to explore the association between personal sexual distress and avoidance of sex, help-seeking behavior, and sexual
Methods: This study used home-based computer-assisted personal interviewing and computer-assisted selfinterviewing
of a representative, randomly selected, population-based cross-sectional sample of 651 Flemish men
and 695 women 14 to 80 years old.
Main Outcome Measures: Prevalence of sexual difficulties, prevalence of sexual dysfunctions (ie, sexual difficulties
causing personal distress), and association of sexual distress with avoidance of sex, help-seeking behavior,
and sexual satisfaction.
Results: In this sample, 43.5% of women (95% CI ¼39.7e47.3) and 34.8% of men (95% CI ¼31.3e38.3)
reported a moderate to severe sexual difficulty. When considering the diagnostic criteria of the Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (ie, minimum duration of 6 months and presence of personal
sexual distress), prevalence rates decreased to 19.0% in women (95% CI ¼16.0e22.0) and to 15.1% in men
(95% CI ¼12.4e17.8). Sexual distress was associated with more sexual dissatisfaction and greater sexual
avoidance. Sexual distress also was associated with help-seeking behavior, although most individuals with distressing
sexual difficulties had not sought help.
Conclusion: Although sexual difficulties per se are quite prevalent, severe and persistent sexual difficulties
causing sexual distress are far less common. Despite sexual distress being associated with avoidance of sex and
lower sexual satisfaction, most people tend not to seek help for their sexual problem, even when being distressed
by the problem.