**3.3 Orgasm dysorders**

4 Sexual Dysfunctions – Special Issue

issue is to select the study sample. Community-based samples are the most appropriate ones which define the potential number of patients sustaining the disorder/condition who might benefit from treatment. The study sample must be a representative of the studied population in terms of social, cultural and health status. And, the last one is to select the

In this chapter, the criterion was the prevalence estimate for general populations, which included a representative sample of community with overall methodological quality. The internal validity of the study was assessed by data collection procedures, measurement instruments, defining health conditions and informative content of reported prevalence. External validity was assessed by the generalizability of the study and source of population,

The second important issue is that sexual dysfunction may be best conceptualized as the global inhibition of sexual response due to interpersonal factors (Hartmann et al, 2002) because many cases of sexual dysfunction can be regarded as the adaption to sexual relationship problems. In other words, sexual dysfunction must be seen in a multi-faceted socio-psycho-biologic context. Therefore, there are different scales for defining and classifying sexual dysfunction including the American Psychiatric Association's Diagnosis and Statistical Manual for Mental Disorder, 4th text revision (DSM-III or IV-TR), the World Health Organization's International Classification of Diagnosis (ICD-10), Profile of Female Sexual Function(PFSF), Female Sexual Function Index (FSFI), Golombok Rust Inventory of Sexual Satisfaction (GRISS), International Index of Erectile Function (IIEF), Sexual Function Questionnaire (SFQ) and other researcher-made validated questionnaires . Clearly, the type of applied definition affects the prevalence estimate of sexual problems. Although the database in both groups is rapidly growing, in this chapter, we tried to include all the recent

We focused on epidemiologic studies on sexual problems, sexual disorders or sexual distress which have estimated prevalence of one or more sexual problems for general populations in the world. Thus, we excluded studies with a small sample size and studies in

In this review, we searched MEDLINE, SCIENCEDIRECT, PUBMED, GOOGLE SCHOLAR, JSTORE and JSTORE PROQUEST using the following key words: epidemiology, prevalence plus sexual dysfunction, sexual function disturbance, sexual disorder, dyspareunia, vaginismus, anorgasmia, lack of lubrication, sexual arousal, sexual desire, hypoactive sexual desire disorder, sexual aversion disorder, orgasmic disorder, erectile dysfunction, early

Despite increasing scientist interest in female sexual difficulty and dysfunction, the true prevalence of female sexual dysfunctions (FSD) in the general population remains a contentious issue. One reason is the great deal of variation in the published prevalence estimates of female sexual difficulties/ dysfunctions. This variation may be due, in part, to real differences among populations, and the way FSD is measured (Lindau et al,. 2007). Lack of standardization of outcome measures is an important issue in the FSD literature which has been raised by previous authors. Also, different time frames have influenced the prevalence rate. If the period of study increases, prevalence increases, too (Mercer et al,.

sampling, eligibility of criteria and response rate (Tsai et al, 2011).

tools used for screening.

studies of the field.

2003).

special populations like specific health conditions.

**3. Prevalence of female sexual dysfunction** 

ejaculation and premature ejaculation.

The prevalence of orgasmic dysfunction varies considerably within and between different geographic areas and some researchers believe that this problem may or may not be agedependent. The highest report belongs to India in which more than 86% of women report this problem. Also, this problem is very common among African women.

### **3.4 Dyspareunia**

The manifest of genital pain during intercourse has been also reported by a large number of women all over the world. Overall, high prevalence of about 64% has been found in Asia and Africa.

*Vaginismus* is another painful condition during intercourse with high prevalence in Asia. But, it appears that there is clear lack of investigation of this problem in the world.

## **4. Prevalence of male sexual dysfunction**

Male sexual dysfunction includes erectile dysfunction (ED), ejaculation disorders, orgasmic dysfunctions and disorders of sexual interest/desire. Epidemiologic studies have supported the high prevalence of male sexual dysfunction worldwide; however, the data are limited. Many of the epidemiologic studies are old and related to poor methodology. In this chapter, we reviewed 29 multiethnic studies about these problems. Tables 1-4 show validated studies on the prevalence of male sexual dysfunction.

#### **4.1 Erectile dysfunction (ED)**

Erectile dysfunction (ED) is defined as the consistent or recurrent inability of a man to attain and/or maintain penile erection sufficiently for a sexual activity. A 3-month minimum duration is accepted for the establishment of the diagnosis. Several studies have provided data on the prevalence of ED. The prevalence of ED on a worldwide basis has a great deal of variation around 9%-69%. And, there is a clear increase of this disorder at older ages. In all studies, ED has a rather high rate from 20% to 40% for the ages 60 to 69 years old, some increasing after the age of 65 years old.

Prevalence of Sexual Dysfunctions: A Systemic Approach 7

967 Ad hoc

936 Ad hoc

601 Ad hoc

805 Ad hoc

questionnaire

questionnaire

728 DSM-IV 20-80

questionnaire

questionnaire 20+

Scale Cohort

31581 CSFQ-14 18+

age (year)

255 GRISS 19+

40-80

16-49

18-60

50-59 60-69 70-79

31.5 49.6 36 16.9

26.6 18.3 15 12 8.3 7.5 6.2

66 64.7 59.6 59.2 49

Prevalence (%)

37.7

Lack of sexual interest Inability to reach orgasm Orgasm too quickly Pain during sex Lubrication difficulties

Dyspareunia Decreased sexual desire Difficult arousal Anorgasmia

*Overall* sexual dysfunction Hypoactive sexual desire disorder Sexual aversion disorder Orgasmic disorder Sexual arousal disorder Dyspareunia Vaginismus

Overall sexual dysfunction Low sexual desire Dyspareunia Sexual dissatisfaction Lack of lubrication Low sexual arousal Orgasmic disorder

Erectile dysfunction

Overall sexual dysfunction Premature ejaculation Impotency No sensuality Avoidance

Problem or question Sample

size

Female

GRISS: Golombok Rust Inventory of Sexual Satisfaction

2008 Low desire

DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th Table 1. Characteristics of African studies of sexual dysfunction

Laumann et al, 2005

Elnashar et al, 2007

Kadri et al, 2002

Hassanin et al, 2010

Seyam et al, 2003

Amidu et al, 2011

Shifren et al,

Male

#### **4.2 Ejaculation disorders**

Ejaculation disorders include early ejaculation, delayed ejaculation and anejaculation. The term early ejaculation is used to replace premature ejaculation, a term considered relatively inaccurate and pejorative. Early ejaculation is the ejaculation that occurs sooner than desired, either before or shortly after penetration, over which the sufferer has minimal or no control. Like all or most other dysfunctions, this is primarily a self-reported diagnosis. Delayed ejaculation is the undue delay in reaching a climax during sexual activity. Anejaculation is the absence of ejaculation during orgasm (Althof et al, 2006).

The major problem in assessing the prevalence of early ejaculation is lack of an accurate (validated) definition. It can be defined by time of ejaculation, in the context of the sufferer's or partner's satisfaction, the number of penile thrusts after intromission or even in the context of the amount of sexual stimulation. Similarly, there is lack of definition for the delayed ejaculation. The highest prevalence rate of 31% (men aged 18-59 years old) was given by the NHSLS study in the United States (Laumann et al., 1999). In the sub-groups aged 18 to 29, 30 to 39, 40 to 49 and 50 to 59 years old, the prevalence was 30%, 32%, 28% and 55%, respectively. These high prevalence rates may be a result of the dichotomous scale (yes/no) in a single question asking whether the ejaculation occurred too early or not.

### **4.3 Orgasmic dysfunction**

Orgasmic dysfunction is the inability in achieving orgasm, markedly diminished intensity of orgasmic sensations or marked delay of orgasm during conscious sexual activity. There is a self-report of high sexual arousal/excitement in this disorder. Prevalence data on orgasmic dysfunction are scarce and report 5%-33% of all men in the world. One simple reason explaining the difficulty of assessing the prevalence of orgasmic dysfunction is that some men may be unable to distinguish between ejaculation and orgasm.

### **4.4 Sexual interest/desire dysfunctions**

Sexual interest/desire dysfunctions are diminished or no feelings of sexual interest or desire, no sexual thoughts or fantasies and lack of responsive desire. This problem has been neglected in epidemiologic studies to some extent; but it is quite commonly seen in clinical practices. The prevalence rate of sexual interest disorders is 11%-28% around the world. The highest prevalence rate of sexual interest disorders was reported in a study conducted in Asia in men aged 40 to 80 years old. It seems that there is not any pronounced age effect on this problem. However, more research would shed more light on this issue.


Ejaculation disorders include early ejaculation, delayed ejaculation and anejaculation. The term early ejaculation is used to replace premature ejaculation, a term considered relatively inaccurate and pejorative. Early ejaculation is the ejaculation that occurs sooner than desired, either before or shortly after penetration, over which the sufferer has minimal or no control. Like all or most other dysfunctions, this is primarily a self-reported diagnosis. Delayed ejaculation is the undue delay in reaching a climax during sexual activity.

The major problem in assessing the prevalence of early ejaculation is lack of an accurate (validated) definition. It can be defined by time of ejaculation, in the context of the sufferer's or partner's satisfaction, the number of penile thrusts after intromission or even in the context of the amount of sexual stimulation. Similarly, there is lack of definition for the delayed ejaculation. The highest prevalence rate of 31% (men aged 18-59 years old) was given by the NHSLS study in the United States (Laumann et al., 1999). In the sub-groups aged 18 to 29, 30 to 39, 40 to 49 and 50 to 59 years old, the prevalence was 30%, 32%, 28% and 55%, respectively. These high prevalence rates may be a result of the dichotomous scale (yes/no) in a single question asking whether the ejaculation occurred too early or not.

Orgasmic dysfunction is the inability in achieving orgasm, markedly diminished intensity of orgasmic sensations or marked delay of orgasm during conscious sexual activity. There is a self-report of high sexual arousal/excitement in this disorder. Prevalence data on orgasmic dysfunction are scarce and report 5%-33% of all men in the world. One simple reason explaining the difficulty of assessing the prevalence of orgasmic dysfunction is that some

Sexual interest/desire dysfunctions are diminished or no feelings of sexual interest or desire, no sexual thoughts or fantasies and lack of responsive desire. This problem has been neglected in epidemiologic studies to some extent; but it is quite commonly seen in clinical practices. The prevalence rate of sexual interest disorders is 11%-28% around the world. The highest prevalence rate of sexual interest disorders was reported in a study conducted in Asia in men aged 40 to 80 years old. It seems that there is not any pronounced age effect on

Anejaculation is the absence of ejaculation during orgasm (Althof et al, 2006).

men may be unable to distinguish between ejaculation and orgasm.

this problem. However, more research would shed more light on this issue.

Overall sexual problems Anorgasmia Sexual infrequency Dissatisfaction Vaginismus Avoidance of sexual intercourse

Problem or question Sample

size

Scale Cohort

301 GRISS 18-58

age (year) Prevalence (%)

> 72.8 72.4 71.4 77.7 68.1 62.5

**4.2 Ejaculation disorders** 

**4.3 Orgasmic dysfunction** 

Female

Amidu et al, 2011

**4.4 Sexual interest/desire dysfunctions** 


GRISS: Golombok Rust Inventory of Sexual Satisfaction DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th

Table 1. Characteristics of African studies of sexual dysfunction


Prevalence of Sexual Dysfunctions: A Systemic Approach 9

2207 PFSF 30-70

questionnaire

questionnaire

questionnaire

questionnaire 57-64

728 Ad hoc

1455 Ad hoc

2205 Ad hoc

1550 Ad hoc

505 IIEF

5198 Ad hoc

1286 Ad hoc

3566 Ad hoc

1156 Ad hoc

BMSFI

questionnaire 50-76

questionnaire 20+

questionnaire 40-69

Unable to achieve orgasm 57-64

Experienced pain during sex 57-64

36.2 8.3

23.4 22.7

37

17.6 14.5 27.4 3.6 20.6

27.8 28.7 24.4

16.1 22.9 33

> 3 3.2 1

> > 8

46.3 26 34.9 46.9 57.8 69.4

12.3 4.7 3.4 7 19.9 27 38 30

25.9 12.4 29.8 46.4

40-80

65-74 75-85

65-74 75-85

65-74 75-85

50-54 55-59 60-64 65-69 70-76

questionnaire 18+ 46.2

20-29 30-39 40-49 50-59 60-69 70-74 ≥75

40-49 50-59 60-69

50-70 18

57-85

40-80

Low Sexual Desire Hypoactive Sexual Desire Disorder

Lubrication difficulties Lack of sexual interest

Inability to reach orgasm Early ejaculation Pain during sex Erectile difficulties

Erectile dysfunction

Erectile dysfunction

2007 Erectile difficulties

2005 Lack of sexual interest

2008 Lacked interest in sex

2000 Erectile dysfunction

2001 Erectile dysfunction

2000 Erectile dysfunction

West et al, 2008

Junior et al, 2005

Lindau et al,

Laumann et al,

Laumann et al,

Derby et al, 2000

Ansong et al,

Moreira et al,

Saigal et al, 2006

Johannes et al,

Male


1550 Ad hoc

1845 Ad hoc

2109 Ad hoc

1550 Ad hoc

1219 Ad hoc

1749 DSM-IV

questionnaire

Unable to achieve orgasm 57-64

Experienced pain during sex 57-64

Lacked Interest in Sex 18-29

Unable to Achieve Orgasm 18-29

Experienced Pain During Sex 18-29

Difficulty in Lubricating 18-29

questionnaire

questionnaire

questionnaire

987 DSM-IV 20-65

questionnaire 57-64

25.3 21.1 43.1

> 43 39 34

32.9 25.2 10.5 14 27.1

> 31 3 9

> 24

45.4 37.6 49.3

35 33.4 38.2

18.2 18.9 11.8

26.7 23.1 21

40-69

65-74 75-85

65-74 75-85

65-74 75-85

30-39 40-49 50-59

30-39 40-49 50-59

30-39 40-49 50-59

30-39 40-49 50-59

18+

18-59 43

57-85

40-80

Low arousal Low orgasm Any (desire, arousal or orgasm)

Difficulty with vaginal lubrication Inability to climax

> Inability to reach orgasm Orgasm too quickly Pain during sex Pain during sex

> > Pain disorders No orgasm

Overall sexual dysfunction

Lack of sexual desire Pain during sexual intercourse Orgasmic dysfunction

2007 Low desire

2005 Lack of sexual interest

2002 Lubrication problems

2008 Lacked interest in sex

1999 Overall sexual dysfunction

Lindau et al,

Laumann et al,

Bancroft et al,

Addis et al, 2006

Laumann et al,

Abdo et al, 2004

Laumann et al,


Prevalence of Sexual Dysfunctions: A Systemic Approach 11

1200 FSFI 20-40

questionnaire 17-40

149 FSFI 18+

17-40 17-40 17-40 40-70 40-70 40-70 40-70

40-80

15-49

15+

5042 Ad hoc

426 Ad hoc

319 Ad hoc

1456 Ad hoc

2701 Ad hoc

600 Ad hoc

questionnaire

230 FSFI 18-70

questionnaire

questionnaire

1516 DSM-IV 18-59

questionnaire

questionnaire

26.3

15.2 32.2 27.7 57.9 29.7 57.9 12.5 51.2

77.2 91.3 96.6 86.6 64.4

37 31 29.4 28.1 26.9

59.1 60.9 50.4 52.2 67.8

54.5

52 19.3 18.6 11.9 21.3 18.2 19.4

3.4 9.6 29.7 7.2

19.1 29.8 8.9 27.6

34

40-80 23.8

40-70

Najafabady et al,

Hisasue et al, 2005

Singh et al, 2009

Moreira et al, 2001

Sidi et al, 2007

Sobhgol et al, 2007

Goshtasebi et al,

Lau et al, 2005

Laumann et al, 2005

Nicolosi et al 2003

Male

2011 Anorgasmia

Orgasmic disorder Sexual desire disorder Arousal disorder Lubrication disorder Orgasmic disorder Sexual desire disorder Arousal disorder Lubrication disorder

Difficulties with desire Arousal disorder Lubrication problem Orgasmic disorder Pain disorder

Lack of sexual pleasure Inability to reach orgasm Lubrication difculties Pain during sex Lack of sexual interest

Lack of orgasms Low sexual arousal Lack of lubrication Sexual dissatisfaction Sexual pain

Dyspareunia

Desire difficulty Arousal difficulty Lubrication difficulty Orgasmic difficulty Pain difficulty Satisfaction difficulty

Pain disorder Erectile problems Premature orgasm No orgasm

Lack of sexual interest Inability to reach orgasm Early ejaculation Pain during sex Erectile difficulties

Erectile dysfunction

2009 Overall sexual dysfunction


CSFQ-14: Changes in Sexual Functioning Questionnaire short-form

DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th

PFSF: Profile of Female Sexual Function

IIEF: International Index of Erectile Function

BMSFI: Brief Male Sexual Function Inventory

#### Table 2. Characteristics of American studies of sexual dysfunction


Lacked interest in sex 18-29

Unable to achieve orgasm 18-29

Climax too early 18-29

size

112 Ad hoc

2106 Ad hoc

questionnaire

3257 DSM-IV 18-59

questionnaire

2626 FSFI 20-60

1410 DSM-IV

18-59 31

Prevalence (%)

44

11.4 23.7 13.1 16.2

39 36.7 21.9 30.4 36

31.5

30-39 40-49 50-59

30-39 40-49 50-59

30-39 40-49 50-59

30-39 40-49 50-59

Scale Cohort

age (year)

40-55

40-80

18-29

Laumann et al,

1999 Overall sexual dysfunction

Trouble maintaining or Achieving an erection

CSFQ-14: Changes in Sexual Functioning Questionnaire short-form DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th

Table 2. Characteristics of American studies of sexual dysfunction

Dyspareunia

Pain disorder Lubrication problems No orgasm No pleasure

Inability to reach orgasm Orgasm too quickly Pain during sex Lubrication difficulties

Overall female sexual dysfunction Orgasmic disorder Orgasmic disorder Arousal disorders Pain disorders

2005 Lack of sexual interest

Problem or question Sample

PFSF: Profile of Female Sexual Function IIEF: International Index of Erectile Function BMSFI: Brief Male Sexual Function Inventory

Female

Chen et al, 2003

Lau et al, 2005

Laumann et al,

Safarinejad 2006


Prevalence of Sexual Dysfunctions: A Systemic Approach 13

547 Ad hoc

979 Ad hoc

3017 Ad hoc

744 Ad hoc

4489 Ad hoc

4311 Ad hoc

600 Ad hoc

questionnaire

questionnaire

518 FSFI 18-55

questionnaire

questionnaire

questionnaire

questionnaire

questionnaire

11161 ICD-10 16-44

14.4 1.3 11.8 9.2

33.8 11.2 12.1 18.4 6.4

48.3 48.3 35.9 40.9 42.7 42.9

> 9.3 13 10 8.6 6.5

37 26 9

19.2 2.3 9.5 15.7 34.4 53.4

12.7 10.6 21.1 3.6 13.1

17

17.1 5.3 11.7 17

20-60

18-75

20-60 20-29 30-39 40-49 50-60

18-67

30-80 30-39 40-49 50-59 60-69 70-80

40-80

40-70

Unable to experience orgasm Premature orgasm Painful intercourse Trouble lubricating

experienced sexual problems inhibited desire Inhibited arousal inhibited orgasm Dyspareunia

Orgasmic Dysfunction Dyspareunia Vaginal Dryness problem with arousal inhibited enjoyment

overall sexual dysfunction desire problem arousal problem lubrication problem orgasm problem pain problem

Reduced sexual desire Problem achieving orgasm Genital pain

erectile dysfunction

Lack of sexual interest Inability to reach orgasm Early ejaculation Pain during sex Erectile difficulties

erectile dysfunction

Lack of interest in sex Unable to experience orgasm Premature orgasm

2003 Dyspareunia

Štulhofer et al, 2005

Dunn et al, 1998

Oksuz et al, 2006

Danielsson et al,

TrÆen et al, 2010

Braun et al, 2000

Laumann et al, 2005

Nicolosi et al 2003

Mercer et al, 2003

Male


DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th FSFI: Female Sexual Function Index

IIEF: International Index of Erectile Function

#### Table 3. Characteristics of Asian studies of sexual dysfunction


471 Ad hoc

546 Ad hoc

1259 Ad hoc

1517 IIEF

questionnaire

questionnaire

questionnaire

Scale Cohort

2467 PFSF 50-70

questionnaire

questionnaire

questionnaire

356 SFQ 20-70

11161 ICD-10 16-44

3494 Ad hoc

1000 Ad hoc

703 Ad hoc

40-80

40-80

40-70

23-29 30-39 40-49 50-59 60-69 70-79

age (year)

15-88

20-80

30.3 14 13.1 11.2

32.7 31.9 28.3 19.3 18.1

37.5

19.2 2.3 9.5 15.7 34.4 53.4

Prevalence (%)

12

20.9 9.6 10.4 17.2

10.3

40.6

40-80 27.6

Early ejaculation Inability to reach orgasm Erectile difficulties Lack of sexual interest

Early ejaculation Erectile difficulties Lack of sexual interest Inability to reach orgasm Sex not pleasurable

Erectile difficulties

DSM-IV: Diagnosis and Statistical Manual for Mental Disorder, 4th

2006 Hypoactive sexual desire

Laumann et al, 2005 Lack of sexual interest

2004 desire disorders

Table 3. Characteristics of Asian studies of sexual dysfunction

disorder

Inability to reach orgasm Orgasm too quickly Pain during sex Lubrication difficulties

Arousal Disorder

arousal disorders orgasmic problems Pain disorders

hypoactive sexual desire disorder sexual arousal disorder (lubrication) orgasmic disorder dyspareunia

Lack of interest in sex

Problem or question Sample

size

2000 Erectile difficulties

Junior et al, 2005

Moreira et al, 2001

Kongkanand et al,

Marumu et al, 2001

Female

Dennerstein et al,

Weiss et al, 2009

Ponholzer et al,

Hayes et al, 2008

Mercer et al, 2003

FSFI: Female Sexual Function Index IIEF: International Index of Erectile Function


Prevalence of Sexual Dysfunctions: A Systemic Approach 15

Existing epidemiologic data on sexual dysfunction support high prevalence of these problems worldwide. However, the data are limited and the prevalence data on male sexual dysfunction, except for ED, are too limited. Widely accepted definitions of disorders and scales are primary prerequisites to make prevalence comparisons possible and describe the

Abdo, C. Oliveira, W. Moreira, E. Fittipaldi, J. 2004. Prevalence of sexual dysfunctions and

Addis, I. Van Den Eeden, S. Wassel-Fyr, C. Vittinghoff, E. Brown, J. Thom, D. 2006. Sexual

Akkus, E. Kadioglo, A.Esen, A. Doran, A. Ergen, A. ans et. al. 2002. prevalence and correlate

Althof, S. 2006.Prevalence, Characteristics and Implications of Premature Ejaculation/Rapid

Amidu, N. Owired, W. Gyasi-Sa rpong, C. Wood, E. Quaye, L. 2011. Sexual dysfunction

Ansong, K. Lewis, C. Jenkins, P. Bell, J. 2000. Epidemiology of Erectile Dysfunction: A Community-based Study in Rural New York State. Ann Epidemiol ,10,293–296. Bancroft, J. Loftus, J., Scott Long, J. 2003. Distress about Sex: A National Survey of Women in Heterosexual Relationships. Archives of Sexual Behavior, 32, 3, 193–208. Blanker, M. Bosch, J. Grooeneveld, F. Bohnen, A. Thomas, A. Hop, W. 2001.Erectile and

prevalence, concern, and relation to sexual activity. UROLOGY, 57,763–768. Braun, M. Wassmer, G. Klotz, T. Reifenrath, B. Mathers, M. Engelmann, U. Epidemiology of

Chen , O. 2003. Taneepanichskul, S. Prevalence of Dyspareunia in Healthy Thai Perimenopausal Women. Thai Journal of Obstetrics and Gynaecology, 15, 113-121. Danielsson,I. berg, I. s Stenlund, H. Wikman, M. 2003. Prevalence and incidence of

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in menopausal women: a survey of western European women. *The Journal of Sexual* 

Authors would like to thank Ms Zahra Sehat for searching and organizing papers.

**5. Conclusions** 

severity of the problem.

**6. Acknowledgement** 

2004, 160–166.

755–764.

41,268-304.

3-7.

**7. References** 


PFSF: Profile of Female Sexual Function

SFQ: Sexual Function Questionnaire

ICD-10: International Classification of Diagnosis-10

FSFI : Female Sexual Function Index

IIEF-5: International Index of Erectile Function-5

IIEF: International Index of Erectile Function

Table 4. Characteristics of European studies of sexual dysfunction

#### **5. Conclusions**

14 Sexual Dysfunctions – Special Issue

1982 Ad hoc

789 Ad hoc

2010 Ad hoc

1688 ICS male sex

questionnaire

questionnaire

1004 IIEF-5 40+

questionnaire

873 Ad hoc questionnaire 18-67

IIEF Simple question

2476

questionnaire 50-54

5.8

69.2

31.6 32.2 27 19.7 21

12.8 2.8 1.9 4.8 15.7 26.8 48.3

> 13 6 2

18.9 12.1

40+

18-75

40-49 50-59 60-69 ≥70

18+ 18-29 30-39 40-49 50-59 60-70 >70

55-59 60-64 65-69 70-78 50-54 55-59 60-64 65-69 70-78

25-70

Painful intercourse Unable to achieve or maintain erection

erectile dysfunction

Difficulty getting erection Difficulty maintaining erection erectile dysfunction Premature ejaculation inhibited enjoyment

erectile dysfunction

Erectile Dysfunction

Ejaculatory dysfunction

Reduced sexual desire Problem achieving orgasm Genital pain

Table 4. Characteristics of European studies of sexual dysfunction

2001 Erectile dysfunction

al, 2001 Erectile dysfunction

ICD-10: International Classification of Diagnosis-10

IIEF-5: International Index of Erectile Function-5 IIEF: International Index of Erectile Function

PFSF: Profile of Female Sexual Function SFQ: Sexual Function Questionnaire

FSFI : Female Sexual Function Index

Akkus et al, 2002

Dunn et al, 1998

Giuliano et al, 2002

Parazzini et al, 2000

Blanker, M et al,

TrÆen et al, 2010

Martin-Morales et

Existing epidemiologic data on sexual dysfunction support high prevalence of these problems worldwide. However, the data are limited and the prevalence data on male sexual dysfunction, except for ED, are too limited. Widely accepted definitions of disorders and scales are primary prerequisites to make prevalence comparisons possible and describe the severity of the problem.

#### **6. Acknowledgement**

Authors would like to thank Ms Zahra Sehat for searching and organizing papers.

#### **7. References**


Prevalence of Sexual Dysfunctions: A Systemic Approach 17

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Martin-Morales A, Sanchez-Cruz JJ, Saenz de Tejada I, Rodriguez-Vela L, Jimenez-Cruz JF,

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**Part 2** 

**Sexual Dysfunction in Special Conditions**

