Sexual dysfunction among women of reproductive age: A systematic review and meta-analysis
Background: Available statistics show a high prevalence of sexual dysfunction (SD) among women worldwide. Various factors affect SD among women of reproductive age.
Objectives: To evaluate studies on the prevalence and determinants of SD in different parts of the world.
Materials and Methods: MEDLINE, EMBASE, Web of Science, Scopus and ProQuest databases were systematically reviewed during 2000–2019. All original articles were reviewed. The STROBE checklist was used to evaluate the quality of the papers. I2 was calculated to determine heterogeneity. Fixed effects and/or random-effects models were applied to estimate the pooled prevalence. Meta-regression analysis was also performed to identify the sources of heterogeneity.
Results: Based on the results of the meta-analysis (21 eligible studies), the pooled prevalence with 95% confidence interval of SD was estimated at 50.75% (41.73–59.78). The prevalence of pain and disorders in arousal, sexual desire, lubrication, orgasm, and sexual satisfaction were calculated (39.08%, 48.21%, 50.70%, 37.60%, 40.16%, and 35.02%, respectively). Also, age, depression, low education level, increased duration of the marriage, and the presence of chronic diseases were the highest risk factors for SD.
Conclusion: The prevalence of SD in women of reproductive age varies in different countries. Considering the importance of female SD, further studies are needed to facilitate the development of relevant educational interventions.
Key words: Sexual dysfunction, Women, Reproductive age.
 Abdi F, Atarodi Kashani Z, Pakzad R, Alidost F. Urinary disorders and sexual dysfunction in patients with multiple sclerosis: A systematic review and meta-analysis. Int J Sex Health 2020; 32: 312–330.
 Greil AL, Slauson-Blevins K, McQuillan J, Lowry MH, Burch AR, Shreffler KM. Relationship satisfaction among infertile couples: Implications of gender and self-identification. J Fam Issues 2018; 39: 1304–1325.
 Barikani A, Ebrahim SM, Mohammadi N. The cause of divorce among men and women referred to marriage and legal office in Qazvin, Iran. Glob J Health Sci 2012; 4: 184–191.
 Xiao Z, Mehrotra P, Zimmerman R. Sexual revolution in China: Implications for Chinese women and society. AIDS Care 2011; 23: 105–112.
 Yeniel A, Petri E. Pregnancy, childbirth, and sexual function: Perceptions and facts. Int Urogynecol J 2014; 25: 5–14.
 Smith AM, Lyons A, Ferris JA, Richters J, Pitts MK, Shelley JM, et al. Incidence and persistence/recurrence of women's sexual difficulties: Findings from the Australian longitudinal study of health and relationships. J Sex Marital Ther 2012; 38: 378–393.
 Safarinejad MR. Female sexual dysfunction in a population-based study in Iran: Prevalence and associated risk factors. Int J Impot Res 2006; 18: 382–395.
 Alizadeh Sh, Riazi H, Alavi Majd A, Ozgoli G. Sexual health and its related factors amoung Iranian pregnant women: A review study. AIMS Med Sci 2019; 6: 296–317.
 Ramezani TF, Farahmand M, Mehrabi Y, Malekafzali H, Abedini M. Prevalence of female sexual dysfunction and its correlated factors: A population based study. Payesh 2012; 11: 869–875.
 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: 533–539.
 Najafabady MT, Salmani Z, Abedi P. Prevalence and related factors for anorgasmia among reproductive aged women in Hesarak, Iran. Clinics 2011; 66: 83–86.
 Sabola NE, Shahin MA, Khader KA, Metwally HM, Desoky MM. Sexual nursing care for the postpartum period and its impact on sexual dysfunction and life satisfaction among Egyptian women. Malaysia J Pub Health Med 2020; 20: 108–115.
 Abdi F, Roozbeh N, Mortazavian AM. Effects of date palm pollen on fertility: Research proposal for a systematic review. BMC Res Notes 2017; 10: 1–4.
 Incedere A, Küçük L. Sexual life and associated factors in psychiatric patients. Sex Disabil 2017; 35: 89–106.
 Bancroft J. The medicalization of female sexual dysfunction: The need for caution. Arch Sex Behav 2002; 31: 451–455.
 Abdi F, Roozbeh N. [The effects of Humulus lupulus L. hops on menopausal vasomotor symptoms: A systematic review and meta-analysis.] Iran J Obstet Gynecol Infert 2016; 19: 9–17. (in Persian)
 Abdi F, Alimoradi Z, Alidost F. Pregnancy outcomes and effects of antiretroviral drugs in HIV-positive pregnant women: A systematic review. Future Virol 2019; 14: 197–210.
 Hallajzadeh J, Khoramdad M, Izadi N, Karamzad N, Almasi-Hashiani A, Ayubi E, et al. Metabolic syndrome and its components in premenopausal and postmenopausal women: A comprehensive systematic review and meta-analysis on observational studies. Menopause 2018; 25: 1155–1564.
 Hashemi H, Pakzad R, Heydarian S, Yekta A, Aghamirsalim M, Shokrollahzadeh F, et al. Global and regional prevalence of strabismus: A comprehensive systematic review and meta-analysis. Strabismus 2019; 27: 54–65.
 Alidost F, Dolatian M, Shams J, Nasiri M, Sarkhoshpour E. The correlation of sexual dysfunction with prenatal stress and quality of life: A path analysis. Iran Red Cres Med J 2017; 19: e55686.1–8.
 Shittu R, Alabi K, Odeigah L, Sule A, Ampitan A, Odeigah C. Female sexual dysfunction in women of reproductive age group in Nigeria, West Africa. Niger J Fam Pract 2017; 8: 17–28.
 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: 101–106.
 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: 679–684.
 Sidi H, Puteh SEW, Abdullah N, Midin M. Epidemiology: The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in malaysian women. J Sex Med 2007; 4: 311–321.
 Oksuz E, Malhan S. Prevalence and risk factors for female sexual dysfunction in Turkish women. J Urol 2006; 175: 654–658.
 Çayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E. The prevalence of female sexual dysfunction and potential risk factors that may impair sexual function in Turkish women. Urol Int 2004; 72: 52–57.
 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 Midwif Reprod Health 2016; 4: 498–505.
 Javadifar N, Pargar F, Musavi P, Haghighizadeh MH. Comparing sexual function in females of reproductive age referred to rural and urban healthcare centers in ahvaz, Iran. Jundi J Chron Dis Care 2016; 5: e37038.1–6.
 Sepehrian F, Hosseni L. [Female sexual dysfunction and its related factors in Urmia.] Stud Med Sci 2012; 23: 148–154. (in Persian)
 Sadat Z, Kafaei-Atrian M, Abbaszadeh F, Karimian Z, Mirbagher-Ajorpaz N. Female sexual dysfunction and related factors among reproductive age women in Kaskan, Iran. Health Educ Health Promot (HEHP) 2015; 3: 53–64.
 Bagherzadeh R, Zahmatkeshan N, Gharibi T, Akaberian S, Mirzaei K, Kamali F, et al. Prevalence of female sexual dysfunction and related factors for under treatment in Bushehrian women of Iran. Sex Disabil 2010; 28: 39–49.
 Lou WJ, Chen B, Zhu L, Han SM, Xu T, Lang JH, et al. Prevalence and factors associated with female sexual dysfunction in Beijing, China. Chine Med J 2017; 130: 1389–1394.
 Bahrami N, Alizadeh S, Bahrami S. Sexual dysfunctions and associated factors in women of reproductive age. Adv Nurs Midwife 2012; 21: 9–15.
 Hoseini Tabaghdehi M, Hoseini F. The relative frequency of sexual dysfunction and some related factors in the women referred to the health centers of Sari City (2006). J Mazandaran Uni Med Sci 2012; 22: 102–107.
 Bakouei F, Omidvar SH, Nasiri F. [Prevalence of female sexual dysfunction in married women and its related factors (Babol 2006).] J Babol Uni Med Sci 2007; 9: 59–64. (in Persian)
 Shaeer O, Shaeer K, Shaeer E. The global online sexuality survey (GOSS): Female sexual dysfunction among internet users in the reproductive age group in the Middle East. J Sex Med 2012; 9: 411–424.
 Echeverry MC, Arango A, Castro B, Raigosa G. Study of the prevalence of female sexual dysfunction in sexually active women 18 to 40 years of age in Medellín, Colombia. J Sex Med 2010; 7: 2663–2669.
 Singh JC, Tharyan P, Kekre NS, Singh G, Gopalakrishnan G. Prevalence and risk factors for female sexual dysfunction in women attending a medical clinic in south India. J Postgrad Med 2009; 55: 113–120.
 Song SH, Jeon H, Kim SW, Paick JS, Son H. The prevalence and risk factors of female sexual dysfunction in young Korean women: An internet‐based survey. J Sex Med 2008; 5: 1694–1701.
 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: 3080–3087.
 Frank JE, Mistretta P, Will J. Diagnosis and treatment of female sexual dysfunction. Am Fam Physician 2008; 77: 635–642.
 Ibrahim ZM, Ahmed MR, Ahmed WAS. Prevalence and risk factors for female sexual dysfunction among Egyptian women. Arch Gynecol Obstet 2013; 287: 1173–1180.
 Aggarwal RS, Mishra VV, Panchal NA, Patel NH, Deshchougule VV, Jasani AF. Sexual dysfunction in women: An overview of risk factors and prevalence in Indian women. J South Asian Fed Obstet Gynecol 2012; 4: 134–136.
 Pujols Y, Meston CM, Seal BN. The association between sexual satisfaction and body image in women. J Sex Med 2010; 7: 905–916.
 Convery KM, Spatz DL. Sexuality & breastfeeding: What do you know? MCNAm J Matern Child Nurs 2009; 34: 218–223.
 Falk SJ, Dizon DS. Sexual dysfunction in women with cancer. Fertil Steril 2013; 100: 916–921.
 Abdi F, Daryani NE, Khorvash F, Yousefi Z. Experiences of individuals with liver cirrhosis. Gastroenterol Nurs 2015; 38: 252–257.