Socioeconomic Variables Effecting Female Sexual Function in an Urban, Community Setting


Introduction: Female sexual dysfunction is a common problem affecting 12% - 63% of the population, and its relationship with demographic factors, depression, and urinary incontinence needs to be more clearly identified. Aims: To determine demographic and clinical conditions associated with female sexual dysfunction in an urban population of women seeking routine gynecologic care. Methods: A cross-sectional, IRB approved study with a convenience sample was performed of 238 sexually-active, non-pregnant women reporting to two urban gynecology clinics: a private practice (n = 168) and a publicly funded ambulatory clinic (n = 70). Main Outcome Measures: The participants completed informed consent and a demographic questionnaire, plus validated questionnaires that measured sexual function with the Female Sexual Function Index (FSFI), depression with the Center for Epidemiologic Studies Depression Scale (CES-D), and urinary incontinence with the Questionnaire for Urinary Incontinence Diagnosis (QUID). Results: The mean FSFI score for those with public insurance and private insurance was 29.5 ± 4.2 and 27.8 ± 5.1 (OR 0.746, p = 0.0005, 95% CI 0.633, 0.881) respectively. In comparing “private” and “public” patient groups, age, weight, race, education, employment, exercise, household income, smoking, alcohol frequency, and sex frequency were all significantly different (p < 0.05). Multivariate logistic regression analysis found that female sexual dysfunction correlated with less education (OR 1.379, p = 0.0346, 95% CI 1.024, 1.858), and worsening depression identified by CES-D score (OR 1.088, p < 0.0001, 95% CI 1.043, 1.135). Conclusions: Female sexual dysfunction was associated with decreased household income, urinary incontinence, less education, and depression.

Share and Cite:

Neal, K. , Teng, S. , Nyamukapa, M. , Greenberg, V. , Braverman, A. and Worly, B. (2015) Socioeconomic Variables Effecting Female Sexual Function in an Urban, Community Setting. Open Journal of Obstetrics and Gynecology, 5, 195-202. doi: 10.4236/ojog.2015.54028.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Worly, B., Gopal, M. and Arya, L. (2010) Sexual Dysfunction among Women of Low-Income Status in an Urban-Setting. International Journal of Gynecology & Obstetrics, 111, 241-244.
[2] Laumann, E.O., Paik, A. and Rosen, R. (1999) Sexual Dysfunction in the United States: Prevalence and Predictors. JAMA, 281, 537-544.
[3] Shifren, J., Monz, B., Russo, P., Segreti, A. and Johannes, C. (2008) Sexual Problems and Distress in United States Women: Prevalence and Correlates. Obstetrics & Gynecology, 112, 970-978.
[4] Jiann, B.P., Su, C.C., Yu, C.C., Wu, T. and Huang, J.K. (1999) Risk Factors for Individual Domains of Sexual Function. The Journal of Sexual Medicine, 6, 3364-3375.
[5] Frank, E., Anderson, C. and Rubinstein, D. (1978) Frequency of Sexual Dysfunction in “Normal” Couples. The New England Journal of Medicine, 299, 111-115.
[6] Masters, W. and Johnson, V. (1966) Human Sexual Response. Little, Brown, Boston.
[7] American Psychiatric Assoc. (2000) Diagnostic and Statistical Manual of Mental Disorders. 4th Edition, Text Revision. Washington DC, 535 p.
[8] Bancroft, J., Loftus, J. and Long, J. (2003) Distress about Sex: A National Survey of Women in Heterosexual Relationships. Archives of Sexual Behavior, 32, 193-208.
[9] Kaplan, H. (1979) Disorders of Sexual Desire and Other New Concepts and Techniques in Sex Therapy. Brunner/ Hazel Publications, New York.
[10] Berman, J. and Bassuk, J. (2002) Physiology and Pathophysiology of Female Sexual Function and Dysfunction. World Journal of Urology, 20, 111-118.
[11] Working Group on a New View of Women’s Sexual Problems (2000) A New View of Women’s Sexual Problems. Electronic Journal of Human Sexuality, 3.
[12] Whipple, B. (2002) Women’s Sexual Pleasure and Satisfaction. A New View of Female Sexual Function. The Female Patient, 27, 39-44.
[13] Basson, R. (2001) Female Sexual Response: The Role of Drugs in the Management of Sexual Dysfunction. Obstetrics & Gynecology, 98, 350-353.
[14] Whipple, B. and Brash-McGreer, K. (1997) Management of Female Sexual Dysfunction. In: Sipski, M.L. and Alexander, C.J., Eds., Sexual Function in People with Disability and Chronic Illness. A Health Professional’s Guide, Aspen Publishers, Inc., Gaithersburg, 509-534.
[15] Sand, M. and Fisher, W.A. (2007) Women’s Endorsement of Models of Female Sexual Response: The Nurses’ Sexuality Study. The Journal of Sexual Medicine, 4, 708-719.
[16] World Health Organization (2012) Sexual Health.
[17] Marwick, C. (1999) Survey Says Patients Expect Little Physician Help on Sex. JAMA, 281, 2173-2174.
[18] Avis, N., Zhao, X., Johannes, C., Ory, M., Brockwell, S. and Greendale, G. (2005) Correlates of Sexual Function among Multi-Ethnic Middle-Aged Women: Results from the Study of Women’s Health Across the Nation (SWAN). Menopause, 12, 385-398.
[19] Rogers, R.G., Kammerer-Doak, D., Villarreal, A., Coates, K. and Qualls, C. (2001) A New Instrument to Measure Sexual Function in Women with Urinary Incontinence or Pelvic Organ Prolapse. American Journal of Obstetrics and Gynecology, 184, 552-558.
[20] Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., Ferguson, D. and D’agostino, R. (2000) The Female Sexual Function Index (FSFI): A Multi-Dimensional Self-Report for the Assessment of Female Sexual Function. Journal of Sex & Marital Therapy, 26, 191-208.
[21] Wiegel, M., Meston, C. and Rosen, R. (2005) The Female Sexual Function Index (FSFI): Cross-Validation and Development of Clinical Cutoff Scores. Journal of Sex & Marital Therapy, 31, 1-20.
[22] Eaton, W., Muntaner, C., Smith, C., Tien, A. and Ybarra, M. (2004) Center for Epidemiologic Studies Depression Scale: Review and Revision (CESD and CESD-R). In: Maruish, M.E., Ed., The Use of Psychological Testing for Treatment Planning and Outcomes Assessment, 3rd Edition, Lawrence Erlbaum, Mahwah, 363-377.
[23] Bradley, C.S., Rahn, D.D., Nygaard, I.E., Barber, M.D., Nager, C.W., Kenton, K.S., Siddiqui, N.Y., Abel, R.B., Spino, C. and Richter, H.E. (2010) The Questionnaire for Urinary Incontinence Diagnosis (QUID): Validity and Responsiveness to Change in Women Undergoing Non-Surgical Therapies for Treatment of Stress Predominant Urinary Incontinence. Neurourology and Urodynamics, 29, 727-734.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.