即使考虑到个人苦恼,女性性功能障碍的患病率也不清楚,因为流行病学研究使用的问卷是基于过时的性障碍定义,更多反映了男性性欲(例如在性活动之前缺乏性幻想和性欲意味着有障碍)。Natsal-3 调查是一个进步,对性反应和性功能两者间存在问题的 6,777 例妇女进行研究,且使用一份经过验证的新问卷评估性生活。在此份问卷中,功能障碍的生物医学方面不是主要关注点。[15]Mitchell KR, Mercer CH, Ploubidis GB, et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382:1817-1829.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898902/http://www.ncbi.nlm.nih.gov/pubmed/24286787?tool=bestpractice.com
引入苦恼标准后,妇女经常报告无苦恼的功能障碍,性欲障碍的患病率数值一般会从大约 35% 降到 9% 左右。[16]Leiblum SR, Koochaki PE, Rodenberg CA, et al. Hypoactive sexual desire disorder in postmenopausal women: US results from the Women's International Study of Health and Sexuality (WISHeS). Menopause. 2006;13:46-56.http://www.ncbi.nlm.nih.gov/pubmed/16607098?tool=bestpractice.com[17]Dennerstein L, Koochaki P, Barton I, et al. Hypoactive sexual desire disorder in menopausal women: a survey of western European women. J Sex Med. 2006;3:212-222.http://www.ncbi.nlm.nih.gov/pubmed/16490014?tool=bestpractice.com然而,英国一项大型研究使用 6 个月或更长时间此标准,诊断 10.7% 妇女,其中 28% 是来寻求帮助(苦恼的间接指标)。[18]Mitchell KR, Mercer CH, Wellings K, et al. Prevalence of low sexual desire among women in Britain: associated factors. J Sex Med. 2009;6:2434-2444.http://www.ncbi.nlm.nih.gov/pubmed/19549088?tool=bestpractice.com来自美国全国代表性调查的妇女患病率数据显示,性欲障碍的患病率是 8.3% - 9.5%,多数在年龄间的差异很小,但在 60 岁以上妇女中下降。[16]Leiblum SR, Koochaki PE, Rodenberg CA, et al. Hypoactive sexual desire disorder in postmenopausal women: US results from the Women's International Study of Health and Sexuality (WISHeS). Menopause. 2006;13:46-56.http://www.ncbi.nlm.nih.gov/pubmed/16607098?tool=bestpractice.com[19]West SL, D'Aloisio AA, Agans RP, et al. The prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med. 2008;168:1441-1449.http://www.ncbi.nlm.nih.gov/pubmed/18625925?tool=bestpractice.com手术绝经的妇女中,患病率一般达到 12.5%,45 岁以下妇女则达 19.9%。[19]West SL, D'Aloisio AA, Agans RP, et al. The prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med. 2008;168:1441-1449.http://www.ncbi.nlm.nih.gov/pubmed/18625925?tool=bestpractice.com大多数调查关注性唤起功能障碍的润滑部分,而不是主观性兴奋/性唤起问题。最近针对 40 岁以上妇女的一项大型调查显示,约 17% 报道存在中至重度性唤起问题。[20]Addis IB, Van Den Eeden SK, Wassel-Fyr CL, et al. Sexual activity and function in middle-aged and older women. Obstet Gynecol. 2006;107:755-764.http://journals.lww.com/greenjournal/Fulltext/2006/04000/Sexual_Activity_and_Function_in_Middle_Aged_and.4.aspxhttp://www.ncbi.nlm.nih.gov/pubmed/16582109?tool=bestpractice.comNatsal-3 调查关注最近一年至少持续 3 个月的发生问题。约 30% 的妇女缺乏性兴趣,几乎 25% 缺乏性享受,约 8% 经历性疼痛,类似结果均感觉兴奋很少:约 16% 发现性高潮难以想起,所有这些问题均与年龄差异不大。焦虑在年轻妇女性活动期间,更常见,发生率约为 8%;阴道干燥在绝经后 10 年期间最常见,影响 30% 的妇女。[15]Mitchell KR, Mercer CH, Ploubidis GB, et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382:1817-1829.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898902/http://www.ncbi.nlm.nih.gov/pubmed/24286787?tool=bestpractice.com未使用苦恼标准。
在美国居住的妇女中,日本人和华人背景的妇女,功能障碍患病率较高,非洲裔美国人较低。[21]Cain VS, Johannes CB, Avis NE, et al. Sexual functioning and practices in a multi-ethnic study of midlife women: baseline results from SWAN. J Sex Res. 2003;40:266-276.http://www.ncbi.nlm.nih.gov/pubmed/14533021?tool=bestpractice.com一项国际研究显示,与欧洲和北美人群相比,居住在中东、东南亚和中东的妇女中,功能障碍的患病率最高。[22]Laumann EO, Nicolosi A, Glasser DB, et al. Sexual problems among women and men, aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviours. Int J Impot Res. 2005;17:39-57.http://www.ncbi.nlm.nih.gov/pubmed/15215881?tool=bestpractice.com
根据报告,美国妇女中,女性性高潮障碍 (FOD) 的患病率为 24%,英国妇女为 9.3%。然而,严格使用苦恼标准后,患病率接近 5%。[3]Bancroft J, Loftus J, Long JS. Distress about sex: a national survey of women in heterosexual relationships. Arch Sex Behav. 2003;32:193-208.http://www.ncbi.nlm.nih.gov/pubmed/12807292?tool=bestpractice.com