Prevalence and correlates of female sexual dysfunctions- A pilotstudyfromBahrain

Background: Epidemiological research in the field of female sexual dysfunctions [FSD] is limited by the diagnostic dilemma caused by the intricacy of female sexual response. As yet, there are also no data in the literature from our community regard- ing FSD. Objective: Determine the prevalence and socio-med- ical correlates of FSD in Bahrain and assess the consequences in affected women in order to investigate the public health bur- den of the disease and increase awareness amongst health care providers. Methods: A hospital-based, two-centre, cross-section- al study was conducted in Bahrain on a consecutive sample of 255 married and non-pregnant women (a priori assumption: background prevalence = 20%, confidence level = 95%, margin of error = 0.05) aged 18-55 years who presented to the ambula- tory clinic with gynaecological complaints not related to FSD. Participants were interviewed using the validated Female Sexu- al Function Index [FSFI] questionnaire. Demographic, obstet- ric, medical and socio-economic date were collected. A cut-off FSFI score of <26.55 (out of a maximum of 36) was used to define the presence of FSD based on previous studies. Results: 84% of study subjects were Bahraini, 11.5% Arabs and 4.5 % other nationals. The difference in population characteristics between the 3 subgroups was not significant. The 2 majority of women had a university education, worked as professionals, had > 2 deliveries and were not smoking. The primary com- plaint was chronic pelvic pain, dysmenorrhea and/or severe premenstrual symptoms in 60% while 11.3% and 2.9% of the study cohort admitted having at least one episode of urinary and fecal incontinence, respectively, in the last 12 months on further questioning. The overall prevalence of FSD was 55.7% (n=142). FSD was significantly associated with age (p= 0.01), abnormal uterine bleeding (p= 0.04), vaginitis (p= 0.005) and use of anti-hypertensive medications (p= 0.01). The association between FSD and other known risk factors such as socio-eco- nomic (income, educational level), demographic (smoking, obesity), obstetric (parity, previous episiotomy, perineal tears or anal sphincter injuries at birth, forceps or vacuum delivery) gynaecological (infertility, urinary or fecal incontinence, pre- menstrual symptoms, chronic pelvic pain) or medical (previous laparotomy, diabetes mellitus) variables was not significant in our cohort. The most significant domain component effect on low FSFI score was pain, satisfaction, lubrication, orgasm, de- sire and arousal in that order.