Sexual Difficulties and Associated Sexual Distress in Flanders (Belgium): A Representative Population-Based Survey Study

IntroductionBecause severity and duration of sexual impairment and any distress caused by the sexual impairment are not assessed in most epidemiologic studies on sexual dysfunction, the available prevalence rates are probably an overestimation.AimsTo provide prevalence estimates of severe and persistent sexual difficulties that cause personal distress and to explore the association between personal sexual distress and avoidance of sex, help-seeking behavior, and sexual satisfaction.MethodsThis study used home-based computer-assisted personal interviewing and computer-assisted self-interviewing of a representative, randomly selected, population-based cross-sectional sample of 651 Flemish men and 695 women 14 to 80 years old.Main Outcome MeasuresPrevalence of sexual difficulties, prevalence of sexual dysfunctions (ie, sexual difficulties causing personal distress), and association of sexual distress with avoidance of sex, help-seeking behavior, and sexual satisfaction.ResultsIn this sample, 43.5% of women (95% CI =39.7–47.3) and 34.8% of men (95% CI =31.3–38.3) reported a moderate to severe sexual difficulty. When considering the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (ie, minimum duration of 6 months and presence of personal sexual distress), prevalence rates decreased to 19.0% in women (95% CI =16.0–22.0) and to 15.1% in men (95% CI =12.4–17.8). Sexual distress was associated with more sexual dissatisfaction and greater sexual avoidance. Sexual distress also was associated with help-seeking behavior, although most individuals with distressing sexual difficulties had not sought help.ConclusionAlthough sexual difficulties per se are quite prevalent, severe and persistent sexual difficulties causing sexual distress are far less common. Despite sexual distress being associated with avoidance of sex and lower sexual satisfaction, most people tend not to seek help for their sexual problem, even when being distressed by the problem.