Sociodemographic factors associated with female sexual dysfunction in primary care: a systematic review and meta-analysis

Abstract Introduction Little research examines the prevalence of female sexual dysfunction (FSD) in primary care, especially among racially/ethnically and culturally diverse women of various ages and medical statuses across the globe. However, differences in healthcare access, utilization, and education as well as social and cultural values surrounding women’s health and sexuality suggest there are unique factors that place minoritized women at higher risk of developing FSD. Objectives To determine whether country of origin and racial/ethnic identity account for differences in the FSD prevalence in primary care settings among studies included in a recent meta-analysis. Methods Meta-analytic data were gathered and extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, which involved article identification, screening and inclusion resulting in n = 2177 records initially screened and a final sample of n = 48. Predictor variables included economic status (more versus less developed country), country of origin (Middle Eastern, North African, or Asian region or not), and racial identity (percentage of White, Caucasian, and/or European American women included in studies from Western societies). Outcome variables included overall FSD, genitopelvic pain, and sexual desire prevalence via meta regressions conducted in R Studio. Results Studies including women from less developed countries reported higher prevalence rates of FSD. Studies including a greater proportion of White, Caucasian, and/or European American women also reported higher prevalence rates of female sexual desire dysfunction. Studies including women from the Middle East or North Africa (MENA) and Asia reported higher prevalence rates of overall FSD and female sexual desire dysfunction compared to studies with women from other regions. Conclusion Cross-cultural differences in values about sex and sexuality also appear to be contributing to the higher rates of FSD found among women in MENA/Asia, low-income and middle-income regions found in the present study. Health providers located in these regions need to ensure they are screening for FSD and potentially comorbid issues across all health care settings to ensure they are providing the best possible care. The findings align with prior literature suggesting that acculturation/immigration, religion, and culture may impact sexuality and should be considered accordingly in FSD prevention and intervention efforts.