Background
Methods
Protocol and registration
Search strategy and selection criteria
Data collection
Qualitative analysis
Countries with a gender-equal sexual regime | Countries with a male-centered sexual regime | |
---|---|---|
mixed | Asian | |
Austria, Belgium, France, Germany, Spain, Sweden, the United Kingdom, Mexico, Australia, Canada, New Zealand, South Africa, and the United States | Algeria, Egypt, Israel, Italy, Morocco, Turkey, Korea, Malaysia, the Philippines, and Singapore | China, Indonesia, Japan, Taiwan, and Thailand |
Results
Eligible studies from the systematic literature search
Categorical variable | N (%) |
---|---|
World region | 94 |
Europe | 31 (33.0) |
Non-Europe Westa | 14 (14.9) |
Asia | 19 (20.2) |
Central and South America | 10 (10.6) |
Africa | 9 (9.6) |
Middle East | 11 (11.7) |
Sexual regime | 56 |
gender-equal | 27 (48.2) |
male-centered | 19 (33.9) |
Asian (male-centered) | 10 (17.9) |
Human development group | 92 |
very high | 43 (46.7) |
high | 35 (38.0) |
medium | 11 (12.0) |
low | 3 (3.3) |
Significant predictors of female sexual dysfunction
Risk factor | Unclear effect | Protective factor | |
---|---|---|---|
Female Sexual Dysfunction | Demographic: unemployment, unemployment of partner, low education of partner, low SES, illiteracy, economic hardship, restrictive upbringing, sharing a bedroom with family members. Health and wellbeing: poor physical health, poor perceived health, poor mental health, low life satisfaction, poor quality of life, poor social relationships, environment with limited opportunities, chronic illness, heart disease, obesity, physical disability in previous year, depression, anxiety, taking antidepressants, dieting, alcohol, smoking, sleeping problems, polypharmacy. OBGYN: high number of births, ever pregnant, use of IUD, cervical erosion, late debut menarche, abnormal menstrual pattern, female genital mutilation, guilt about abortions, difficult delivery, menopause, urinary incontinence, endometriosis, yeast infection, gynecological surgery, genitourinary problems, pelvic inflammatory disease, hysterectomy, STI. Partner: poor partner health, partner smokes, older partner, partner has SD, relationship dissatisfaction, arranged marriage, polygamous relationship, living separately from partner, long duration of relationship. Sexual life: dissatisfaction with sex life, no / too little foreplay, no genital contact without intercourse (past month), ≥10 lifetime sexual partners, negative attitude toward sex, difficulty talking to partner about sex, not competent at first intercourse, bisexual preferences, homosexual preferences, non-sensuality, sexual abuse, sexual harassment, rape, dissatisfaction with partner’s penis size | age, level of education (high/low), level of income (high/low), residence (rural/urban), masturbation, use of contraceptives, use of HRT, being in a relationship/marriage, parity (having children/not having children), race | older age at marriage, faithful partner, access to private health care, emotional intelligence, frequent communication with partner, intimate communication, only 1 current sexual partner, pregnancy in last year, steady relationship without cohabitation, higher frequency of intercourse, church attendance, sex education, “sex is important” |
Desire Disorder | Demographic: unemployment of partner, low education of partner, low SES, being religious, urban living, having young children, sharing a bedroom with family. Health and wellbeing: poor physical health, poor mental health, low life satisfaction, chronic illness, breast cancer, heart disease, diabetes, thyroid problems, hypertension, depression, anxiety, post-traumatic stress disorder (PTSD), drug addiction, habitualized negative thinking about oneself, dissatisfaction about how housework is done. OBGYN: late debut menarche, abnormal menstrual pattern, STI, female genital mutilation, tubal ligation, cervical erosion, ever pregnant, fear of pregnancy, birth in past year, menopause, urinary incontinence, genitourinary problems, hysterectomy, hormonal contraceptives, low hormones, multiparity. Partner: partner has SD, relationship dissatisfaction, internal stress with partner, habitualized negative thinking about partner, being widowed, long duration of relationship, married more than once. Sexual life: non-sensuality, sexual abuse, childhood sexual abuse, no / too little foreplay, low foreplay enjoyment, low sexual satisfaction, unidirectional coital initiation | age, level of education (high/low), level of income (high/low), employment (unemployed/full-time), masturbation, being in a relationship/marriage, race, frequency of intercourse | older age at marriage, moderate alcohol consumption, smoking, spontaneous sexual initiation, varied sexual repertoire, exercising, non-exclusive relationship, liberal attitudes towards sex, good communication with partner, intimate communication, early sexual debut, having >1 lifetime sexual partner, daily affection, currently pregnant, imbalance of commitment (woman more committed than man), sex education, “sex is important” |
Arousal Disorder | Demographic: unemployment of partner, low education of partner, low SES, being religious. Health and wellbeing: poor physical health, poor mental health, chronic illness, arthritis, thyroid problems, irritable bowel, anxiety, depression, polypharmacy, physical abuse. OBGYN: urinary incontinence, genitourinary problems, menopause, hormonal contraceptives, fear of pregnancy. Partner: partner has SD, partner has low desire, relationship dissatisfaction, internal stress with partner, polygamous relationship, long duration of relationship. Sexual life: “sex is dirty”, no/too little foreplay, low foreplay enjoyment, high acceptance for pornography, liberal sex values, unidirectional coital initiation | age, level of education (high/low), employment (unemployed/full-time), being in a relationship/marriage, race | older age at marriage, divorced/widowed/separated, emotional intelligence, exercising, intimate communication, positive body image, higher frequency of intercourse, use of HRT, daily affection, “sex is important” |
Lubrication Difficulties | Demographic: older age, unemployment, unemployment of partner, low education of partner, low SES, economic hardship, sharing a bedroom with family, manual laborer. Health and wellbeing: poor physical health, poor perceived health, poor mental health, chronic illness, anxiety, seeking medical help, physical abuse. OBGYN: abnormal menstrual pattern, late debut menarche, cervical erosion, infertility, urinary incontinence, STI, menopause. Partner: partner has SD, relationship dissatisfaction, long duration of relationship, partner is unattractive. Sexual life: masturbation, higher frequency of intercourse, “sex is dirty”, knowledge of clitoris | level of income (high/low), level of education (low/high), being in a relationship/marriage | older age at marriage, faithful partner, intimate communication, sex education, “sex is important” |
Orgasm Disorder | Demographic: unemployment, unemployment of partner, low education of partner, urban living, sharing a bedroom with family, being religious, job insecurity, low SES, manual laborer. Health and wellbeing: poor physical health, poor mental health, chronic illness, smoking, alcohol, stress/anxiety, feelings of guilt, arthritis, thyroid problems, depression, critical life event, seeking medical help. OBGYN: late debut menarche, abnormal menstrual pattern, cervical erosion, STI, urinary incontinence, multiparity, abortion, fear of pregnancy, menopause. Partner: partner has SD, relationship dissatisfaction, partner is unattractive, polygamous relationship, married more than once, long duration of marriage. Sexual life: low foreplay enjoyment, masturbation, knowledge of clitoris, non-sensuality, “sex is a duty”, anti-masculinity, sexual embarrassment, rape by partner, no /too little foreplay, never/unsure if ever had orgasm, unidirectional coital initiation, sexual dissatisfaction, absence of sexual pleasure, unsatisfied with thickness/size of partner’s penis | age, level of education (low/high), level of income (high/low), being in a relationship/marriage, race, frequency of intercourse | older age at marriage, faithful partner, exercising, good communication with partner, intimate communication, satisfactory relationship with partner, use of contraceptives, daily affection, being divorced, married less than 5 years, sex education, “sex is important” |
Pain Disorder | Demographic: unemployment, working overtime, unemployment of partner, low education of partner, urban living, sharing a bedroom with family, being religious, low SES. Health and wellbeing: poor physical health, poor perceived health, poor mental health, chronic illness, lung disease, arthritis, lower back pain, anxiety, exhaustion, seeking medical help, colitis, heavy lifting, constipation. OBGYN: late debut menarche, abnormal menstrual pattern, menopause, abortion, infertility, ever pregnant, early (< 15 years old) sexual debut, use of IUD, hormonal contraceptives, STI, chronic urinary tract infections, urinary incontinence, genitourinary problems, cervical erosion, pelvic organ prolapse, pelvic inflammation. Partner: partner smokes, relationship dissatisfaction, planning more children. Sexual life: masturbation, “sex is dirty”, varied sexual practices, sexual dissatisfaction, non-sensuality | age, level of education (high/low), level of income (high/low), being in a relationship/marriage, mode of delivery, parity (having children/not having children), race, frequency of intercourse | older age at marriage, at least 4 years of regular intercourse, positive body image, liberal attitudes towards sex, currently pregnant, sex education, “sex is important” |