Association between comorbidities and female sexual dysfunction: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

  • Allison R. Polland
  • Meghan Davis
  • Alexander Zeymo
  • Cheryl B. Iglesia
Original Article


Introduction and hypothesis

Although medical comorbidities are widely recognized to be associated with erectile dysfunction, less research has been done on their association with female sexual dysfunction (FSD). The purpose of this study was to assess whether FSD is associated with comorbidities; we hypothesized that there is an association.


This is a secondary analysis of the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a prospective stratified probability sample of individuals aged 16–74. We assessed for association between sexual function scores and heart attack, heart disease, hypertension, stroke, diabetes, chronic lung disease, depression, other mental health condition, other neurologic conditions, and incontinence, as well as menopause and smoking status. Correlation between comorbidities and specific domains of sexual function was also assessed.


A total of 6777 women, with an average age of 35.4 (14.1), responded to the survey and reported sexual activity in the past year. There was an association between sexual function score and age, menopause, hysterectomy, heart disease, hypertension, diabetes, obesity, smoking, depression, other mental health condition, stroke, other neurological condition, and homosexual attraction (p < 0.05). On multivariate analysis, age, sexual attraction, smoking status, depression, and other mental health conditions remained significantly correlated with sexual function (p < 0.05). Comorbidities were found to be correlated with specific domains.


Comorbidities were associated with FSD and specific comorbidities associated with dysfunction in specific domains. Urogynecologists and urologists must assess for comorbidities, as women presenting with sexual dysfunction may provide an opportunity for early diagnosis of life-threatening conditions.


Female sexual dysfunction Desire Lubrication Comorbidities Depression Smoking 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Allison R. Polland
    • 1
    • 2
  • Meghan Davis
    • 2
  • Alexander Zeymo
    • 3
  • Cheryl B. Iglesia
    • 1
    • 2
  1. 1.Georgetown UniversityWashingtonUSA
  2. 2.MedStar Washington Hospital CenterWashingtonUSA
  3. 3.MedStar Health Research InstituteWashingtonUSA

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