London School of Hygiene & Tropical Medicine

An estimated 1.8 million adults in Britain are experiencing sexual problems that need medical help but only around one third of these men and women seek professional support, according to new research published in the Journal of Sex Research.

The findings come from the National Survey of Sexual Attitudes and Lifestyles - the largest scientific study of sexual behaviour in Britain - led by the London School of Hygiene & Tropical Medicine in partnership with UCL and NatCen Social Research.

The researchers looked at survey responses from 11,509 sexually active adults aged 16-74 who answered questions about sexual function problems. They then compared these problems to the international classification of sexual dysfunction as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by health professionals worldwide.

To be considered a medical issue, three 'morbidity criteria' must be met: the problems had to have lasted for at least six months, happened 75% of the time or more, and caused significant distress.

Women reported a range of problems, including a lack of interest in sex and arousal (6.5%), physical pain as a result of sex (7.4%), and difficulty reaching climax (16%). However, once the DSM-5 criteria had been applied, only 3.6% of women were estimated to have problems that could be considered sexual dysfunction.

Problems reported by men included difficulty reaching climax (9.2%), getting and keeping an erection (12.9%), and lacking interest in sex or reaching climax too quickly (15%). However, once the DSM-5 criteria had been applied, only 4.2% of men were estimated to have problems that could be considered sexual dysfunction.

The researchers say that previous studies that have not included morbidity criteria may have overestimated the prevalence of problems. Many problems are 'mild and transient' issues which are sufficiently common to be considered normal.

Nonetheless, there are still an estimated 1.8 million adults in Britain who do experience sexual dysfunction that may require medical support. Only a third of those are seeking help.

Lead author Dr Kirstin Mitchell, who carried out the research at the London School of Hygiene & Tropical Medicine, said: "Although the proportion of people experiencing sexual dysfunction is smaller than we previously thought, it is still a significant amount - around 1.8 million adults in Britain. Only a third of these individuals sought help in the last year, suggesting that around 1.2 million experienced severe sexual problems but did not seek any professional help. Doctors and nurses need to be aware of this unmet need, as our data suggests a significant public health problem that is not currently being addressed."

The authors caution that close involvement of the pharmaceutical industry in previous measurement and classification of sexual dysfunction may have encouraged mild symptoms to be viewed as severe, leading to potential over-medicalization.

The National Survey of Sexual Attitudes and Lifestyles was funded by the Medical Research Council and the Wellcome Trust, with additional funding from the Economic & Social Research Council and the Department of Health.

The authors note that their survey asked about an individual's experience of a problem rather than an official diagnosis, meaning they had to approximate between their findings and the DSM-5 criteria.

Publication:

• Kirstin R. Mitchell, Kyle G. Jones ,Kaye Wellings, Anne M. Johnson, Cynthia A. Graham, Jessica Datta, Andrew J. Copas, John Bancroft, Pam Sonnenberg, Wendy Macdowall, Nigel Field and Catherine H. Mercer. Estimating the Prevalence of Sexual Function Problems: the Impact of Morbidity Criteria. The Journal of Sex Research. DOI: 10.1080/00224499.2015.1089214