A reported disorder does not necessarily mean suffering
The analysis included 9,118 people aged 18 to 89 who had been sexually active during the previous 12 months.
The questions explored desire disorders, dyspareunia—pain during intercourse—and lack of pleasure among all respondents. They also addressed vaginal dryness in women and erectile and ejaculatory disorders in men.
Based on these responses, the researchers developed two indicators.
The first corresponds to the report of at least one disorder that has persisted for more than six months. The second focuses on dysfunctions causing distress, taking into account their impact on sexuality in accordance with the criteria used by the DSM-5.
These two measures therefore do not convey exactly the same information. A person may report a long-standing sexual difficulty without considering that it significantly affects their sex life.
Furthermore, this is a self-report survey: the results are based on the experiences reported by the participants. The authors highlight the challenges inherent in this type of measurement regarding an intimate subject, particularly the sensitivity of the questions and the risk of reporting errors. Potential underreporting and the subjective nature of distress must therefore be kept in mind when interpreting the results.
36.4% of women and 18.9% of men report at least one persistent disorder
In total, 36.4% of women and 18.9% of men report at least one persistent sexual disorder.
When considering only dysfunctions that affect sexuality and are considered a source of distress, the proportions are lower: 21.2% of women and 10.9% of men.
The relationship between these two indicators is also revealing. Among those who reported disorders, 58.2% of women and 57.6% of men indicated that these disorders affect their sexuality. Conversely, a significant proportion of those reporting a persistent disorder do not attribute this impact to it.
This difference explains why the prevalence of a symptom alone is not sufficient to measure its impact on a person’s life.
The Type of Difficulty Changes with Age
The results also vary by age and by the type of disorder studied.
Among those under 30, the dysfunctions causing distress mainly involve low sexual desire and difficulty reaching orgasm. After age 60, vaginal dryness and erectile dysfunction become predominant.
Overall, the prevalence of symptoms increases with age, with a particularly marked increase among men over 60. However, not all disorders follow the same pattern: their frequency and nature vary by gender and age group.
Among men, for example, the proportion reporting at least one dysfunction rises from 12.6% between the ages of 18 and 29 to 44.3% between the ages of 80 and 89.
Referring to “sexual dysfunctions” as a single phenomenon therefore masks different realities: desire, orgasm, pain, lubrication, and erection do not change in the same way over the course of a lifetime.
Sexual Health and General Health Are Linked
The study also highlights several associations between sexual difficulties and health status.
Functional disability is associated with a higher likelihood of dysfunction in both women and men. Chronic diseases also appear to be more common among people reporting distressing difficulties, while a history of urogenital conditions is particularly associated with sexual dysfunction in men.
These are statistical associations. These results do not establish that any given factor alone causes sexual dysfunction.
Regarding sexual violence, the publication specifically reports that among women who reported having experienced sexual violence during their lifetime, distressing sexual dysfunction is reported more frequently than among women who did not report such violence. This association remains statistically significant in the multivariate analysis.
This result therefore describes an association observed among the women in the study sample. It does not, on its own, establish a causal relationship.
Persistence and Distress Do Not Measure the Same Reality
The distinction between the two indicators is one of the most useful contributions of this analysis.
More than one-third of women and nearly one in five men report at least one persistent disorder. However, among those reporting disorders, 58.2% of women and 57.6% of men state that these disorders affect their sexuality.
The authors note that the manifestations studied are classified as disorders or dysfunctions according to established criteria, whereas the perceived impact also depends on individual expectations, practices, and attitudes toward norms surrounding sexuality.
Considering persistence and distress separately thus helps avoid two oversimplifications: downplaying a difficulty that genuinely impacts one’s sex life, or automatically considering any lasting variation to be clinically problematic.
The survey provides population-level estimates. A prevalence figure is therefore insufficient to determine what constitutes a difficulty for a given individual.
When a Difficulty Warrants Attention
CSF-2023 does not define a threshold beyond which a person should seek consultation.
The study does, however, show that sexual difficulties often occur within a broader health context and that their impact varies greatly from person to person. The authors therefore advocate for a holistic approach to sexual health.
When a difficulty persists, causes pain, or affects a person’s sex life, it can be discussed with a healthcare professional to put it into context, without prejudging its cause.
Ultimately, the central lesson of CSF-2023 lies in this distinction: reporting a problem, seeing it persist, and experiencing distress as a result are three related realities, but they should not be conflated.
