Sex Difficulty in women not distressing to most

Sex is painful, uninteresting or unsatisfying for four of every 10 U.S. women, yet just 12 percent say they feel distress because of their difficulties, a survey by a Harvard University researcher found.

Women ages 45 to 64 were more likely to be distressed than older or younger females, said the report in the November issue of Obstetrics & Gynecology. In the 45-to-64 group, one in eight was unhappy because of a lack of desire and one in 15 was upset over their difficulties with arousal or orgasm.

The research mirrors a 1999 survey's conclusion that 43 percent of women from age 18 to 59 had sexual dysfunction. It adds that most aren't ``distressed,'' a word the authors relate to unhappiness, guilt, worry, frustration, embarrassment or anger. Because most women aren't distressed by sexual activity, there probably should be less focus on pharmaceutical solutions and more emphasis on counseling that considers a woman's entire life experience, according to an accompanying editorial.

``We thought it would be important to have an accurate statistic for distressing sexual problems,'' said Jan Shifren, the lead author and an assistant professor of obstetrics and gynecology at Harvard Medical School in Boston, ``If it's not associated with distress, then it's probably not affecting a woman's quality of life.''

``We're used to hearing statistics like 30 to 40 percent of women have sexual dysfunction,'' Shifren said. ``That number seems very high, which suggests it may be normal. To determine the true prevalence, it has to be associated with distress.''

``The question is, if it's not a problem for the person who's got low desire, is it a problem?'' said Katherine Rachlin, a clinical psychologist and sex therapist in New York City. She wasn't affiliated with the study. ``I know one person who thought he had a problem because it took him so long to have an orgasm, and the woman he was with said that was one of the best things about their sex life.''

Women's sexuality is complicated, Rachlin said. It has been her experience that some women don't mind that they don't always orgasm, because they may value the intimacy and closeness sex brings, she said.

``Enjoying sex might rate very high, but having an orgasm may be more optional,'' Rachlin said.

About 38 percent of U.S. women have low sexual desire; about a quarter experience low arousal, and a fifth rarely or never achieve orgasm, if the findings are extrapolated through the U.S. population, the authors wrote.

The 1999 survey may have caused some people to exaggerate the extent of the dysfunction and regard it as a disease, wrote Ingrid Nygaard, a doctor at the University of Utah School of Medicine, in Salt Lake City, in the accompany editorial.

``What's to be gained by over inflating rates and turning symptoms into disease?'' Nygaard wrote. ``Lots -- market shares, provider income, grant support and so on -- that is, fame and fortune.''