Sexual behaviour and dysfunction and help-seeking patterns in adults aged 40–80 years in the urban population of Asian countries


Alfredo Nicolosi, Department of Epidemiology and Medical Informatics, Institute of Biomedical Technologies, National Research Council, Via Fratelli Cervi 93, 20090 Segrate MI, Italy.



To study sexual activity, the prevalence of sexual dysfunction and related help-seeking behaviour among middle-aged and elderly people in Asia.


A random population survey was carried out in 2001–2002 among urban residents aged 40–80 years in China, Taiwan, South Korea, Japan, Thailand, Singapore, Malaysia, Indonesia and The Philippines, with interviews based on a standardized questionnaire covering demographic details, health, relationships, and sexual behaviours, attitudes and beliefs. An intercept method of sampling was used in all countries except Japan, where questionnaires were mailed to a sample drawn from telephone directories. Sexual dysfunction was defined as persistent sexual problems.


The questionnaire was completed by 6700 people (3350 men and 3350 women), giving a response rate of 27%. Across all countries, 82% of men and 64% of women had engaged in sexual intercourse during the year preceding the interview. Most of the respondents considered satisfactory sex an essential means of maintaining a relationship. More than 20% of men and 30% of women complained of having at least one sexual dysfunction, although there were marked variations among the countries. The sexual dysfunctions most frequently reported were early ejaculation (20%; 95% confidence interval, CI, 18–21) and erectile dysfunction (15%, 14–17) among men; and a lack of sexual interest (27%, 25–29), lubrication difficulties (24%, 22–25), and an inability to reach orgasm (23%, 22–25) among women. Of the 948 men and 992 women who were sexually active and reported sexual dysfunctions, 45% did sought no help or advice and only 21% sought medical care.


Men and women in Asian countries continue to show sexual interest and activity into middle age and beyond. Although sexual dysfunction is prevalent in this age group, several sociocultural and economic factors appear to be preventing individuals from seeking medical help for these problems.