• Regression Model;
  • Response Rate;
  • Female Sexual Difficulty;
  • Female Sexual Dysfunction


Introduction.  Studies that address sensitive topics, such as female sexual difficulty and dysfunction, often achieve poor response rates that can bias results. Factors that affect response rates to studies in this area are not well characterized.

Aim.  To model the response rate in studies investigating the prevalence of female sexual difficulty and dysfunction.

Methods.  Databases were searched for English-language, prevalence studies using the search terms: sexual difficulties/dysfunction, woman/women/female, prevalence, and cross-sectional. Studies that did not report response rates or were clinic-based were excluded. A multiple linear regression model was constructed.

Main Outcome Measures.  Published response rates.

Results.  A total of 1,380 publications were identified, and 54 of these met our inclusion criteria. Our model explained 58% of the variance in response rates of studies investigating the prevalence of difficulty with desire, arousal, orgasm, or sexual pain (R2 = 0.581, P = 0.027). This model was based on study design variables, study year, location, and the reported prevalence of each type of sexual difficulty. More recent studies (β = −1.05, P = 0.037) and studies that only included women over 50 years of age (β = −31.11, P = 0.007) had lower response rates. The use of face-to-face interviews was associated with a higher response rate (β = 20.51, P = 0.036). Studies that did not include questions regarding desire difficulties achieved higher response rates than those that did include questions on desire difficulty (β = 23.70, P = 0.034).

Conclusion.  Response rates in prevalence studies addressing female sexual difficulty and dysfunction are frequently low and have decreased by an average of just over 1% per anum since the late 60s. Participation may improve by conducting interviews in person. Studies that investigate a broad range of ages may be less representative of older women, due to a poorer response in older age groups. Lower response rates in studies that investigate desire difficulty suggest that sexual desire is a particularly sensitive topic. Hayes RD, Bennett C, Dennerstein L, Gurrin L, and Fairley C. Modeling response rates in surveys of female sexual difficulty and dysfunction. J Sex Med 2007;4:286–295.