Sexual Health Difficulties in a Population-Based Sample of Croatian Women Aged 18–35 and the Effects of the Dual (Career and Motherhood) Role


Aleksandar Štulhofer, PhD, Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lučića 3, 10000 Zagreb, Croatia. Tel: (+385) 1 6120 007; Fax: (+385) 1 615 6879; E-mail:


Introduction.  The prevalence of sexual health difficulties among women in Croatia is presently unknown. Although women under 40 years of age may be exposed to the most intense demands of the dual role (career and motherhood), they are often assumed to be at lower risk for sexual difficulties.

Aim.  To assess the prevalence of sexual difficulties in a population-based study of women aged 18–35 and to explore the possible impact of the dual role on female sexual health.

Methods.  The study was carried out in April 2010 on a multistage probability sample of 1,000 women aged 18–35 years. The response rate was 37.3% (1,680 women refused to participate). Multivariate logistic regression was used to analyze the correlates of sexual difficulties, including the dual role.

Main Outcome Measures.  The prevalence of the four most common female sexual health difficulties (lack of desire, lubrication difficulties, inability to reach orgasm, and pain during intercourse) were measured using the one-item indicators from the Global Study of Sexual Attitudes and Behaviors.

Results.  Among coitally experienced women (N = 870), 27.6% reported having a lack of desire, 23.6% pain during sexual intercourse, 23.1% inability to reach orgasm, and 18.5% difficulties with genital lubrication. All four difficulties were negatively associated with sexual satisfaction, but only the lack of sexual interest and inability to reach orgasm seemed to substantially decrease sexual well-being. In multivariate analyses, age, education, being in a steady relationship or married, and partner communication about sexuality were significant correlates of reported sexual difficulties. The dual role was not a significant predictor of sexual health difficulties.

Conclusions.  A substantial proportion of participants reported one or more sexual health difficulties that lasted for at least 2 months. Women in the dual role were not at an increased risk of experiencing difficulties in sexual functioning. Štulhofer A, Kuljanić K, and Buzina DŠ. Sexual health difficulties in a population-based sample of Croatian women aged 18–35 and the effects of the dual (career and motherhood) role. J Sex Med 2011;8:1314–1321.