Prevalence and Predictors of Sexual Dysfunction among Female Adults Attending Government Primary Healthcare Clinics in the Kuala Langat District (FSD-PHC): A Cross-Sectional Study

Abstract

Aims: To identify the prevalence and predictors of female sexual dysfunction (FSD) and compare sexual functioning across different reproductive phases. Study Design: Cross-sectional. Place and Duration of Study: Government primary healthcare clinics in Kuala Langat district, Malaysia, from April to July 2025. Methodology: A total of 361 married, sexually active women aged 18-70 years, literate in the Malay language, participated in the study. Women with illiteracy in the Malay language or cognitive impairment were excluded. Sexual function was assessed using the validated Malay version of the Female Sexual Function Index (MVFSFI), which measures desire, arousal, lubrication, orgasm, satisfaction, and pain. Data were analysed using logistic regression to identify factors associated with FSD, with initial bivariate analysis, followed by preliminary final model variable selection and multivariate analysis adjusted for confounders. Results: Over half FSD, (54.6%, n=197) of the participants experienced FSD. Factors significantly associated (p-value <0.05) with FSD included older age, ethnicity (Chinese), higher education levels, infrequent sexual intercourse, perimenopausal status, urogenital symptoms, having a partner with sexual dysfunction, depression, and anxiety. Sexual functioning profiles varied significantly across premenopausal, perimenopausal, and menopausal women, with dysfunction increasing through these reproductive phases. Conclusion: FSD is prevalent and increases with advancing reproductive phases. Routine screening for FSD should be integrated into primary care, particularly for perimenopausal and menopausal women, with emphasis on addressing psychosocial, relational, and partner-related factors through couple-based interventions.