Female Sexual Dysfunction in Primary Care: A Systematic Review and Meta-Analysis of Prevalence

39% prevalence of female sexual dysfunction in primary care — but the evidence base is five years stale

Journal: Journal of Women's Health | Published: 2026-01-06 | Type: Systematic Review, Meta-Analysis | PMID: 41468175 Authors: Vechiu C et al. (Edward Hines Jr. VA Hospital; UMass Chan Medical School; University of Tulsa; University of Kansas Medical Center; University of Nevada Reno) Funding/COI: Funding not disclosed. Authors declare no competing financial interests.

Summary

Vechiu et al., 2026 pooled 48 studies to estimate how common female sexual dysfunction (FSD) is among women seen in primary care. They found 39% overall prevalence, with individual domains clustered tightly between 24% and 29%. The headline number is credible enough, but the evidence base was frozen at July 2020 — the paper sat in the pipeline for over five years before publication, leaving it dated on arrival.

Claims

• Overall FSD prevalence in primary care: 39% (16 studies, random-effects model)
• Prevalence by domain: desire 29%, lubrication 29%, arousal 28%, satisfaction 27%, orgasm 26%, pain 24%
• Domain prevalences cluster in a narrow 5-point band, suggesting either a true pattern or shared measurement artifact
• Moderator analysis across subpopulations (e.g., women with depression vs. diabetes vs. pregnancy) was not statistically significant — sample type did not explain variance in prevalence estimates
• Authors flag "considerable variability" in both clinical subpopulations and measurement instruments across included studies

Study Quality

The methodological choice of a random-effects meta-analysis is appropriate given the acknowledged heterogeneity in populations and tools. Forty-eight included studies is a reasonable corpus. Eligible designs included cross-sectional, longitudinal, retrospective, and cohort — a wide net that captures breadth but compounds the measurement noise problem when prevalence tools aren't standardized.

The non-significant moderator test is cited as reassuring, but it's not. Underpowered moderator analyses routinely fail to detect real subgroup differences. With 16 studies contributing to the overall FSD estimate, the analysis likely lacked the statistical power to distinguish whether a diabetic patient population versus a postpartum population produces meaningfully different prevalence. The abstract also omits I² and Q statistics entirely — critical numbers for interpreting a meta-analysis — which makes it impossible to assess how much the 39% figure should be trusted as a generalizable estimate.

Red Flags

• Five-year evidence gap: search cutoff was July 2020; published January 2026. The field moved on and this paper didn't.
• Funding undisclosed. Not "no funding" — genuinely not listed. That's a reporting failure.
• No heterogeneity statistics reported in the abstract (I², Q, τ²). A random-effects model was chosen specifically because heterogeneity was expected — then they don't report how much there was.
• Mixed measurement instruments across studies (screening tools, diagnostic interviews, clinical records) undermine comparability. A positive screen on a validated questionnaire and a clinician's chart note are not the same thing.
• Domain prevalences are suspiciously uniform (24%–29% range). Either these domains genuinely co-occur at similar rates, or the overlapping measurement tools are artificially compressing variance.
• The conclusion that "patients with diverse presenting concerns would benefit from regular screening" edges toward clinical recommendation — the data here supports "FSD is common," not "screening is effective."

Strengths

• 48 included studies is a substantive sample for a primary care-specific meta-analysis
• Separately quantifying each FSD domain (desire, arousal, lubrication, orgasm, pain, satisfaction) is more informative than a single composite estimate
• Random-effects model is the correct choice for this kind of heterogeneous literature
• Primary care framing is practically useful — most women with FSD never reach a specialist

Verdict

The 39% figure will get cited widely because it's a clean, usable number — and it's probably in the right neighborhood. But this paper has a serious credibility problem: it was published in 2026 on a literature search that stopped in July 2020. Half a decade of FSD research, including the post-pandemic literature on sexual health disruption, is simply absent. The missing heterogeneity statistics and undisclosed funding are separate problems that compound the concern. Read it as a rough prior on prevalence, not as a current evidence summary.