The sex lives of young women marked by frustration, stress, guilt and embarrassment

Professor Susan Davis, a leading Monash University expert on women’s health, admits it was a highly ambitious project: minutely studying the sexual wellbeing of 7000 young Australian women with particular focus on complicated, intimate ideas such as desire, arousal, orgasm, responsiveness and self-esteem.

Now that it's done (and published this week in the international journal Fertility and Sterility), she's “very concerned.” The main finding is that half of the women studied experience personal "distress" related to sex. One in five has at least one sexual dysfunction. "Young" means aged 18 to 39. The concern, she says, is because “sexual wellbeing is recognised as a fundamental human right”.

Professor Davis is a professor of women’s health at Monash, and also president of the International Menopause Society.

“This is a wake-up call to the community,” she says. “This is what we [society] are doing to people. We expected to find that a meaningful number of young women had sexual issues, but we were not expecting to find half were distressed sexually.”

The study was funded by the Grollo-Ruzzene Foundation. Lead author is a young Monash University researcher, Jia Zheng. Women surveyed came from Victoria, New South Wales and Queensland. Almost half of them had a "normal" body weight, and the vast majority had a job. White Australians, Indigenous Australians, and those with Asian, Pacific Island, North African and Middle Eastern heritage were represented. Almost 70 per cent were sexually active in the previous month.

 Professor Davis says the paper is a first. “No one has ever reported on the broad dimensions of sexual wellbeing in this manner" she says.

“There's an assumption that sexual wellbeing only becomes a problem when a woman is older. Sex is everywhere – we assume everyone under 40 understands sex, and is comfortable with sex and doesn’t have a problem.

“And if there is a problem,” she adds, “there's an assumption it will be a visible problem like a sexually transmitted infection or an abusive relationship.”

Professor Davis explains "distress" in this context for young women as “any distress about their sex life – unhappiness, stress, guilt, frustration, feeling inferior, worry or embarrassment”. Almost 30 per cent experienced these forms of sexual distress without dysfunction, while about 20 per cent had at least one type of sexual dysfunction.

Antidepressants and dysfunction

The most common FSD – female sexual dysfunction – was low sexual self-image, followed by dysfunctions around arousal, desire, orgasm or responsiveness. The dysfunctions were associated with factors such as weight, the woman’s partner, marriage or relationship status, or breastfeeding. But the most serious effects on sexual dysfunction came from using anti-depressants or other psychotropic medications. Twenty-five per cent of surveyed women were using such medicines. The contraceptive pill was found to have no impact.

The differences between men and women who take psychotropic medications – particularly SSRI antidepressants – is stark, says Professor Davis.

“We know that in men, SSRI antidepressants can impair erectile function. It's easy for a man to say, ‘Since I have been on this tablet, I have erectile dysfunction’, But it's harder for a woman to wonder, ‘Since I have been on this tablet, am I less interested?’. It’s less definable for women. The literature suggests adverse impact for both genders, but it's much more clearly demonstrated in men.”

"We expected to find that a meaningful number of young women had sexual issues, but we were not expecting to find half were distressed sexually.”

Professor Davis said the study crossed over into sociological or cultural studies in that much of it touched on body image and the pressure young women (and young men, she adds) face regarding their appearance or sexuality.

“Women who more habitually monitor their appearance, and for whom their appearance is a more substantial determinant of their physical self-worth, are less sexually assertive and more self-conscious during intimacy,” the paper states, “and experience lower sexual satisfaction.”

The paper calls for the health sector to take more notice of young women and their sexual wellbeing. It states: “The high prevalence of sexually related personal distress signals the importance of health professionals, particularly those working in the field of gynaecology and fertility, being adequately prepared to routinely ask young women about any sexual health concerns, and to have an appropriate management or referral pathway in place.”