The Association Between Female Sexual Dysfunction and Sexual Dysfunction in the Male Partner: A Systematic Review and Meta-Analysis

Published:December 08, 2020DOI:



      The field of study addressing the relationship between FSD and male sexual dysfunction (MSD) represents a pivotal worldwide health issue as interrelationship between FSD and MSD studies are still inconclusive.


      To review the interrelationship between FSD and MSD and to conclude whether there is a definitive risk of men developing sexual dysfunction when his partner is suffering from FSD.


      The investigation was conducted following the standard practice for conducting and reporting the findings of systematic reviews and meta-analyses comprising of 4 electronic databases, that is, Embase, PsycInfo, Cochrane Library and Ovid (Medline) from inception to December 2019. Search strategies were developed based on relevant keywords with appropriate truncation and Boolean operators’ approach. The quality of studies was employed using the McMaster Critical Review Form for Quantitative Studies and were assessed by independent reviewers. The levels of evidence of the included studies were also determined.


      MSD who had been exposed to FSD.


      From more than 8,000 studies searched, 26 studies were finally included, and most included studies have reasonable quality. Meta-analysis found a significant sexual dysfunction in men who are partnered with women with FSD. It found a consistent correlation between FDS and sexual dysfunction in men with a significant 3-fold increase in MSD who are partnered with women with FSD (odds ratio = 3.011, 95% confidence interval: 1.856–4.885, P = <.001, I² = 42.26%). Among subtypes of MSD, likelihood increased 4-fold for erectile dysfunction and that of premature ejaculation doubled. The data for several other domains on their components were mixed.

      Clinical Translation

      These findings support the notion that clinicians should evaluate sexual function pertaining to both partners and encompassing several dimensions and needing an interdisciplinary approach.

      Strength & Limitations

      This review exhaustively examines data search from vast electronic databases and as the comparison of studies is extracted from English journal publications, not all regions worldwide are represented.


      This meta-analysis and systematic review found an association between sexual dysfunction in men partnered with women with FSD, especially in the domains of erectile and ejaculatory function.
      Chew PY, Choy CL, Sidi Hb, et al. The Association Between Female Sexual Dysfunction and Sexual Dysfunction in the Male Partner: A Systematic Review and Meta-analysis. J Sex Med 2021;18:99–112.

      Key Words

      To read this article in full you will need to make a payment
      ISSM Member Login
      Login with your ISSM username and password.
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Purchase one-time access:

      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • World Health Organisation
        Defining sexual health: Report of a technical consultation on sexual health, 28–31 January 2002.
        Geneva WHO Press, Geneva, Switzerland2006 (Geneva, Switzerland)
        • Basson R.
        Human sex-response cycles.
        J Sex Marital Ther. 2001; 27: 33-43
        • Nappi P.R.E.
        • Cucinella L.
        • Martella S.
        • et al.
        Female sexual dysfunction (FSD): prevalence and impact on quality of life (QoL).
        Maturitas. 2016; 94: 87-91
        • Rosen R.C.
        • Althof S.
        Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences.
        J Sex Med. 2008; 5: 1296-1307
        • Amidu N.
        • Owiredu W.K.B.A.
        • Gyasi-Sarpong C.K.
        • et al.
        Sexual dysfunction among married couples living in Kumasi metropolis, Ghana.
        BMC Urol. 2011; 11: 3
        • Enzlin P.
        • Mathieu C.
        • Van den Bruel A.
        • et al.
        Prevalence and predictors of sexual dysfunction in patients with type 1 diabetes.
        Diabetes Care. 2003; 26: 409
        • McCool-Myers M.
        • Theurich M.
        • Zuelke A.
        • et al.
        Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms.
        BMC Womens Health. 2018; 18: 108
        • Nordin R.B.
        • Soni T.
        • Kaur A.
        • et al.
        Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia.
        Singapore Med J. 2019; 60: 40-47
        • Heiman J.R.
        Sexual dysfunction: overview of prevalence, etiological factors, and treatments.
        J Sex Res. 2002; 39: 73-78
        • Laumann E.O.
        • Paik A.
        • Rosen R.C.
        Sexual dysfunction in the United States: prevalence and predictors.
        JAMA. 1999; 281: 537-544
        • Frank E.
        • Anderson C.
        • Rubinstein D.
        Frequency of sexual dysfunction in normal couples.
        N Engl J Med. 1978; 299: 111-115
        • Greenstein A.
        • Abramov L.
        • Matzkin H.
        • et al.
        Sexual dysfunction in women partners of men with erectile dysfunction.
        Int J Impot Res. 2006; 18: 44-46
        • Nelson C.J.
        The impact of male sexual dysfunction on the female partner.
        Curr Sex Health Rep. 2006; 3: 37-41
        • Çayan S.
        • Bozlu M.
        • Canpolat B.
        • et al.
        The assessment of sexual functions in women with male partners complaining of erectile dysfunction: does treatment of male sexual dysfunction improve female partner's sexual functions?.
        J Sex Marital Ther. 2004; 30: 333-341
        • Beck J.G.
        • Barlow D.H.
        • Sakheim D.K.
        The effects of attentional focus and partner arousal on sexual responding in functional and dysfunctional men.
        Behav Res Ther. 1983; 21: 1-8
        • Ibrahim Z.M.
        • Ahmed M.R.
        • Ahmed W.A.S.
        Prevalence and risk factors for female sexual dysfunction among Egyptian women.
        Arch Gynecol Obstet. 2013; 287: 1173-1180
        • Gao J.Z.
        • Y
        • Li H.
        • et al.
        Different evaluations exist between men with erectile dysfunction and their female partners when using erectile hardness model: an interesting, observational, and cross-sectional field survey.
        Biomed Res Int. 2020; 2020: 2302348
        • West S.L.
        • Vinikoor L.C.
        • Zolnoun D.
        A systematic review of the literature on female sexual dysfunction prevalence and predictors.
        Annu Rev Sex Res. 2004; 15: 40-172
        • American Psychiatric Association
        DSM-5: sexual dysfunctions.
        Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association, Arlington, VA2013
        • IsHak W.W.
        • Tobia G.
        DSM-5 changes in diagnostic criteria of sexual dysfunctions.
        Reprod Syst Sex Disord. 2013; 2
        • Lim R.
        • Liong M.L.
        • Leong W.S.
        • et al.
        Sexual function in couples with or without female incontinent partners: correlates and predictors.
        Urology. 2018; 112: 46-51
        • Klein V.
        • Koops T.
        • Lange C.
        • et al.
        Sexual history of male partners of women with the diagnosis vaginismus.
        Sex Relation Ther. 2015; 30: 376-384
        • Pazmany E.
        • Bergeron S.
        • Verhaeghe J.
        • et al.
        Sexual communication, dyadic adjustment, and psychosexual well-being in premenopausal women with self-reported dyspareunia and their partners: a controlled study.
        J Sex Med. 2014; 11: 1786-1797
        • Lau J.T.F.
        • Yang X.
        • Cheng Y.
        • et al.
        Co-occurrence of sexual dysfunction within young married couple dyads living in rural China: a population-based study.
        Int J Impot Res. 2006; 18: 150-159
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.
        Ann Intern Med. 2009; 151: W65-W94
        • Law M.
        • Stewart D.
        • Letts L.
        • et al.
        Guidelines for critical review of qualitative studies.
        McMaster University Occupational Therapy Evidence-Based Practice Research Group, 1998 ( Accessed April 20, 2020)
        • Akhavan-Taghavi M.H.
        • Asghari-Moghaddam M.A.
        • Froutan S.K.
        • et al.
        Vaginismus in Iran: a single center report of 7 years experience.
        Nephrourol Mon. 2015; 7: e30077
        • Bronner G.
        • Kitrey N.
        • Uziel N.
        • et al.
        Correlation between premature ejaculation and female vaginal penetration difficulties.
        Int J Impot Res. 2015; 27: 152-156
        • Chedraui P.
        • Perez-Lopez F.
        • San Miguel G.
        • et al.
        Assessment of sexuality among middle-aged women using the female sexual function index.
        Climacteric. 2009; 12: 213-221
        • Chedraui P.
        • Pérez-López F.R.
        • Sánchez H.
        • et al.
        Assessment of sexual function of mid-aged Ecuadorian women with the 6-item female sexual function index.
        Maturitas. 2012; 71: 407-412
        • Dogan S.
        • Dogan M.
        The frequency of sexual dysfunctions in male partners of women with vaginismus in a Turkish sample.
        Int J Impot Res. 2008; 20: 218-221
        • Elran E.
        • Bronner G.
        • Uziel N.
        • et al.
        The impact of vaginal penetration difficulties on the sexual functioning of women and their male partners.
        Eur J Contracept Reprod Health Care. 2014; 19: 352-358
        • Grewal G.S.
        • Gill J.S.
        • Sidi H.
        • et al.
        Sexual desire disorder in female healthcare personnel in M alaysia.
        Asia Pac Psychiatry. 2013; 5: 14-20
        • Grewal G.S.
        • Gill J.S.
        • Sidi H.
        • et al.
        Prevalence and risk factors of female sexual dysfunction among healthcare personnel in Malaysia.
        Compr Psychiatry. 2014; 55: S17-S22
        • Jahan M.S.
        • Billah S.M.B.
        • Furuya H.
        • et al.
        Female sexual dysfunction: facts and factors among gynecology outpatients.
        J Obstet Gynaecol Res. 2012; 38: 329-335
        • Jiann B.P.
        • Su C.C.
        • Tsai J.Y.
        Is female sexual function related to the male partners' erectile function?.
        J Sex Med. 2013; 10: 420-429
        • Nelson C.J.
        • Shindel A.W.
        • Naughton C.K.
        • et al.
        Prevalence and predictors of sexual problems, relationship stress, and depression in female partners of infertile couples.
        J Sex Med. 2008; 5: 1907-1914
        • Rosen N O.
        • Santos-Iglesias P.
        • Byers E.S.
        Understanding the sexual satisfaction of women with provoked vestibulodynia and their partners: comparison with matched controls.
        J Sex Marital Ther. 2017; 43: 747-759
        • Rosen N.O.
        • Dubé J.P.
        • Corsini-Munt S.
        • et al.
        Partners experience consequences, too: a comparison of the sexual, relational, and psychological adjustment of women with sexual interest/arousal disorder and their partners to control couples.
        J Sex Med. 2019; 16: 83-95
        • Rosen N.O.
        • Muise A.
        • Bergeron S.
        • et al.
        Daily associations between partner responses and sexual and relationship satisfaction in couples coping with provoked vestibulodynia.
        J Sex Med. 2015; 12: 1028-1039
        • Shindel A.W.
        • Nelson C.J.
        • Naughton C.K.
        • et al.
        Sexual function and quality of life in the male partner of infertile couples: prevalence and correlates of dysfunction.
        J Urol. 2008; 179: 1056-1059
        • Smith K.B.
        • Pukall C.F.
        Sexual function, relationship adjustment, and the relational impact of pain in male partners of women with provoked vulvar pain.
        J Sex Med. 2014; 11: 1283-1293
        • Stephenson K.R.
        • Meston C.M.
        Consequences of impaired female sexual functioning: individual differences and associations with sexual distress.
        Sex Relation Ther. 2012; 27: 344-357
        • Witting K.
        • Santtila P.
        • Varjonen M.
        • et al.
        Couples' sexual dysfunctions: female sexual dysfunction, sexual distress, and compatibility with partner.
        J Sex Med. 2008; 5: 2587-2599
        • Yanez D.
        • Castelo-Branco C.
        • Hidalgo L.
        • et al.
        Sexual dysfunction and related risk factors in a cohort of middle-aged Ecuadorian women.
        J Obstet Gynaecol. 2006; 26: 682-686
        • Yeoh S.H.
        • Razali R.
        • Sidi H.
        • et al.
        The relationship between sexual functioning among couples undergoing infertility treatment: a pair of perfect gloves.
        Compr Psychiatry. 2014; 55: S1-S6
        • American Psychiatric Association
        “Male hypoactive sexual desire disorder, 302.71 (F52.0)”.
        in: Diagnostic and statistical manual of mental disorders, fifth edition. American Psychiatric Publishing, 2013: 440-443
        • Herbenick D.
        • Reece M.
        • Schick V.
        • et al.
        Sexual behavior in the United States: results from a national probability sample of men and women ages 14–94.
        J Sex Med. 2010; 7: 255-265
        • Laumann E.
        • Glasser D.
        • Neves R.
        • et al.
        A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America.
        Int J Impot Res. 2009; 21: 171-178
        • Maseroli E.
        • Fanni E.
        • Mannucci E.
        • et al.
        Which are the male factors associated with female sexual dysfunction (FSD)?.
        Andrology. 2016; 4: 911-920
        • Masters W.H.
        • Johnson V.E.
        Human sexual response.
        Little, Brown, Boston1966
        • Basson R.
        • Brotto L.A.
        • Laan E.
        • et al.
        Assessment and management of women's sexual dysfunctions: problematic desire and arousal.
        J Sex Med. 2005; 2: 291-300
        • Nowosielski K.
        • Wróbel B.
        • Kowalczyk R.
        Women's endorsement of models of sexual response: correlates and predictors.
        Arch Sex Behav. 2016; 45: 291-302
        • Koon C.S.
        • Sidi H.
        • Kumar J.
        • et al.
        The phosphodiesterase 5-inhibitors (PDE-5i) for erectile dysfunction (ED): a therapeutic challenge for psychiatrists.
        Curr Drug Targets. 2018; 19: 1366-1377
        • Chung E.
        • Gilbert B.
        • Perera M.
        • et al.
        Premature ejaculation: a clinical review for the general physician.
        Aust Fam Physician. 2015; 44: 737-743
        • Rowland D.L.
        Psychological impact of premature ejaculation and barriers to its recognition and treatment.
        Curr Med Res Opin. 2011; 27: 1509-1518
        • Sidi H.
        • Yusof F.
        • Das S.
        • et al.
        Understanding the pathophysiology of premature ejaculation: bridging the link between pharmacological and psychological interventions.
        Curr Drug Targets. 2018; 19: 856-864