Prevalence of female sexual dysfunction in Africa: A systematic review and meta-analysis

Abstract

Female Sexual Dysfunction (FSD) is a multifactorial health issue influenced by physiological, psychological, and sociocultural factors. Despite a global prevalence of 10–63%, FSD is underrecognized in African contexts due to cultural taboos and limited healthcare access. This review and meta-analysis aim to assess FSD prevalence and risk factors across Africa, guiding culturally sensitive interventions, policies, and future research to improve women's sexual health. Following PRISMA guidelines, a systematic search was conducted in databases including PubMed, Embase, CINAHL, and African Journals Online (AJOL) for studies published between 2000 and 2023. Eligible studies reported FSD prevalence in African women aged 18 years and older. A meta-analysis of pooled prevalence was conducted using a random-effects model, with heterogeneity assessed using I² and Cochran’s Q tests. Thirteen studies involving 11,585 women from five African countries met the inclusion criteria. The pooled prevalence of FSD was 52.1% (95% CI: 45.7–58.4%), with significant heterogeneity (I² = 97.1%). Regional prevalence rates ranged from 39% in East Africa to 61% in West Africa (p=0.051). The pooled prevalence was 76.2% for desire disorder; 59.7%for arousal disorder; 73.7% for lubrication; 73.1% for orgasm disorder; 60.6% for sexual dissatisfaction and 51.6% for pain/dyspareunia. The diagnostic tool used influenced prevalence estimates, with the Female Sexual Function Index (FSFI) reporting lower rates (44%) compared to other tools (70%) (p<0.001). FSD affects over half of African women, underscoring the need for standardized diagnostic criteria, increased awareness, and culturally appropriate interventions to address this pervasive issue and improve women’s quality of life. • Female sexual dysfunction (FSD) is highly prevalent in Africa, with a pooled rate of 52.1% (95% CI: 45.7–58.4%). • Prevalence varies by region, culture, and methodology, showing significant heterogeneity across studies. • Female sexual dysfunction (FSD) is a multifactorial condition influenced by diverse contextual factors in Africa.