Sexual difficulties, distress and dysfunction among women with refugee background in Australia

This study aimed to document the prevalence of sexual difficulties, sexually-related personal distress, sexual dysfunction and associated factors among refugee women in Australia. The cross-sectional study included refugee women aged 18–63 years. Sexual difficulties were defined as selecting ‘always’ or ‘very often’ on the Profile of Female Sexual Function, while distress was a score of at least 11 on the Female Sexual Distress Scale – Revised. Female sexual dysfunction (FSD) combined these scores. Participants also completed the Woman Abuse Screening Tool and the Bristol Female Lower Urinary Tract Symptoms questionnaire. Among 299 participants (median age 41 years), sexual difficulties, sexually-related personal distress and FSD were present in 39.3%, 33.2% and 7.0%, respectively. Perimenopausal/postmenopausal status (adjusted odds ratio [aOR] = 2.8, 95% confidence interval [CI]: 1.4–5.6, <i>p</i> = 0.003) and sexual activity (aOR = 0.2, 95% CI: 0.1–0.4, <i>p</i> &lt; 0.001) predicted sexual difficulties. Intimate partner abuse (aOR = 5.9, 95% CI: 2.4–14.5, <i>p</i> &lt; 0.001) and urinary incontinence (aOR = 4.5, 95% CI: 1.5–13.0, <i>p</i> = 0.006) were associated with sexually-related personal distress. Perimenopausal/postmenopausal status and sexual inactivity were associated with sexual difficulties, while intimate partner abuse and urinary incontinence were associated with sexually-related distress, highlighting the importance of proactive screening for psychosocial and physical health issues in sexual health assessments among refugee women. This study looked at the sexual health of women with refugee backgrounds living in Australia. Sexual health includes not only physical experiences but also emotional and psychological well-being. Many refugee women face challenges that can affect their sexual health, including stress, trauma and changes in life circumstances after resettling in a new country. This study asked 299 refugee women aged 18–63 years to complete surveys about their sexual experiences and how they felt about them. The study also asked about other factors like their age, menopause status, partner relationships, urinary symptoms and experiences of abuse. The study found that about 4 in 10 women had sexual difficulties, such as low desire or trouble with arousal or orgasm. About one in three women felt distress or worry related to their sexual life. However, only 7% met the criteria for female sexual dysfunction, which includes both physical difficulties and emotional distress. Women going through or after menopause were more likely to have sexual difficulties. Women who were sexually active reported fewer problems. Those who had experienced abuse by a partner or had urinary incontinence were much more likely to feel distress about their sexual lives. Our findings show that sexual health is a serious concern for many refugee women. Health services should routinely ask about both physical and emotional aspects of sexual well-being, and ensure care is sensitive to their backgrounds and needs.