SEX IN AMERICA
50 YEARS AFTER THE KINSEY REPORT

The hoopla over Viagra following its FDA approval in 1998 suggested to mindful researchers that perhaps the iceberg was truly deep. Fifty years after the Kinsey Report set Americans spinning, a February 10 Journal of the American Medical Association (JAMA) article detailed the findings of the largest investigation and assessment of sexual problems in America since that landmark study. Co-authored by Raymond Rosen, PhD, professor of psychiatry at UMDNJ-Robert Wood Johnson Medical School, with Edward O. Laumann, PhD, of the University of Chicago, the intent of the new study was to assess the prevalence and risk of experiencing sexual problems across various age and social groups, and to determine whether health-related and psychosocial factors influence who is affected.

The researchers analyzed data on adult sexual behavior collected for the government's National Health and Social Life Survey in 1992. The 1,749 women and 1,410 men surveyed ranged in age from 18 to 59. According to the JAMA article, 43 percent of women and 31 percent of men experience sexual problems -- low sexual desire (22 percent), problems with arousal (14 percent) and pain during intercourse (7 percent) in women and premature ejaculation (21 percent), erectile dysfunction (5 percent) and low desire (5 percent) in men.

According to the study, sexual problems are more common among young women and older men. In the 18 to 29 age group, more than 25 percent of women said they did not find sex pleasurable. But for women, increasing age seems to herald a decrease in sexual problems. For men, aging is associated with a higher incidence of impotence and lack of sexual desire. Men age 50 to 59 reported these problems at three times the rate of men age 18 to 29, although about 30 percent of men in all age groups said they had problems with premature ejaculation.

Marital status also seemed related to the incidence of sexual problems in both men and women. Unmarried women reported about one and a half times more climax problems and sexual anxiety than married women. Unmarried men reported higher rates of sexual problems in all categories than married men.

Stress, poverty, a personal history of traumatic sexual experiences, falling household income and a lower level of education all seem to increase the incidence of sexual problems. The researchers also studied the association between race and ethnicity and sexual problems. In general, black women have higher rates of low desire and pleasure, and white women more sexual pain. Hispanic women reported fewer sexual problems. In general, black men reported more and Hispanic men fewer sexual problems. Rosen warns that magazines such as Cosmopolitan -- which suggest that everyone is having great sex all the time --make many individuals feel deficient. However, the researchers call sexual dysfunction a "significant public health concern" associated with both physiologic and stress-inducing factors.

But the time may be right to address these problems, Rosen says. A better understanding of the physiologic mechanisms of sexual response, the availability of new drugs such as Viagra and changing cultural attitudes now make successful treatment of sexual problems a real possibility.