The aim was to analyze the prevalence of unobserved sexual dysfunction and the impact on women's health. The hypothesis is that the prevalence of unnoticed sexual dysfunction will be high.

This is a cross-sectional study with data collection conducted from August to October 2022 using an online questionnaire. Participants were invited through social networks (Instagram, Facebook, and WhatsApp) to participate. The inclusion criteria were: women over 18 years old who have an active sexual life, were in agreement with the research, and signed the free and informed consent form. Exclusion criteria were: women undergoing oncological treatment and psychological illness. An online questionnaire (Google Forms) was used, with 62 questions that were divided into sociodemographic profile (age, marital status, education, religion, profession, family income, children, contraceptive method), health condition (treatment with a psychiatrist or oncologist, use of medications, physical activity, prevalence of abuse), FSQ (female sexual quotient), and questions about sexual self-perception.
The FSQ is a questionnaire used to assess female sexual function, consisting of 10 questions focusing on four items: sexual desire and interest, foreplay, women's arousal and harmony with their partner, orgasm, and sexual satisfaction. Each answer is assigned a value from 0 to 5, where 0 means ''never'' and 5 means ''always'', and then a mathematical calculation is used to obtain a final score. Data were expressed as percentages and frequencies, and the Excel (16.42 - 2020) program was used.

One hundred nineteen non-pregnant Brazilian women participated in this study, with a mean age of 25.4 ± 6 years. The majority declared themselves single (62.2%), followed by married (19.3%), in a stable union (16.8%), and divorced (1.7%). The level of education showed a predominance of higher education being completed for 43.7% and incomplete for 45.5%. Of the participants, 69.7% had a religious affiliation, 78.15% did not take medication, and 16.8% used antidepressants. Regarding contraceptive methods, although 32.8% did not use any type of contraception, the contraceptive pill stood out as the most prevalent method (26.9%), followed by the non-hormonal IUD (12.6%) and hormonal IUD (11.76%). Monthly family income was distributed as follows: 33.6% had 1 to 2 minimum wages, 36.1% declared 3 to 5, and the remainder had 5 or more minimum wages. Only 18.4% of the sample had children, with cesarean section being the most common method of delivery, occurring in 77.7% of cases.
According to the score on the Female Sexual Quotient (QS-F) scale (Table 1), 54 women rated their sexual performance standard as highly satisfied (45.38%), 52 as partially satisfied (43.7%), 10 as average (8.40%), 2 as dissatisfied (1.68%), and 1 as highly dissatisfied (0.84%). Considering the scale of 0 being never and 5 being always, the questions with the highest average were questions 3 (about foreplay stimulation), 4 (about lubrification), and 5 (partner’s arousal). The questions that had the lowest average were questions 7 (about pain during sexual intercourse) and 1 (about thinking spontaneously), respectively. Furthermore, 90% of the questions scored above average.
Fifty-one of the interviewees (42.9%) responded that they considered it normal not to think about sex spontaneously, and 30.3% considered it normal to think about sex spontaneously. One hundred-five women (88.2%) considered it normal to be lubricated, and 108 (90.8%) did not think it was normal to feel pain during sexual intercourse. Regarding being distracted during sex, 56.3% did not  consider it normal. Of the participants, 58.8% (70) women considered it normal to reach orgasm, and 31.9% considered it normal not to reach orgasm.
When asked about abuse, 58 women (48.7%) said they had suffered some type of abuse. Among them, 39 (32.8%) declared having suffered verbal abuse, 36 (30.3%) reported having suffered emotional or sexual abuse, 24 (20.2%) claimed to have suffered physical abuse, and 9 (7.6%) did not want to respond. Furthermore, 53 women (44.5%) did not suffer abuse, and 8 (6.7%) preferred not to respond.

Although the population of female respondents mostly had complete and incomplete higher education (89.2%), there were respondents who considered it normal to feel pain during intercourse (4.2%) and considered it normal not to have an orgasm during sexual intercourse (31.9%), signs suggestive of sexual dysfunction. It shows the importance of health professionals in combating stigmas related to sexual health, focusing on educating women about their own bodies in physiological and pathological situations (Reed, 2022).

All of these factors indicate suggestive, unnoticed sexual dysfunction that impacts a woman's life in several ways (social, emotional, cultural, among others). To alleviate the negative effects of a lack of perception of one's own body and a lack of knowledge and approach to female sexuality, it is essential that informative campaigns be carried out on sexual function, campaigns to encourage self-knowledge and perception, and greater research in the area by health professionals. In the literary search for the theme “sexual dysfunction,"  existing studies are still scarce and not so recent. Within this vision of unnoticed dysfunction, with a focus on the analysis of female perception regarding their sexual function as normal or pathological, there is limited research, confirming the importance and need for more studies and approaches in the area.

Reed, M.A. Female Sexual Dysfunction. (2022). Clinics in Plastic Surgery, 49(4), 495-504. https://doi.org/10.1016/j.cps.2022.06.009