Prevalence and Factors Associated with Sexual Dysfunction among Patients Seeking Fertility Care at Two Tertiary Hospitals in Uganda: Across-sectional study

Background Sexual dysfunction is a common but under-recognized problem in fertility care with potential implications on treatment outcomes. We determined the prevalence, forms and factors associated with sexual dysfunction among patients seeking fertility care at two tertiary Hospitals in Uganda. Methods A cross-sectional study was conducted at Jinja and Kayunga Regional Referral Hospitals from May to August 2025. A total of 226 participants (113 males and 113 females) seeking fertility care were consecutively recruited. A validated Arizona Sexual Experiences Scale with a cutoff of ≥ 19 was used to define sexual dysfunction. Demographic data were collected using a pre-tested questionnaire. Data was analyzed using Stata version 19. Bivariate and Multivariate analysis for associations was done with statistical significance set at p  < 0.05. Results The mean age was 34.1 years (SD ± 8.3); most had secondary education, unemployed, middle income status, had no living child with Infertility for more than five years. The prevalence of sexual dysfunction was 42.5% (96/226), higher in females (52.2%, 59/113) than in males (32.7%, 37/113). Among women, the most common dysfunctions were reduced sexual desire (33.6%), orgasm difficulties (32.7%), and painful intercourse (27.4%). Among men, reduced desire (27.4%), painful intercourse (23.8%), and erectile difficulties (23.0%) predominated. Independent predictors of sexual dysfunction included age 40–49 years (aOR 2.9; 95% CI: 1.24–6.80, p  = 0.014), low household income (aOR 10.7; 95% CI: 2.14–52.92, p  = 0.004), absence of a living child (aOR 2.8; 95% CI: 1.28–5.10, p  = 0.021), and infertility duration ≥ 5 years (aOR 7.4; 95% CI: 3.38–16.32, p = <  0.001). Being male was associated with a 52% lower likelihood of sexual dysfunction (aOR 0.48; 95% CI: 0.37–0.89, p = <  0.023). Conclusions Sexual dysfunction was common among patients with infertility, especially women thus integrating routine screening, counseling and targeted support for high‑risk groups should be prioritized in fertility care.