Reviewer ’s report  
Title: Predictors of female sexual dysfunction: A systematic review and qualitative analysis 
through gender inequality paradigms  
 
Version: 2 Date: 15 Sep 2017  
 
Reviewer: Marjan Khajehei  
 
Reviewer's report:  
Thank you for conducting this systematic review of the predictors of female sexual dysfunction!  
 
My comments are:  
- The authors have used the words "women of reproductive age" and "premenopausal women" 
alternately.  Reproductive age can be roughly from 12 to 49. However, premenopausal refer 
to women in their 40s. What were the age ranges of women in the cited literature? Please 
clarify and be consistent throughout. If the aim is only premenopausal women, the majority  
of the literature cited may not be applicable and the manuscript needs major revision. 
However, if the authors aimed to investigate predictors of sexual dysfunction in reproductive 
women then the cited literature are suitable. The manuscript needs to be t horoughly revised 
accordingly.  
- The number of Figures on the last pages of the manuscript don't match with in -text Figures. 
For example, page 11, para 1 says "Figure 1 illustrates the significant risk factors for female 
sexual dysfunction …". However, thi s should be referred to as "Figure 2…". Similar error on 
page 13 referring to 'Figure 2', while it should be 'Figure 3'.  
- There should not be one -sentence paragraphs. Please revise throughout (pages 6, 13, 14).  
- Page 13, Line 9, please cite the literatur e (Shaeer, Blumel et al.) according to the Journal's 
requirements.  
- There are contradictory reports in the literature on protective factors and risk factors of 
sexual dysfunction. For example, some studies have reported that masturbation results in 
better  orgasmic function while others reported that women who masturbate have more sexual 
desire disorder. I understand that there are controversies in the literature on some factors. 
However, there are a few factors reported in this systematic review that may n ot make sense 
to the readers. For example, on page 12 line 7 and page 14 line 2 'smoking and alcohol 
consumption' have been noted as protective factors of sexual dysfunction in gender -equal 
regimes and countries with high HD. While this report is interesti ng, it may not make sense 
to the readers. Similarly, on page 13, line 1, 'knowledge of the clitoris' was reported as a risk 
factors for sexual dysfunction in Asian male centred sexual regime! Since each report is from 
a different study and in order to avoi d confusion and add more credibility to this systematic 
review, I suggest the authors add references to the results.  
- Page 16, para 3, line 1, the paragraph starts with 'Luaumann et al. established two different 
….'. Please cite that research properly and  add the reference number to the text.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
Yes 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
Unable to assess  
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
Yes 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscri pt: 
Needs some language corrections before being published  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
1. Have you in the past five years received reimbursements, fees, fundi ng, or salary from an 
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from t he publication of this manuscript, either now or in the future?  
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
6. Do you have any non -financial com peting interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests'  
 
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