A longitudinal study of the effects of premarital communication, relationship stability, and self-esteem on sexual satisfaction in the first year of marriage

The impact of positive psychology counseling on sexual and marital satisfaction and anxiety among reproductive-aged women during the COVID-19 pandemic: a randomized controlled clinical trial

BACKGROUND

Sexual and marital satisfaction is considered one of the important factors in happiness and life satisfaction of couples. COVID-19 pandemic results in psychological effects, such as increased anxiety levels which can affect sexual and marital satisfaction. This study aimed to investigate the impact of positive psychology on women's sexual and marital satisfaction.

METHODS

A randomized controlled trial was conducted on 72 married women of reproductive age in Tabriz, Iran between February 2021 and May 2022. The participants were randomly divided into the intervention and control groups. There was no significant difference between the control and intervention groups in terms of the socio-demographic characteristics (p < 0.05). The mean age of the participants in the intervention and control groups was 31.8 ± 6.92 and 30.97 ± 5.09 years, respectively. The intervention group attended seven 60-90 min counseling sessions at weekly intervals. The Spielberger anxiety, sexual satisfaction and marital satisfaction questionnaires were completed before and four weeks after the intervention.

RESULTS

The results of this study indicated that after counseling, the average overall score of marital satisfaction [MD: 15.46, 95% CI: 7.47 to 23.41, p = 0.034] and sexual satisfaction [MD: 7.83, 95% CI: 6.25 to 9.41, p = 0.001] significantly increased in the intervention group compared to the control group. Also, the mean score of state anxiety [MD: -2.50, 95% CI: -4.19 to -0.80, p = 0.001] and trait anxiety [MD: -1.03, 95% CI: -2.46 to -0.09, p = 0.032] significantly decreased after counseling in the intervention group compared to the control group.

CONCLUSIONS

Using counseling based on a positive psychology approach can improve anxiety, sexual and marital satisfaction, and anxiety of women of reproductive age during the COVID-19 pandemic. However, further randomized clinical trials are needed before making a definitive conclusion.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N8. Date of registration: 11/28/21. Date of first registration: 11/28/21. URL: https://www.irct.ir/user/trial/58680/view ; Date of recruitment start date: 12/01/21.

Modeling the relationship between depression in people with cancer and perceived stress, with the mediating role of eating problems, sexual satisfaction, emotion regulation and self-compassion

Aim

With the rising prevalence of cancer and the adverse physical and psychological experiences endured by affected individuals, this study aims to establish a model illustrating the relationship between depression in people with cancer and perceived stress. Additionally, it examines the mediating influence of eating problems, sexual satisfaction, emotional regulation, and self-compassion.

Method

This study employs a descriptive-correlational research method, utilizing structural equation analysis (modeling) to explore the role of mediators. The research sample comprised 200 individuals diagnosed with cancer, selected based on predetermined inclusion and exclusion criteria. Participants completed Beck's 13-item depression questionnaire, a 10-item perceived stress questionnaire, an 8-item appetite measurement questionnaire, a 25-item sexual satisfaction questionnaire, a 10-item emotion regulation questionnaire, and a 12-item compassion questionnaire. The data were subsequently analyzed using SPSS-24 and Lisrel 80/8 software.

Findings

The research findings indicate a significant positive relationship between perceived stress and depression in people with cancer. Furthermore, eating problems exhibited a mediating role in the relationship between perceived stress and depression, with a direct effect coefficient of (t = 0.28, ß = 0.02). However, the path from perceived stress to depression, mediated by sexual satisfaction, was found to be statistically insignificant, with a standard coefficient of 0.01 at the p < 0.05 level. Emotion regulation demonstrated a direct effect coefficient of (t = -3.52, ß = -0.33) on depression. Likewise, self-compassion exhibited a direct effect coefficient of (t = -3.08, ß = -0.28) on depression, while the path from perceived stress to depression was mediated by self-compassion, with a standard coefficient of 0.12 at the p < 0.05 level.

Conclusion

In conclusion, this study sheds light on the interplay between depression and perceived stress in individuals with cancer, revealing a significant positive association. Eating problems emerged as a mediating factor, directly influencing the manifestation of depressive symptoms. However, the mediation pathway through sexual satisfaction was found to be statistically insignificant. Emotion regulation and self-compassion were identified as influential factors, with direct effects on depression and self-compassion also serving as a mediator in the relationship between perceived stress and depression. The findings emphasize the importance of targeted interventions addressing eating problems, enhancing emotion regulation, and fostering self-compassion to alleviate the impact of depression and perceived stress in individuals facing cancer-related challenges. Further research is encouraged to refine and expand upon these insights, advancing holistic care for this population.

Effects of stress management and relationship-enrichment counseling on sexual and marital satisfaction of working women with high occupational stress

BACKGROUND

Industrialization of societies has placed considerable stress on employees influencing marital and sexual satisfaction. This study investigated the effects of stress management (SM) and relationship enrichment (RE) counseling on marital and sexual satisfaction in stressed women working at Tabriz University of Medical Sciences hospitals, Iran.

MATERIALS AND METHODS

In this quasi-experimental study, 75 nurses and midwives experiencing moderate-to-severe occupational stress after obtaining written informed consent were assigned to SM and RE counseling and control groups randomly. The SM and RE attended six-related counseling sessions, and control group received no intervention. The participants completed Osipow's Revised Occupational Stress Inventory (OSI-R), ENRICH Marital Satisfaction Scale, and Larson's Sexual Satisfaction Questionnaire before and 2 weeks after the intervention. The data were analyzed using one-way ANOVA and ANCOVA.

RESULTS

SM counseling led to relatively good increase in sexual satisfaction. In addition, there was no significant difference between the three groups in the mean occupational stress scores and marital satisfaction scores.

CONCLUSION

SM counseling increased the level of sexual satisfaction. The approaches had no significant effect on occupational stress and marital satisfaction. Further studies are required to identify the best counseling approaches.

Adjuvant administration of probiotic effects on sexual function in depressant women undergoing SSRIs treatment: a double-blinded randomized controlled trial

BACKGROUND

According to the Institute of Health Metrics and Evaluation's Global Health Data Exchange (2023) it is estimated that 5% of all adults will experience depressive disorder. Amongst the general loss of pleasure and interest in everyday activities that are symptoms of low mood, reduced sexual desire and sexual dysfunction can be particularly overlooked. Human sexuality is complex, but finding solutions based on scientific evidence to limit the symptoms of depressive disorder and the iatrogenic impact of antidepressant treatment to improve this outcome is an important step in promoting psychological health and general wellbeing.

OBJECTIVE

The present study aimed is to provide scientific evidence to assess the effect of oral probiotic on sexual function in women with depressive disorder treated with Selective Serotonin Reuptake Inhibitors (SSRIs) in an Iranian population.

DESIGN

This study was a double-blind randomized clinical trial. Eligible women were assigned to lactofem plus SSRIs (n = 58) or SSRIs alone (n = 54). In group A, SSRI antidepressants were prescribed together with Lactofem, and in group B, SSRI antidepressants were prescribed alone. Lactofem including Lactobacillus acidophilus 2 × 109 cfu/g, Bifidobacterium bifidus 2 × 109 cfu/g, Lactobacillus rutri 2 × 109 cfu/g, Lactobacillus fermentum 2 × 109 cfu/g; capsule weight of 500 mg bio-capsule administered orally and daily. The duration of intervention in two groups was two months. All questionnaires were completed by the patients before and after the intervention. The Female Sexual Function Index (FSFI), Hamilton Depression Rating Scale and Larson's Sexual Satisfaction Questionnaire were used to evaluate sexual function, severity of depressive disorder and sexual satisfaction, respectively.

RESULTS

Based on the results of the present study, there was a statistically significant difference in sexual satisfaction and severity of depressive disorder between the groups before and after the intervention (P < 0.05). Also, our findings showed that after eight weeks, the Lactofem plus SSRIs group showed significant improvement in FSFI domains and total scores compared to SSRIs alone group (P < 0.05).

CONCLUSIONS

The results of the present study show that taking probiotics for eight weeks may improve the severity of depressive disorder, sexual function and sexual satisfaction in depressed women treated with SSRIs.

TRIAL REGISTRATION

ClinicalTrials.govidentifier: IRCT20160524028038N14 (19/12/2022).

Effectiveness of online sexual education based on the extended PLISSIT model on sexual function and sexual satisfaction in women undergoing breast cancer treatment

BACKGROUND

Despite therapeutic interventions having increased the survival rate of women with breast cancer, sexual dysfunction occurs in cancer survivors due to treatment. The aim of this study is to determine the effect of online sexual education, based on the Ex-PLISSIT model on sexual function and satisfaction, on women undergoing breast cancer treatment.

MATERIALS AND METHODS

The present study was a quasi-experimental and interventional control study. It was conducted with a pretest-posttest design between April and July 2022 in Isfahan, Iran. The participants were divided into an intervention (n = 40) and a control group (n = 40). The intervention group received sexual education based on the Ex-PLISSIT model that consisted of four levels of intervention, namely, permission (P), limited information (LI), specific suggestions (SS), and intensive therapy (IT), presented in four sessions. The Female Sexual Function Index (FSFI) and Larson's Sexual Satisfaction Questionnaire were used to measure the sexual function and sexual satisfaction of the participants. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. P values below 0.05 were considered statistically significant.

RESULTS

The results showed that the mean of sexual satisfaction and function scores in the intervention group significantly increased after intervention. Moreover, the results showed a statistically significant difference in the mean of sexual satisfaction scores between the intervention and control groups after intervention (P = 0.020). Although there was a difference between the mean of sexual function scores in the intervention and control groups after the intervention, the t-test showed no statistically significant difference (P = 0.176).

CONCLUSIONS

According to the results of the study, sexual education based on the Ex-PLISSIT model could effectively enhance sexual satisfaction of women undergoing breast cancer treatment. It seems that this model can help health care providers evaluate the sexual needs of the patients and provide appropriate suggestions in order to decrease sexual problems.

Effect of mindfulness on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women: a quasi-experimental study

Background

Menopause with anatomical, physiological, and psychological changes can affect sexual satisfaction and consequently the quality of life.

Aims

The study sought to evaluate the effects of mindfulness-based counseling on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women.

Methods

This quasi-experimental study was conducted on 110 women who were assigned to an intervention group (n = 55) and a control group (n = 55). The intervention group received 8 sessions of mindfulness-based training and daily mindfulness exercises. Data collection tools included questionnaires of demographics and midwifery, sexual self-efficacy, and sexual satisfaction. They were completed before and 8 weeks after the intervention. The collected data were analyzed through a t test, a chi-square test, and repeated-measures analysis of variance.

Outcomes

Changes in sexual self-efficacy and sexual satisfaction scores were evaluated.

Results

The mindfulness-based intervention significantly improved sexual self-efficacy (F = 146.98, P = .000, ^ƞ2 = 0.576) and sexual satisfaction (F = 129.47, P = .000, ^ƞ2 = 0.545) over time. The mean scores of sexual self-efficacy (17.03 ± 2.08) and sexual satisfaction (87.94 ± 8.26) in the intervention group increased after the intervention as opposed to the mean scores of sexual self-efficacy (12.65 ± 1.70) and sexual satisfaction (76.61 ± 6.45) in the control group.

Clinical Implications

Mindfulness training can improve sexual self-efficacy and sexual satisfaction in postmenopausal women.

Strengths and Limitations

The intervention was implemented on a population of menopausal women in a culture in which the expression of sexual issues is taboo and has not been noticed in the past. The main limitation of this study was self-reporting, which may have affected the responses. The next limitation was the nonrandomized controlled design. Finally, the research sample included menopausal women who were heterosexual and married. Hence, the findings may not be generalizable to more diverse samples. In this study, psychological maladjustment or psychological distress was not analyzed. They should also be considered in future research.

Conclusion

According to the results, it is advisable to employ mindfulness-based intervention in routine care, because it can improve different aspects of menopausal women's life.

Hormone therapy for sexual function in perimenopausal and postmenopausal women: a systematic review and meta-analysis update

IMPORTANCE

Distressing sexual problems are a common complaint of menopausal women. In 2013, a Cochrane review assessed the effect of hormone therapy on sexual function in menopausal women; however, new evidence has since been published, which should be considered.

OBJECTIVE

This systematic review and meta-analysis aims to update the evidence synthesis on the effect of hormone therapy, compared with control, on sexual function in perimenopausal and postmenopausal women.

EVIDENCE REVIEW

Thirteen databases and clinical trial registries (Cochrane Central Register of Controlled Trials, EMBASE, Medical Literature Analysis and Retrieval System Online, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciéncias da Saúde, Database of Abstracts of Reviews of Effects, ClinicalTrials.gov, International Clinical Trials Registry Platform, Iranian Registry of Clinical Trials, Chinese Clinical Trial Registry, ISRCTN) were searched from December 2012 to March 30, 2022. Backward reference searching on all retrieved full texts was also performed. Study quality was assessed using the Cochrane ROB.2 tool. Data were pooled in random-effect model meta-analyses, which included all studies identified in the present search and all studies previously included in the 2013 Cochrane review.

FINDINGS

Forty-seven randomized controlled trials (35,912 participants) were included in the systematic review, and 34 randomized controlled trials (15,079 participants) were included in the meta-analysis. The meta-analysis revealed that, in comparison to control, estrogen therapy (standardized mean difference [SMD], 0.16; 95% confidence interval [CI], 0.02 to 0.29; I2 = 59%; 2,925 participants, 16 studies), estrogen plus progestogen therapy (SMD, 0.11; 95% CI, -0.07 to 0.29; I2 = 65%; 2,432 participants, 7 studies), tibolone (SMD, 0.15; 95% CI, 0.02 to 0.28; I2 = 0%; 916 participants, 2 studies), and selective estrogen receptor modulators (SMD, 0.18; 95% CI, 0.06 to 0.30; I2 = 0%; 1,058 participants, 4 studies) may result in no effect to small benefit on sexual function composite score.

CONCLUSION AND RELEVANCE

Hormone therapy may slightly improve sexual functioning. This potential small benefit should be considered when discussing treatment options for other menopausal symptoms.

The effect of cognitive-behavioral therapy and sexual health education on sexual assertiveness of newly married women

BACKGROUND

The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women.

METHOD

This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5-7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests.

RESULTS

The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05).

CONCLUSION

The results of this research indicated that CBT and sexual health education are effective in improving women's sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir .

Evaluation of the safety and efficacy of wormwood vaginal gel in improving sexual function and sexual satisfaction in women of reproductive age: A randomized, triple-blinds, placebo-controlled clinical trial

INTRODUCTION

All aspects of sexual function are related to sexual satisfaction, and not paying attention to sexual problems leads to sexual dissatisfaction. According to studies, sexual satisfaction is a key factor in a couple's quality of life. The aim of this study was to evaluate the safety and efficacy of wormwood vaginal gel in improving sexual function and sexual satisfaction in women of reproductive age.

METHODS

This study was a randomized, triple-blinds, parallel-groups clinical trial performed on 76 women of reproductive age (18-45 years) referred to the gynecological clinic of Ghaem Hospital in Mashhad who had sexual dysfunction and low sexual satisfaction. 76 women were assigned to the wormwood gel (n = 38) and placebo (n = 38) groups using random permuted blocks of sizes 4 or 6 and an allocation ratio of 1:1. Wormwood gel or placebo was used for 4 weeks and 3 times a week for 4 weeks from22 May to 23 October 2021. The main data collection tools were the Female Sexual Function Index (FSFI) and Larson Sexual Satisfaction Questionnaire (LSSQ) to access changes in sexual function and sexual satisfaction at baseline and after 4 weeks.

RESULTS

The Mean and Standard Deviation of the age of the studied women was 36.8 ± 5.9 years in the intervention group and 37.1 ± 7.3 years in the placebo group. Before the intervention, the Mean and Standard Deviation of the total score of sexual function and sexual satisfaction in the studied women were 17.70 ± 3.66 and 72.20 ± 6.56 in the intervention group and in the placebo group were 18.23 ± 3.84 and 73.26 ± 5.86, respectively. At the end of the intervention, the Mean and Standard Deviation of the total score of female sexual function and sexual satisfaction in the intervention group were 32.11 ± 2.03 and 96.91 ± 7.93 and in the placebo group were 21.07 ± 3.22 and 75.91 ± 8.87, respectively. sexual function and satisfaction improved significantly in the wormwood gel compared to the control group(p < 0.0001).

CONCLUSIONS

Based on the findings of this trial, it seems that the wormwood vaginal gel can be used as a topical supplement to improve sexual function and sexual satisfaction in women of reproductive age who have sexual dysfunction and low sexual satisfaction.

How does multiple sclerosis affect sexual satisfaction in patients' spouses?

Background

Sexual dysfunction (SD) is a common complaint among multiple sclerosis (MS) patients with a significant impact on the quality of life (QoL) of afflicted couples. The purpose of this study was to determine sexual satisfaction (SS) in the spouses of MS patients and its impact on the QoL.

Methods

A total of 214 spouses of MS patients were enrolled in this cross-sectional study. They completed the Larson Sexual Satisfaction Questionnaire and SF-8 Health Survey.

Results

The mean ± SD age of the spouses was 39.8 ± 9.7 years, and the duration of MS was 5 years or less in most of their partners. The mean ± SD score of QoL was 71.0 ± 20.3 (out of 100), and the mean SS score was 89.2 ± 18.6 (out of 125), showing moderate satisfaction. The highest score was among male spouses younger than 40 years old. The SS scores were also lower among female spouses. In the final model, it was found that SD, psychiatric symptoms, cognitive impairment, and the level of disability of patients were independent explanatory factors for the SS of their spouses.

Conclusion

The findings supported the role of SS in the QoL of spouses of MS patients. Therefore, the attention of physicians to this hidden aspect of the life of MS patients is crucial.

Evidence of a Bidirectional Association Between Daily Sexual and Relationship Satisfaction That Is Moderated by Daily Stress

Prior research provides mixed evidence regarding the direction of the association between sexual and marital satisfaction. Whereas some studies suggest a bidirectional association, other studies fail to document one direction or the other. The current investigation used a 12-day diary study of 287 married individuals to clarify the nature of this association. Results from time-lagged mixed modeling revealed a significant positive bidirectional association. Both higher global sexual satisfaction one day and satisfaction with sex that occurred that day predicted higher marital satisfaction the next day; likewise, higher marital satisfaction one day significantly predicted higher global sexual satisfaction the next day and higher satisfaction with sex that occurred the next day. Both associations remained significant after controlling for participant's gender/sex, neuroticism, attachment insecurity, self-esteem, stress, perceived childhood unpredictability and harshness, age of first intercourse, construal level, age, and length of marriage. We also explored whether these covariates moderated either direction of the association. Daily stress was the most reliable moderator, with three of the four interactions tested remaining significant after Bonferroni corrections. The bidirectional association between global sexual and marital satisfaction and the positive association between satisfaction with sex that occurred that day and marital satisfaction the next day were significantly stronger when individuals experienced high versus low stress. Although the exploratory nature of all moderation analyses suggests they should be replicated before drawing strong conclusions, these findings highlight the importance of sexual satisfaction to marital satisfaction and vice versa and point to the power of stress in strengthening these associations.

Internet- and mobile-based psychological interventions for sexual dysfunctions: a systematic review and meta-analysis

Sexual dysfunctions are highly prevalent and undertreated. Internet- and mobile-based psychological interventions (IMIs) could be a promising addition to close this treatment gap, given their accessibility, anonymity, and scalability. This systematic review and meta-analysis investigated the efficacy of IMIs for sexual dysfunctions. A comprehensive literature search was conducted in August 2021 on randomized controlled trials investigating the effects of IMIs on sexual functioning and satisfaction compared to a control condition. Twelve RCTs with 14 comparisons were reviewed with six IMIs targeting female and six IMIs targeting male sexual dysfunctions and n = 952 participants were evaluated in the meta-analysis. IMIs were significantly more effective than control conditions (k = 11 waitlist control group, k = 3 online discussion board) at post-treatment for female sexual functioning (g = 0.59, CI: 0.28–0.90, I²= 0%) and satisfaction (g = 0.90, CI: 0.02–1.79, I²= 82%), and male sexual functioning (g = 0.18, CI: 0.02–0.34, I²= 0%). No significant effect was found for male sexual satisfaction (g = 0.69, CI: −0.13–1.51, I²= 88%) with substantial heterogeneity in studies. Most studies showed high dropout, with ten studies indicating some concern of risk of bias, and two studies showing high risk of bias. The results suggest that IMIs can be an effective treatment for sexual dysfunctions, although additional high-quality research is needed. Given the limited availability of specialized treatment for sexual dysfunctions and individual preferences for discrete treatment options, IMIs seem to be a valuable addition to routine care, empowering individuals to promote their sexual health on a guided self-help basis.

Identifying themes relevant to sexual dissatisfaction of dual career couples: Design and effectiveness of a psycho-educational package - A mixed method study

BACKGROUND: Today, dual-career couples are becoming increasingly prevalent around the world. Due to the nature of the life of this group of people, their sexual and marital life can be damaged. OBJECTIVE: The aim of this study was to develop a psycho-educational model based on the lived experiences of dual career couples who are dissatisfied with sexual relations and its effectiveness on sexual satisfaction. METHODS: This research was done based on a mixed (qualitative and quantitative) method. The qualitative part was performed using the phenomenological method and 13 couples were selected for semi-structured interviews using the purposive sampling method. In a small part of this study, a single case plan (AB plan) was used, and three couples were selected from those who referred to counseling centers in Ardabil and underwent counseling interventions. In a small part, the Sexual Satisfaction Questionnaire was used to measure the changes of couples during the implementation of the intervention program. The information obtained in the qualitative part was analyzed through content analysis and the quantitative part was analyzed using visual analysis, clinical significance and recovery percentage. RESULTS: Based on the results obtained in the qualitative analysis section, the experiences of sexual dissatisfaction of dual-career couples can be classified into 10 main themes, 20 sub-themes and 30 categories that affect the sexual satisfaction of dual-career couples. The results of the quantitative section indicate that the designed psycho-educational model has led to an increase in sexual satisfaction of dual-career couples. CONCLUSION: Achieving sexual and marital satisfaction and finally mental health and reducing divorce is a process that begins with pathology in the cultural context and is achieved by emphasizing indigenous culture through developing a counseling package for appropriate intervention by therapists and counselors.

Sexual Satisfaction and Cognitive Schemas Activated in a Sexual Context among Iranian Married Women of Reproductive Age

The present study examined the relationship between sexual satisfaction (SS) and cognitive schemas activated in sexual context. In a cross-sectional study, the participants comprised 313 Iranian married women (mean age of 36.7 years and mean marriage duration of 12.4 years). Data were collected utilizing an online survey comprising the Index of Sexual Satisfaction, the Cognitive Schema Activated in Sexual Context Questionnaire, and a number of sociodemographic questions. A linear regression model utilizing the stepwise method was performed. The mean score of cognitive schemas relating to sexual problems was 35.56 (out of 140; SD = 14.68) with the highest mean in the Difference/Loneliness subscale (higher scores indicating greater negative schema activation). The mean score of sexual satisfaction on the ISS was 96.80 (out of 125; SD = 16.77). The highest scores of cognitive schemas relating to sexual problems were observed among individuals with low sexual satisfaction. Based on a multivariable linear regression model, age (β = 0.33), spouse social support (β = 0.23), and spouse job (β = 0.21) had the highest regression coefficients in relation to sexual satisfaction among Iranian married women. Cognitive schemas activated in a sexual context were strongly and significantly associated with sexual satisfaction among Iranian married women of reproductive age. The findings suggest that schema therapy techniques be used alongside initiatives to promote spouse social support to help prevent problematic sexual cognitive schemas.

Effectiveness of Group Counseling with a Client-Centered Approach Based on the GATHER Principles on Sexual Satisfaction in Women with Multiple Sclerosis: A Randomized Clinical Trial

Background

Multiple sclerosis (MS) is the most prevalent progressive sensory/neurological disability in young adults, with important psychological consequences. The present study was designed to assess the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction in women with MS.

Methods

In this clinical trial, conducted from January 2018 to May 2019, in the MS Referral Center of Tehran (Iran), 72 eligible participants were assigned to intervention and control groups (36 in each group) via simple randomization. The intervention group received group counseling based on the client-centered approach, while the control group received routine counseling. Data were collected using the Larson Sexual Satisfaction Questionnaire (LSSQ) at three different time points: before the intervention, after the final session, and one month after the intervention. The collected data were analyzed in SPSS software (version 19). In order to analyze the obtained data, independent t test, Mann-Whitney U test, paired t test, Wilcoxon test, Chi-square test, Fisher exact test, and Friedman test were used.

Results

The mean score of sexual satisfaction before the intervention showed no statistically significant difference between the two groups. Based on the Friedman test in the intervention group, the trend of changes in the mean score of sexual satisfaction had a significant difference before the intervention, after the final session, and one month after the intervention (P=0.001); however, no significant difference was observed in the control group.

Conclusion

Our results showed the effectiveness of group counseling with a client-centered approach based on the GATHER principles on sexual satisfaction and intimacy among women with MS. Trial Registration Number IRCT20180110038302N3.

Associations Between Premarital Factors and First-Married, Heterosexual Newlywed Couples' Frequency of Sex and Sexual Satisfaction Trajectories

Sex is a defining feature of marriage with important implications for marital success. Nevertheless, frequency and quality of sex decline across the early years of marriage. Given many modern-day couples in the U.S. are delaying marriage and thus experiencing many traditional aspects of marriage before their nuptials, the current research explored the extent to which premarital factors such as courtship duration, cohabitation, and children are associated with trajectories of couples' sexual relationships during the early years of marriage. Using a 4-year longitudinal study of newlywed couples, results demonstrated that couples with longer (versus shorter) courtships or who did (versus did not) cohabit engaged in less frequent sex at the start of marriage; interestingly, couples with longer (versus shorter) courtships or with (versus without) children prior to marriage experienced less steep declines in frequency of sex over time. Couples who did (versus did not) cohabit were less sexually satisfied initially and over time; couples with longer (versus shorter) courtships experienced less steep declines in sexual satisfaction over time. Notably, each of these associations emerged independent of related individual differences and marital quality. These findings highlight the notion that premarital factors can explain, at least in part, differences in newlywed couples' sexual relationships.

A mobile-based educational intervention on sexo-marital life in Iranian men with spinal cord injury: a randomized controlled trial

STUDY DESIGN

A randomized controlled trial.

OBJECTIVE

To assess the effectiveness of a mobile-based educational intervention on sexo-marital life in Iranian men with spinal cord injury (SCI).

SETTING

Foundation of Martyrs and Veterans Affairs', "Spinal Cord Injury Association", and the "Protection Center of Spinal Cord Disables".

METHODS

Participants were men with SCI aged at least 18 years old. The effectiveness of a mobile App was evaluated on 70 married men with SCI. Sexual adjustment, sexual satisfaction, marital adjustment, and marital satisfaction were assessed by valid and reliable questionnaires at baseline, 4 and 8 weeks after the intervention.

RESULTS

The between-group mean difference (95% CI) of sexual adjustment (4.2, CI: 3.6-4.8) after 4 weeks as well as 8 weeks (8.6, CI: 7.6-9.5) after baseline was significant (P < 0.001). The between-group mean difference (95% CI) of sexual satisfaction (6.9, CI: 8-11.2) after 4 weeks as well as 8 weeks (16.4, CI: 14.1-18.7) after baseline was significant (P < 0.001). There were significant increases in all the domains of marital satisfaction's between-group mean differences after 4 weeks as well as 8 weeks after baseline (P < 0.001). Repeated measures ANOVA showed there was no statistically significant increase in marital adjustment's between-group mean difference (95% CI) after 4 weeks (-0.1, CI: -0.1- 0, P < 0.16) as well as 8 weeks (0.4, CI: -0.3-1.1, P < 0.25) after baseline.

CONCLUSION

The application-based educational intervention showed the positive effect of education on sexo-marital life in men with SCI. We recommend the rehabilitation team's healthcare providers embrace this educational strategy for individuals with SCI.

Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women

Introduction

A person's sexual satisfaction reflects their judgment and analysis of their own sexual behavior. Factors that affect sexual satisfaction vary in different societies and cultures.

Aim

This study investigated the determinants of sexual satisfaction in women referred to health centers in Sari, north of Iran, in 2016.

Methods

This cross-sectional study investigated 490 women who had been referred to health centers in 2016 and who were qualified for the study; the population was selected using convenient sampling method.

Main Outcome Measure

The main outcome of this study was sexual satisfaction that assessed by the Larson's sexual satisfaction questionnaire. Other Data were 2 questionnaires: the general health questionnaire–28 and a researcher-made questionnaire developed on factors related to sexual satisfaction. Data were analyzed with IBM SPSS software using the one-way analysis of variance, Pearson correlation coefficient, and t-test. To determine the predictors of sexual satisfaction, all the significant independent variables were incorporated into a linear regression model.

Results

The average age of the women in this study was 33.6 years, and average sexual satisfaction score was 99.26. The results of the linear regression model showed that the spouse's job as a laborer (P = .003), a low income (P < .002), insufficient income of the spouse (P < .001), and dissatisfaction with being a woman (P < .001) were the main social determinants of sexual satisfaction (r² = 0.54).

Conclusion

It can be concluded from the findings of this study that several factors influence women's sexual satisfaction. The main social determinants of women's sexual satisfaction were dissatisfaction with their gender, the spouse's job as a laborer, low income, and insufficient income. Sexual healthcare providers can play a prominent role in increasing women's sexual satisfaction, thereby, improving the quality of their sexual life by identifying and discussing ways to control them.

Afzali M, Khani S, Hamzehgardeshi Z, et al. Investigation of the Social Determinants of Sexual Satisfaction in Iranian Women. Sex Med 2020;8:290–296.

Randomized controlled trial protocol to evaluate the effect of an educational intervention using information, motivation and behavioral skills model on sexual satisfaction of new couples in Iran

Background

Sexual satisfaction is considered as one of the key factors in assessing a person’s quality of life and the quality and continuity of marital relationships. According to the results of reports in Iran, many couples are dissatisfied with their sexual lives. Sexuality education is one of the important strategies to prevent early sexual problems and improve sexual satisfaction. The aim of this randomized controlled trial is to compare the efficacy of sexual and marital enrichment package using information, motivation and behavioral skills model on sexual satisfaction of new couples in Iran to routine sexual care program that provided at governmental health centers.

Methods

This is a randomized, controlled, superiority trial with two parallel groups. One hundred new couples (n = 200) will be recruited and randomized with simple randomization method and a 1:1 allocation. Recruitment will be from governmental health centers and calling on social networks. Couples will be randomized to intervention which will receive Sexual and Marital Enrichment package and control group (routine care at health centers). Couples will be followed up for 4 months. Then primary outcomes (mean score of couples’ sexual information, motivation and behavior skills) and secondary outcome (mean score of couples’ sexual satisfaction) of study will be measured through the online questionnaire.

Discussion

This trial will be examined the impact of the sexual and marital skills training package tailored to the values and norms governing the sexual life of Iranian couples on their sexual satisfaction. If the trial is effective, its results will be presented to policy makers for implementation at national level.

Trial registration

(Iranian Registry of Clinical Trials (IRCT) number): IRCT20181211041926N1. Date of registration: March 2, 2019.

Sexual satisfaction and self-esteem in women with acne

BACKGROUND

A significant number of problems related to mental and social functioning is a common occurrence in patients with acne.

AIMS

The aim of our study was to determine how acne affects self-esteem and sexual satisfaction in the affected women.

PATIENTS/METHODS

The study was conducted among 90 women, aged 18-51 years (mean 30.29 ± 7.10), diagnosed with acne. Demographic data, medical history and information concerning their sexual life were obtained from all study participants. After dermatological assessment of lesion location and severity, all subjects completed the following questionnaires: Rosenberg Self-Esteem Scale, Sexual Self-Esteem Inventory, Body Attitudes Questionnaire, and Whitley Sexual Satisfaction Inventory.

RESULTS

Two factors-lesion severity and self-assessment of the body-proved to shape the sexual satisfaction of women, but the influence turned out to be mediated through self-esteem.

CONCLUSION

Acne proves to play an important negative role in female sexuality and satisfaction.

Changes in Commitment and Sexual Satisfaction: Trajectories in Couple Therapy

The purpose of this study was to examine the covarying relationship between commitment and sexual satisfaction in committed relationships throughout the course of couple therapy. A sample of 366 heterosexual couples completed questionnaires regarding sexual satisfaction and commitment at each of the first five sessions of couple therapy. Cross-lagged panel analyses revealed that, between the first and second therapy sessions, there was a bidirectional relationship between commitment and sexual satisfaction, with each variable at the first session predicting the other at the second session. In addition, sexual satisfaction at the second session predicted commitment at the third session.

Exploring clinical communication in a teaching hospital in Ghana

Purpose

The purpose of this paper is to investigate the clinical communication using Tamale Teaching Hospital as a case.

Design/methodology/approach

The paper is based on the Reassure, Explain, Listen, Answer, Take Action and Express Appreciation (RELATE) model and the Four Habits models of Clinical Communication.

Findings

The results of the study indicate that leadership conducted staff meetings with some of the components of the RELATE model. These include staff meetings, employee rounding and communication/notice boards. The results of the study also suggest that much as some parts of the Four Habits model was used in provider–patient communication, certain aspects of the model were absent. The study identified some communication challenges including poor dissemination, lack of unity among some health workers, poor attendance in meetings and, with respect to patients, language barrier, patients’ reluctance to disclose their actual health problems to health providers, lack of privacy and lack of a friendly environment.

Practical implications

Providers, especially physicians, should be given training on the local languages in areas where they perform their services. Health service providers should receive as part of their learning in-depth training on the Four Habits model of Clinical Communication, especially the Medical Officers.

Originality/value

It is imperative to embrace evidence-based practices/models aimed at securing proper communication in all hospitals but most especially teaching hospitals.

Sexual Function and Socio-Sexual Difficulties in Women with Polycystic Ovary Syndrome (PCOS)

Introduction PCOS is the most common endocrine syndrome in women of the reproductive age that has manifold effects on the life of affected women. Little scientific attention has been devoted to these womenʼs sexual lives.

Aim To investigate sexual quality of life in women with PCOS.

Methods The sample size was n = 44. Measures employed were: An extended list of sexual dysfunctions and perceived distress based on DSM-IV-TR, Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. The relationships of these components were examined including further variables (body mass index, degree of hirsutism using the Ferriman-Gallwey Score, wish for a child). An open question about what participants see as the source of their sexual problems was presented.

Results Only moderate impairment in sexual function was detected, but feelings of inadequacy in social and sexual situations were markedly elevated and positively correlated with the degree of hirsutism. Depression showed to be a major problem.

Conclusion Patients with PCOS should be screened for socio-sexual difficulties and emotional problems. Specialized psychological and sexological counselling can complement patient care.

They Shall Be One: Sexual Satisfaction Among Men and Women Married in the LDS Faith

Sexual satisfaction is understudied among highly religious communities, such as the Church of Jesus Christ of Latter-day Saints (LDS). Through an Internet-based self-report survey, this study (N = 266) examined potential predictors of sexual satisfaction among adults living in Utah who had married in the LDS faith, regardless of current faith practice. Both men and women reported their perceived partner satisfaction as the top contributing factor to their own overall sexual satisfaction. These findings have implications for clinicians, educators, and researchers evaluating the sexual lives, including sexual satisfaction, of men and women who have married in the LDS faith.

The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women

Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide, and an important health problem especially in women of reproductive age. This study aimed to determine the relationship between IDA and sexual satisfaction and function among reproductive-aged Iranian women. In this study, 129 women (52 with IDA and 77 non-IDA) with age 18–45 in Mahshahr, Iran were recruited. Data was gathered by a demographic questionnaire, Female Sexual Function Index (FSFI) and Larson Sexual Satisfaction Questionnaire. Data were analyzed using an independent t-test, Mann-Whitney test, Chi-square, and correlation coefficient test. The results of this study showed that the means of hemoglobin (Hb), hematocrit (HCT), serum iron and ferritin were significantly lower in the IDA group than those in the non-IDA group (p<0.01). All dimensions of sexual function and satisfaction were significantly lower in women with IDA compared to the healthy women (p<0.001). Also, all blood indices for IDA had a significant relationship with all sexual function components and sexual satisfaction (p = 0.01) except for pain with Hb and ferritin. Health care providers should provide screening, education, and counseling about anemia and sexual function in reproductive age women.

Dyadic Empathy Predicts Sexual and Relationship Well-Being in Couples Transitioning to Parenthood

Becoming a new parent is typically a time of great joy, yet it is also marked by significant declines in sexual and relationship functioning. Dyadic empathy, a combination of perspective taking and empathic concern for one's romantic partner, may facilitate sexual and relationship quality for new parents. The purpose of this study was to examine the associations between dyadic empathy and sexual satisfaction, relationship adjustment, and sexual desire in a sample of first-time parents. Couples (N = 255) with an infant aged three to 12 months completed an online survey assessing dyadic empathy, sexual satisfaction, relationship adjustment, and sexual desire. Data were analyzed using multilevel analyses guided by the actor-partner interdependence model. When new mothers and fathers reported greater dyadic empathy, both they and their partners reported higher sexual satisfaction and relationship adjustment. New mothers who reported higher dyadic empathy also had higher sexual desire, although when they had more empathic partners new mothers reported lower sexual desire. Results remained significant after controlling for potential challenges unique to the postpartum period (e.g., fatigue, breastfeeding), as well as relationship duration. Targeting dyadic empathy in interventions aimed at helping couples transition to parenthood may promote the maintenance of sexual and relationship well-being.

On the Link Between Benevolent Sexism and Orgasm Frequency in Heterosexual Women

Previous research on subclinical orgasmic difficulties among women has focused on intrapsychic and interpersonal variables, but little attention has been paid to the more distal ideological factors that might indirectly constrain sexual pleasure. We hypothesized that women's endorsement of a benevolently sexist worldview would be negatively associated with orgasm frequency. Specifically, we predicted that benevolent sexism would be associated with increased perceptions of male sexual selfishness. This perception of men as interested in their own sexual pleasure would then predict decreased willingness to ask a partner for sexual pleasure, which in turn would be associated with less frequent orgasms. We found support for our model across two studies (Study 1: N = 339; Study 2: N = 323). We did not, however, find a direct effect of benevolent sexism on orgasm frequency. We discuss possible additional variables linking benevolent sexism with orgasm frequency, implications, and future directions.

Determinants of Women's Sexual Dissatisfaction: Assessing a Cognitive-Emotional Model

INTRODUCTION

Recent studies have demonstrated the role of sexual dysfunctional beliefs, negative automatic thoughts, and emotional responses in relation to sexual functioning. Nevertheless, no studies seem to have evaluated the role of these cognitive-emotional factors in determining sexual dissatisfaction.

AIM

To test a cognitive-emotional model of sexual dissatisfaction in women.

METHODS

In total, 207 women answered questionnaires assessing sexual dissatisfaction and cognitive and emotional variables that might affect sexual dissatisfaction.

MAIN OUTCOME MEASURES

Sexual dissatisfaction was measured by the Index of Sexual Satisfaction, sexual beliefs were measured by the Sexual Dysfunctional Beliefs Questionnaire, and thoughts and emotional responses were measured by the Sexual Modes Questionnaire.

RESULTS

A path analysis was conducted to assess the conceptual model proposed. Results indicated that dysfunctional sexual beliefs work as predisposing factors by eliciting negative automatic thoughts and emotions, which impair the processing of erotic stimuli and interfere negatively with sexual satisfaction.

CONCLUSION

This finding suggests a role for cognitive and emotional factors in predisposing and maintaining sexual dissatisfaction in women, suggesting relevant implications for intervention.

Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls

Traumatic brain injury (TBI) can substantially alter many areas of a person's life and there has been little research published regarding sexual functioning in women with TBI. Methods. A total of 58 women (29 with TBI and 29 healthy controls) from Neiva, Colombia, participated. There were no statistically significant differences between groups in sociodemographic characteristics. All 58 women completed the Sexual Quality of Life Questionnaire (SQoL), Female Sexual Functioning Index (FSFI), Sexual Desire Inventory (SDI), and the Sexual Satisfaction Index (ISS). Results. Women with TBI scored statistically significantly lower on the SQoL (p < 0.001), FSFI subscales of desire (p < 0.05), arousal (p < 0.05), lubrication (p < 0.05), orgasm (p < 0.05), and satisfaction (p < 0.05), and the ISS (p < 0.001) than healthy controls. Multiple linear regressions revealed that age was negatively associated with some sexuality measures, while months since the TBI incident were positively associated with these variables. Conclusion. These results disclose that women with TBI do not fare as well as controls in these measures of sexual functioning and were less sexually satisfied. Future research is required to further understand the impact of TBI on sexual function and satisfaction to inform for rehabilitation programs.

Relationship Between Ischemic Heart Disease and Sexual Satisfaction

AIM

Ischemic heart disease is a life-threatening condition. Considerable doubts exist over the effects of this disease on patients' sexual activity and satisfaction. The aim of this study was to evaluate the relationship between ischemic heart disease and sexual satisfaction.

METHODS

In a retrospective cohort study, the convenience sample of 150 patients exposure with ischemic heart disease and 150 people without exposure it was drawn from Shahid Beheshti hospital, Kashan, Iran. Sampling was performed from March to September 2014. We employed the Larson's Sexual Satisfaction Questionnaire for gathering the data. Data were analyzed using descriptive statistics and Chi-square, t-test and linear regression analysis.

RESULTS

The means of sexual satisfaction in patients exposure with ischemic heart disease and among the subjects without exposure it were 101.47±13.42 and 100.91±16.52, respectively. There was no significant difference between the two groups regarding sexual satisfaction. However, sexual satisfaction was significantly correlated with gender and the use of cardiac medications (P value<0.05).

CONCLUSION

The level of sexual satisfaction in patients with exposure ischemic heart disease is similar to the people without exposure it. Moreover, the men and the patients who do not receive cardiac medications have higher levels of sexual satisfaction. Nurses who are providing care to patients with ischemic heart disease need to pay closer attention to patient education about sexual issues.

Predictors of extra-marital partnerships among women married to fishermen along Lake Victoria in Kisumu County, Kenya

BACKGROUND

The vulnerability of women to HIV infection makes establishing predictors of women's involvement in extra-marital partnerships critical. We investigated the predictors of extra-marital partnerships among women married to fishermen.

METHODS

The current analyses are part of a mixed methods cross-sectional survey of 1090 gender-matched interviews with 545 couples and 12 focus group discussions (FGDs) with 59 couples. Using a proportional to size simple random sample of fishermen as our index participants, we asked them to enrol in the study with their spouses. The consenting couples were interviewed simultaneously in separate private rooms. In addition to socio-economic and demographic data, we collected information on sexual behaviour including extra-marital sexual partnerships. We analysed these data using descriptive statistics and multivariate logistic regression. For FGDs, couples willing to participate were invited, consented and separated for simultaneous FGDs by gender-matched moderators. The resultant audiofiles were transcribed verbatim and translated into English for coding and thematic content analysis using NVivo 9.

RESULTS

The prevalence of extra-marital partnerships among women was 6.2% within a reference time of six months. Factors that were independently associated with increased likelihood of extra-marital partnerships were domestic violence (aOR, 1.45; 95% CI 1.09-1.92), women reporting being denied a preferred sex position (aOR, 3.34; 95% CI 1.26-8.84) and spouse longer erect penis (aOR, 1.34; 95% CI 1.00-1.78). Conversely, women's age--more than 24 years (aOR, 0.33; 95% CI 0.14-0.78) and women's increased sexual satisfaction (aOR, 0.92; 95% CI 0.87-0.96) were associated with reduced likelihood of extra-marital partnerships.

CONCLUSION

Domestic violence, denial of a preferred sex positions, longer erect penis, younger age and increased sexual satisfaction were the main predictors of women's involvement in extra-marital partnerships. Integration of sex education, counselling and life skills training in couple HIV prevention programs might help in risk reduction.

The implications of sexual narcissism for sexual and marital satisfaction

There is theoretical reason to believe narcissism is associated with a number of sexual behaviors and outcomes that affect both sexual and relationship satisfaction. Nevertheless, research on the association between personality and behavior demonstrates that personality traits, such as narcissism, only predict behavior in domains that activate the components of the personality system. Given that global assessments of narcissism do not capture the extent to which the components of narcissism are activated in the sexual domain, we examined the extent to which the facets of a domain-specific measure of sexual narcissism accounted for the trajectories of own and partner sexual and marital satisfaction over the first five years of 120 new marriages. Three of the four facets of sexual narcissism (sexual exploitation, sexual entitlement, and low sexual empathy) were negatively associated with both trajectories. The fourth facet (sexual skill) was positively associated with both trajectories. Notably, sexual satisfaction mediated the effect of every facet of sexual narcissism on marital satisfaction. A global assessment of narcissism was not associated with either trajectory of satisfaction. These findings highlight (1) the importance of narcissistic tendencies for sexual processes, (2) the benefits of using domain-specific measures of personality in research on sexual behavior, and (3) the importance of examining the implications of the specific facets of personality constructs.

Tradução e adaptação cultural do Index of Premature Ejaculation (IPE) para o português do Brasil

O presente estudo traduziu e adaptou o Index of Premature Ejaculation (IPE) para o português do Brasil, por método de equivalência semântica. O IPE é uma escala em autorrelato composta por 10 itens que avaliam critérios como senso de controle, satisfação sexual e sofrimento. Compuseram esse processo 11 profissionais qualificados para tal método e uma amostra de 50 participantes para avaliação quanto à inteligibilidade. As etapas foram: tradução, retrotradução, avaliação da equivalência semântica, crítica final por especialistas e pré-teste da versão. Os resultados para avaliação da equivalência apresentaram concordância significativa entre os juízes. Essa avaliação classificou os itens como inalterados ou pouco alterados. A crítica final por especialista avaliou qualitativamente as divergências e consolidou a versão aplicada na amostra. Após essa aplicação, algumas sugestões foram incorporadas e constituíram a versão final. Os resultados foram satisfatórios na compreensão da linguagem empregada. Para essa versão, conservou-se o nome em inglês, acrescido ao final de "adaptação brasileira".

The association between sexual motives and sexual satisfaction: gender differences and categorical comparisons

Past research suggests that sexual satisfaction may be partially dependent on sexual motives (the reasons people have sex). The primary goal of this study was to determine which of a wide range of empirically derived sexual motives were related to sexual satisfaction, and whether gender differences existed in these relationships. Examining data from 544 undergraduate participants (93 men, 451 women), we found that certain types of motives predicted levels of sexual satisfaction for both genders. However, a greater number of motive categories were related to satisfaction for women than for men, and sexual motives were a more consistent predictor of satisfaction in general for women than for men. We also found that empirical categories of motives predicted more variance in satisfaction ratings than did previously used theoretical categories. These findings suggest that a wide range of sexual motives are related to sexual satisfaction, that these connections may be moderated by gender, and that empirically-constructed categories of motives may be the most effective tool for studying this link.

When are sexual difficulties distressing for women? The selective protective value of intimate relationships

INTRODUCTION

Recent studies have shown that sexual functioning and sexually related personal distress are weakly related in women, with only a minority of sexual difficulties resulting in significant levels of distress. However, there has been little systematic research to date on which factors moderate the relationship between sexual functioning and sexual distress.

AIM

To assess the degree to which relational intimacy and attachment anxiety moderate the association between sexual functioning and sexual distress in college-age women.

METHODS

Two hundred women (mean age=20.25) completed surveys assessing sexual functioning, relational intimacy, attachment anxiety, and sexual distress.

MAIN OUTCOME MEASURES

Participants completed the Sexual Satisfaction Scale for Women, the Female Sexual Function Index, the Dimensions of Relationship Quality Scale, and the Revised Experiences in Close Relationships Measure of Adult Romantic Attachment.

RESULTS

Relational intimacy and attachment anxiety moderated the association between multiple aspects of sexual functioning and sexual distress. For lubrication and sexual pain, functioning was more strongly associated with distress in low-intimacy vs. high-intimacy relationships, but only for women with high levels of attachment anxiety. Results regarding desire were mixed and neither intimacy nor attachment anxiety interacted with subjective arousal or orgasm in predicting distress.

CONCLUSION

Both relational intimacy and attachment anxiety are important moderators of the association between sexual functioning and subjective sexual distress in women. Theoretical and practical implications are discussed.