Alcohol Use and Sexual Function in Women: A Literature Review

Reclaiming Pleasure: Does Satisfying Consensual Sexual Activity Predict Next-Day Positive Affect Among Women with a History of Sexual Assault?

Substantial research documents the psychosocial benefits of sexual activity, including heightened positive affect and lowered negative affect following sexual encounters. However, it is important to examine whether affective benefits of consensual sexual activity are present among individuals who have also experienced non-consensual sexual activity (i.e. sexual assault), given that sexual assault may have harmful consequences for sexual functioning and pleasure during consensual encounters. This study tested consensual sexual activity and satisfaction as predictors of next-day positive and negative affect among 82 women sexual assault survivors. Participants completed ecological momentary assessment measures for three weeks, including measures of past-day dyadic (i.e. partnered) sexual activity and satisfaction in the morning and current affect in the afternoon. As hypothesized, dyadic sexual activity and greater than usual sexual satisfaction predicted increased next-day positive affect after controlling for past-day positive affect. In contrast, and partially supporting hypotheses, sexual satisfaction, but not activity alone, predicted lowered next-day negative affect after controlling for past-day negative affect. At the between person level, greater sexual satisfaction (but not overall frequency of dyadic sexual activity) was associated with greater positive and lower negative affect on average after controlling for several covariates. Findings indicate that satisfying dyadic sexual encounters lead to relatively long-lasting positive affect changes in women who have experienced sexual assault.

A Scoping Review of the Prevalence and Correlates of Sexual Dysfunction in Adults With Substance use Disorders

BACKGROUND

Substance use may affect sexual functioning in both men and women. Comorbid sexual dysfunction adds to the clinical burden of substance use disorders (SUD).

AIMS

The broad aims were to identify research conduct, types of the available evidence, and research gaps in (i) estimating the incidence, prevalence, type, and severity of sexual dysfunction in adults with SUD; (ii) exploring correlates of sexual dysfunction in SUD.

METHODS

We conducted systematic searches on PubMed, Google Scholar, and Embase for studies published in the English language between August 1954 and November 2020. We included prospective and cross-sectional observational studies that had examined the prevalence or incidence of any sexual dysfunction in adults of either gender with substance use disorders. Review articles and those with an exclusive focus on tobacco use disorders were excluded. The review was registered in PROSPERO.

RESULTS

Our search identified 65 relevant articles, including five prospective studies. All the prospective studies and most of the cross-sectional studies (n = 40) were done among men and subjects with alcohol (n = 20) and opioid (n = 23) use disorders in clinical populations. Substance use and sexual dysfunction were assessed by a wide range of instruments. Prospective studies reported a prevalence of sexual dysfunction at 75% and 61% for alcohol and opioid use disorders, respectively. The prevalence of any sexual dysfunction in cross-sectional studies ranged between 15 and 100 percent. Erectile dysfunction was the most commonly studied and observed sexual dysfunction. Comorbidity and socioeconomic deprivation were consistently associated with a higher occurrence of sexual dysfunctions.

STRENGTHS

We did not limit our review by the type of substances and year of publication. We adhered to the standards of conducting and reporting scoping reviews; hence, our review results should be replicable, transparent, and reliable.

LIMITATIONS

The wide clinical and methodological heterogeneity precluded a systematic review.

CONCLUSION

Research gaps exist in women, non-clinical population, stimulants, and cannabis use disorders, and effect of treatment of SUD in sexual functioning. The quality of evidence is poor. Ghosh A, Kathiravan S, Sharma K, Mattoo SK. A Scoping Review of the Prevalence and Correlates of Sexual Dysfunction in Adults With Substance use Disorders. J Sex Med 2022;19:216-233.

Barriers to help seeking and provider preferences for sexual functioning concerns among undergraduates

Researchers who have studied help-seeking for sexual health concerns have consistently documented that individuals, couples, and families underutilize sexual health services. Additionally, research has demonstrated that individuals endorse myriad barriers to seeking informal and formal help, especially for sexual health concerns. This study examined past, present, and future provider preferences for sexual functioning concerns. Participants: A sample of 347 undergraduate students at a large university in the Northeast United States. Methods: Participants responded to questionnaires about their help-seeking behaviors for formal and informal help sources. Results: Despite the occurrence of sexual functioning concerns in the current study, services that address sexual concerns were largely underutilized. However, barriers to seeking help and negative attitudes toward seeking help did not seem to be primary reasons for the underutilization of services for the current sample. Results also indicated that providers that focus specifically on the treatment of sexual functioning concerns are among the most underutilized services. Discussion: Implications for sexual health providers based on results are provided.

Using Latent Variable Mixture Modeling to Understand Trauma-Related Outcomes in Undergraduate Women

Posttraumatic stress disorder (PTSD) and sexual functioning problems often co-occur after trauma. Researchers have linked certain factors (e.g., depression, relationship satisfaction) to PTSD and sexual functioning, but it is unclear how these variables interact. Adult undergraduate female trauma survivors (N = 280) completed self-report measures via an online survey. Latent variable mixture modeling generated four groups that differed in terms of their PTSD symptom severity, sexual functioning, sexual pain, relationship status, and relationship functioning. ANOVAs explored group differences. Classes were not differentiated by trauma, relationship satisfaction, or drug use. Results highlight the complex relations between sexual functioning and post-trauma symptomology.

Alcohol and Sexual Health Behavior: "What We Know and How We Know It"

Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women's sexual victimization history and men's condom use resistance. Limitations and implications associated with this body of research are also discussed.

Women's sexual arousal: effects of high alcohol dosages and self-control instructions

The basic relationship between alcohol and women's sexual arousal - especially genital arousal - received little research attention for nearly 30 years (e.g. Wilson and Lawson, 1978) until very recently (e.g. George et al., 2009). To investigate hypotheses based on earlier findings and Alcohol Myopia Theory (AMT), two experiments evaluated the effects of high blood alcohol concentrations (BACs) and arousal instructional demands on indices of vaginal responding and self-reported sexual arousal. In Experiment 1, self-control instructions to maximize (versus suppress) arousal increased peak and average Vaginal Pulse Amplitude (VPA) change. Self-control also interacted with a target BAC of .08% (versus .00%) to influence latency to peak arousal onset: Intoxicated women instructed to maximize showed a shorter latency to peak arousal than did intoxicated women instructed to suppress; however, sober women showed an undifferentiated pattern. Also, in Experiment 1, the target BAC of .08% had no effect on VPA or subjective arousal measures. In Experiment 2, a target BAC of .10% (versus .00%) attenuated peak change and average change in VPA, but this dosage had no effects on latency to peak achieved arousal, or on subjective arousal. Instructions to maximize arousal (versus no instruction) had no effect on any arousal measures. Overall, among young moderate drinking women, alcohol had attenuating effects but only at the higher dosage. Maximize versus suppress instructions about arousal had predicted effects on arousal and interactive effects on latency, but only at the lower dosage. The findings highlight the importance of dosage and contextual factors in alcohol's impact on the variability of women's sexual responding.