The male sexual quotient: a brief, self-administered questionnaire to assess male sexual satisfaction

IntroductionSexual satisfaction is an important aspect of overall life satisfaction. The Male Sexual Quotient (MSQ) was designed to provide a versatile, user-friendly instrument to measure various aspects of male sexual function and satisfaction.AimAssess responses to the MSQ in men with sexual dysfunction (SD).MethodsItems for inclusion in the MSQ were developed through interviewing 612 randomly recruited men in São Paulo, Brazil, about factors considered to influence sexual quality of life. Validation of the MSQ was conducted in two phases in men with and without SD.Main Outcome MeasureThe correlation between patients’ total MSQ score and scores on the Sexual Health Inventory for Men (SHIM).ResultsThe resulting MSQ questionnaire contains 10 items that address sexual function and satisfaction and is scored on a 100-point scale, with higher scores indicating greater sexual function and satisfaction with such function. Patients’ scores on the MSQ were positively correlated with scores on the SHIM (r = 0.86; P < 0.0001). Scores on MSQ item 8, which assesses ejaculatory control, indicated that 46% of patients may have premature ejaculation (PE). The mean time for patients to complete the MSQ was 11 minutes.ConclusionsThe MSQ is a brief, comprehensive, and easily self-administered tool designed to help men identify aspects of their sexual experience that could be improved through partner dialogue, physician consultation, and appropriate treatment. MSQ scores correlated well with SHIM scores, and scores were inversely related to the severity of erectile dysfunction or PE and other male SDs. These preliminary findings suggest that the MSQ possesses good convergent validity. Nearly half of men reported problems with ejaculatory control, indicating an association between PE and other SD. Further validation of the MSQ in a double-blind trial is needed. The MSQ may aid in decision making for the treatment of SD. Abdo CHN. The Male Sexual Quotient: A brief, self-administered questionnaire to assess male sexual satisfaction.     

Sexual Function,Sexual Dysfunctions,and ADHD: A Systematic Literature Review

BackgroundThe scientific literature on sexuality among mentally ill patients clearly shows a higher prevalence of sexual disorders for many mental disorders, but little is known about sexuality in individuals suffering from ADHD. Clinicians will often assume that specific difficulties of ADHD are bound to affect sexual functioning.AimThe aim of this study was to provide a review of the literature to gain better knowledge about sexuality in subjects with ADHD and to discuss screening and management of their potential sexual problems.MethodsA systematic review of the literature was performed in Pubmed, PsychInfo, and Embase databases.Main Outcome MeasuresThe main outcome measures were sexual function and sexual dysfunctions.ResultsThe studies indicated that subjects with ADHD report more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population.Clinical ImplicationsClinicians working with subjects with ADHD should explore the quality of their sexual life.Strengths & LimitationsThis is the first systematic review of the sexuality of individuals with ADHD. However, the results are limited by the small number of studies, by the small sample size of many studies, and the potential for bias.ConclusionsADHD is a mental disorder affecting sexual health. Further studies are warranted to learn more about sexuality in subjects with ADHD.Soldati L, Bianchi-Demicheli F, Schockaert P, et al. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020;17:1653–1664.     

Associations Among Physiological and Subjective Sexual Response,Sexual Desire,and Salivary Steroid Hormones in Healthy Premenopausal Women

IntroductionFew studies have examined how sexual arousal influences healthy premenopausal women's hormones, limiting our understanding of basic physiology and our ability to transfer knowledge from clinical and nonhuman populations.AimTo examine how sexual arousal and steroid hormones (testosterone [T], cortisol [C], estradiol [E]) were linked, to see whether hormone levels influenced and/or changed in response to sexual arousal elicited via visual erotic stimuli in healthy women.MethodsParticipants included 40 healthy premenopausal women not using exogenous hormones.Main Outcome MeasuresChange in genital sexual arousal (vaginal pulse amplitude), change in subjective sexual arousal, sexual desire (via the Sexual Desire Inventory and Female Sexual Function Index scales), as well as T, C, and E via saliva samples taken before and following viewing of erotic stimuli as genital arousal was recorded via a vaginal photoplethysmograph.ResultsE increased in response to sexual stimuli but this was not statistically associated with genital sexual arousal, whereas C decreased in association with genital sexual arousal, and T showed no statistically significant change. Relationship status was linked to genital but not subjective sexual arousal such that dating women exhibited higher genital sexual arousal than single or partnered women. Results indicated that all three hormones were associated with self-reported genital arousal (via the Detailed Assessment of Sexual Arousal scales) and sexual desire in different domains, and both T and E were associated with self-reported orgasms.ConclusionFindings point to the need to examine multiple hormones in multiple ways (e.g., baseline, changes, stimulated) and question using erotic stimuli-induced arousal as a model for women's endocrine responses to sexuality. van Anders SM, Brotto L, Farrell J, and Yule M. Associations among physiological and subjective sexual response, sexual desire, and salivary steroid hormones in healthy premenopausal women. J Sex Med 2009;6:739–751.     

Sexual Arousal and Desire: Interrelations and Responses to Three Modalities of Sexual Stimuli

IntroductionTraditionally, sexual desire is understood to occur spontaneously, but more recent models propose that desire responds to sexual stimuli.AimsTo experimentally assess whether sexual stimuli increased sexual desire; to compare how sexual arousal and desire responded to three modalities of sexual stimuli: erotic story, unstructured fantasy, and the Imagined Social Situation Exercise (ISSE).MethodsIn an online study, participants (128 women, 98 men) were randomly assigned to one of four arousal conditions (ISSE, story, fantasy, or neutral), and then completed desire measures. In the ISSE, participants imagined and wrote about a positive sexual encounter with a self‐defined attractive person.Main Outcome MeasuresSexual arousal (perceived genital, psychological, and perceived autonomic), anxiety, positive and negative affect, and state sexual desire via self‐report measures pre‐ and post‐condition; “trait” desire via the Sexual Desire Inventory post‐condition.ResultsAll three sexual conditions significantly increased sexual arousal and positive affect compared with the neutral condition, with trends for higher arousal to unstructured fantasy than the ISSE or story conditions. Sexual conditions significantly increased scores on state measures of sexual desire. In addition, sexual context influenced measurement of “trait” solitary sexual desire in women, such that women reported significantly higher trait desire after the neutral and ISSE conditions vs. fantasy.ConclusionResults highlight the responsiveness of sexual desire, problems with measurement of desire as a long‐term trait, trade‐offs of using the ISSE and other stimuli in sexuality research, and the need to address context in discussions of women's and men's desire. Goldey KL and van Anders SM. Sexual arousal and desire: Interrelations and responses to three modalities of sexual stimuli. J Sex Med 2012;9:2315–2329.     

The Effects of Experimentally-Induced Sad and Happy Mood on Sexual Arousal in Sexually Healthy Women

IntroductionIn depressed women, common sexual difficulties include decreased sexual desire, sexual arousal and orgasmic difficulties, reduced sexual satisfaction, and reduced sexual pleasure. Experimental research on the influence of depressed mood on genital and subjective sexual arousal in women is scarce.AimTo investigate the effects of sad mood on genital and subjective sexual arousal in sexually healthy women, using a mood induction procedure.MethodThirty-two subjects received a sad mood and a happy mood induction, on two different days, using a within subjects design. The mood induction procedure was a combination of the Velten procedure and music. In the Velten procedure, the subject is asked to read sad or happy self-referent sentences and to experience the mood suggested by these sentences. Immediately following mood induction, the subjects were exposed to an erotic film clip.Main Outcome MeasureGenital arousal was assessed using vaginal photoplethysmography. Self-report ratings of sad and happy mood, subjective sexual arousal and affective reactions were collected before and after the erotic clip.ResultsThe sad and happy mood ratings indicated that the mood inductions affected mood as intended. No difference in genital sexual arousal was found between the sad and happy mood conditions. Subjects reported significantly less subjective sexual arousal and positive affect and marginally significant fewer genital sensations and more negative affect in the sad mood condition than in the happy mood condition.ConclusionsThe results provide empirical support for the idea that mood can impact on subjective sexual arousal in women. ter Kuile MM, Both S, and van Uden J. The effects of experimentally-induced sad and happy mood on sexual arousal in sexually healthy women.     

Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction

IntroductionSexual problems are common during pregnancy, but the proportion of pregnant women who experience sexual distress is unknown. In non-pregnant samples, sexual distress is associated with lower sexual and relationship satisfaction.AimTo identify the proportion of women experiencing sexual distress during pregnancy and to compare the sexual and relationship satisfaction of women who report sexual distress during pregnancy with that of women without distress.MethodsTwo-hundred sixty-one pregnant women completed a cross-sectional online survey.Main Outcome MeasuresWomen completed validated measurements of sexual functioning (Female Sexual Function Index; score < 26.55 indicates a sexual problem), sexual distress (Female Sexual Distress Scale; score ≥ 15 indicates clinically significant distress), sexual satisfaction (Global Measure of Sexual Satisfaction), and relationship satisfaction (Couples Satisfaction Index).ResultsOverall, 42% of women met the clinical cutoff for sexual distress. Of sexually active women (n = 230), 26% reported concurrent sexual problems and distress and 14% reported sexual distress in the absence of sexual problems. Sexual distress and/or problems in sexual functioning were linked to lower sexual and relationship satisfaction compared with pregnant women with lower sexual distress and fewer sexual problems.ConclusionSexual distress is common during pregnancy and associated with lower sexual and relationship satisfaction. Health care providers should ask pregnant women about feelings of sexual distress. Identifying pregnant women who experience sexual distress and referring them to appropriate resources could help minimize sexual and relationship problems during pregnancy.Vannier SA, Rosen NO. Sexual Distress and Sexual Problems During Pregnancy: Associations With Sexual and Relationship Satisfaction. J Sex Med 2017;14:387–395.     

Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM)

BackgroundA number of studies have found that hypersexuality is associated with a high propensity for sexual excitation. In comparison, less is known about the relationship between hypersexuality and sexual arousal at the state level. Also, previous research has revealed a relationship between hypersexuality and negative mood. However, the possibility that sexual response might not be as negatively impacted by negative mood in hypersexual individuals has, as yet, not been tested.AimThe purpose of this study was to investigate sexual responsivity and the effects of negative mood on sexual arousal in hypersexual men who have sex with men (MSM).MethodsA total of 211 MSM were assigned to a hypersexuality (N = 81) or a control (N = 130) group using an interview patterned with a semi-structured Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders format. Participants filled out questionnaires and were shown neutral, sexual, and anxiety- and sadness-inducing films.OutcomesChanges in penile circumference and self-reported sexual arousal were the primary outcomes analyzed in this study.ResultsControlling for age and HIV status, no differences were found in genital response between hypersexual and non-hypersexual men. Also, the 2 groups did not differ in subjective sexual arousal. Moreover, no effects of negative mood were found. Time series clustering analyses revealed 3 groups—low responders and slow and fast high responders. Sexual excitation, but not sexual compulsivity or pornography use, predicted cluster membership.Clinical TranslationHypersexual MSM may benefit more from an exploration of motivational and behavioral, as compared to psychophysiological, mechanisms underlying possible links between (negative) mood and sexual behavior.Strengths & LimitationsStrengths of the study include its sample size, making it one of the larger psychophysiological sex studies; the use of clinical interviews for group assignment; the inclusion of genital response measures; and the application of time series clustering to examine differences among participants. Limitations include possible sample heterogeneity and the reliance on researcher-selected stimuli.ConclusionGiven the lack of any effects of negative mood on sexual response in hypersexual MSM, future studies could explore in more depth possible motivational and behavioral effects, including, for example, the impact of negative mood on the tendency to seek out sex as a form of distraction or for validation or emotional support.Janssen E, Prause N, Romine RS, et al. Sexual Responsivity and the Effects of Negative Mood on Sexual Arousal in Hypersexual Men Who Have Sex With Men (MSM). J Sex Med 2020;17:1751–1760.     

Partner Responses to Low Desire: Associations With Sexual,Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder

BackgroundThe experience of distressing low sexual interest/arousal—female sexual interest/arousal disorder (FSIAD)—is prevalent in women of all ages and is associated with poorer sexual, relationship, and psychological well-being than women without this difficulty. Women who are partnered are almost 5 times more likely to be distressed by low desire and to receive a diagnosis of FSIAD than unpartnered women, indicating that interpersonal factors are highly relevant, although largely neglected in past research.AimIn a dyadic cross-sectional and longitudinal study, we examined whether partner responses to FSIAD were associated with the sexual, relationship, and psychological well-being of couples, and whether any effects persisted 1 year later.MethodsWomen diagnosed with FSIAD (N = 89) completed a validated measure of perceived partner positive vs negative responses to their low sexual interest/arousal and their partners reported on their own responses, as well as measures of sexual desire, sexual satisfaction, relationship satisfaction, sexual distress, and anxiety. 1 year later, couples (N = 66) completed the outcome measures again. Data were analyzed according to the Actor-Partner Interdependence Model.OutcomesOutcomes included were the Sexual Desire Inventory–Solitary and Partner-Focused Subscales; Global Measure of Sexual Satisfaction; Female Sexual Distress Scale; Couple Satisfaction Index; and State-Trait Anxiety Inventory–Short-Form.ResultsWhen women with FSIAD perceived more positive partner responses (eg, warm, supportive, compassionate) than negative responses (eg, hostile, unsupportive, indifferent), they were more satisfied with the relationship and they and their partners reported lower anxiety. When partners reported more positive than negative responses, they had greater relationship and sexual satisfaction and lower sexual distress and anxiety. Exploratory analyses revealed that women's perceptions of their partners' responses accounted for the link between partners' own responses and women's relationship satisfaction and anxiety. Partner responses did not predict any change in outcomes over time.Clinical ImplicationsFindings support interpersonal conceptualizations of FSIAD and may inform the development of future couple-based interventions.Strengths & LimitationsThis study is one of the few dyadic investigations of FSIAD, as diagnosed via a clinical interview. Significant associations were only observed cross-sectionally, limiting causal conclusions. There was limited power to detect longitudinal effects.ConclusionMore positive responses to women's low sexual interest/arousal by partners is linked to better adjustment among couples affected by FSIAD.Rosen NO, Corsini-Munt S, Dubé JP, et al. Partner Responses to Low Desire: Associations With Sexual, Relational, and Psychological Well-Being Among Couples Coping With Female Sexual Interest/Arousal Disorder. J Sex Med 2020;17:2168–2180.     

Sexual Dysfunction and Satisfaction in Kidney Transplant Patients

Introduction10% of the world’s population suffers from chronic kidney disease. Kidney transplants provide an improvement in the quality of life of those patients. Sexual dysfunction is common after kidney transplantation, and its etiology is presumed to be multifactorial. It has a negative impact on sexual satisfaction and health-related quality-of-life. The integration of a new organ into the body can imply an adjustment of body image, which may eventually have a negative influence on intimacy and sexual behaviors.AimTo evaluate male sexual function, sexual satisfaction, and body image satisfaction among a convenience sample of patients who have had a kidney transplant.MethodsThis is a cross-sectional study that included 460 patients, from a single healthcare center, who had undergone a kidney transplant procedure >4 weeks ago. A total of 112 respondents (mean = 55.5 years, SD = 11.4) answered the questionnaires properly.Main Outcome MeasuresAll recruited patients answered a self-reported sociodemographic questionnaire, in addition to the International Index of Erectile function, the New Scale of Sexual Satisfaction, the Brief Symptom Inventory, and the Body Image Scale.ResultsA correlation was found between sexual function and sexual satisfaction (r = 0.598, P < .001, n = 112), as well as between body image satisfaction and sexual function (r = −0.193, P = .042, n = 112). The length of time after a kidney transplant (≤ or >36 months) was not associated with a difference in sexual functioning or sexual satisfaction.Clinical ImplicationsThis study showed the obvious implications of sexual function on sexual satisfaction, which should alert healthcare professionals to the importance of identifying and managing sexual dysfunction in patients with chronic kidney disease, to optimize their global and sexual health satisfaction.Strength & LimitationsThis study identified a high prevalence of sexual dysfunction among kidney transplant recipients. This should reinforce the need for the medical community to evaluate the quality-of-life domains of patients with chronic disease. There is still a lack of information concerning any longitudinal evaluation of kidney transplant patients’ sexual function and the effects that this surgery has on sexuality.ConclusionsThis study corroborated the severe effects that kidney transplant patients often report regarding their sexuality. Among the patients who participated in the study, sexual function proved to be relevant in relation to sexual satisfaction.Mota RL, Fonseca R, Santos JC, et al. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019;16:1018–1028.     

Sexual Behavior and Symptoms among Reproductive Age Chinese Women in Hong Kong

IntroductionAs sexual medicine evolves, much advancement has been achieved in understanding male sexuality and treating male sexual dysfunction. Less is known about female sexual pattern, the prevalence of sexual problems, and their correlation with confounding factors.AimTo enhance our understanding of female sexuality and the risk factors that contributed to sexual problems in reproductive age women.MethodA cross‐sectional survey was conducted in family planning and prepregnancy checkup clinics from December 2007 to December 2009, with 2,146 sexually active Chinese women aged 21 to 40 years completed the entire questionnaire.Main Outcome MeasuresPrevalence of sexual symptoms, coital frequency, and other sexual behavior–related activities were measured.ResultsOverall, 59.0% of respondents had at least one sexual problem. In this sample, 31.8% of respondents reported no desire; 31.7% had arousal problems; 40% had anorgasmia, and 33.8% experienced coital pain for at least 3 months within the past 1 year. Chi‐square test showed significant correlation among the four types of sexual problems(P < 0.001). Univariate regression model showed that all sexual symptoms were significantly correlated with unidirectional coitus initiation, low coital frequency, and low foreplay enjoyment. Loglinear model revealed that desire, arousal, and orgasmic problems were correlated with low foreplay enjoyment. Arousal problem was correlated with high acceptance toward pornography and history of medical disease. Coital pain was correlated with secondary education and planning to have more children. Both unidirectional coitus initiation and low coital frequency were major contributors to all four sexual symptoms.ConclusionsSexual problem is a prevalent health issue among reproductive age women. A number of risk factors are identified, which provide useful direction to the design of counseling and education materials that might help to enhance sexual performance in women. Lo SST and Kok WM. Sexual behavior and symptoms among reproductive age Chinese women in Hong Kong. J Sex Med 2014;11:1749–1756.     

Sexual behavior predictors of satisfaction in a Chinese sample

IntroductionPrevious multivariate research in Europe found that sexual satisfaction was associated directly with frequency of penile–vaginal intercourse (PVI) but inversely with masturbation and some aspects of non‐PVI partnered sex.AimsTo examine the associations of sexual satisfaction in a sample from the People's Republic of China, including not only frequencies of various sexual behaviors, but also frequencies of orgasm.MethodsChinese industrial workers (N = 158, age over 24 years) completed the sexual satisfaction scale of the Multidimensional Sexuality Questionnaire (MSQ) and a short form of the Marlowe‐Crowne social desirability scale, and provided details of the one month frequencies of engaging in, and having an orgasm from, PVI, masturbation, and non‐PVI partnered sex.Main Outcome MeasuresMultiple regression prediction of sexual satisfaction from age, social desirability responding, and in separate analyses, frequencies of the sexual behaviors or the corresponding orgasm frequencies.ResultsFor men and women, sexual satisfaction was associated with frequency of PVI and of PVI orgasm (the latter for women only), but not other sexual behavior or orgasm frequency. Similar results were obtained for the MSQ satisfaction scale and for a single satisfaction item.ConclusionsDespite cultural differences (and our smaller, less diverse sample), the positive prediction of satisfaction from only PVI (and in our sample of women, PVI orgasm) frequency—but not other sexual activities—was similar to that in a Swedish sample. Future research might also examine possible occasional avoidance of ejaculation by some Chinese men. Tao P and Brody S. Sexual behavior predictors of satisfaction in a Chinese sample.     

Sexual Arousal in East Asian and Euro-Canadian Women: A Psychophysiological Study

IntroductionStudies of ethnic differences in self-report measures of sexuality have shown East Asian women to be more sexually conservative and less sexually experienced than Caucasian women. There is also strong evidence supporting the notion of ethnic group differences in general measures of nonsexual psychophysiological arousal; however, there have been no previous studies exploring ethnicity and physiological sexual arousal.AimThe objective of this study was to explore group differences in self-reported and physiological sexual arousal in Euro-Canadian and East Asian women living in Canada; we also aimed to explore the association between level of acculturation (both mainstream and heritage) and sexual arousal in East Asian women only.MethodsSeventy-five women (N = 38 Euro-Canadian, N = 37 East Asian) completed a battery of questionnaires and underwent psychophysiological sexual arousal testing using the vaginal photoplethysmograph. They also completed a self-report measure of subjective arousal before and after erotic stimulus exposure.Main Outcome MeasuresAll women completed the Female Sexual Function Index, Vancouver Index of Acculturation, and Sexual Beliefs and Information Questionnaire. Change in genital sexual arousal (vaginal pulse amplitude; VPA), and change in subjective sexual arousal were measured during exposure to erotic stimuli.ResultsThe groups did not differ in the percent increase in VPA induced by erotic stimuli, nor was there a correlation between VPA and subjective sexual arousal. Among East Asian women alone, neither heritage nor mainstream acculturation was correlated with change in VPA.ConclusionsEast Asian and Euro-Canadian women who show similar ratings of sexual behaviors and self-reported sexual arousal do not differ in physiological or subjective arousal induced by erotic stimuli in the laboratory. Yule M, Woo JST, and Brotto LA. Sexual arousal in East Asian and Euro-Canadian women: A psychophysiological study.     

Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women

BackgroundSexual self-esteem and communication on sexual issues with a partner contribute greatly to an individual's quality of sex life; however, their effects on the relationship between body image and sexual function are underexplored.AimTo test a serial mediating pathway of sexual self-esteem and sexual communication underlying the relationship between body image and sexual function.MethodsA total of 510 women aged 18–53 years (mean = 28, SD = 5.5) who were involved in an intimate relationship completed an online survey.OutcomesWomen's (i) body appreciation, (ii) body image self-consciousness during sexual intimacy, (iii) sexual self-esteem, (iv) dyadic sexual communication, (v) negative disclosure apprehension, and (vi) sexual function were assessed.ResultsFindings revealed that sexual self-esteem and dyadic sexual communication played a serial mediating role in the relationship between body image (body appreciation and body image self-consciousness during sexual intimacy) and sexual function, and the relationship between body image and arousal, lubrication, orgasm, satisfaction, and pain. Sexual self-esteem and negative disclosure apprehension also played a serial mediating role in the relationship between body image and sexual pain. In addition, dyadic sexual communication played a unique mediating role in the relationship between body image and sexual function, which is isolated from the effect of sexual self-esteem.Clinical ImplicationsWomen's sexual self-esteem and sexual communication with their partner can make beneficial contributions to the relationship between body image and sexual function. Therefore, promoting women's positive body image, sexual self-esteem, and sexual communication skills deserves attention from women themselves and clinicians.Strengths & LimitationsThis study used a robust method of data analysis to test the mediating effect of sexual self-esteem and sexual communication to clarify the mechanism underlying the relationship between body image and sexual function among Chinese women; however, causal conclusions cannot be drawn. Furthermore, various demographics including participants' age, education level, sexual orientation—factors such as relationship status and length, relationship functioning, and partner-related variables—and other aspects of sexual self-concept and sexual communication should be examined in future research.ConclusionThe current study indicates that women's thoughts and feelings regarding sexuality and communicating sexual issues with their partner are associated closely with their body image and sexual function.Wu T, Zheng Y. Effect of Sexual Esteem and Sexual Communication on the Relationship Between Body Image and Sexual Function in Chinese Heterosexual Women. J Sex Med 2021;18:474–486.     

Mediators of Sexual Functioning and Marital Quality in Chronically Depressed Adults with and Without a History of Childhood Sexual Abuse

IntroductionSexual dysfunction is common among depressed adults. Childhood sexual abuse (CSA) and depressive symptomology are among the risk factors for sexual dysfunction, and these factors may interact to predict adult relationship functioning. Several models have been developed postulating interactions between these variables.AimWe tested models of the effects of CSA and elucidate the associations between CSA, sexual dysfunction, depression severity, anxiety, and relationship quality in chronically depressed adults.MethodsBaseline data from 808 chronically depressed outpatients enrolled in the Research Evaluating the Value of Augmenting Medication with Psychotherapy study were evaluated using structural equation modeling.Main Outcome MeasuresThe Inventory of Depressive Symptomology, self‐report version (IDS‐SR) assessed depression severity, and the Mood and Anxiety Symptom Questionnaire Anxious Arousal subscale assessed anxiety. Sexual function was assessed with the Arizona Sexual Experiences Scale (ASEX), and the Quality of Marriage Index (QMI) assessed relationship quality for patients in stable relationships.ResultsCSA scores predicted depression severity on the IDS‐SR, as well as lower relationship quality and sexual satisfaction. ASEX scores were significantly associated with depression severity but were not correlated with the QMI. Two models were evaluated to elucidate these associations, revealing that (i) depression severity and anxious arousal mediated the relationship between CSA and adult sexual function, (ii) anxious arousal and sexual functioning mediated the association between CSA and depression symptoms, and (iii) when these models were combined, anxious arousal emerged as the most important mediator of CSA on depression which, in turn, mediated associations with adult sexual satisfaction and relationship quality.ConclusionsAlthough CSA predicts lower relationship and sexual satisfaction among depressed adults, the long‐term effects of CSA appear to be mediated by depressive and anxious symptoms. It is important to address depression and anxiety symptoms when treating patients with CSA who present with sexual dysfunction or marital concerns. Dunlop BW, Hill E, Johnson BN, Klein DN, Gelenberg AJ, Rothbaum BO, Thase ME, and Kocsis JH. Mediators of sexual functioning and marital quality in chronically depressed adults with and without a history of childhood sexual abuse. J Sex Med 2015;12:813–823.     

Sexual and Relationship Satisfaction in Young,Heterosexual Couples: The Role of Sexual Frequency and Sexual Communication

BackgroundAlthough their individual contributions to sexual and relational outcomes are well-established, there has been a lack of research on the importance of sexual frequency and sexual communication to sexual and relationship satisfaction.AimTo examine the contribution of sexual frequency and sexual communication to sexual and relationship satisfaction in the early stages of couple relationships.MethodsA sample of 126 young, heterosexual couples (mean age = 23.3 years, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) filled out questionnaires about sexual frequency, sexual communication, and sexual and relationship satisfaction. Analyses were guided by the actor-partner interdependence model.OutcomesMain outcome variables were sexual satisfaction and relationship satisfaction, measured by the Quality of Sex Inventory and the Couple Satisfaction Index, respectively.ResultsAnalyses revealed a significant actor effect of both sexual communication and sexual frequency for sexual satisfaction. Only sexual communication, not sexual frequency, predicted relationship satisfaction. No significant partner or gender effects were found.Clinical TranslationThese findings lend support to the notion that couples could benefit from focusing on non-behavioral processes (eg, sexual communication), rather than sexual behavior per se, when pursuing a fulfilling partnership.Strengths & LimitationsStrengths of the study include the dyadic nature of the data and analyses, allowing for the evaluation of both individual- and couple-level processes. Also, to our knowledge, this is the first study to specifically examine the importance of sexual frequency and sexual communication to both sexual and relationship satisfaction. Limitations include the reliance on self-report measures and a relatively homogeneous sample.ConclusionAlthough both sexual frequency and sexual communication were relevant to the prediction of sexual satisfaction, only sexual communication predicted relationship satisfaction in this sample of young, heterosexual couples.Roels R, Janssen E. Sexual and Relationship Satisfaction in Young, Heterosexual Couples: The Role of Sexual Frequency and Sexual Communication. J Sex Med 2020;17:1643–1652.     

Treatment of Low Sexual Desire or Frequency Using a Sexual Enhancement Group Couples Therapy Approach

BackgroundSexual desire or frequency problems are exceedingly common, but treatment of them has been less than effective.AimThe goal of this study was to develop a cost-effective, accessible intervention to deal with sexual desire or frequency problems, including sexual desire discrepancy, by enhancing the quality of couples’ erotic intimacy.Methods45 couples (38 heterosexual and 7 same-sex couples) distressed by sexual desire or frequency problems were seen in a 16-hour, group couples therapy intervention. Participants completed the New Sexual Satisfaction Scale (NSSS) at pretest, posttest, and at 6-month follow-up.OutcomesThe NSSS plus 3 additional items at pretest, posttest, and at 6-month follow-up and patients’ written feedback.ResultsStatistically significant differences were found between pre-tests and post-tests in satisfaction with intensity of sexual arousal; creativity; frequency; sexual functioning; partner's sexual availability; partner's initiation of sexual activity; emotional opening up during sex; positive sexual reactions to the partner; communication of sexual wishes, preferences and desires; and balance between giving and receiving during sex. The largest improvement and effect sizes were found in overall satisfaction with one's sex life from pre-test to post-test and 6-month follow-up.Clinical ImplicationsLow sexual desire or frequency problems can be treated effectively by enhancing the quality of the couple's erotic connection, thereby creating desirable sex.Strengths & LimitationsThe strengths include the combination of quantitative and qualitative data. Limitations included the small number of same-sex couples.ConclusionSexual enhancement group couples therapy provides an effective, accessible, and affordable approach to low desire or frequency complaints in distressed couples.Kleinplatz PJ, Charest M, Paradis N, et al. Treatment of Low Sexual Desire or Frequency Using a Sexual Enhancement Group Couples Therapy Approach. J Sex Med 2020;17:1288–1296.     

Physical Activity and Female Sexual Dysfunction: A Lot Helps,But Not Too Much

BackgroundResearch on the relationship between physical activity (PA) and female sexual dysfunction (FSD) is lacking.AimTo investigate the clinical, psychological, and sexual correlates of PA in women with FSD.MethodsA non-selected series of n = 322 pre- and post-menopausal patients consulting for FSD was retrospectively studied. Regular involvement in PA and its frequency (<1 hour/week: sedentary, 1–3 hours/week: active, 4–6 hours/week: very active, >6 hours/week: extremely active) were investigated with a specific question.OutcomesFSDs, including HSDD (Hypoactive sexual desire disorder) and FGAD (Female genital arousal disorder), were diagnosed according to a structured and clinical interview. Participants underwent a physical examination and a clitoral Doppler ultrasound, and were asked to complete the Female Sexual Function Index, Female Sexual Distress Scale-Revised, Body Uneasiness Test, and Middlesex Hospital Questionnaire.ResultsAt multivariate analysis, women engaging in PA (67.4%, n = 217) scored significantly higher in several Female Sexual Function Index domains - including desire, arousal and lubrication - and showed lower sexual distress and lower resistance of clitoral arteries, as compared to sedentary women. A significant, inverse association between PA and HSDD was observed. Mediation analysis demonstrated that the negative association between PA and HSDD was partly mediated by body image concerns (Body Uneasiness Test Global severity index), psychopathological symptoms (Middlesex Hospital Questionnaire total score) and sexual distress (Female Sexual Distress Scale-Revised score). These latter 2 factors also partly mediated the association between PA and a reduced risk of FGAD, whilst a lower BMI was a full mediator in the relationship between PA and FGAD. Finally, extreme PA was associated with significantly worse scores in several psychosexual parameters (i,e, sexual satisfaction and histrionic/hysterical symptoms), even compared to a sedentary lifestyle.Clinical ImplicationsWomen consulting for FSD may gain benefits on desire, arousal, lubrication and sex-related distress from regular PA; however, physicians should remain alert to the downsides of excessive exercise.Strengths & LimitationsThe main strength lies in the novelty of the findings. The main limitations are the cross-sectional nature, the clinical setting, the small sample size of the different PA groups, and the use of self-reported instruments for the evaluation of PA.ConclusionIn women with FSD, PA was associated with better sexual function and clitoral vascularization, lower sexual distress and reduced odds of HSDD and FGAD; the benefits of PA on sexuality were mediated by both psychological and organic determinants; excessive PA was related with a poor overall sexual function and with a low sexual satisfaction.Maseroli E, Rastrelli G, Di Stasi V, et al. Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much. J Sex Med 2021;18:1217–1229.     

Sexual Dysfunction Among Secondary School Teachers in Ilorin,Nigeria

IntroductionThere is an increasing emphasis on human sexuality, which may reflect cultural and scientific development in recent years.AimTo determine the prevalence, pattern of sexual dysfunction, and its associated factors among secondary school teachers in Ilorin, Kwara State, Nigeria.MethodsFour hundred fifty consenting teachers were invited to complete an anonymous self administered questionnaire on demography as well as two to three other instruments for the assessment of human sexuality and general mental health status. This was thereafter collected by hand.Main Outcome MeasuresThe International Index of Erectile Function (IIEF), a modified Sexual Activity Questionnaire (SAQ) and the General Health Questionnaire-30 (GHQ-30).ResultsThe following prevalence rates were found: female anorgasmia (40%), lubrication failure (30%); dyspareunia (12%); erectile dysfunction, premature ejaculation, and male orgasmic disorder (23% each); loss of sexual desire (24%); sexual life dissatisfaction and relationship dissatisfaction 6 months prior to interview (10% each). Age was a significant factor in sexual dysfunction in males (erectile dysfunction, premature ejaculation, and male anorgasmia), also in females (lubrication failure, superficial dyspareunia, anorgasmia). Marital status was found to be significant in relationship satisfaction, overall sexual satisfaction and presence of sexual dysfunctions whereas GHQ-30 scores were significant in sexual dysfunction in both genders, except for female anorgasmia and premature ejaculation in males. However, a presence of psychiatric “caseness” was significantly found in overall sexual life dissatisfaction as well as relationship dissatisfaction.ConclusionThe extent and pattern of sexual dysfunctions found in this study is comparable with those reported in earlier Nigerian studies. Despite this, there is apparently no health services specially designed to address sexual dysfunction among the teacher's group or the general population at large. This study thus draws attention to the urgent need for services geared towards alleviating sexual problems in our society. Adegunloye OA, Makanjuola AB, and Adelekan ML. Sexual dysfunction among secondary school teachers in Ilorin, Nigeria.     

Sexual Functioning in Women with Mild and Severe Symptoms of Charcot-Marie-Tooth Disease

IntroductionCharcot-Marie-Tooth (CMT) disease is one of the most frequently inherited neurological disorders, and while it is known that individuals suffering from this condition have low quality of life, little is known about their sexual function and satisfaction.AimTo describe the functioning on different domains of sexuality in a relatively large sample of women with CMT, provide comparisons between mildly and severely affected patients and between women with the two different types of CMT (demyelinating vs. axonal), and assess the relationship between sexual function and age of onset.MethodsFifty-seven women (age: 18–60 years) were approached in a CMT rehabilitation clinic by a psychologist and administered the Italian version of the McCoy Female Sexuality Questionnaire (MFSQ). Data from 40 patients who had had sexual intercourse in the previous 4 weeks were analyzed.Main Outcome MeasureThe main outcome measures are the factors MFSQ-SEX and MFSQ-PARTNER, which describe sexual functioning and sexual satisfaction with a partner, respectively.ResultsAlmost 30% of women did not engage in sexual intercourse with a partner. Overall sexual problems were more prominent in younger women and tended to be lower as age increased: this pattern was different from what was reported in previous studies in comparable samples of healthy Italian women. Severity of CMT was associated with better sexual functioning in the areas of desire, arousal, orgasm, and satisfaction, with women with more severe symptoms reporting greater functioning. Women with more severe CMT symptoms reported more pain during intercourse. Age of CMT onset and type of CMT (demyelinating vs. axonal) were not associated with differences in sexual functioning.ConclusionsFindings point to the importance of including assessment of sexual dysfunction in young women with mild CMT symptoms and the importance of providing sex therapy or counseling to these patients. Gargiulo P, Vinci P, Navarro-Cremades F, and Rellini AH. Sexual functioning in women with mild and severe symptoms of Charcot-Marie-Tooth Disease.