Reduced sexual desire in a random sample of Norwegian couples

Abstract

The purpose of this study was to analyse reduced sexual desire in Norwegian heterosexual couples and to identify factors associated with loss of sexual desire in both men and women. The study comprises a sample of 399 couples (798 individuals) between 22 to 67 years of age. Data were collected by the means of self-administered postal questionnaires. The majority of the couples (59%) did not report distressing problems related to loss of sexual desire. In 26% of the couples the female partner had experienced distressing loss of sexual desire; in 8% of the couples the male partner did, and in 8% of the couples both experienced distressing problems. Most of the men and women who had sexual desire problems believed their loss of sexual desire was related to stress, disease, or “other” factors. Reduced capacity for sexual arousal was the best predictor of loss of desire in both genders. Among women, negative work-to-home interference was related to loss of sexual desire. It seems reduced sexual desire may represent a new area of public health concern in Norway.     

When sex isn't the answer: Examining sexual compliance,restraint, and physiological stress

Past research suggests that sexual activity has numerous health benefits; however, we argue that the association between sexual behavior and health is nuanced. More specifically, we argue that when individuals comply with their partner's sexual desire, sex may have unintended negative health consequences. As such, we evaluated how sexual desire and frequency interact to predict individuals' cortisol levels (i.e. a physiological measure of stress) in romantic relationships. Sixty-four participants (38 women, 26 men) who were in generally good health provided salivary cortisol samples and completed questionnaires assessing sexual behavior. As hypothesized, multiple regression analyses confirmed that the interaction between desired and actual sexual frequency predicted cortisol; participants who reported higher sexual frequency than desired (i.e. sexual compliance) had higher cortisol than participants whose desired and actual frequency matched. Interestingly, participants who reported lower frequency than desired (i.e. sexual restraint) had cortisol levels similar to participants whose desired and actual frequency matched. Overall, the results suggest that being sexually compliant (i.e. engaging in more frequent sex than desired) may be stressful and thus lead to negative physiological consequences.     

Recent advances in female sexual dysfunction

Female sexuality has received little scientific study. Recently, increased interest in this field has generated new research in the epidemiology, pathophysiology, and pharmacotherapy of female sexual dysfunction (FSD). A new FSD classification system has been proposed. Although sexual difficulties are highly prevalent among women, the degree of associated distress is unknown. Risk factors for FSD are probably both psychologic and physiologic. Aging or menopause is associated with lubrication difficulties, which can be treated with hormone replacement. Hysterectomy seems more likely to result in improvement rather then deterioration of sexual functioning. Depression may be a predictor of sexual dysfunction after hysterectomy. Vasoactive agents are currently being evaluated as treatment for female sexual arousal disorder. The most important advance in the study of female sexual function is the recent surge of interest in this relatively unexplored field.     

Sexuality and romantic relationships: investigating the relation between attachment style and sexual satisfaction

Attachment theories have recently been applied to adult romantic relationships, and more specifically, sexuality within these relationships. However, few studies have examined the influence of attachment-related avoidance and anxiety on sexual communication, gender role ideology, sexual satisfaction or the relations between these constructs. Men (n = 106) and women (n = 349) undergraduate students and young adults from the community completed an online questionnaire measuring attachment style, sexual communication, gender role ideology, and sexual satisfaction. Multiple mediation and path analyses showed several interrelations between these variables among women. Additionally, gender role ideology and sexual communication together were found to totally mediate the relation between attachment-related anxiety and sexual satisfaction in women. Sexual communication partially mediated the relation between attachment-related avoidance and sexual satisfaction in women. Among men, the only significant finding was that attachment-related anxiety and avoidance were related to lower sexual communication. These results indicate that there is disparity in sexual communication, gender role ideology, and sexual satisfaction among individuals with differing attachment orientations and that these effects may be more prominent in women than men.     

Age-related prevalence rates of sexual difficulties,sexual dysfunctions and sexual distress in heterosexual men: results from an online survey in Flanders

Abstract

Besides erectile difficulties, age-related prevalence rates of male sexual difficulties remain inconsistent. Moreover, apart from erectile and premature ejaculation, epidemiological studies that provide detailed age-related prevalence rates of other sexual difficulties (e.g. lack of sexual desire) in men are rare. Prevalence rates of sexual dysfunctions (i.e. sexual difficulties that cause personal distress) are almost non-existent. Based on an online study of 14,836 heterosexual Flemish men aged 16–74 years, age-related prevalence of sexual difficulties, sexual dysfunctions and associations with personal sexual distress are presented. While most sexual difficulties increased from age 55 to 60, hyperactive sexual desire and premature ejaculation decreased with age. Compared to sexual difficulties, sexual dysfunctions displayed only a mild association with age, suggesting that sexual difficulties per se and sexual distress are differently associated with age. The current results imply that research on predictors of sexual dysfunctions could benefit from assessing protective and risk factors associated with sexual difficulties and those associated with sexual distress separately.     

Recent advances in female sexual dysfunction

Female sexuality has received little scientific study. Recently, increased interest in this field has generated new research in the epidemiology, pathophysiology, and pharmacotherapy of female sexual dysfunction (FSD). A new FSD classification system has been proposed. Although sexual difficulties are highly prevalent among women, the degree of associated distress is unknown. Risk factors for FSD are probably both psychologic and physiologic. Aging or menopause is associated with lubrication difficulties, which can be treated with hormone replacement. Hysterectomy seems more likely to result in improvement rather then deterioration of sexual functioning. Depression may be a predictor of sexual dysfunction after hysterectomy. Vasoactive agents are currently being evaluated as treatment for female sexual arousal disorder. The most important advance in the study of female sexual function is the recent surge of interest in this relatively unexplored field.     

Sexual revictimization in a clinical sample of women reporting childhood sexual abuse

Background: Child and adolescent sexual abuse (CSA) increases the risk for adult sexual assault (ASA), and psychological vulnerability as well as aspects of CSA and upbringing might influence the risk. Aims: The aims of this study were to investigate whether women who reported both CSA and ASA: 1) have been exposed to more severe CSA and 2) have greater psychological distress and vulnerability than women who were not revictimized. Methods: The study was a cross-sectional study of 161 adult women with a reported history of intrafamilial CSA. Thirty-six per cent of the women stated they had been exposed to ASA. The severity of CSA, psychological distress (Symptoms Checklist-90-R) and Cognitive Distortion were assessed. Five factors of Cognitive Distortion (fearful, scared, shy, mistrust and vulnerable) were identified by factor analysis of Symptoms Checklist-90-R sub-scale. Results: The CSA was significantly more severe (penetration: 77%/60%; multiple offenders: 67%/25%) in women exposed to ASA compared with their counterparts, as was the rate of suicide attempts (47%/30%). Also, the psychological distress and the factors: fearful, scared, shy and mistrust were significant higher. Conclusion: The results showed an increased psychological vulnerability among women with ASA, but whether the results are cause or effect of sexual revictimization or can be generalized to other clinical samples are not clear. Interventions targeting the increased risk of ASA should be developed, implemented and tested in prevention as well treatment programmes.     

The sexual function of women during puerperium: a qualitative study

This study aimed to explore women's sexual function during the puerperal period. Based on a qualitative methodology with a phenomenological focus, 30 women were interviewed eight weeks after childbirth. Childbirth and puerperium modify the sexual function of women, causing issues that can be divided into the following categories: (1) the expression of sexual desire after childbirth, (2) dealing with changes that interfere in arousal, (3) changes in exploring the energy and character of the orgasm and (4) the perceptions of puerperal women of their relationships with their partners. Although sexual function was negatively perceived by women, their assessments of their relationships tended to be positive, with increased levels of emotional intimacy between partners contributing to the strength of the relationship.     

Late positive potential to explicit sexual images associated with the number of sexual intercourse partners

Risky sexual behaviors typically occur when a person is sexually motivated by potent, sexual reward cues. Yet, individual differences in sensitivity to sexual cues have not been examined with respect to sexual risk behaviors. A greater responsiveness to sexual cues might provide greater motivation for a person to act sexually; a lower responsiveness to sexual cues might lead a person to seek more intense, novel, possibly risky, sexual acts. In this study, event-related potentials were recorded in 64 men and women while they viewed a series of emotional, including explicit sexual, photographs. The motivational salience of the sexual cues was varied by including more and less explicit sexual images. Indeed, the more explicit sexual stimuli resulted in enhanced late positive potentials (LPP) relative to the less explicit sexual images. Participants with fewer sexual intercourse partners in the last year had reduced LPP amplitude to the less explicit sexual images than the more explicit sexual images, whereas participants with more partners responded similarly to the more and less explicit sexual images. This pattern of results is consistent with a greater responsivity model. Those who engage in more sexual behaviors consistent with risk are also more responsive to less explicit sexual cues.     

Antidepressants and sexual dysfunction

OBJECTIVE: Many patients with depression suffer from sexual dysfunction and sexual dysfunction is a recognized side-effect of antidepressants. The aim of this review was to examine the prevalence of psychosexual dysfunction associated with antidepressants, and to review treatment options which are specific to the affected component of sexual functioning and antidepressants. METHOD: Comprehensive literature review using Medline and Cochrane databases. RESULTS: Up to 70% of patients with depression may have sexual dysfunction. Tricyclic antidepressants, selective-serotonin reuptake inhibitors and venlafaxine are most and the non-serotonergic antidepressants and duloxetine least likely to produce sexual dysfunction. Pharmacological treatment options include antidepressants less likely associated or 'antidotes' to reverse sexual dysfunction. CONCLUSION: Sexual dysfunction may be a preventable or treatable side-effect of antidepressants. Patients need routinely to be asked about sexual function to identify problems early. If sexual dysfunction is ignored it may maintain the depression, compromise treatment outcome and lead to non-compliance.     

Support providers of sexual minority women with breast cancer: who they are and how they impact the breast cancer experience

OBJECTIVE: The aim of this study was to identify the factors associated with adjustment to breast cancer among sexual minority women with breast cancer and their support person. METHODS: In a cross-sectional study, sexual minority women with breast cancer and their support provider were asked to self-report social support, distress, and coping, using standardized measures. RESULTS: Twenty-three (77%) women had a support provider participating in the study. Disclosure of sexual orientation, less helpless-hopeless coping, and support provider perception of high fighting spirit were related to lower patient distress. Lower support provider distress was related to more patient disclosure of sexual orientation, a larger social network, and an underestimation of fatalistic patient coping. An overestimation of patients' anxious preoccupation coping was linked to higher support provider distress. CONCLUSIONS: Providing opportunities to sexual minority patients and their support providers to focus on issues such as disclosure of sexual orientation and coping may lower patient and support provider distress.     

Positive and negative sexual cognitions: similarities and differences between men and women from southern Spain

The aim of this study was to explore the frequency of sexual cognitions in Spanish men and women, distinguishing between positive sexual cognitions (PSC) and negative sexual cognitions (NSC), and various subtypes of such cognitions based on their content (intimate, exploratory, dominance, submission, and impersonal). We also examined the relationship between both age and education level and Christian religion/religiosity and the frequency of all subtypes of sexual cognitions. The sample was composed of 1332 participants aged between 18 and 45 years. Results showed that the most and least frequent sexual cognitions were intimate and sadomasochistic cognitions, respectively. Overall, men reported a higher frequency of PSC than did women, except for cognitions involving submission. In addition, undergraduate students reported a higher frequency of dominant PSC than older individuals. Regarding NSC, men reported a higher frequency of dominance themes, while women reported more frequent cognitions involving submission. In addition, intimate, exploratory, and impersonal NSC were more frequently reported in the younger sample. Religion was associated with the frequency of most PSC but not with NSC. We discuss the implications of assessing both the affect and content of sexual cognitions for their training in sex therapy.     

Implications of sexual fantasy characteristics and memory intensity for harmful sexual behaviour

Background

Sexual fantasies and memories are aetiological considerations in the perpetration of sexual violence, but fantasy–memory–behaviour relationships may be influenced by various factors, including sexual fantasy and memory phenomenology, that are the properties of mental imagery.

Aims

To investigate differences in sexual fantasy phenomenology and sexual memory intensity in men who report a history of harmful sexual behaviour compared to those who do not. We also investigated whether the likelihood of reporting harmful sexual intent was related to sexual memory intensity, independently of age and harmful sexual behaviour history.

Methods

An online cross-sectional survey design was used, focusing on men aged ≥18 years who were recruited from the general population via social media. The survey prompted participants to envisage a favoured sexual fantasy, then obtained data on fantasy phenomenology, including vividness and sensations, and arousal level. In addition, information was requested about sexual memory intensity and harmful sexual behaviour history and intent.

Results

A total of 322 men completed the survey. Multiple Welch's t-tests showed that men self-reporting one or more harmful sexual behaviours, such as rape or child sexual abuse, gave significantly higher ratings of sexual fantasy phenomenology but not fantasy frequency or masturbation. They were also more likely to report higher sexual memory intensity. Although the significance of fantasy phenomenology varied between subgroups, binary logistic regression indicated that age, history of harmful sexual behaviour and sexual memory intensity were each independently associated with harmful sexual intent.

Conclusions

Our findings provide new insights into the importance of fantasy phenomenology, demonstrating nuanced differences between those with and without a history of harmful sexual behaviour and illustrating that memory intensity is associated with harmful sexual behaviour intent. Further research into these differences in the context of assessment and intervention for sexual violence perpetration is warranted.

     

Sex addiction: therapist perspectives

Sexual addiction may be defined as sexual behaviour that is “compulsive and yet continues despite adverse consequences”. Knowledge and understanding of sexual addiction has been impaired by the use of multiple labels, definitions, and assessment procedures, hence the present study investigated therapist perspectives and experiences of assessing and treating the condition. Interviews were conducted with nine psychosexual therapists and subjected to interpretive phenomenological analysis. Three superordinate themes emerged from the analysis. These were distress, risk, and treatment. The distress theme included three sub-themes: stress and coping; suicidal ideation; and partner experience. Three sub-themes formed the risk theme: physical safety; disease, dysfunctions, and pregnancy; and co-addiction. The treatment theme contained three sub-themes: awareness; assessment and diagnosis; and successful therapy. Findings have important implications for the diagnosis and treatment of sexual addiction. Future research should investigate these themes further and introduce interventions to support the safety and well-being of sexual addiction clients.     

Women who have sex with women: a comprehensive review of the literature and conceptual model of sexual function

Women who have sex with women (WSW) have been underrepresented in studies on sexual function. Consequently, much of what is known of female sexual function may not be representative of, or generalizable to, the experiences of WSW. The purpose of this paper is to provide a comprehensive and critical review of the literature on the sexual function of WSW, followed by an integration of the literature in a conceptual model to guide and stimulate research. Twenty-six articles are reviewed and 15 factors are identified as contributing to sexual functioning in WSW and are subsequently included in the conceptual model. Of these, it is suggested that eight factors may contribute directly to sexual function. These include: age, income, religion, cultural recognition, relationship duration, sexual satisfaction, psychological well-being, and relationship satisfaction. The literature suggests the remaining seven factors may indirectly contribute to sexual function. These include: sexual frequency, desire discrepancy between partners, internalized homonegativity, power, social support, emotional intimacy, and a discrepancy between partners in level of being “out” as a lesbian or bisexual woman. Comparisons are made to the sexual function of women who have sex with men and the implications of having a model that recognizes similarities while also considering unique influences for WSW are discussed.     

Low sexual desire in women: amongst the confusion,could distress hold the key?

With the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) recently released, there has been important debate as to what constitutes low sexual desire/low sexual interest in women and how best to operationalise this construct. A new set of diagnostic criteria has been included for women who present with concerns relating to their level of desire. However, inherent to the diagnosis of “abnormal” or low level of sexual desire or interest, is the notion that there is a “normal” or average level of desire. Given that low desire is present in as many as 55% of women, it is possible that variations in desire levels may be a normative response to life circumstances. Increasing desire level has traditionally been the focus of therapy when individuals and couples experiencing desire problems present for treatment. However, this goal has proven difficult to achieve. Recent research investigating the distress associated with low desire, rather than low desire itself, may encourage a new line of potential treatment targets to address distress, as well as improve relationship quality. This paper will highlight the gaps in our understanding of this construct, outlining the seminal research conducted within the field, and offering support for new directions of enquiry.     

Comparison of sexual offenders against children with sexual offenders against adolescents and adults: data from the New York State Sex Offender Registry

OBJECTIVE: To examine whether sexual offenders against children have fewer characteristics associated with impulsive-aggression and more characteristics associated with aberrant sexual arousal than do sexual offenders against adolescents and adults. METHODS: Data on 837 sex offenders from the New York State Sex Offender Registry for the five counties of New York City were analyzed using multinomial logistic regression. RESULTS: Compared to offenders against older age groups, offenders against children were older and less likely to use force or a weapon. They were more likely to molest males or victims of both genders than female victims only, and they were also more likely to molest known victims. They were also more likely to commit multiple acts and "deviate intercourse" and less likely to commit sexual intercourse. Offenders against adolescents largely fell between the two other groups. CONCLUSIONS: Relative to sexual offenders against adults, pedophiles may be characterized more by aberrant sexual arousal than by impulsivity and aggression. This distinction has significant implications for the selection of targeted treatments and for the direction of future research.     

The relationships between induced abortion,attitudes towards sexuality and sexual problems

Abstract

This study aimed to investigate whether abortion is associated with (i) changes in attitudes and feelings towards sexual matters (erotophobia–erotophilia), (ii) sexual problems, and (iii) whether erotophobia–erotophilia and sexual problems are associated. Ninety-eight women having a first-trimester abortion were investigated together with a comparison sample of 51 non-pregnant women. Standardised questionnaires assessing sexual problems and attitudes and feelings towards sexual matters were completed by the study sample (prior to and 2 months after abortion) and the non-pregnant comparison sample. The findings indicated that attitudes and feelings towards sexual matters were similar in the study and comparison sample, and were more positive 2 months after the abortion than prior to it. More sexual problems were experienced following the discovery of the pregnancy than prior to the pregnancy or in the 2 months after abortion. Levels of sexual problems reported by the study sample prior to pregnancy and by the comparison sample were similar. Erotophobia–erotophilia and sexual problems were moderately correlated in the study sample. In conclusion, becoming pregnant did not appear to affect erotophobia–erotophilia, but having the abortion was followed by more positive attitudes and feelings towards sexual matters. Becoming pregnant had short-term negative effects on sexual relationships but these were not sustained following abortion.     

Psychiatric comorbidity differences between women with history of childhood sexual abuse who are methadone-maintained former opiate addicts and non-addicts

Following our finding of high rates of obsessive compulsive disorder (OCD) among methadone maintained (MMT) former opiate addict women with a history of childhood sexual abuse, we compared 68 MMT sexually abused women to 48 women from a Sexual Abuse Treatment Center (SATC) without a history of opiate addiction, for clinical-OCD (Yale–Brown Obsessive Compulsive Scale), dissociation (Dissociative Experiences Scale (DES), complex-post-traumatic stress disorder (PTSD) (Structured Interview for Disorders of Extreme Stress – Non-Other Specify), sexual PTSD (the Clinician-Administered PTSD Scale) and trauma events history (Life Event Inventory). MMT patients were treated for longer periods and were older and less educated. Clinical OCD was more prevalent among the MMT patients (66.2% vs. 30.4%, respectively), while complex-PTSD and high dissociation score (DES≥30) were more prevalent among the non-addicts (46.9% vs. 19.1%, and 57.1% vs. 11.8% respectively). The high rate of OCD among sexually abused MMT women was not found in women who are sexually abused non-addicts. As dissociation was rare among the MMT group, it may just be that the opioids (either as street-drugs or as MMT) serve as an external coping mechanism when the access to the internal one is not possible. Future study about OCD and dissociation before entry to MMT are needed.