Pregnancy and Sexual Relationships Study Involving wOmen and meN (PASSION Study)

IntroductionSexual satisfaction is believed to decrease during pregnancy; however, the effect of pregnancy on the sexual relationship in a couple is not well studied.AimTo assess for sexual dysfunction in heterosexual couples during pregnancy.MethodsWe performed a cross-sectional study of heterosexual pregnant women in the third trimester and their cohabitating partners.Main Outcome MeasuresSexual satisfaction in heterosexual couples during pregnancy was assessed with a self-reported questionnaire, the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaire.ResultsA total of 53 couples met eligibility criteria, and nearly all of those approached participated (52 of 53 couples). All couples were enrolled at or after 35 weeks’ gestation. The mean age was 29.0 ± 6.4 and 31.3 ± 6.9 years for women and men, respectively. 60% of couples were married, and the remainder were cohabitating and in a committed relationship. When analyzing the results of the GRISS questionnaire for both partners, a significant difference was seen in mean avoidance of sex between women and men (3.31 vs 2.63; P = .047) and non-sensuality (3.54 vs 2.75; P = .040). Women reported more of a decrease in communication about sex when compared with their partners (3.79 vs 3.23; P = .047). Vaginismus was more problematic during pregnancy than before (mean = 4.17), and frequency of intercourse was decreased (mean = 4.93) based on calculated GRISS scores.Clinical ImplicationsPregnant couples reported decreased frequency of intercourse and more pain with intercourse in women. Women were more likely to avoid intercourse and reported more problems with communication regarding sexual needs.Strength & LimitationsThis study is the first to assess both partners in pregnancy. Due to the nature of the study, we were unable to assess other factors affecting the relationship that may result in sexual dysfunction, there was no control group, and the results are limited to heterosexual couples.ConclusionOverall sexual satisfaction and function were not problematic for these couples during pregnancy based on the GRISS scale.Dwarica DS, Garbe Collins G, Fitzgerald C, et al. Pregnancy and Sexual Relationships Study Involving WOmen and MeN (PASSION Study). J Sex Med 2019;16:975–980.     

The Relationship Between Self-Reported Sexually Explicit Media Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men in China

IntroductionPrevious studies have indicated that viewing sexually explicit media (SEM) might be associated with sexual risk behaviors in men who have sex with men (MSM). However, most prior research has not explored this association cross-culturally or the potential influence that important covariates might have on the association.AimTo explore the association between self-reports of viewing SEM depicting various sexual risk behaviors and engagement in sexual risk behaviors after controlling for relevant covariates in MSM in China.MethodsThree hundred fourteen Chinese MSM participated in a web-based survey.Main Outcome MeasuresSEM consumption, sexual risk behavior, and measurements of covariates.ResultsSEM consumption was frequent in MSM in China. Viewing a larger proportion of SEM depicting sexual risk behaviors was associated with a larger number of regular partners with whom MSM reported engaging in sexual risk behaviors, but not with the number of casual partners, after controlling for covariates. HIV-related knowledge and seeking male sex partners were associated with the number of regular partners with whom MSM had engaged in sexual risk behaviors. Seeking sexual sensation, HIV-related knowledge, and seeking male sex partners were associated with the number of casual partners with whom MSM had engaged in sexual risk behaviors.ConclusionFuture research exploring the relation between SEM use and sexual health risk behaviors should consider theoretically important psychological and behavioral covariates.Xu Y, Zheng Y, Rahman Q. The Relationship Between Self-Reported Sexually Explicit Media Consumption and Sexual Risk Behaviors Among Men Who Have Sex With Men in China. J Sex Med 2017;14:357–365.     

Perceived Effects of Sexually Explicit Media among Men Who Have Sex with Men and Psychometric Properties of the Pornography Consumption Effects Scale (PCES)

IntroductionResearchers have proposed that consumption of Sexually Explicit Media (SEM) may not only adversely influence sexual attitudes and behaviors of Men Who Have Sex with Men (MSM) but (also) play a positive role in the development and sexual education of MSM, be a major source of sexual information for MSM, and provide validation, understanding, and confirmation of MSM's sexual orientation. However, such claims are in urgent need of empirical validation as is the development of psychometrically sound and easily implemented instruments able to reliably assist such validations.AimsTo investigate how MSM who consume SEM self-perceive the impact of SEM on their sexually-transmitted-infections-related sexual risk behaviors (i.e., anal intercourse), sexual knowledge, enjoyment of sex, interest in sex, attitudes toward sex, and understanding of their sexual orientation. Further, to provide a thorough psychometric validation of a reduced and reworked version of the Pornography Consumption Effects Scale (PCES).Main Outcome MeasureA revised version of the PCES by Hald and Malamuth.MethodsOnline cross-sectional survey study of 1,333 US adult Men Who Have Sex with Men.ResultsThis study found that 97% of MSM reported positive effects of SEM consumption on their sexual knowledge, enjoyment of and interest in sex, attitudes toward sex, and understanding of their sexual orientation. Only 3% reported any negative effects of their SEM consumption. SEM consumption was found to significantly increase consumers' interest in having protected anal intercourse while not significantly influencing their interests in having unprotected anal intercourse. The revised version of the PCES showed excellent psychometric performance.ConclusionThe study found that MSM generally report positive effects of their consumption of sexually explicit materials in areas related to their sexual knowledge, attitudes, behaviors, and orientation. This finding could have important implications for the sexual health and well-being of MSM by suggesting that SEM-based education and intervention might hold considerable overall health potential for MSM. Hald GM, Smolenski D, and Rosser BRS. Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the Pornography Consumption Effects Scale (PCES). J Sex Med 2013;10:757–767.     

Self-Focused Reasons for Having Sex: Associations Between Sexual Goals and Women's Pain and Sexual and Psychological Well-being for Couples Coping With Provoked Vestibulodynia

BackgroundFor couples coping with provoked vestibulodynia (PVD), interpersonal sexual goals are associated with sexual and psychological functioning as well as women’s pain during intercourse, however, self-focused sexual goals (eg, having sex for personal pleasure, having sex to avoid feeling bad about oneself) have not been studied in this clinical population.AimThe purpose of this study was to examine the associations between self-focused approach and avoidance sexual goals and women's pain during intercourse and sexual satisfaction and depressive symptoms for both women and their partners.MethodsWomen diagnosed with PVD (N = 69) and their partners completed measures of self-focused sexual goals, sexual satisfaction, and depressive symptoms. Women also reported on pain experienced during sexual intercourse.OutcomesOutcomes included the Global Measure of Sexual Satisfaction, the Beck Depression Inventory-II, and a Numerical Rating Scale of pain during sexual intercourse.ResultsWhen women reported higher self-focused approach sexual goals, they also reported lower pain intensity. Women's higher self-focused avoidance sexual goals were associated with their own higher depressive symptoms, whereas men's higher self-focused approach goals were associated with their own higher depressive symptoms. When controlling for frequency of sexual intercourse, there were no significant associations between women or partners' sexual goals and sexual satisfaction.Clinical ImplicationsWithin a clinical context where many interpersonal pressures for sex exist, interventions should target self-focused sexual goals alongside interpersonal sexual goals to improve pain and psychological adjustment.Strengths & LimitationsThis is the first study to examine self-focused sexual goals among women with PVD and their partners. This study is cross-sectional, and the direction of associations cannot be inferred. Couples were in mixed-sex relationships, and results may not generalize to same-sex couples.ConclusionFindings suggest that self-focused goals are relevant to the psychological adjustment of women with PVD and their male partners and for women's pain.Corsini-Munt S, Bergeron S, Rosen NO. Self-Focused Reasons for Having Sex: Associations Between Sexual Goals and Women's Pain and Sexual and Psychological Well-being for Couples Coping With Provoked Vestibulodynia. J Sex Med 2020;17:975–984.     

Sexual,Marital, and Social Impact of a Man's Perceived Infertility Diagnosis

IntroductionMale factor infertility is a relatively common problem. This diagnosis may increase sexual, marital, and relationship strain in male partners of infertile couples.AimTo measure the personal, social, sexual, and marital impacts of a male factor infertility diagnosis among men in couples evaluated for infertility.MethodsCross-sectional analysis of 357 men in infertile couples from eight academic and community-based fertility clinics. Participants completed written surveys and face-to-face and telephone interviews at study enrollment. This interview queried each participant's perception of their infertility etiology to determine the primary study exposure (i.e., male factor only, male and female factors, female factor only, unknown).Main Outcome MeasuresPersonal Impact, Social Impact, Marital Impact, and Sexual Impact scales.ResultsAmong the 357 men, no male factor was reported in 47%, isolated male factor was present in 12%, combined male and female factors were present in 16%, and unexplained infertility was present in 25% of couples. Male factor infertility was independently associated with worse Sexual (mean 39 vs. 30, standard deviation [SD] 2.7, P = 0.004) and Personal (mean 37 vs. 29, SD 3.8, P = 0.04) Impact scores relative to men in couples without male factor infertility. These differences remained statistically significant after controlling for male age, partner age, race, religion, educational level, employment status, prior pregnancy, duration of infertility, and prior paternity.ConclusionsMale partners in couples who perceive isolated male factor infertility have a lower sexual and personal quality of life compared with male partners of couples without perceived male factor infertility. Social strain is highest among couples without a clear etiology for infertility. These findings highlight the clinically significant negative sexual, personal, and social strains of a perceived infertility diagnosis for men. Smith JF, Walsh TJ, Shindel AW, Turek PJ, Wing H, Pasch L, Katz PP, and The Infertility Outcomes Program Project Group. Sexual, marital, and social impact of a man's perceived infertility diagnosis. J Sex Med 2009;6:2505–2515.     

A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls

BackgroundProvoked vestibulodynia (PVD) is a prevalent form of vulvodynia that interferes with the sexual and relational functioning of affected couples. Approach and avoidance sexual goals are associated with the sexual and relationship well-being of women with PVD and their partners. However, whether sexual goals differ in couples coping with PVD compared with community couples is unknown.AimsTo compare the approach and avoidance sexual goals of women with PVD and their partners with a control sample of community women and their partners to build on an established motivational model and to compare the sexual goals of women with PVD with those of their partners.MethodsWomen diagnosed with PVD and their partners (n = 161) and control couples (n = 172) completed measures of approach and avoidance sexual goals.OutcomeApproach and Avoidance Sexual Goals Questionnaire.ResultsWomen with PVD reported lower approach and higher avoidance sexual goals than control women, whereas partners of women with PVD did not differ from control partners in their sexual goals. Women with PVD also reported lower approach and higher avoidance sexual goals compared with their partners, whereas there were no differences between partners in the control sample.Clinical ImplicationsGiven that avoidance sexual goals have been linked to negative sexual and relational outcomes, clinicians could strive to help couples with PVD become aware of their sexual motives, with the aim of weakening avoidance sexual goals and bolstering approach sexual goals.Strengths and LimitationsThis is the first study to empirically document differences in sexual goals between couples affected by PVD and community couples. Limitations include the study's correlational design, differences in demographic characteristics between samples, and the homogeneity of participants' sexual orientation.ConclusionsFindings suggest that the sexual goals of women affected by PVD differ from those of community women and from their partners and support sexual goals as targets for psychological interventions to help couples coping with PVD.Dubé JP, Bergeron S, Muise A, et al. A Comparison of Approach and Avoidance Sexual Goals in Couples With Vulvodynia and Community Controls. J Sex Med 2017;14:1412–1420.     

Fear-based reasons for not engaging in sexual activity during pregnancy: associations with sexual and relationship well-being

Objective: Pregnant women consistently report fears that sexual activity could harm their pregnancy. Little is known, however, about the degree to which women report these fears as reasons for not having sex during pregnancy and whether these fears relate to women’s well-being. The aims of this study were to assess the importance of women’s fears of sexual activity harming the pregnancy in their decision not to engage in sex during pregnancy, and the associations between these fears and sexual and relationship well-being.

Methods: Pregnant women (N?=?261) were recruited online to complete a survey that included a novel scale of fear-based reasons for not engaging in sexual activity during pregnancy and validated measures of sexual functioning, sexual satisfaction, sexual distress and relationship satisfaction.

Results: Over half of the women (58.6%) reported at least one fear as a reason for not engaging in sexual activity while pregnant, though total fear scores were low. Greater fear-based reasons for not having sex were associated with greater sexual distress but were unrelated to sexual functioning, sexual satisfaction and relationship satisfaction.

Conclusions: Women who reported higher rates of refraining from sex due to fear that it could harm their pregnancy reported greater sexual distress, but not lower sexual functioning or sexual and relationship satisfaction. Results suggest that interventions focused on minimizing fears of sexual activity during pregnancy may not be essential for promoting women’s broader sexual and relationship well-being in pregnancy, but may help to reduce women’s global feelings of worry and anxiety about their sexual relationship.     

Meeting Sexual Partners Online and Associations With Sexual Risk Behaviors in the Swedish Population

BackgroundOnline arenas may facilitate sexual encounters. However, to what extent finding sexual partners online is associated with sexual risk behavior and sexual health outcomes is still not fully explored.MethodsA stratified randomized population based study on sexual and reproductive health and rights of 50,000 Swedes was conducted in 2017. The final sample consisted of 14,537 women and men aged 16–84 years. We identified sexual health factors associated with finding sexual partners online and estimated prevalences thereof.ResultsHaving used the internet to meet sexual partners was reported by 11% (95% confidence interval: 10.1–12.3) of men and 7% (95% confidence interval: 6.0–7.4) of women and was most common among men aged 30–44 years (13.7%). After adjustment, those reporting a non-heterosexual identity were most likely to meet sexual partners online. Meeting sexual partners online was also associated with reporting several sexual risk behaviors: condomless sex with temporary partner during the past 12 months, adjusted odds ratio (AOR): 5.1 (3.8–6.8) for women and AOR: 6.0 (4.5–7.9) for men, and having had a test for sexually transmitted infections (STIs) generated a 4-fold AOR for both sexes, STI diagnosis showed a 2-fold AOR, ever having paid or given other compensation for sex AOR: 4.8 (2.7–8.8) for women and AOR: 4.2 (2.9–6.1) for men as well as ever having received money or other compensation for sex AOR: 4.0 (1.3–11.9) for women and AOR: 6.0 (2.4–15.1) for men.Clinical translationMeeting sexual partners online was associated with sexual risk behaviors, which is of importance in tailoring sexual health interventions and STI/HIV-control activities.Strengths and limitationsFew studies of online sexual behaviors are based on population-based surveys of the general population with results stratified by sexual identity. However, the use of lifetime prevalence of ever having used the internet, smartphone, or app to meet sexual partners has limitations.ConclusionMeeting sexual partners online was associated with sexual risk behaviors in a randomized sample of the Swedish population, which is of importance to tailoring sexual health interventions.Deogan C, Jacobsson E, Mannheimer L, et al. Meeting Sexual Partners Online and Associations With Sexual Risk Behaviors in the Swedish Population. J Sex Med 2020;17:2141–2147.     

Unfaithful Individuals are Less Likely to Practice Safer Sex Than Openly Nonmonogamous Individuals

IntroductionGiven the prevalence and harm of sexually transmitted infections (STIs), there is a need to examine safer sex strategies in the context of romantic relationships and extradyadic sexual encounters. Sexual infidelity is associated with a variety of detrimental psychosocial outcomes; however, little research has addressed the sexual health ramifications of sexually unfaithful partners and members of other high-risk nonmonogamous lifestyles.AimsTo determine whether sexually unfaithful individuals or “negotiated nonmonogamous” individuals are more likely to engage in sexual health risk reduction behaviors during extradyadic encounters and with their primary partner.MethodData were collected via an anonymous Internet-based study. Several hundred sexually unfaithful individuals and individuals with a negotiated nonmonogamy agreement completed a sexual health questionnaire.Main Outcomes MeasuresSelf-reported measures of risk reduction behaviors within the primary relationship and risk reduction behaviors during the extradyadic encounter were assessed.ResultsSexually unfaithful participants demonstrated significantly lower rates of protective sexual health behaviors both within their primary partnerships and during their extradyadic sexual encounters. Sexually unfaithful participants were also less likely to engage in frequent STI testing, and less likely to discuss safer sex concerns with new partners.ConclusionsThese data add to the literature on the negative effects of sexual unfaithfulness. Understanding rates of nonengagement in safer sex strategies will be helpful to those who lead efforts to increase condom use and other preventive STI measures. Conley TD, Moors AC, Ziegler A, and Karathanasis C. Unfaithful individuals are less likely to practice safer sex than openly nonmonogamous individuals. J Sex Med 2012;9:1559–1565.     

Curvilinear Relationship Between Depression and Unprotected Sexual Behaviors among Men Who Have Sex with Men

IntroductionThe relationship between depressive symptomatology and risky sexual behaviors has been controversial in literature.AimThe current study aims to reexamine the relationship between depression and sexual behaviors among men who have sex with men (MSM) using different sets of analytical assumption.MethodsSix hundred twenty MSM were recruited in a lesbian, gay, bisexual, and transgender community center in Taiwan to participate in a cross‐sectional survey. An additional variable of squared depressive symptomatology was used to detect nonlinearity between depressive symptomatology and logit‐transformed unprotected anal intercourse (UAI) and unprotected oral sex (UOS). Multivariable logistic regression was applied to further estimate the relationship among the three variables.Main Outcome MeasuresDepressive symptomatology was measured by the Beck Depression Inventory (BDI), UAI, and UOS.ResultsDepressive symptomatology had a nonlinear relationship with unprotected anal and oral sex. While linear BDI scores of MSM were not associated with unprotected sexual behaviors in the logistic model, their scores were significantly associated with unprotected sexual behaviors in the model that included both the linear (UAI, odds ratio [OR] = 1.087; P < 0.01; UOS, OR = 1.099, P < 0.01) and quadratic BDI scores (UAI, OR = 0.998, P < 0.01; UOS, OR = 0.997, P < 0.01). The relationship between BDI scores and the probability of unprotected sexual behaviors corresponded to an inverted U‐shaped curve, as opposed to a straight line.ConclusionsOur findings suggest that depressive symptomatology has a significant curvilinear relationship with unprotected sexual behaviors. MSM with moderate levels of depression may be at elevated risk of engaging in unprotected sexual behaviors in comparison to their peers who exhibit either significantly higher or lower depression scores. Shiu CS, Chen YC, Tseng PC, Chung AC, Wu MT, Hsu ST, and Ko NY. Curvilinear relationship between depression and unprotected sexual behaviors among men who have sex with men. J Sex Med 2014;11:2466–2473.     

Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples

BackgroundThe Female Sexual Distress Scale and the Female Sexual Distress Scale-Revised—herein called the Sexual Distress Scale (SDS and SDS-R)—are among the most widely used self-report instruments to assess sexual distress, but no version for use in the Portuguese population is available to date.AimThe current study aimed to validate the Portuguese version of the SDS/SDS-R in samples of women and men with and without distressing sexual problems.MethodsA sample of 1,109 participants without distressing sexual problems (761 women) and 382 participants with distressing sexual problems (283 women), ages ranging from 18 to 72 years, were used to examine the psychometric properties of the Portuguese SDS and SDS-R.OutcomesParticipants completed a survey that included a sociodemographic and health questionnaire, the Portuguese version of the SDS and SDS-R, and measures of sexual satisfaction, sexual quality of life, sexual function, dyadic adjustment, and psychological distress.ResultsResults indicated that the Portuguese SDS and the SDS-R assess 1 general domain of sexual distress and showed good evidences of validity based on content and on relations with other variables. Sexual distress was associated with poorer sexual function, satisfaction, and quality of life, with higher psychological distress, and lower dyadic adjustment. Internal consistency and test-retest (1 month) reliabilities were excellent. Tests of differential functioning of items indicated that the SDS and SDS-R scores can be used to compare women and men on sexual distress, but the SDS/SDS-R scores flagged differential functioning of items and test (DFIT) between participants with and without distressing sexual problems.Clinical translationClinicians and researchers can now make use of the SDS and of the SDS-R in the Portuguese population, facilitating the assessment of sexual distress in clinical settings.Strengths & LimitationsThe Portuguese SDS/SDS-R scores can be compared between women and men, providing information on sexual distress independently of sexual function. With the current evidence, comparisons between individuals with and without distressing sexual problems should be made with caution, as the scores may be biased against the former.ConclusionThis study provides a validation of the Portuguese version of the SDS/SDS-R that can be used to assess sexual distress in Portuguese women and men and can be used to compare between these 2 groups.Tavares IM, Santos-Iglesias P, Nobre PJ. Psychometric Validation of the Sexual Distress Scale in Male and Female Portuguese Samples. J Sex Med 2022;19:834–845.     

Opportunities and challenges of sexual health services among young people: a study in Nepal

IntroductionIt has been well documented that young people are more likely to engage in high-risk sexual activity. Appropriate understanding of safe sex, sexual practices, and related behaviors must recognize the importance of socioeconomic and cultural factors in prevention efforts related to HIV and other sexual transmitted infections (STIs).AimTo examine and summarize the opportunities and challenges of sexual health services among young people in Nepal.Main Outcome MeasuresReview of literature—assessing knowledge, attitudes, and understanding of sex, sexual health, and related sexual risk behaviors, among young people (15–24), in line with the current sociocultural and health service practices.MethodsMedline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science, Cochrane database, and Google were searched. Similarly, documents published at the WHO, United Nations Population Fund, United Nations Development Program, and at national/local level—Ministry of Health, National Center for AIDS, and STD Control were also assessed to access the relevant reports and articles. Published and gray articles were also reviewed.ResultsThis study contends growing expansion of communication and transportation networks, urbanization, and urban in-migration is creating a different sociocultural environment, which is conducive to more social interactions between young girls and boys in Nepal. Rising age at marriage opens a window of opportunity for premarital and unsafe sexual activity among young people and this creates risks of unwanted pregnancy, STIs/HIV and AIDS. Socioeconomic, demographic, and cultural factors have been identified as encouraging factors for risk-taking behaviors among young people.ConclusionsUnderstanding safer sex and responsible sexual/reproductive behavior is important. Effective and appropriate interventions on sexual and reproductive health education directed at young people and the whole family, including fathers, could have significant effect on reducing risk and related risk practices in the context of Nepal. Regmi K. Opportunities and challenges of sexual health services among young people: A study in Nepal. J Sex Med 2009;6:352–361.     

Sexual Satisfaction,Sexual Compatibility,and Relationship Adjustment in Couples: The Role of Sexual Behaviors,Orgasm, and Men's Discernment of Women's Intercourse Orgasm

IntroductionResearch indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures.AimThe aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners.MethodsIn a sample of 85 Czech long‐term couples (aged 20–40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used.Main Outcome MeasureThe association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed.ResultsIn multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile–vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment.ConclusionsThe findings suggest that specifically penile–vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm. Klapilová K, Brody S, Krejčová L, Husárová B, and Binter J. Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: The role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm. J Sex Med 2015;12:667–675.     

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.     

A Comparison of the Sexual Well-Being of New Parents With Community Couples

BackgroundChanges in sexual well-being are common for new mothers and their partners after the birth of a baby. However, most research has sampled mothers not couples, assessed only one aspect of sexual well-being, and has not included a control sample of couples.AimThis study aimed to compare the sexual well-being (ie, sexual frequency, sexual satisfaction, sexual desire, sexual distress) of first-time mothers and their partners in the transition to parenthood (first 12-month postpartum) to community couples who are not actively in this transition. We also compared the sexual well-being within couples (eg, mothers to their partners).MethodsCouples in the transition to parenthood (n = 99) completed measures of sexual satisfaction, sexual desire, sexual distress, and sexual frequency at 3, 6, and 12 months postpartum, and community couples (n = 104) completed the measures at a single time point.OutcomesMeasures included the following: (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index and International Index of Erectile Function sexual desire subscale; (iii) Female Sexual Distress Scale-Revised; and (iv) checklist of sexual behaviors.ResultsCompared with community controls, new parents reported lower sexual satisfaction, lower sexual desire, and higher sexual distress at all time-points; however, these group differences became less pronounced by 12 months postpartum. By 6 months postpartum, there was no difference in sexual frequency between postpartum couples and the control group. Mothers experienced persistently lower sexual desire relative to their partners throughout the 12 months postpartum. Between 39% and 59% of mothers reported clinically low sexual desire, and 47–57% reported significant sexual distress at all time points. There were no significant differences reported in sexual satisfaction, sexual desire, or sexual distress between women and their partners in the community sample.Clinical ImplicationsClinicians should be aware that sexual well-being may be compromised in new parents, and some of these challenges are still present for new parents at 12 months postpartum. Findings can be used to educate new parents regarding their expectations about postpartum sexual well-being.Strengths & LimitationsThe strengths of the present study are the dyadic approach, assessing multiple aspects of sexual well-being in new parents over time, and the comparison with a community sample. An important limitation is that the control sample was not followed up over time.ConclusionEducation regarding postpartum sexual well-being should be incorporated in routine perinatal and postnatal healthcare practices to support new parents in developing realistic expectations about changes during the transition to parenthood, potentially preventing undue distress.Schwenck GC, Dawson SJ, Muise A, et al. A Comparison of the Sexual Well-Being of New Parents With Community Couples. J Sex Med 2020;17:2156–2167.     

Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples

BackgroundWhile links between pornography use and couple relational well-being have been the subject of multiple research studies, less attention has been paid to the associations between pornography use and specific sexual behavior within the relationship.AimThis study aimed to explore associations between each partner's pornography use, sexual desire, sexual satisfaction, and intercourse/non-intercourse sexual behavior. The confounding and moderating role of religiosity was also explored.MethodsA dyadic sample of 240 heterosexual couples was used. Measurement assessed pornography use, sexual desire, sexual satisfaction, and sexual behavior.OutcomesSexual satisfaction as well as intercourse and non-intercourse sexual behaviors were examined.ResultsResults suggested consistent gendered differences where female pornography use was directly associated with higher reports of female sexual desire, whereas male pornography use was directly associated with more male but less female partner desire and lower overall male sexual satisfaction. Male pornography use was also indirectly associated with sexual satisfaction for both partners and non-intercourse behaviors within the relationship through sexual desire. Overall, religiosity had little impact on the results of the study.Clinical TranslationThe complex associations between pornography use, sexual desire, and sexual behaviors suggested by our results highlight the importance of comprehensive and systemic assessment and education around sexuality when working with individuals and couples.Strengths & LimitationsThe main strength of this study is the use of dyadic data. The main limitation is the cross-sectional nature of the dataConclusionThe associations between pornography use and a variety of outcomes are highly nuanced. This study provides an important step forward in more fully accounting for the complications of pornography use in a relationship.Willoughby BJ, Leonhardt ND, Augustus RA. Associations Between Pornography Use and Sexual Dynamics Among Heterosexual Couples. J Sex Med 2021;18:179–192.     

Tattoos,Piercing, and Sexual Behaviors in Young Adults

IntroductionBody piercing and tattooing are accepted by a growing number of teenagers and young adults as a way of self‐expressing. Some authors suggest association between body piercings/tattoos and early sexual initiation, higher number of sexual partners, or risky sexual behaviors.AimThe aim of the study was to evaluate sexual behaviors among young adults with body modifications (BMs)—tattoos and piercings.MethodsOne hundred twenty young healthy adults, ages between 20 and 35, were included in the population study. The study group was divided into three subgroups: controls (N = 60), adults with tattoos (N = 28), and adults with piercings (N = 32). The research instrument was a self‐prepared questionnaire containing 59 questions assessing socioepidemiological parameters, sexual behaviors, incidents of sexual harassment in the past, and self‐attractiveness evaluation, as well as questions concerning tattoos and piercings. Socioepidemiological variables and sexual behaviors were compared between subgroups.Main Outcome MeasuresTo assess and describe the correlation between having BM—tattoos and piercings—and sexual behaviors in the population of young adults by using the logistic regression model.ResultsAdults with BMs have had their first intercourse statistically earlier and were more sexually active compared with controls. There were no statically significant differences in sexual orientation, sexual preferences, engaging in risky sexual behaviors, frequency of masturbation, and history of sexual abuse between the groups. In contrast, the frequency of sexual intercourses was statistically higher and oral sex was more likely to be a dominant sexual activity in adults with BM compared with controls. The multivariate logistic model revealed that adults with BM were four times less likely to participate in religious practices and twice more likely to have early sexual initiation.ConclusionsHaving BM is associated with early sexual initiation and more liberal attitudes toward sexual behaviors but not with engaging in risky sexual behaviors. Nowosielski K, Sipiński A, Kuczerawy I, Koz?owska‐Rup D, and Skrzypulec‐Plinta V. Tattoos, piercing, and sexual behaviors in young adults. J Sex Med 2012;9:2307–2314.     

Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults

IntroductionSeveral theoretical models and intervention programs overlook the importance of individual motivations for the decision to have condomless sex. For instance, people focused on promotion (ie, eager to pursue pleasure) report less intentions to use condoms, because they perceive a lower risk of acquiring sexually transmitted infections.AimWe aimed at understanding to what extent individual motivations are predictive of condomless sex behavior among single individuals.MethodsA sample of 415 Portuguese individuals (254 women) with ages ranging from 18−46 years (M = 23.30; SD = 5.28) were recruited to a cross-sectional study. All participants were neither dating nor in a romantic relationship at the time of the study. The link to an anonymous web survey was shared in social networking platforms.Main Outcome MeasureThe survey included self-reported demographic variables (eg, age and sex), recent condomless sex behavior, and previously validated measures assessing regulatory focus in sexuality, ability in sexual restraint, perceived control over condom use, perceived safety with sex partners, and salience of the condom use norm.ResultsMore than two-thirds of the sample had recently engaged in condomless sex. A logistic regression showed that condomless sex was more likely for participants predominantly focused on promotion in sexuality. It was also more likely among less educated participants, those with a lower ability to restrain their sexual behavior, those who perceive to have less control over condom use, those for whom the condom use norm was less salient, and those who perceived to be safer with their sex partners. No other results were significant.Clinical ImplicationsOur results can be informative to sexual health care professionals when planning strategies to increase condom use awareness, by considering the role of specific individual motivations.Strengths & LimitationsThis is the first study showing that individual motivations uniquely contribute to the decision to have condomless sex. This study has 2 main limitations that constraint the generalizability of the findings: (a) cross-sectional data prevents us from establishing causality, and (b) individual data does not account for dyadic processes in sexuality (eg, condom use negotiation).ConclusionOur findings showed that condomless sex results from an individual focus on seeking pleasure, a lack of control in sexual behavior, and a perception of sex partners as more trustworthy. Overall, these findings are likely to help researchers and health care professionals improving theoretical models predicting condom use and preventing the spread of sexually transmitted infections.Rodrigues DL, Lopes D, Pereira M, et al. Predictors of Condomless Sex and Sexual Health Behaviors in a Sample of Portuguese Single Adults. J Sex Med 2020;17:26−36.     

Maternal Adjustment and Maternal Attitudes in Adolescent and Adult Pregnant Women

Study ObjectiveThis study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy.Design, Setting, and ParticipantsA sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24^th and 36^th weeks of gestation.Main Outcome MeasuresMaternal Adjustment and Maternal Attitudes Questionnaire¹ResultsAdolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education.ConclusionAdolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.     

The Effect of Vasectomy on the Sexual Life of Couples

IntroductionThere are several contraceptive methods to prevent pregnancy, reversible as well as nonreversible ones. The sexual satisfaction of couples is affected by many types of contraceptives used.AimThe aim of this study was to evaluate prospectively the effect of vasectomy on the sexual life and satisfaction of couples.MethodsSeventy‐six couples took part in this evaluation and filled out respective questionnaires before and after vasectomy. All the questionnaires were evaluated statistically for differences in the respective sexual domain scores.Main Outcome MeasuresStandardized questionnaires were used. The International Index of Erectile Function (IIEF) as well as postoperative pain score were completed by men. Female Sexual Function Index (FSFI) was completed by the female partner. For statistical analysis, the T‐Square Test was used.ResultsThe average age of couples, who chose the vasectomy procedure, was 37 years for women and 39 years for men. The contraception method most frequently used prior to the vasectomy was the birth control pill. For the male partner, the IIEF showed no significant change in the respective domains. Out of the 76 couples, 93% of the males and 96% of their female partners would recommend and do vasectomy again. The postoperative pain score was 3.5 on 0–10 scale, and there were no postoperative complications reported. The best improvement of the sexual function was noticed for the female partners. The FSFI showed a significant improvement in the domains desire (P < 0.05), arousal (P < 0.05), orgasm (P < 0.05), lubrication (P < 0.05), and satisfaction (P < 0.05).ConclusionThis is the first report to our very best knowledge that showed the positive impact of vasectomy on sexual satisfaction of couples. Vasectomy is a safe operation with minimal complication rates. Mohamad Al‐Ali B, Shamloul R, Ramsauer J, Bella AJ, Scrinzi U, Treu T, and Jungwirth A. The effect of vasectomy on the sexual life of couples. J Sex Med 2014;11:2239–2242.