Vaginal Squirting: Experiences, Discoveries, and Strategies in a U.S. Probability Sample of Women Ages 18-93

Vaginal squirting is a phenomenon in which women expel fluid during the sexual response process, but it remains poorly understood in the extant literature. The study purpose was to use nationally representative data to investigate adult women's experiences with vaginal squirting. We assessed the prevalence of women who have ever squirted in their lifetime, the level of pleasure and concurrency of orgasm women reported during squirting, the ways in which women discovered squirting, and the challenges and/or concerns women experience with squirting. Forty percent of U.S. adult women (M = 47.6 years, SD = 16.8; Md = 24 years) had ever squirted in their lifetime (Md frequency = three to five times). Two thirds of women reported unintentional discovery of squirting, and most (75%) used specific techniques to promote build up and release of squirting versus squirting spontaneously. About 60% of participants reported squirting to be very or somewhat pleasurable, but only 20% "always" experienced squirting and orgasm together. Women reported different challenges with squirting, such as the time required to reach squirting or the experience being too emotionally intense. Our findings contribute to the growth of much needed, detailed literature on the ways in which women discover and enjoy squirting as part of their sexual lives. Knowledge of these techniques can enable women to better identify their own preferences, communicate about them with their partners, and advocate for their sexual pleasure.

Occurrence, Frequency, and Correlates of Faking Orgasm and Satisfaction in Sexual Minority Men

Existing literature on "faking" orgasm focuses almost exclusively on women. Limited research exists among men, and none focuses on sexual minority (e.g., gay, bisexual, queer) men. Additionally, faking satisfaction (pretending to be sexually satisfied) remains an unknown concept. This study examined the occurrence, frequency, and correlates of faking orgasm and satisfaction in sexual minority men. Participants (N = 211, age = 18-53, 59% identified as gay) responded to an online survey assessing frequencies of faking orgasm and satisfaction as well as potential correlates of faking (age, relationship status, sexual frequency, orgasm frequency, internalized sexual stigma). Results showed that faking orgasm and faking satisfaction were highly prevalent among sexual minority men in this sample (83% had faked orgasm and 88% had faked satisfaction in the past two years). The frequency of faking was also high; 62% and 68% faked orgasm and satisfaction at least "sometimes." Higher internalized sexual stigma and lower orgasm frequency were associated with higher frequencies of faking orgasm and satisfaction. For faking orgasm, however, the relationship between internalized sexual stigma and faking only existed in gay men. The findings suggest that faking pleasure in sexual minority men is common and deserves more empirical attention.

Orgasm Consistency in Mixed-Gender Couples: Actor, Partner, and Discrepancy Effects from Dyadic Response Surface Analysis

The potential link between orgasm consistency (i.e., the percentage of time an individual experiences orgasm during sexual interactions with a partner) and sexual satisfaction in mixed-gender sexual relationships remains underexamined in the literature. We combined two dyadic samples (N = 725 couples) and utilized Dyadic Response Surface Analysis (DRSA) to examine how both partners' orgasm consistency and their discrepancy of orgasm consistency predict both partners' sexual satisfaction. We found that partners' discrepancy in orgasm consistency was not uniquely connected to higher sexual satisfaction for either women or men; rather, the overall consistency of orgasm was connected to better sexual satisfaction for both partners. In addition, there was some evidence tentatively suggesting that men were more likely than women to report lower sexual satisfaction if his partner was orgasming more consistently than he was, as opposed to her reporting lower sexual satisfaction from him orgasming more consistently than she was; though this appears to be a rare scenario as only 5.9% of couples had women who orgasmed more consistently than men. This study may assist educators and clinicians as they help couples consider the sexual scripts surrounding orgasm consistency, and how they can attend to each others' desires in a way that maximizes sexual satisfaction for both partners.

Feasibility Cues during a Sexual Encounter Impact the Strength of Heterosexual Women's Orgasm Goal Pursuit

The "orgasm gap" for women who have sex with men remains a pressing gender equity issue. Recent research found that women who pursued orgasm as a goal were more likely to have one. The current research replicated this relationship between orgasm goal pursuit and orgasm frequency for heterosexual women, and found that this relationship did not exist for heterosexual men (Study 1). Then, across two experimental studies, we examined how heterosexual women vary their orgasm goal pursuit across sexual encounters. In Study 2, women who read that a hypothetical sexual encounter would be "quick" reported less intent to pursue orgasm than women who were told they could "take their time" or received no time information. In Study 3, women who read that their hypothetical sexual partner seemed selfish reported less intent to pursue orgasm than women who were given a non-selfish partner or no partner information. Importantly, these effects were mediated by women's perceived orgasm likelihood in the scenario. These results suggest that women shift their pursuit of orgasm depending on cues which signal whether orgasm will be feasible. This research used self-regulation theory to understand women's motivations for pursuing orgasm during sexual encounters with men, with implications for reducing the orgasm gap.

Effects of Subjective Orgasm Experience in Sexual Satisfaction: A Dyadic Analysis in Same-Sex Hispanic Couples

Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.

Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.

Development of the Italian version of the Orgasmic Perception Questionnaire (OPQ)

Orgasm is a phase of the human sexual response, and the possible discrepancies between male and female ways to experience it are still not clear in the literature. There is a lack of tools to adequately assess orgasm perception. This study aims to develop an instrument and verify possible differences between males and females. We constructed the Orgasmic Perception Questionnaire (OPQ) through different stages: first, 316 items selection was conducted on a sample of 96 people, where items came mainly from written descriptions of orgasm perception; second, an exploratory factor analysis was conducted on 674 Italian adults with a 63-item OPQ; finally, a confirmatory factor analysis was conducted on 1100 Italian adults with a 47-item OPQ. In the first study, 63 items fitted an equidistributional pattern and were to form the 63-item OPQ used for EFA. The EFA showed that five factors out of 47 explained 44.01% of the total variance and were named: Ecstasy, Contractions, Relaxation, Power, and Sensations. The confirmatory factor analyses run on the 47-item OPQ confirmed that the five-factor structure fits. Moreover, females scored higher than males with an adequate effect size in two factors: Contractions and Sensations. In conclusion, the OPQ could be a useful tool in both clinical settings and research studies to investigate the perception of orgasmic experience in its totality.

The complexity of female orgasm and ejaculation

The anatomy and physiology of the female orgasm are often neglected. The female orgasm is a normal psychophysiological function to all women, and some even can achieve ejaculation as part of the normal physiological response at the height of sexual arousal. The complexity of female sexuality requires a deep understanding of genital anatomy. The clitoris is the principal organ for female pleasure. The vaginal stimulation of the anterior vaginal wall led women to orgasm due to the stimulation of the clitourethrovaginal complex and not due to stimulation of a particular organ called the G spot in the anterior distal vaginal wall. Female ejaculation follows orgasm. It consists of the orgasmic expulsion of a smaller quantity of whitish fluid produced by the female prostate. Squirting can be differentiated from female ejaculation because it is the orgasmic transurethral expulsion of a substantial amount of diluted urine during sexual activity, and it is not considered pathological. The female orgasm is influenced by many aspects such as communication, emotional intimacy, long-standing relationship, adequate body image and self-esteem, proper touching and knowledge of the female body, regular masturbation, male sexual performance, male and female fertility, chronic pain, and capacity to engage in new sexual acts. Stronger orgasms could be achieved when clitoral stimulation, anterior vaginal wall stimulation, and oral sex is involved in the same sexual act.

The Relational Nature of Gender, the Pervasiveness of Heteronormative Sexual Scripts, and the Impact on Sexual Pleasure

This study examined how gender shapes sexual interactions and pleasure outcomes. We highlight varying expectations people have in regard to sex by combining questions about orgasm frequency and sexual pleasure. Our analysis was driven from a sample of 907 survey responses from cis women, cis men, trans women, trans men, non-binary, and intersex millennial respondents, 324 of which had gender-diverse sexual histories. The findings built upon previous literature about the orgasm gap by including those with underrepresented gender identities and expanding our conceptualization of gender's role in the gap beyond gender identity. Qualitative results indicated that individuals change their behavior based on their partner's gender and follow strong gendered scripts. Participants also relied upon heteronormative scripts and cis normative roles to set their interactions for the sexual encounter. Our findings support previous research on how gender identity impacts pleasure outcomes and has implications for how we might make gender progress in the arena of sexuality.

Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis

Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.

The female orgasm and the homology concept in evolutionary biology

The definition of homology and its application to reproductive structures, external genitalia, and the physiology of sexual pleasure has a tortuous history. While nowadays there is a consensus on the developmental homology of genital and reproductive systems, there is no agreement on the physiological translation, or the evolutionary origination and roles, of these structural correspondences and their divergent histories. This paper analyzes the impact of evolutionary perspectives on the homology concept as applied to the female orgasm, and their consequences for the biological and social understanding of female sexuality and reproduction. After a survey of the history of pre-evolutionary biomedical views on sexual difference and sexual pleasure, we examine how the concept of sexual homology was shaped in the new phylogenetic framework of the late 19th century. We then analyse the debates on the anatomical locus of female pleasure at the crossroads of theories of sexual evolution and new scientific discourses in psychoanalysis and sex studies. Moving back to evolutionary biology, we explore the consequences of neglecting homology in adaptive explanations of the female orgasm. The last two sections investigate the role played by different articulations of the homology concept in evolutionary developmental explanations of the origin and evolution of the female orgasm. These include the role of sexual, developmental homology in the byproduct hypothesis, and a more recent hypothesis where a phylogenetic, physiological concept of homology is used to account for the origination of the female orgasm. We conclude with a brief discussion on the social implications for the understanding of female pleasure derived from these different homology frameworks.

The influence of sexual arousal on subjective pain intensity during a cold pressor test in women

BACKGROUND & OBJECTIVES

Pain can be significantly lessened by sex/orgasm, likely due to the release of endorphins during sex, considered potent analgesics. The evidence suggests that endorphins are also present during sexual arousal (that is, prior to sex/orgasm). It follows then that pain can be modulated during sexual arousal, independent of sex/orgasm, too. Accordingly, sexual arousal induced by erotic slides has been demonstrated to lessen pain in men, but not in women. One explanation could be that for women, the erotic slides were not potent enough to elicit a lasting primed state of sexual arousal by the time pain was induced. Thus, the current study aims to optimize the means of inducing a potent state of sexual arousal and subsequently examine the potentially analgesic influence of sexual arousal on pain in women. As a subsidiary aim, the study also assesses whether the anticipated analgesic effect of sexual arousal would be stronger than that of distraction or generalized (non-sexual) arousal.

METHODS

Female participants (N = 151) were randomly distributed across four conditions: sexual arousal, generalized arousal, distraction, neutral. Mild pain was induced using a cold pressor while participants were concurrently exposed to film stimuli (pornographic, exciting, distracting, neutral) to induce the targeted emotional states. A visual analogue scale was utilized to measure the subjective level of pain perceived by the participants.

RESULTS

Sexual arousal did not reduce subjective pain. Generalized arousal and distraction did not result in stronger analgesic effects than the neutral condition.

CONCLUSION

The present findings do not support the hypothesis that sexual arousal alone modulates subjective pain in women. This might be due to the possibility that genital stimulation and/or orgasm are key in pain reduction, or, that feelings of disgust may inadvertently have been induced by the pornographic stimulus and interfered with sexual arousal in influencing pain.

Orgasm Rating Scale and Bodily Sensations of Orgasm Scale: Validation for Use With Pre, Peri, and Post-Menopausal Women

BACKGROUND

Orgasm, particularly in older women, remains a poorly understood aspect of female sexual response partly because of a lack of validated self-report measures.

AIM

To evaluate the Orgasm Rating Scale (ORS) and Bodily Sensations of Orgasm Scale (BSOS) for use with pre, peri, and post-menopausal women and between solitary and partnered orgasm contexts.

METHODS

Participants (solitary context, 252 pre, 139 peri, 190 post; partnered context, 229 pre, 136 peri, and 194 post-menopausal women, aged 18-82 years) were asked to complete an online questionnaire based on most recent solitary and partnered orgasm. Principal components analysis with Varimax rotation summarized the data into interpretable baseline models for all groups. Multi-Group Confirmatory Factor Analysis tested for multi-group measurement invariance. Adjustments to the models were made, and final model structures were presented.

MAIN OUTCOME MEASURES

ORS and BSOS measuring solitary and/or masturbation and partnered orgasm.

RESULTS

For the ORS, 10 factor solutions were preferred, explaining 81% (pre), 80% (peri), and 81% (post) of the variance for the solitary and 83% (pre), 86% (peri), and 84% (post) of the variance for the partnered context. Factors included pleasurable satisfaction, ecstasy, emotional intimacy, relaxation, building sensations, flooding sensations, flushing sensations, shooting sensations, throbbing sensations, and general spasms. For the BSOS, 3 factor solutions were preferred, explaining 55% (pre), 60% (peri), and 56% (post) of the variance for the solitary and 56% (pre), 61% (peri), and 60% (post) of the variance for the partnered context. Factors included extragenital sensations, genital sensations and spasms, and nociceptive sensations and sweating responses. Divergent validity was observed (solitary r = -.04; partnered r = -.11) and configural, metric and scalar invariance for the solitary and partnered versions of the ORS and BSOS were found, suggesting the measures were interpreted similarly by all women.

CLINICAL IMPLICATIONS

With valid measurement tools, women's varying orgasm experiences can be investigated more systematically and compared to address gaps and conflicts in the existing literature. Ultimately, these additions may assist with improved interventions for women who are unsatisfied with their orgasm experiences.

STRENGTHS AND LIMITATIONS

Strengths include gaining the ability to compare age and menopausal status groups using empirically validated measures of orgasm experience. Limitations include cross-sectional design and lack of test-retest reliability measurement.

CONCLUSION

The ORS and BSOS are supported for use with women across adulthood in solitary and partnered orgasm contexts and can be used concurrently to provide a comprehensive assessment. Webb AE, Reissing ED, Huta V. Orgasm Rating Scale and Bodily Sensations of Orgasm Scale: Validation for Use With Pre, Peri, and Post-Menopausal Women. J Sex Med 2022;19:1156-1172.

Single and Partnered Individuals' Sexual Satisfaction as a Function of Sexual Desire and Activities: Results Using a Sexual Satisfaction Scale Demonstrating Measurement Invariance Across Partnership Status

Although some evidence exists to suggest that single (i.e., unpartnered) individuals are less sexually satisfied on average than are partnered individuals, it is unclear whether the variables correlating with each group's sexual satisfaction are similar or different. This research sought to examine how desire for and actual engagement in solitary and partnered sexual activities are associated with both groups' sexual satisfaction. We first conducted a preliminary study (n = 572) to test and refine existing measures of sexual satisfaction for applicability across relationship status. In two follow-up studies (N = 1,238), measurement invariance (across relationship status and gender) of the resulting 4-item sexual satisfaction scale was established. Further, results across the studies showed that for singles dyadic sexual desire was negatively related to sexual satisfaction, whereas no significant link was found with solitary desire. For individuals in romantic relationships, having higher sexual desire involving a partner and lower solitary desire were both associated with greater sexual satisfaction. When analyzing participants' responses on the desired and actual frequency of engaging in specific sexual acts, we found that for both single and partnered individuals, frequent engagement in partnered acts was associated with greater sexual satisfaction. Wanting frequent engagement in partnered acts was associated with lower sexual satisfaction for both groups, but only if the current frequency of engaging in these acts was low. These findings suggest that at least during the COVID-19 pandemic, meeting desires for partnered sex plays an important role in maintaining a sexually satisfying life, regardless of one's relationship status.

Feelings of Masculinity and Accomplishment in Response to Penetrative versus Non-Penetrative Orgasms

Research indicates that men view their women partner's orgasms as reflections of their masculinity and sexual esteem. The purpose of this study was to examine this phenomenon in more detail by exploring whether men's feelings of masculinity and sexual esteem, as well as their feelings of accomplishment, were influenced by the method by which their woman partner experienced orgasm. Specifically, 193 young adult men (primarily between the ages of 18 and 24) read one of three vignettes (a partner orgasming from intercourse, from manual/oral stimulation, or from vibrator use) and then rated their imagined feelings of masculinity, accomplishment, and sexual esteem. Findings indicated that men who imagined their partner orgasmed from intercourse or manual/oral stimulation had higher feelings of masculinity and accomplishment than those who imagined their partner orgasmed from a vibrator. We found a significant interaction between clitoral knowledge and vignette condition in predicting masculinity, with clitoral knowledge only predicting masculinity for men in the manual/oral stimulation condition. The results of this study have important implications for sex education and the prevention of sexual problems, as well as for the future study of positive sexual functioning in women and men.

Women's techniques for making vaginal penetration more pleasurable: Results from a nationally representative study of adult women in the United States

The study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to make vaginal penetration more pleasurable. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified four previously unnamed, but distinct, techniques women use to make vaginal penetration more pleasurable: Angling, Rocking, Shallowing and Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report—a cross-sectional, online, national probability survey of 3017 American women’s (age 18–93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 87.5% of women make vaginal penetration more pleasurable using ‘Angling’: rotating, raising, or lowering the pelvis/hips during penetration to adjust where inside the vagina the toy or penis rubs and what it feels like. Approximately 76% of women make vaginal penetration more pleasurable using ‘Rocking’: the base of a penis or sex toy rubbing against the clitoris constantly during penetration, by staying all the way inside the vagina rather than thrusting in and out. About 84% of women make vaginal penetration more pleasurable using ‘Shallowing’: penetrative touch just inside of the entrance of the vagina—not on the outside, but also not deep inside—with a fingertip, sex toy, penis tip, tongue, or lips. Finally, 69.7% of women orgasm more often or make vaginal penetration more pleasurable using ‘Pairing’: when a woman herself (Solo Pairing) or her partner (Partner Pairing) reaches down to stimulate her clitoris with a finger or sex toy at the same time as her vagina is being penetrated. These data provide techniques that are at women’s disposal to make penetration more pleasurable—which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.

The impact of menopause on sexual function in women and their spouses

Background

The purpose of this study is to evaluate the impact of menopause on sexual function in women and their spouses.

Methods

This is a cross-sectional study that was conducted from January 2018 to May 2019 in Rasht (North of Iran). The participants included 215 menopausal women and their spouses. Data were collected using the demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and the International Index of Erectile Function (IIEF) questionnaire.

Results

On the basis of the FSFI and IIEF scores, 36.28% (78/215) women reported female sexual dysfunction (FSD) and 17.2% (37/215) men reported erectile dysfunction (ED) with 8.37% (N = 18) being mild, 5.58% (N = 12) mild to moderate, and 3.25% (N = 7) moderate ED. After adjusting differences in the female age distribution, the total score and scores of the IIEF subscales were also not significantly lower in the spouses of women with FSD than women without FSD.

Conclusion

Although, significant correlations between male erectile function and menopausal female sexual function have not identified; but, low scores of the subscales of FSFI in female participants mostly impaired sexual satisfaction and overall satisfaction in their spouses.

The effect of endometriosis on sexual function as assessed with the Female Sexual Function Index: systematic review and meta-analysis

AIM

To systematically compare sexual function between non-treated women with and without endometriosis.

METHODS

A systematic review was performed on PubMed/Medline, Scopus, EMBASE, Web of Science and Cochrane Library databases searching studies that analyzed sexual function (assessed with the 19-item Female Sexual Function Index [FSFI]), and dyspareunia, chronic pelvic pain and dysmenorrhea (assessed with a visual analogue scale [VAS]) in women with and with endometriosis.

RESULTS

In 4 studies, non-treated women with endometriosis presented a higher risk of female sexual dysfunction (mean total FSFI score ≤ 26.55; OR = 2.38; 95% confidence interval [CI] = 1.12, 5.04). Although mean total FSFI scores were not significantly different between women with and without endometriosis (mean difference [MD] = -2.15; 95% CI -4.96, 0.67); all FSFI domain scores were significantly lower in women with endometriosis (n = 4 studies): desire (MD = -0.43; 95% CI -0.57, -0.19); arousal (MD = -0.66; 95% CI -1.15, -0.17); lubrication (MD = -0.41; 95% CI -0.79, -0.02); orgasm (MD = -0.40; 95% CI -0.73, -0.06); satisfaction (MD = -0.45; 95% CI -0.72, -0.18); and pain (MD = -1.03; 95% CI -1.34, -0.72). Women with endometriosis displayed differences (more severity) in terms of VAS scores (2 studies) for dyspareunia (MD = 1.88; 95% CI 0.38, 3.37) and chronic pelvic pain (MD = 2.92; 95% CI 1.26, 4.58); but not for dysmenorrhea.

CONCLUSION

Non-treated women with endometriosis displayed altered sexual function as evidenced by lower scores in all FSFI domains, and severity of dyspareunia and chronic pelvic pain.

The importance of and satisfaction with sex life among breast cancer survivors in comparison with healthy female controls and women with mental depression or arterial hypertension: results from the Finnish nationwide HeSSup cohort study

INTRODUCTION

Breast cancer (BC) and its treatment is associated with several physical and psychosocial changes that may influence sexuality for years after treatment. Women with BC show significantly greater rates of sexual dysfunction than do healthy women. The purpose of the study was to evaluate how a BC diagnosis associates with women's perceived sexuality and sexual satisfaction.

MATERIAL AND METHODS

The data of the ongoing prospective Health and Social Support (HeSSup) survey was linked with national health registries. Respondents with registry data confirmed BC (n = 66), mental depression (n = 612), arterial hypertension (n = 873), and healthy women (n = 9731) formed the study population. The importance of and satisfaction with sex life were measured by a self-report questionnaire modified from the Schover's and colleagues' Sexual History Form.

RESULTS

Women with BC considered sex life less important than did healthy women (p < 0.001). They were significantly less satisfied with their sex life than healthy women (p = 0.01) and women with arterial hypertension (p = 0.04). Living single or educational level did not explain the differences between the groups.

CONCLUSIONS

BC survivors depreciate their sex life and experience dissatisfaction with it. Sexuality can be a critical issue for the quality of life of women surviving from BC, and hence, the area deserves major attention in BC survivorship care. Health care professionals should regularly include sexual functions in the assessment of BC survivors' wellbeing.

On the Relationship Between Erectile Function and Sexual Distress in Men with Prostate Cancer

Erectile difficulties are common after prostate cancer (PCa) treatment and are associated with sexual distress. However, the relationship between erectile function and sexual distress has yet to be carefully examined. This study had three goals: (1) examine the relationship between erectile function and sexual distress; (2) determine groups of men based on erectile function and sexual distress; and (3) examine the psychosexual characteristics of these groups. A cross section of 233 sexually active men after PCa treatment (age M = 64.90 years, SD = 7.50) completed an online survey containing demographic, health, and sexuality and relationship questionnaires. The relationship between erectile function and sexual distress was curvilinear. Four groups of men were found: good erectile function and low sexual distress, poor erectile function and high sexual distress, but also good erectile function yet high sexual distress, and poor erectile function and low sexual distress. Regardless of erectile function, men with greater sexual distress were more depressed, reported additional sexual concerns, placed less value on sex, were less sexually satisfied, and used protective buffering communication more frequently. They were also less likely to be satisfied with their adaptation to sexual changes and less likely to have found a solution to those changes. The relationship between erectile function and sexual distress is complex, characterized by a wide array of responses to erectile function (high and low distress) and multiple correlates of sexual distress. These results broaden the concept of sexual recovery after PCa treatment, which may assist clinicians and researchers to better address sexual problems after PCa treatment.

Statistical Mediators of the Association Between Mindfulness and Sexual Experiences in Men with Impaired Sexual Function

Mindfulness-based therapy has shown promise as a treatment for female sexual dysfunction and has the potential to be an efficacious treatment for male sexual dysfunction. However, there has been little empirical evidence regarding the mechanisms through which mindfulness may improve sexual experiences, especially for men. Recent theoretical reviews have suggested potential mediators that may explain the beneficial effects of mindfulness on symptoms of male sexual dysfunction, including reduced avoidance of sex, reduced distraction during sex, and/or reduced activation of negative sexual schemas. We attempted an initial statistical test of these factors as potential mediators of the association between trait mindfulness and multiple sexual outcomes (sexual function, sexual satisfaction, and sexual distress) using a cross-sectional correlational design. A total of 163 men with self-reported current impairments in one or more aspects of sexual function completed self-report scales using a secure online survey. Bivariate correlations indicated that mindfulness was significantly associated with sexual satisfaction, sexual distress, and premature ejaculation, but not other aspects of sexual function. Sexual avoidance statistically mediated the link between mindfulness and sexual satisfaction, both distraction and activation of negative schemas statistically mediated the link between mindfulness and premature ejaculation, and all three factors statistically mediated the link between mindfulness and sexual distress. These results generally supported previous theoretical work and have implications for future treatment outcome research.

Posttraumatic Stress and Sexual Satisfaction in Husbands and Wives: A Dyadic Analysis

Trauma survivors who suffer from posttraumatic stress symptoms (PTSS) are known to experience impairments in sexual satisfaction. However, the negative effects of PTSS are not limited to the primary survivors, as they can lead to secondary PTSS in their spouses as well. The implications of secondary PTSS in the sexuality of couples remain unknown. This study aimed to investigate whether specific symptom clusters of PTSS (i.e., intrusions, hyperarousal, and avoidance) are implicated in the sexual satisfaction of couples. We assessed a sample of primarily exposed Israeli veterans from the Yom Kippur War and their wives who had been secondarily exposed (N = 191). The dyadic data were analyzed in an Actor-Partner Independence Model. When scrutinizing specific PTSS clusters, the husbands' avoidance related to their own sexual satisfaction. The wives' hyperarousal related to their own and their spouses' sexual satisfaction, whereas their intrusions were associated only with their husbands' sexual satisfaction. In conclusion, PTSS in one spouse is related to both spouses' sexual satisfaction; it is therefore recommended that clinicians adopt a dyadic approach when delivering interventions.