The DSM diagnostic criteria for female orgasmic disorder

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.

Sexual Desire Emerges from Subjective Sexual Arousal, but the Connection Depends on Desire Type and Relationship Satisfaction

According to models of responsive sexual desire, desire emerges from sexual arousal. This study examined how sexual desire type (dyadic-partner, dyadic-other, solitary) and relationship satisfaction affect the connection between subjective sexual arousal (SSA) and desire. Women (N = 100; 27% with sexual interest/arousal disorder symptoms) reported SSA while viewing a sexual film. Solitary and dyadic responsive sexual desire were assessed immediately before and following the film (immediate desire) and three days later (delayed desire). SSA predicted higher immediate solitary desire. SSA also predicted higher immediate dyadic desire, and this link was stronger for those with higher relationship satisfaction; for those with low relationship satisfaction, SSA was unrelated. For delayed desire, SSA predicted higher dyadic-partner desire, regardless of relationship satisfaction. SSA also predicted higher dyadic-other desire, yet this association was stronger for those with low relationship satisfaction; for those with high relationship satisfaction, SSA was unrelated to dyadic-other desire. Findings support the theoretical premise that desire emerges from arousal, but that this connection is dependent upon additional factors, specifically the target and timing of desire and participants' current relationship quality. Relationship satisfaction may affect the motivational value of sex with (and without) a current partner.

Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary

Female sexual dysfunction (FSD) has a negative impact on women's quality of life, self-esteem, and physical health. The aim of the present study was to explore the prevalence and the factors associated with FSD using an online questionnaire. A cross-sectional survey was conducted among young adults (18-35 years old) in Hungary using the DSM-5 criteria. The participants (n = 5942) were divided into three major groups: FSD (20.3%), an intermediate group (43.9%), and a control group (35.6%). Most of the women showing FSD were affected with female orgasmic disorder (9.2%) and genito-pelvic pain/penetration disorder (4.6%), while female sexual interest/arousal disorder was found in altogether 100 women (1.7%); 4.8% of women were affected by more than one definite disorder. The occurrence of female sexual dysfunction was related to the women's previous sexual history (first sexual experience, sexual education, early encounter with pornographic content, and sexual abuse), their self-satisfaction (with their own body, genitalia, and sexual attraction), and their sexual orientation. Sexual dysfunction showed a strong association with abuse, sexually transmitted diseases, and self-esteem. The present study identified the relationship between sexual dysfunctions and other health conditions, which can be the basis for some form of screening and early assistance programs for FSD.

Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction

Introduction

This study explored the role of body image dissatisfaction on orgasmic response during partnered sex and masturbation and on sexual relationship satisfaction. The study also described typologies of women having different levels of body image satisfaction.

Methods

A sample of 257 Norwegian women responded to an online survey assessing body image dissatisfaction, problems with orgasm, and sexual relationship satisfaction. Using structural equation modeling and factor mixture modeling, the relationship between body image dissatisfaction and orgasmic response was assessed, and clusters of sexual response characteristics associated with varying levels of body image dissatisfaction were identified.

Main Outcome Measure

Orgasmic function during partnered sex and masturbation, along with sexual relationship satisfaction, were assessed as a function of body image.

Results

Body image dissatisfaction, along with a number of covariates, predicted higher levels of “problems with orgasm” during both partnered sex and masturbation, with no significant difference in the association depending on the type of sexual activity. Varying levels of body image dissatisfaction/satisfaction were associated with differences in orgasmic incidence, difficulty, and pleasure during partnered sex; with one orgasmic parameter during masturbation; and with sexual relationship satisfaction.

Conclusion

Body image dissatisfaction and likely concomitant psychological distress are related to impaired orgasmic response during both partnered sex and masturbation and may diminish sexual relationship satisfaction. Women with high body image dissatisfaction can be characterized by specific sexual response patterns.

Horvath Z, Smith BH, Sal D, et al. Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction. Sex Med 2020;8:740–751.

Self-reported reasons for having difficulty reaching orgasm during partnered sex: relation to orgasmic pleasure

Purpose: This study investigated women's perceived causes for orgasmic difficulty during partnered sex and their relation to orgasmic pleasure.Method: From a community sample of 1843 women, we investigated 814 women's attributions for their orgasmic difficulty during partnered sex. Frequencies of 18 attributions were generated and subsequently reduced to eight principal variables through dimension reduction. Women with and without distress were compared across these eight principal variables. These variables, along with relevant covariates, were then used to predict orgasmic pleasure through regression analysis.Results: The most frequently endorsed reasons for orgasmic difficulty were, in descending order, general stress/anxiety, arousal difficulty, sex-specific anxiety and issues with the partner. Women reporting high distress were more likely to cite partner issues and less likely to report general stress/anxiety as reasons for their difficulty. Regression analysis, however, indicated that the reasons most frequently endorsed by women were not necessarily those accounting for the greater variance in orgasmic pleasure, such reasons including inhibition/lack of interest, insufficient experience and partner-related issues. Difficulty reaching orgasm during masturbation as well as relationship satisfaction also explained differences in orgasmic pleasure.Conclusion: Women cite various reasons for orgasmic difficulty, most commonly general anxiety/stress, inadequate arousal, sex-specific stress and partner issues. Women who were distressed by their condition more frequently cited partner issues. Variance in orgasmic pleasure was most related to partner issues, sexual inhibition/lack of interest and insufficient experience. Overall, partner issues and relationship satisfaction played important roles in attributions for both orgasmic difficulty and orgasmic pleasure.

Typologies of Women With Orgasmic Difficulty and Their Relationship to Sexual Distress

BACKGROUND

About 50% of women who report orgasmic difficulty (OD) during partnered sex are distressed by their condition, yet why some women are distressed and others are not is unclear.

AIM

To determine whether sexual distress is related to women's perceived causes of their OD during partnered sex.

METHODS

We established homogenous subgroups of women based on their attributions for OD during partnered sex, and these groups were validated by comparing them on variables relevant to sexual response. We then predicted OD-related distress from subgroup memberships as well as from a number of sociodemographic, control, and empirically supported sexual response variables.

RESULTS

3 distinct OD subgroups emerged: type 1-high psychological-high somatic reasons; type 2-partner-related reasons; and type 3-moderate psychological-low somatic reasons. These groups also differed on independent parameters related to sexual frequency and arousal. Subgroup membership, along with age, sexual relationship satisfaction, and frequency of partnered sex predicted sexual distress related to OD.

CLINICAL IMPLICATION

Particular perceptions regarding the causes for OD help predict women's sexual distress, and such factors might be considered in identifying sexual issues and managing them within the context of a sexual relationship.

STRENGTHS & LIMITATIONS

A large sample size drawn from a multinational population powered the study, while the cross-sectional nature of the sample could not rule out bidirectional associations between predictor covariates (including OD subgroup) and the outcome measure (sexual distress).

CONCLUSION

Type 1 membership (high levels of psychological and somatic attributions) predicted greater levels of OD-related distress than type 2 (partner-related attributions) or type 3 (moderate psychological and low somatic attributions) membership, with type 1 women having a greater likelihood of internalizing (accepting responsibility/blame for) OD attributions. Hevesi K, Miklós E, Horváth Z, et al. Typologies of Women With Orgasmic Difficulty and Their Relationship to Sexual Distress. J Sex Med 2020;17:1144-1155.

What Does Research Tell Us About Women's Experiences, Motives and Perceptions of Masturbation Within a Relationship Context?: A Systematic Review of Qualitative Studies

This systematic review provides an overview of what qualitative research has revealed about partner-related factors around women's masturbation and explores how these factors relate to women's behavior, perceptions, and motives toward masturbation. Eleven studies were identified and secondary thematic analysis was used for synthesis. Women's perceptions often focus on the (potential) negative influences of masturbation on current or future relationships. Motivations some women reported for masturbating due to partner-related factors were diverse. Findings suggested that some women modify their masturbation behavior when in a relationship. The implications of these findings for sexual health educators and clinicians are discussed.

The Experience of Orgasmic Pleasure during Partnered and Masturbatory Sex in Women with and without Orgasmic Difficulty

Pleasure is critically important to the experience of sexual behavior, yet few studies have examined factors that influence it. We explored orgasmic pleasure during masturbation and partnered sex in women with and without orgasmic difficulty, as well as the mutual influence of each type of activity on the other. Data were collected from 2059 women through online surveys and paper-and-pencil tests in both the USA and Hungary. Among women who both masturbated and had partnered sex, orgasmic pleasure was higher during partnered sex. Although women with orgasmic difficulty exhibited a similar pattern of greater pleasure during partnered sex, they reported lower pleasure during partnered sex than women without orgasmic difficulty. Women struggling most to reach orgasm were likely to view masturbation as equally or more satisfying than partnered sex. Several covariates were relevant to pleasure during partnered sex, including the importance of sex, the frequency of partnered sex, and the relationship quality, affirming the idea that relational factors play a critical role in orgasmic pleasure in women. Pleasure during masturbation was associated with higher age, frequency of masturbation, and shorter latencies to orgasm, suggesting that pleasure during masturbation was related to greater experience with masturbation and greater efficiency in reaching orgasm.

Validation of a Visual Analogue Scale to measure the subjective perception of orgasmic intensity in females: The Orgasmometer-F

The female orgasm represents one of the most complex functions in the field of human sexuality.

The conjunction of the anatomical, physiological, psycho-relational and socio-cultural components contributes to make the female orgasm still partly unclear. The female orgasmic experience, its correlates and the relation with sexual desire, arousal and lubrication as predictors are highly debated in scientific community. In this context, little is known about the impact of female sexual dysfunction (SD) on sexual pleasure expressed by subjective orgasmic intensity, and there are no suitable psychometric tools suited to investigate this dimension. Thus, we validate, in female subjects, a Visual Analogue Scale (VAS) that we named Orgasmometer-F, to verify if SD is accompanied by a lower perceived orgasmic intensity. A total of 526 women, recruited through a web-based platform and from sexological outpatient clinic, were enrolled in the study. They were divided into, on the basis of the Female Sexual Function Index (FSFI) score in two groups: 1) 112women suffering from SD, (SD Group); and 2) 414 sexually healthy women (Control Group). The participants were requested to fill out the Orgasmometer-F, recording orgasmic intensity on a Likert scale from 0 (absence of orgasmic intensity) to 10 (maximum orgasmic intensity experienced). Women with SD experienced significantly lower orgasmic intensity than controls, as measured by the Orgasmometer-F (p < 0.0001). Interestingly, masturbatory frequency was positively correlated with orgasmic intensity, as were the lubrication, orgasm and sexual satisfaction domains of the FSFI. The Orgasmometer-F was well understood, had a good test-retest reliability (ICC = 0.93) and a high AUC in differentiating between women with and without sexual dysfunction (AUC = 0.9; p < 0.0001). The ROC curve analysis showed that a cut-off <5 had 86.5% sensitivity (95% CI 82,8–89,6), 80.4% specificity (95% CI 71.8–87.3), 75.4% positive predictive value (PPV) and 89.5% negative predictive value (NPV). In conclusion, the Orgasmometer-F, a new psychometrically sound tool for measuring orgasmic intensity in female population, demonstrated that SD impair orgasmic intensity.

Women With Hypoactive Sexual Desire Disorder Versus Sexual Interest/Arousal Disorder: An Empirical Test of Raising the Bar

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published with a major revision to the sexual dysfunction categories, and the diagnosis of female hypoactive sexual desire disorder (HSDD) was replaced with female sexual interest/arousal disorder (SIAD). Since being introduced, concern has been expressed that SIAD inappropriately "raises the bar" for diagnosis. To address these concerns, we sought to evaluate the number of women with a diagnosis of HSDD who also met criteria for SIAD. In a sample of 151 women, we found that 73.5% of women with a diagnosis of HSDD met criteria for SIAD. The two groups were compared on the Sexual Interest/Desire Inventory, and women who met criteria for both HSDD and SIAD consistently scored lower on sexual desire frequency and satisfaction, satisfaction with sex, receptivity, positive sexual thoughts, reactions to erotica, arousal frequency, ease, continuation, and orgasm ease/achievement, and higher on distress. In addition, women meeting criteria for HSDD only tended to have mild symptoms across the six SIAD criteria compared to those meeting criteria for both HSDD and SIAD. These findings suggest that the SIAD criteria does not unduly raise the bar for diagnosis.

When, If, and How: Young Women Contend With Orgasmic Absence

While cultural ideas about "healthy" and "fulfilling" sexuality often include orgasm, many young women do not experience orgasm during partnered sex. The current study examined how women described this absence of orgasm in their sexual experiences with male partners. We examined interviews (N = 17) with women ages 18 to 28 and focused on their ideas about orgasm and their explanations concerning when and why they do not orgasm. We explored three themes that illustrate the strategies young women use to contend with orgasmic absence: (1) What's the big deal?; (2) It's just biology; and (3) Not now, but someday. We found that young women's explanations allowed them to reduce feelings of abnormality and enabled them to distance themselves from sexual expectations regarding the perceived value of orgasm. In analyzing the complicated gender and sexual dynamics surrounding orgasm, we turned to Fahs' (2014) work on sexual freedom and the importance of articulating freedom from sexual obligations as a key intervention in critical sexuality research. In our discussion, we examine the implications of our findings for critical researchers looking to better understand the role of sexual norms in how young women imagine and discuss the role of pleasure in their own sexual lives.

Women's Attributions Regarding Why They Have Difficulty Reaching Orgasm

Difficulty reaching orgasm during partnered sex is relatively common among women. Yet the reasons, likely multivariate, are not fully understood. This study identified perceived causes for orgasmic difficulty in 452 women during partnered sex. The most commonly endorsed reasons were stress/anxiety, insufficient arousal, and lack of time during sex; body image, pain, inadequate lubrication, and medical/medication issues were endorsed less frequently. Distressed and nondistressed women differed on several attributions, including sexual interest, partner perceptions, stress, and adequate time during sex. These findings implicate greater internalization of attributions among distressed women compared with nondistressed women and suggest possible avenues for remediation.

Variation in orgasm occurrence by sexual orientation in a sample of U.S. singles

INTRODUCTION

Despite recent advances in understanding orgasm variation, little is known about ways in which sexual orientation is associated with men's and women's orgasm occurrence.

AIM

To assess orgasm occurrence during sexual activity across sexual orientation categories.

METHODS

Data were collected by Internet questionnaire from 6,151 men and women (ages 21-65+ years) as part of a nationally representative sample of single individuals in the United States. Analyses were restricted to a subsample of 2,850 singles (1,497 men, 1,353 women) who had experienced sexual activity in the past 12 months.

MAIN OUTCOME MEASURES

Participants reported their sex/gender, self-identified sexual orientation (heterosexual, gay/lesbian, bisexual), and what percentage of the time they experience orgasm when having sex with a familiar partner.

RESULTS

Mean occurrence rate for experiencing orgasm during sexual activity with a familiar partner was 62.9% among single women and 85.1% among single men, which was significantly different (F1,2848  = 370.6, P < 0.001, η(2)  = 0.12). For men, mean occurrence rate of orgasm did not vary by sexual orientation: heterosexual men 85.5%, gay men 84.7%, bisexual men 77.6% (F2,1494  = 2.67, P = 0.07, η(2)  = 0.004). For women, however, mean occurrence rate of orgasm varied significantly by sexual orientation: heterosexual women 61.6%, lesbian women 74.7%, bisexual women 58.0% (F2,1350  = 10.95, P < 0.001, η(2)  = 0.02). Lesbian women had a significantly higher probability of orgasm than did either heterosexual or bisexual women (P < 0.05).

CONCLUSIONS

Findings from this large dataset of U.S. singles suggest that women, regardless of sexual orientation, have less predictable, more varied orgasm experiences than do men and that for women, but not men, the likelihood of orgasm varies with sexual orientation. These findings demonstrate the need for further investigations into the comparative sexual experiences and sexual health outcomes of sexual minorities.

The role of psychopathological and personality covariates in orgasmic difficulties: a prospective longitudinal evaluation in a cohort of women from age 30 to 50

INTRODUCTION

There are little published data on the prevalence of orgasmic difficulties in representative samples and no longitudinal data on the subject. In addition, our knowledge of the factors, which increase or protect against the risk of orgasmic difficulties, is still rudimentary.

AIM

The aim of this study was to evaluate the cumulative incidence rate and longitudinal course of orgasmic difficulties from age 30 to age 50, and the role of psychopathological and personality covariates in a representative population cohort of women.

METHODS

Semi-structured interviews with single-item questions on sexual problems in general as well as on orgasmic difficulties were conducted. Psychopathological covariates were from the Symptom Checklist 90 Revised and personality characteristics from the Freiburg Personality Inventory. Coping resources were measured by the scales of mastery and self-esteem.

MAIN OUTCOME MEASURES

One-year prevalences of orgasmic difficulties, associations with psychopathological and personality covariates as well as coping resources were the main outcome measures.

RESULTS

Orgasmic difficulties were reported annually by 7.4% to 13.5% of the women with a mean of 10.0% and a cumulative risk of 27.3% from age 30 to 50. No relation between age and the prevalence of orgasmic difficulties could be demonstrated. Psychopathological covariates such as depression, psychoticism, interpersonal sensitivity, obsessive-compulsive symptoms, and somatization were moderately associated with orgasmic difficulties. Also, personality traits, i.e., nervousness, aggressiveness, depressiveness, irritability, sociability, and openness, were related to orgasmic difficulties.

CONCLUSIONS

With a cumulative risk of 27.3%, orgasmic difficulties represent a frequent sexual problem. Annual prevalence rates are particularly high in women with psychopathological characteristics and modestly related to various personality traits. Our findings support the relevance of psychosocial factors in the regulation of female orgasm. More basic research is needed to better understand underlying pathophysiological mechanisms and to improve diagnostic as well as therapeutic tools for women suffering from orgasmic difficulties.

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

INTRODUCTION

Although age-related prevalence rates of female sexual difficulties, i.e., difficulties with sexual desire, arousal, orgasm, or pain have occasionally been studied-with mostly inconsistent results-the age-related prevalence rates of female sexual dysfunctions, i.e., sexual difficulties that are associated with sexual distress, have not. Moreover, the association of age with sexual distress, i.e., distress due to sexual difficulties, has almost completely been neglected in epidemiological research.

AIMS

The aims of the present study were to provide age-related prevalence estimates of sexual difficulties and sexual dysfunctions and to provide proportions of participants reporting sexual distress in heterosexual women.

METHODS

An online survey comprising on sexual difficulties (i.e., low sexual desire, lack of responsive sexual desire, difficulties with lubrication, lack of subjective sexual arousal, absent or delayed orgasm, and dyspareunia) and associated sexual distress that enables us to classify respondents with sexual dysfunctions.

MAIN OUTCOME MEASURE

Sexual Functioning Scale.

RESULTS

A total of 15,048 heterosexual women aged 16-74 years living in Flanders (the Nothern, Dutch-speaking part of Belgium) completed the online survey. This study revealed that all sexual difficulties and all sexual dysfunctions are significantly associated with age in women. Although most sexual difficulties and sexual dysfunctions increase with age, some display a U-shaped association with age. Furthermore, it was found that-except for lubrication difficulties-sexual distress was also significantly associated with age and that sexual distress is more common in younger women.

CONCLUSION

The association between age and sexual difficulties, sexual dysfunctions, and sexual distress in women is complex and deserves more attention from scholars.

Orgasmic dysfunction: prevalence and risk factors from a cohort of young females in Mexico

INTRODUCTION

Orgasmic dysfunction (OD) is defined as the inability to achieve an orgasm, markedly diminished intensity of orgasmic sensations, or marked delay of orgasm during any kind of sexual stimulation. OD definition and method of diagnosis vary widely across studies.

AIM

The aim of this study was to identify the prevalence and risk factors that predispose Mexican women to OD.

METHODS

A representative sample of women from Mexico City was surveyed using an online website. Women between 18 to 40 years old were selected, and the orgasm domain from the Female Sexual Function Index was used to identify OD. A cutoff point was calculated using a construct with a histogram and calculated median. A univariate and multivariate analysis was conducted to examine the relationship between potential risk factors and sexual function.

MAIN OUTCOME MEASURES

OD prevalence; significant risk factors on multivariate analysis.

RESULTS

OD prevalence was 18.3%. Univariate analysis showed younger age (P = 0.01), lower degree of education (P = 0.02), single marital status (P = 0.038), and dissatisfaction with the thickness and/or size of partner's penis (P = 0.01) as significant variables related to OD. In multivariate analysis, younger age (P = 0.01) and dissatisfaction with the thickness/size of partner's penis (hazard ratio 3.04, P = 0.01) remained significant.

CONCLUSION

OD is a prevalent alteration in young women. Marital status, education, and dissatisfaction with thickness/size of partner's penis are definitely related variables.

The faking orgasm scale for women: psychometric properties

The Faking Orgasm Scale for Women (FOS) was designed to assess women's self-reported motives for faking orgasm during oral sex and sexual intercourse. Exploratory factor analysis (EFA) was conducted on the responses of 481 heterosexual undergraduate females (M age = 20.33 years, SD = 2.48). Results of the EFA revealed that the FOS-Sexual Intercourse Subscale was composed of four factors: (1) Altruistic Deceit, faking orgasm out of concern for a partner's feelings; (2) Fear and Insecurity, faking orgasm to avoid negative emotions associated with the sexual experience; (3) Elevated Arousal, a woman's attempt to increase her own arousal through faking orgasm; and (4) Sexual Adjournment, faking orgasm to end sex. The analysis of the FOS-Oral Sex Subscale yielded four factors: (1) Altruistic Deceit; (2) Insecure Avoidance, faking orgasm to avoid feelings of insecurity; (3) Elevated Arousal; and (4) Fear of Dysfunction, faking orgasm to cope with concerns of being abnormal. Each factor of the two subscales was found to have excellent internal consistency. Confirmatory factor analysis on a separate sample of 398 heterosexual female undergraduates (M age = 20.52 years, SD = 2.55) confirmed the factor structure of each subscale with excellent fit statistics. The FOS should allow researchers and clinicians to better understand why women fake orgasm. Deepening this understanding may serve future research examining sexual desire, satisfaction, and dysfunction as well as have applications in sex and couples' therapy.

“What do you mean when you say that you are sexually satisfied?” A mixed methods study

Not enough is understood about the role of gender norms and sexual stigma in shaping individuals’ definitions of sexual satisfaction. The current study aimed to investigate the heterogeneity of definitions of sexual satisfaction in a sample of young adults, ages 18–28 (M = 22.6; SD = 4.78). Forty US participants (50% females; 45% LGBTQ; 53% white) sorted 63 statements about sexual satisfaction using a Q methodology design ( Watts and Stenner, 2005 ), followed by semi-structured interviews. This mixed methods procedure enabled both a systematic and in-depth examination of the dimensions participants prioritized when determining their sexual satisfaction. Analysis of participants’ Q sorts indicated four distinct perspectives on sexual satisfaction: emotional and masculine; relational and feminine; partner focused; and orgasm focused. These four factors were further explored using participants’ interview data. Findings indicated that individuals interpreted sexual satisfaction using several key dimensions not regularly included in survey research. Existing survey items do not regularly attend to the gendered and heteronormative components of sexual satisfaction appraisals and as a result, important interpretive patterns may be overlooked.

Prevalence rates of sexual difficulties and associated distress in heterosexual men and women: results from an Internet survey in Flanders

As most epidemiological surveys on sexual problems have not included assessment of associated distress, the principal aim of this study was to provide prevalence estimates of both DSM-IV-TR-defined (American Psychiatric Association [APA], 2000 ) and less commonly assessed sexual difficulties and dysfunction (e.g., lack of responsive sexual desire, lack of subjective arousal). A secondary aim was to obtain information about comorbidity between sexual desire and sexual arousal difficulties/dysfunction. This study comprised an online survey completed by 35,132 heterosexual Flemish men and women (aged 16 to 74 years). Results indicated that sexual dysfunctions were far less common than sexual difficulties, and some uncommonly assessed sexual problems (e.g., "lack of responsive desire" in women; "hyperactive sexual desire" in men) were quite prevalent. In women, there was a high comorbidity between "lack of spontaneous sexual desire" and "lack of responsive sexual desire"; between "lack of genital arousal" and "lack of subjective sexual arousal"; and between sexual desire and sexual arousal difficulties/dysfunctions. The implications of these findings for epidemiological research on sexual dysfunction and for the newly defined DSM-5 Female Sexual Interest/Arousal Disorder (APA, 2013 ) are discussed.

Sex therapy for female sexual dysfunction

INTRODUCTION

About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions.

OBJECTIVE

Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions.

METHOD

Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review.

RESULTS

Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions.

CONCLUSION

There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes.

What does Bancroft’s Human Sexuality and its Problems tell us about current understandings of sexuality?

Human Sexuality and its Problems is an influential text in the arenas of sex research and psychosexual medicine. The current edition specifically aimed to incorporate the full range of perspectives on human sexuality. However, an analysis of the book found that sociological, social psychological, feminist and queer perspectives were still marginalised or lacking. In addition to this, the text was heteronormative in its construction of sexuality and sexual practice. An in-depth analysis of coverage of vaginismus and trans highlights problematic understandings of gender roles and their involvement in sexual difficulties, as well as little awareness of the diversity of gender identities and experiences.

Female orgasm rates are largely independent of other traits: implications for "female orgasmic disorder" and evolutionary theories of orgasm

INTRODUCTION

The criteria for "female orgasmic disorder" (FOD) assume that low rates of orgasm are dysfunctional, implying that high rates are functional. Evolutionary theories about the function of female orgasm predict correlations of orgasm rates with sexual attitudes and behavior and other fitness-related traits.

AIM

To test hypothesized evolutionary functions of the female orgasm.

METHODS

We examined such correlations in a community sample of 2,914 adult female Australian twins who reported their orgasm rates during masturbation, intercourse, and other sexual activities, and who completed demographic, personality, and sexuality questionnaires.

MAIN OUTCOME MEASURES

Orgasm rates during intercourse, other sex, and masturbation.

RESULTS

Although orgasm rates showed high variance across women and substantial heritability, they were largely phenotypically and genetically independent of other important traits. We found zero to weak phenotypic correlations between all three orgasm rates and all other 19 traits examined, including occupational status, social class, educational attainment, extraversion, neuroticism, psychoticism, impulsiveness, childhood illness, maternal pregnancy stress, marital status, political liberalism, restrictive attitudes toward sex, libido, lifetime number of sex partners, risky sexual behavior, masculinity, orientation toward uncommitted sex, age of first intercourse, and sexual fantasy. Furthermore, none of the correlations had significant genetic components.

CONCLUSION

These findings cast doubt on most current evolutionary theories about female orgasm's adaptive functions, and on the validity of FOD as a psychiatric construct.

Sexual arousal in men: a review and conceptual analysis

Sexual arousal is an emotional/motivational state that can be triggered by internal and external stimuli and that can be inferred from central (including verbal), peripheral (including genital), and behavioral (including action tendencies and motor preparation) responses. This article, while focusing on sexual arousal in men, provides a conceptual analysis of this construct, reviews models of sexual arousal, and discusses the usefulness of perspectives derived from motivation and emotion research in improving our understanding of its determinants and behavioral correlates. In this, it considers the role of genital feedback in men's subjective sexual arousal and the connections between sexual arousal and sexual desire. Future research and definitions may increasingly focus on its central integrative functions (as opposed to its input and output characteristics). Yet, the study of sexual arousal can be expected to continue to benefit from the measurement of its genital, verbal, and behavioral components. Instances of discordance between response components suggest that they are, at least in part, under the control of different mechanisms, and it is proposed that a better understanding of sexual arousal will prove contingent on a better understanding of such mechanisms and the conditions under which they converge and diverge.

The varied nature of women's sexuality: unresolved issues and a theoretical approach

During the 20th century there were clear indications that the socio-cultural suppression of women's sexuality had lessened, revealing a marked variability of women's sexual expression. In this article we review the recent literature to explore explanations for this variability. It is clear that we know little about the nature of sexual desire, and in particular, what it is that is desired. There is also now substantial evidence that vaginal response, as measured by vaginal pulse amplitude, is a relatively automatic response to perception of sexual stimuli, regardless of whether these stimuli are perceived positively or result in subjective arousal. This is considered as a possible mechanism that allows vaginal intercourse without pain, even when the woman is not sexually aroused. The roles of androgens and estrogen in women's sexuality remain uncertain. The evidence is, however, consistent with there being a testosterone-dependent component of women's sexuality that is more important for some women than others. Finally, a new theoretical model is presented that aims to resolve these uncertainties and that proposes different types of women's sexuality. Once we have a better understanding of "normal" female sexuality, in its various forms, our ability to develop effective treatments for women's sexual problems should improve.