Sexual satisfaction and relationship happiness in midlife and older couples in five countries

Self-Esteem and Sexual Experiences

There is evidence that people with higher self-esteem tend to have more satisfying sexual relationships, but little is known about how changes in people's self-esteem and sexual experiences are related over time. Several theories predict reciprocal effects between self-esteem and sexual experiences. The present study tested these theories using 12-wave longitudinal data from more than 11,000 participants of a representative sample in Germany. Data were analyzed using Random Intercept Cross-lagged Panel Models. Results indicated significant between-person associations between stable levels of self-esteem and both the frequency and the quality of sexual experiences. Moreover, we found reciprocal within-person transactions between self-esteem and sexual satisfaction but not sexual frequency. Overall, the present pattern of results provides evidence for theories that consider self-esteem as both a source and consequence of intimate sexual relationships.

Exploring sexual life enrichment: a journey into strengthening well-being for women post- menopause through qualitative study

BACKGROUND

women post-menopause, are faced with various physical, emotional, and relational challenges. One such aspect that tends to be overlooked is the impact of menopause on sexual well-being. This study aimed to elucidate the concept of enriching the sexual life of women post-menopause.

METHODS

A qualitative research strategy was adopted using a conventional content analysis approach. Data collection was conducted through semi-structured interviews with 24 participants (17 women post-menopause and 7 experts), using purposive sampling.

RESULTS

The data analysis resulted in the extraction of 341 codes, 24 subcategories, and 8 categories. Ultimately, the following three themes emerged: "maintaining and enhancing the position of sexual relationships," "deepening sexual relationships and expanding intimacy," and "improving communication skills with the spouse ".

CONCLUSION

Enriching the sexual life of women post-menopause, as suggested by the themes, involves nurturing their relationships, keeping these connections strong and valued, deepening intimacy, and promoting effective communication to ensure a fulfilling and enjoyable experience during this phase of life. This leads to a sense of security, health, and tranquility, ultimately manifesting positive repercussions on the couple's and family's health.

Sexual satisfaction of postmenopausal women: An integrative review

A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.

Sexual satisfaction and attitude toward marital infidelity among married people in Iran: the role of social media and entertainment preferences

BACKGROUND AND PURPOSE

Sexual satisfaction and attitudes toward marital infidelity are crucial components of marital quality and well-being. This study investigates the impact of social media and entertainment preferences on these aspects among married couples in Iran, acknowledging the sociocultural nuances unique to the region.

METHOD AND MATERIAL

A cross-sectional survey design was employed, gathering data from 1,756 married participants through an online questionnaire in Iran. Variables included social media and entertainment preferences, sexual satisfaction, attitude toward marital infidelity, and demographic details. Descriptive statistics, non-parametric tests (Mann-Whitney U test, Kruskal-Wallis test), and GLM (Generalized linear model) were used for exploration.

RESULTS

Key results reveal significant associations between demographic factors, social media usage, and attitudes toward marital infidelity. Notable trends include higher sexual satisfaction among younger participants (p < 0.05), those with shorter marital durations (p < 0.01), and those residing outside Tehran (p < 0.001). Attitudes toward marital infidelity were influenced by gender, age, ethnicity, income levels, and social media habits, reflecting a complex interplay of factors. The GLM analysis emphasizes the impact of variables such as marital duration, ethnicity, spouse's education, Iranian social media usage, and attitudes toward marital infidelity on sexual satisfaction. Participants with shorter marriages (p < 0.01), higher spouse education (p < 0.05), and more frequent Iranian social media usage (p < 0.001) reported higher sexual satisfaction.

CONCLUSIONS

This study explores the dynamics of marital relationships in Iran, examining the interconnections between demographics, media habits, sexual satisfaction, and attitudes toward infidelity. The findings provide valuable insights into factors influencing marital satisfaction, emphasizing the importance of considering cultural contexts. Robust statistical methods, including Generalized Linear Models, support the reliability of results. The study contributes to understanding non-western marital dynamics, highlighting implications for research and interventions in the digital age.

Positive sexuality, relationship satisfaction, and health: a network analysis

Introduction

Positive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions.

Methods

The present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18-71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women.

Results

Results indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse.

Discussion

The findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.

The impact of positive psychology counseling on sexual and marital satisfaction and anxiety among reproductive-aged women during the COVID-19 pandemic: a randomized controlled clinical trial

BACKGROUND

Sexual and marital satisfaction is considered one of the important factors in happiness and life satisfaction of couples. COVID-19 pandemic results in psychological effects, such as increased anxiety levels which can affect sexual and marital satisfaction. This study aimed to investigate the impact of positive psychology on women's sexual and marital satisfaction.

METHODS

A randomized controlled trial was conducted on 72 married women of reproductive age in Tabriz, Iran between February 2021 and May 2022. The participants were randomly divided into the intervention and control groups. There was no significant difference between the control and intervention groups in terms of the socio-demographic characteristics (p < 0.05). The mean age of the participants in the intervention and control groups was 31.8 ± 6.92 and 30.97 ± 5.09 years, respectively. The intervention group attended seven 60-90 min counseling sessions at weekly intervals. The Spielberger anxiety, sexual satisfaction and marital satisfaction questionnaires were completed before and four weeks after the intervention.

RESULTS

The results of this study indicated that after counseling, the average overall score of marital satisfaction [MD: 15.46, 95% CI: 7.47 to 23.41, p = 0.034] and sexual satisfaction [MD: 7.83, 95% CI: 6.25 to 9.41, p = 0.001] significantly increased in the intervention group compared to the control group. Also, the mean score of state anxiety [MD: -2.50, 95% CI: -4.19 to -0.80, p = 0.001] and trait anxiety [MD: -1.03, 95% CI: -2.46 to -0.09, p = 0.032] significantly decreased after counseling in the intervention group compared to the control group.

CONCLUSIONS

Using counseling based on a positive psychology approach can improve anxiety, sexual and marital satisfaction, and anxiety of women of reproductive age during the COVID-19 pandemic. However, further randomized clinical trials are needed before making a definitive conclusion.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N8. Date of registration: 11/28/21. Date of first registration: 11/28/21. URL: https://www.irct.ir/user/trial/58680/view ; Date of recruitment start date: 12/01/21.

Biopsychosocial determinants of sexual health in older age: the role of health-related, relationship, and psychosexual factors

BACKGROUND

Given the unprecedented aging of the population and the increased focus on overall well-being in older age, investigating the determining factors of sexual well-being in older adults becomes essential as it offers insights into promoting healthy aging and overall quality of life.

AIM

By applying the biopsychosocial model of sexuality in older age, we aimed to identify the role of biomedical and psychosocial factors in predicting sexual well-being in partnered older adults (≥55 years old).

METHODS

A total of 111 participants (mean [SD], 63.2 [5.96]) completed a self-report questionnaire assessing biopsychosocial dimensions. Bivariate correlational analyses and hierarchical multiple regression were conducted to investigate factors associated with sexual well-being. Health-related factors were entered into the first regression model. The second model included factors pertaining to relationship dimensions. Sexual beliefs were introduced in the third regression model.

OUTCOMES

Self-rated health, psychological distress, subjective cognitive decline, sexual beliefs, duration of the relationship, relationship satisfaction, and sexual well-being were assessed.

RESULTS

Findings from the hierarchical regression revealed that duration of relationship [t(104) = -3.07, P < .01], relationship satisfaction [t(104) = 8.49, P < .001], and age-related sexual beliefs [t(104) = -2.75, P < .01] were significant predictors of sexual well-being of partnered older adults [F(6, 104) = 22.77, P < .001, R2 = .57], after controlling for health-related factors. These findings suggest that relationship factors and sexual beliefs play a significant role in predicting sexual well-being of older adults, above and beyond health-related dimensions.

CLINICAL IMPLICATIONS

Interventional approaches aimed at promoting sexual well-being in older age might benefit from incorporating exercises that demystify age-related sexual beliefs, by normalizing changes that occur with aging and fostering positive attitudes toward sexual expression in older age; particularly for older adults in long-term relationships, relationship satisfaction must also be considered as an important intervention target.

STRENGTHS AND LIMITATIONS

Further investigation using longitudinal designs is required to examine the causal links between these factors and sexual well-being in older age.

CONCLUSION

Findings from this study underscore the role of relationship dimensions and age-related sexual beliefs for the sexual well-being of partnered older adults.

Dyadic associations and prediction of maternal and paternal sexual satisfaction in couples-Findings from an 18-year longitudinal study

Background

: Sexual satisfaction is one of many crucial factors for the long-term success of romantic relationships. Longitudinal studies examining the dyadic associations between maternal and paternal factors in middle adulthood for predicting sexual satisfaction in later adulthood are scarce.

Method

The German longitudinal intervention study "Future Family" followed families with at least one child over 18-years (Pre: N = 477, mothers: M = 35.2 years, fathers: M = 38.8 years, children: M = 4.1 years). At the time of the 18-year follow-up, N = 150 mothers (M = 54.1 years) were still living together with the biological fathers (M = 56.1 years; mean relationship duration: 32 years). Dyadic associations between individual and dyadic factors at Pre were analyzed with Actor-Partner Interdependence models to predict sexual satisfaction 18 years later.

Results

Higher relationship quality was significantly associated with higher levels of one's own sexual satisfaction 18 years later. Higher levels of maternal and paternal mental health problems were linked to lower levels of sexual satisfaction in both the individual themselves and their partner. General life satisfaction of mothers and fathers only predicted their own sexual satisfaction. The model for dysfunctional parenting yielded no significant effects.

Conclusions

The results indicate that relationship quality, mental health problems, and general life satisfaction of both parents could be starting points for preventive and therapeutic interventions to achieve long-term effects in sexual satisfaction in married couples.

Women Who Experience More Affectionate Touch Report Better Body Satisfaction and Relationship Outcomes

Affectionate touch (e.g. hugging, handholding) is an essential component of many intimate relationships and is a primary contributor to overall relationship satisfaction as well as sexual satisfaction. Affectionate touch is understood to be a form of non-verbal communication in which the giver is expressing positive feelings toward the receiver. Here, we propose that affectionate touch also positively impacts receivers' body satisfaction, because affectionate touch is a positive message communicated toward the receiver's body. In a cross-sectional sample of romantically partnered women (N = 1,156), we assessed the association between affectionate touch frequency and body satisfaction. We also investigated whether affectionate touch is associated with relationship/sexual satisfaction in part because touch helps to improve women's evaluations of their own bodies. Our results showed that body satisfaction was a significant, partial mediator and a valid path through which affectionate touch shapes relationship quality. Receiving affectionate touch could bolster relationship satisfaction and self-perceptions among women. Given the prevalence of body dissatisfaction amongst women, these results suggest that the underexplored associations between affectionate touch and body satisfaction may have significant impacts on a wide array of future empirical and applied research trajectories.

The Role of Ageist Sexual Stereotypes in the Network of Sexual Difficulties, Sex and Relationship Satisfaction Among Adults Aged 50

As people age, their sexual activity, including sexual and relationship satisfaction, may change due to the onset of health and sexual difficulties and the activation of internalized ageist sexual stereotypes. We studied whether ageist sexual stereotypes were relevant for the importance of sex for people aged 50+ and how sexual and relationship satisfaction are interlinked with health and sexual difficulties when ageist sexual stereotypes are considered. Data for the network analysis were collected from a sample of 897 Czechs and Slovaks aged 50-96 (52% men, mean age = 62.01). Two models were analyzed - with and without the inclusion of ageist sexual stereotypes. The findings indicated that ageist sexual stereotypes play an important role in the sexuality of women and men aged 50 + .The fewer ageist sexual stereotypes people had, the less sexual difficulties they reported and the more they perceived sex as important. The inclusion of stereotypes into the models, however, weakened the negative link between sexual difficulties and the importance of sex for both women and men. These findings show that the effect of ageist sexual stereotypes are likely complex in the sexual lives of people aged 50 +.

Effect of Duration of Education on Sexual Activity and the Mediating Role of Illness in Later Life: A Natural Experiment in English Schooling Reform

This study aimed to examine the effect of increases in the duration of education on sexual activity in later life using the instrumental variable approach. Cross-sectional data were obtained from the English Longitudinal Study of Ageing, Wave 6 (2012/2013) for the analysis. The effect of the duration of education on a binary variable for sexual activity in the past month was examined by two-stage least squares estimation using the 1947 schooling reform as the instrument. A total of 1493 participants were included. The 1947 schooling reform significantly extended the duration of education by a mean of 0.86 years (95% confidence interval (CI), 0.52-1.20; F = 24.70) for men and 0.81 years for women (95% CI, 0.54-1.09; F = 33.82). The second-stage regression showed that an additional year of education increased the probability of having sexual activity in the past month by 0.16 points (95% CI, 0.07-0.25) for men and decreased the probability of having sexual activity in the past month by 0.18 points (95% CI, - 0.30- - 0.05) for women. The causal mediation analysis revealed that long-standing illness mediated the mechanism between education and sexual activity, but the mediational effect was clearly observed only for men: the indirect effect for men was 0.10 (95% CI, 0.01-0.20; the proportion mediated, 78.1%) and for women was - 0.16 (95% CI, - 1.23-0.90; the proportion mediated, 97.8%), respectively. This study confirmed the causal effect of education on sexual activity. However, the effect for men and women was completely opposite.

Sexual experiences of postmenopausal women in China: a qualitative study

Background

Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life.

Aim

This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China.

Methods

We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted.

Outcomes

Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study.

Results

Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period.

Clinical Implications

This study highlights the importance of and need for effective dissemination of sexual health-related knowledge and the opening of appropriate communication channels.

Strengths and Limitations

By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples.

Conclusion

The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life.

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.

Long-distance romantic relationships among college students: Prevalence, correlates, and dynamics in a campus probability survey

OBJECTIVE

To determine the prevalence of long-distance relationships (LDRs) among college students and explore how relationship dynamics differed between LDRs and geographically close relationships (GCRs).

PARTICIPANTS

Data were from romantically involved students (N = 2075) who participated in the 2020 College Sexual Health Survey.

METHODS

Students completed an online survey in which they reported their current romantic relationship status, if they were in a long-distance relationship, and relationship dynamics (happiness, commitment, and conflict).

RESULTS

Overall, 34.2% of romantically involved students were in LDRs, which were more common for first-year students, students in longer duration relationships, dating relationships, and Hispanic, Asian, and multiracial students. LDRs were less common for older students. Based on χ2 tests, relationship happiness, commitment, and conflict did not differ based on LDR status.

CONCLUSIONS

As LDRs are common, providing students with resources focused on navigating LDRs may help them manage their romantic relationships.

Attachment Injury Severity, Injury-related Stress, Forgiveness, and Sexual Satisfaction in Injured Adult Partners

An attachment injury can occur when one partner violates the assumption that they will provide comfort and caring during a moment of increased need. For injured partners, unresolved attachment injuries can underlie an enduring stress reaction and lower relationship satisfaction. However, no research has examined the associations between the perceived severity of the injury and sexual satisfaction, a central component of relationship well-being. In this cross-sectional study, we examined the direct and indirect associations between the perceived severity of the attachment injury and sexual satisfaction via injury-related stress symptoms and levels of forgiveness, in injured partners. A total of 145 adults who reported having experienced an attachment injury in their current relationship completed self-report questionnaires measuring injury severity, event-related stress, forgiveness, and sexual satisfaction. An indirect association between the perceived severity of the attachment injury and sexual satisfaction through higher injury-related stress and lower forgiveness was found via a path analysis. Results suggest that fostering forgiveness and attending to injury-related stress may be key toward sexual satisfaction in couples where a partner reports an attachment injury. Clinical implications of these results are discussed in light of theory and potential treatment strategies for addressing an attachment injury in couple's therapy.

A critical evaluation of QIDS-SR-16 using data from a trial of psilocybin therapy versus escitalopram treatment for depression

BACKGROUND

In a recent clinical trial examining the comparative efficacy of psilocybin therapy (PT) versus escitalopram treatment (ET) for major depressive disorder, 14 of 16 major efficacy outcome measures yielded results that favored PT, but the Quick Inventory of Depressive Symptomatology, Self-Report, 16 items (QIDS-SR16) did not.

AIMS

The present study aims to (1) rationally and psychometrically account for discrepant results between outcome measures and (2) to overcome psychometric problems particular to individual measures by re-examining between-condition differences in depressive response using all outcome measures at item-, facet-, and factor-levels of analysis.

METHOD

Four depression measures were compared on the basis of their validity for examining differences in depressive response between PT and ET conditions.

RESULTS/OUTCOMES

Possible reasons for discrepant findings on the QIDS-SR16 include its higher variance, imprecision due to compound items and whole-scale and unidimensional sum-scoring, vagueness in the phrasing of scoring options for items, and its lack of focus on a core depression factor. Reanalyzing the trial data at item-, facet-, and factor-levels yielded results suggestive of PT's superior efficacy in reducing depressed mood, anhedonia, and a core depression factor, along with specific symptoms such as sexual dysfunction.

CONCLUSION/INTERPRETATION

Our results raise concerns about the adequacy of the QIDS-SR16 for measuring depression, as well as the practice of relying on individual scales that tend not to capture the multidimensional structure or core of depression. Using an alternative approach that captures depression more granularly and comprehensively yielded specific insight into areas where PT therapy may be particularly useful to patients and clinicians.

Sexual dysfunction, depression, and marital dissatisfaction among Brazilian couples

BACKGROUND

Health professionals treating sexual dysfunction and relational dissatisfaction recognize that they are multifactorial phenomena, and depression can be bidirectionally associated with both.

AIM

The purpose of this study was to investigate sexual dysfunction in heterosexual couples in relation to the quality of their marital relationship and depression symptoms.

METHODS

The sample consisted of 100 heterosexual couples recruited in Brazil. Both partners of each couple completed the Golombok-Rust Inventory of Sexual Satisfaction and the Golombok-Rust Inventory of Marital Satisfaction, which were translated and adapted, and the Beck Depression Inventory, which was validated for the Brazilian population. Both partners completed their questionnaires separately, and the couple's surveys were linked to preserve conjugal data for dyadic analysis. The Actor-Partner Interdependence Model was used to understand how sexual dysfunction in couples is related to depression and relationship quality among and between partners.

RESULTS

Sexual dysfunction was found to be strongly associated with dissatisfaction in the relationship (husbands, β = 0.57, P < 0.001; wives, β = 0.60, P < 0.001), and a positive association was found between depressive symptoms and marital dissatisfaction (husbands, β = .32, P < .001; wives β = .40, P < .001).

CLINICAL IMPLICATION

The results suggest that it is important for health professionals to be aware of the dyadic impact of struggles with both sex and the relationship and the presence of depression symptoms in patients who seek care for sexual complaints or depression and who are in a marital relationship.

STRENGTHS AND LIMITATIONS

The different results found for men and women may shed light on the biopsychosocial dimensions of human sexuality. When treated as a purely physical experience, sex is myopic. In this study we demonstrated psychosocial aspects associated with gender and sexuality, and the partner's variables were found to have a greater impact on women than they did on the men. A limitation of this study is that the sample is not generalizable as it is not demographically representative of all socioeconomic groups in Brazil. Furthermore, the participants in this sample did not have clinical levels of depression, so the results cannot be extended to couples in which one or both spouses have depressive disorder.

CONCLUSION

It was found that sexual dysfunction is strongly associated with the quality of the couple relationship, and that the quality of relationship plays a mediating role between depression and marital quality, especially for the women.

The Role of Information in Later-Life Sexuality: An Invitation for Further Exploration

Despite the key role of information in realizing, questioning, or respecting one's sexual health, individuals' engagement with information about sex and sexuality remains understudied, particularly in older adult populations. Beginning with current understandings of later-life sexuality to contextualize how older adults may need, use, and manage information about their sexual lives and practices, this forum article follows with what is currently known about older adults' sexuality-related information needs and practices. We conclude with an invitation for collaboration between gerontologists and Library and Information Science scholars and professionals as a means to step outside the medicalization of older adults' sexuality and bolster our understandings of how information and later-life sexuality are mututally shaping.

Retirement and Sexual Satisfaction

BACKGROUND AND OBJECTIVES

Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner.

RESEARCH DESIGN AND METHODS

Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years.

RESULTS

On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction.

DISCUSSION AND IMPLICATIONS

Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted.

Associations between Relationship Status, Anxiety, Sexual Function, and Sexual Satisfaction in Lesbian, Gay, and Bisexual People

Objectives

The purpose of this study was to describe associations between relationship status, anxiety, and sexual function and satisfaction in lesbian, gay, and bisexual (LGB) adults.

Methods

Linear regression determined associations between sexual function, relationship characteristics and anxiety in 979 LGB participants.

Results

Relationship status was not related to sexual interest in gay men. Partnered relationship status was associated with higher sexual satisfaction for gay men, lesbians, and bisexual women. Anxiety symptoms were negatively associated with sexual interest, satisfaction, and orgasm pleasure for gay men but not associated with sexual outcomes in lesbian women.

Conclusion

Using a nationally representative sample of LGB adults, differences were found in factors related to sexual function and satisfaction by gender and sexual orientation.

Sexual and Affectionate Behaviors in Asexual and Allosexual Adults

Prior experience with physical behaviors - both sexual and affectionate - is common among adults in romantic relationships. However, less is known about differences in physical behaviors for asexual and allosexual adults, and these differences may explain how asexual adults navigate sexuality in romantic relationships. In this study we used sexual script theory to examine asexual (n = 109; 59% women; M_age = 27.7) and allosexual adults' (n = 403; 58% women; M_age = 29.0) prior experiences with and future likelihood to engage in sexual and affectionate behaviors in romantic relationships, and how these differences vary by gender. Asexual adults had less prior experience with and were less likely to intend to engage in future physical behaviors than allosexual adults. There were some gender differences in past experience and future likelihood. Prior experience with physical behaviors was associated with expected likelihood to engage in these behaviors for allosexual and asexual adults, although the association was stronger for asexual adults. These results have implications for how asexual adults engage in physical behaviors, and how differing interest in physical behaviors may cause conflict within asexual-allosexual couples.

Exploring the Relationship between Early Adaptive Schemas and Sexual Satisfaction

Rationale

Early maladaptive schemas (EMS) develop from unmet core emotional needs during childhood and adolescence. EMS influence the way individuals perceive themselves and others, while also sharing associations with various sexual difficulties. Contrastingly, Early Adaptive Schemas (EAS) develop when core emotional needs are met. Yet, the potential influence of EAS on sexual wellbeing remains underinvestigated.

Objective

The current study assessed the relationship between EAS and sexual satisfaction as a primary component of sexual wellbeing.

Method

The study design was an online, cross-sectional survey. Participants included 732 adults (Mage = 32.05, SDage = 9.30), who completed self-report questionnaires assessing sexual satisfaction and EAS.

Results

Two, three-step hierarchical regressions evaluated the effect of EAS on sexual satisfaction, controlling for several potentially confounding variables. Results indicated that the only EAS that was associated with sexual satisfaction in both men and women was Realistic Expectations. EAS of Social Belonging and Success were associated with sexual satisfaction for women alone, whereas Self-Compassion was for men.

Conclusion

Findings provide preliminary evidence that EAS are associated with sexual satisfaction. As such, schema therapy may be a useful therapeutic framework for improving sexual satisfaction, when indicated.

Partnership, sexuality, and fertility-related communication: findings from a register-based study among long-term hematological cancer survivors

PURPOSE

Even though the number of hematological cancer survivors suffering from long-term and late consequences of their disease is growing, knowledge about their situation regarding partnership, sexuality, and fertility-related communication is sparse to date.

METHODS

We recruited survivors of hematological malignancies (≥ 3 years after diagnosis) from two cancer registries in Germany. We applied validated instruments and study-specific items on satisfaction with partnership, sexual functioning, and fertility-related communication with physicians. We provided descriptive statistics and conducted multiple regression analyses to identify associations of the outcomes with patient factors and well-being (anxiety, depression, and quality of life).

RESULTS

Of 2001 eligible survivors, 922 (46%) participated. Fifty-seven percent were male, and the mean age was 64 years. Ninety percent and 60% reported to be satisfied with their partnership and sexual life, respectively. However, 81% and 86% reported being sexually impaired by physical or mental symptoms, respectively. Seventy-four percent of those with incomplete family planning had a fertility-related conversation with a physician. Female gender (p < .05, Beta =  - .09), older age (p < .01, Beta = .10), and chemotherapy (p < .01, Beta = .10) were associated with less sexual pleasure caused by physical impairment. Satisfaction with partnership (p < .001, Beta = .22), satisfaction with sexual life (p < .001, Beta = .28), and conversation about fertility (p < .05, Beta = .26) were associated with better quality of life.

CONCLUSION

Even though long-term survivors seem to be generally satisfied with their partnership and sexual life, they may suffer from specific impairments. Our findings need to be verified in longitudinal studies.

Who seeks sex therapy? Sexual dysfunction prevalence and correlates, and help-seeking among clinical and community samples

Sexual dysfunctions (SD; e.g., female sexual interest/arousal disorder, erectile disorder, female orgasmic disorder, delayed ejaculation, genito-pelvic pain/penetration disorder, etc.) affect up to a third of individuals, impairing sexuality, intimate relationships, and mental health. This study aimed to compare the prevalence of SDs and their sexual, relational, and psychological correlates between a sample of adults consulting in sex therapy (n = 963) and a community-based sample (n = 1,891), as well as examine barriers to sexual health services for SD and the characteristics of individuals seeking such services. Participants completed an online survey. Analyses showed that participants in the clinical sample reported lower levels of sexual functioning and sexual satisfaction and higher levels of psychological distress than participants in the community-based sample. Moreover, higher SD rates were related to lower relational satisfaction and higher psychological distress in the community sample, and to lower sexual satisfaction in both samples. Among participants in the community sample who sought professional services for SD, 39.6% reported that they were unable to access services, and 58.7% reported at least one barrier to receiving help. This study provides important data regarding the prevalence of SD and the link between SD and psychosexual health in clinical and nonclinical samples, as well as barriers to treatment access.

Sexual intimacy and relationship happiness in living apart together, cohabiting, and married relationships: evidence from Britain

Research on relationship happiness have traditionally compared cohabiting and married relationships. Studies including LAT relationships are scarce and have disregarded sexual aspects of the relationships. This paper compares how married, cohabitating, and LAT relationships in Britain differ with respect to sexual intimacy (defined as emotional closeness during sex, compatibility in terms of sexual preferences, and interest in having sex with a partner), and relationship happiness. Rich data from the British National Study of Sexual Attitudes and Lifestyles (NATSAL-3, 2010–2012) are used to estimate ordered logistic regression models. Cohabiting individuals share the same levels of sexual intimacy as those married, but they are less happy in their relationship than those married. LAT individuals enjoy overall greater sexual intimacy than coresidential individuals but they are less happy in their relationships. Women in LAT relationships feel less often emotionally close to their partner during sex than married women. By knitting the sex research with the demographic literature, this paper offers new insights in understanding the nature of partnerships, opening up new venues for future research.

Pornography and Relational Satisfaction: Exploring Potential Boundary Conditions

Recent meta-analytic and other large-scale multi-sample studies have established that pornography use is generally associated with lower relational satisfaction. Nevertheless, much remains unknown about the potential boundary conditions of this relationship. Using data from a campus-representative probability sample of more than 750 graduate students in a committed romantic relationship, this exploratory study examined whether the association between more frequent pornography consumption and lower relational satisfaction was moderated by gender, sexual orientation, race, relational length, religious participation, and moral disapproval of pornography. The bivariate correlation between more frequent pornography use and lower relational satisfaction was small, but significant and replicative of prior meta-analytic results. Planned two-way interaction analysis indicated that this association was moderated by gender, with men, but not women, evidencing the negative association. None of the other potential moderators yielded significant two-way interactions. A supplementary three-way interaction analysis, however, suggested that the negative association between pornography consumption and relational satisfaction was primarily carried by White men. These results provide optimism for the replicability of previous findings on pornography and relational satisfaction and suggest that moderated models should incorporate race, in addition to gender, when predicting relational satisfaction from pornography use.

Norwegian Data on Prevalence, Sexual Risk Behaviors, Sexual Problems, and Sexual Satisfaction in Women Who Have Sex Exclusively with Women, Women Who Have Sex Exclusively with Men, and Women Who Have Sex with Men and Women

Objective

The study explores the difference between Women Who Have Sex Exclusively with Men (WSEM), Women Who Have Sex Exclusively with Women (WSEW), and Women Who Have Sex with Women and Men (WSWM).

Method

The data were obtained from a survey of a probability-based web sample of 1967 Norwegian women.

Results

Most WSWM identified themselves as heterosexuals (76.3%), and three out of 10 used a condom when having sex with a new partner. The highest number of sex partners during the last year was reported by WSWM. More WSEW than the other categories reported premature orgasm.

Conclusions

WSWM should be targeted in health campaigns.

Italian Versions of the 12-Item Sexual Distress Scale (SDS) and the 5-Item Sexual Distress Scale-Short Form (SDS-SF): Psychometric Properties

The study aimed to analyze the psychometric properties of the Italian versions of the 12-item Sexual Distress Scale (SDS) and the 5-item Sexual Distress Scale-Short Form (SDS-SF). A total sample of 2291 adults (1361 women, 930 men) participated through a web survey completing the SDS, the FSFI, the IIEF, the PANAS and the SCL-90-R. The results supported the adequacy of both the SDS and SDS-SF factor structures, good reliability (respectively, α = .96 and .92), discriminant validities and strong associations with satisfaction, fear, depression, and psychoticism. SDS and SDS-SF may facilitate the assessment of sexual distress for both clinical and research purposes.

How Inclusion of Other in the Self Relates to Couple's Sexuality and Functioning - Results from the German Health and Sexuality Survey (GeSiD)

Closeness, in the sense of inclusion of other in the self, has been found to be an important factor for relationship well-being, satisfaction and pair-bonding. In the past ten years, the self-expansion theory has also been incorporated into sex research, although studies are still very scarce and not without limitations. The present research aimed at further elucidating the relevance of relational factors for couple's sexuality, and to clarify the role inclusion of other in the self plays for sexual satisfaction and sexual distress. A broadly representative sample of 3,046 men and women aged 18 to 75 was taken from the German Health and Sexuality Survey (GeSiD). Throughout analyses, inclusion of other in the self and love were positively related to sexual satisfaction. Furthermore, inclusion of other in the self was negatively related to how strongly someone was distressed by experiencing sexual problems. Closeness seems to have a compensatory role especially for women with sexual problems, protecting them from experiencing sexual distress. In future research, couple's sexual satisfaction should not be compartmentalized from relational aspects. Results clearly promote the Inclusion of Other in the Self Scale as an interesting tool for both research and treatment.

An Exploratory Network Analysis of Sexual and Relationship Satisfaction Comparing Partnered Cisgendered Men and Women

BACKGROUND

Sexual and relationship satisfaction are intimately connected and share many predictors.

AIM

The aim of the present study is to disentangle the relationship between sexual and relationship satisfaction, by exploring the connections to other relevant correlates.

METHODS

Regularized mixed graphical model networks were estimated separately for men and women, which were compared using the network comparison test. In addition, strength centrality and community structure were explored.

OUTCOME

The partial correlation structure between sexual satisfaction, relationship satisfaction and their correlates.

RESULTS

The associations between variables measuring sexual and relationship satisfaction and related constructs did not differ significantly between partnered, cisgendered men and women. Sexual and relationship satisfaction were associated with sexual pleasure, sexual distress, and sexual communication for both men and women. Sexual satisfaction was the most central variable in the network for men (strength = 1.1), while sexual desire was the most central variable for women (strength = 1.1). Frequency of sexual activity was a central variable for both men and women (strength men = 1.0, strength women = 1.1). The community analysis showed similar communities of variables for men and women, except that frequency of sexual activity consistently belonged to the same community as sexual and relationship satisfaction for men, but not as consistently for women.

CLINICAL TRANSLATION

The results have clinical implication in sex and couples therapy, as they increase the knowledge on sexual and relationship satisfaction.

STRENGTHS & LIMITATIONS

A strength of the study is the population-based dataset, and a limitation is that inferences of causality cannot be made due to the cross-sectional study design.

CONCLUSION

The present study suggests that men and women are largely similar when comparing constructs related to sexual and relationship satisfaction. Nickull S, Källström M, Jern P. An Exploratory Network Analysis of Sexual and Relationship Satisfaction Comparing Partnered Cisgendered Men and Women. J Sex Med 2022;19:711-718.

An Exploration of Dyadic Relationship Approach-Avoidance Goals and Relationship and Sexual Satisfaction in Couples Coping with Endometriosis

Endometriosis affects women of reproductive age and is associated with higher levels of sexual and relational distress. Despite the relational context of endometriosis, the research pertaining to dyadic relationship goals is lacking. An exploration of the relationship goals of couples coping with endometriosis can facilitate the understanding of potential protective mechanisms that mitigate the relational components of the condition. Guided by the approach-avoidance theoretical framework, the current cross-sectional study aimed to examine the role relationship goals play in sexual and relationship satisfaction in couples coping with endometriosis. Approach goals relate to the pursuit of a positive outcomes, whereas avoidance goals relate to the avoidance of negative outcomes. Women with endometriosis and their partners (N = 61) completed an online survey measuring relationship goals and relationship and sexual satisfaction. The study results indicated that, for women, their own and their partner's higher relationship approach goals were linked to higher sexual satisfaction. For partners of women with endometriosis, their own higher relationship approach goals were associated with their own higher relationship satisfaction. Higher relationship avoidance goals in both women with endometriosis and partners were associated with higher relationship satisfaction. The study's findings highlight relationship goals as relevant to the relational and sexual experience of couples coping with endometriosis. When treating women with endometriosis, the inclusion of partners and consideration of factors beyond the physical illness are important for a holistic management approach.

Mechanisms of the association between PTSD and sexual arousal and lubrication functioning among trauma-exposed female service members/veterans

BACKGROUND

The presence of a post-traumatic stress disorder (PTSD) diagnosis or higher PTSD severity is associated with higher overall sexual dysfunction in female service members/veterans. However, the mechanisms linking PTSD to specific components of women's sexual arousal function, like lubrication and mental arousal, are unknown.

METHODS

We conducted a survey among 464 women who reported probable Criterion A exposure for PTSD. Path analysis examined (1) the association of PTSD with sexual arousal, (2) whether specific PTSD symptom clusters were uniquely associated with sexual arousal, and (3) whether this association is indirect, through the effects of higher depression severity and lower romantic relationship satisfaction. Arousal was operationalized to measure both mental (subjective arousal) and physical (lubrication) experiences.

RESULTS

Higher PTSD severity was associated with lower lubrication and arousal function. The association of PTSD severity with arousal was indirect, through lower romantic relationship satisfaction (estimate: -0.12; 95% CI: [-0.014, -0.007]) and higher depression (estimate: -0.08, 95% CI: [-0.012, -0.002]). The association of PTSD severity with lubrication was also indirect, but only through lower relationship satisfaction (estimate: -0.10, 95% CI: [-0.013, -0.006]). PTSD symptom clusters were not uniquely associated with arousal and lubrication through mediated pathways.

LIMITATIONS

Data were from a cross-sectional study using a convenience sample. Criterion A exposure could not be confirmed.

CONCLUSIONS

PTSD may lead to arousal and lubrication dysfunction by contributing to higher depression severity and strained romantic relationships. Interventions targeting reductions in depressive symptoms and bolstering relationship satisfaction may minimize the burden of PTSD on sexual arousal concerns.

Perceived Partner Responsiveness Forecasts Behavioral Intimacy as Measured by Affectionate Touch

Affectionate touch is an important behavior in close relationships throughout the lifespan. Research has investigated the relational and individual psychological and physical benefits of affectionate touch, but the situational factors that give rise to it have been overlooked. Theorizing from the interpersonal process model of intimacy, the current studies tested whether perceived partner responsiveness forecasts affectionate touch in romantic couples. Following a preliminary integrative data analysis (N = 842), three prospective studies use ecologically valid behavioral (Studies 1 and 2) and daily (Studies 2 and 3) data, showing a positive association between perceived partner responsiveness and affectionate touch. Furthermore, in Study 3, we tested a theoretical extension of the interpersonal process of intimacy, finding that affectionate touch forecasts the partner's perception of the touch-giver's responsiveness the next day. Findings suggest affectionate touch may be an untested mechanism at the heart of the interpersonal process of intimacy.

Dyadic Satisfaction and Shared Affectivity Are Associated with Psycho-Sexual Functioning in Elderly Men and Women

Objectives The quality of sexual life of elderly people represents an understudied topic of sexual medicine and of psycho-sexology. Hence, we aimed to evaluate the association of specific psycho-relational variables, such as intimacy, increased affective gestures towards a partner (AGtP), daily shared activities, and dyadic satisfaction, with the psychosexual wellbeing of elderly people, expressed in terms of sexual satisfaction. Methods: A cohort of elderly people was selected from a sample of a broader study evaluating the role of sexual activity in protecting the emotional wellbeing of a population subjected to quarantine due to the COVID-19 pandemic. Specifically, the presence of sexual dysfunctions, the emotional wellbeing (i.e., absence of anxiety and/or depression), and the quality of the partners’ relationships were studied. For the study’s purpose, the Sexual Health Inventory for Males (SHIM), the Female Sexual Function Index (FSFI), the Orgasmometer and the Orgasmometer-F, the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Dyadic Adjustment Scale were adopted. Results: A group of 124 elderly subjects (≥60) was selected for the study’s purposes. Among these, 84% were males (120/124), and 16% were females (20/124). All the subjects declared to be in a stable relationship and to be sexually active during the first lockdown period. Gender differences were found for the Dyadic Satisfaction subscale (males: 37.04 ± 6.57; females: 32.85 ± 10.04; p < 0.05) and the Orgasmometer (males: 7.64 ± 1.30; females: 6.60 ± 2.46; p < 0.01). Linear regression analysis showed the association between higher Orgasmometer scores and: (i) the absence of sexual dysfunctions (β = −1.213; SE = 0.271; p < 0.0001), (ii) higher dyadic satisfaction (β = 0.042; SE = 0.019; p < 0.05), and (iii) reduced shared activities with partner (β = −0.463; SE = 0.143; p < 0.01) and increased affective gestures towards partner (DAS measured AGtP) (β = 0.595; SE = 0.065; p < 0.0001). Post hoc analysis of ANCOVA with the Bonferroni correction method showed a significant difference in the Orgasmometer scores between subjects with and without sexual dysfunction (mean difference: 2.102; SE = 0.340; pBonf < 0.001), with healthy subjects reporting higher scores compared to dysfunctional ones. Conclusions: It is reasonable to suppose that, beyond the presence of sexual dysfunctions, the sexual health of elderly people may benefit from the quality of the relationship, and, specifically, from the presence of affective gestures towards the partner and the dyadic satisfaction. To the contrary, the quantity of time spent together, sharing specific activities, may be considered a factor worsening relational and sexual health. These data should be considered during the evaluation of sexual health among elderly people.

Insecure Attachment and Sexual Satisfaction: A Path Analysis Model Integrating Sexual Mindfulness, Sexual Anxiety, and Sexual Self-Esteem

This study examines the intermediary role of three variables (sexual mindfulness, sexual anxiety, and sexual self-esteem) in a path analysis model to explain the association between insecure attachment and sexual satisfaction. A community sample of 543 adults completed an online survey. Results supported our hypothesized integrative model, which explained 44.1% of the variance in sexual satisfaction and presented satisfactory fit indices. This study suggests that the association between attachment insecurities and lower sexual satisfaction could be partially explained by a proximal association with lower sexual mindfulness, which emphasizes the relevance of examining sexual mindfulness during the screening and treatment of people presenting low sexual satisfaction.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.2011808 .

Discrepancy in Dyadic Sexual Desire Predicts Sexual Distress over Time in a Community Sample of Committed Couples: A Daily Diary and Longitudinal Study

In long-term relationships, sexual desire discrepancy (SDD) occurs frequently between partners. For many, this discrepancy is persistent and significant, and a source of distress. However, the dynamics of SDD in couples and, specifically, its implications for sexual distress have received scant empirical attention. This study examined the associations between SDD and sexual distress from one day to the next and over a 12-month span, in a community sample of 229 same-sex/gender and mixed-sex/gender couples. Two datasets were collected: A 35-day daily diary and a 12-month longitudinal survey. In both, dyadic sexual desire and sexual distress were measured, and SDD was calculated as the absolute value of the difference in sexual desire between partners. Directional associations between SDD at one time point and sexual distress at the next time point were assessed using multilevel, 2-pane autoregressive cross-lagged models, controlling for within-variable changes, dependencies between partners, and partner age. Results were consistent with the study's hypotheses: Couples' SDD on one day predicted sexual distress on the next day. Similarly, SDD at baseline predicted sexual distress 12 months later. Participant gender, partner gender, and couple type did not significantly moderate these associations, nor did differentiating partners based on higher and lower average sexual desire. The reverse associations (i.e., sexual distress predicting SDD) were non-significant. The associations' directionality and the fact that they remained significant over days and months were consistent with the proposal that SDD is a precursor of sexual distress. The present study provides support for dyadic conceptualizations of sexual desire. Clinically, findings suggest that therapeutic approaches should address issues with sexual desire and sexual distress by focusing not on the individual, but on the couple.

Multidimensional Sexual Well-being Scale for Older Adults: Validity Evidence from a Polish Sample

Here, we report the results of a Polish adaptation of the Multidimensional Sexual Well-being Scale (MSWBS) for older adults. The MSWBS is a short self-report scale for assessing the five dimensions of an individual's sexual well-being: frequency of caressing, sexual intimacy, sexual compliance, sexual satisfaction, and sexual distress. The aim of our adaptation was to examine the utility of the scale in a country with conservative views on the sexuality of older people, which will help health care providers and researchers to better understand the sexual needs of older people. The study included 507 participants, aged 60-92. We found the reliability of the scale to be satisfactory (Cronbach's alpha = .71-.87). Confirmatory factor analysis (CFA) showed a good fit of the data to a five-factor model. This study demonstrates that the MSWBS-PL is connected to general life satisfaction and diversity of sexual activity, confirming the scale's validity.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.1991535.

Attachment Orientations, Sexual Behavior, and Relationship Satisfaction in Young, Mixed-Sex Couples: A Dyadic Approach

We examined if and to what degree attachment orientations of both partners moderate the link between different behavioral characteristics of the sexual relationship and relationship satisfaction in the early stages of romantic attachment. A sample of 126 young, mixed-sex couples (N = 252, mean age = 23.3, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) filled out questionnaires assessing attachment anxiety and avoidance, a range of intimate and sexual couple behaviors, and relationship satisfaction. Exploratory factor analyses revealed two behavioral factors: Intimate behavior (kissing, cuddling) and sexual behavior (oral sex, coitus). Although frequency of sexual behavior was not directly associated with relationship satisfaction, we found a significant positive interaction with anxious attachment, indicating that higher frequencies of sexual behavior were associated with greater self-reported relationship satisfaction in more anxiously attached individuals. Exploration of the effects of intimate behaviors on relationship satisfaction revealed significant positive associations as well, but, unexpectedly, only for avoidantly attached individuals. These results call for a dyadic and differentiated approach to the study of sexuality in couples and are in line with prior findings that the impact of intimate and sexual behaviors on relationship satisfaction varies depending on attachment orientations.

The Health Benefits of Sexual Expression

Objective

Sexual activity is a fundamental human function with short-term and long-term emotional, social, and physical benefits. Yet within healthcare, sexuality has been marginalized and many HCPs are unaware of its beneficial implications for immediate and long-term health.

Methods

To challenge this assumption we combined the data that already had been collected by the authors with an extensive search of articles on the various health benefits of sexual activity. The results of this process are displayed according to short-term, intermediate-term, and long-term benefits with some explanation about potential causal relationships.

Results

For the time being, it cannot yet be proved that "good sex promotes good health" since good health also favors good sex.

Conclusions

Despite lacking such convincing evidence, the article concludes with recommendations for the relevant professions. The balance of research supports that sexuality anyhow deserves greater attention among HCPs and that sexuality research needs better integration within health research.

Women's sexual satisfaction in the context of midlife relationships: examining an ecological model

This study examined an ecological model of sexual satisfaction in midlife women. Participants were 1,411 midlife women who participated in the Midlife in the United States (MIDUS) study. Regression analyses were used to test the hypothesis that an ecological model - including the macrosystem level variable of religiosity, the exosystem level variables of SES, social support, and parenthood, the mesosystem level variables of affectual solidarity, relationship length, and sexual functioning, and the microsystem level variables of age, negative affect, and physical health - would together predict sexual satisfaction. Partial support for an ecological understanding of sexual satisfaction was found.

Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study

BACKGROUND

Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality.

OBJECTIVE

To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges.

METHODS

Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author's institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data.

RESULTS

21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients' experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in.

CONCLUSION

This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.

Associations among Sexual Activity, Relationship Types, and Health in Mid and Later Life

Despite a growing amount of research on sexuality in mid and later life, relatively little is known about the associations among sexual activity, relationship types, and health. This paper analyzes data from the Survey of Health, Ageing and Retirement in Europe (SHARE) for the subpopulation of respondents residing in the Czech Republic (N = 1304, 49% women; M_age = 69.1, SD_age = 8.0). Hierarchical ordinal regression models showed that persons who stayed in newly formed or less traditional relationship types, such as dating, Living-Apart-Together (LAT) relationships, and cohabitation, reported a higher frequency of sexual activity than married people. Overall, the dating and LAT relationship group displayed the highest sexual frequency and the lowest incidence of chronic diseases. People in marriages and cohabitation were comparable with respect to the number of chronic diseases. The findings suggest that sexual activity is intertwined with later-life relationships and sexual frequency may vary according to the relationship type. Future research may benefit from probing the extent to which partnered sex is important for maintaining bonds between older partners with separate households.

Is Reproductive Orientation Associated with Sexual Satisfaction Among Partnered U.S. Women?

Little is known about how "reproductive orientation" (i.e., trying to get pregnant, ambivalent about pregnancy, trying to avoid pregnancy, or having had a sterilization surgery) is associated with sexual satisfaction among women of childbearing age. Using data from the National Survey of Fertility Barriers (N = 2811), we examined the association of reproductive orientation with sexual satisfaction, adjusting for relationship characteristics including union type (cohabitation versus marriage), quality, and length; infertility history; and demographic characteristics including age, parity, and race/ethnicity. Results indicated that women who were ambivalent or trying to get pregnant reported significantly higher levels of sexual satisfaction than women who were sterile in the unadjusted model, but not in the models that included relationship quality. The association of reproductive orientation and sexual satisfaction depended upon relationship quality; among women with lower relationship quality, "trying" was associated with higher, and among those with higher relationship quality, with lower sexual satisfaction.

One Line of Sexual Decline? Growth Mixture Modeling for Midlife Sexual Satisfaction

Most research has shown that sexual satisfaction in long-term relationships tends to decline over time. Studies showing the average trajectory, however, are limited by only assessing one slope. With longitudinal data from the Flourishing Families Project, Marital Instability Dataset, and the Iowa Youth and Families Project, we utilized growth mixture modeling to assess what trajectories of sexual satisfaction exist in midlife marriages. In the three samples (one individual, two dyadic), we found clear evidence for heterogeneous sexual satisfaction trajectories, for both wives and husbands. Through the datasets, we found some trajectories did decline over time. We also found stably high, stably medium, stably low, and some trajectories that showed an increase in sexual satisfaction over time. Overall, trajectories were similar for wives and husbands, though some classes had one partner with variability while the other was stable, some classes had trajectories with wives having higher sexual satisfaction than husbands, and some classes had trajectories with husbands having higher sexual satisfaction than wives. Demographic variables were not strong distinguishers of these differing trajectories. Both marital satisfaction and perceived marital stability trajectories (based on sexual satisfaction classes) generally had similar patterns to sexual satisfaction trajectories, with a few exceptions. Both marital satisfaction and perceived marital stability were less likely to significantly change over time, have discrepancies between wives and husbands, and have either low marital satisfaction or high perceived marital instability, even if sexual satisfaction was low. These data can help couples recognize various possibilities for sexual satisfaction over time, perhaps helping them to avoid cultural myths of inevitably declining sexual satisfaction.