The link between sexual satisfaction and subjective well-being: a longitudinal perspective based on the German Ageing Survey

Sexual Well-Being and Aging Patterns: Findings of a Cluster Analysis among Older Adults in Portugal and Spain

OBJECTIVES

From a cross-cultural perspective, aging well may encompass pertinent challenges in terms of adjustment, sexual well-being, and satisfaction with life in the late years. Considering the paucity of empirical data concerning cultural diversity of experiencing aging, this study aims to help fill this gap by assessing the specific patterns of sexual satisfaction, adjustment to aging (AtA), and life satisfaction with life (SwL) of older adults in Portugal and Spain.

METHODS

This cross-national study included 326 older adults, age 65 and older, from Portugal and Spain. Five instruments were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale-Short (NSSS-S); (d) Mini-Mental State Exam; and (e) Sociodemographic, Health and Lifestyle questionnaire. K-means cluster analysis was employed to identify and characterize the clusters considering adjustments to aging, sexual satisfaction, and life satisfaction. One-way ANOVAs were conducted to analyze differences in sexual well-being among clusters.

RESULTS

Findings indicated three clusters, which explained 77.7% (R-sq = 0.777) of the total variance: Cluster 1: "Most skilled" (n = 26, 8.0%), Cluster 2: "Least adjusted" (n = 115, 35.3%), and Cluster 3: "Aging strivers" (n = 185, 56.7%). Participants in Cluster 1 were mostly Portuguese, with high levels of AtA, sexual satisfaction, and SWL. Conversely, Cluster 2 included mostly Portuguese participants with moderate sexual satisfaction and lower levels of AtA and SwL. Participants from Cluster 3 were mostly Spanish, with moderate levels of AtA and reduced sexual satisfaction and SwL.

CONCLUSIONS

This study innovates by exploring the elaborate interplay among sexual satisfaction, AtA, and SwL in a cross-cultural perspective, with implications for tailoring interventions, service planning, development, and evaluation of culturally diverse older populations.

The Influence of the COVID-19 Pandemic on the Sexual Lives of Polish Young Adults

Background: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic's impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). Methods: The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. Results: Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. Conclusions: The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences.

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.

Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men

The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.

The associations of sexual desire, daily stress, and intimacy in gay men in long-term relationships

We investigated the associations between daily stress, sexual desire and intimacy in gay men in long-term relationships. A daily diary method of data collection was used. Twenty-two adult participants completed brief questionnaires ten times per day during seven consecutive days. Multilevel regression analyses revealed significant negative associations of daily stress with sexual desire (p = 0.003); higher stress came with lower levels of sexual desire, and vice versa. The hypothesized moderation effect of the associations of stress with sexual desire by intimacy was found significant (p = 0.003). However, the effect was not as predicted: at higher levels of intimacy the negative effect of stress on sexual desire was shown to be stronger than at lower levels. Most temporal associations of stress and intimacy with sexual desire were not significant. Nevertheless, the present findings implicate that daily stress and intimacy are important factors in sexual functioning of gay men in long-term relationships.

Psychedelics and sexual functioning: a mixed-methods study

Do psychedelics affect sexual functioning postacutely? Anecdotal and qualitative evidence suggests they do, but this has never been formally tested. While sexual functioning and satisfaction are generally regarded as an important aspect of human wellbeing, sexual dysfunction is a common symptom of mental health disorders. It is also a common side effect of selective serotonin reuptake inhibitors (SSRIs), a first line treatment for depression. The aim of the present paper was to investigate the post-acute effects of psychedelics on self-reported sexual functioning, combining data from two independent studies, one large and naturalistic and the other a smaller but controlled clinical trial. Naturalistic use of psychedelics was associated with improvements in several facets of sexual functioning and satisfaction, including improved pleasure and communication during sex, satisfaction with one's partner and physical appearance. Convergent results were found in a controlled trial of psilocybin therapy versus an SSRI, escitalopram, for depression. In this trial, patients treated with psilocybin reported positive changes in sexual functioning after treatment, while patients treated with escitalopram did not. Despite focusing on different populations and settings, this is the first research study to quantitively investigate the effects of psychedelics on sexual functioning. Results imply a potential positive effect on post-acute sexual functioning and highlight the need for more research on this.

A Systematic Review on Psychological Interventions for Sexual Health in Older Age

Objectives

The present review aims to identify the existing evidence on outcome-treatment studies of psychological sexual health interventions in older age.

Methods

A systematic search was conducted for studies published until October 2022. Data search was conducted on EBSCO, MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials databases.

Results

From 30,840 screened records, 12 reports were selected. Results were grouped into four categories according to the intervention that was implemented.

Conclusions

Despite results presenting some bias concerns, this review suggests that educational and cognitive-behavioral approaches seem to be effective for promoting sexual health in older age.

What Is the Mediating Role of Communication Skills and Sexual Satisfaction between Job and Life Satisfaction of Healthcare Employees?

There are three areas of harmony in human life that are related to each other: "work environment", "love-to be loved-sexual area" and "social environment". Incompatibility and dissatisfaction in one area can also affect other areas. Therefore, the aim of this study is to examine the relationship between job satisfaction, life satisfaction, communication, and sexual satisfaction of healthcare employees. The data collected by questionnaires from 394 employees working in university hospitals in Turkey were analysed using SPSS and AMOS programs. The findings show that there is a positive relationship between the job and life satisfaction of employees of healthcare organizations. Additionally, the findings revealed that communication skills and sexual satisfaction have a mediating role between job satisfaction and life satisfaction of employees in healthcare organizations. Life satisfaction, sexual satisfaction, and relationships are some of the factors that should be considered by healthcare organizations. It would be beneficial to employees and the public if health policy makers implemented programmes to enhance job satisfaction.

Factors influencing the quality of sexual life in the older adults: A scoping review

Objective

Older people are often considered asexual, but sex is still important for older adults. So, this review aimed to analyze relevant studies on the sexual life of older adults to clarify factors, and provide a basis for their quality of sexual life.

Method

A scoping review was performed according to Arksey and O'Malley's framwork, aiming to identify eligible research studies in PubMed, Web of Science, CINAHL, and PsycINFO, Cochrane Library, and Scopus databases. Peer-reviewed articles published in Chinese or English language from January 2012 to April 2022 were retrieved. All of identified studies were screened, extracted, and analyzed independently by two researchers.

Result

A total of 7,374 studies were retrieved, and 13 eligible studies were finally included. The factors affect the sexual quality of life in older adults that included physiological, sociocultural, and health factors and being affected by marital relationships and a lack of relevant knowledge.

Conclusion

The factors that affect the quality of old people's sex life interact and influence each other. Medical and health professionals can assist with the improvement of sexual health.

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.

Sexual Orientation and Psychosocial Factors in Terms of Loneliness and Subjective Well-Being in Later Life

BACKGROUND AND OBJECTIVES

The aim of our study was to fill the gap in knowledge regarding the association between sexual orientation and psychosocial outcomes (loneliness and subjective well-being) based on nationally representative samples.

RESEARCH DESIGN AND METHODS

Cross-sectional data collected in 2017 were taken from a nationally representative sample of individuals in the second half of life (>40 years) in Germany (n = 4,785, average age 66.4 years, standard deviation [SD]: 10.5 years). Outcomes were assessed using well-established tools (life satisfaction: Satisfaction with Life Scale; positive and negative affect: Positive and Negative Affect Schedule; loneliness: De Jong Gierveld Loneliness Scale). Sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual, and other). Analyses were adjusted for socioeconomic factors, lifestyle-related factors, and health-related factors.

RESULTS

In total, around 7.8% of respondents belonged to sexual minorities. Adjusted for various several socioeconomic, lifestyle-related and health-related covariates, linear regressions showed that sexual minority older adults reported higher loneliness scores (β = 0.07, p < .05), whereas sexual orientation was not associated with subjective well-being (life satisfaction, as well as positive and negative affect). Furthermore, our analysis showed that gender, age, marital status, and depressive symptoms were consistently associated with loneliness and subjective well-being.

DISCUSSION AND IMPLICATIONS

In accordance with minority stress theory, our study showed that sexual minority older adults report higher loneliness scores. This finding is important as loneliness has become widely acknowledged as a new geriatric giant, which could increase, for example, the risk of morbidity and mortality. Moreover, reducing loneliness is important for successful aging.

Development of a Japanese Version of the Index of Sexual Satisfaction for Use in Couples with Young Children

The occurrence of sexual dysfunction in couples after childbirth is well recognized, yet sexual satisfaction in couples with young children (CYC) has received little research attention. This study sought to enable this construct to be measured by developing and validating a Japanese version of the Index of Sexual Satisfaction (ISS) in CYC. Data were collected using a self-administered questionnaire. Scale construction and validation were conducted using two independent samples drawn from 316 mothers and 272 fathers in Japan who had at least one child aged 6 or younger. Two underlying factors were identified using exploratory factor analysis: sexual satisfaction, measured by eight items, and sexual dissatisfaction, measured by three. Polychoric ordinal alpha coefficients indicated the reliability of the resulting scale (overall: 0.89, factor 1: 0.89, factor 2: 0.78), and confirmatory factor analysis and testing supported its validity, showing good model fit (goodness of fit index: 0.984, root mean square residual: 0.062) and satisfactory composite reliability (scale: 0.93, factor 1: 0.90, factor 2: 0.81) and average variance extracted (all ≥0.5). The Japanese version of the ISS for Couples with Young Children will be useful for investigating sexual satisfaction, which is essential to marital stability.

Do Sexually Satisfied Individuals Think That They Live Longer? Results from the German Ageing Survey

The aim of this study was to determine the association between sexual satisfaction and expected longevity among middle-aged and older adults (also stratified by sex). Data were taken from the German Ageing Survey (year 2011; n = 3231)—a nationally representative sample of community-dwelling individuals ≥ 40 years in Germany. A widely used question was used to quantify sexual satisfaction. Furthermore, the expected life expectancy served as an outcome measure. After adjusting for various covariates, multiple linear regressions showed that sexual satisfaction was associated with higher expected longevity among the total sample (β = 0.28, p < 0.05). Moreover, it was associated with higher expected longevity among women (β = 0.48, p < 0.05), but not men. In conclusion, adjusting for several covariates, our results showed that there is an association between sexual satisfaction and higher expected longevity, particularly in women. Efforts to increase sexual satisfaction may thus also contribute to expected longevity which, in turn, can be beneficial for actual longevity.

A systematic review of sexual health and subjective well-being in older age groups

Objectives.

This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years).

Methods.

A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as “sexual health” or “sexuality” and “well-being” and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being.

Results.

A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dissertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being.

Conclusions.

This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.

Climacteric status is associated with sexual dysfunction at the age of 46 years: a population-based study

OBJECTIVE

Increasing age and menopausal transition increase the risk of sexual dysfunction. Sexual dysfunction is common in women experiencing menopause before the age of 40 years, whereas evidence on sexual function in women experiencing menopause in their mid-40s is scarce. We aimed to investigate sexual function in 46-year-old women in relation to their menopausal status.

METHODS

This study cross-sectionally evaluated sexual function of women in a prospective population-based Northern Finland Birth Cohort 1966 (NFBC1966). A 46-year follow-up study of NFBC1966 included a broad questionnaire evaluating health, lifestyle, and life situation, as well as menstrual history and sexual function, and blood sampling analysis including follicle stimulating hormone and free androgen index (FAI). The participants were divided into two groups by their menopause status, defined by follicle-stimulating hormone and menstrual history. We performed logistic regression models in which parameters of sexual function were dependent factors and climacteric status, self-reported health, FAI, relationship status, smoking, and education level were independent variables.

RESULTS

The study population included 2,661 women. In regression models, more advanced climacteric status was associated with higher frequency and difficulty level of low sexual desire and vaginal dryness (odds ratios with 95% confidence intervals: 2.80 [2.12-3.71], 3.22 [2.43-4.27], 3.83 [2.82-5.20], 3.75 [2.75-5.12], respectively), lower frequency of sexual thoughts (1.34 [1.02-1.75]), and higher frequency of problems with intercourse (2.35 [1.51-3.66]). Lower FAI and poorer health were associated with impaired sexual function.

CONCLUSIONS

The current study suggests that women experiencing menopausal transition in their mid-40s are at risk of impaired sexual function.

Mental Health Service Use Among Middle-aged and Older Lesbians: Application of Andersen's Health Service Use Model

Guided by Andersen's Health Service Use Model, this study examined the predisposing, enabling, and need factors of MH service use among middle-aged and older lesbians. Data were collected from 455 lesbians ages 50 and over through a national online survey. Ordered logistic regression was conducted to examine the predictors of mental health counseling use. Results show that those who were widowed and single were more likely to participate in MH counseling than those who were partnered. Being out to healthcare providers, the number of mental health conditions, and being unsatisfied with sex were positively associated with participation in MH counseling. The study highlights the need to tailor MH service among those who are widowed and single and the importance of enhancing MH referral and integrating MH service in primary care for this population. Further, sexual health should be treated as an integral part of psychological wellbeing in MH treatment.

It is not just about sex: viewpoints of men with inflammatory arthritis on the overall impact of the disease on their sexual health

Objectives

Sexual health is defined as a state of physical, emotional, mental and social well-being in relation to sexuality. The impact of inflammatory arthritis (IA) on male sexual health has been mainly studied focusing on erectile function, one of the physical components of sexual health. Our objective was to describe the viewpoints among men with IA in the Netherlands on the overall impact of IA on their sexual health.

Methods

Q-methodology, a mixed methods approach to systematically study subjectivity was used. Adult men diagnosed with IA ranked 34 opinion statements about potential impacts of IA on their sexual health and were interviewed. By-person factor analysis was used to identify common patterns in the rankings, which were interpreted as viewpoints. Data from the interviews were used to verify and adjust the interpretations.

Results

30 men (22–77 years) with IA were included. The analysis revealed three viewpoints. Men with the viewpoint ‘Arthritis negatively affects my sexual health’ experience a dramatic impact on all components of sexual health. In viewpoint ‘I am keeping up appearances’, IA negatively impacts sexual health but a distinguishing coping mechanism could mask a more serious negative impact. Men with the viewpoint ‘I am satisfied with my sexual health’' experience no significant impact of IA on their sexual health.

Conclusions

We identified three viewpoints on the impact of IA on male sexual health, two revealed a negative influence that goes beyond the physical act of sex. IA can severely affect the emotional, mental and social components of sexual health.

#Fitspiration on Instagram: The effects of fitness-related images on women's self-perceived sexual attractiveness

The present study looks at how exposure to Instagram #fitspiration images affects self‐rated sexual attractiveness among women. An experimental pre‐test/post‐test control group design was implemented. Four hundred and forty‐two female undergraduate students (mean age of 22.06 ± 2.15 years) were randomly exposed to either fitspiration (N = 233) or travel Instagram images (N = 209). Well known self‐report measures of Instagram use, body satisfaction, and self‐perceived sexual attractiveness were completed. The results showed that viewing fitspiration models on Instagram was more likely to lower self‐perceived sexual attractiveness among women than travel images. This effect was mediated by body satisfaction. The present findings built upon previous research that focuses on the detrimental effects of exposure to appearance‐focused Instagram profile images on body image satisfaction by showing that exposure to Instagram fitspiration might also influence women perceived sexual attractiveness. Negative consequences of social media exposure on women’s sexual well‐being need to be further investigated.

Sexual satisfaction of middle-aged and older adults: longitudinal findings from a nationally representative sample

BACKGROUND

whilst previous studies have investigated the determinants of sexual satisfaction (i) using longitudinal data or (ii) among older adults, only a few studies have done both at the sametime.

OBJECTIVE

the purpose of this study was to investigate the determinants of sexual satisfaction longitudinally among middle-aged and older adults.

DESIGN

nationally representative longitudinal study (German Ageing Survey-DEAS).

SETTING

community-dwelling individuals in Germany. Data drawn from three waves (2002, 2008, 2011).

SUBJECTS

individuals aged 40-95 (36.9% age group 65+). At wave 2 in the year 2002, n = 3,843 individuals took part.

METHODS

well-established and widely used scales were used to quantify the independent variables. We included variables such as sociodemographic factors, self-rated health, physical functioning, depression and loneliness in our analysis. Sexual satisfaction was our outcome measure. Results were stratified by age (40-64, 65+). To take into account the multilevel data structure, we used random coefficient models.

RESULTS

random-effects regressions showed that increased sexual satisfaction was consistently associated with the following variables in both age groups: lower number of physical illnesses, β = -0.03, P < 0.001 (betas coefficients given for individuals 65 years and over); better self-rated health, β = -0.06, P < 0.001; absence of depression, β = -0.16, P < 0.01; and higher importance of sexuality and intimacy, β = 0.08, P < 0.001. Moreover, sexual satisfaction was associated with having a partner: β = 0.16, P < 0.001; living with a partner in the same household, β = 0.26, P < 0.001; and a lower score of loneliness, β = -.28, P < 0.001. In contrast, sexual satisfaction was, for example, not associated with cognitive functioning.

CONCLUSIONS

the most surprising findings were that among both middle-aged and older adults, almost the same determinants (with exception of sociodemographic factors) were associated with satisfaction with sexlife.

Effects of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being in postoperative patients with early-stage cervical cancer: A randomized controlled trial

BACKGROUND

Sexual dysfunction is a common long-term complication of cervical cancer and its treatment. However, due to traditional Chinese culture, there are few studies on interventions to improve sexual function in China.

OBJECTIVES

To evaluate the effectiveness of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being amongst postoperative patients with early-stage cervical cancer.

DESIGN

A randomized controlled trial.

SETTINGS AND METHODS

Patients who had undergone radical hysterectomy for early-stage cervical cancer and were followed up in gynaecological clinics were recruited via convenience sampling from three tertiary hospitals in Chongqing, China. Patients who met the inclusion criteria and agreed to participate (N = 91) were randomly assigned to a nurse-led positive psychology intervention (intervention group, n = 46) or usual care (control group, n = 45). The Female Sexual Function Index, Self-rating Depression Scale and Index of Well-being were used to assess sexual function, depression and subjective well-being, respectively, at baseline and 3 and 6 months after the intervention. Data were analysed by the chi-square test, Mann-Whitney U test, t-test and Pearson correlation analysis.

RESULTS

Compared with participants in the control group, participants in the intervention group showed significant improvements in sexual function (mean difference [MD]: -3.95, P = 0.005 at 3 months post-intervention; MD: -4.36, P = 0.001 at 6 months post-intervention). In addition, at 3 and 6 months after the intervention, the number of patients with improvements in their levels of depression and well-being in the intervention group was higher than that in the control group (P<0.05). The Pearson correlation analysis results showed that there was a negative correlation between sexual function and level of depression in patients (r =-0.612, P<0.001) and that sexual function was positively correlated with subjective well-being (r = 0.638, P<0.001).

CONCLUSION

The intervention group experienced significant improvements in sexual function, depression and subjective well-being. These findings suggest that a nurse-led positive psychology intervention should be implemented for postoperative patients with early-stage cervical cancer.