Partners Experience Consequences, Too: A Comparison of the Sexual, Relational, and Psychological Adjustment of Women with Sexual Interest/Arousal Disorder and Their Partners to Control Couples

Trajectories of sexual well-being and links with grief after a recent pregnancy loss: a dyadic longitudinal study

BACKGROUND

Pregnancy loss affects 1 in 4 women and is linked with poorer overall health and relationship outcomes. Despite sexual well-being's importance to health, how sexual well-being changes across time after a pregnancy loss and what might predict such changes, like perinatal grief, have never been examined, leaving practitioners and couples without knowledge of what to expect.

AIM

We aimed to examine (1) how sexual satisfaction, sexual desire, sexual distress, and perinatal grief change from 10 to 25 weeks postloss for both couple members; and (2) if perinatal grief levels at 10 weeks postloss predict sexual well-being trajectories.

METHODS

Women and gender-diverse individuals who were pregnant when a pregnancy loss occurred (within the last 4 months) and men, women, and gender-diverse partners who were not pregnant (N = 132 couples) independently completed 4 monthly assessments of sexual well-being and perinatal grief.

OUTCOMES

Outcomes included sexual satisfaction (Global Measure of Sexual Satisfaction), sexual desire (Sexual Desire Inventory), sexual distress (Sexual Distress Scale-Short Form), perinatal grief (Perinatal Grief Scale).

RESULTS

Dyadic growth curve modeling indicated that, from 10 to 25 weeks postloss, both couple members' sexual satisfaction increased, and their sexual desire remained stable; sexual distress decreased for partners but remained stable for individuals who were pregnant; and both couple members' perinatal grief decreased. Perinatal grief levels at 10 weeks postloss did not predict sexual well-being trajectories over time.

CLINICAL IMPLICATIONS

Given sexual well-being's dynamic nature, clinicians should regularly discuss sexuality with both couple members after pregnancy loss. During such discussions, clinicians could reassure couples about their sexual relationship's recovery by sharing that, on average, sexual satisfaction, sexual desire, and sexual distress tend to improve or stay the same (rather than worsen) from 10 to 25 weeks postloss. They can also share that perinatal grief tends to decrease during this time and is unrelated to trajectories of sexual satisfaction, sexual desire, and sexual distress.

STRENGTHS AND LIMITATIONS

This is the first study, to our knowledge, to examine how sexual well-being changes across time after a pregnancy loss and perinatal grief's role in such changes. The results may not generalize broadly, as most couples were in mixed-gender/sex relationships, identified as White, and were relatively affluent.

CONCLUSION

From 10 to 25 weeks postloss, both couple members tend to experience improvements in their overall sexual well-being and declines in their perinatal grief. Early perinatal grief levels and subsequent sexual well-being trajectories are seemingly unrelated.

Attraction Toward One's Partner is Associated with Sexual Desire, Satisfaction, and Distress Among Couples Coping with Sexual Interest/Arousal Disorder

The sexual incentive motivation model suggests that attractive stimuli activate the sexual response system. Attraction toward one's partner has been linked to greater sexual satisfaction, but no quantitative studies have examined its links to sexual desire or distress among those with sexual dysfunction. We examined associations between daily attraction toward one's partner and sexual satisfaction, desire, and distress for individuals with Sexual Interest/Arousal Disorder (SIAD) and their partners. Participants (N = 227 couples) completed daily online surveys measuring attraction for one's partner, sexual desire, satisfaction, and distress. Multilevel models showed that on days when women and gender diverse individuals with SIAD reported higher attraction for their partner, they and their partners reported higher sexual satisfaction and desire, and their partners reported lower sexual distress. On days when partners reported higher attraction, both they and participants with SIAD reported higher sexual desire and partners reported lower sexual distress; however, women and gender diverse individuals with SIAD reported higher sexual distress. Daily fluctuations in attraction may be important for daily fluctuations in sexual wellbeing among couples coping with SIAD. Findings may inform novel treatment targets for SIAD.

Sexual Synchrony During Partnered Sex

There is growing interest in understanding how sexual arousal unfolds between partners, and how this may change over the course of a relationship and in the face of sexual distress. To capture the variable, dynamic, and dyadic nature of sexual responding, this paper introduces the concept of sexual synchrony, defined as the temporal, reciprocal, and coordinated interchange between partners' subjective and genital sexual arousal. Sexual synchrony is a key mechanism for understanding how partners experience and adapt their sexual arousal responses as they evolve over time. Its relevance lies in examining the mechanisms that may disrupt and facilitate synchrony and exploring how it may contribute to sexual well-being by enabling partners to mutually regulate their sexual arousal within and across sexual interactions. The paper also discusses how sexual synchrony may evolve throughout relationship development and its potential role in sexual problems, offering valuable insights into improving sexual relationships. Suggestions are provided for future research, together with a discussion of the methodological and statistical issues involved when examining sexual dynamics. Understanding how partners jointly regulate their sexual responses allows the development of dyadic models of sexual arousal which will inform treatments for improving couples' (sexual) well-being. The study of sexual synchrony also exemplifies the importance of translational research that is relevant across disciplinary borders.

Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women

Background

Psychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them.

Methods

In a cross-sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress.

Results

Across the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms.

Discussion

Overall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems.

Under Pressure: Men's and Women's Sexual Performance Anxiety in the Sexual Interactions of Adult Couples

Most research on sexual performance anxiety has focused on men's experiences and links to erectile functioning and premature ejaculation, with little research attention given to women's experiences or to relationship dynamics. At times, sexual performance anxiety has been examined in the context of dysfunction, but rarely as a focus in its own right. Study 1 asked 51 participants reporting sexual performance anxiety to describe the cognitive and affective components of their experiences, coping strategies, and perceived impact on their relationship using open-ended responses from online surveys. Through directed content analysis, Study 1 revealed that men and women experience a range of cognitive and affective processes with predominant feelings of inadequacy, and overall promoting more approach coping strategies. Study 2 used quantitative surveys to examine whether sexual performance anxiety was associated with higher sexual distress and lower sexual and relationship satisfaction in a sample of 228 community-based couples. Guided by the Actor-Partner Interdependence Model, multilevel modeling analyses indicated that higher sexual performance anxiety was linked to higher sexual distress and lower sexual and relationship satisfaction in both individuals and their partners. This work advances knowledge of sexual performance anxiety to women's experiences, not just men's, and to couples' experiences. Effective treatment for those suffering from this anxiety may incorporate education around sexual beliefs and expectations.

Examining the Treatment Relevance of the Approach-Avoidance Motivation Model for Sexual Interest/Arousal Disorder in Women and Non-Binary Individuals

Up to 8% of cisgender women meet diagnostic criteria for Female Sexual Interest/Arousal Disorder (SIAD), a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, yet treatment research for SIAD remains scarce, particularly for transgender women and non-binary individuals. The treatment relevance of the Approach-Avoidance Motivation Model for SIAD was tested in a sample of cis- and transgender women, and non-binary individuals, who either met criteria for SIAD (n = 45) or reported no sexual concerns (n = 76). Participants completed an online writing exercise previously found to increase the salience of approach or avoidance sexual motivation, or a control writing task. At baseline, and 72 hours following the writing task, they completed measures of sexual motivation, sexual desire, and partnered sexual behaviors. Participants with SIAD in the approach condition significantly increased in approach sexual motivation immediately following the manipulation but these improvements were not maintained 72 hours later. Compared to baseline, participants who wrote about an approach-motivated sexual encounter experienced a decrease in sexual desire and partnered sexual behaviors, while participants who wrote about an avoidance-motivated sexual encounter had decreased motivation but increased partnered sexual behaviors 72 hours following the manipulation. Overall, findings did not show support for the relevance of the approach-avoidance motivation manipulation for SIAD. Future studies might explore novel ways of targeting sexual motivation to address sexual difficulties.

Feasibility of a Cognitive-Behavioral Couple Therapy Intervention for Sexual Interest/Arousal Disorder

Female sexual interest/arousal disorder (SIAD) is strongly influenced by interpersonal factors; however, there are no empirically-supported, couple-based sex therapy interventions for this disorder. This pre-registered study tested the feasibility of a cognitive-behavioral couple therapy (CBCT) intervention for SIAD. A sample of 19 couples in which a female partner was diagnosed with SIAD completed a 16-session CBCT intervention delivered online by therapists with PhD-level training in clinical psychology. Women with SIAD (Mage = 43.47, SD = 12.76) and their partners (Mage = 43.74, SD = 11.68) were in long-term relationships (M = 13.86, SD = 9.15). The CBCT sessions were video recorded and independently coded for treatment manual adherence and therapists reported on the completion of in-session and homework exercises. Participants completed measures of treatment satisfaction following the intervention as well as dyadic sexual desire (women with SIAD only) and sexual distress prior to treatment, post-treatment, and at 6 months follow-up. The therapists exhibited a high level of adherence to the treatment manual and couples had high rates of homework completion. Moreover, couples had low dropout rates, high attendance rates, and reported moderately high global treatment satisfaction and high satisfaction with virtual care. Women with SIAD reported large improvements in dyadic sexual desire and sexual distress from pre-treatment to post-treatment and pre-treatment to 6-month follow-up. Partners reported moderate and small improvements in sexual distress for post-treatment and 6-month follow-up, respectively. Results support the feasibility of an evidence-based CBCT intervention for SIAD and the need for a randomized clinical trial of the intervention.

Motivation When Desire Is Low: Associations Between Sexual Motivation and Sexual Intimacy, Sexual Satisfaction, and Sexual Distress for Men with Hypoactive Sexual Desire Disorder and Their Partners

Hypoactive sexual desire disorder (HSDD) in men, characterized by chronically low sexual desire, is associated with poor sexual well-being, such as lower sexual satisfaction and higher sexual distress. Additionally, despite their low desire, men with HSDD often report wanting sexual intimacy and validation within their sexual lives/relationships. Studies that apply self-determination theory to sexual relationships demonstrate that adopting more autonomous (e.g., engaging in sex for its inherent pleasure) and less controlled (e.g., engaging in sex for some external reward or consequence) motives for engaging in sex is associated with greater sexual well-being for both members of the couple. Given that autonomous motivation in relationships is associated with intimacy and sexual satisfaction, and lower sexual distress, having sex for autonomous reasons may allow men with HSDD and their partners to feel more sexually intimate despite their lower sexual desire, whereas having sex for controlled reasons may hinder sexual intimacy and satisfaction and augment sexual distress. In this dyadic cross-sectional study, we examined the associations between types of sexual motivation and sexual intimacy, sexual satisfaction, and sexual distress for men with HSDD and their partners (n = 64 couples). Men with HSDD who reported having sex for more autonomous reasons reported more sexual satisfaction and both partners reported more sexual intimacy. Men with HSDD who had sex for more controlled reasons had partners who felt less sexual intimacy and satisfaction, and both partners were more sexually distressed. Promoting autonomous sexual motivation and decreasing controlled motivation may help couples navigating HSDD to feel closer in their relationship, more sexually satisfied, and less sexually distressed.

Rights or Obligations: The Extent to Which Sexual Desire and Gender Roles Determine Sexual Intimacy in Romantic Relationships

The present study aims to investigate the relationship between traditional gender roles and the frequency of sexual intimacy within romantic relationships, considering sexual desire and societal norms and expectations. The study was conducted among a convenience sample of men and women in Israel. The survey included measures of sociodemographic information, traditional gender roles, sexual desire, perceived partner's sexual desire, and frequency of engaging in sex. Findings suggest that men who embraced less traditional gender roles exhibit a greater synchronization between their own sexual desire and their perceived partner's sexual desire, whereas women who embraced more traditional gender roles tend to rely more on their partners' sexual desire in their frequency of sex. These results imply that men's sexual desire plays a significant role in determining the frequency of sexual activity in romantic relationships, especially in relationships where traditional gender roles are more strongly embraced. Findings from the current study underscore the idea that the decision to engage in intimate acts may not solely hinge on individual sexual desire; rather, it operates within a broader context influenced by societal and cultural expectations. It is important to challenge societal norms to promote more balanced and equitable sexual dynamics in committed relationships.

Responsiveness in the Face of Sexual Challenges: The Role of Sexual Growth and Destiny Beliefs

Implicit--or lay--sexual beliefs have been associated with how people respond to sexual challenges in romantic relationships. People who endorse sexual destiny beliefs view a satisfying sex life as the result of finding the right partner and report poorer sexual, relationship, and personal well-being when there are sexual challenges. In comparison, people who endorse sexual growth beliefs view satisfying sexual relationships as requiring hard work and effort to maintain and tend to report high sexual, relationship, and personal well-being even when facing sexual challenges. High sexual responsiveness - being motivated to meet a partner's sexual needs - is associated with maintaining high sexual satisfaction, even when couples face sexual challenges in a relationship. In the current research, we tested whether sexual growth and destiny beliefs are associated with general and sexual responsiveness and whether the associations are moderated by the presence of sexual challenges. Across three (clinical and non-clinical) samples (N = 820) facing different types of sexual challenges (Study 1 (Mage = 31.64, SD = 8.53), clinically low sexual desire; Studies 2 (Mage = 32.63, SD = 10.19) and 3 (Mage = 32.40, SD = 9.31), unmet sexual ideals; Study 3, changes in sex since the onset of the COVID-19 pandemic), we found that sexual growth beliefs were associated with higher sexual responsiveness and perceived partner sexual and general responsiveness, even when couples were coping with sexual challenges, whereas sexual destiny beliefs were not associated with responsiveness, and at times were associated with lower sexual responsiveness and perceived partner sexual and general responsiveness. This research provides initial evidence about how implicit sexual beliefs are associated with sexual and general responsiveness when couples are coping with sexual challenges in a romantic relationship.

Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model

BACKGROUND

Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships.

AIM

This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD.

METHODS

A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3.

OUTCOMES

Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction.

RESULTS

After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01).

CLINICAL IMPLICATIONS

This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support.

STRENGTHS AND LIMITATIONS

The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners.

CONCLUSION

The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.

What Does a Pregnancy Loss Mean for Sex? Comparing Sexual Well-Being Between Couples With and Without a Recent Loss

It is unclear whether sexual well-being, which is an important part of individual and relational health, may be at risk for declines after a pregnancy loss given the limits of prior work. Accordingly, in a cross-sectional study, we used structural equation modeling to (1) compare sexual well-being levels-satisfaction, desire, function, distress, and frequency-of both partners in couples who had experienced a pregnancy loss in the past four months (N = 103 couples) to their counterparts in a control sample of couples with no history of pregnancy loss (N = 120 couples), and (2) compare sexual well-being levels of each member of a couple to one another. We found that gestational individuals and their partners in the pregnancy loss sample were less sexually satisfied than their control counterparts but did not differ in sexual desire, problems with sexual function, nor sexual frequency. Surprisingly, we found that partners of gestational individuals had less sexual distress than their control counterparts. In the pregnancy loss sample, gestational individuals had lower levels of sexual desire post-loss than their partners but did not differ in sexual satisfaction, problems with sexual function, nor sexual distress. Our results provide evidence that a recent pregnancy loss is associated with lower sexual satisfaction and greater differences between partners in sexual desire, which may be useful information for clinicians working with couples post-loss. Practitioners can share these findings with couples who may find it reassuring that we did not find many aspects of sexual well-being to be related to pregnancy loss at about three months post-loss.

Comparing Responses to Sexual Rejection and Sexual and Relationship Well-Being in Couples Coping with Sexual Interest/Arousal Disorder and Community Couples

Four distinct partner responses to sexual rejection - sexual advances that are declined by a partner - have been identified. This study assessed the frequency of these responses between and within North American couples coping with Sexual Interest/Arousal Disorder (SIAD) and community couples and - in line with the Interpersonal Emotion Regulation Model - compared the associations between responses to sexual rejection and sexual and relationship well-being across the two samples. Individuals with SIAD and their partners (n = 241) and community couples (n = 105) completed online measures of sexual rejection responses, sexual satisfaction, sexual desire, sexual distress, sexual frequency, and relationship satisfaction. Results showed that after accounting for sexual rejection frequency, individuals with SIAD and their partners reported greater resentful and insecure partner responses to sexual rejection than individuals in the community sample, and individuals with SIAD perceived less understanding responses than their own partners reported. For both groups, more understanding and less resentful and insecure responses were associated with greater sexual and relationship well-being. Clinicians might encourage couples to reflect on their rejection responses and to shift to more helpful ways of responding to sexual rejection.

Interpersonal Experiences with Persistent Genital Arousal: Connections between Symptom Disclosure, Partner Responses, and Catastrophizing on Relationship Adjustment and Symptom Severity

Increased research attention to interpersonal factors in genitopelvic pain conditions, such as vulvodynia, have led to more comprehensive understanding of couple dynamics in pain, sexual, and relationship outcomes. There has been very little examination of interpersonal factors in Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD), a distressing condition involving persistent sensations of arousal and often pain. The aims of the present study were to examine whether individuals disclose their symptoms to intimate partners and whether interpersonal variables (e.g., partner responses, symptom disclosure, and catastrophizing) are related to relationship adjustment and symptom severity. Seventy-six individuals with symptoms of PGAD/GPD participated in a one-time anonymous online survey. Over three-quarters (85.5%) of the sample disclosed their symptoms to their partners in some way. Greater supportive partner responses and lower symptom catastrophizing were related to better relationship adjustment among participants with PGAD/GPD symptoms. Greater symptom catastrophizing also predicted greater PGAD/GPD symptom severity. Partner responses were not related to PGAD/GPD symptom severity. Although interpersonal factors have been linked to symptom severity in chronic pain and genitopelvic pain conditions, the results of the current study suggest that interpersonal factors may play a slightly different role in PGAD/GPD symptom experiences and in the conceptualization of PGAD/GPD more broadly.

Attitudes toward Help-Seeking for Sexual Problems among College Women

Prior research has indicated that 65-70% of college age women have experienced at least one sexual problem. Sexual problems are associated with higher rates of depression, anxiety, and relationship distress; however, few college age women seek professional help for sexual difficulties. The present study used the Theory of Planned Behavior to explore how adherence to traditional feminine norms and self-stigma are associated with intention to seek professional psychological help for a sexual difficulty. Results of structural equation modeling analysis demonstrated approximate fit in a sample of 259 college women. The structural model indicated that self-stigma and stronger endorsement of specific feminine gender norms (i.e., romantic relationship, sexual fidelity, sweet and nice) were found to be associated with less intention to seek help for a sexual problem. We discuss future research directions and implications for clinical services.

A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults

Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.

Will you be happy for me? Associations between self-reported, perceived, and observed responses to positive events and sexual well-being in cohabiting couples

Whereas greater levels of intimacy have been shown to promote couples' sexual well-being, recent theories suggest that satisfying sex is maintained via the capacity to encourage the partner's individuality, while remaining intimately connected. Responses to capitalization attempts (i.e., the disclosure of a positive personal event) provide an opportunity to strengthen both the couple's intimacy and each partner's autonomy. Although responses to capitalization attempts are linked to couples' greater relationship adjustment, very little is known about their relation to couples' sexual well-being. The aim of this study was to examine the associations between self-reported, perceived, and observed responses to capitalization attempts and sexual satisfaction, sexual distress, and sexual function in 151 cohabiting couples who participated in a filmed discussion in the laboratory. They also completed self-report questionnaires pertaining to their responsiveness and to that of the partner during the discussion, as well as their sexual well-being. Results indicated that one's higher levels of self-reported and partner-perceived active-constructive responses (enthusiasm/elaboration) during the discussion were associated with one's own greater sexual satisfaction. Higher levels of perceived passive-constructive responses (quiet but interested) from one's partner were associated with one's own lower sexual satisfaction, and one's higher levels of self-reported and perceived passive-destructive responses (lack of interest/self-focus) were associated with one's own greater sexual distress. Finally, higher levels of observed active-destructive responses (undermines/denies the positive nature of the event) were associated with one's own lower sexual function, while in women, they were associated with their lower sexual satisfaction. Findings contribute to a growing body of literature underscoring the importance of intimacy for sexual well-being in long-term relationships.

Sexual Satisfaction in Portuguese Women: Differences Between Women With Clinical, Self-Perceived and Absence of Sexual Difficulties

Objectives

Female sexual functioning and satisfaction are affected by the presence of sexual difficulties. The current study examines differences in sexual satisfaction according to three groups of women: (i) clinical sexual difficulties assessed by the Female Sexual Functioning Index (FSFI) cutoff; (ii) self-perceived sexual difficulties at a non-clinical level; and (iii) sexually healthy.

Methods

A convenience sample of 329 Portuguese women, with a mean age of 28.69 (SD = 8.78), answered a specific question on the presence of self-perceived sexual difficulties, the Sexual Satisfaction Scale for Women and the FSFI. From the 329 women, 56 were assigned to the group with clinical sexual difficulties, 60 were assigned to the group with self-perceived sexual difficulties at non-clinical level, and 213 constituted the sexually healthy group.

Results

Sexually healthy women were more sexually satisfied compared with women who self-perceived sexual difficulties and women who had clinical sexual difficulties according to the FSFI. In addition, women who self-perceived sexual difficulties were also more sexually satisfied compared to women with clinical sexual difficulties according to the FSFI.

Conclusions

Women's sexual satisfaction was negatively affected by sexual difficulties assessed by the FSFI cutoff. Although with less impact, self-perceived sexual difficulties also negatively affect women's sexual satisfaction.

Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being

BACKGROUND

Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD) is characterized by sensations of physiological genital sexual arousal (and/or other types of genitopelvic dysesthesia) that occur in the absence of subjective feelings of sexual desire.

AIMS

The aim of this study was to compare relationship, sexual, and psychological well-being in partnered individuals with and without distressing symptoms of PGAD/GPD.

METHODS

The sample (N = 65 individuals with vulvas and vaginas, N = 11 individuals with penises) of 152 partnered individuals (N = 76 with and 76 without PGAD/GPD symptoms) participated in a one-time anonymous online survey.

OUTCOMES

The questionnaires assessed relationship satisfaction (Couple Satisfaction Index-Short Form, CSI); sexual satisfaction (Global Measure of Sexual Satisfaction, GMSEX); sexual functioning (Female Sexual Functioning Index, FSFI, or International Index of Erectile Functioning, IIEF); sexual distress (Sexual Distress Scale, SDS); and psychological well-being, as determined by the presence of depression and/or anxiety symptoms (Hospital Anxiety and Depression Scale, HADS).

RESULTS

Among individuals with vulvas and vaginas, those with PGAD/GPD symptoms reported significantly lower relationship and sexual satisfaction, greater sexual distress, and more symptoms of depression and anxiety than their counterparts in the control group. In addition, these individuals with PGAD/GPD symptoms also reported significantly worse sexual functioning (arousal, orgasm, satisfaction, and pain), and they were significantly more distressed about each aspect of their sexual functioning difficulties compared to those in the control group. Among the small sample of individuals with penises (N = 11), descriptive analyses revealed that total sexual functioning scores did not differ across the PGAD/GPD symptom and control groups. In addition, 64.5% of the total sample with PGAD/GPD symptoms managed unwanted genital arousal by avoiding sex with their partner, while 55.3% managed their symptoms by having sex with their partner, and some individuals with PGAD/GPD used both strategies.

CLINICAL IMPLICATIONS

The finding that PGAD/GPD symptoms impact relationships indicates that treatment for PGAD/GPD should include consideration of the well-being of one's intimate relationship(s).

STRENGTHS & LIMITATIONS

This study added to the small literature on experiences of PGAD/GPD in relationships, and it was the first to assess sexual satisfaction. Limitations include the small sample of individuals with penises, and the cross-sectional, correlational design, which does not allow for causal conclusions to be drawn.

CONCLUSION

Results emphasize the importance of continued research of this population (and their partners) in order to improve diagnosis, intervention, and recognition within the medical community. Mooney KM, Poirier É, Pukall CF., Persistent Genital Arousal in Relationships: A Comparison of Relationship, Sexual, and Psychological Well-Being. J Sex Med 2022;19:234-248.

Navigating Women's Low Desire: Sexual Growth and Destiny Beliefs and Couples' Well-Being

People's beliefs about how to maintain sexual satisfaction have been associated with how they navigate sexual differences, but research has yet to explore the consequences of these beliefs for couples facing a distressing sexual issue. The current research extends past work on sexual growth beliefs (i.e., the view that sexual satisfaction requires continuous effort to maintain) and sexual destiny beliefs (i.e., the view that sexual satisfaction is the result of natural sexual compatibility with a partner) to couples for whom these beliefs might be especially consequential - those coping with sexual dysfunction. In a dyadic longitudinal study of 97 couples coping with women's clinically significant low desire and arousal, we tested how sexual growth and destiny beliefs are associated with sexual, relationship, and personal well-being. We found that endorsing greater sexual growth beliefs was associated with higher sexual desire for both partners, whereas, with some exceptions, endorsing greater sexual destiny beliefs was linked to lower sexual desire and relationship satisfaction, more conflict, and more depressive and anxious symptoms. However, these effects did not persist one year later. Our findings highlight the implications of sexual growth and destiny beliefs for both couple members when navigating a chronic sexual difficulty.

Measurement invariance of Female Sexual Function Index: a study with heterosexual and lesbian Portuguese women

The Female Sexual Function Index is a powerful screening tool for female sexual dysfunction extensively used worldwide. Nonetheless, its factorial structure and psychometric properties have been tested almost exclusively with heterosexual samples. The current study aimed to testing the original factorial structure, reliability and temporal stability in two samples of women (heterosexual and lesbian), and to assess the measurement invariance across sexual orientation. An online sample of 752 Portuguese women (376 lesbian women and 376 heterosexual women) recruited between May 2012 and 2013 participated in the study and completed a sociodemographic questionnaire and the FSFI. For temporal stability, 30 Portuguese women were recruited online in May 2017. Confirmatory factor analysis, reliability analysis and temporal stability were assessed independently for each sample. Measurement invariance (configural, metric, and scalar) was also assessed. Main findings for both samples corroborate the six-factor structure and revealed excellent levels of temporal stability, with Cronbach alphas and McDonalds Omega of .95 for heterosexual sample, and .96 for lesbian women sample. Results corroborate measurement invariance (configural, metric, and scalar) across sample type. Overall, the FSFI revealed a good-fit for the six-factor model in both heterosexual and women sample, with excellent levels of reliability and temporal stability, and showed measurement invariance across sexual orientation. These findings support the use of the FSFI with lesbian women.

A Typology of Women with Low Sexual Desire

Low sexual desire is the most common sexual issue reported by women and research suggests that the presentation and experience of low sexual desire may vary considerably between women. This study explored whether women with low desire differ qualitatively from one another based on several key contextual factors theoretically associated with low desire. We collected data from women in long-term relationships (N = 508) using an online platform. Using latent profile analysis, we explored whether women could be distinguished from one another based on several contextual variables (sexual and relationship satisfaction, life stress, sexual communication). Results supported a 3-profile solution, with two distinct profiles emerging for women with low sexual desire. The first profile consisted of women with low desire who were dissatisfied with the sexual and nonsexual aspects of their relationships (Globally Distressed Group: 8%). The second profile consisted of women with low desire who were sexually, but not relationally, dissatisfied (Sexually Dissatisfied Group: 24%). In addition, a third profile emerged that consisted of generally satisfied women with average desire (Average Desire Group: 67%). t-tests revealed that the two low desire groups shared similar mean levels of sexual desire, but that their overall presentations were conceptually distinct. This research supports a categorical conceptualization of low sexual desire in women and suggests that evaluating category membership for women with low desire can provide valuable information about women's sexual experiences beyond assessing mean levels of sexual desire alone.

Are Couples More Satisfied When They Match in Sexual Desire? New Insights From Response Surface Analyses

While sexual frequency and satisfaction are strong contributors to the quality and longevity of romantic relationships and overall well-being, mismatches in sexual desire between partners are common and have been linked with poorer satisfaction. Previous findings linking mismatches in desire with poorer relationship and sexual outcomes have typically been derived using difference scores, an approach that does not account for partners’ overall levels of desire. In a sample of 366 couples, we investigated whether partners who match in desire are more satisfied than desire-discrepant couples. Results of dyadic response surface analyses provided no support for a unique matching effect. Higher desire rather than matching in desire between partners predicted relationship and sexual satisfaction. These findings shed new light on whether the correspondence between partners’ levels of sexual desire is associated with satisfaction and suggest the need to focus on sustaining desire and successfully navigating differences rather than promoting matching in desire.

Association between Sexual Satisfaction and Depression and Anxiety in Adolescents and Young Adults

The role of sexual satisfaction in adolescents and young adults’ mental health has not been thoroughly investigated. The aim of this work is to study differences in sexual satisfaction and mental health (anxiety and depression) based on romantic relationship status (having a partner vs. not having one) and gender. Likewise, the association between sexual satisfaction and mental health and the moderating effect of romantic relationship status and gender was addressed in this research. A total of 1682 Spanish adolescents (14–17) and young adults (18–29) agreed to participate in this cross-sectional investigation. Two-factor ANOVA and MANOVA, and hierarchical regression models were utilized in this study. In general, results showed more difficulties in sexual satisfaction and mental health for those not in a current relationship and for women. Additionally, higher levels of sexual satisfaction was associated with lower levels of anxiety for adolescents and lower levels of depression for young adults. These associations were stronger for those in a current relationship. This study highlights the importance of sexual satisfaction as a modifying factor against mental health problems, especially in the context of a current romantic relationship.

Emotion Regulation in Couples Affected by Female Sexual Interest/Arousal Disorder

Female sexual interest/arousal disorder (FSIAD) is associated with psychological, relational, and sexual consequences for affected women, and their romantic partners also suffer repercussions. Prior research suggests that women with FSIAD report more difficulties with emotion regulation than controls. Yet, whether emotion regulation is associated with the psychological, relational, and sexual well-being of both members of affected couples is unknown. Eighty-seven women diagnosed with FSIAD via a clinical interview and their male partners completed standardized measures of difficulties in emotion regulation, depression, anxiety, relationship satisfaction, dyadic conflict, sexual desire, and sexual distress. A subset (n = 71 couples) also completed measures of emotional suppression and reappraisal in relation to sex. Analyses used multilevel modeling guided by the actor-partner interdependence model. When women reported greater difficulties regulating negative emotion, they reported greater depression and anxiety, and when men reported more of these difficulties, they had greater depression, anxiety, and sexual distress, and the women with FSIAD reported lower relationship satisfaction. When women reported greater emotional suppression, they reported greater depression and anxiety, and lower relationship satisfaction; when they reported greater use of emotional reappraisal, they had fewer symptoms of depression and anxiety, and their partners reported lower dyadic conflict. When men reported greater emotional suppression, they had greater depression, lower relationship satisfaction, and sexual desire; when they reported greater emotional reappraisal, they had lower depression and anxiety, higher relationship satisfaction, lower dyadic conflict, higher sexual desire and women reported higher relationship satisfaction and lower dyadic conflict. Emotion regulation may be an important target for interventions to help couples cope with FSIAD.

Sexual communal motivation in couples coping with low sexual interest/arousal: Associations with sexual well-being and sexual goals

Women coping with female sexual interest/arousal disorder (FSIAD) report lower sexual and relationship satisfaction compared to healthy controls. In community samples, high sexual communal strength (i.e., the motivation to meet a partner's sexual needs) is associated with higher sexual desire and satisfaction, but high unmitigated sexual communion (i.e., the prioritization of a partner's needs to the exclusion of one's own needs) is associated with lower sexual satisfaction. People higher in sexual communal strength report engaging in sex for approach goals (i.e., to enhance intimacy in their relationship), but not for avoidance goals (i.e., to avert conflict or a partner's disappointment) and this is one reason why they report greater sexual desire. In the current sample of 97 women diagnosed with FSIAD and their partners we investigated the association between sexual communal strength and unmitigated sexual communion and sexual well-being (i.e., sexual desire, sexual satisfaction and sexual distress) and sexual goals (i.e., approach and avoidance goals). Women who reported higher sexual communal strength were more likely to pursue sex for approach goals and their partner reported greater sexual satisfaction. When partners reported higher sexual communal strength, they reported higher sexual desire, but when they reported higher unmitigated sexual communion, they reported higher sexual distress. Additional associations emerged for couples who engage in sex more (compared to less) frequently. Our findings demonstrate that being motivated to meet a partner's sexual needs is associated with greater sexual well-being for couples coping with FSIAD, but when this motivation involves neglecting one's own needs, people do not report greater sexual well-being and instead, partners report higher sexual distress.

Sexual Motivation in Couples Coping with Female Sexual Interest/Arousal Disorder: A Comparison with Control Couples

A lack of interest in sex is a common sexual issue, especially among women, and can be associated with lower relationship satisfaction and greater psychological distress. Research on sexual motivation has demonstrated that, in both community and clinical samples, people higher in sexual communal strength (motivated to meet their partner's sexual needs) and approach sexual goals (motivated to engage in sex to pursue positive outcomes) report higher desire and relationship satisfaction; whereas people higher in avoidance sexual goals (motivated to engage in sex to avert negative outcomes) tend to report lower desire and satisfaction. In the current study, we compared the sexual motivation of women diagnosed with female sexual interest/arousal disorder (FSIAD), who report chronic low desire and arousal accompanied by distress, and their partners (N = 97 couples) with couples without a sexual dysfunction (N = 108 couples). Women with FSIAD reported lower sexual communal strength and approach goals and higher avoidance sexual goals compared with control women and their own partners. However, the partners of women with FSIAD did not report differences in sexual motivation compared with control partners. Sexual motivation may be a target for future intervention studies with couples coping with low desire and arousal.