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Rowland DL, Kӧvi Z, Hevesi K. Age-related differences in the prevalence of premature ejaculation: taking a second and more detailed look. Sex Med 2024; 12:qfae057. [PMID: 39224133 PMCID: PMC11368441 DOI: 10.1093/sexmed/qfae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/22/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background Research indicates an inconsistent relationship between age and the prevalence of premature ejaculation (PE), with studies reporting an increase, decrease, or no change with age. Aim To reexamine the possible relationship between age and PE prevalence, implementing methodological improvements that enhance the likelihood of detecting real effects. Methods From a sample of 2772 men, we analyzed a subset of 418 classified as having probable or definite PE based on the Premature Ejaculation Diagnostic Tool. We not only analyzed men with lifelong PE (LPE; n = 316) and acquired PE (APE; n = 102) separately but assessed prevalence differences across age groups using an omnibus measure to establish PE status and specific PE diagnostic criteria, individually and in multifactorial combination. Outcome Prevalence of PE in younger vs older men. Results LPE, but not APE, showed age-related differences in prevalence, with LPE being lower in the higher age group. This pattern was most discernible when a multifactorial approach was used to establish PE status. Clinical Translation Older men may be less distressed about their dysfunction or may benefit from diminishing ejaculatory function with age. Strengths and Limitations This cross-sectional study used an improved methodology to detect age-related differences in PE prevalence. Future studies would benefit from a larger sample size that enables a breakdown of prevalence using a greater number of age categories. Conclusion According to an improved methodology, men with LPE showed a decline in prevalence with aging. A methodology aimed at exploring this relationship should-at the very least-not only distinguish between LPE and APE subtypes but also consider using a multifactorial method of determining PE status that includes a measure of bother/distress.
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Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN 46383, United States
| | - Zsuzsanna Kӧvi
- Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest 1091, Hungary
| | - Krisztina Hevesi
- Institute of Psychology, Eötvös Loránd University, Budapest 1075, Hungary
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Wang B, Peng X, Fu L, Lu Z, Li X, Tian T, Xiao X, Zhang W, Guo Z, Ouyang L, Wang Y, Yu M, Wu G, Wu D, Tang W, Tucker JD, Cai Y, Zou H. Sexual function and correlates among adults aged 50+ years in China: Findings from the sexual well-being (SWELL) study. J Am Geriatr Soc 2024; 72:1122-1135. [PMID: 38319006 DOI: 10.1111/jgs.18789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Sexual function is an important yet understudied aspect of overall health and well-being in older adults. We aimed to examine sexual function and its correlates among people 50 years and older in China. METHODS We enrolled people aged 50 years and older recruited from four regions in China between September 2021 and July 2022 in a multicenter cross-sectional study. Data were collected through an investigator-administered questionnaire about demographic characteristics, health characteristics, and sexual function status. Logistic regression was used to assess correlates of lower sexual function (the highest quintile of the sex-specific population distribution of Natsal-SF scores [i.e., lower functioning compared with the remaining]). RESULTS A total of 465 women and 832 men who were sexually active in the past year were included in the analysis (mean age: 60.4 ± 7.2) [Correction added after first online publication on 12 Feb 2024. The word "years" has been changed to "year" in this sentence.]. Over a quarter of all participants were dissatisfied with their sex life. Notably, 92 women and 167 men were categorized as having a lower sexual function. Age (in men only), living in urban areas, general health status, being underweight or overweight (in men only), and having depressive symptoms were associated with lower sexual function. Among all participants, 43.1% of men and 54.0% of women experienced sexual response problems lasting 3 months or more. Less than one-third of all participants had sought help or advice for sex life in the past year. CONCLUSIONS Sexual dysfunction and sexual dissatisfaction are prevalent among older adults in China and are associated with self-assessed poor health. More efforts are needed to better understand sexual health needs and tailor service provision.
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Affiliation(s)
- Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xin Peng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xinyi Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
- Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Lin Ouyang
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Guohui Wu
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Joseph D Tucker
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- University of North Carolina Project-China, Guangzhou, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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3
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Mark KP, Arenella K, Girard A, Herbenick D, Fu J, Coleman E. Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing. J Sex Med 2024; 21:296-303. [PMID: 38410029 DOI: 10.1093/jsxmed/qdae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There has been a great deal of public speculation regarding a surge in erectile dysfunction (ED) in younger men despite data consistently indicating that the ED prevalence rates increase with age. AIM In this study we sought to assess the prevalence and risk of experiencing ED in a nationally representative sample of men in the United States across various social groups, describe comorbidities, and examine barriers to treatment. METHODS Data from the 2021 National Survey of Sexual Wellbeing were analyzed by utilizing the Ipsos KnowledgePanel®, a probability-based online panel, for the purpose of obtaining US nationally representative data of adults aged 18 years and older. The analytic sample consisted of 1822 cisgender men ranging in age from 18 to 87 years, with a mean age of 47.5 years. OUTCOMES Study outcomes were ED as measured by the 5-item version of the International Index of Erectile Function (IIEF-5), as well as self-reported diagnosis by a medical professional, comorbidities with other health issues, medications taken for ED, and barriers to treatment. RESULTS The ED prevalence rate based on IIEF-5 scores was 24.2%. Prevalence increased with age: 52.2% of the 75+ age group, and 48.0% of the 65-74 age group meeting diagnostic criteria for ED. Diagnostic criteria were met for more participants in the 18-24 age group (17.9%) than the 25-34 (13.3%) or 35-44 (12.7%) age groups, but less than the 45-54 (25.3%) or 55-64 (33.9%) age groups. Only 7.7% (n = 141) of the sample reported having been diagnosed by a provider (n = 4 in 25-34, n = 6 in 35-44, n = 13 in 45-54, n = 39 in 55-64, n = 44 in 65-74, and n = 34 in ≥75-year olds), indicating a gap in access to treatment. The most common reason selected for not accessing care for ED concerns was a lack of need to see a provider in the past year. CLINICAL IMPLICATIONS The discrepancy between ED self-report and medical diagnosis is critical, given that ED can be an indication of underlying health risks. STRENGTHS AND LIMITATIONS This study is the first nationally representative update to information regarding the prevalence of ED in almost 2 decades. Standard administration of the IIEF-5 is limited to participants who have had sex in the last 6 months, so these rates do not include those men with ED who have been avoiding penetrative sex for a significant time. CONCLUSION The results indicate that ED prevalence and severity remain highest in older age groups and that most individuals who meet criteria for ED have not sought medical care related to this concern.
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Affiliation(s)
- Kristen P Mark
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Kat Arenella
- California School of Professional Psychology, Alliant International University, Los Angeles, CA 91803, United States
| | - Abby Girard
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Jane Fu
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Eli Coleman
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
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Anantapong K, Burapakiat B, Ananchaisarp T. Sex and concepts of sexuality influence sexual problems and help-seeking behaviours of older people. J Women Aging 2024; 36:139-151. [PMID: 37922193 DOI: 10.1080/08952841.2023.2276636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/15/2023] [Indexed: 11/05/2023]
Abstract
In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people.
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Affiliation(s)
- Kanthee Anantapong
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Bongkot Burapakiat
- Division of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Thareerat Ananchaisarp
- Division of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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5
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Vanti C, Ferrari S, Chiodini M, Olivoni C, Bortolami A, Pillastrini P. Sexual Disability in Low Back Pain: Diagnostic and Therapeutic Framework for Physical Therapists. Healthcare (Basel) 2023; 12:80. [PMID: 38200986 PMCID: PMC10778778 DOI: 10.3390/healthcare12010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. METHODS Based on a literature review, a team of specialized physical therapists developed a pattern for the management of LBP-related sexual disability. RESULTS A patient reporting LBP-related sexual disability may be included in one of four clinical decision-making pathways corresponding to one of the following: #1 standard physical therapy (PT); #2 psychologically informed physical therapy (PIPT); #3 PIPT with referral; or #4 immediate referral. Standard PT concerns the management of LBP-related sexual disability in the absence of psychosocial or pathological issues. It includes strategies for pain modulation, stiffness management, motor control, stabilization, functional training, pacing activities comprising education, and stay-active advice. PIPT refers to patients with yellow flags or concerns about their relationship with partners; this treatment is oriented towards a specific psychological approach. "PIPT with referral" and "Immediate referral" pathways concern patients needing to be referred to specialists in other fields due to relationship problems or conditions requiring medical management or pelvic floor or sexual rehabilitation. CONCLUSIONS The proposed framework can help clinicians properly manage patients with LBP-related sexual disability.
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Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (C.V.); (P.P.)
| | | | - Marco Chiodini
- Poliambulatorio Medico Associato, Via Monsignor Bertazzoni, 1, 46027 San Benedetto Po, Italy;
| | - Cesare Olivoni
- Studio Associato Fisioterapico Gallinucci Olivoni, Piazzale Marconi, 3/4, 48025 Riolo Terme, Italy;
| | | | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (C.V.); (P.P.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138 Bologna, Italy
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6
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Towler LB, Graham CA, Bishop FL, Hinchliff S. Sex and Relationships in Later Life: Older Adults' Experiences and Perceptions of Sexual Changes. JOURNAL OF SEX RESEARCH 2023; 60:1318-1331. [PMID: 35852483 DOI: 10.1080/00224499.2022.2093322] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to explore the sexual lives of older adults in the UK to elucidate their experiences of sexual changes and problems, and the role of intimacy and interpersonal support in coping with these changes. We conducted in-depth semi-structured interviews with 31 participants (aged 66-92, mean = 74, 16 women and 15 men), analyzed using reflexive thematic analysis. Our analysis generated three themes: Sexual Changes are "Natural," Sex is the Icing on the Cake, and Maintaining Sexual Connection and Relationship Satisfaction. The participants often rationalized and accepted sexual changes and problems as part of the natural aging process, or as a consequence of other age-related health issues. Sexual activity was seen by many as the "icing on the cake" of a satisfying romantic relationship, built on strong foundations of intimacy, connection, and companionship. Relationship satisfaction and sexual wellbeing can be maintained despite changes to sexual function by retaining a sexual connection through shared experiences, emotional closeness, and support. The findings have important implications for researchers and health providers, and suggest that adopting an "affirmative older age" perspective would be useful for not only future research but also when providing support for older adults with sexual difficulties.
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Affiliation(s)
| | | | | | - Sharron Hinchliff
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield
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Ågmo A, Laan E. The Sexual Incentive Motivation Model and Its Clinical Applications. JOURNAL OF SEX RESEARCH 2023; 60:969-988. [PMID: 36378887 DOI: 10.1080/00224499.2022.2134978] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual motivation (desire) requires the simultaneous presence of an active central motive state and a stimulus with sexual significance. Once activated, sexual motivation leads to visceral responses and approach behaviors directed toward the emitter of the sexual stimulus. In humans, such behaviors follow cognitive evaluation of the context, including predictions of the approached individual's response. After successful approach and establishment of physical contact, manifest sexual activities may be initiated. Sexual interaction is associated with and followed by a state of positive affect in most animals, whereas aversive consequences may be experienced by humans. The affective reactions may become associated with stimuli present during sexual interaction, and these stimuli may thereby alter their incentive properties. Here we show how the incentive motivation model can be used to explain the origins and possible treatments of sexual dysfunctions, notably disorders of desire. We propose that associations formed between negative outcomes of sexual interaction and the salient stimuli, for example, the partner, underlies hypoactive desire disorder. Highly positive outcomes of sexual interaction enhance the incentive value of the stimuli present, and eventually lead to hyperactive sexual desire. Treatments aim to alter the impact of sexual incentives, mainly by modifying cognitive processes.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam
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8
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Fosså SD, Dahl AA, Børge Johannesen T, Gjelsvik YM, Holck Storås A, Myklebust TÅ. Late Adverse Health Outcomes and Quality of Life after Curative Radiotherapy+ long-term ADT in Prostate Cancer Survivors:Comparison with men from the General Population. Clin Transl Radiat Oncol 2022; 37:78-84. [PMID: 36093341 PMCID: PMC9450064 DOI: 10.1016/j.ctro.2022.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
More than 5 years after radiotherapy for prostate cancer ) 54 % elderly patients report at least one moderate or big problem within the urinary, bowel or sexual domain. (Controls : 30%) Such problems reduce Quality of Life., which, however ,is similar in the two cohorts , the least difference observed within the sexual domain.
Background Few studies have described the impact of urinary, bowel and sexual Adverse Health Outcomes (AHOs) on Quality of Life (QoL) in Prostate Cancer Survivors living for more than 5 years after curative radiotherapy (“long-term PCaSs”), and compared the findings with those in men from general population. Here we assess self-reported AHOs in such PCaSs focusing on the association between problem experience and QoL. The findings are compared to corresponding symptoms in age-similar men from the general population without a PCa diagnosis (Norms). Methods Nine years (mean) after curative radiotherapy 1231 PCaSs and 3156 Norms completed the EPIC-26 questionnaire and the EORTC QLQ-C30 instrument. Domain Summary Scores (DSSs) for the urinary, bowel and sexual domains, the percentages of moderate/big dysfunctions and the proportions of overall problems were determined. Inter-cohort differences were interpreted based on cut-off values for published Minimal Clinically Important Differences (MCIDs). Multivariable linear regression models analyzed the associations between QoL and domain-related overall problems. Results Only the inter-cohort differences regarding bowel and sexual DSSs exceeded the respective MCIDs. Among PCaSs 54% had at least one moderate/big problem (Norms: 30%). In PCaSs and Norms, QoL increased with decreasing urinary and bowel problems, For sexuality this association was weaker in Norms and was almost lacking in PCaSs. Multivariable-adjusted QoL was similar in PCaSs and Norms, with general health being the strongest covariate. Conclusions During follow-up of long-term PCaSs health professionals should be aware of the survivors’ persisting moderate/big urinary, bowel or sexual problems associated with reduced QoL. In particular , alleviation of urinary and bowel problems can increase the men’s QoL.
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Fischer N, Træen B. Prevalence of Sexual Difficulties and Related Distress and Their Association with Sexual Avoidance in Norway. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:27-40. [PMID: 38595676 PMCID: PMC10903600 DOI: 10.1080/19317611.2021.1926040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 04/11/2024]
Abstract
Aim To assess the prevalence of sexual difficulties and related distress, the association between sexual difficulties and sexual avoidance, and to establish whether sexual difficulties and sexual avoidance are moderated by relationship satisfaction. Methods This study included a sample of 4160 adults aged 18-89 years enrolled from a randomly selected web panel of 11,685 Norwegians. Results Sexual difficulties were particularly common among adults aged <30 years. In men and women, lack of interest in sex and general sexual distress were associated with more sexual avoidance. The association between lack of sexual interest and sexual avoidance was, however, buffered by relationship satisfaction. Climaxing too early was related to less sexual avoidance in both genders. Yet for men, this association was only significant among those with lower relationship satisfaction. Conclusion The findings underline the important links among specific sexual difficulties, sexual distress, and the frequency of avoiding sexual activity.
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Affiliation(s)
- Nantje Fischer
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
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10
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Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021; 18:1532-1544. [PMID: 37057431 DOI: 10.1016/j.jsxm.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/01/2021] [Accepted: 06/24/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction. AIM This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction. METHODS A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey. OUTCOMES Participants reported on their experience of five different sexual problems and associated level of distress. RESULTS We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations. CLINICAL TRANSLATION These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment. STRENGTHS AND LIMITATIONS Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales. CONCLUSION The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;XX:XXX-XXX.
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Ševčíková A, Gottfried J, Blinka L. Associations among Sexual Activity, Relationship Types, and Health in Mid and Later Life. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2667-2677. [PMID: 34427846 PMCID: PMC8383927 DOI: 10.1007/s10508-021-02040-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/21/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
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; Mage = 69.1, SDage = 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.
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Affiliation(s)
- Anna Ševčíková
- Faculty of Social Studies, Masaryk University, 602 00, Brno, Czech Republic.
| | - Jaroslav Gottfried
- Faculty of Social Studies, Masaryk University, 602 00, Brno, Czech Republic
| | - Lukas Blinka
- Faculty of Social Studies, Masaryk University, 602 00, Brno, Czech Republic
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12
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Traeen B, Hansen T, Štulhofer A. Silencing the sexual self and relational and individual well-being in later life: a gendered analysis of North versus South of Europe. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1883579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bente Traeen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Norwegian Institute of Public Health and Oslo Metropolitan University, Oslo, Norway
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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Graham CA, Štulhofer A, Lange T, Hald GM, Carvalheira AA, Enzlin P, Træen B. Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2951-2961. [PMID: 32533517 PMCID: PMC7641931 DOI: 10.1007/s10508-020-01742-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 05/07/2023]
Abstract
There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.
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Affiliation(s)
- Cynthia A Graham
- Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Shackleton Building (B44), Room 44/3073, Southampton, SO17 1BJ, UK.
| | | | - Theis Lange
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Paul Enzlin
- Department of Neurosciences, KU Leuven, Institute for Family and Sexuality Studies, Leuven, Belgium
| | - Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
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Lonza A, Štulhofer A, Graham C. Emotional Intimacy and Distress About Sexual Difficulties in Partnered Older European Men and Women: A Network Analysis. JOURNAL OF SEX & MARITAL THERAPY 2020; 46:474-490. [PMID: 32370627 DOI: 10.1080/0092623x.2020.1760979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Although research in older individuals' sexual health is steadily increasing, the nature of, and predictors related to, their distress about changes in sexual function have not been well-studied. Using data from sexually active and partnered 1,047 Norwegian and Danish women and men aged 60-75 years, this study employed network analysis to explore the structure of older individuals' sexual distress and the role of emotional intimacy. Men's network of sexual distress facets was more densely interconnected than women's network. Higher emotional intimacy was associated with lower sexual distress levels across gender. The findings have implications for sexual health interventions targeting older people.
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Affiliation(s)
- Anamarija Lonza
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Cynthia Graham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, England
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Affiliation(s)
- Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Cynthia Graham
- Department of Psychology, University of Southampton, Southampton, UK
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Seeking help for sexual difficulties: findings from a study with older adults in four European countries. Eur J Ageing 2019; 17:185-195. [PMID: 32547347 PMCID: PMC7292843 DOI: 10.1007/s10433-019-00536-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Sexual well-being is an important part of life for many people aged 60 and older. However, older adults often face barriers to seeking and receiving help for sexual difficulties. This study used data from a probability survey (n = 3820) on sexuality and ageing to examine help-seeking in 60–75-year-olds in Norway, Denmark, Belgium, and Portugal. More men (12.2%) than women (6.8%) had sought professional help for a sexual difficulty in the past 5 years. The main reason for help-seeking was that sex was important to the participant and/or their relationship. The main source of professional help was the primary care physician. Of those who had sought professional help, 48% were satisfied or very satisfied with the help received, 31.6% were neither satisfied nor dissatisfied, and 20.4% were dissatisfied or very dissatisfied. Others had sought help from informal sources, particularly partners, friends, or websites. The main reasons for not seeking professional help included not being distressed by the symptoms, and thinking that the difficulty would clear up on its own. Multivariable regression analysis revealed that significant correlates of seeking professional help for women and men were level of distress about the sexual difficulty. With regard to women, those who were married, and/or from Portugal were more likely to have sought help. And regarding men, those who attended religious services were more likely to have sought professional help. These results have important implications for healthcare and can be used to inform the development and delivery of services for older adults who experience sexual difficulties.
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