"Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States

Effects of education given in the menopausal period on the day-to-day impact of vaginal aging, self-efficacy in sexual abstinence and sexual distress: A randomized clinical trial

Despite physiological differences, women have to struggle with many problems related to menopause. It is the responsibility of nurses to provide women with the information and guidance they need during this period. Study was carried out to investigate the effects of education given in the menopausal period on the day-to-day impact of vaginal aging, self-efficacy in sexual abstinence, and sexual distress. This randomized controlled study was conducted at a center operated by a local municipality that provides services only to women, between 01.09.2023-10.12.2023 with 62 women (experimental:31, control:31). The data were collected using a "Personal Information Form," the "Day-to-Day Impact of Vaginal Aging Questionnaire-DIVA," the "Self-Efficacy Scale for Sexual Abstinence-SESSA," and the "Female Sexual Distress Scale-FSDS." ANOVA, independent-samples t-tests, paired-samples t-tests, and regression analyses were used to analyze the data. After the pretest, the experimental group were given education by the researcher in weekly sessions lasting 50/min. each for 5 weeks. In the posttest, the forms were administered 45 days after the last education session. There were significant differences between the experimental group in terms of their mean posttest DIVA (11.10 ± 2.65; 8.94 ± 1.65), FSDS (39.11 ± 9.07; 31.48 ± 10.27) and SESSA (17.85 ± 5.36; 21.25 ± 10.49 total scores (p < .001), while there was no significant difference between the pre-posttest of the control group (p < .05). Additionally, age was found to be a significant predictor of DIVA, whereas education level and marital satisfaction status were significant predictors of their SESSA. Education provided to women reduced the day-to-day impact of vaginal aging and sexual distress levels of the women and increased their self-efficacy in sexual abstinence.

The Intimate and Sexual Costs of Emotional Labor: The Development of the Women's Sexual Emotional Labor Assessment

Emotional labor, the act of suppressing or altering one's feelings to enhance another person's well-being, is predominantly performed by women, especially within intimate relationships. Despite its impact on well-being, research on its role in sexuality remains limited. We developed the Women's Sexual Emotional Labor Assessment (WOSELA), a 12-item scale based on themes identified by past qualitative studies. To ensure its reliability and validity, we conducted three studies with women partnered with men, as well as heterosexual single women from the UK and the USA (N = 831). Drawing on exploratory factor analysis in Study 1, four subscales were identified: faking orgasm, performing desire, tolerating discomfort or pain, and partner-referenced sexual satisfaction. Confirmatory factor analyses in Study 2 (pre-registered) provided support for the WOSELA in its current form. In Study 3 (pre-registered), we demonstrated the validity of the WOSELA by establishing significant negative correlations with sexual agency, sexual communication, and sexual pleasure. Our results further show that the WOSELA was not significantly related to positive-partner-oriented sexual responsiveness. The WOSELA offers a unique tool to explore the role of emotional labor in sustaining the pleasure gap, as well as in broader power dynamics within intimate relationships and its impact on women's well-being.

"What Is Normal?": A Qualitative Exploration of Health Practitioners' Reports of Treating Patients Presenting with Unpleasant Sexual Experiences

Sexual health, including sexual pleasure, is fundamental to holistic health and well-being, and is considered an area of priority health in Australia. Despite the importance of sexual functioning, women experience significant gaps in sexual well-being compared to men and often do not seek medical care or treatment. Health practitioners are central to the identification and treatment of sexual dysfunction, including fostering sexual well-being for patients. Despite this, minimal research has explored health practitioners' experiences in treating reports of unpleasant sex. This study aimed to explore health practitioners' experiences, responses, and confidence in treating patients presenting for unpleasant sexual experiences. An online, mixed-methods survey was completed by 96 participants. Thematic analysis identified 11 core themes. These themes included five patient centred themes (health risks, diverse sex acts, painful vaginal intercourse, relationship breakdown and violence, unwanted sex) and six health practitioner centred themes (communication and counselling, what is normal, ongoing care and follow up, emotional response, limited practical training, and highly prevalent). Participants described a complex sexual health landscape, with social contexts impacting women's sexual experiences and engagement in treatment. Additionally, health practitioners reported the need for a biopsychosocial approach to understanding and responding to unpleasant sexual experiences for patients, while simultaneously reporting limited education in this area. Findings reflect the need for health practitioners to be cognisant of matters related to sexual function, consent, coercion, client engagement, and treatment pathways, identifying a need for greater education and holistic approaches to sexual healthcare across medical settings.

The Prioritization of Women's Orgasms During Heterosex: A Critical Feminist Review of the Implications for Women's Sexual Liberation

Orgasm is considered by many to be an essential part of women's ideal sexual experiences. As a result, sexual liberation narratives have often advocated for the prioritization of women's orgasms - particularly during heterosex - framing them as a central indicator of "good," healthy, liberated sex. However, scholars have increasingly critiqued these narratives, arguing that they result in an orgasm imperative that has negatively impacted women's sexual lives. Perspectives that promote the prioritization of women's orgasm and those that warn against the negative repercussions strive for the same thing - to draw attention to women's sexuality in ways that will lead to more pleasurable, enjoyable, and equitable sex for women overall. Yet, together, they offer contradictory messages about the role that women's orgasms can or should play in women's sexual liberation. For example, one could argue that it perhaps makes sense to prioritize women's orgasms given that they often are highly pleasurable for women, center a unique form of embodied pleasure, and offer a supposedly clear objective for women and their men partners. On the other hand, such narratives frame women's orgasm absence as abnormal, concede to men's sexuality in problematic ways, and constrain more comprehensive possibilities for women's sexual pleasure. In this critical feminist review, I offer a summative outline of these and other contradictions, focusing on how narratives prioritizing women's orgasms can have simultaneous benefits and negative repercussions when it comes to (1) women's sexual pleasure, (2) the medicalization/pathologization of women's orgasms, and (3) heterosex norms.

The interrelationship between women's help-seeking experiences for vaginismus and their sense of self: a qualitative study and abductive analysis

Objective

There is a lack of research on women's holistic experiences of vaginismus, also called sexual pain-penetration disorder, from their perspective. To address this gap, an abductive qualitative study aimed to examine women's help-seeking experiences for vaginismus, and its impact on their sense of self.

Methods

This study was informed by a feminist approach to the theory of self focused on participants' negotiation of dis/empowerment when help-seeking for vaginismus. Twenty-one participants aged 19-37 years (mean 27.6 years) and diagnosed with vaginismus in Australia participated in semi-structured interviews, which were thematically analysed.

Results

Three themes were developed: Interconnected constructions of womanhood and help-seeking, Elicit agency to move forward, Resilience to surmount challenges with subthemes. Participant's overall help-seeking experiences, within and outside the healthcare system, shaped their sense of self in ways that drove their approach/es to future help-seeking behaviours.

Conclusions

Positive help-seeking experiences for vaginismus strengthened participants' sense of self to persevere with treatment even when it was difficult. Conversely, negative help-seeking experiences led to participants' weakened sense of self which was often caused by a gap between their ideal and perceived self. This led to negative feelings and responses of demotivation or halting subsequent help-seeking. Recommendations are provided to improve health professional practice to support women help-seeking for vaginismus, and to help close the gap between their ideal and perceived selves. Such insight can help to empower women's sense of self and motivate them to persevere with help-seeking to experience improvement for their vaginismus and quality of life.

Women's Self-Management of Dyspareunia Associated With Endometriosis: A Qualitative Study

Given the limitations of medical treatment for endometriosis, self-management is a critical component of symptom management, and providing patients with information and education is a necessary complement to medical interventions. Though 50 to 70% of people with endometriosis experience dyspareunia (painful sex), there is limited knowledge of self-management specific to painful sex. A comprehensive understanding of the self-management strategies used is foundational to developing supportive care interventions that help ease pain and related psychosocial sequelae. The objective was to describe people's experiences of navigating endometriosis-associated painful sex and developing self-management strategies. We analyzed interview data from 20 women using constant comparative and thematic analysis techniques, guided by qualitative interpretive description methodology. Participants (age range 18-44 years) all identified as women and were predominately Caucasian (90%) and heterosexual (80%). Throughout their lives, the women appeared to gradually develop self-management strategies while navigating painful sexual experiences. This complex journey encompassed four phases: 1) viewing painful sex as normal, 2) experiencing evolving thoughts and emotions, 3) coming to understand painful sex and seeking help, and 4) learning strategies to navigate painful sex, these include preparing mentally and physically for sex and communicating with intimate partner(s). Women in this study developed self-management strategies over time through engagement with others who understood their challenges. Future research is warranted regarding initiatives to counter the normalization of painful sex, develop and disseminate patient-facing information, provide education specific to dyspareunia, improve access to multidisciplinary care, facilitate social connections and support, and enhance communication with intimate partners. PERSPECTIVE: In this paper, we report on the experiences of women with endometriosis-associated painful sex and their self-management strategies. Clinicians may be interested in a qualitative exploration of endometriosis-associated painful sex as they seek to further understand their patient's experiences and what strategies can be implemented to alleviate dyspareunia. DATA AVAILABILITY: The data sets generated during and/or analyzed during the current study are not publicly available as participants did not consent to making their data publicly available but are available from the corresponding author on reasonable request.

'Just be strong and keep going': the influence of Superwoman Schema on Black women's perceived expectations of coping with sexual pain

Superwoman Schema, a conceptual framework that reflects Black women's ability to overcome gendered racism and stress, affects the way Black women choose to cope with health-related issues. The purpose of this study was to investigate how Black women perceive they should cope with sexual pain using the Superwoman Schema as an analytic and interpretative guide. Data were derived from participants who completed an individual interview on sexual pain and pleasure. Deductive thematic analysis was conducted. Results indicated whereas some Black women endorsed all five components of Superwoman Schema as coping strategies for sexual pain, other Black women resisted SWS completely. Additionally, one participant was an outlier and did not endorse or resist SWS. Implications for generational sexual health interventions for Black women are discussed.

Conceptualizing Sexual Pleasure at Home as a Work-Related Stress Recovery Activity

Job stress is pervasive in today's workforce and has negative implications for employees' mental and physical well-being and job performance. Recovery activities outside of work can reduce strain and improve work outcomes; however, little is known about pleasurable intimate recovery experiences and their influence on work outcomes, even though these experiences are important parts of most people's lives outside of work. The present study examined sexual activity that is shared either with a relationship partner or oneself (masturbation) and how pleasure specifically predicts well-being and work outcomes to induce recovery. Results suggest that pleasurable sexual activity, with a partner or alone, is related to perceived recovery from work stress, job satisfaction, work engagement, and life satisfaction. Moreover, perceived recovery from work mediated the relationship between pleasurable sex and work outcomes. Gender moderated this relationship such that pleasurable sex was a stronger predictor of recovery for women (compared to men) in the context of sex within committed relationship partners (but not masturbation). Theoretical and practical implications are discussed.

A conceptual model for managing sexual pain with somatocognitive therapy in women with provoked vestibulodynia and implications for physiotherapy practice

Somatocognitive therapy is a multimodal physiotherapy treatment developed in the early 2000s to alleviate the burden of chronic pelvic pain. In recent years, somatocognitive therapy has been further developed to treat women with provoked vestibulodynia. This prevalent gynecological pain condition is a subgroup of chronic pelvic pain and the most common form of vulvodynia. Provoked vestibulodynia is a neglected multifactorial pain condition of unknown cause, adversely affecting women's sexual life, relation to their partners and their psychological health. Pain is located at the vulvar vestibule and is provoked by touch or pressure such as sexual intercourse. In the management of sexual pain, somatocognitive therapy combines bodily exploration, pain education, cognitive coping strategies and structured homework to improve sexual function and reduce pain. To support these processes, developing a sound therapeutic alliance with the patient is essential. The aim of this article is to provide a conceptual model for managing provoked vestibulodynia with somatocognitive therapy, including a theoretical rational for this treatment. We base our conceptual model on the biopsychosocial model, i.e., considering the complex interplay of biomedical, emotional/cognitive, psychosexual and interpersonal factors in provoked vestibulodynia management. In addition, implications for practice and a detailed description of somatocognitive therapy for provoked vestibulodynia will be provided, to allow replication in clinical practice and in clinical trials.

What Sexual Problems Does a Sample of LGB+ People Report Having, and How Do They Define Sexual Pleasure: A Qualitative Study to Inform Clinical Practice

Introduction: Sexual pleasure is a human right and a central aspect of human sexuality that contributes significantly to people's overall well-being, making it an essential element to consider in clinical settings. This study aims to expand the understanding of sexual pleasure by examining how LGB+ people (lesbian, gay, bisexual, and other minority sexual orientations)-who perceived having a sexual problem-define solitary and partnered sexual pleasure. Methods: A cross-sectional exploratory qualitative study was conducted online. The current study included 85 people who self-identified as LGB+ and reported experiencing a sexual problem. Data analysis was performed using summative content analysis. Results: The results for solitary sexual pleasure comprised the creation of 5 categories (Enhancing the relationship with oneself, Specification of solitary pleasure, Negative experience, Unrestrained experience and A goal). For partnered sexual pleasure, 9 categories were created (The perks of being with another, Openness to experience, A result of sexual techniques, Psychophysiological experience, Misconceptions about sexual pleasure, Absence of intrapersonal constraints, Undesirable feelings, Explicit consent, and Absence of interpersonal constraints). Discussion: Despite reporting sexual problems, most participants reported having experienced sexual pleasure, and were able to define it. This study provided a deeper understanding of the perspectives on and experiences of sexuality among LGB+ people who experience sexual problems. Our findings highlight that current diagnostic criteria (e.g., DSM-5) do not seem to align with the problems reported by this sample population (the problems presented are beyond their sexual function). This reinforces the importance of viewing sexual problems from a perspective that goes beyond the categorial psychopathology model. Our study's findings may offer valuable insights for the evaluation and treatment of sexual problems, where sexual pleasure is considered a crucial aspect of sexual well-being.

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.

A qualitative investigation into the role of illness perceptions in endometriosis-related quality of life

Endometriosis is related to adverse quality of life (QoL) and wellbeing outcomes. The way in which endometriosis is perceived by individuals experiencing the condition has not been directly considered, yet illness perceptions (IPs) are predictors of QoL in several chronic conditions. This research aims to gain an understanding of the IPs held by individuals experiencing endometriosis and their impact on QoL. Semi-structured, one-to-one interviews with 30 UK-based participants sought to gain an understanding of participant experiences and perceptions linked to endometriosis. Three themes were constructed through reflexive thematic analysis: a life disrupted; lost sense of self; and complex emotional responses. Largely negative IPs were held by individuals experiencing endometriosis which, along with endometriosis-specific symptoms, fuelled fears for the future and reduced QoL. IP-based interventions may support the QoL of those experiencing endometriosis whilst effective treatment is sought.

'My partner will think I'm weak or overthinking my pain': how being superwoman inhibits Black women's sexual pain disclosure to their partners

Black women experience persistent sexual pain that may often last longer than White women. Despite the value of sexual communication to alleviate sexual pain concerns, many women do not disclose sexual pain to their partners. Limited research explores barriers to disclosing sexual pain to partners among Black women. This study seeks to fill this gap. Relying on an integration of Sexual Script theory and Superwoman Schema, the study explored the barriers that premenopausal, cisgender Black women from the Southern USA perceived when disclosing sexual pain to their primary partners. We identified five common themes from women's open-ended responses to an online survey: (a) distressing emotions associated with disclosure; (b) limited knowledge and communication skills; (c) protecting partner's feelings and ego; (d) invading privacy; and (e) taking sole responsibility for managing sexual pain. Findings suggest a combination of intrapsychic, interpersonal and cultural factors influence Black women's perceived ability to have direct and open dyadic communication about sexual pain with their partners. Implications for Black women's sexual health and relationship outcomes are discussed.

Comparison of male and female perspective in couples involved in sexual relationships and facing endometriosis

Background

While the sexuality of patients with endometriosis is an established topic in research, the possible effect of endometriosis on partnership sexuality has come to the fore only recently. To improve counseling, more information is needed on how both partners experience sexuality in the context of endometriosis.

Aim

Previous research regarding endometriosis and sexuality normally focused on one partner to explore couples' intimate relations, whereas this study provides a comparison on both partners' perspectives on their common sexuality.

Methods

An overall 302 couples received a questionnaire based on the Brief Index of Sexual Functioning and Sexual History Form, which was modified by endometriosis specialists to better focus on endometriosis-specific aspects. To detect different perspectives on common sexuality within the couple, the Wilcoxon test and the Pearson chi-square test were performed.

Outcomes

Various aspects of couple sexuality were assessed by both partners to investigate divergent perspectives between the man and the woman within a couple.

Results

On one hand, male and female partners seem to have divergent perspectives on sexual satisfaction in general, desired frequency of sexual contacts, and the question of the female partner engaging in sexual activity despite discomfort. On the other, they have similar perspectives on who takes initiative in sexual contacts, satisfaction with variety in the sexual relationship, and the impact of sexual limitations on their satisfaction within the partnership.

Clinical implications

Endometriosis research addressing issues related to sexuality should include male partners; the same applies to consulting women with endometriosis in the context of their relationships rather than as individuals.

Strengths and Limitations

This is the first analysis conducted on a larger scale of data from both partners in couples dealing with endometriosis. As it provides quantitative information only, some qualitative information remains unexplored.

Conclusion

As both partners showed tendencies to overestimate their partners' sexual satisfaction and had different perspectives on sensitive topics in sexuality, such as the female partner engaging in sexual activity despite discomfort, addressing sexual communication could be a starting point in counseling couples dealing with endometriosis.

The scarlet V: how women with dyspareunia negotiate postfeminist discourses of sexual agency

Young women must often contend with cultural scripts dictating neoliberal/postfeminist ideals of female sexual agency, including the ability to act in accord with one's personal sexual self-interest. The aim of this study was to explore how young women (n = 26) living with dyspareunia (pain experienced during penetrative sexual activity) negotiate these ideals. We found that in addition to discussing traditional discourses that assign value to women in accordance with their perceived sexual virtue, women judged themselves according to the degree to which their behaviour reflected sexual agency. Women perceived to be sexually agentic were, for the most part, lauded, while those perceived to lack sexual agency were either denigrated (in the case of high sexual activity) or seen as deficient (in the case of low sexual activity). The inability to be penetrated without pain significantly limited women's sexual repertoires. Contrasting their sexual agency with that of other women and of their past selves, women expressed feelings of disempowerment. Conceptualising agency as a spectrum rather than something that one has or lacks, as well as actively cultivating the potentialities of sexual 'transgression', may allow young women to resist heteronormative sexual hierarchies - including those rooted in a a postfeminist ethos.

Changes in Penile-Vaginal Intercourse Frequency and Sexual Repertoire from 2009 to 2018: Findings from the National Survey of Sexual Health and Behavior

Solo and partnered sexual behaviors are relevant to health, well-being, and relationships. Recent research shows that sexual frequency has declined in the U.S. and in other countries; however, measurement has been imprecise. We used data from 14- to 49-year-old participants in the 2009 and 2018 waves of the National Survey of Sexual Health and Behavior (NSSHB), a confidential U.S. nationally representative survey that is conducted online. We aimed to: (1) assess changes in frequency of past-year penile-vaginal intercourse and (2) examine combinations of past-year sexual behaviors for each of the two waves. We hypothesized that we would observe lower frequency of penile-vaginal intercourse (PVI) from 2009 to 2018 and that we would observe greater engagement in sexual repertoires involving non-coital partnered behaviors (e.g., partnered masturbation, oral sex) in 2018 as compared to 2009. Participants were 4155 individuals from the 2009 NSSHB (Adolescents: 406 females, 414 males; Adults: 1591 women, 1744 men) and 4547 individuals from the 2018 NSSHB (Adolescents: 416 females, 411 males; Adults: 2007 women, 1713 men). Compared to adult participants in the 2009 NSSHB, adults in the 2018 NSSHB were significantly more likely to report no PVI in the prior year (28% in 2018 vs. 24% in 2009). A similar difference in proportions reporting no PVI in the prior year was observed among 14-17-year-old adolescents (89% in 2018 vs. 79% in 2009). Additionally, for both adolescents and adults, we observed decreases in all modes of partnered sex queried and, for adolescents, decreases in solo masturbation.

Women Get Worse Sex: A Confound in the Explanation of Gender Differences in Sexuality

Gender differences in sexuality have gained considerable attention both within and outside of the scientific community. We argue that one of the main unacknowledged reasons for these differences is simply that women experience substantially worse sex than men do. Thus, in examinations of the etiology of gender differences in sexuality, a confound has largely been unacknowledged: Women and men are treated to different experiences of what is called "sexuality" and "having sex." We discuss four arenas in which women's experience of sexuality may often be worse than men's: (a) anatomical differences, (b) sexual violence, (c) stigma, and (d) masculine cultures of sexuality. Then we consider how each disparity might explain well-known gender differences in sexuality.

"You Feel Like Normal Sex is not Enough Anymore": Women's Experiences of Coercive and Unwanted Anal Sex with Men

In this article, we explore the gendered dynamics of coercion described by 18 women we interviewed about their experiences of unwanted and nonconsensual heterosexual anal sex. Several women referred to what they believed to be the normative status of heterosexual anal sex. In many cases, the socially coercive effects of perceived norms intertwined with threads of interpersonal coercion, leaving women feeling pressured to agree to, or little room to refuse, anal sex they did not want. We discuss the ways that new sexual norms can translate into new pressures for women within the gendered framework of heterosexual relationships.

Pursuing Pleasure Despite Pain: A Mixed-Methods Investigation of Black Women's Responses to Sexual Pain and Coping

The current mixed-methods study is the first to explore Black women's (N = 153) cognitive (e.g., worry about being perceived as sexually unresponsive) and emotional (e.g., sadness) responses to sexual pain based on age and relationship status, and coping strategies. Findings indicated significant differences in younger and single Black women's cognitive and emotional responses to sexual pain compared to older and coupled Black women. Qualitative responses revealed Black women engage in several proactive coping strategies to mitigate their sexual pain, including non-penetrative activities, foreplay, tools for increasing arousal, making physical adjustments, and intimacy and sexual communication. Implications for sexual health providers are discussed.

Women's Sexual Health During the Pandemic of COVID-19: Declines in Sexual Function and Sexual Pleasure

Purpose of the Review

The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women’s sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women’s sexual health during this period.

Recent Findings

Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period.

Summary

Research identified a deterioration of women’s sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women.

Psychosocial and Behavioral Aspects of Women's Sexual Pleasure: A Scoping Review

Objectives

To clarify the psychosocial and behavioral factors related to women's sexual pleasure.

Methods

A search was conducted on EBSCO and Web of Science databases using the key terms "female sexual pleasure" and "women sexual pleasure" and following PRISMA guidelines.

Results

76 articles were identified, referring to sexual practices, individual factors, interpersonal factors, societal factors, and ways of enhancing sexual pleasure.

Conclusions

Age, sexual experience, arousability, body-esteem, sexual autonomy, and sexual assertiveness seem to benefit women's sexual pleasure, while sexual compliance and a gender power imbalance seem to compromise it. Additional research regarding non-western and non-heterosexual women is still required.

Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S

INTRODUCTION

Despite a growing body of research on psychosocial factors in Genito-Pelvic Pain/Penetration Disorder (GPPPD) during sexual intercourse, there are few studies examining adolescent and young adult women's experiences with painful sex and the effects of religiosity, sexual education, and sex guilt.

AIM

The purpose of the study was to examine the occurrence of GPPPD among sexually active female college students, including psychosocial factors of religiosity and religious practice, sexual education, sex guilt, and sexual distress.

METHODS

Data were collected from 974 college women from a university in the Northeastern U.S. We limited our sample to sexually active women (n = 593, 60.9%; mean age: 18.96) who responded to the questionnaire item, "In general, do you feel pain with sexual intercourse?" Participants completed the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), Revised Mosher Sex Guilt Scale, Abbreviated Santa Clara Strength of Religious Faith Questionnaire, 10-item Gender Role Beliefs Scale, and measures on sexual wellness and practice and sexual education experiences. Data were analyzed using standard bivariate and regression analyses as well as path analysis.

MAIN OUTCOME MEASURES

Women were asked, "In general, do you feel pain with sexual intercourse?" and categorized into one of three pain groups: occasional (10%-25% of the time), frequent (50% or more), and no pain (less than 10%).

RESULTS

GPPPD with sex was prevalent among young college women, with 113 (19.1%) reporting frequent pain and 143 (24.1%) occasional pain (control n = 337, 56.8%). Numerous statistically significant factors were identified, including frequency of sex, ability to orgasm, sensations during intercourse, presence of a steady sexual partner, expectations of painful sex, sex guilt, and sexual distress. Sex guilt acted as full mediator between religiosity and painful sex.

IMPLICATIONS

Healthcare providers should proactively initiate conversations with young female patients about painful intercourse to identify issues and normalize language on pain with sex. Educators are urged to teach evidence-based information on pain-free and guilt-free sexual experiences inside and outside religious contexts.

CONCLUSION

Painful sex affects adolescent and young adult women at a similar rate as non-college adult women and while religiosity does not directly impact young women's GPPPD, religiosity does lead to painful sex if it causes sex guilt. Further research is needed into the mechanisms of religion-based sexual shaming and among religiously conservative women who practice abstinence until marriage. Azim KA, Happel-Parkins A, Moses A, et al. Exploring Relationships Between Genito-Pelvic Pain/Penetration Disorder, Sex Guilt, and Religiosity Among College Women in the U.S. J Sex Med 2021;18:770-782.

The woman and the penile prosthetic implant. Primary or secondary role? Personal experiences on 355 implanted patients

In a group of 355 pts  submitted to Penile Prosthesis Implant (PPI) we recorded data on their relationships with the woman (wife, partner, girlfriend, lover); the aspects of their sexual life; if they were married, divorced or widowed; if they had a lover; if they frequented brothels; if they were satisfied of their actual couple's life; after operation we recorded data concerning if they had some difficulties utilizing the PPI and their level of satisfaction. After operation most pts (93%) confirmed their satisfaction. Relational aspects:  Unmarried pts: 6 pts (21-30 years old) who weren't able to penetrate their girlfriends managed to have regular sex with PPI and could marry. 42/46 unmarried pts after PPI decided to marry.  In the group of married pts 3 pts weren't able to penetrate  their wives; after PPI  they  managed to have regular intercourses and pregnancies. 15 widowers and 23 divorced  pts decided to have a PPI for possible sexual encounters or stable relationships. 96/271 (28,2%) married pts declared a stable extramarital relation that could represent the main reason for having a PPI.  The results of PPI are commonly accepted. Until now PPI may re-establish  penile rigidity and maintenance. In our opinion the simple act of penetrate and ejaculate in vagina, without considering the importance of personal, relational, emotional factors  often well linked to the specific woman, cannot be considered the ideal target of PPI.

Long-Acting Reversible Contraceptive Users' Knowledge, Conversations with Healthcare Providers, and Condom Use: Findings from a U.S. Nationally Representative Probability Survey

Objectives To describe long-acting reversible contraceptive (LARC) users' knowledge, patient-provider interactions, and condom use associated with LARC use. Methods: Data are from the 2018 National Survey of Sexual Health and Behavior, a probability survey of Americans aged 14-49. Results: Of 1,451 sexually active women, 11.2% used intrauterine devices, and 3.1% used implants. Approximately 19-26% of LARC users reported inaccurately on LARC longevity, and 30% reported relying on their provider to indicate the timing of intrauterine device removal. Consistent condom use among LARC users was rare (6.1%). Conclusions: Our findings have implications for how clinicians educate patients on LARC and condom use.