Arousal and desire problems: conceptual, research and clinical considerations or the more things change the more they stay the same

Expectations and Sexual Desire in Romantic Relationships: An Experimental Investigation of Pleasure and Emotional Closeness Expectancies among Young Adults

Drawing from expectancy-value theory, the current study documented expected likelihoods (i.e., expectancies) of orgasm, non-orgasmic sexual pleasure, and emotional closeness during sex with a romantic partner, then tested their causal roles in sexual desire. Participants (N = 582, 50.3% women) were drawn from college student and online samples of young adults in the US. Expectancies were high overall; men reported much higher orgasm expectancies than women and this gender difference was larger in the college sample. Using a within-subjects, factorial experimental design, hypothetical vignettes manipulated participants' expectancies (high/low) pertaining to sex with a romantic partner. Multilevel models indicated emotional closeness expectancies had the strongest effects on men's and women's desire. Orgasm expectancies had stronger effects among the online sample, yet had the weakest effects on desire overall. Both emotional closeness and non-orgasmic pleasure expectancies had stronger effects on women's desire than on men's. Findings indicate young adults' expectations for their romantic sexual experiences may play strong roles in stimulating or stifling their sexual desire, suggesting some desire differences may be partially explained by differences in expectancies, and underscore sex as an important mechanism for fostering intimacy and experiencing pleasure for both young men and young women. Implications for clinical practice are discussed.

The Role of Sexual Desire, Sexual Satisfaction, and Relationship Satisfaction in the Sexual Function of Arab Couples Living in Saudi Arabia

INTRODUCTION

This study is one of the first to examine the association between relationship and sexual variables as approached from a dyadic perspective in Saudi Arabian couples. Theoretical models assign an important role to relationship factors in women's sexuality.

AIM

We examined the role of sexual and relationship satisfaction relative to sexual desire in explaining sexual function in a sample of clinical versus nonclinical couples.

METHODS

This is a cross-sectional, observational study in a sample of 50 heterosexual couples with sexual problems and 50 control couples without problems (N = 100 couples; 200 men and women).

MAIN OUTCOME MEASURE

All participants completed an Arabic version of measures of relationship satisfaction, sexual satisfaction, sexual desire, sexual distress, and sexual function.

RESULTS

Results showed that in the clinical group, sexual function of women was predicted by their own and their partner's level of sexual satisfaction, and their own level of solitary and dyadic sexual desire. Men's sexual function was predicted by their own sexual satisfaction and their partner's relationship satisfaction. In the control group, the sexual function of women was predicted only by their level of sexual satisfaction. In men, sexual function was predicted by their own sexual satisfaction and their level of dyadic sexual desire.

CONCLUSION

These results suggest that sexual desire rather than relationship satisfaction plays an important role in women's sexual dysfunction. Being the most consistent determinant of male and female sexual functioning, sexual satisfaction is an important target of intervention in Arabian couples. A Attaky, J Schepers, G Kok, et al. The Role of Sexual Desire, Sexual Satisfaction, and Relationship Satisfaction in the Sexual Function of Arab Couples Living in Saudi Arabia. Sex Med 2021;9:100303.

History of the Treatment of Female Sexual Dysfunction(s)

This article reviews the history of the treatment of women's sexual problems from the Victorian era to the twenty-first century. The contextual nature of determining what constitutes female sexual psychopathology is highlighted. Conceptions of normal sexuality are subject to cultural vagaries, making it difficult to identify female sexual dysfunctions. A survey of the inclusion, removal, and collapsing of women's sexual diagnoses in the Diagnostic and Statistical Manual of Mental Disorders from 1952 to 2013 illuminates the biases in the various editions. Masters and Johnson's models of sexual response and dysfunction paved the way for the diagnosis and treatment of women's sexual dysfunctions. Their sex therapy paradigm is described. Conceptions of and treatments for anorgasmia, arousal difficulties, vaginismus, dyspareunia, and low desire are reviewed. The medicalization of human sexuality and the splintering of sex therapy are discussed, along with current trends and new directions in sexual health care for women.

Partners' Similarity in Differentiation of Self is Associated With Higher Sexual Desire: A Quantitative Dyadic Study

The relationship between sexual desire and differentiation of self in couples has been frequently discussed in clinical literature but lacks empirical support. This exploratory study investigates the associations between individual and dyadic levels of sexual desire, differentiation of self, and couple satisfaction. Similarities and discrepancies in sexual desire and differentiation of self between partners were especially targeted. Partners were expected to have a lower discrepancy of differentiation of self than unrelated individuals (Bowen's similarity hypothesis). Partners' discrepancy in differentiation of self was expected to be negatively associated with sexual desire, and higher levels of sexual desire and differentiation in the dyad were expected be positively associated with couple satisfaction. Results suggest that partners' similarity regarding differentiation of self predicted individual sexual desire. Other findings suggest that couple satisfaction was positively associated with both sexual desire and differentiation of self. Limitations and clinical implications are discussed.

How do men and women define sexual desire and sexual arousal?

The purpose of this study was to understand how men and women define sexual desire and sexual arousal and how they distinguish between the two. The authors conducted 32 semi-structured interviews with individuals in South East England, using a purposive sampling strategy to maximize the variation in experience of sexual function across the group. The authors identified three criteria that participants used to define and distinguish between desire and arousal: the sequence in which they occurred; whether the mind or the body (or both) were engaged; and the extent to which feelings of desire or arousal were responsive (in response to person or stimulus) and motivational (oriented toward a goal). Most participants attempted to distinguish between desire and arousal when prompted, but often with difficulty. Participants commonly felt that desire preceded arousal; some felt that desire was "mind" and arousal "body"; and many felt that both desire and arousal were responsive and motivational. However, the authors identified numerous times when these distinctions were reversed or the differences between terms were blurred. The results support recent proposals to merge the two diagnostic categories of female sexual arousal disorder and hyposexual desire disorder into a single diagnostic category.

Three decades of sex: Reflections on sexuality and sexology

This commentary provides selected observations drawn from 30 years of experience teaching university sexology courses and as a sex therapist. Over the past three decades, there have been social changes in our perceptions of sexuality, even if on the personal level, little has shifted. The changes include the dramatic impact of the Internet in shaping sexual knowledge and defining restrictive norms as well as the increasing use of drugs that affect sexuality. Evolving attitudes towards sexual assault and LGBTQ issues are among the most significant of these changes. It is noteworthy that the field of sexology is thriving in Canada.