Predictors of women's sexual desire: the role of psychopathology, cognitive-emotional determinants, relationship dimensions, and medical factors

Sexual desire and erotic fantasies questionnaire: development and validation of the sexual desire scale (SDEF1)

The evolution in conceptualization of sexual desire has stimulated many attempts to measure it. However measures able to assess multiple expressions of desire in all sexual identities are still lacking. The main aim of the present study was to test the psychometric properties of the Sexual Desire and Erotic Fantasies questionnaire - Part 1 Sexual Desire (SDEF1), developed as a sex-positive measure of different sexual desire expressions. The SDEF1 was assessed in 1773 participants from the Italian general population (1105 women, 645 men, and 23 other genders; ranged between 18-78 years old, mean age 29.31 ± 10.35) on an online survey, together with the Sexual Desire Inventory - 2, the International Index of Erectile Function, the Female Sexual Function Index, and the Marlowe-Crowne Social Desirability Scale-Short Form. Results support a factorial structure of six dimensions, including 28 items and accounting for 58.11% of the total variance: sexual desire, negative feelings to sexual desire, autoerotic desire, regular partner desire, attractive person desire, and responsive desire. The confirmatory factorial analysis showed satisfactory indexes (RMSEA = 0.042 [90% CI = 0.039-0.045]; GFI = 0.97; NFI = .96; and CFI = 0.97). Regression coefficients ranged from 0.39 to 0.94 and were all statistically significant (p < 0.001). The SDEF1 showed good psychometric properties such as internal reliability, construct, and discriminant validity, and to differentiate women and men with and without sexual difficulties. Men reported significantly higher levels of desire than women in all areas except for desire for a regular partner, were no gender difference was detected. Desire for autoerotic activity was the factor accounting for more variance explained among genders (11.7%). The SDEF1 could be a useful measure to assess different areas of sexual desire and its use could be recommended for clinical and research purposes.

Genital arousal and responsive desire among women with and without sexual interest/arousal disorder symptoms

BACKGROUND

Models depicting sexual desire as responsive to sexual arousal may be particularly apt for women experiencing arousal or desire difficulties, and the degree to which arousal triggers desire may depend on the relationship context and desire target and timing-yet, these associations have not been directly tested among women with and without sexual interest/arousal disorder (SIAD).

AIM

To assess the role of SIAD status and relationship satisfaction in the associations between genital arousal and 4 types of responsive desire.

METHODS

One hundred women (n = 27 meeting diagnostic criteria for SIAD) in romantic relationships with men viewed a sexual film (pleasurable intimate depiction of oral sex and penile-vaginal intercourse) while their genital arousal was recorded via vaginal photoplethysmography (n = 63) or thermal imaging of the labia (n = 37). Partner and solitary desire was assessed immediately before and after the film (immediate desire) and 3 days later (delayed desire).

OUTCOMES

Outcomes consisted of genital response (z scored by method) and associations between genital response and responsive sexual desire.

RESULTS

The key difference between women with and without SIAD was not in their ability to experience genital arousal but in how their genital responses translated to responsive sexual desire. Women with SIAD actually exhibited greater genital arousal than unaffected women. Associations between genital arousal and desire were significant only for women with SIAD and depended on relationship satisfaction and desire type. For women with SIAD with low relationship satisfaction, higher arousal predicted lower immediate desire for a partner; for those with high relationship satisfaction, arousal was either positively related (vaginal photoplethysmography) or unrelated (thermal imaging of the labia) to immediate desire for a partner. Associations with other desire types were not significant.

CLINICAL IMPLICATIONS

Patterns of genital arousal and partner-specific responsive desire among women affected with SIAD were indicative of an avoidance model in response to heightened genital arousal, unless relationship satisfaction was high; attending to genital arousal sensations could be a means of triggering sexual desire for women with SIAD who are satisfied in their relationships.

STRENGTHS AND LIMITATIONS

This is one of the first sexual psychophysiologic studies to connect relationship factors to patterns of sexual response. The differing arousal assessment procedures and lack of official diagnosis may have attenuated results. The homogeneous sample and in-person session requirement limit generalizability.

CONCLUSION

When compared with unaffected women, women affected by SIAD may exhibit stronger arousal responses with sufficiently incentivized sexual stimuli, and the connection between their genital arousal and responsive desire for their partners may be stronger and more dependent on relationship context.

Association between obesity and female sexual dysfunction: a review

INTRODUCTION

Obesity is a global health crisis that has been growing over the past few decades. The economic burden associated with obesity is substantial as it is associated with multiple disabling chronic diseases, such as cardiovascular disease, certain cancers, osteoarthritis, chronic pain, and mental illness. Obesity is known to be a risk factor for sexual dysfunction in men, but this association is less well understood in women.

AIMS

To provide a narrative review of the available literature on the relationship between overweight/obesity and female sexual dysfunction, elaborate on the possible mechanisms explaining this association, and discuss the effects of weight loss on sexual function in those with obesity.

METHODS

A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on obesity and sexual function in women.

RESULTS

The relationship between obesity and female sexual function is not consistent across studies. While women with obesity are more likely to have worse sexual function and avoid sexual activity, many studies have failed to identify these associations. Lifestyle changes resulting in weight loss lead to better sexual function, and bariatric surgery has been shown to improve sexual function in the first couple of years following the procedure; yet, the long-term effects of weight loss and bariatric surgery are still uncertain.

CONCLUSIONS

The evidence on the relationship between obesity and female sexual function is mixed. Nevertheless, weight loss has been shown to improve sexual function in women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on female sexual function require further study.

The effect of short-term increase of estradiol levels on sexual desire and orgasm frequency in women and men: A double-blind, randomized, placebo-controlled trial

Estradiol (E2) has been implicated in sexual functioning in both sexes. E2 levels change distinctively over the menstrual cycle, peaking around ovulation. Data on short-term effects of fluctuating E2 levels on sexual desire are however sparse and mostly based on observational studies. To fill this gap, we ran a double-blind, randomized, placebo-controlled study (N = 126) to investigate the effects of a short-term increase in E2 on sexual desire and orgasm frequency in healthy, young men and women. Circulating E2 levels were elevated through estradiol valerate (E2V) administered over two consecutive days to simulate the rise in E2 levels around ovulation. E2V had no effect on orgasm frequency and only minor effects on sexual desire. On average, the administered E2V dampened change in sexual desire compared to untreated participants with comparable baseline sexual desire in such a way that sexual desire was slightly reduced even in those with higher baseline sexual desire. These findings suggest that short-term increases in E2 have little effect on sexual function and are unlikely to explain the increase in sexual desire around ovulation.

Luring the Elusive: Narratives about Sexual Desire for One's Partner by Women and Men in Heterosexual Romantic Relationships

In this qualitative study, we explored women's and men's experience of sexual desire for their romantic partner and its link to dyadic interactions. During interviews and focus group discussions, our participants described sexual desire as 'elusive', 'conditional', 'responsive' and 'malleable'. The subtheme 'elusive' refers to sexual desire having a will of its own, while the remaining three refer to prerequisites for, triggers of, and strategies for enhancing sexual desire respectively. These subthemes come together in the overarching narrative 'luring the elusive', which articulates one's responsibility to accommodate sexual desire for one's partner, but also the necessity to acknowledge its elusiveness.

Reduced Sexual Desire in Young Norwegian Women: A Mixed-Methods Study

Sexuality has become an area of social competence in which individuals strive to be recognized as sexually competent performers. However, a large proportion of young women experience reduced sexual desire. In this study, both quantitative and qualitative methods were applied. Using data from a questionnaire, the aim of this study was to explore the prevalence of, and the factors associated with, lack of sexual interest and desire among young women in Norway. Further, with the help of in-depth interviews, we investigated how young women with reduced sexual desire experience living with their desire problems and what they experience as the cause of their problems. The sample in the quantitative study consisted of 505 Norwegian women between the ages of 18 and 29 years. ANOVA was employed to explore differences in scores on psychological factors and relational factors, as well as between participants who experienced a lack of sexual interest and desire, and those who did not. The results indicate a high prevalence of lack of sexual interest and desire among women (37.1%), while low appearance satisfaction and low relationship satisfaction were central predictors of lack of sexual interest and desire. The sample in the qualitative study consisted of ten Norwegian women with reduced sexual desire between the ages of 18 and 29 years. Through thematic analysis, four themes emerged as experiences of living with reduced sexual desire: (1) physical and mental health, (2) being a young woman in today's society, (3) relational factors, (4) negative experiences, personal expectations toward sexuality, and sexual trauma.

Endometriosis and Sexual Functioning: How Much Do Cognitive and Psycho-Emotional Factors Matter?

Women with endometriosis often suffer from genito-pelvic pain. The objective of the present study was to analyze the relationship between cognitive and psycho-emotional factors and sexual functioning of women with endometriosis, comparing women with and without endometriosis. A total of 87 women with endometriosis (EG) and 100 women without endometriosis (CG) completed a socio-demographic questionnaire; the short-form of McGill Pain Questionnaire (SF-MPQ); the Female Sexual Functioning Index (FSFI); the Sexual Distress Scale (SDS); the Symptoms Checklist (SCL-90-R); the Toronto Alexithymia Scale (TAS-20); the Positive and Negative Affects Scale (PANAS); the Sexual Dysfunctional Belief Questionnaire (SDBQ); the Sexual Modes Questionnaire (SMQ); and the Questionnaire of Cognitive Schema Activation in Sexual Context (QCSASC). EG obtained worse scores than CG in SF-MPQ, Pain subscale of FSFI, and SDS. EG reached higher scores than CG on almost all scales of SCL-90-R and lower scores in the “Identifying Feelings” scale of TAS-20. Furthermore, EG reported more negative emotions toward sexuality than CG (PANAS) higher scores on the “Affection Primacy” scale of SDBQ and the “Helpless” sexual cognitive schema of QCSASC than CG. No significant differences were found in SMQ. Sexual health professionals should address psychological, emotional, and cognitive factors since they seem involved in patients’ sexual experiences.

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.

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.

Low sexual function is associated with menopausal status in mid-aged women with human immunodeficiency virus infection

OBJECTIVE

To assess the association between menopausal status and female sexual function among mid-aged women with human immunodeficiency virus (HIV) infection.

METHODS

We carried out a cross-sectional study of 221 sexually active HIV-infected women ages 40 to 59 years, based on a secondary analysis of a three-hospital survey in Lima, Perú. We classified menopausal status according to Stages of Reproductive Aging Workshop criteria (STRAW+10); this exposure variable was categorized as binary (non-postmenopausal and postmenopausal) and-for exploratory analysis-as multinomial (pre-, peri-, and postmenopausal). We defined low sexual function (LSF) using the 6-item Female Sexual Function Index (total score ≤19). Socio-demographic and clinical variables were assessed, including age, used highly active antiretroviral therapy scheme, disease duration, depressive symptoms, and co-morbidities. We performed Poisson generalized linear models with a robust variance to estimate 95% confidence interval (CI), crude prevalence ratios (cPRs), and adjusted prevalence ratios (aPRs) by epidemiological and statistical approaches using nonparametric method of bias-corrected and accelerated bootstrap resampling with 1,000 repetitions.

RESULTS

Studied women had a median age of 47.0 years (interquartile range: 7.5); 25.3% were premenopausal, 25.8% were perimenopausal, and 48.9% were postmenopausal. Also, 64.3% had LSF. The frequency of LSF was 53.6% in non-postmenopausal and 75.0% in postmenopausal women. Postmenopausal status was associated with LSF in both the crude (cPR = 1.39; 95% CI: 1.13-1.71) and the adjusted regression models (aPR = 1.38; 95% CI: 1.12-1.71).

CONCLUSIONS

HIV-infected postmenopausal women have a higher prevalence of LSF than those non-postmenopausal ones, even when adjusting for multiple potential confounders.

The Heteronormativity Theory of Low Sexual Desire in Women Partnered with Men

Low sexual desire in women partnered with men is typically presumed to be a problem-one that exists in women and encourages a research agenda on causation and treatment targeting women. In this paper, we present a distinct way forward for research on low sexual desire in women partnered with men that attends to a more structural explanation: heteronormativity. A heteronormative worldview assumes that relationships and structures are heterosexual, gender (usually conflated with sex) is binary and complementary, and gender roles fit within narrow bounds including nurturant labor for women. We propose the heteronormativity theory of low sexual desire in women partnered with men, arguing that heteronormative gender inequities are contributing factors. We outline four hypotheses and their predictions related to: inequitable divisions of household labor, blurring of partner and mother roles, objectification of women, and gender norms surrounding sexual initiation. We discuss some mechanisms-social, physiological, and otherwise-for the heteronormativity theory, especially related to stress, objectification, and nurturance. We close by noting some limitations of our paper and the ways that the heteronormativity theory of low sexual desire in women partnered with men provides a rigorous, generative, and empirical way forward.

Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal

Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.

Women's Cognitive and Emotional Appraisal of Sex Pictures: The Predictive Role of Age, Exposure Time, and Sexual Beliefs

This study researched how age predicts women's cognitive and emotional appraisal of sex pictures. One hundred and fifty five women were exposed to romantic, sexually moderate and sexually explicit pictures. Women reported on the emotional valence, subjective sexual arousal, and level of sexual content attributed to the pictures; women's sexual beliefs were further evaluated. Findings revealed that age predicted increased pleasantness to sexually moderate and explicit pictures, as well as higher subjective sexual arousal to all type of pictures. Some predictions were moderated by sexual beliefs and exposure time, pointing the role of contextual factors in women's appraisal of erotica.

Using Three Indirect Measures to Assess the Role of Sexuality-Related Associations and Interpretations for Women's Sexual Desire: An Internet-Based Experimental Study

Theoretical models emphasize the role of both automatic appraisals (i.e., associations) and conscious appraisals (i.e., interpretations) for sexual desire. Studies on sexuality-related appraisals have not combined self-report measures and experimental paradigms in order to compare the relevance of associations or interpretations. The aim of this study was to assess the relative contribution of both associations and interpretations to the explanation of low sexual desire in women. Toward this goal, indirect measures assessing associations (via a Single Target Implicit Association Test [STIAT]) and interpretations (via a Scrambled Sentences Test [SST] and a scenario task) were administered in a sample of 263 women (M_age = 27.90, SD 8.27) with varying levels of sexual desire and different sexual orientations (exclusively heterosexual women: 54.6%). Negative sexuality-related interpretations as assessed with two variants of the SST as well as the scenario task added to the explanation of lower sexual desire in women. Negative associations as measured with the STIAT were predictive of lower sexual desire only in women who did not indicate an exclusively heterosexual orientation. In this study, sexuality-related interpretations were more relevant to women's sexual desire than automatic associations. Future studies should assess the causal mechanism underlying sexuality-related interpretations (e.g., by evaluating whether these can be changed via cognitive bias modification techniques or psychological treatments).

Eating disorders and sexuality: A quantitative study in a French medically assisted procreation course

OBJECTIVE

Among medically assisted procreation (MAP) patients, the prevalence of eating disorders (ED), clinical or subclinical, current or past, is considerable. In addition to metabolic repercussions, the literature suggests that these patients present with more sexual dysfunction, leading to anxiety. This quantitative research on a population of women consulting a MAP department for unexplained or ovulatory infertility proposed to study the sexuality of this population by comparing the sexuality of patients suffering from or having suffered from an ED to the sexuality of the non-ED group.

METHOD

Patients (n = 61) filled out the Eating Disorder Examination Questionnaire (EDE-Q), the Brief Index of Sexual Functioning for Women (BISF-W), the ED Whole Life Research Questionnaire, the Hospital Anxiety and Depression Scale (HADS) and the Kansas Marital Satisfaction Scale (KMSS).

RESULTS

We found a prevalence of 54% of ED, current or past. Even though these patients reported the same prevalence of sexual intercourse, they had significantly more physical problems (e.g., anorgasmia, vaginismus, headache) affecting their sexuality (p = .01) than the non-ED group, after adjusting for depression. Approximately 10% of the study population reported no intravaginal intercourse during the last month.

DISCUSSION

This study provides evidence for the existence of more sexual dysfunction in patients who have a fertility disorder and have ED or a history of ED. Future research should evaluate the results of psychological or sexological care that may be more suitable for the infertility of these patients.

Fibromyalgia and sexual performance: a cross-sectional study in 726 Brazilian patients

Fibromyalgia (FM) causes generalized musculoskeletal pain and sexual life may also be impaired in these patients. We aimed to study sexual performance in FM patients comparing them with healthy controls and verify if there is association of epidemiological variables, degree of musculoskeletal pain and associated diseases with sexual performance in this group of patients. This is a cross-sectional study based in an internet survey. FM and controls filled a questionnaire on epidemiological data, associated diseases, and musculoskeletal pain. Also answered the validate questionnaires Female Sexual Function Index (FSFI) and the Sexual Quotient-Females (SQ-F) to evaluate the sexual performance. The survey was answered for 1584 individuals: 726 FM patients and 858 paired controls. Sexual performance evaluated by FSFI and by SQ-F was worse in the FM group than controls in all studied domains (all with p < 0.0001). According to SQ-F, 63% of them had a regular to null performance; according to FSFI, 83% had sexual dysfunction. Sexual performance was worse in those on menopause (< 0.0001). A modest correlation of age (rho - 0.09 for SQ-F and - 0.10 for FSFI) and degree of musculoskeletal pain (rho = - 0.21 for SQ-F and - 0.23 for FSFI) with sexual performance indexes were found. Psychiatric illness was also associated with lower SQ-F (p = 0.001). There is a high prevalence of sexual dysfunction in FM that associates with the presence of menopause, psychiatric comorbidities, older age, and high degree of musculoskeletal pain.

Body Image and Hypoactive Sexual Desire Disorder Relationship in a Representative Sample of Iranian Women

Objective: Hypoactive Sexual Desire Disorder (HSDD) among women is a complicated one which is created by various factors playing roles. One of the potential concerns related to Body Image (BI) is lack of sexual appeal in women. Body Image is often described as what a person perceives of their body encompassing the biological, psychological and social factors. The present research pursues the goal to investigate the association between BI and HSDD among the reproductive age women in Iran. Materials and methods: The current study is a cross-sectional (descriptive -analytical) research done on 1000 reproductive age included woman (15-49 years), performed by systematic random sampling method. The data collection tool includes the socio-demographics and the sexual desire scale in addition to the revised sexual distress scale to measure HSDD completed as self-report by the samples. Univariate and multivariate regression tests have been used in order to analyze the data. Results: The mean ± SD age of the women participating in the study was 32.09 ± 7.33. Having adjusted the confounder variables' effect by logistic regression multivariate analysis; the odd ratio for HSDD has been analyzed. The findings suggested that the odd ratio for HSDD in those not satisfied or slightly feeling fulfilled with their BI has been OR: 4.2 (95% CI: 1.98-9.05) and OR: 3.9 (95% CI: 2.29-6.65), respectively, times more than the ones highly satisfied with their body image. Conclusion: The present study results indicate that being dissatisfied with BI is a determinant factor of HSDD that is more probable in the people with negative image of their body structure and feeling lack of bodily appeal. Thus it is imperative to pay attention to this factor when analyzing HSDD.

Ebbs and Flows of Desire: A Qualitative Exploration of Contextual Factors Affecting Sexual Desire in Bisexual, Lesbian, and Straight Women

Previous research has found that sexual desire ebbs and flows over time within and across relationships, leading to instances of desire discrepancy. The purpose of the present study was to understand factors that may contribute to desire and desire discrepancy and examine differences and similarities across women from diverse sexual identity groups. The present qualitative study involved semi-structured interviews with 31 women (10 bisexual, 8 lesbian, and 13 straight). We identified six main themes (changes across lifespan, hormonal influences, mental and physical health, objective of desire, partner dynamics, external factors) with 21 subthemes. The findings showed more similarities between the women than differences.

Analysis of low sexual desire in Chinese women: a national population-based epidemiological survey in mainland China

Background Low sexual desire is the most prevalent female sexual health problem; however, national epidemiologic data on female sexual desire in China are absent. Understanding factors related to low sexual desire are essential in preparing educational and consultative programs and policies to improve women's sexual health.

METHODS

A national epidemiological survey on female sexual function was conducted from February 2014 to January 2016 in mainland China. Women were randomly selected using multistage, stratified, cluster sampling. The sexual functioning was assessed by using the Chinese version of the 19-item Female Sexual Function Index (FSFI) questionnaire.

RESULTS

The questionnaire on sexual dysfunction was completed by 25446 women who were aged 20-70 years. The prevalence of low sexual desire was 21.6% (domain score ≤4.28), and the declines in sexual desire started as early as 25-29 years. Sexual arousal was most closely related to sexual desire (Pearson's correlation = 0.760). Higher educational attainment was associated with a decreased risk of low sexual desire. Diabetes, non-gynaecological cancer, pelvic inflammatory disease and pelvic pain had negative effects on sexual desire (OR = 1.44, 99% CI = 1.11-1.87; OR = 1.92, 99% CI = 1.18-3.13; OR = 1.32, 99% CI = 1.07-1.63; OR = 1.77, 99% CI = 1.13-2.76 respectively).

CONCLUSIONS

The prevalence of low sexual desire in females in China was modest. Low sexual desire is correlated with sexual arousal disorder. Biopsychosocial factors have overlapping effects on sexual desire.

Using spectral and cross-spectral analysis to identify patterns and synchrony in couples' sexual desire

Sexual desire discrepancy is one of the most frequently reported sexual concerns for individuals and couples and has been shown to be negatively associated with sexual and relationship satisfaction. Sexual desire has increasingly been examined as a state-like construct that ebbs and flows, but little is known about whether there are patterns in the fluctuation of sexual desire. Utilizing spectral and cross-spectral analysis, we transformed 30 days of dyadic daily diary data for perceived levels of sexual desire for a non-clinical sample of 133 couples (266 individuals) into the frequency domain to identify shared periodic state fluctuations in sexual desire. Spectral analysis is a technique commonly used in physics and engineering that allows time series data to be analyzed for the presence of regular cycles of fluctuation. Cross-spectral analysis allows for dyadic data to be analyzed for shared rates of fluctuation between partners as well as the degree of (a)synchrony (or phase shift) between these fluctuations. Men and women were found to exhibit fluctuations in sexual desire at various frequencies including rates of once and twice per month, and to have sexual desire that was unlikely to fluctuate over periods of three days or less and therefore exhibited persistence. Similar patterns of fluctuation were exhibited within couples and these patterns were found to be largely synchronous. While instances of desire discrepancy may arise due to differences in rates of sexual desire fluctuation and random fluctuations, such instances may be normal for romantic relationships. The results have important implications for researchers, clinicians, and educators in that they corroborate the supposition that sexual desire ebbs and flows and suggest that it does so with predictable regularity.

The Facial Width-to-Height Ratio Predicts Sex Drive, Sociosexuality, and Intended Infidelity

Previous research has linked the facial width-to-height ratio (FWHR) to a host of psychological and behavioral characteristics, primarily in men. In two studies, we examined novel links between FWHR and sex drive. In Study 1, a sample of 145 undergraduate students revealed that FWHR positively predicted sex drive. There were no significant FWHR × sex interactions, suggesting that FWHR is linked to sexuality among both men and women. Study 2 replicated and extended these findings in a sample of 314 students collected from a different Canadian city, which again demonstrated links between the FWHR and sex drive (also in both men and women), as well as sociosexuality and intended infidelity (men only). Internal meta-analytic results confirm the link between FWHR and sex drive among both men and women. These results suggest that FWHR may be an important morphological index of human sexuality.

Using Emotionally Focused Therapy to Treat Sexual Desire Discrepancy in Couples

Couples in committed relationships encounter a multitude of issues. According to Metz and McCarthy (2010), when couples report high sexual satisfaction, it accounts for 15% to 20% of their overall relationship satisfaction. However, when couples report low sexual satisfaction, it contributes 50% to 70% of their overall satisfaction with their partner. Issues of sexual desire, currently referred to as sexual desire discrepancy, are among the most difficult to treat. Although there are many factors contributing to the issue of sexual desire discrepancy, current literature highlights the importance of emotional intimacy as an outcome and predictor of increased sexual desire. Given the complex nature of sexual desire, clinicians often lack the understanding and treatment options that are systemic. By viewing sexual desire discrepancy as a relational problem that can be treated using emotionally focused therapy, clinicians are better equipped to work with emotional and sexual factors that impact desire and couple distress.

The Activation of Incompetence Schemas in Response to Negative Sexual Events in Heterosexual and Lesbian Women: The Moderator Role of Personality Traits and Dysfunctional Sexual Beliefs

Personality traits and dysfunctional sexual beliefs have been described as vulnerability factors for sexual dysfunction in women, and have also been proposed as dispositional variables for the activation of incompetence schemas in response to negative sexual events. However, no study has tested the role of personality traits and dysfunctional sexual beliefs in the activation of incompetence schemas. The current study aimed to assess the moderator role of neuroticism, extraversion, and dysfunctional sexual beliefs in the association between frequency of unsuccessful sexual episodes and activation of incompetence schemas in heterosexual and lesbian women. An online survey was completed by 1,121 women (831 heterosexual; 290 lesbian). Participants completed the NEO Five-Factor Inventory (NEO-FFI), the Sexual Dysfunctional Beliefs Questionnaire-Female Version (SDBQ), and the Questionnaire of Cognitive Schemas Activated in Sexual Context (QCSASC). Findings indicate that neuroticism moderates the association between frequency of negative sexual events and activation of incompetence schemas in heterosexual women. Moreover, several sexual beliefs also act as moderators of the relationship between negative sexual episodes and the activation of cognitive schemas in both heterosexual and lesbian women. Overall, findings support the cognitive-emotional model of sexual dysfunctions, emphasizing the role of personality traits and dysfunctional sexual beliefs as facilitators of the activation of incompetence schemas in response to negative events in women.

Psychological Features and Sexual Beliefs Characterizing Self-Labeled Asexual Individuals

The present study was aimed at exploring and describing potential psychological and cognitive features characterizing asexual individuals. A web survey targeting a community of single and highly educated asexual individuals (68 women and 19 men) and matching controls (58 women and 19 men) was carried out in volunteers over 18 years old. Participants responded to a set of questions assessing personality traits, state psychopathological dimensions, and sexual beliefs. Findings on asexual women revealed that they reported higher levels of neuroticism, depression, phobic anxiety, personal sensitivity, as well as lower extraversion and conscientiousness than nonasexual women; also, asexual women reported more sexually conservative beliefs (including regarding sexual desire as a sin), beliefs related to the negative impact of age in sexuality, and the primacy of affection in sexual intercourse. Findings on asexual men showed that they reported more neuroticism, openness, psychoticism, and less extraversion. Findings on sexual beliefs showed that asexual men reported more sexually conservative beliefs, more beliefs related to the propensity for believing that women may use sex as a means to subjugate men, and beliefs related to the idea that erectile performance is central to female satisfaction. Findings further suggested that some of these features may have tapped into asexual individuals' religious status.

Women's Postpartum Sexual Health Program: A Collaborative and Integrated Approach to Restoring Sexual Health in the Postpartum Period

The postpartum period presents unique challenges to couples' relationships and sexuality, yet these factors are often left unaddressed by health care providers. The Women's Postpartum Sexual Health Program (WPSHP), a four-session, group- and couples-based program delivered by an interdisciplinary care team at a family practice center, was designed specifically to address common concerns among postpartum women and their partners. The interrelated, biopsychosocial aspects of women's sexuality in the postpartum period are summarized, followed by a detailed description of the WPSHP content and structure. This information is intended to serve as a practical resource for implementation and adaptation of the WPSHP across different practice settings.

Psychological Factors Involved in Sexual Desire, Sexual Activity, and Sexual Satisfaction: A Multi-factorial Perspective

This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to maintaining a balance between motivational aspects and self-control abilities, as both have been considered important in relation to adaptive sexuality. Moreover, the study explored the relationship between sexual desire, activity, and satisfaction. Participants completed questionnaires assessing sexual desire (dyadic, solitary), sexual activity (with a partner, alone), sexual satisfaction, approach and avoidance motivation, attachment, self-control, sensation seeking, and mindfulness. Cluster analyses, based on participants' level of sexual desire and sexual activity, highlighted three distinct profiles for each gender related to different types of psychological functioning: (a) participants with high dyadic sexual desire and activity were the most sexually satisfied, showed optimal psychological functioning, and were characterized by a balance between motivational tendencies to seek positive rewards and self-control abilities (high approach motivation, secure attachment, high self-control, high mindfulness); (b) participants with high dyadic and solitary sexual desire and activity were moderately satisfied and showed a type of psychological functioning predominantly characterized by impulsivity (an overly high motivation to obtain rewards in women, and low self-control in men); (c) participants with low dyadic sexual desire and activity were the least sexually satisfied and were characterized by high motivation to avoid negative consequences and low self-control (high avoidance motivation, insecure attachment, and poor mindfulness). These results shed further light on how fundamental psychological factors contribute to explain the individual variability in sexual desire, activity, and satisfaction.

Automatic Thoughts During Sexual Activity, Distressing Sexual Symptoms, and Sexual Orientation: Findings from a Web Survey

Studies with heterosexual samples have supported the role of cognitions on sexual functioning in men and women. However, there is no research on the impact of automatic thoughts on sexual functioning in sexual-minority samples. Therefore, the current study aimed to analyze the differences in automatic thoughts during sexual activity between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual symptoms, in order to establish similarities and differences between samples. A web survey was completed by 156 men and 168 women. A group of men and women with distressing sexual symptoms (78 men and 84 women) and a group without distressing sexual symptoms (78 men and 84 women) equally distributed in terms of sexual orientation and matched for sociodemographic variables were constituted. Participants answered a sociodemographic questionnaire, a questionnaire about sexual symptoms, and an automatic thoughts measure. Main findings suggested that men and women with distressing sexual symptoms reported significantly more negative automatic thoughts and fewer erotic thoughts during sexual activity, regardless of sexual orientation. Overall, current findings were consistent with previous research with heterosexual samples, suggesting a similar pattern in heterosexual samples, and gay men and lesbian women samples.

Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version

Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias.

The Relationship between Sexual Cues and Sexual Desire in Women

Sexual desire is one of the most studied dimensions of sexual response. There is extensive research on bio-medical, psychosocial, and relationship predictors of desire particularly in women. Despite this accumulated knowledge, there is a lack of studies investigating the ability of sexual cues to predict sexual desire. A sample of 546 heterosexual and premenopausal Portuguese women, aged between 18 and 53 years old, completed a web survey assessing socio-demographic variables, medical conditions, psychopathology, relationship dimensions, sexual cues and sexual desire. Findings from hierarchical regression analyses indicated that sexual cues significantly predict sexual desire. In particular, explicit/arousal cues (β = .321, p < .001) were the most significant predictor of female sexual desire. Additionally, somatization (β = .188, p < .001), relationship satisfaction (β = .159, p < .001), anxiety (β = -.165, p = .006), and antidepressant medication (β = -.094, p = .014) were also significant predictors. Results emphasize the strong ability of explicit/arousal cues to predict sexual desire in women above and beyond other known factors. These findings suggest that the assessment of sexual desire problems in women as well as treatment approaches should take into consideration the role of sexual cues and particularly explicit/arousal cues.

BIOPSYCHOSOCIAL DETERMINANTS OF HYPOACTIVE SEXUAL DESIRE IN WOMEN: A NARRATIVE REVIEW

Background:

As a mental response to sexual stimuli, sexual desire determines human sexual behavior and represents the cognitive capacity of sexual stimulation, so that avoiding sexual activity has a very negative effect on the discharge of intimacy and joy in couple’s relationship and threatens the stability relationship, which can finally end in sexual dissatisfaction and divorce; it may even affect the reproduction. This study, reviews the literature on biopsychosocial determinants of hypoactive sexual desire disorder in women in childbearing ages.

Method:

The search was done from January to March 2015 by the use of the data bases ProQuest, Pubmed, CINAHL, Ovid and Medline and the words sexual desire, related factors and biopsychosocial determinants were used as free text words. The words reduce sexual desire, hypoactive sexual desire disorder, dyadic relationship, biopsychosocial factors and women were used as keywords in the search. Also, the articles focusing on any aspects of sexual desire such as biological, social and psychological factors and relationship factors alone or integrated, were included in the study. The articles which specifically targeted the hypoactive sexual desire disorder in pregnant and lactating women and also the articles targeting biopsychosocial factors related to other types of sexual function disorder such as arousal disorder, orgasm disorder and dyspareunia, were all excluded from this study.

Findings:

After reviewing the literature, the findings were categorized in three main class of effect of biologic factors on sexual desire and sexual hypoactivity, the effect of psychological factors on sexual desire and the effect of cultural factors and couple’s relationship on sexual desire, each of these domains cover a wide range (such as hormonal changes, chronic diseases, psychological difficulties (perceived stress, anxiety, depression). Incompatibility of couples, the spouse’s sexual function disorder) which may overlap. Because of the complexity of etiology and the difficulty of treating hypoactive sexual desire disorder, it is necessary to use biopsychosocial approaches to diagnose and treat the disorder.

Conclusion:

According to the findings of this reviewing study, the factors able to affect sexual desire and activity are not distinct and often overlap, therefore, the complicated etiology of hypoactive sexual desire disorder often needs multidimensional intervention to use biopsychosocial approach; Multi factor assessment with a combination of psychological, physical, social and hormonal intervention can be effective in making strategies to treat the symptoms of HSDD.

Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review

The scientific community appears to be less interested in sexuality of eating disorders (EDs) as compared to other psychiatric or medical comorbidities. However, a clear association between sexual problems and ED psychopathology was reported from different perspectives. The overarching goal of this systematic review was to evaluate the general approach of the scientific literature toward the topic of sexuality and EDs. In particular, four different categories of research have been individuated, encompassing the role of puberty, and sexual abuse in the pathogenesis of the disorders, sexual dysfunctions, and the association between sexual orientation and EDs psychopathology. Timing of puberty with its hormonal consequences and the changes in the way persons perceive their own body represent a crucial period of life for the onset of the disorder. Sexual abuse, and especially childhood sexual abuse are well-recognized risk factors for the development of ED, determining a worse long-term outcome. Recent research overcome the approach that considers sexual activity of EDs patients, in terms of hypersexuality and dangerous sexual behaviors, considering the sexuality of EDs persons in terms of sexual desire, satisfaction, orgasm and pain. Results from this line of research are promising, and describe a clear relationship between sexual dysfunction and the core psychopathological features of EDs, such as body image disturbances. Finally, the analysis of the literature showed an association between sexual orientation and gender dysphoria with EDs psychopathology and pathological eating behaviors, confirming the validity of research developing new models of maintaining factors of EDs related to the topic of self-identity.

Sexual Dysfunctional Beliefs Questionnaire (SDBQ): Translation and Psychometric Properties of the Iranian Version

INTRODUCTION

The sexual dysfunctional beliefs questionnaire (SDBQ) is a validated measure for assessing dysfunctional sexual beliefs.

AIMS

The aim of this study was to translate and validate the SDBQ to Iranian context.

METHODS

In order to translate the questionnaire from English into Persian, a forward-backward procedure was applied. After linguistic validation, the psychometric properties of the Iranian version were assessed for both men and women. A total of 387 participants (226 women and 161 men) completed the SDBQ.

MAIN OUTCOME MEASURES

A principle component analysis with varimax rotation was performed for both the male and female samples. Reliability was evaluated by calculating Cronbach's alpha (internal consistency) and test-retest coefficients (intraclass correlation coefficient).

RESULTS

The results from the principle component analysis identified six factors in the female version: sexual conservatism and female sexual passivity, beliefs about masturbation, body image beliefs, sexual desire and pleasure as a sin, age-related beliefs, and denying affection primacy. In the male version six factors were also identified: sex as an abuse of men's power, beliefs related to women's satisfaction, sexual conservatism, female sexual power, "macho" beliefs, and restrictive attitudes toward sex. Findings support the original six-factor solution for the male sample. For the female sample, although a six-factor solution was found, original motherhood-related beliefs were included in the sexual conservatism and female sexual passivity factor, and a new dimension has emerged, related to masturbation beliefs. Additionally, results indicated that the SDBQ had good internal consistency and test-retest reliability in both male and female versions.

CONCLUSION

Current findings support the reliability and validity of the SDBQ in an Iranian sample and suggest its applicability to assess sexual beliefs in both clinical samples and the general population in Iran.

Dysfunctional sexual beliefs: a comparative study of heterosexual men and women, gay men, and lesbian women with and without sexual problems

INTRODUCTION

Conservative and dysfunctional sexual beliefs are commonly associated with sexual problems among heterosexual men and women. However, little is known about the role of sexual beliefs in sexual problems in gay men and lesbians.

AIM

The present study aimed at analyzing the role of sexual beliefs in sexual dysfunction in a sample of heterosexual and homosexual men and women.

MAIN OUTCOME MEASURES

Participants answered questions about self-perceived sexual problems and completed the Sexual Dysfunctional Beliefs Questionnaire.

METHODS

Two hundred twelve men (106 gay) and 192 women (96 lesbian) completed a Web survey.

RESULTS

Findings indicated that men with sexual dysfunction (regardless of sexual orientation) reported significantly more conservative beliefs and more erroneous beliefs related to partner's sexual satisfaction compared with sexually healthy men. Also, gay men with sexual dysfunction (but not heterosexual men) scored higher on belief in sex as an abuse of men's power compared with healthy controls. In addition, heterosexual men scored higher on "macho" beliefs, beliefs regarding partner's sexual satisfaction, and partner's power, compared with gay men. For women, a main effect was found for sexual orientation, with lesbian women scoring higher on sexual desire as a sin, age-related beliefs, and affection primacy and lower on beliefs related to motherhood primacy.

CONCLUSIONS

Overall, findings suggest that dysfunctional sexual beliefs may play a role as vulnerability factors for sexual dysfunction regardless of sexual orientation, particularly in men.

Group mindfulness-based therapy significantly improves sexual desire in women

At least a third of women across reproductive ages experience low sexual desire and impaired arousal. There is increasing evidence that mindfulness, defined as non-judgmental present moment awareness, may improve women's sexual functioning. The goal of this study was to test the effectiveness of mindfulness-based therapy, either immediately or after a 3-month waiting period, in women seeking treatment for low sexual desire and arousal. Women participated in four 90-min group sessions that included mindfulness meditation, cognitive therapy, and education. A total of 117 women were assigned to either the immediate treatment (n = 68, mean age 40.8 yrs) or delayed treatment (n = 49, mean age 42.2 yrs) group, in which women had two pre-treatment baseline assessments followed by treatment. A total of 95 women completed assessments through to the 6-month follow-up period. Compared to the delayed treatment control group, treatment significantly improved sexual desire, sexual arousal, lubrication, sexual satisfaction, and overall sexual functioning. Sex-related distress significantly decreased in both conditions, regardless of treatment, as did orgasmic difficulties and depressive symptoms. Increases in mindfulness and a reduction in depressive symptoms predicted improvements in sexual desire. Mindfulness-based group therapy significantly improved sexual desire and other indices of sexual response, and should be considered in the treatment of women's sexual dysfunction.

Psychological factors predicting the distress to female persistent genital arousal symptoms

Symptoms of persistent genital arousal are expected to negatively affect women's sexual and emotional well-being. However, not all women who experience persistent genital arousal complain about their genital condition. Against this background, this study aimed to evaluate psychological predictors of the distress associated with persistent genital arousal symptoms, as well as psychological moderators influencing the conditions under which persistent genital arousal causes distress. A total of 117 women reporting symptoms of persistent genital arousal answered to online questionnaires measuring personality traits, sexual beliefs, and dyadic adjustment. Women have also completed a checklist measuring the frequency/severity of persistent genital arousal symptoms and the distress/impairment caused by these symptoms. Results showed that neuroticism, (low) openness, sexual conservatism, and (low) dyadic adjustment significantly predicted distress associated with genital symptoms. Furthermore, sexual conservatism was found to moderate the relation between the symptoms' severity and the distress associated with those symptoms. Overall, sexual conservatism seems to be a key differentiator factor, influencing the psychological conditions under which women may report higher levels of distress caused by persistent genital arousal. Because such findings focus on the distress to genital arousal symptoms rather than on persistent genital arousal disorder as a clinical entity, the results under consideration may or may not characterize women formally assigned to the persistent genital arousal disorder label.

Cognitive aspects of sexual functioning: differences between East Asian-Canadian and Euro-Canadian women

The purpose of this study was to investigate the sexual beliefs of female undergraduates, as well as the thoughts they experience during sexual experiences. The study aimed to determine potential differences in these variables between East Asian-Canadians and Euro-Canadians, as well as the influence of acculturation on these variables. In addition, the relationships between sexual beliefs, automatic thoughts, and specific aspects of sexual functioning were examined. Euro-Canadian (n = 77) and East Asian-Canadian (n = 123) undergraduate women completed the Sexual Dysfunctional Beliefs Questionnaire, the Sexual Modes Questionnaire, the Female Sexual Function Index, and the Vancouver Index of Acculturation. East Asian women endorsed almost all sexual beliefs assessed in this study more than did Euro-Canadian women, and endorsement of these beliefs was associated with acculturation. In addition, East Asian-Canadian and Euro-Canadian women differed in the frequency of experiencing negative automatic thoughts. Results also revealed associations between difficulties in sexual functioning, and both sexual beliefs and automatic thoughts. Together, these results provide preliminary support for the hypothesis that differences in cognitive aspects of sexuality may underlie the differences in sexual functioning previously observed between these two groups.

Body image and female sexual functioning and behavior: a review

Knowledge in the research fields of body image and sexuality has significantly increased in the last decade. In this review, data from 57 studies were compiled for a review of empirical evidence regarding the association between sexuality and body image among healthy women. The overall conclusion is that body image issues can affect all domains of sexual functioning. Cognitions and self-consciousness seem to be key factors in understanding the complex relationships between women's body image and sexuality. Body evaluations and cognitions not only interfere with sexual responses and experiences during sexual activity, but also with sexual behavior, sexual avoidance, and risky sexual behavior.