Sexual activities, sexual and life satisfaction, and successful aging in women

Love (and) ageing well: A qualitative study of sexual health in the context of ageing well among women aged 50 and over

BACKGROUND

The United Nations has declared 2021-2030 the 'Decade of Healthy Ageing' and identified the need to strengthen the evidence base on interpretations and determinants of healthy ageing to inform policy.

OBJECTIVES

This study sought to interrogate a 'policy blind spot' and examine interpretations and experiences of sexuality and sexual health within the context of ageing well among women aged 50+.

DESIGN

The qualitative study design was underpinned by an interpretivist epistemology. Research was guided by principles of feminist scholarship and located in an affirmative ageing framework.

METHODS

Semi-structured individual interviews were conducted between April-June 2019 with 21 English-speaking women aged 52-76. Women were recruited through community organizations in North West England. Transcripts were analysed using a framework approach to thematic analysis, applying an inductive approach to theme generation.

RESULTS

Narratives encompassed six broad themes: reflections on 'ageing well'; age alone does not define sexuality and sexual health; interpretations of sexual health and sexuality; vulnerability and resistance in later-life sexual health; narratives of (in)visibility; and reimagining services to promote sexual health in later life. There was a dominant belief that sexual health represents a component of ageing well, despite a broad spectrum of sexual expression and health challenges. Sexual expression was diversely shaped by conflicting societal expectations within an evolving digitized environment. In clinical settings, however, sexual health discussions were often muted or framed from a disease-focussed lens. Women expressed a preference for holistic, person-centred sexual health provision from an orientation of wellness to support varied sexual expression, sensitive to wider health, life and relationship realities.

CONCLUSION

This work strengthens calls to disentangle sexual health from disease-centred narratives and legitimize sexual health as part of the healthy ageing agenda.

Sexual Wellbeing according to Transgender Individuals

Objective

Sexual wellbeing is an important aspect of quality-of-life. In transgender individuals who seek gender affirming treatment, various aspects of sexuality have been assessed. However, not much is known on how transgender individuals themselves perceive sexual wellbeing. This study aims to explore the perception of sexual wellbeing in transgender-individuals (an emic-perspective).

Methods

To explore sexual wellbeing from an emic perspective, qualitative interviews with transgender individuals were conducted, recorded and transcribed verbatim. Inductive coding and thematic analysis were used to assess topics and themes pertaining to sexual wellbeing.

Results

Based on interviews wih15 participants (19-74 years) with diverse self-identified genders, four main themes, relating to sexual wellbeing were derived: (1) given description of sexual wellbeing, (2) conditions for sexual wellbeing, (3) factors affecting sexual wellbeing, and (4) experienced sexual wellbeing.

Conclusion

Positive experiences, feeling comfortable with body/self, intimacy, acceptation and communication with partner appeared helpful to overcome hurdles and experience sexual wellbeing.

What Is the Mediating Role of Communication Skills and Sexual Satisfaction between Job and Life Satisfaction of Healthcare Employees?

There are three areas of harmony in human life that are related to each other: "work environment", "love-to be loved-sexual area" and "social environment". Incompatibility and dissatisfaction in one area can also affect other areas. Therefore, the aim of this study is to examine the relationship between job satisfaction, life satisfaction, communication, and sexual satisfaction of healthcare employees. The data collected by questionnaires from 394 employees working in university hospitals in Turkey were analysed using SPSS and AMOS programs. The findings show that there is a positive relationship between the job and life satisfaction of employees of healthcare organizations. Additionally, the findings revealed that communication skills and sexual satisfaction have a mediating role between job satisfaction and life satisfaction of employees in healthcare organizations. Life satisfaction, sexual satisfaction, and relationships are some of the factors that should be considered by healthcare organizations. It would be beneficial to employees and the public if health policy makers implemented programmes to enhance job satisfaction.

Sexual-related determinants of life satisfaction among married women: A cross-sectional study

BACKGROUND AND AIM

Life satisfaction refers to the perceived satisfaction of individuals concerning various aspects of their lives. The present study investigated the predictive role of sexual-related determinants in life satisfaction among married women.

METHODS

A cross-sectional study was conducted from August to November 2021. A total of 350 married women with at least six months of cohabitation with husbands were included in the study. The study utilized a multi-stage random sampling method from 10 comprehensive health centers in Qazvin, Iran. Scores on the Emotional Intimacy Questionnaire (EIQ), Dyadic Sexual Communication Scale (DSCS), Female Sexual Distress Questionnaire (FSDQ), Female Sexual Quality of Life Scale (FSQLS), Female Sexual Function Index (FSFI), and Life Satisfaction Scale (LSS) were assessed. Data were analyzed using univariable and multivariable linear regression models with a significance level of p < 0.05.

RESULTS

The mean age of participants was 33.77 years (SD = 9.77) and they had been married for an average of 10.21 years (SD = 9.93). The mean scores on the LSS were 20.16 (out of 35; SD = 6.79). Based on the multivariable linear regression model adjusted for socio-demographic characteristics, the two strongest predictors of life satisfaction among Iranian married women were marital intimacy (β = 0.49, p < 0.001) and sexual functioning (β = 0.17, p = 0.009). Together, these variables explained 45% of variance in life satisfaction.

CONCLUSION

Given that marital intimacy and sexual functioning were the most significant sexual-related determinants of life satisfaction among married women, designing and implementing interventions which increase women's marital intimacy and sexual functioning might improve married women's life satisfaction.

Use of metaphors when treating unexplained medical symptoms

The words one chooses to describe personal pain mirror current usage, but may also hold echoes of an individual’s lived experience. They may provide clues to the origin of physical symptoms that are medically hard to explain. The aim of this commentary is to propose, on the basis of the available literature, that verbal metaphors can prove effective in the psychotherapy of such conditions. I provide a case history of a 45 year old woman referred to psychiatry because of extreme ‘burning’ pain in her mouth and tongue. She had been to numerous doctors, had undergone a variety of tests, had tried many medical treatments, and had been prescribed a number of different pharmaceutical agents. She had changed her diet, done her daily dental mouth exercises, drunk a lot of water, but the burning continued and interfered, with her job (she was a teacher), her friendships, and her everyday life. This made her angry and recalcitrant to therapy, but the metaphor ‘burning with rage,’ as applicable to her pain, worked to establish a good alliance that led to a decrease of symptoms. Burning Mouth Syndrome is a medically unexplained condition of complex etiology that psychotherapy alone cannot reverse. The literature bears out, however, that the use of metaphors can help to open avenues of psychological exploration that accelerate adaptation to pain and improve quality life.

Exploring the Relationship between Early Adaptive Schemas and Sexual Satisfaction

Rationale

Early maladaptive schemas (EMS) develop from unmet core emotional needs during childhood and adolescence. EMS influence the way individuals perceive themselves and others, while also sharing associations with various sexual difficulties. Contrastingly, Early Adaptive Schemas (EAS) develop when core emotional needs are met. Yet, the potential influence of EAS on sexual wellbeing remains underinvestigated.

Objective

The current study assessed the relationship between EAS and sexual satisfaction as a primary component of sexual wellbeing.

Method

The study design was an online, cross-sectional survey. Participants included 732 adults (Mage = 32.05, SDage = 9.30), who completed self-report questionnaires assessing sexual satisfaction and EAS.

Results

Two, three-step hierarchical regressions evaluated the effect of EAS on sexual satisfaction, controlling for several potentially confounding variables. Results indicated that the only EAS that was associated with sexual satisfaction in both men and women was Realistic Expectations. EAS of Social Belonging and Success were associated with sexual satisfaction for women alone, whereas Self-Compassion was for men.

Conclusion

Findings provide preliminary evidence that EAS are associated with sexual satisfaction. As such, schema therapy may be a useful therapeutic framework for improving sexual satisfaction, when indicated.

Sexual Function, Behavior, and Satisfaction in Masters Athletes

Objectives

Masters athletes are endowed with high functional capacity, long-term health, and psychological outlook. However, their sexual activity and function are largely unknown. We investigated the influence of sustained moderate to vigorous exercise on sexual life using a model of masters athletes.

Methods

A 55-item survey adapted from previous American Association of Retired People (AARP) sexuality study were distributed to masters athletes associations. The responses from 166 masters athletes were compared with AARP dataset that represented a general population.

Results

Both male and female masters athletes demonstrated more frequent sexual desire and greater involvements in different types of sexual activities (i.e., kissing or hugging, touching or caressing, sexual intercourse, oral sex, and self-stimulation; all p < 0.05). Sexual satisfaction was greater in female masters athletes than in female general population (p = 0.025), but no such group difference was observed in men. Male athletes had a lower degree of erectile dysfunction. No difference was observed in orgasm frequency between the two population groups. Age-associated decline in sexual activity was apparent in general population (p < 0.05) but absent in masters athletes. Females recorded lower engagements in partner-involved sexual behaviors than men in the general population, but no such gender difference was observed in women. The primary factor predicting improvement in sexual satisfaction was "better health for myself" (29.7%) in the general population, whereas master athletes identified "better health for partner" (23.5%).

Conclusion

Masters athletes in general and female athletes in particular demonstrate superior sexual function, satisfaction, and behavior presumably due to their better overall health status.

The role of testosterone in male sexual function

Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The specific contribution of low T to sexual function impairment in aging men has still not been completely clarified. Similarly, the role of T replacement therapy (TRT), as well as the combination of TRT with phosphodiesterase type 5 inhibitors (PDE5i) for patients with erectile dysfunction (ED), is still conflicting. Here we aim to summarize and critically discuss all available data supporting the contribution of low T to sexual impairment observed with aging as well as the possible role of TRT. Available data on men with sexual dysfunction show that reduced sexual desire is the most important correlate of male hypogonadism. Conversely, aging and associated morbidities substantially attenuate the relationship between ED and T. TRT is effective in improving sexual function in middle-aged and older subjects but its role is small and extremely variable. Lifestyle interventions can result in similar outcomes to those of TRT. In conclusion, it is our opinion that PDE5i along with lifestyle measures should be considered the first approach for treating ED even in subjects with milder T deficiency. When these interventions fail or are difficult to apply, TRT should be considered.

Norwegian Data on Prevalence, Sexual Risk Behaviors, Sexual Problems, and Sexual Satisfaction in Women Who Have Sex Exclusively with Women, Women Who Have Sex Exclusively with Men, and Women Who Have Sex with Men and Women

Objective

The study explores the difference between Women Who Have Sex Exclusively with Men (WSEM), Women Who Have Sex Exclusively with Women (WSEW), and Women Who Have Sex with Women and Men (WSWM).

Method

The data were obtained from a survey of a probability-based web sample of 1967 Norwegian women.

Results

Most WSWM identified themselves as heterosexuals (76.3%), and three out of 10 used a condom when having sex with a new partner. The highest number of sex partners during the last year was reported by WSWM. More WSEW than the other categories reported premature orgasm.

Conclusions

WSWM should be targeted in health campaigns.

Climacteric status is associated with sexual dysfunction at the age of 46 years: a population-based study

OBJECTIVE

Increasing age and menopausal transition increase the risk of sexual dysfunction. Sexual dysfunction is common in women experiencing menopause before the age of 40 years, whereas evidence on sexual function in women experiencing menopause in their mid-40s is scarce. We aimed to investigate sexual function in 46-year-old women in relation to their menopausal status.

METHODS

This study cross-sectionally evaluated sexual function of women in a prospective population-based Northern Finland Birth Cohort 1966 (NFBC1966). A 46-year follow-up study of NFBC1966 included a broad questionnaire evaluating health, lifestyle, and life situation, as well as menstrual history and sexual function, and blood sampling analysis including follicle stimulating hormone and free androgen index (FAI). The participants were divided into two groups by their menopause status, defined by follicle-stimulating hormone and menstrual history. We performed logistic regression models in which parameters of sexual function were dependent factors and climacteric status, self-reported health, FAI, relationship status, smoking, and education level were independent variables.

RESULTS

The study population included 2,661 women. In regression models, more advanced climacteric status was associated with higher frequency and difficulty level of low sexual desire and vaginal dryness (odds ratios with 95% confidence intervals: 2.80 [2.12-3.71], 3.22 [2.43-4.27], 3.83 [2.82-5.20], 3.75 [2.75-5.12], respectively), lower frequency of sexual thoughts (1.34 [1.02-1.75]), and higher frequency of problems with intercourse (2.35 [1.51-3.66]). Lower FAI and poorer health were associated with impaired sexual function.

CONCLUSIONS

The current study suggests that women experiencing menopausal transition in their mid-40s are at risk of impaired sexual function.

Sexual Health and Women Living With Spinal Cord Injury: The Unheard Voice

Women's sexual health within the context of sexual function and psychosocial dimensions while living with a spinal cord injury (SCI) has rarely been discussed separately from men living with a SCI or from a collective with other chronic conditions. To date, over 64,000 women in the U.S. are currently living with SCI, with total numbers increasing each year, as well as the demographics shifting to include more diversity in race and incidences occurring later in life. On average, SCI tends to be acquired during the childbearing years (~30–50 years old), as well as when women experience other health concerns associated with aging, including perimenopause and menopause. Additionally, women's sexual health is often conceptualized from the position of the absence of disease and dysfunction. However, consistent with definitions furthered by the World Health Organization (WHO) and World Association of Sexual Health (WAS), we believe women's sexual health is multifaceted, moving beyond a focus on reproduction to also encompass sexual function and the psychosocial dimensions of sexual health both living with and without disabling conditions and diseases. Within this lens, we present prior research that has been conducted, conclusions from these studies, implications for practice, and recommendations for future research. Thus, the paper will expand the understanding of both sexual function and psychosocial dimensions for women living with SCI.

The sexual wholeness model: An initial evaluation with two samples

Based upon the psychological needs delimited in self-determination theory, we created the sexual wholeness model to encapsulate the different dimensions (physical, emotional, and meaning) that create couple sexuality. We evaluated the model with data from two national samples (Sample 1, n = 610; Sample 2, n = 884), by examining the association between sexual, relationship, and life satisfaction, and attachment with the different elements of the sexual wholeness model using harmonious sexual passion as an intermediate variable. The emotional dimension had the strongest associations in both samples with harmonious sexual passion and all other outcomes except attachment. The physical dimension of sexuality had a surprisingly strong association with attachment and sexual satisfaction. In addition, couples' self-evaluation of the degree of sexual wholeness in their relationship was strongly associated with harmonious passion and all other outcomes, providing another level of validity to the dimensions of the model and the potential utility for using this model to assist in couple therapy.

The assessment of sexual wellbeing in treatment-seeking transgender individuals: a systematic review of the medical literature

Sexual-wellbeing is recognized as an important aspect of quality-of-life. Yet, no overview exists of which aspects of sexual-wellbeing have been assessed in trans individuals seeking or undergoing medical treatment, nor is it clear what tools are used to evaluate the effect of medical treatment on sexual-wellbeing. First, to identify which topics pertaining to sexual-wellbeing have been assessed in transgender individuals in a medical context. Second, to determine which tools have been used for measuring aspects of sexual-wellbeing. A conceptual framework of sexual-wellbeing, was used as reference. A literature search (in PubMed, Embase, Cochrane Library) was performed up to March 10th, 2020. Studies that assessed aspects of sexual-wellbeing in transgender individuals' medical context were included in this review. Specific sexual topics addressed in each study were extracted by two independent reviewers. Thematic analysis was performed to identify sexual themes. Additionally, tools used to measure topics related to sexuality in transgender individuals were identified. In 172 papers, a total of 178 topics related to sexual-wellbeing were identified. Ten overarching themes were identified; sexuality, enacted sexual script, sexual activities, sexual relations, sexual response cycle, genital function, sexual function, sexual pleasure, sexual satisfaction, and quality-of-sex-life. Functional aspects of sexuality are assessed most frequently. A variety of methods was used to evaluate aspects related to sexual-wellbeing in trans individuals and over 50 different tools were identified. Self-developed questionnaires were used most frequently (n = 80), followed by chart reviews (n = 50), self-developed structured interviews (n = 37) and physical examination (n = 13). 23 previously developed questionnaires were used, all of which were developed for a cisgender population. Many studies in trans individuals touch on topics related to sexual-wellbeing, however, a comprehensive conceptualisation of (10 themes of) sexual-wellbeing is still lacking. Still, no valid tool exists for assessing sexual-wellbeing in the trans population, but is much needed.

‘Why would I want sex now?’ A qualitative study on older women's affirmative narratives on sexual inactivity in later life

The existing research tries to understand the reasons for discontinuing sex in later life with the assumption that people want to be sexual. Although the growing body of literature informs that sex remains an integral part of older adults’ lives, a substantial number of older adults declare not being sexually active. This study aimed at exploring motives for deliberately choosing sexual inactivity among older women. Semi-structured interviews with 16 Polish women (aged 65–82) were thematically analysed in relation to the sexual scripts theory and the participants’ specific socio-cultural background. Three main themes regarding the reasons for cessation of their sex life were identified: ‘I am glad that sex does not concern me anymore’, ‘I am satisfied with my memories’ and ‘The right one’ or no one. The results indicate that some women give up sex for good, with no regrets or feeling of a loss; for others, it may be a temporary decision, its duration dependent on meeting the right partner. Developing sexual agency may encourage discontinuing their sex life – a choice perceived as optimal and liberating. Personal factors and the memories of marital relationships seem to shape older women's (a)sexual expectations. Acknowledging these nuances may contribute to a better understanding of older women's sexual functioning; implications for consideration in further research and practice are also discussed.

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.

Components of psychosocial health

Purpose

“Psychosocial health” is a new term to comprehend the already established factors involved in mental health and psychological well-being. The term has not been specifically defined and explained within the framework of psychology.

Design/methodology/approach

The study proposed and validated a new model of psychosocial health. Principal component analysis, exploratory factor analysis and confirmatory factor analysis were conducted by involving a total of 4,086 participants.

Findings

Psychosocial health was interpreted as the “sexual, emotional, social, environmental, cognitive, religious, moral and spiritual satisfaction” of a person. The proposed model of psychosocial health was statistically validated. The additional findings revealed significantly higher levels of psychosocial health in women and significant inverse correlations between psychosocial health and age.

Originality/value

The current paper provided a comprehensive picture of psychosocial health from a psychological perspective and presented a statistically reliable tool for measuring psychosocial health.

"What Do You Mean by Sex?" A Qualitative Analysis of Traditional versus Evolved Meanings of Sexual Activity among Older Women and Men

ABSTRACTOlder adults remain sexually active well into later life; yet, there is no consistency in the literature about what sex means to them. The study described in this paper investigated the understanding of sexual activity as reported by 30 women and men from Poland, aged 65 to 82 (M = 71, SD = 5,24). Semi-structured interviews were thematically analyzed in relation to sexual scripts theory and the participants' specific sociocultural background. The results demonstrate the diversity of opinions on what sex is: from penetrative intercourse, through various expressions of physical intimacy, to emotional intimacy as a central concept. The dominant perception of sex as intercourse among some study participants evolved into an intimacy-oriented and partner-focused activity, with the discovery of fondling and female sexual pleasure as components of sex. Certain life events - such as ending a long-term marriage or engaging in a new romantic relationship - were identified as facilitating this change. Notable similarities in older women's and men's perceptions of satisfying sex in later life were observed. Acknowledging the nuanced meaning of sex for this population can contribute to a better understanding of the specificity of older adults' sexuality.

Sextech Use as a Potential Mental Health Reprieve: The Role of Anxiety, Depression, and Loneliness in Seeking Sex Online

Depression, anxiety, and loneliness have long been recognized as global mental health concerns. To temporarily relieve psychological distress, self-soothing behavior is common, including engagement in sexual behaviors that are linked to positive mental well-being. Considering the COVID-19 pandemic further exacerbated many mental health ailments alongside physical distancing regulations, we specifically examined online sexual behavior via the use of emergent digital sexual technologies, or sextech. In a 2019 study of 8004 American adults, we assessed whether people experiencing higher anxiety, depression, and/or loneliness were more likely to engage in sextech use. Furthermore, we examined whether anxiety or depression mediated the association between loneliness and sextech use, as loneliness is one contributor to anxiety and depression. People with higher anxiety and depression were more likely to engage in sextech. However, those who were more lonely were less likely to engage with sextech, suggesting the aforementioned patterns were not due to lack of social connection. Our findings suggest people with mental health struggles may be drawn to interactive, digital forms of sexual behavior as a means of alleviating symptoms through distraction or self-soothing. This insight offers an important pathway for expanding the scope of mental health interventions, particularly as technology becomes increasingly prevalent and accessible in everyday life.

One Line of Sexual Decline? Growth Mixture Modeling for Midlife Sexual Satisfaction

Most research has shown that sexual satisfaction in long-term relationships tends to decline over time. Studies showing the average trajectory, however, are limited by only assessing one slope. With longitudinal data from the Flourishing Families Project, Marital Instability Dataset, and the Iowa Youth and Families Project, we utilized growth mixture modeling to assess what trajectories of sexual satisfaction exist in midlife marriages. In the three samples (one individual, two dyadic), we found clear evidence for heterogeneous sexual satisfaction trajectories, for both wives and husbands. Through the datasets, we found some trajectories did decline over time. We also found stably high, stably medium, stably low, and some trajectories that showed an increase in sexual satisfaction over time. Overall, trajectories were similar for wives and husbands, though some classes had one partner with variability while the other was stable, some classes had trajectories with wives having higher sexual satisfaction than husbands, and some classes had trajectories with husbands having higher sexual satisfaction than wives. Demographic variables were not strong distinguishers of these differing trajectories. Both marital satisfaction and perceived marital stability trajectories (based on sexual satisfaction classes) generally had similar patterns to sexual satisfaction trajectories, with a few exceptions. Both marital satisfaction and perceived marital stability were less likely to significantly change over time, have discrepancies between wives and husbands, and have either low marital satisfaction or high perceived marital instability, even if sexual satisfaction was low. These data can help couples recognize various possibilities for sexual satisfaction over time, perhaps helping them to avoid cultural myths of inevitably declining sexual satisfaction.

Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age

Introduction

Despite the rapidly increasing population of older adults, little is currently known about sexual activity and sexual satisfaction among the oldest people.

Aim

The present study aimed to investigate sexual activity and sexual satisfaction among people of ≥60 years of age. We also examined whether sexual activity and sexual satisfaction were influenced by age, gender, cohabiting, socioeconomic factors, education, functional ability, and self-reported health.

Methods

We performed a descriptive analysis of self-stated sexual activity and sexual satisfaction among 1680 participants who were 60 years and older from the Swedish National Study on Aging and Care. Chi-square tests and logistic regression were used to analyze relationships between factors.

Main Outcome Measure

Sexual activity and sexual satisfaction.

Results

Among participants aged ≥90 years, about 10% were sexually active. Within the total study population, 46% (654/1680) were sexually active. Overall, sexually activity was more commonly reported by men (55%) than women (40%). However, men in all age cohorts reported sexual dissatisfaction more commonly than women. In the total sample, 24% (246/1680) reported dissatisfaction with their sex life. Sexual activity and sexual satisfaction were positively associated with self-reported health and cohabitation.

Conclusion

The present results suggest that sexual activity is present throughout life. For persons older than 90 years, about 10% of participants were sexually active, regardless of gender. Every third man reported dissatisfaction with his sex life. Women were more satisfied with their sex lives than men, and this difference varies more widely among age cohorts. These findings confirm that it is important that health professional take sexuality into account during caring encounters with older persons.

M Stentagg, L Skär, JS Berglund, et al. Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age. Sex Med 2021;9:100316.

The role of stress and absence: How household member incarceration is associated with risky sexual health behaviors

Sexual health is a critical indicator of wellbeing with consequences for population health. However, little is known about whether and how household member incarceration affects the sexual health behaviors of young adults. This study seeks to assess the association between household member incarceration and sexual health behaviors and provides an initial test of mechanisms. Drawing upon data from the NLSY97, this study estimates the association between household member incarceration and sexual health behaviors using linear probability models, and then re-estimates these associations using two alternative comparison groups; 1) youth who experienced other forms of stress, and 2) youth who experienced other forms of family absence. Results indicate that household incarceration is positively associated with a higher risk of reporting sexual intercourse with an intravenous drug user net of individual and family characteristics and is negatively associated with condom use net of individual but not family characteristics. The results also show that the associations between household member incarceration and sexual health behaviors may be attributable, at least in part, to the well documented stress associated with incarceration. Yet, the results provide little evidence that absence is a pathway linking household member incarceration to risky sexual health behaviors. It is possible that household member incarceration is linked to deleterious outcomes for youth through different mechanisms than parental incarceration given the differing roles of parents versus other adults in the home. Future research should explore the pathways linking household member incarceration to health risks for youth and consider household member incarceration as a unique family stressor.

Female Sexual Satisfaction and Sexual Identity

This study addressed three goals related to better understanding the factors that contribute to female sexual satisfaction: (a) exploring differences in factors that contribute to perceptions of sexual satisfaction among women with varying sexual identities, (b) evaluating an existing measure of sexual satisfaction among women with diverse sexual identities, and (c) developing potential items for a future expanded measure of the factors contributing to sexual satisfaction. Participants were 996 heterosexual women, 333 bisexual women, and 204 lesbians. They completed an online survey that included a demographic questionnaire, an item measuring sexual satisfaction, an open-ended question about factors contributing to sexual satisfaction, the newly-developed Potential Sexual Satisfaction Factors, and the New Sexual Satisfaction Scale (NSSS). A multinomial regression, an internal consistency analysis, and qualitative analyses were performed to examine the three research questions. Several important differences in factors related to sexual satisfaction were found as a function of sexual identity. In particular, several of the factors that contributed to bisexual women's sexual satisfaction were different than those that contributed to heterosexual and lesbian women's satisfaction. These findings point to the importance of considering sexual identity when researching sexual satisfaction and when providing interventions to improve sexual satisfaction.

Prevalence and Predictors of Sexual Difficulties and Associated Distress Among Partnered, Sexually Active Older Women in Norway, Denmark, Belgium, and Portugal

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process.

Female Sexual Dysfunction Among a Sample of Egyptian Patients with Asthma

Background:

Despite asthma being a worldwide disease, still little awareness regarding the sexual function of asthmatic patients exists. So this study attempts to assess the Female Sexual Dysfunction (FSD) amongst Egyptian females with asthma and its burden on their quality of life.

Materials & Methods:

The sample consisted of 180 subjects, comprising 90 asthma patients and 90 healthy controls aged between 20 - 45 years old, who visited the Chest Department Outpatient Clinic of Ain Shams University Hospital between January and December 2018. We reported all the subjects' demographic and clinical data; both groups answered an Arabic version of the Female Sexual Function Index (Ar FSFI) and World Health Organization Quality of Life Questionnaire abbreviated version (WHOQL-Bref).

Results:

90% of asthmatic females had FSD; total Female Sexual Function Index score was 12.956 ± 10.3 in asthmatic females compared to 25.423 ± 5.521 in healthy controls; 45.6% of asthmatic females with sexual dysfunction had moderate asthma and 86.4% had uncontrolled asthma, 40.1% of them had a low educational level and 80.2% were unemployed.

Conclusion:

Jobless females with severe uncontrolled asthma and a low educational level had higher sexual dysfunction and a poor quality of life.

"Why not ask the doctor?" Barriers in help-seeking for sexual problems among older adults in Poland

OBJECTIVES

Existing data show that older adults rarely seek medical or psychological help for their sexual problems. The current study explores the barriers in help-seeking faced by older adults from a conservative Central European country.

METHODS

Thirty semi-structured interviews were conducted among Polish residents (16 women, 14 men) aged 65-82. The data were analysed thematically, with coding validity and analytical rigour ensured throughout the process.

RESULTS

Three main barriers in seeking help were identified: not recognising sexual problems; fear for the doctors' disapproval; lack of knowledge how to access appropriate services. The data reveal that the participants' main concern is that health providers would dismiss their problems as trivial. Older adults from Poland suffer from the lack of fundamental knowledge about their sexual functioning.

CONCLUSIONS

Employing qualitative methodology to understand why older adults from conservative cultures do not seek help for their sexual problems might contribute to existing literature by providing evidence from different cultural settings, and help to develop and implement appropriate interventions. Implications related to health providers' attitude towards older patients' concerns are further discussed.

Exploring Determinants of Sexual Satisfaction in a Chilean Representative Sample

This article examines the relationship between sexual satisfaction and gender, age, social status, being in stable relationships, intercourse frequency, and satisfaction with physical attractiveness (physical appearance and sex appeal). A self-report questionnaire was applied in a representative sample of 767 residents of Santiago (Chile), over 18 years old and that have had, at least, one sexual relation (with penetration) during their lives. Higher sexual satisfaction was predicted negatively by age and positively by higher satisfaction with sex appeal, higher intercourse frequency and having a stable relationship. Among women, the principal predictors are satisfaction with sex appeal and intercourse frequency. Among men to the above, it is necessary to add satisfaction with physical appearance and having a stable relationship - at odds with supposed higher relevance for women of body satisfaction and sensibility to social relationships. Discussion emphasizes the controversial nature of the gender differences found regarding the Latin American culture.

Posttraumatic Stress and Sexual Satisfaction in Husbands and Wives: A Dyadic Analysis

Trauma survivors who suffer from posttraumatic stress symptoms (PTSS) are known to experience impairments in sexual satisfaction. However, the negative effects of PTSS are not limited to the primary survivors, as they can lead to secondary PTSS in their spouses as well. The implications of secondary PTSS in the sexuality of couples remain unknown. This study aimed to investigate whether specific symptom clusters of PTSS (i.e., intrusions, hyperarousal, and avoidance) are implicated in the sexual satisfaction of couples. We assessed a sample of primarily exposed Israeli veterans from the Yom Kippur War and their wives who had been secondarily exposed (N = 191). The dyadic data were analyzed in an Actor-Partner Independence Model. When scrutinizing specific PTSS clusters, the husbands' avoidance related to their own sexual satisfaction. The wives' hyperarousal related to their own and their spouses' sexual satisfaction, whereas their intrusions were associated only with their husbands' sexual satisfaction. In conclusion, PTSS in one spouse is related to both spouses' sexual satisfaction; it is therefore recommended that clinicians adopt a dyadic approach when delivering interventions.

An overview of sexual behaviour research in later life-Quantitative and qualitative findings

AIM

This article provides an overview of current sexual behaviour research in later life by describing associated factors, including the physical and psychological benefits.

METHODS

Recent systematic reviews were interrogated for findings on sexual behaviour research in adults aged 60+.

RESULTS

Regardless of research methods employed, all studies showed that there were a range of physical and psychological benefits to remaining sexually active in later life. While quantitative studies placed an emphasis on measuring penile-vaginal intercourse, they provided no definitive conclusion about the benefits due to 'inconsistent results' across studies. Qualitative studies described the myriad ways in which older adults redefine what constitutes sexual activity despite the onset of dysfunction and disability.

CONCLUSION

While the different research methods show that engaging in sexual behaviour has physical and psychological benefits at all adult ages, there is limited conclusive evidence about what the overall benefits might be in later life.

Mechanisms underlying the association between perceived discrepancy in sexual interest and sexual satisfaction among partnered older adults in four European countries

The ways in which the discrepancy between one's own interest in sex and that of one's partner may affect personal sexual satisfaction has rarely been systematically studied, especially among older adults. Previous research among younger adults indicates that a discrepancy in sexual desire can be detrimental in terms of several relationship outcomes, including sexual satisfaction. This study aimed to investigate a conceptual model of sexual satisfaction among coupled older adults which posits that the association between perceived discrepancy in sexual interest and sexual satisfaction is mediated by the frequency of sexual activity and emotional closeness during sex. Data from a probability-based postal survey that included 2695 partnered heterosexual adults aged 60-75 years from four European countries (Norway, Denmark, Belgium, and Portugal) were used to test the mediation model. Due to expected gender differences in the two mediators, all analyses were carried out separately for men and women. The findings supported the proposed model, suggesting that as an individual's perception of a discrepancy in sexual interest increases, his or her levels of sexual frequency and perceived closeness during sex decrease-which in turn diminishes sexual satisfaction. The results of this study provide insights into links among sexual interest, sexual frequency, emotional closeness, and sexual satisfaction in older adults, and point to substantial similarities in the sexuality of aging men and women in this regard.

Validation of the Sexual Personal Well-being Index (PWI-Sex)

Objective: The purpose of this study is the validation of a proposed additional item for the PWI-7 scale for measuring sexual satisfaction as a dimension of Personal Well-being.Methodology: An adaptation of the PWI-7 questionnaire was administered to adult inhabitants of urban areas of Santiago, Chile. Analysis consisted of exposition of descriptive statistics, item-scale correlation, item-item correlation, multiple linear regression with the Overall Life Satisfaction Scale (OLS), moderation analysis and, confirmatory factor analysis. All analyses were divided by gender due to significant differences in sexual satisfaction found in literature reviewed.Results: All items were significantly and positively associated with the PWI. Internal consistency was satisfactory for Cronbach's alpha (α = 0.884 for males and α = 0.877 for females). After conducting a Confirmatory Factor Analysis using maximum likelihood (ML) as estimator, adequate levels of adjustment were obtained.Discussion: Results indicate that adding a new item on sexual satisfaction might be a contribution for the measurement of life satisfaction. The scale shows adequate internal consistency once the item is added and the new item on sexual satisfaction has a better fit than the one regarding satisfaction with spiritual life. Factor structure was invariant for males and females.

Women's successful aging

The authors investigated women's successful aging in the context of well-being and satisfaction with life. This study was conducted with 129 women in Women's Rest Homes in the province of Adana, Turkey. It was found that satisfaction with life (SL) was significantly associated with successful aging (SAS) (β = .350; p = .005; t = 2.833), and SAS (β = .358; p = .008; t = 2.632) and SL (β = .669; p ≤ 0.001; t = 4.774) were significantly associated with women's well-being (WBI). Women in the 60-66 age range had significantly higher SAS (md = 1.30314; p = .004) and struggle against difficulties (SAD) (md = 1.35624; p = .005) than those in the 81-87 age range, and women with bachelor's degrees had significantly higher SAD (md = .73590; p = .001) than women with primary school education. Women who had high monthly incomes (md = 1.75741; p = .000) were more satisfied with life than women with moderate incomes (md = .87905; p = .000), who were in turn more satisfied with life than women with low incomes (md = -.87905; p = .000). Women with high monthly incomes (md = 1.34606; p = .005) had higher well-being than women with moderate incomes (md = .70101; p = .005), who in turn had higher well-being than women with low incomes (md = -.70101; p = .005). The validity and reliability of the SAS [χ ²(27) = 67.088, p < .01; χ ²/df = 2.033; SRMR: .090; RMSEA: .080; NNFI: .905; IFI: .932; CFI: .930; GFI: .911; AGFI: .851] were verified in this study. It was determined that satisfaction with life and well-being were crucial determinants of women's successful aging.

Why Do Older Adults Have Sex? Approach and Avoidance Sexual Motives Among Older Women and Men

Although many older adults reportedly maintain an active sex life, limited research has focused on the reasons they engage in sex. The present study identified and described sexual motives in the second half of life reported by 47 older adults. Twenty-four men (51%) and 23 women (49%) aged 60-91 (M = 66, SD = 8.1) were interviewed. In-depth interviews were thematically analyzed using the theory of motivational approach-avoidance and personal-interpersonal motivational framework. Five main themes were identified: (a) to maintain overall functioning, (b) to feel young again, (c) to feel attractive and desirable, (d) from lust to love, and (e) from "getting sex" to "giving sex." Investigating sexual motives in the second half of life can improve the understanding of older adults' sexual behavior, function, and satisfaction.

The effect of vaginal erbium laser treatment on sexual function and vaginal health in women with a history of breast cancer and symptoms of the genitourinary syndrome of menopause: a prospective study

OBJECTIVES

To assess the effects of vaginal erbium laser treatment on the vaginal health and sexual function of postmenopausal women with a history of breast cancer.

METHODS

An open, prospective, therapeutic intervention study was conducted with 24 postmenopausal women with a history of breast cancer and vaginal dryness, and/or dyspareunia, who had not used vaginal hormone therapy for at least 6 months. The women were treated using a 2,940-nm Erbium: YAG laser (Etherea-MX, Athena, São Carlos, São Paulo, Brazil), with 90 and 360 scanning scopes, between August, 2017 and October, 2017 in a private clinic in a city of southeastern Brazil. Vaginal erbium laser treatment was performed at three sessions with a 30-day interval between each session. Sexual function was assessed before and 1 month after treatment using the Short Personal Experiences Questionnaire. Questions related to genitourinary symptoms were also applied. Vaginal health was assessed before each laser session using the Vaginal Health Index Score.

RESULTS

Mean age was 53.7 years. Vaginal health improved, as shown by an increased overall score (P < 0.001). The effect size was large between pretreatment and post-treatment scores for vaginal elasticity, fluid volume, epithelial integrity, and moisture. The effect size was also significant for the overall sexual function score and for the score in the dyspareunia domain between pretreatment and 1 month after the final treatment session.

CONCLUSION

Vaginal erbium laser may represent a novel therapeutic option for improving vaginal health and sexual function in postmenopausal women with a history of breast cancer.

Sexual Satisfaction in Spouses of Ex-POWs: The Role of PTSD Symptoms and Self-Differentiation

Spouses of former prisoners-of-war (ex-POWs) are at risk for posttraumatic stress symptoms (PTSS) and marital distress. This study assessed the implications of PTSS and self-differentiation for sexual satisfaction among 90 ex-POWs' spouses and 75 matched combatants' spouses from the 1973 Yom Kippur War. Standardized questionnaires were used. Ex-POWs' spouses had elevated PTSS and imbalanced self-differentiation. PTSS were associated with poorer self-differentiation and lower sexual satisfaction. Imbalanced self-differentiation mediated the association between PTSS and sexual satisfaction. The findings imply that PTSS and imbalanced self-differentiation contribute to low sexual satisfaction among spouses of primary trauma survivors.

Sexuality-Related Factors and Quality of Life Among Reproductive-Aged Married Female Migrant Workers: A Cross-Sectional Study in Southern China

Introduction

Sexuality is a critical part of overall well-being. However, until now, studies on women’s health related to the effect of sexuality on physical and psychosocial outcomes have been seriously ignored, especially the health-related quality of life (QOL) of reproductive-aged married female migrant workers.

Aim

To analyze the associations between sexuality-related factors and QOL and explore the independent contributions of sexuality-related factors to QOL in this population group in southern China.

Methods

In this cross-sectional survey, 609 Chinese married female migrant workers aged 19–49 years were studied. Clustered multiple linear regressions were used to analyze the associations between sexuality-related variables and QOL.

Outcomes

QOL was measured using the Short Form (SF-36) Healthy Survey. Details of the participants (sociodemographic, health-related and sexuality-related factors) were obtained.

Results

Approximately 10.0% of respondents always felt a lack of sexual interest and lubrication difficulties, and 37.5% of respondents seldom or never experienced sexual satisfaction. Multiple regression analyses revealed that women who never felt lubrication difficulties obtained higher role physical, bodily pain, general health, and physical component summary scores in physical domains and higher vitality (VT), mental health (MH), and mental component summary (MCS) scores in mental domains compared with those who always felt lubrication difficulties. Compared with those who always experienced sexual satisfaction, women who never experienced sexual satisfaction had relatively lower role physical, bodily pain, and general health scores in physical domains, and women who never or seldom experienced sexual satisfaction had lower VT, MH, and MCS scores in mental domains. The independent contributions of sexuality-related factors in mental domains (VT, MH, and MCS) accounted for 50.0%, 52.4%, and 39.5%, respectively; more than that of all sociodemographic and health-related variables in the VT and MH domains.

Conclusions

Sexuality-related factors (lubrication difficulties and sexual satisfaction) were significant independent determinants of QOL among reproductive-aged Chinese married female migrant workers, especially in mental domains.

Li BB, Liu N, Li B, et al. Sexuality-Related Factors and Quality of Life Among Reproductive-Aged Married Female Migrant Workers: A Cross-Sectional Study in Southern China. Sex Med 2019;7:384–395.

Relationships between body image, sexual dysfunction, and health-related quality of life among middle-aged women: A cross-sectional study

OBJECTIVES

To examine whether body image, sexual function, and relationship with a partner influence health-related quality of life (HRQoL) among middle-aged women, as well as to identify the association with menopausal symptoms.

MAIN OUTCOME MEASURES

Physical component summary and mental component summary of HRQoL.

METHODS

This was an analysis of 1026 women (2013-2014); data regarding demographic characteristics, sexual function, body image, relationship with partner, menopausal symptoms and HRQoL during middle age were collected. HRQoL, sexual function, body image, relationship with partner, and menopausal symptoms were measured using the Medical Outcomes Study SF-12, Female Sexual Function Index (FSFI), Multidimensional Body-Self Relations Questionnaire-Appearance Scale, the Relationship Assessment Scale, and the Greene Climacteric Scale, respectively. A multivariate regression was used to examine factors influencing HRQoL.

RESULTS

After adjusting for covariates, significant factors predicting the physical component summary (PCS) of HRQoL among middle-aged women included the orgasm domain of the FSFI (β = 0.69; p =  0.023), appearance evaluation (β = 0.93; p =  0.037), and menopausal symptoms (β = -0.25; p <  0.001). The factors predicting the mental component summary (MCS) of HRQoL included the satisfaction domain of the FSFI (β = 0.70; p =  0.014), appearance evaluation (β = 2.09; p < 0.001), self-classified weight (β = 1.21; p <  0.001), relationship with partner (β = 0.16; p =  0.034), and menopausal symptoms (β = -0.36; p <  0.001).

CONCLUSION

The results indicated that negative appearance evaluation and menopausal symptoms predicted poor HRQoL among middle-aged women. Higher frequency of orgasm predicted better PCS; sexual satisfaction and satisfaction with relationship with a partner predicted better MCS of HRQoL.

Sexual Activity and Sexual Satisfaction Among Older Adults in Four European Countries

The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe.

Psychobiological Factors of Sexual Functioning in Aging Women - Findings From the Women 40+ Healthy Aging Study

Background: A variety of biological and psychosocial factors are associated with women’s sexual health in midlife and older age. Evidence suggests a decline in sexual functioning in the context of aging and the menopausal transition, including changes in sexual desire, arousal, lubrication, orgasm, pain, and/or contentment. However, not all women in midlife and older age experience such a decline, and it remains unclear how the endocrine environment and psychosocial aspects contribute to the maintenance of healthy sexual functioning. Therefore, the aim of this study was to examine psychobiological predictors of sexual functioning in healthy middle-aged and elderly females.

Methods: A total of 93 healthy, sexually active women aged 40–73 years completed a battery of validated psychosocial questionnaires, including measures of sexual functioning (Female Sexual Function Index) and of protective psychological traits and interpersonal variables. The steroid hormones estrogen, testosterone, progesterone and dehydroepiandrosterone sulfate were determined in saliva samples, while follicle-stimulating hormone, luteinizing hormone and sex hormone-binding globulin were determined in dried blood spots. The findings were statistically adjusted for multiple testing.

Results: Age and postmenopausal status were negatively associated with overall sexual functioning, arousal, and lubrication. Regression analyses revealed that relationship satisfaction, emotional support, self-esteem, optimism, and life satisfaction each significantly predicted overall sexual functioning or specific aspects of sexual functioning, including arousal, contentment, orgasm, and pain (all p < 0.029). For desire and lubrication, no associations were found with the tested psychosocial factors. In terms of steroid hormones, testosterone was positively linked to orgasm (p = 0.012). In this sample, 79.6% reported to have healthy sexual functioning according to the questionnaires’ cutoff. Younger age (OR = 0.911, 95% CI 0.854–0.970, p = 0.004) and a higher level of emotional support (OR = 1.376, 95% CI 1.033–1.833, p = 0.029) were associated with the presence of healthy sexual functioning.

Discussion: Although aging and menopause negatively affected aspects of sexual functioning, the accompanying endocrine correlates were not predictive for sexual functioning in this healthy sample of middle-aged and older females. Instead, our findings suggest that sexual functioning is highly dependent on psychosocial aspects related to well-being. Accordingly, personality traits such as optimism, and interpersonal aspects such as emotional support and relationship satisfaction were identified as important predictors of sexual functioning.

Sexual Activity and Relationship Quality in Middle and Older Age: Findings From The Irish Longitudinal Study on Ageing (TILDA)

Objectives

This study assessed the association between sexual activity, mismatches in the importance attributed to sex within couples, and relationship quality in older Irish adults.

Method

We used data from the Irish Longitudinal Study on Ageing (TILDA) to derive a scale of subjective relationship strain in married or cohabiting individuals. Negative binomial regression was used to assess the association between relationship strain and sexual activity. Separate models assessed the associations with importance of sex and within-couple mismatch in the importance attributed to sex and whether these associations were independent from sexual activity. Age interactions were tested.

Results

Sexual activity and within-couple mismatch in the importance attributed to sex were associated with relationship strain. The frequency of sexual activity was consistently associated with less relationship strain for men, but less so for women when the importance attributed to sex was accounted for. Results were largely consistent across age groups for men, but sexual activity and importance of sex varied with age in women.

Discussion

Frequent sexual activity was associated with less strain within-intimate relationships. For women, this association was weakened when accounting for the importance attributed to sex. Within-couple mismatch in the importance attributed to sex was associated with relationship strain, independent from frequency of sexual activity, for both men and women at all ages.

The Relationship Between the Sexual Self and the Experience of Pregnancy

Studies reveal that prenatal health-care providers and educators often refrain from discussing sexuality with their patients. The present study explored the relationship between sexuality and pregnancy by considering whether the way in which women view themselves sexually is associated with their experience of pregnancy. Findings revealed that a positive sexual self was significantly related to a positive experience of pregnancy and that particular experiences of pregnancy were more significantly related to how women viewed themselves sexually than others. The findings encourage further discussion regarding the role that comprehensive sex education and training of prenatal health-care providers might play in ultimately establishing open, honest, and nonjudgmental discussions about sexuality between providers and their pregnant patients and partners.

Successful aging, change in sexual interest and sexual satisfaction in couples from four European Countries

Although the importance of sexuality and physical intimacy for well-being of older adults has been recognized, the role of sexuality in successful aging (SA) has been largely neglected. Building on our previous work, here we further validated a three-dimensional model of SA and examined its associations with sexual satisfaction and change in sexual interest among older heterosexual couples (aged 60-75 years). Participants were recruited in a probability-based survey, which was carried out in 2016-2017 in four European countries. Using structural equation modeling of the Actor-Partner Interdependence, we observed significant relationships between SA and sexual satisfaction for both male and female partners across countries. Among women, their retrospectively assessed change in sexual interest over the past 10 years was consistently associated with sexual satisfaction. Partner effects were gender-specific: male partners' SA was significantly related to their female partners' change in sexual interest, which in turn was linked to male partners' sexual satisfaction. The findings point to substantial ties between successful aging and sexuality in older European couples. Taking into account the prevalent stereotypes about old age and sexuality, this study's findings can assist professionals working with aging couples.

Vivências e perceções de sexualidade de portuguesas com mais de 65 anos

Resumo: Este estudo objetiva compreender as vivências e perceções sexuais de mulheres portuguesas com mais de 65 anos. Foram realizadas entrevistas individuais semiestruturadas a 13 mulheres (sete casadas e seis viúvas), com idades compreendidas entre os 66 e os 85 anos, e a informação obtida foi analisada através do método da análise temática. Desta análise foram construídos 5 (cinco) temas - Perceções sobre papéis de género, Sexo “obrigação”, Sexualidade e envelhecimento, Medos do casamento e da sexualidade e Educação sexual. Para as participantes deste estudo, encarar as alterações provocadas pelo envelhecimento como fim da obrigação sexual ou como uma oportunidade de readaptação sexual está inteiramente relacionado com a relação conjugal em si e com as ideologias que os membros do casal têm.

Influence Factors of Sexual Activity for Internal Migrants in China

Background

Sexual frequency is associated with the quality of life. China’s internal migrants that are sexually active are more likely to participate in sexual behavior. However, less work has been undertaken to assess the sexual frequency and its predictors in migrants.

Aim

This study seeks to explore which factors were related to sexual frequency in migrants and how the association varies with different levels of sexual frequency.

Methods

A total of 10,834 men and 4,928 women aged 20–49 years from 5 cities in China were enrolled by multi-stage sampling during August 2013–August 2015.

Outcomes

Sexual frequency among migrants was determined by asking: How many times have you had sexual intercourse with a man/woman in the past 30 days?

Results

In this study, sexual frequency with an average age of 38.28 years was 5.06 (95% CI 5.01–5.11) time per month. Negative binomial showed that male gender, younger age, earlier age of sexual debut, masturbation, more knowledge of sexual and reproductive health, longer time together with a spouse, and higher school education and incomes were predictors of increased sexual frequency in migrants. Communicating with sexual partners frequently had the largest effect on sexual frequency compared with occasional communicating (β = 0.2419, incidence rate ratio = 1.27, 95% CI 1.23–1.31). In the quantile regression, months of cohabitation (β = 0.0999, 95% CI 0.08–0.12), frequent sexual communication (β = 0.4534, 95% CI 0.39–0.52), and masturbation (β = 0.2168, 95% CI 0.14–0.30) were positively related to lower levels of sexual frequency. Interestingly, migrants who had low and high sexual frequency would be affected in opposite directions by the knowledge of sexual and reproductive health.

Clinical Translation

Clinicians can more understand the relationship between sexual frequency and its factors that can as the symptom basis of sexually-related diseases.

Conclusions

The present findings indicate that specific demographic, socioeconomic, and epidemiological characteristics influenced sexual frequency among migrants. Sexual communication as the largest effect predictor to sexual frequency should be paid more attention to, to improve sexual activity of migrants.

Zhang J, Wu J, Li Y, et al. Influence factors of sexual activity for internal migrants in China. J Sex Med 2018;6:97–107.

Sexual Quality of Life, Sexual Knowledge, and Attitudes of Older Adults on the Example of Inhabitants Over 60s of Bialystok, Poland

Introduction: Aging has a strong influence on the quality of relationships and sexual functioning, but in itself does not cause a lack of sexual desire.

Objectives: The aim of this study was to assess the quality of sexual life and define sexual knowledge and attitudes of older people on the example of residents of Bialystok, Poland at the age of 60 and over.

Methods: The study included 170 people, inhabitants of Bialystok, Poland aged over 60: 85 students of the University of Healthy Senior and the University of Psychogeriatric Prophylaxis and 85 students of the University of the Third Age. The study used three standardized psychometric scales: Sexual Quality of Life Questionnaire-Male (SQoL-M), Sexual Quality of Life Questionnaire-Female (SQoL-F), and Aging Sexual Knowledge and Attitudes Scale (ASKAS).

Results: The overall mean score for the ASKAS scale for knowledge was 65.21 ± 12.32 and for attitudes −124.65 ± 22.00. The overall mean SQOL score was 62.92 ± 18.18. Taking into account the gender of the respondents, the knowledge of men on sexuality of seniors was at the level of 63.48 ± 12.63, while in the female group −65.74 ± 12.23. The attitudes of men on sexuality of seniors was at the level of 128.80 ± 21.56, while in the female group −123.38 ± 22.05. Satisfaction with sex life among men (72.36 ± 27.49) was significantly higher than among women (60.02 ± 12.88).

Discussion: The seniors were characterized by moderate knowledge and attitudes to sexuality of older people and the average level of sexual satisfaction. There was no significant relationship between knowledge on sexuality and sexual satisfaction in the study groups, and there was a positive correlation between attitudes toward sexuality and the satisfaction of sex life outside the group of men. In addition, a significant positive relationship was found between attitudes toward sexuality and sexual satisfaction. In order to improve the knowledge of senior citizens about sexuality of old age and to overcome the taboos that are prevalent in this topic, a structured training should be provided in this field. Such training should be carried out by specialists in the field of sexology. It is desirable to conduct in-depth studies in the assessment of knowledge, attitudes, and quality of sexual life in a larger research group, in order to get results for the population of the whole country.