Prevalence and sociodemographic predictors of sexual problems in Portugal: a population-based study with women aged 18 to 79 years

Studies on epidemiology of female sexual problems consistently indicate high prevalence rates worldwide, suggesting that this clinical presentation should be considered as a public health concern. However, there are no published studies on prevalence of sexual problems in Portugal. The present study investigated the prevalence, severity, and comorbidity of female sexual problems in a Portuguese community sample. In addition, the authors assessed the role of sociodemographic predictors of women's sexual difficulties. The authors recruited 500 women using quota methods to resemble the Portuguese population according to its demographic characteristics. Participants answered to the Female Sexual Function Index and to a sociodemographic questionnaire. Findings indicated that 37.9% of the Portuguese women reported symptoms of sexual problems. Symptoms of lack of sexual desire was the most frequent sexual difficulty with 25.4% of the women reporting low desire most times or always, followed by symptoms of orgasmic (16.8%), sexual arousal (15.1%), and lubrication difficulties (12.9%), dyspareunia (9.8%), and vaginismus (6.6%). Results indicated that age was a significant predictor of female sexual problems. Results also indicated that symptoms of female sexual problems are a significant health concern in Portugal, suggesting that public policies should be developed to promote sexual health.

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.

Prevalence of sexual problems and associated distress among lesbian and heterosexual women

Prevalence studies on female sexual problems among heterosexual samples have been conducted extensively across different countries. However, relatively little is known regarding prevalence of sexual problems in lesbians. The present study aimed to assess and compare the frequency of self-perceived sexual problems and associated levels of distress in lesbians and heterosexual women. In all, 390 lesbians and 1,009 heterosexual women completed an online survey. The authors assessed the frequency of self-perceived sexual problems in lesbians and heterosexual women, over the past 6 months, as well as the associated levels of distress. Main results suggested that, after controlling for distress levels, sexual pain was the most frequent sexual problem reported by lesbians and heterosexual women. Also, when distress was considered a significant decrease on prevalence rates of sexual problems were found for both lesbians and heterosexual women. Current findings emphasize the role of associated levels of distress to self-perceived sexual problems in women, regardless of sexual orientation. In addition, results suggest that length of relationship play a major role on sexual problems. Overall, data indicated a relatively similar pattern in prevalence of sexual problems in lesbians and heterosexual women.

Annexin A11 gene polymorphism (R230C variant) and sarcoidosis in a Portuguese population

A recent genome-wide association study detected a protective effect for the annexin A11 rs1049550*T allele (R230Cvariant) in susceptibility to sarcoidosis. We evaluated the association between rs1049550 C/T and sarcoidosis susceptibility, distinct disease phenotypes and evolution in a Portuguese population. We performed a case-control study of 208 patients and 197 healthy controls. Samples were genotyped for rs1049550 C/T using real-time polymerase chain reaction. The frequency of the annexin A11 rs1049550*T allele was significantly lower in patients than in controls (33.2 vs 44.9%, P < 0.001). Odds ratio of 0.52 and 0.44 were obtained, respectively for carriers of one (CT) and two (TT) copies normalized to the CC wild-type genotype (P < 0.001). There were no significant differences in patients with and without Löfgren syndrome. A significant increase in the frequency of the T allele was observed in patients with bronchoalveolar lavage (BAL) fluid neutrophilia (P = 0.04). No significant associations were seen for lung function pattern, radiological stages or different forms of disease evolution. Our study confirms that rs1049550*T allele exerts a significant protective effect on sarcoidosis susceptibility. Given the role of annexin A11 in cell division, apoptosis and neutrophil function, this polymorphism may affect key elements of granulomatous and interstitial inflammation in sarcoidosis.

The Association between Externalizing and Internalizing Problems with Bullying Engagement in Adolescents: The Mediating Role of Social Skills

Bullying has severe public health consequences, due to its high prevalence worldwide and devastating effects on physical and mental health. Therefore, it is relevant to further understand the factors that contribute to the emergence and maintenance of bullying. This study aimed to examine the differential mediating role of social skills in the relationship between (i) externalizing problems and engagement in aggressive bullying behaviors, and (ii) internalizing problems and the engagement in victimization bullying behaviors. Participants were 669 Portuguese adolescents aged between 12 and 19 years. The Social Skills Improvement System-Rating Scales and the Scale of Interpersonal Behavior at School were used to assess social skills and the engagement in bullying behaviors, respectively. Boys scored higher on aggressive behaviors and externalizing problems. Girls reported higher scores on internalizing problems, communication, cooperation and empathy. Social skills differently mediated the association between behavior problems and engagement in bullying. While empathy negatively mediated the association between externalizing problems and aggressive bullying behaviors, assertiveness negatively mediated the relationship between internalizing problems and victimization bullying behaviors. The risk factors for engaging in bullying are discussed, and so are the protective ones, which may help to prevent bullying behaviors and reduce their negative impact.

Positive and Negative Affect During Sexual Activity: Differences Between Homosexual and Heterosexual Men and Women, With and Without Sexual Problems

Empirical research suggests that emotional response during sexual activity discriminates between sexually functional and dysfunctional heterosexual men and women, with clinics presenting lower positive and higher negative affect. However, there is no evidence about the role of emotions in gay men and lesbian women with sexual problems. The present study analyzed affective states during sexual activity in homosexual and heterosexual men and women, with and without sexual problems. Participants in this study were 156 men and 168 women. A 2 (group) × 2 (sexual orientation) multivariate analysis of variance was performed. Participants completed a web-survey assessing sexual functioning and the Positive Affect-Negative Affect Scale. Findings indicated a main effect of group, with groups with sexual problems reporting significantly more negative and lower positive affect compared with men and women without sexual problems, regardless of sexual orientation. However, findings have also shown an interaction effect in the male sample with gay men, contrary to heterosexual men, reporting similar affective responses regardless of having a sexual dysfunction or not. Overall, findings emphasize the role of affective responses during sexual activity in men and women with sexual problems, suggesting the importance of addressing emotional responses in assessment and treatment of sexual problems in individuals with different sexual orientations.

Individual and community psychological experiences of the COVID-19 pandemic: The state of emergency in Portugal

Individuals have different ways of coping with crisis. Individual factors, family and contextual features, and community support may influence how individuals feel, think and act during a crisis. COVID-19 was an unexpected pandemic that forced many European countries to take confinement measures and restrict social face to face interactions. This study is an effort to understand how Portuguese residents dealt with the pandemic during the first confinement period, considering different sociodemographic characteristics and trauma exposure perceptions. Five hundred and five adults, between 18 and 79 years old participated in this study via an online self-report assessment protocol. Sociodemographic characteristics such as gender, age, marital status, employment status, and caring responsibilities had an impact on individuals' perceptions regarding their exposure to the pandemic and their quality of life. Perceived exposure to the pandemic was found to predict quality of life in the physical, psychological, and environmental domains. Results have practical implications for European and local policy-making, as well as for targeting psychological interventions for those whose mental health has been negatively affected by the pandemic and for those who may become more affected if confinement measures are implemented again.

Personality Traits, Sexual Problems, and Sexual Orientation: An Empirical Study

Personality traits, namely neuroticism, have been suggested as vulnerability factors for the development and maintenance of sexual dysfunction in heterosexual samples. However, no evidence was found regarding homosexual samples. This study aimed to analyze the differences on personality traits between heterosexual and homosexual men and women with and without sexual problems. Participants were 285 individuals (142 men, 143 women) who completed a web-based survey. Participants answered the NEO Five-Factor Inventory, the Brief Symptomatology Inventory, and questions regarding sexual problems. The groups of men and women with and without sexual problems were matched for sociodemographic variables. A 2 (Group) × 2 (Sexual Orientation) multivariate analysis of covariance was conducted separately for each gender. Results indicated a significant main effect for group and for sexual orientation in male and female samples. Men with sexual problems scored higher on neuroticism, whereas women with sexual problems scored higher on neuroticism and lower on extraversion when compared with healthy controls, regardless of sexual orientation. In addition, gay men scored higher on neuroticism and lesbian women scored higher on conscientiousness compared with the heterosexual groups. The present findings emphasize the central role of neuroticism on sexual problems in both men and women regardless of sexual orientation.

Sexual and Relationship Satisfaction: The Role of Perceived (Non)problematic Sexual Desire Discrepancy in Gay and Heterosexual Men

Sexual desire discrepancy has been associated with sexual and relationship dissatisfaction. Nonetheless, little is known regarding the role of desire discrepancy in gay men, as main research has been systematically conducted with heterosexual couples. Also, only one study has focused on problematic sexual desire discrepancies and sexual satisfaction with lesbian women. This study sought to understand if perceived sexual desire discrepancy influences sexual and relationship satisfaction in men, and to explore differences according to sexual orientation. A total of 346 men (245 heterosexual and 101 gay) completed an online survey and answered sociodemographic questions, a specific question about sexual desire discrepancy, and completed the Global Measure of Sexual Satisfaction and the Global Measure of Relationship Satisfaction. The main findings showed differences in sexual and relationship satisfaction according to sexual desire discrepancy groups, with men who experienced no desire discrepancy being more satisfied within their relationship and sex life compared to men who experienced both problematic and nonproblematic sexual desire discrepancy. Additionally, men who experienced nonproblematic sexual desire discrepancy reported being more sexually and relationship satisfied than men who experienced problematic sexual desire discrepancy. No sexual orientation differences were found. Overall, current findings emphasize the role of (non)problematic desire discrepancy in sexual and relationship satisfaction among heterosexual and gay men.

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.

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.

The association of social skills and behaviour problems with bullying engagement in Portuguese adolescents: From aggression to victimization behaviors

This study examines sex differences regarding social skills, behavior problems and bullying engagement, and the association of social skills and behavior problems with bullying engagement, in adolescents. Participants were 447 Portuguese adolescents (252 girls and 195 boys) aged between 12 and 19-years-old. Social skills and behavior problems were assessed using the self-report version of Social Skills Improvement System - Rating Scales. Bullying engagement was assessed using the Scale of Interpersonal Behavior at School. Girls scored higher on social skills and reported more internalizing and fewer externalizing problems than boys, whereas boys reported more aggressive verbal behaviors than girls. Adolescents exhibiting fewer social skills and more internalizing and externalizing problems engage more frequently in bullying aggressive behaviors. In addition, adolescents presenting more internalizing and externalizing problems are more often victimized by bullies. Furthermore, boys more frequently engage in bullying aggressive and victimization behaviors, whereas younger adolescents with more social skills tend to engage less frequently in bullying aggressive behaviors.

Distressing Sexual Problems and Dyadic Adjustment in Heterosexuals, Gay Men, and Lesbian Women

Empirical studies have focused on dyadic adjustment and sexual satisfaction in men and women. Nevertheless, little is known regarding the role of dyadic adjustment in sexual problems among individuals in same-sex and mixed-sex dyads. The aim of the current study was to analyze the differences in dyadic adjustment between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual problems. One hundred and sixty men (80 gay and 80 heterosexual) and 184 women (92 lesbian and 92 heterosexual) completed an online survey. Participants responded to the Dyadic Adjustment Scale-Short Version and to questions about self-perceived sexual problems and associated levels of distress. A 2 (gender) × 2 (sexual orientation) × 2 (group with or without sexual problems) univariate analysis of covariance was performed. The findings suggested that individuals with distressing sexual problems, regardless of gender or sexual orientation, scored significantly lower on the Dyadic Adjustment Scale. Additionally, lesbian women, regardless of having or not having a distressing sexual problem, scored significantly higher on the Dyadic Adjustment Scale, compared to heterosexual women. No gender differences were found. Overall, our findings emphasize the negative association between dyadic adjustment and distressing sexual problems, regardless of gender and sexual orientation.

Cognitive-Emotional Predictors of Sexual Functioning in Lesbians, Gays, and Heterosexuals

Cognitive-emotional dimensions play a core role in predisposing and maintaining sexual difficulties. This study aimed to assess the role of personality traits, sexual beliefs, cognitive schemas, automatic thoughts and affective states in predicting sexual functioning in a Portuguese sample. A total of 226 lesbian women, 254 heterosexual women, 243 gay men, and 274 heterosexual men completed a web-survey. For each sample, hierarchical regression analyses were conducted, separately. Results indicated that positive affective states and fewer thoughts associated with failure and disengagement during sexual activity act as significant predictors for sexual functioning, in both lesbian and heterosexual women's groups. Specific predictors of better sexual functioning in lesbian women were lower activation of schemas of undesirability and incompetence, and fewer thoughts associated with sexual abuse, body-image and sexual passivity were, whereas particular predictors of better sexual functioning for heterosexual women were erotic thoughts, lower activation of schemas of undesirability and difference/loneliness, and beliefs related to sexual desire as a sin. For men's groups, the best predictor of sexual functioning was the presence of erotic thoughts. Particularly for gay men's group, fewer failure anticipation thoughts were also a predictor of better sexual functioning. Overall, this study supports the core and predictive role of cognitive-emotional dimensions in sexual functioning for lesbian and heterosexual women, as for gay and heterosexual men.

Sexual Satisfaction, Solitary, and Dyadic Sexual Desire in Men According to Sexual Orientation

Research on male sexual desire and satisfaction according to sexual orientation remains insufficient. An online survey was fulfilled by 415 men (142 gay; 273 heterosexual), and participants completed the SDI-2 and the GMSEX. Main findings suggested that gay men scored significantly higher on both solitary sexual desire and attractive person-related dyadic sexual desire subscales, but not on a partner-related dyadic sexual desire subscale, compared to heterosexual men. Despite sexual orientation, partner-related dyadic sexual desire positively predicts sexual satisfaction, whereas solitary and attractive person-related dyadic sexual desire negatively predicts sexual satisfaction in men. Overall, gay men appear to experience higher levels of both attractive person-related dyadic and solitary sexual desire. Also, experiencing sexual desire toward a partner predicts positively, whereas experiencing desire to engage in sexual behavior with oneself and toward an attractive person predict negatively sexual satisfaction in men.

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.

Sexual functioning beliefs, sexual satisfaction, and sexual functioning in women: a cross-sectional mediation analysis

BACKGROUND

Sexual dysfunctional beliefs are known to be negative predictors of women's sexual functioning and sexual satisfaction, but little is known about the role that beliefs about sexual functioning play in women's sexual functioning and sexual satisfaction.

AIM

The purpose of the present study was to examine the mediating role of sexual functioning in the relationship between women's beliefs about sexual functioning and sexual satisfaction.

METHODS

A sample of 301 women was invited to participate in a web survey about female sexuality in May 2020.

OUTCOMES

Participants completed the sociodemographic questionnaire, the Beliefs About Sexual Functioning Scale, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index.

RESULTS

Sexual functioning was a significant mediator in the relationship between beliefs about sexual functioning and sexual satisfaction in women. When the dimensions of sexual functioning were considered as mediators, only sexual desire and absence of sexual pain were significant mediators in the relationship between beliefs about sexual functioning and sexual satisfaction in women.

CLINICAL IMPLICATIONS

Negative beliefs about sexual functioning in women are associated with poor sexual functioning and lack of sexual satisfaction. Therefore, beliefs about sexual functioning should be assessed during the intervention for women's sexual difficulties and to increase sexual pleasure and satisfaction. In addition, special attention should be paid to women with problems with sexual desire and sexual pain when beliefs about sexual functioning are being assessed.

STRENGTHS AND LIMITATIONS

This study is one of the first attempts to explore the role of beliefs about sexual functioning in women's sexual satisfaction and to examine the mediating role of sexual functioning. Limitations include the small sample size, the lack of a clinical sample, and the nonlongitudinal methodological approach.

CONCLUSION

Beliefs about sexual functioning are a negative predictor of sexual functioning and sexual satisfaction in women. In addition, women with sexual pain and lack of sexual desire are more likely to have lower sexual satisfaction if they have more negative beliefs about sexual functioning.

Solitary and Dyadic Sexual Desire and Sexual Satisfaction in Women With and Without Sexual Concerns

Women's sexual difficulties have been associated with sexual-related dimensions. The present study aims to analyze the differences between women with and without sexual concerns, according to the Female Sexual Functioning Index cutoff score, on dyadic and solitary sexual desire and sexual satisfaction dimensions. A total of 314 women participated in the study and answered to a sociodemographic screening, to the Sexual Desire Inventory - 2, to the Female Sexual Functioning Index, and to the Sexual Satisfaction Scale for Women. Main findings showed that women with sexual concerns revealed lower levels of global sexual desire and partner-related sexual desire, experienced lower levels of communication and compatibility with sexual partner, and have more personal and relational sexual concerns. Overall, results enhance the role of dyadic and relational dimensions that allow to differentiate between women with and without sexual concerns. Clinical implications are discussed.

Repetitive Negative Thinking and Sexual Functioning in Portuguese Men and Women: A Cross-Sectional Study

Objective: Repetitive negative thinking (RNT) is a transdiagnostic process involved in the development and maintenance of emotional disorders that negatively affect sexual functioning. However, empirical evidence for the role of RNT on sexual functioning is still lacking. The current study aimed to investigate the role of RNT on sexual functioning in men and women by examining differences in RNT between men and women and between individuals with and without subclinical sexual difficulties. It also aimed to investigate the predictive role of RNT on sexual function indices in men and women. Methods: A total of 424 participants (270 women) completed online a sociodemographic questionnaire and Portuguese versions of the Persistent and Intrusive Negative Thoughts Scale, the Female Sexual Functioning Index, and the International Index of Erectile Function. Results: The main findings showed that women scored significantly higher than men on the RNT. Similarly, individuals with subclinical sexual difficulties scored significantly higher on the RNT compared with individuals without sexual difficulties. RNT was a statistically significant and negative predictor of sexual functioning in women and men. The role of RNT on sexual functioning in women and men was found, with men and women with subclinical sexual difficulties more likely to express persistent and intrusive negative thoughts compared with men and women without sexual difficulties. Conclusions: In summary, RNT appears to be a negative predictor of sexual functioning in both women and men, suggesting that individuals with more intrusive and negative persistent thoughts also have more difficulty in their sexual response.

Sexual Satisfaction and Cognitive Schemas Activated in a Sexual Context among Iranian Married Women of Reproductive Age

The present study examined the relationship between sexual satisfaction (SS) and cognitive schemas activated in sexual context. In a cross-sectional study, the participants comprised 313 Iranian married women (mean age of 36.7 years and mean marriage duration of 12.4 years). Data were collected utilizing an online survey comprising the Index of Sexual Satisfaction, the Cognitive Schema Activated in Sexual Context Questionnaire, and a number of sociodemographic questions. A linear regression model utilizing the stepwise method was performed. The mean score of cognitive schemas relating to sexual problems was 35.56 (out of 140; SD = 14.68) with the highest mean in the Difference/Loneliness subscale (higher scores indicating greater negative schema activation). The mean score of sexual satisfaction on the ISS was 96.80 (out of 125; SD = 16.77). The highest scores of cognitive schemas relating to sexual problems were observed among individuals with low sexual satisfaction. Based on a multivariable linear regression model, age (β = 0.33), spouse social support (β = 0.23), and spouse job (β = 0.21) had the highest regression coefficients in relation to sexual satisfaction among Iranian married women. Cognitive schemas activated in a sexual context were strongly and significantly associated with sexual satisfaction among Iranian married women of reproductive age. The findings suggest that schema therapy techniques be used alongside initiatives to promote spouse social support to help prevent problematic sexual cognitive schemas.