Viewing Time Measures of Sexual Interest and Sexual Offending Propensity: An Online Survey of Fathers

Relative viewing times (VTs)-time required to view and evaluate sexually salient images-discriminate individuals with a sexual interest in children, as indirectly indexed by their history of sexual offending against children, from those without such history. In an online sample of 652 fathers, we measured VTs and sexual attraction ratings to child and adult images. We assessed participants' sexual offending history and propensity (self-reported likelihood to have a sexual contact with a child, a non-consensual sexual contact with an adult, and propensity toward father-daughter incest). In contrast with VT studies involving clinical or forensic samples, VTs and attraction ratings failed to discriminate participants with a sexual offending history. VTs successfully distinguished participants with a propensity to sexually offend against children but failed to identify those with a propensity toward incest. Conversely, attraction ratings distinguished participants with a propensity toward incest but failed to identify those with a propensity to sexually offend against children. Correlations between VTs and attraction ratings were small. Results illustrate, for the first time, the distribution of VT measures in community fathers, support the feasibility of online administration of VT tasks to detect propensity to sexually offend against children, and indicate that sexual interest in children and incest propensity are distinct.

Measurement of Sexual Interests with Pupillary Responses: A Meta-Analysis

Objective measures of sexual interest are important for research on human sexuality. There has been a resurgence in research examining pupil dilation as a potential index of sexual orientation. We carried out a meta-analytic review of studies published between 1965 and 2020 (Mdn year = 2016) measuring pupil responses to visual stimuli of adult men and women to assess sexual interest. Separate meta-analyses were performed for six sexual orientation categories. In the final analysis, 15 studies were included for heterosexual men (N = 550), 5 studies for gay men (N = 65), 4 studies for bisexual men (N = 124), 13 studies for heterosexual women (N = 403), and 3 studies for lesbian women (N = 132). Only heterosexual and gay men demonstrated discrimination in pupillary responses that was clearly in line with their sexual orientation, with greater pupil dilation to female and male stimuli, respectively. Bisexual men showed greater pupil dilation to male stimuli. Although heterosexual women exhibited larger pupils to male stimuli compared to female stimuli, the magnitude of the effect was small and non-significant. Finally, lesbian women displayed greater pupil dilation to male stimuli. Three methodological moderators were identified-the sexual explicitness of stimulus materials, the measurement technique of pupillary response, and inclusion of self-report measures of sexual interest. These meta-analyses are based on a limited number of studies and are therefore preliminary. However, the results suggest that pupillary measurement of sexual interest is promising for men and that standardization is essential to gain a better understanding of the validity of this measurement technique for sexual interest.

Sexual Health Issues in Cancer Survivors

OBJECTIVE

To review the sexual health issues cancer survivors may experience, including incidence, association with treatment modalities, and approach to evaluation and treatment.

DATA SOURCES

Peer-reviewed journal articles, medical society or government Web sites.

CONCLUSION

Cancer diagnosis and treatment often impacts sexual function and addressing this is a key component of health-related quality of life.

IMPLICATIONS FOR NURSING PRACTICE

Screening, evaluation, and treatment of sexual dysfunction should be incorporated into routine oncologic care.

Measuring Pedophilic Sexual Interest

INTRODUCTION

Pedophilic sexual interest is an important risk factor in sexual offender recidivism and remains a key component in the clinical assessment of child sexual offenders and people diagnosed with pedophilia. Despite concerns about the absence of universally accepted standardized clinical assessment methods, there are a number of established techniques aimed at assessing people with sexual interest in children.

AIM

To provide a foundation from which to understand existing methods available for the assessment of people with pedophilic sexual interests, including strengths and limitations of each approach.

METHODS

A group of clinical experts provide a clinically oriented, narrative review on assessment methods for pedophilic sexual interest, including the rationale behind each method and its implementation. Evidence on validity supporting the techniques, limitations, and ethical issues is also discussed.

RESULTS

The assessment methods were grouped according to the following categories: self-report, genital psychophysiological assessment, indirect measurement, and behavioral measurement of pedophilic interest. Although most techniques performed well in discriminating child sexual offenders with pedophilic interest from distinct comparison groups, there are several limitations, including the current lack of standardization and the ethical challenges posed by this sensitive area.

CLINICAL IMPLICATIONS

An understanding of the different measures available for the assessment of problematic sexual interests plays a vital role in forensic clinical determinations of risk of recidivism and in the identification of treatment targets for men who have committed sexual offenses. Several independent but complimentary methods exist to assess sexual interest. Ongoing work on the international standardization of assessment based on methodologically sound research aimed at determining best practices will address some of the shortcomings of these assessments while improving their reliability.

STRENGTHS & LIMITATIONS

This article provides a general review on a number of methods aimed at assessing pedophilic interest. However, these methods mirror clinical practice largely used within North America and parts of continental Europe. As a result of cultural differences, opposing paradigms on assessment and treatment of pedophilia, and diverse legal regulation between jurisdictions and countries, these practices may not be applicable on an international scale where other special procedures may be required.

CONCLUSION

A number of techniques have been used within clinical and research settings that vary from self-report to objective measures. Most methods have demonstrated efficacy. Continued work to combine evidence and experience from diverse populations and multiple countries will improve the quality of the methods available. Carvalho J, Bradford J, Murphy L, et al. Measuring Pedophilic Sexual Interest. J Sex Med 2020;17:378-392.

Tracking Mouse Trajectories Related to Decisions About Sexual Interest

The current research explored continuous behavioral processes by recording participants' hand movements toward a response option using Mousetracker software. Across three studies, we tested the idea that sexual interest-related decisions can be indexed using automatic movements. Using a UK sample of self-identified same- and opposite-gender attracted men (N = 43), Study 1 showed that the process of approaching the response button was faster, more direct, and less curved when participants responded from their own (vs. a non-preferred) perspective. Study 2 supported these findings using a German sample of self-identified same- and opposite-gender attracted men (N = 66). Using a teleiophilic sample of 100 self-identified opposite-gender attracted men (n = 51) and women (n = 49), Study 3 examined age-specific sexual interests (i.e., responding to stimuli from a pedophilic and a teleiophilic perspective). As expected, in the teleiophilic block, participants' responses were faster, more direct, and less curved than in the pedophilic block. Collectively, the results suggest that mousetracking shows promise as a measure of sexual interest (across the dimension of both gender and age), providing grounds for future research.

Exploring parent sexuality profiles and links with the sexuality profiles of adolescents who have engaged in sexual abuse

BACKGROUND

Parents play an important role in children's development of sexual norms and behaviors. Regarding the family environment of adolescents who have engaged in sexual abuse (AESA), some studies have suggested potential factors of interest, although the sexuality of AESA parents has yet to be considered.

OBJECTIVES

(1) Explore sexual profiles among parents, (2) Examine if the sexual profiles of parents are related to the sexual profiles of AESA.

PARTICIPANTS AND SETTING

Participants include 201 parents (116 mothers, 85 fathers) of AESA recruited from specialized treatment and youth centers in Quebec.

METHODS

Hierarchical and nonhierarchical methods were used to generate cluster solutions. Chi-square or Fisher's exact tests were then conducted to explore links between parents' and AESA sexuality profiles.

RESULTS

Three sexuality profiles emerged separately for mothers and fathers, showing similar patterns. Parents in the first two clusters (Overinvested and Atypical Sexuality - OAS and Overinvested and Non-Atypical Sexuality - ONAS) showed greater interest/investment in sexuality and an earlier sexual onset. However, they differed on their sexual interests: Most parents in the OAS cluster reported a greater variety of atypical fantasies and atypical sexual behaviors, while the sexual interests of parents in the ONAS cluster were mainly limited to non-atypical sexuality. Parents in the third cluster (Constrictive Sexuality - CS) were less interested and invested in sexuality. A link between the exacerbated sexuality of mothers (OAS cluster) and of adolescents was also found.

CONCLUSIONS

This study represents a first step in showing a potential correspondence between parents' and AESA sexuality profiles.

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.

Putting Sex Into Context in Later Life: Environmental Disorder and Sexual Interest Among Partnered Seniors

Background and Objectives

This study examines whether neighborhood and household disorder is associated with sexual interest among partnered seniors.

Research Design and Methods

Analyses use dyadic data from Wave 2 of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of community-dwelling older adults (2010-2011). Measures of environmental disorder were conducted by trained interviewers. Survey data were also linked to census tract information from the 2009 American Community Survey. We used actor-partner interdependence models to estimate the likelihood of reporting low sexual interest.

Results

There was no observed association between neighborhood context (physical disorder or census tract socioeconomic disadvantage) and sexual interest, but husbands were more likely to report low sexual interest if they lived in more disorderly households. High marital quality protected against low sexual interest, but these evaluations did not mediate or moderate the putative effect of household disorder.

Discussion and Implications

Regardless of the broader neighborhood context, helping older adults maintain an orderly home space may help sustain sexual functioning. Future research should consider how various features of the environment matter for additional aspects of late-life sexuality.

An integrated model to understand sexuality in older adults in urban China: The mediating role of sexual interest

BACKGROUND

The subject of sexuality in older adults has remained grossly understudied in China, despite the country having the largest older population in the world.

OBJECTIVE

Guided by the Sexual Script Theory and the Theory of Planned Behavior (TPB), this study used path analysis to test an integrated path model for sexual activity with sexual interest as a mediator.

METHODS

Survey data was collected from a representative sample of 688 community-dwelling older Chinese adults aged 60 or above residing in Tianjin, China.

RESULTS

The final integrated model yielded a satisfactory model fit. Sexual knowledge, sexual attitude and perceived sexual control have direct positive effects on sexual interest in sample older Chinese. Furthermore, sexual interest mediated the effect of sexual knowledge, sexual attitude, perceived sexual control, available sexual partner, male gender and education level on sexual activities. Age was found negatively associated with sexual activities, while a non-significant relationship for sexual interest was observed. Male gender positively associated with sexual activities and sexual interest. In addition, education level has a positive effect on sexual interest.

CONCLUSION

The integrated model highlighted the mediating role of sexual interest on sexual activities, thereby contributes to advancements of understanding of sexuality in older Chinese population.The current study also provides empirical evidence to the development of intervention and education programmes on sexuality among older Chinese adults. These programmes should pay attention to address the issues of sexual interest and partnership in older adults. Frontline health professionals should be sensitive to the needs of sex education in older population.

The Use of Film Clips in a Viewing Time Task of Sexual Interests

Viewing time tasks using still pictures to assess age and gender sexual interests have been well validated and are commonly used. The use of film clips in a viewing time task would open up interesting possibilities for the study of sexual interest toward sexual targets or activities that are not easily captured in still pictures. We examined the validity of a viewing time task using film clips to assess sexual interest toward male and female targets, in a sample of 52 young adults. Film clips produced longer viewing times than still pictures. For both men and women, the indices derived from the film viewing time task were able to distinguish individuals who identified as homosexual (14 men, 8 women) from those who identified as heterosexual (15 men, 15 women), and provided comparable group differentiation as indices derived from a viewing time task using still pictures. Men's viewing times were more gender-specific than those of women. Viewing times to film clips were correlated with participants' ratings of sexual appeal of the same clips, and with viewing times to pictures. The results support the feasibility of a viewing time measure of sexual interest that utilizes film clips and, thus, expand the types of sexual interests that could be investigated (e.g., sadism, biastophilia).

Latency-Based and Psychophysiological Measures of Sexual Interest Show Convergent and Concurrent Validity

Latency-based measures of sexual interest require additional evidence of validity, as do newer pupil dilation approaches. A total of 102 community men completed six latency-based measures of sexual interest. Pupillary responses were recorded during three of these tasks and in an additional task where no participant response was required. For adult stimuli, there was a high degree of intercorrelation between measures, suggesting that tasks may be measuring the same underlying construct (convergent validity). In addition to being correlated with one another, measures also predicted participants' self-reported sexual interest, demonstrating concurrent validity (i.e., the ability of a task to predict a more validated, simultaneously recorded, measure). Latency-based and pupillometric approaches also showed preliminary evidence of concurrent validity in predicting both self-reported interest in child molestation and viewing pornographic material containing children. Taken together, the study findings build on the evidence base for the validity of latency-based and pupillometric measures of sexual interest.

Sexual interest and sexual self-control in men with self-reported sexual interest in children - A first eye tracking study

Sexual child abuse is one of the most destructive events for child development. One possible approach to avert it is the preventive treatment of individuals with a sexual interest in children. The aim of the current eye tracking study was to compare people with a self-reported sexual interest in children who participate in the outpatient preventive treatment project "PsM", pedophilic forensic inpatients, and a non-pedophilic control group. Groups were compared with respect to sexual interest and attentional control in the presence of sexual stimuli, both assessed independently of self-report. Two approaches were applied, namely the initial orientation approach for measuring sexual interest, and a sexual distractor task for measuring attentional control. Our data showed for the first time that outpatients with a self-reported sexual interest in children differed from pedophilic forensic inpatients with respect to attentional control but not with regard to sexual interest. Outpatients showed similar sexual interest in children as pedophilic forensic inpatients. They demonstrated significantly better attentional control than pedophilic forensic inpatients in the face of adult sexual stimuli, but the difference regarding child sexual stimuli did not reach significance. This might reflect a higher capacity for self-control and self-regulation in these patients. Nevertheless, child stimuli remain to be important distractors for them. Our results provide valuable additional information for the diagnosis and therapy of outpatients with a self-reported sexual interest in children. Obviously, these data are preliminary and further studies with larger groups should examine if they are replicable.

Development of a Cued Pro- and Antisaccade Paradigm: An Indirect Measure to Explore Automatic Components of Sexual Interest

We developed a cued pro- and antisaccade paradigm (CPAP) to explore automatic components of sexual interest. Heterosexual participants (n = 32 women, n = 25 men) had to perform fast eye movements toward and away from sexually relevant or irrelevant stimuli across a congruent (i.e., prosaccade toward sexually relevant stimuli, antisaccade away from sexually irrelevant stimuli) and an incongruent condition (i.e., prosaccade toward sexually irrelevant stimuli, antisaccade away from sexually relevant stimuli). We hypothesized that pro- and antisaccade performance would be influenced by the sexual interest-specific relevance of the presented stimulus (i.e., nude female or male stimulus) and the instructed task (i.e., pro- or antisaccade) and, thus, differ meaningfully between conditions. Results for prosaccades toward sexually relevant stimuli in the congruent condition showed that error rates were lower and latencies were shorter compared with prosaccades toward sexually irrelevant stimuli in the incongruent condition, but only for male participants. In addition, error rates for antisaccades away from sexually irrelevant stimuli in the congruent condition were lower than for antisaccades away from sexually relevant stimuli in the incongruent condition, for both female and male participants. Latencies of antisaccades, however, did not differ between conditions. In comparison with established indirect sexual interest paradigms, the CPAP benefits from measuring highly automated processes less prone to deliberate control. To this end, the CPAP could be applied to explore the interplay of early automatic and deliberate components of sexual information processing.

Gender-Specificity in Viewing Time Among Heterosexual Women

Measures of sexual interest tend to be more gender-specific in heterosexual men than in heterosexual women. Cognitive measures, such as viewing time to attractive stimuli, may also show similar patterns of gender-specificity or nonspecificity among men and women and thus serve as useful adjuncts to more direct measures of sexual interest. The objectives of the present research were to determine the extent of gender-specificity in women's viewing times for female pictures (varying in their perceived physical attractiveness) and explore the influence of social comparison of physical appearance on these patterns of responses. In Study 1, we recorded only women's viewing times for pictures of both genders, measured self-reported menstrual cycle phase, and manipulated the waist-to-hip ratio of the women in the female pictures. In Study 2, we recorded women's and men's viewing times, self-reported sexual attraction to pictures of males and females, and physical appearance social comparison. Study 1 found that heterosexual women's viewing time toward female pictures was not associated with manipulation of the perceived attractiveness of those pictures. Study 2 found that heterosexual men were more gender-specific than heterosexual women in their viewing time patterns. We also found that reported sexual attraction and physical appearance social comparison were associated with heterosexual women's viewing times for female pictures, while heterosexual men's viewing times were associated with sexual attraction only. Our results are discussed in relation to the utility of viewing time as an indicator of visual attention toward attractive or sexually appealing visual stimuli.

Pupillary Response as an Age-Specific Measure of Sexual Interest

In the visual processing of sexual content, pupil dilation is an indicator of arousal that has been linked to observers' sexual orientation. This study investigated whether this measure can be extended to determine age-specific sexual interest. In two experiments, the pupillary responses of heterosexual adults to images of males and females of different ages were related to self-reported sexual interest, sexual appeal to the stimuli, and a child molestation proclivity scale. In both experiments, the pupils of male observers dilated to photographs of women but not men, children, or neutral stimuli. These pupillary responses corresponded with observer's self-reported sexual interests and their sexual appeal ratings of the stimuli. Female observers showed pupil dilation to photographs of men and women but not children. In women, pupillary responses also correlated poorly with sexual appeal ratings of the stimuli. These experiments provide initial evidence that eye-tracking could be used as a measure of sex-specific interest in male observers, and as an age-specific index in male and female observers.

Pupillary Response as an Age-Specific Measure of Sexual Interest

In the visual processing of sexual content, pupil dilation is an indicator of arousal that has been linked to observers' sexual orientation. This study investigated whether this measure can be extended to determine age-specific sexual interest. In two experiments, the pupillary responses of heterosexual adults to images of males and females of different ages were related to self-reported sexual interest, sexual appeal to the stimuli, and a child molestation proclivity scale. In both experiments, the pupils of male observers dilated to photographs of women but not men, children, or neutral stimuli. These pupillary responses corresponded with observer's self-reported sexual interests and their sexual appeal ratings of the stimuli. Female observers showed pupil dilation to photographs of men and women but not children. In women, pupillary responses also correlated poorly with sexual appeal ratings of the stimuli. These experiments provide initial evidence that eye-tracking could be used as a measure of sex-specific interest in male observers, and as an age-specific index in male and female observers.

Automatic Direction of Spatial Attention to Male Versus Female Stimuli: A Comparison of Heterosexual Men and Women

Abundant research has shown that men's sexual attractions are more category-specific in relation to gender than women's are. We tested whether the early automatic allocation of spatial attention reflects these sexual attractions. The dot-probe task was used to assess whether spatial attention was attracted to images of either male or female models that were naked or partially clothed. In Experiment 1, men were faster if the target appeared after the female stimulus, whereas women were equally quick to respond to targets after male or female stimuli. In Experiment 2, neutral cues were introduced. Men were again faster to female images in comparison to male or neutral images, but showed no bias on the male versus neutral test. Women were faster to both male and female pictures in comparison to neutral pictures. However, in this experiment they were also faster to female pictures than to male pictures. The results suggest that early attentional processes reveal category-specific interest to the preferred sexual category for heterosexual men, and suggest that heterosexual women do not have category-specific guidance of attentional mechanisms. The technique may have promise in measuring sexual interest in other situations where participants may not be able, or may not be willing, to report upon their sexual interests (e.g., assessment of paedophilic interest).

The Temporal Stability of Lack of Sexual Attraction Across Young Adulthood

There is a large and growing literature on the stability of sexual orientation across the lifespan. However, virtually no studies have been conducted on the longitudinal stability of any dimension of asexuality. Here I utilized Kinsey scale-type data from Wave III and Wave IV of the Add Health survey to measure the stability of indicating "not sexually attracted to either males or females" in a forced-choice, Kinsey-type scale and during the time participants were moving through early adulthood (18-26 years in Wave III and 24-32 years in Wave IV). I found that, for the most part, individuals who reported no sexual attraction in Wave III were not the same individuals who reported no sexual attraction in Wave IV, with only three out of the 25 in Wave III who indicated no sexual attraction going on to do the same in Wave IV. This inter-wave consistency was lower than it was for other sexual minorities. However, indicating no sexual attraction in one wave was still a statistically significant predictor of indicating no sexual attraction in the other wave, as was refusing to answer or indicating the "don't know" option in the other wave. These findings do not necessarily denote change in sexual attraction across waves; the fact that not answering the question in one wave was a significant predictor of indicating no sexual attraction in the other wave provides quantitative evidence for the ambiguities involved in sexual identities when sexuality is taken for granted in the broader culture. This ambiguity affects the operationalization and quantification of asexuality.

Contextual Influences on Men's Perceptions of Women's Sexual Interest

The current study evaluated whether the sexual relevance of the social environment potentiated men's judgments of women's sexual interest, particularly among men reporting more frequent misperception of a potential partner's sexual interest. Twenty-eight scenes were constructed depicting social environments that were either lower or higher in sexual relevance (e.g., office vs. bar). A full-body photograph of one of 14 college-aged women was inserted into each scene; the women all expressed neutral-to-positive affect and varied in provocativeness of dress and attractiveness. A total of 237 undergraduate males viewed each scene and judged how sexually interested and friendly each woman felt. Sexually relevant social environments potentiated men's judgments of women's sexual interest far more than their friendliness. This effect was stronger among more conservatively dressed women and among men reporting more frequent experiences of misperceiving a woman's sexual interest. The findings highlight the contextualized nature of emotional perception, whereby perception of emotion is potentiated in congruent, relative to incongruent, contexts.

Lower Psychological Well-Being and Excessive Sexual Interest Predict Symptoms of Compulsive Use of Sexually Explicit Internet Material Among Adolescent Boys

Although a growing body of literature addresses the effects of young people's use of sexually explicit Internet material, research on the compulsive use of this type of online content among adolescents and its associated factors is largely lacking. This study investigated whether factors from three distinct psychosocial domains (i.e., psychological well-being, sexual interests/behaviors, and impulsive-psychopathic personality) predicted symptoms of compulsive use of sexually explicit Internet material among adolescent boys. Links between psychosocial factors and boys' compulsive use symptoms were analyzed both cross-sectionally and longitudinally with compulsive use symptoms measured 6 months later (T2). Data were used from 331 Dutch boys (M age = 15.16 years, range 11-17) who indicated that they used sexually explicit Internet material. The results from negative binomial regression analyses indicated that lower levels of global self-esteem and higher levels of excessive sexual interest concurrently predicted boys' symptoms of compulsive use of sexually explicit Internet material. Longitudinally, higher levels of depressive feelings and, again, excessive sexual interest predicted relative increases in compulsive use symptoms 6 months later. Impulsive and psychopathic personality traits were not uniquely related to boys' symptoms of compulsive use of sexually explicit Internet material. Our findings, while preliminary, suggest that both psychological well-being factors and sexual interests/behaviors are involved in the development of compulsive use of sexually explicit Internet material among adolescent boys. Such knowledge is important for prevention and intervention efforts that target the needs of specific problematic users of sexually explicit Internet material.

Sexuality and physical contact in National Social Life, Health, and Aging Project Wave 2

INTRODUCTION

Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sample.

METHOD

We describe the new measures and compare the distributions of each across gender and age groups, in some cases by partnership status.

RESULTS

Two components of sexuality decrease with age among both men and women: frequency of finding an unknown person sexually attractive and receptivity to a partner's sexual overtures. In contrast, the inclination to make one's self sexually attractive to others was a more complicated function of partner status, gender, and age: partnered women and unpartnered men made the most effort, with the more effortful gender's effort decreasing with age. Both men and women find nonsexual physical contact appealing but sexual physical contact is more appealing to men than women. Finally, two fifths of men and women report dissatisfaction with their partner's frequency of caring behaviors that make later sexual interactions pleasurable, and a fifth of women and a quarter of men who had vaginal sex in the past year report dissatisfaction with amount of foreplay.

DISCUSSION

These data offer the opportunity to characterize sexual motivation in older adulthood more precisely and richly and to examine how the context of sexual experience and the nonsexual aspects of physical intimacy correlate with sexual behavior, enjoyment, and problems.

Environmental exposure to di-2-ethylhexyl phthalate is associated with low interest in sexual activity in premenopausal women

Phthalates, a ubiquitous class of environmental chemicals, may interfere with typical reproductive hormone production both in utero and in adulthood. Although they are best known as anti-androgens, increasingly, evidence suggests that phthalates, particularly di-2-ethylhexyl phthalate (DEHP), may also suppress estrogen production. Given that both androgens and estrogens are essential for sexual function, particularly sexual interest, it is plausible that adult exposure to phthalates alters sexual function. To this end, we used data from 360 women participating in a pregnancy cohort study (the Study for Future Families) to examine whether urinary phthalate metabolite concentrations were associated with two dimensions of self-reported sexual dysfunction in the months prior to conception: lack of sexual interest and vaginal dryness. Women in the highest quartile of urinary concentrations of mono-2-ethyl-5-hydroxyhexyl phthalate, a DEHP metabolite, had 2.58 (95% CI 1.33, 5.00) times the adjusted odds of reporting that they almost always or often lacked interest in sexual activity, and results were similar for mono-2-ethyl-5-oxohexyl phthalate (aOR: 2.56, 95% CI 1.32, 4.95), another DEHP metabolite. Self-reported vaginal dryness was not associated with any phthalate metabolite concentration. This study is novel in its focus on sexual function in relation to environmentally relevant (rather than occupational) exposure to phthalates in adult women and these preliminary findings merit replication in a large, prospective study. Better understanding how adult exposure to phthalates may affect reproductive health, including sexual function, is of public health interest given that virtually all Westerners are exposed to phthalates.