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Sex response cycle, showing responsive desire experienced during the sexual experience as well as variable initial (spontaneous) desire. At the "initial" stage (left) there is sexual neutrality, but with positive motivation. A woman's reasons for instigating or agreeing to sex include a desire to express love, to receive and share physical pleasure, to feel emotionally closer, to please the partner and to increase her own well-being. This leads to a willingness to find and consciously focus on sexual stimuli. These stimuli are processed in the mind, influenced by biological and psychological factors. The resulting state is one of subjective sexual arousal. Continued stimulation allows sexual excitement and pleasure to become more intense, triggering desire for sex itself: sexual desire, absent initially, is now present. Sexual satisfaction, with or without orgasm, results when the stimulation continues sufficiently long and the woman can stay focused, enjoys the sensation of sexual arousal and is free from any negative outcome such as pain. (Modified from Basson 2001, 14 and published with the permission of the American College of Obstetricians and Gynecologists.)
Source publication
Acceptance of an evidence-based conceptualization of women's sexual response combining interpersonal, contextual, personal psychological and biological factors has led to recently published recommendations for revision of definitions of women's sexual disorders found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-I...
Contexts in source publication
Context 1
... and empirical studies, mainly of North Ameri- can and European adult women without sexual complaints, have clarified sexual response cycles that are different from the linear progression of discrete phases already men- tioned. Women describe overlapping phases of sexual re- sponse in a variable sequence that blends the responses of mind and body (Fig. 1). [11][12][13][14] That women have many reasons for initiating or agreeing to sex with their partners is an im- portant finding. 15 Women's sexual motivation is far more complex than simply the presence or absence of sexual de- sire (defined as thinking or fantasizing about sex and yearn- ing for sex between actual sexual ...
Context 2
... because the partner wanted to, to relieve tension) and to refrain (lack of interest, tiredness or physical problems [their own or their partner's], or no current partner). 15 These findings and those from other studies are in keeping with the sexual response cycle illustrated in Fig. ...
Context 3
... women report desire that appears to be spontaneous (also shown in Fig. 1), leading to arousal or to more enthusi- asm to find or be receptive to sexual stimuli. This type of de- sire has a broad spectrum across women and may be related to the menstrual cycle. 22 It decreases with age, 23 and at any age commonly increases with a new relationship. 12,21 Previous definitions of women's sexual dysfunctions un- ...
Context 4
... model in Fig. 1 clarifies the importance of women being able to become subjectively aroused. Many psycho- logical and biological factors may negatively influence this sexual ...
Context 5
... the various phases in patient's sex response cycle ( Fig. 1): her sexual motivations; the couple's emotional intimacy; their sexual skills; sexual stimuli and context, including interactions in the preceding hours; psychological factors, including distractions; and biological factors such as fatigue, depression or medications. Address abnormal loss of androgen activity* (e.g., from bilateral ...
Context 6
... on a careful history in which the physician helps the patient construct her sex response cycle (Fig. 1), prob- lem areas will be identified. 11 Thus the physician provides insight and direction to the many changes that need to be made by the woman and her partner. Having clarified the problems, the physician may be able to assist with some. For example, a partner's premature ejaculation can be addressed, the sexual context improved, ...
Citations
... Many studies have focused on identifying or distinguishing the people with sexual dysfunctions from those who do not have any dysfunction (e.g., Basson, 2005;Rosen et al., 2000), considering dysfunction to be the woman not reaching orgasm or not being satisfied in a sexual relationship, without considering the characteristics of this relationship or the cultural factors that intervene in the female orgasm. These studies have focused on exploring the causes of these dysfunctions, from medical/physiological point of view, however they have not analyzed the relationship of false ...
Introduction
Many of the sexual problems of the couples that come to psychology and sexology consultations are due to erroneous beliefs surrounding the topic of sex. Beliefs that have been turned into widespread sexual myths and fallacies in society. In this study, we conducted a survey on knowledge and fallacies related to sexual intercourse with a large Spanish random sample. Our aim was to evaluate the presence of these fallacies and myths in today's modern society.
Methods
A total of 1162 participants of different genders (female, male, and non-binary), different sexual orientation (mostly heterosexual) and different ages (from 14 –two cases- to 64 with mean of 24.62 and SD of 8.96), answered an online questionnaire, developed ad hoc for this study, during the years 2019, 2020 and 2021. This questionnaire or survey collects the different fallacies, myths and “machismo” attitudes collected in clinical practice (psychology/sexology) that have caused couples or individuals to request professional therapeutic help, as well as knowledge related to sexual practices.
Results
The results show that the current level of knowledge is in general good (between 99 and 73% of adequate responses, with some exceptions mainly related to anatomy), higher among women (reaching their highest percentage of correct answers at 99%) than men (reaching their highest percentage of correct answers at 97%), and independent of age. In addition, we observe the weight and relationship that certain myths and traditional cultural fallacies have, as well as the presence of false expectations and beliefs about what the "ideal" sexual relationship should be, which are still very present in modern Spanish society, and which are responsible for the majority of clinical consultations and alleged disorders related to couples’ sexual life.
Conclusions
These myths, false beliefs, and unrealistic expectations, as well as the subtle attitudes of "machismo" (that people are not aware that they possess), must be combated (information, campaigns) since they are responsible for many of the apparent disorders and dysfunctions in the human sexual response (which are mostly attributed to women), and in the sexual life, in general, of couples.
Policy Implications
This study presents the level that these fallacies and negative attitudes are present in a large sample in Spain, and the questionnaire developed will allow evaluating the level of presence of these fallacies and negative attitudes, both in different societies/ groups and in particular individuals. Information that will be of great help to professional therapists who treat dysfunctions and sexual problems in couple/marital life, which are based on these fallacies, on attitudes of “machismo” and/or on the lack of knowledge on the one's own sex and that of their partner.
... An important component of maintaining interest in sex is that sexual experiences are positive and rewarding (Basson, 2005). The Interpersonal Exchange Model of Sexual Satisfaction (Lawrance & Byers, 1995) provides a model to understanding sexual motivation. ...
As academic mothers of children with disabilities, the authors are stretched between our roles as scholar, teacher, mentor, parent, caregiver, advocate, and partner (Good et al., 2017). In this chapter, the authors draw on personal and professional experiences to discuss the benefits and barriers to an academic career while simultaneously parenting disabled children, with a specific focus on how social media, through a private Facebook group, has provided support. Within the community, the members find connections, resources, and peer-to-peer mentoring, which remain scarce to nonexistent in the authors’ personal and professional communities, largely due to implicit ableism. While academics sometimes define success as intellectual vitality, academic parents of children with disabilities may have different definitions of success. The gap between conventional academic measures of success and our revised assessments exacerbates maternal stress and professional pressures as the authors pursue work-life fit.KeywordsDisabilityInformal supportBoundary-settingAffinity groups
... Feelings of intimacy and connection with a partner may influence female sexual satisfaction as well as relationship satisfaction, both of which can lead women to be receptive to the next sexual experience. 10 A large body of research has been conducted to examine the links between sexual desire and sexual satisfaction. 11 The links are quite clear among partnered individuals: higher sexual desire toward the current partner is associated with other sexual responses and reactions and, moreover, greater sexual satisfaction. ...
... Fear of intimacy, concentration on oneself and one's thoughts, and so-called spectatoring, instead of experiencing intimacy with a partner, contribute to the lack of response to sexual stimulation and emotional disconnection from the sexual relationship. 10 In the analysis of the causes of sexual difficulties among women, demedicalization and a more careful approach to diagnosis are also postulated, taking into account contextual factors and factors resulting from natural changes in the life cycle that may affect sexual activity. 21 Protocols used for treating anxiety as the main cause of sexual dysfunction have been proposed by Masters and Johnson 22 as well as Helen Kaplan. ...
... It is worth remembering that lubrication is not the only element of the genital response indicating arousal: apart from it, there is also increased sensitivity and swelling of the genital organs. 10 In addition, lubrication can be explained by relatively common problems in women: age, the presence of sexually transmitted infections, or the use of hormonal contraception. 73 In the NSD group, the participants obtained reasonably high scores on the pain scale, which remained relatively high. ...
Background:
Mindfulness-based therapies (MBTs) are frequently used in the treatment of sexual dysfunctions. So far, there has not been sufficient evidence for the effectiveness of interventions based on mindfulness monotherapy.
Aim:
The aim of the study was to assess the effect of mindfulness monotherapy on the reduction of sexual dysfunction symptoms and sex-related quality of life.
Methods:
We conducted 4 weeks of MBT for 2 groups of heterosexual females: 1 with psychogenic sexual dysfunction (WSD) and 1 with no sexual dysfunction (NSD). Overall 93 women were recruited for the study. We collected data via an online survey regarding sexual satisfaction, sexual dysfunctions, and mindfulness-related features at baseline, 1 week after MBT, and follow-up 12 weeks after MBT. Research tools included the Female Sexual Function Index, Five Facet Mindfulness Questionnaire, and Sexual Satisfaction Questionnaire.
Outcomes:
Participating in the mindfulness program had a positive effect on women with and without sexual dysfunction.
Results:
The overall risk for sexual dysfunction decreased from 90.6% at baseline to 46.7% at follow-up in the WSD group and from 32.5% at baseline to 6.9% at follow-up in the NSD group. Participants in the WSD group reported a significant increase in levels of sexual desire, arousal, lubrication, and orgasm between measurements, although not in the pain domain. Participants in the NSD group reported a significant increase in the level of sexual desire between measurements but not in levels of arousal, lubrication, orgasm, and pain. A significant increase in sex-related quality of life was observed in both groups.
Clinical implications:
The results of the study have a chance to translate into an introduction of a new therapeutic program for specialists and more effective help offered to women experiencing sexual dysfunctions.
Strengths and limitations:
This mindfulness monotherapy research project, which included assessment of meditation "homework," is the first to verify the potential of MBT in reducing symptoms of psychogenic sexual dysfunctions among heterosexual females. Major limitations include the lack of randomization, an adequate control group, and a validated measure of sexual distress.
Conclusion:
The applied training was beneficial in the treatment of sexual dysfunctions in terms of increasing desire and arousal as well as the ability to reach orgasm. However, this approach needs more investigation before it can be recommended in the treatment of sexual dysfunction. The study should be replicated under a more rigorous research design, including adequate control groups and random allocation of participants to study conditions.
... A DSF foi definida pelo Consenso de Paris em 2004 como uma alteração persistente e recorrente do desejo/interesse sexual, da excitação subjetiva e genital, do orgasmo e ou dor/dificuldade para permitir a relação sexual (BASSON, 2005). Diferentes sistemas de classificação para disfunções sexuais são propostos, como: a Classificação Internacional de Doenças (OMS, 1997), 10ª. ...
... A partir do melhor entendimento da resposta sexual e o reconhecimento do modelo cíclico proposto por Basson, medidas subjetivas foram incluídas na classificação da DSF, no Consenso de Paris em 2004, e confirmadas no Quarto Consenso Internacional de Medicina Sexual, realizado em 2015, sendo classificadas em: disfunção do desejo sexual, disfunção da excitação, disfunção do orgasmo e disfunção da dor sexual, Basson, (2004, 2005) McCABE et al., (2016) -McCABE, (2015. J Sex Med, EUA, (2016). ...
Objetivo: avaliar a saúde psicossexual pela perspectiva humanista da abordagem centrada na pessoa (ACP), antes e após o uso de Tribulus Terrestris em mulheres com disfunção sexual feminina. Métodos: uma série consecutiva de 100 mulheres com disfunção sexual feminina foi recrutada para participar do estudo no serviço de Sexologia, do Ambulatório Jenny de Andrade Faria/Hospital das Clínicas – UFMGEBSERH. As pacientes foram submetidas à anamnese dirigida, ao rastreio do desejo sexual diminuído (DSDS) (Decreased Sexual Desire Screener) e à avaliação psicológica baseada na abordagem centrada na pessoa (ACP), antes e após 90 dias de uso do Tribulus Terrestris. Resultados: a idade média das pacientes na menacme era de 38 anos e as da pós-menopausa, de 55 anos. A idade média total das 100 pacientes era de 47 anos de idade. A interação medicamentosa foi benéfica às pacientes na menacme em relação aos domínios desejo espontâneo e responsivo, excitação subjetiva, excitação genital/lubrificação, orgasmo e satisfação sexual. Quanto aos outros domínios, os benefícios foram melhores para as pacientes na pós-menopausa, pois relataram melhora no desejo espontâneo, excitação subjetiva, excitação genital/lubrificação, orgasmo, dispareunia, satisfação sexual. Este estudo destaca a importância da avaliação psicológica humanística – abordagem centrada na pessoa (ACP) – em mulheres com a disfunção sexual feminina, antes e após tratamento com Tribulus Terrestris. A principal contribuição desta pesquisa é destacar os aspectos psicossexuais sob a perspectiva humanista da saúde sexual em pacientes com disfunção sexual, antes e após tratamento medicamentoso. Conclusão: utilizando a ACP como instrumento obteve-se êxito, nesta pesquisa, em colher os dados sensíveis das pacientes, necessários para a avaliação psicossexual. Concluiu-se que a interação medicamentosa foi preponderantemente benéfica às pacientes na menacme e pós-menopausa, com exceção dos domínios, respectivamente, dor e desejo responsivo.
... Moreover, as they reduce lubrication, they can be considered as psychological factors of Female Sexual Interest/Arousal Disorder (40). Sexual satisfaction is a substantial aspect of female sexual function (41), which is experienced with or without orgasm when the women can stay concentrated, and stimulation remains sufficiently long (42). Research documents the bidirectional correlation between relationships and sexual satisfaction, meaning that they are longitudinally and dynamically interconnected (43). ...
Objective: Perfectaionism is a common personality trait that can affect various aspects of life, especially sexual relationships. The purpose of this systematic review was to summarize the existing evidence for the relationship between perfectionism and sexual function in studies conducted in Iran and the world.
Method: A comprehensive search of databases such as Scopus, PubMed, Cochrane, Science Direct, ProQuest, PsychINFO, IranPsych, Irandoc, SID, and Google Scholar search engine was performed until December 2021 without a time limit. To find studies, we searched for the keywords perfectionism and sexual function in both Persian and English and combined these words with the AND operator. Studies that scored above 15 according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria were included. Data analysis was performed qualitatively.
Results: From the total of 878 articles found in databases, six articles met the inclusion criteria and had moderate quality. Reviewing studies corroborated that, notwithstanding the positive association between general/sexual perfectionism and sexual desire, specific dimensions such as socially prescribed perfectionism, partner-prescribed, and socially prescribed sexual perfectionism, have the utmost unfavorable effect on female sexual function, which means that a higher level of perfectionism ultimately decreases the rate of sexual function in women. In addition, studies suggested that by increasing sexual anxiety and distress levels, perfectionism deteriorates sexual function.
Conclusion: Perfectionism may cause a variety of problems regarding sexual function. However, to clarify the precise role of each dimension of perfectionism on different areas of sexual function, more research must be conducted in this area in various communities and on age groups other than females of reproductive ages.
... This points to the need for better methods for approaching sexual health-related discussions with HT patients, which should consider not only organic issues such as vaginal dryness but also psychic aspects such as depression, self-image, and counseling. [42][43][44][45][46][47][48] Our study had limitations such as small number of patients (41 in total); bigger amostrage in Tamoxifen group (46,35%); the majority of patients were postmenopausal (68%) which could enhance the impact on sexual life as we have seen in some studies cited above; and almost 20% of patients were at a stage IV or recurrent disease, which could lead to a bigger impact not only in sexual quality but also in general quality of life, leading to misunderstanding results. ...
Objectives:
To evaluate how hormonal therapy can impact breast cancer patients sexual quality of life and compare two widely used therapeutic agents: anastrozole and tamoxifen. Studies so far have evaluated the side effects of such therapy on patients general quality of life, but literature remains scarce regarding the impact it has on sexual aspects. We believe there is a demand for a detailed view of these aspects since most patients undergo these treatments for at least five years.
Material and Methods:
Transverse observational study evaluated in 2019, 41 women with a history of breast cancer, all of them undergoing hormonal therapy. Group presented a mean age of 55.4 years (35 to 77 years); those in menopause with a mean time of menopause of 10.92 years (2 to 28 years). Thirty-eight women lived maritally and/or were sexually active. The mean duration of treatment was 36.84 months. We analyzed data in pre-and postmenopausal women, evaluating the results of questionnaires with general parameters (age, treatment time, general quality of life, adaptation to therapy) as well as specific instruments for evaluation of sexual dysfunction (FSDS-R) and quality of life with specific aspects for breast cancer (FACT-B). The results were placed in 2×2 contingency tables comparing the group receiving tamoxifen versus anastrozole.
Results and Conclusion:
Tamoxifen compared to anastrozole is a drug with apparent less impact on most common sexual dysfunctions (orgasm, dyspareunia, and feeling good quality of sex life), following those already published in international literature. We found no impact on physical, socio-familiar, and emotional well-being. Finally, we conclude that the results of this study significantly contribute to the choice of adequate therapeutic agent and highlight the need to bring this topic during routine consults and to the decision with the patient for the best suited treatment option.
... The limited available studies report greater prevalence of SD in women with Type 1 diabetes compared with women with Type 2 diabetes and women without diabetes. [2][3][4] The majority of these studies have been epidemiological studies based on questionnaire surveys. Hence, limited evidence is available about the lived experiences of SD and its effect on the quality of life of women with Type 1 diabetes. ...
... Whilst there are no standard diagnostic criteria for SD, 3 it is generally defined in terms of deficits in sexual desire, arousal and the ability to orgasm. 4,5 It has also been suggested that SD involves psychological and sociocultural processes. 6 Hence, SD is a complex and multifaceted problem, and its aetiology in women with Type 1 diabetes incorporates both biological and psychosocial factors. ...
Background: Survey data suggest that women with Type 1 diabetes mellitus have a higher prevalence of sexual dysfunction (SD) compared with women with Type 2 diabetes or without diabetes. However, little is known about how women with Type 1 diabetes experience SD or its impact on their lives. This exploratory study sought to elicit women with Type 1 diabetes’s experiences of SD and identify their ideas on how SD could be better addressed in diabetes care. Method: A qualitative study using semi-structured interviews was conducted at a diabetes centre in South West of England hospital. A purposeful sample of six women with Type 1 diabetes (<50 years of age) and experience of SD were interviewed. The interviews lasted 20–30 min and were analysed using Interpretive Phenomenological Analysis. Findings: The study identified four superordinate themes: barriers to sex, impact of SD, personal support and ideas for improving support with SD. The majority of the themes were underpinned by diabetes specific factor such as hypoglycaemia, body image and diabetes management (technology and glucose regulation). This study found that women’s perspectives on their sexual identities and behaviours were mediated by emotional and interpersonal issues. This study also highlighted the lack of support provided by healthcare professionals (HCPs) in addressing SD. Conclusion: The findings indicate that SD is a complex issue that needs to be given more attention by HCPs, so that the women can approach sex positively in their lives. HCPs need to be enabled to initiate conversations around SD in their consultations.
... The third factor is "satisfaction with sex organs appearance and function". Normal sexual function is assessed based on the sexual response cycle, which is a combination of mind and body responses (21) . As body image affects all aspects of female sexual function (22) , the items of the third facto are related to the body and sexual self-image. ...
... In the third factor, not only female sexual function but also a spouse's sexual function is assessed from the women's viewpoint. In sexual dysfunction assessment, it is strongly recommended to evaluate sex partner-related factors regularly (18,21) . It is worthy to mention that as sex and sexual desire are considered undesirable for women in the most conservative cultures and communities, such as Iran, especially in the post-reproductive years, thus questioning straight about sexuality may be seemed unfair or accompanied by feelings of shame. ...
Purpose: This study aimed to develop and psychometrically validate the Sexual Health Scale for Middle-Aged sexually active women (SHIMA). Methods: This study was a sequential exploratory study consisting of two phases. In phase one, we interviewed 19 middle-aged women and reviewed the existing instruments to generate an item pool. Then, a panel of experts (n = 16) examined the items. In the second phase, the psychometric properties of the scale were assessed. For content and face validity, a panel of experts (n = 8) and a group of middle-aged women (n = 10) reviewed the items. For construct validity, a cross-sectional study was carried out on a sample of 427 married women. Finally, SHIMA's reliability was assessed. Results: In the first phase, the sexual health concept was explored, and a provisional scale including 60 items was generated. Next, 21 items were removed based on content and face validity. Accordingly, the results obtained from the exploratory factor analysis (EFA) indicated acceptable loading for 34 items tapping into six factors that jointly explained 48.67% of the total variance observed. The internal consistency evaluation revealed that Cronbach's alpha and McDonald's omega were greater than 0.7, and the average inter-item correlation was greater than 0.4, except for one factor that showed borderline results. Test-retest reliability over a 2-weeks interval was 0.90, indicating its high stability. Conclusion: The SHIMA is a reliable and valid scale for measuring sexual health in middle-aged married women. It can be used as a sexual health screening scale by healthcare professionals and for research purposes.
... Most authors note that many women suffer from disorders of sexual desire, arousal, vaginal hydration, orgasm, dissatisfaction, dyspareunia, and vaginismus [7][8][9] . Sexual dysfunction also occurs in men: erectile dysfunction (ED) occurs in 26 cases per 1,000 men/ year. ...
The aim of this cross-cultural study was to examine predictors of sexual satisfaction.
For the present analysis, we used a large-scale sample database that included 8821 individuals
from 4 countries. All participants completed the same questionnaires, which were designed to capture
numerous important variables that have been shown to correlate with sexual satisfaction. According to
our results, predictors of sexual satisfaction were classified into four general categories (demographic
factors, psychological factors, sociocultural factors, and pathophysiological factors). Our international
study found statistically significantly higher satisfaction among homosexual participants, participants
aged 18 to 23 years, those with a higher level of education, in a relationship, with a current sexual
partner, in a current partnered (unmarried) relationship, and without a diagnosed sexual or mental
disorder. At the same time, we found that the correlation between sexual satisfaction and the different
predictors varieed considerably across countries, which calls for further research.
... At least half of women treated for breast cancer and pelvic malignancies experience sexual dysfunction; other patient groups also report sexual side effects in large numbers (e.g., over 90% of head and neck cancer patients) [1][2][3]. Cancer-related changes to sexual function can affect all aspects of the female sexual response cycle [4]. Common sexual side effects include vulvovaginal or avoidance of sex (solo or partnered). ...
Purpose of Review
Sexual problems after cancer are common and multifaceted, particularly among women. The objective of this paper is to review recent and innovative behavioral (non-pharmacologic) interventions that aim to improve the sexual health of women affected by cancer. The review focuses on studies published within the past 5 years, focusing on interventions in three key areas for women with cancer: interventions to facilitate effective patient–provider communication about sexual health concerns, biopsychosocial interventions targeting women specifically, and interventions using a couple-based approach.
Recent Findings
Overall, results suggest advancements in all key areas. First, efforts to facilitate effective clinical communication about sexual health concerns in cancer are growing. Findings from pilot studies were particularly encouraging for brief communication interventions in increasing clinicians’ awareness and comfort in discussing sexual health with their patients. Second, studies have also begun demonstrating feasibility, acceptability, and efficacy for biopsychosocial interventions for women to improve sexual health, based on a variety of therapeutic approaches; technology-based approaches are gaining particular traction. Finally, consistent with prior reviews, recent research continues to support the use of couple-based interventions, suggesting that including partners in education and counseling about cancer-related sexual changes and solutions can have positive effects on patients, partners, and relationship functioning. Additionally, although efforts are growing to improve clinical communication and sexual health outcomes in special populations (e.g., adolescent and young adult survivors, sexual and gender minorities), greater efforts are needed.
Summary
Findings from the review suggest benefit of recent interventions aimed to address sexual concerns and improve outcomes for women affected by cancer. Limitations of studies include small sample sizes and a lack of tailoring to address individual concerns and diverse populations. Future directions should consider existing barriers to participation while leveraging the opportunities for technology and evidence-based digital health strategies to optimize or individualize content and facilitate delivery.
