Over the last decades, women’s sexual life has recorded some noticeable changes, along with new light-shedding perspectives on the understanding of women’s sexuality. A relevant set of studies highlight the importance of different biological, psychological and social dimensions as determinants of sexual functioning and satisfaction, although only a few of them consider those dimensions in an integrated and interdependent way, in order to ascertain each dimension’s significance. Furthermore, and despite the close relation between sexual functioning and sexual satisfaction, the existing literature tends to show some confusion and overlapping between both concepts.
Considering this, the present study is intended to analyse the main relational, psychological, contextual and biomedical predictors of women’s sexual functioning and satisfaction, as well as to explore the relation between these two dimensions of women’s sexuality. In this light, using a sample of 497 women, ten empirical studies were conducted, based on queries aimed at assessing the participants’ social and demographic characteristics, medical history and lifestyle, psychopathology, well-being, cognitive and affective variables, relational aspects, sexual context, sexual activity, sexual functioning and sexual satisfaction.
Results suggested significant differences between women with high and low levels of sexual functioning, and between high and low levels of sexual satisfaction regarding the various dimensions analysed.
On the other hand, the combined analysis of all the biopsychosocial dimensions confirmed the unequivocal contribution of the psychological variables to explain women’s sexual functioning, particularly the role of self-awareness of one’s pleasure during sexual activity, the satisfaction and contentment that derive from meaningful sexual experiences, as well as sexual self-esteem, that is, the image that the woman has of herself as a sexual being. As to the other dimensions considered, only the use of cardiotonic drugs significantly predicted reduced sexual functioning, whereas age, or other social and demographic variables, diseases and the perception of one’s health, menopausal state, lifestyle, psychopathology, general concerns during sexual activity or other contextual variables have shown no predictive value.
Regarding sexual satisfaction, the best predictors were the emotional variables, especially the specific responses of joy and absence of guilt during sexual activity, as well as relational aspects, particularly the relationship’s quality, but also the presence of a sensitive partner to the woman’s needs and sexual preferences. Furthermore, cognitive variables have also shown a significant role, such as women resorting to sexual fantasies and minding their behaviour during sexual activity, contributing to an increased sexual satisfaction. Besides that, sexual self-esteem and the ability to achieve orgasm during sexual encounters were also significant predictors of satisfactory sexual experiences. Conversely, no medical, sociodemographical, lifestyle or psychopathological variables have shown any predictive value for sexual satisfaction.
In a simultaneous analysis of the different biopsychosocial predictors of women’s sexual functioning, cognitive and emotional determinants stand out. Concerning satisfactory sexual experiences, besides those, relational aspects also played a central role, all the more important given the close relation and circularity between sexual functioning and sexual satisfaction. However, these two dimensions of women’s sexual experience seem to have different predictors, thus supporting the need for a differentiated and specific approach, whether in empirical studies or in interventions.
In general, this study was intended to fill a void in the research field regarding women’s sexual experiences, in a positive perspective (both sexual functioning and satisfaction), enabling a deeper knowledge on its determinants, with repercussions for clinical intervention and for the promotion of a more gratifying women’s sexual life.