Does Partner Matter in Sexual Activity?

Abstract

ABSTRACT Introduction A woman's sexual activity is a challenging topic to discuss for both provider and patient. Common questions about sexual activity imply that a woman is having partnered sexual activity with vaginal penetration. Discussion about masturbation or solo sexual experiences tend to be even more uncomfortable and considered a societal taboo. Nevertheless, solo sexual activity is an important part of physical and emotional health. Objective The aim of this pilot study is to examine the differences in sexual health, pelvic floor health and overall wellness among women with predominantly partnered sexual activity (PSA) compared to solo sexual activity (SSA). Methods This is a prospective pilot study of sexually active women with PSA and SSA age 18 to 99 years who presented for consultation to our Female Pelvic Medicine and Reconstructive Surgery clinic with a pelvic floor complain between May 2021 and August 2021. Participants were given validated questionnaires for 1) sexual health: Female Sexual Function Index (FSFI) and The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire International Urogynecological Association (IUGA) Revised (PISQ-IR); 2) pelvic floor function: The Pelvic Floor Distress Inventory Questionnaire (PFDI), Genitourinary Pain Index (GUPI), Interstitial cystitis/Painful bladder syndrome (IC/PBS), and 3) overall health: (Self-reported quality of life (SF-12), Patient Health Questionnaire (PHQ-9)). Physical exam and interview on sexual practices were performed. Demographics and health information were recorded. All data were analyzed with descriptive statistics, comparisons were made using Fisher Exact Test and Wilcoxson Rank Sum Tests. Results Among 23 women recruited in the pilot study, 13 had PSA and ten women had SSA. Among PSA, six women were also masturbating. Those who were sexually active with a partner were younger (p=0.021), and less likely to have neurologic disorders (p=0.022). No significant differences in demographics, comorbidities, hormonal therapies, pelvic floor disorders, or overall well-being were found between two groups. Women involved in PSA had significantly higher total FSFI score (p=0.035), sexual satisfaction (p=0.012). Interestingly, women with PSA had higher scores on ICSI (p=0.046) and less likely used a vibrator or sex toy ever in their lives (p=0.02). Conclusions No significant differences in pelvic health and overall wellness were noted between women with PSA and SSA. Satisfaction from sexual activity is higher among younger women involved in partnered sex, in spite of no significant differences present in desire and orgasm domains. Sexual activity is more than just vaginal penetrative intercourse thus solo sexual practices should be assessed by medical providers especially in older women who might not have available partners. Disclosure No