Abstract
The investigation of short-term changes in female sexual functioning has received little attention so far. The aims of the study were to gain empirical knowledge on within-subject and within- and across-variable fluctuations in women’s sexual functioning over time. More specifically, to investigate the stability of women´s self-reported sexual functioning and the moderating effects of contextual and interpersonal factors. A convenience sample of 206 women, recruited across eight Health care Clinics in Rasht, Iran. Ecological momentary assessment was used to examine fluctuations of sexual functioning over a six week period. A shortened version of the Female Sexual Function Index (FSFI) was applied to assess sexual functioning. Self-constructed questions were included to assess relationship satisfaction, partner’s sexual performance and stress levels. Mixed linear two-level model analyses revealed a link between orgasm and relationship satisfaction (Beta = 0.125, P = 0.074) with this link varying significantly between women. Analyses further revealed a significant negative association between stress and all six domains of women’s sexual functioning. Women not only reported differing levels of stress over the course of the assessment period, but further differed from each other in how much stress they experienced and how much this influenced their sexual response. Orgasm and sexual satisfaction were both significantly associated with all other domains of sexual function (P<0.001). And finally, a link between partner performance and all domains of women`s sexual functioning (P<0.001) could be detected. Except for lubrication (P = 0.717), relationship satisfaction had a significant effect on all domains of the sexual response (P<0.001). Overall, our findings support the new group of criteria introduced in the DSM-5, called “associated features” such as partner factors and relationship factors. Consideration of these criteria is important and necessary for clinicians when diagnosing FSD.
Highlights
Female sexual dysfunction (FSD) describes a range of disorders related to sexual desire, arousal, orgasm, and sexual pain [1]
Descriptive statistics of the items measuring women’s sexual functioning, partner sexual performance, relationship satisfaction and stress levels can be found in Table 1
In terms of sexual functioning, the most frequently reported sexual problem was low arousal and low lubrication (Table 1; note that desire, arousal, orgasm, relationship and sexual satisfaction are inversely scored, i.e. the higher the score the less problems are reported on the specific domain) whereas anorgasmia was the least frequent problem
Summary
Female sexual dysfunction (FSD) describes a range of disorders related to sexual desire, arousal, orgasm, and sexual pain [1]. Numerous studies have suggested that greater feelings of love, lower levels of marital conflict, and greater marital happiness are related with satisfying sexual relationships [7,8,9] These results provide the conceptual basis for the hypothesis that relationship satisfaction plays an important role in women’s sexual functioning and is associated with fewer sexual problems and higher sexual satisfaction [10,11,12]. Stress is another recently discussed factor in the pathogenesis of sexual problems— studies have been few-, describing a complex of outside pressures which bear down on mental and physical well-being e.g., [13]. For some women stress can lead to a decrease in sexual desire or interest in engaging in sex, for others, sex might even become an additional stressor in their lives, making it impossible for them to experience an enjoyable sexual interaction with their partner [15,16]
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