Changes In Sexual Satisfaction Research Articles

Abstract C053: Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer

Abstract Background Adjuvant endocrine therapy (AET) is effective at reducing breast cancer recurrence risk. It is associated with adverse symptoms, including sexual symptoms (e.g., vaginal dryness, reduced libido, dyspareunia), that can contribute to medication nonadherence and poor quality of life (QoL). Black women are least likely to start and maintain AET. We conducted post hoc analysis of a randomized clinical trial (RCT) to examine racial differences in how sexual symptoms affect sexual satisfaction and how these contribute to differences in AET adherence for Black and White women with early-stage breast cancer. Methods We used data from a nonblinded RCT of women diagnosed with early-stage (Stage I-III), hormone receptor-positive breast cancer and prescribed AET at a regional cancer center in the U.S. Mid-South. We restricted to Black and White participants who completed surveys at enrollment, 6-, and 12-months (N=275). The Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES) captured sexual symptoms (e.g., vaginal itchiness, bleeding, dryness, discharge, change in interest in sex, and pain with intercourse) and PROMIS Sexual Function and Satisfaction captured changes in sexual satisfaction with 5-item options ranging from “not at all” to “very much.” The 12-item Short Form Health Survey measured QoL with physical and mental health component summaries (higher scores indicated better QoL). AET adherence, captured by an electronically monitored pillbox, was measured as the proportion of days participants took their medication as prescribed over the 1-year follow-up. We conducted race-stratified linear regressions to examine associations of sexual symptoms with QoL and adherence. Results Among 275 participants, 102 (37%) were Black. Black women reported greater severity of vaginal discharge and that loss of sexual satisfaction was due to sexual symptoms at 6- and 12-months (p<0.05). Vaginal itchiness, vaginal discharge, painful intercourse, and loss of interest in sex were associated with lower mental QoL for Black and White women at all three time points. However, loss of interest in sex was associated with lower physical QoL at all three time points for Black women only. Worsening vaginal dryness was associated with lower 6-month AET adherence for Black (p=0.018) but not for White women (p=0.90). Similarly, lower sexual interest and lower sexual satisfaction was associated with lower 12-month AET adherence for Black women (p<0.05) but not for White (p=0.21 and p=0.13, respectively). Conclusion Women with early-stage breast cancer on AET reported adverse sexual symptoms with associated reductions in their sexual satisfaction and physical and mental QoL. Vaginal dryness, reduced libido, and lowered sexual satisfaction are associated with AET nonadherence among Black women, a group with known adherence barriers and recurrence risks. Our findings suggest that adverse sexual symptoms and sexual health challenges contribute to racial disparities in AET adherence and QoL. Oncosexuality care interventions for Black women are needed. Citation Format: Janeane N. Anderson, Freddie Yang, Xin Hu, Gregory A. Vidal, Ilana Graetz. Racial differences in adverse sexual symptoms and implications for quality of life and adjuvant endocrine therapy adherence among women with early-stage breast cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C053.

Reciprocal associations between depressive symptoms and satisfaction with sexual life in older adults: the roles of gender and importance attached to sexuality

Objectives To gain insight into the longitudinal, reciprocal associations between depressive symptoms and sexual satisfaction as well as the potential moderating roles of gender and perceived importance of sexuality. Method We analyzed longitudinal data from 2113 participants of the Longitudinal Ageing Study Amsterdam (LASA) with an initial age range of 54–93 years, using Generalized Estimating Equations (GEE). Results There were no significant associations between baseline depressive symptoms and change in sexual satisfaction, nor between baseline sexual satisfaction and change in depressive symptoms. Gender and perceived importance of sexuality were moderators: in men higher depression scores were associated with a decrease in sexual satisfaction, whereas in women higher depression scores were associated with an increase in sexual satisfaction. In participants for whom sexual life was important, higher depression scores were associated with a decrease in sexual satisfaction. In participants for whom sexual life was not important, higher depression scores were associated with an increase in sexual satisfaction. Conclusion The associations between baseline depressive symptoms and change in sexual satisfaction as well as between baseline sexual satisfaction and change in depressive symptoms varied according to gender and importance ascribed to sexuality. Potential explanations might lie in the different roles sexual activity plays in sexual satisfaction in men and women.

“Laser vaporization of the prostate: A comparative study between ejaculatory preserving and non-ejaculatory preserving technique”

ABSTRACT Introduction and objectives Laser vaporization techniques have emerged as a prominent alternative to transurethral prostate resection in managing benign prostatic obstruction (BPO). This study focuses on assessing the effectiveness of the ejaculatory preserving laser vaporization of the prostate technique compared to the conventional non-ejaculatory approach in managing BPO. Patients and Methods Our study was performed between August 2022 and September 2023. The study included 120 patients with bladder outlet obstruction, due to benign prostatic hyperplasia (BPH). Patients were randomly assigned to two groups: the first underwent conventional non-ejaculatory preserving laser vaporization of the prostate (n = 80), while the second group underwent the innovative ejaculatory preserving laser vaporization technique using diode laser (n = 40). We assessed baseline International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), post voiding residual urine volume (PVRU), semen volume (semen analysis). Parameters were re-evaluated 3 months post-surgery and the change in sexual satisfaction was evaluated using a scale from 1 (much less satisfied) to 5 (much more satisfied) in response to a question. Results The mean age (±SD) of participants was 59.6 (±7.9) and 57.6 (±7.8) for the non-ejaculatory preserving and ejaculatory preserving groups, respectively, with no statistical difference between groups. Both groups showed significant reduction in IPSS (p < 0.001), improvement in Qmax (p < 0.001), and decline in PVRU (p < 0.001), postoperatively. However, the ejaculatory preserving technique led to a significant improvement in antegrade ejaculation, postoperative semen volume and sexual satisfaction compared to the non-ejaculatory preserving technique (p < 0.001). Conclusions The ejaculatory preserving technique effectively preserved antegrade ejaculation, semen volume and sexual satisfaction compared to the non-ejaculatory preserving technique. However, the later yielded better outcomes in terms of IPSS and urine flow. Both techniques demonstrated significant improvements across all parameters compared to baseline. Further research with extended follow-up periods is needed to fully understand the long-term postoperative effects with this technique.

Call me maybe? In-person vs. teletherapy outcomes among married couples

ABSTRACT Objective: The objective of this study was to investigate the effectiveness of teletherapy compared to in-person couple therapy in outcomes such as couple satisfaction, sexual satisfaction, and the therapeutic alliance. Method: Data from 1157 married clients seeking couple therapy were examined. Individual growth curve models were used to analyze changes in the aforementioned outcomes, with teletherapy as a predictor. The study also examined client age and clinic type as moderators. Results: The results indicated that overall, teletherapy is as effective as in-person therapy in improving outcomes. However, there were notable differences in the development of the therapeutic alliance. The alliance improved at twice the rate in in-person therapy as in teletherapy. Clinic type was also found to be a moderator of changes in sexual satisfaction. Clients in group and private practices reported improvements in sexual satisfaction; whereas clients seen in training clinics reported decreases in sexual satisfaction. Conclusion: The study concludes that although teletherapy may be a viable alternative to in-person couple therapy, there are nevertheless differences in the development of the therapeutic alliance that warrant care and further investigation. The setting of the therapy also plays a role in the effectiveness of therapy, although not specific to therapy modality.

Which Came First, the Money or the Sex? Bidirectional, Indirect Associations between Financial Management Behaviors and Sexual Satisfaction among Newlywed Couples

ABSTRACT Scholars have established connections between how married couples navigate their finances and their sexual relationship. For example, financial management behaviors are associated with sexual satisfaction among newlywed couples. However, we know very little about the direction of the association between financial management behaviors and sexual satisfaction. Understanding which might predict the other, or if there might be a bidirectional association between the two, could provide information on where to intervene to help newlywed couples with financial or sexual obstacles in their marriage. With three waves of dyadic data (N = 1,205 U.S. newlywed couples), we used structural equation modeling to examine the bidirectional, indirect associations between husbands’ and wives’ financial management behaviors and their own sexual satisfaction through their own marital satisfaction. Overall, we found that financial management behaviors indirectly predicted changes in sexual satisfaction through marital satisfaction for both husbands and wives. We also found limited evidence that husbands’ sexual satisfaction indirectly predicted changes in their own financial management behaviors through their own marital satisfaction. Additionally, these indirect associations differed by gender. Partner effects, however, were largely non-significant. Implications of these findings for those who help newlywed couples with their sexual relationships are discussed.

Sexual Satisfaction Predicts Future Changes in Relationship Satisfaction and Sexual Frequency: New Insights From Within-Person Associations Over Time

Considerable research demonstrates a positive association between sexual satisfaction and relationship satisfaction, but longitudinal evidence on the direction of this link remains inconclusive. To address this research gap, the present research provided a stringent test of the within-person associations between sexual and relationship satisfaction over time by analyzing 4-year longitudinal data from a nationally representative sample of newlywed couples in the United States (N = 2,104). The results indicated that within-person changes in sexual satisfaction predicted future changes in relationship satisfaction, whereas changes in relationship satisfaction did not predict future changes in sexual satisfaction. These results remained consistent when accounting for changes in couples’ sexual frequency, which showed significant associations with sexual satisfaction but non-significant associations with relationship satisfaction over time. All associations were consistent across gender. Overall, the current findings inform theory and practice on the roles of sexual dynamics in shaping overall perceptions of intimate relationships.

Retirement and Sexual Satisfaction.

Although interest in sexuality in older age has increased over the last decades, few studies have focused on longitudinal change in sexual satisfaction around retirement age. In the present study, we studied change in sexual satisfaction across retirement in a sample of Swedish older adults with a partner. Our analyses were based on n = 759 participants (359 male, 400 female) from the longitudinal Health, Aging, and Retirement Transitions in Sweden study. For this study, we used 5 waves spanning over a period of 4 years. On average, sexual satisfaction did not change significantly before retirement, but decreased after retirement. Interestingly, women showed higher sexual satisfaction than men, as well as a more positive development of both pre- and postretirement sexual satisfaction. Individuals with higher relationship satisfaction had a higher sexual satisfaction until retirement, but their sexual satisfaction also decreased faster after retirement, whereas those with lower relationship satisfaction showed a stable but lower sexual satisfaction. Sexual satisfaction can change in the retirement transition in several important ways and further studies on the impact of retirement and other late-life stage transitions are warranted.

Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID)

ObjectivesPhysical restrictions imposed to combat COVID-19 dramatically altered sexual lifestyles but the specific impacts on sexual behaviour are still emerging. We investigated physical and virtual sexual activities, sexual frequency and...

Sexual and psychological health of couples with azoospermia in the context of the COVID-19 pandemic.

BackgroundTo date, there have been no reports on the sexual and psychological health of patients with azoospermia during the coronavirus disease 2019 (COVID-19) pandemic. Previous studies on the sexual health of couples with azoospermia are limited and are especially lacking in data on the wives of azoospermic men.MethodsWe conducted a case–control cross-sectional study between 1 July 2020 and 20 December 2020. In total, 100 couples with azoospermia comprised the experimental group and 100 couples with normozoospermia comprised the control group. The couples’ sexual health was measured using standardised sexual function questionnaires (male: International Index of Erectile Function-15 [IIEF-15] and Premature Ejaculation Diagnostic Tool [PEDT]; female: Female Sexual Function Index [FSFI]) and a self-designed questionnaire to evaluate changes in sexual behaviours (sexual satisfaction, desire, frequency of sexual activity, masturbation, and pornography use) during lockdown. The couples’ psychological health was measured using the 7-item Generalized Anxiety Disorder (GAD-7) scale and 9-item Patient Health Questionnaire (PHQ-9). The Actor–Partner Interdependence Model (APIM) was used to analyse the associations between sexual health and psychological health.ResultsThe IIEF-15 scores (53.07 ± 11.11 vs. 57.52 ± 8.57, t = − 3.17, p = 0.00) were lower and the PEDT scores (6.58 ± 3.13 vs. 5.17 ± 2.22, t = 3.67, p = 0.00) and incidence of premature ejaculation (χ2 = 14.73, p = 0.00) were higher for men with azoospermia than for men with normozoospermia. Compared with those of wives of men with normozoospermia, the total FSFI scores (25.12 ± 5.56 vs. 26.75 ± 4.82, t = − 2.22, p = 0.03) of wives of men with azoospermia were lower. The chi-square test showed that the perceived changes in sexual satisfaction (χ2 = 7.22, p = 0.03), frequency of masturbation (χ2 = 21.96, p = 0.00), and pornography use (χ2 = 10.90, p = 0.01) were significantly different between the female groups with azoospermia and normozoospermia, but there were no significant changes in sexual behaviour between the male groups. The GAD-7 (men: 7.18 ± 5.56 vs. 5.68 ± 4.58, p = 0.04; women: 6.65 ± 5.06 vs. 5.10 ± 3.29, p = 0.01) and PHQ-9 scores (men: 10.21 ± 6.37 vs. 7.49 ± 6.10, p = 0.00; women: 8.81 ± 6.50 vs. 6.98 ± 4.43, p = 0.02) were significantly higher for couples with azoospermia than for couples with normozoospermia. The APIM showed that for couples with azoospermia, sexual function negatively correlated with their own anxiety (men: β = −0.22, p = 0.00; women: β = −0.38, p = 0.00) and depression symptoms (men: β = −0.21, p = 0.00; women: β = −0.57, p = 0.00) but not with their partner’s anxiety and depression symptoms (p > 0.05).ConclusionsCouples with azoospermia had a lower quality of sexual function and higher levels of psychological distress than couples with normozoospermia. Their sexual health negatively correlated with psychological distress.

Modeling Dyadic Trajectories: Longitudinal Changes in Sexual Satisfaction for Newlywed Couples.

Using a longitudinal dataset of 117 married couples without children spanning the first three years of marriage, we investigated trajectories of sexual satisfaction for both spouses using a novel Dyadic Latent Growth Model approach that distinguishes the communal sexual experience and the systematic differences in experience between partners. It also recognizes that there may be systematic variation in trajectories over couples. We showed how this approach can be used to predict couple-level sexual experience from couple-level marital satisfaction shortly after marriage. Partners' sexual satisfaction was well represented at the dyadic level; there was a dyad-level decline in sexual satisfaction over the first three years of marriage, but also systematic variation around that average pattern. Level of dyadic marital satisfaction at Time 1 predicted the level of sexual satisfaction over three years, but not the systematic variation in the slope. Intra-dyad contrast of marital satisfaction at Time 1 predicted analogous contrasts of sexual satisfaction, but the strength of this association diminished over time. We discuss theoretical benefits of considering partners as couples rather than individuals.

Management of men with ultra-short penile urethral stricture using augmented anastomotic penile skin flap urethroplasty; a retrospective analysis

BackgroundThe management of short anterior urethral stricture is challenging. Our study aims to evaluate the outcome of augmented anastomotic urethroplasty (AAU) for the management of men with ultra-short penile urethral stricture, and to compare it with the dorsal onlay buccal mucosa graft.MethodsDatabases of two tertiary referral centres were retrospectively reviewed to retrieve data of men with ultra-short penile urethral stricture who underwent urethroplasty from 2013 to 2020. Patients who underwent AAU with ventral onlay pedicled skin flap were considered the study group, while patients treated with the dorsal onlay graft augmentation were included as controls. Surgical outcomes included urethral patency, improvement in the maximum flow rate (Qmax), change in sexual satisfaction, and any reported complications.ResultsThirty-four patients (and 30 controls) with a median age of 26–27 years were included in the study. The maximum flow rate improved significantly in both groups compared to the preoperative value (p < 0.001). The success rate was 88% in the study group compared to 76.7% in the control group. There was no statistically significant difference in the frequency of postoperative penile curvature nor the ventral sacculation between the two groups (p = 0.788 and 0.913). The operative time was statistically significantly longer in the control group (p = 0.044), while the frequency of postoperative void dripping was much higher in the study group (p = 0.007).ConclusionThe success rate and complications of AAU for men with ultra-short penile urethral stricture were comparable to the dorsal buccal graft.

Applying the developmental model of marital competence to sexual satisfaction: Associations between conflict resolution quality, forgiveness, attachment, and sexual satisfaction

Sexual satisfaction is a complex construct that is affected by many diverse factors. Without a comprehensive framework guiding their work, scholars and practitioners who work with married couples may inadvertently focus on a single factor affecting sexual satisfaction and subsequently limit the effectiveness of their research and practice. Through discussion and an empirical example, the current study explores how the developmental model of marital competence—a comprehensive theory for understanding marital processes—can be used by scholars and practitioners to guide their work on sexual satisfaction and broaden their approach. Utilizing U.S. nationally representative data from 2,114 mixed-sex couples and guided by the actor-partner-interdependence-model, cross-sectional and longitudinal associations between wives’ and husbands’ sexual satisfaction and three factors—conflict resolution quality, forgiveness, and anxious and avoidant attachment—that correspond to the three domains of the developmental model of marital competence—marital communication, marital virtues, and marital identities—were tested. Results of the current study provide empirical support for the use of the developmental model of marital competence when approaching work on sexual relationships among married, heterosexual couples. For both partners, variables from each of the three domains of this model were associated with sexual satisfaction cross-sectionally, and variables in one domain—attachment avoidance and anxiety—were associated with changes in sexual satisfaction over time. The merits of researchers and practitioners integrating the developmental model of marital competence into their work are discussed.

Initial Impacts of COVID-19 on Sexual Behaviour in Britain: Findings from a Large, Quasi-Representative Survey (Natsal-COVID)

Background: Social restrictions imposed to combat COVID-19 dramatically altered sexual lifestyles but the specific impacts on sexual behaviour are still emerging. We examined sexual activity, frequency, and satisfaction following lockdown in Britain in March 2020 and compared to pre-lockdown. Methods: Weighted analyses of web-panel survey data collected July/August 2020 from a quota-based sample of 6,654 people in Britain (18-59yrs). Multivariable regression examined independent associations of relationship status, age, and gender with perceived changes in frequency and satisfaction. Findings: Most participants (86.7%) reported some form of sex in the four months following lockdown with physical activities more commonly reported than virtual activities (83.7% vs. 52.6%). Altogether, 63.2% reported sex with someone (‘partnered sex’) since lockdown, three-quarters of whom were in steady cohabiting relationships. With decreasing relationship formality, partnered sex was less frequently reported, while masturbation, sex toy use, and virtual activities were more frequently reported. Around half of all participants perceived no change in partnered sex frequency compared to the three months pre-lockdown, but this was only one-third among those not cohabiting, who were more likely to report increases in non-partnered activities than those cohabiting. Two-thirds of participants perceived no change in sexual satisfaction; declines were more common among those not cohabiting. Relationship informality and younger age were independently associated with perceiving change in both frequency and satisfaction. Interpretation: COVID-19 restrictions led to significant shifts in sexual repertoires, frequency, and satisfaction for a minority in Britain; predominantly those not cohabiting and young people. Funding: Natsal (Wellcome/ESRC/NIHR), MRC/CSO, and UCL COVID-19 Rapid Response Fund. Declaration of Interest: The other authors declare that they have no conflicts of interest. Ethical Approval: We obtained ethics approval from University of Glasgow MVLS College Ethics Committee (reference 20019174) and London School of Hygiene and Tropical Medicine Research Ethics committee (reference 22565).

Sexual Satisfaction Following Bariatric Surgery: A Prospective Exploratory Study

IntroductionBariatric surgery improves sexual function in obese individuals, although the extent to which sexual satisfaction is improved following surgery is unknown. The aims of this study were (1) to describe sexual satisfaction in severely/morbidly obese men and women candidates for bariatric surgery; (2) to assess the effects of bariatric surgery on sexual satisfaction at 12-months follow-up; and (3) to assess whether weight changes at follow-up following bariatric surgery are associated with changes in sexual satisfaction. MethodsWe conducted a prospective observational study from February 2011 to June 2014. A total of 44 patients with severe/morbid obesity participated in the study. Sexual satisfaction was assessed (at baseline and 12-months follow-up) through the Index of Sexual Satisfaction (ISS) questionnaire. ResultsOf 44 patients who completed the ISS at baseline (mean age 40.3 [SD=9.4] years and BMI 46.9 [SD=6.2] kg/m2), 17 were lost to follow-up. The baseline ISS total scores were 32.0 (SD=20.1) in women and 24.4 (SD=16.0) in men (P>.05). The proportion of sexually satisfied men and women at baseline was 62.5% and 46.4%, respectively (P=.360). At follow-up, sexual satisfaction improved significantly in women (average difference 13.7 units; P=.032) but not in men (average difference 3.6 units; P=.717). The percentage of women with sexual satisfaction problems was reduced by 33% at follow-up (P=.038). ConclusionsA relatively large percentage of severely/morbidly obese women and men present clinically significant sexual satisfaction problems before undergoing bariatric surgery. Sexual satisfaction improves significantly 12 months following bariatric surgery, particularly in women.

Satisfacción sexual tras cirugía bariátrica: estudio observacional prospectivo

IntroductionBariatric surgery improves sexual function in obese individuals, although the extent to which sexual satisfaction is improved following surgery is unknown. The aims of this study were 1) to describe sexual satisfaction in severely/morbidly obese men and women candidates for bariatric surgery; 2) to assess the effects of bariatric surgery on sexual satisfaction at 12-months follow-up; and 3) to assess whether weight changes at follow-up following bariatric surgery are associated with changes in sexual satisfaction. MethodsWe conducted a prospective observational study from February 2011 to June 2014. A total of 44 patients with severe/morbid obesity participated in the study. Sexual satisfaction was assessed (at baseline and 12-months follow-up) through the Index of Sexual Satisfaction (ISS) questionnaire. ResultsOf 44 patients who completed the ISS at baseline (mean age 40.3 [SD=9.4] years and BMI 46.9 [SD=6.2] kg/m2), 17 were lost to follow-up. The baseline ISS total scores were 32.0 (SD=20.1) in women and 24.4 (SD=16.0) in men (P>0.05). The proportion of sexually satisfied men and women at baseline was 62.5% and 46.4%, respectively (P=0.360). At follow-up, sexual satisfaction improved significantly in women (average difference 13.7 units; P=0.032) but not in men (average difference 3.6 units; P=0.717). The percentage of women with sexual satisfaction problems was reduced by 33% at follow-up (P=0.038). ConclusionsA relatively large percentage of severely/morbidly obese women and men present clinically significant sexual satisfaction problems before undergoing bariatric surgery. Sexual satisfaction improves significantly 12 months following bariatric surgery, particularly in women.

Appearance Dissatisfaction, Body Appreciation, and Sexual Health in Women Across Adulthood.

Risk and protective factors are equally important to the promotion of sexual health. Yet, in body image and sexuality research, most of the focus has been placed on the deleterious effects of appearance dissatisfaction and body mass index (BMI) at the expense of more adaptive dimensions. Furthermore, although age can affect appearance and sexual function, little is known regarding the experience of older women. Therefore, this study was aimed at comparing how positive body image (operationalized as body appreciation) and negative body image (operationalized as appearance dissatisfaction) each contribute to indicators of sexual health when controlling for BMI in a sample of age-varied women. Cross-sectional data were collected online from 215 heterosexual women aged 18-88years. Results showed that body appreciation was a unique predictor of sexual function, satisfaction, and distress, above and beyond the effect of BMI and appearance dissatisfaction. Body appreciation was not found to fluctuate with age. Further, body appreciation moderated the relationship between age and sexual satisfaction, but not sexual distress. Post hoc analyses showed that high body appreciation may serve as a buffer against age-related changes in sexual satisfaction only in women with clinically significant sexual function difficulties. Increasing body appreciation may be a promising clinical intervention in the treatment of sexual problems in older adult women.

Predictors of Sexual Adjustment in Cancer Patients Receiving Chemotherapy

The goal of this study was to determine the relationship between sexual adjustment, mastery, age, subjective health, and changes in sexual satisfaction in cancer patients receiving chemotherapy. A cross-sectional descriptive correlation study was conducted with a convenience sample comprising cancer patients who were visiting two cancer centers in Korea. Data were collected using self-report questionnaires, including the Global Sexual Satisfaction Index and sexual adjustment subscale of the Psychosocial Adjustment to Illness Scale. The Mastery Scale was used to assess self-control. The hypothesized model was tested using a path analysis with AMOS 17.0. The path model was used to investigate causal relationships between variables, to obtain maximum-likelihood estimates of model parameters, and to provide goodness-of-fit indices. The proposed path model showed a good fit to the data. Subjective health and age may have an effect, mediated by mastery, on sexual adaption. Participants who reported more decreased sexual satisfaction showed lower levels of sexual adjustment. Mastery was not a mediating factor between changes in sexual satisfaction and sexual adjustment. Our model provides a framework for improving sexual adaption in cancer patients with chemotherapy. Health professionals should recognize and assess prior sexual satisfaction and sexual problems when providing sexual health care during treatment.

A Prospective 2-Year Examination of Cognitive and Behavioral Correlates of Provoked Vestibulodynia Outcomes

Provoked vestibulodynia (PVD) is a common genital pain disorder in women that is associated with sexual dysfunction and lowered sexual satisfaction. A potentially applicable cognitive-behavioral model of chronic pain and disability is the fear-avoidance model (FAM) of pain. The FAM posits that cognitive variables, such as pain catastrophizing, fear, and anxiety lead to avoidance of pain-provoking behaviors (eg, intercourse), resulting in continued pain and disability. Although some of the FAM variables have been shown to be associated with PVD pain and sexuality outcomes, the model as a whole has never been tested in this population. An additional protective factor, pain self-efficacy (SE), is also associated with PVD, but has not been tested within the FAM model. Using a 2-year longitudinal design, we examine (1) whether initial levels (T1) of the independent FAM variables and pain SE were associated with changes in pain, sexual function, and sexual satisfaction over the 2-year time period; (2) the prospective contribution of changes in cognitive-affective (FAM) variables to changes in pain, and sexuality outcomes; and (3) whether these were mediated by behavioral change (avoidance of intercourse). A sample of 222 women with PVD completed self-report measures of FAM variables, SE, pain, sexual function, and sexual satisfaction at time 1 and at a 2-year follow-up. Structural equation modeling with Latent Difference Scores was used to examine changes and to examine mediation between variables. Questionnaires included the Pain Catastrophizing Scale, McGill Pain Questionnaire, Trait Anxiety Inventory, Pain Self-Efficacy Scale, and Global Measure of Sexual Satisfaction, Female Sexual Function Index. Participants who reported higher SE at T1 reported greater declines in pain, greater increases in sexual satisfaction, and greater declines in sexual function over the 2 time points. The overall change model did not support the FAM using negative cognitive-affective variables. Only increases in pain SE were associated with reductions in pain intensity. The relationship between changes in SE and changes in pain was partially mediated through changes in avoidance (more intercourse attempts). The same pattern of results was found for changes in sexual satisfaction as the outcome, and a partial mediation effect was found. There were no significant predictors of changes in sexual function other than T1 SE. Changes in both cognitive and behavioral variables were significantly associated with improved pain and sexual satisfaction outcomes. However, it was the positive changes in SE that better predicted changes in avoidance behavior, pain, and sexual satisfaction. Cognitive-behavior therapy is often focused on changing negative pain-related cognitions to reduce avoidance and pain, but the present results demonstrate the potential importance of bolstering positive self-beliefs as well. Indeed, before engaging in exposure therapies, SE beliefs should be assessed and potentially targeted to improve adherence to exposure strategies.

Longitudinal Associations Among Relationship Satisfaction, Sexual Satisfaction, and Frequency of Sex in Early Marriage.

The current research used two 8-wave longitudinal studies spanning the first 4-5 years of 207 marriages to examine the potential bidirectional associations among marital satisfaction, sexual satisfaction, and frequency of sex. All three variables declined over time, though the rate of decline in each variable became increasingly less steep. Controlling for these changes, own marital and sexual satisfaction were bidirectionally positively associated with one another; higher levels of marital satisfaction at one wave of assessment predicted more positive changes in sexual satisfaction from that assessment to the next and higher levels of sexual satisfaction at one wave of assessment predicted more positive changes in marital satisfaction from that assessment to the next. Likewise, own sexual satisfaction and frequency of sex were bidirectionally positively associated with one another. Additionally, partner sexual satisfaction positively predicted changes in frequency of sex and own sexual satisfaction among husbands, yet partner marital satisfaction negatively predicted changes in both frequency of sex and own sexual satisfaction. Controlling these associations, marital satisfaction did not directly predict changes in frequency of sex or vice versa. Only the association between partner sexual satisfaction and changes in own sexual satisfaction varied across men and women and none of the key effects varied across the studies. These findings suggest that sexual and relationship satisfaction are intricately intertwined and thus that interventions to treat and prevent marital distress may benefit by targeting the sexual relationship and interventions to treat and prevent sexual distress in marriage may benefit by targeting the marital relationship.

Does quality of female sexual function improve after a transobturator tape procedure?

The aim of this study was to use a questionnaire to evaluate any changes in sexual satisfaction of women who underwent a transobturator tape (TOT) procedure for stress urinary incontinence. A total of 30 women agreed to participate in the study and were invited to fill out the Female Sexual Function Index (FSFI) questionnaire prior to surgery and 3 months after surgery. As a result, after the TOT operation, there was a statistically significant improvement in libido (desire), arousal, lubrication, orgasm and satisfaction. The TOT procedure seems to have a positive effect on female sexual function by reducing the urinary leakage during sexual activity and by decreasing the pain during or after sexual activity.