Psychological factors and the sexuality of pregnant and postpartum women

This study examined the influence of role quality, relationship satisfaction, fatigue, and depression on women's sexuality during pregnancy and after childbirth. Questionnaire data were obtained from 138 women pregnant with their first child, of whom 104 responded at 12 weeks postpartum, and 70 responded at 6 months postpartum. Women reported significant reductions in sexuality during pregnancy and postpartum. Relationship satisfaction explained levels of sexual satisfaction during pregnancy, and was a predictor of sexual desire in the postpartum. Depression was an important predictor of reduced sexual desire and sexual satisfaction during pregnancy, and of reduced frequency of intercourse at 12 weeks postpartum. At 6 months postpartum, the quality of the mother role strongly related to measures of sexuality. Throughout the perinatal period, fatigue impacted on measures of sexuality, either directly or/and indirectly. The implications of these results in terms of the impact of pregnancy and childbirth on relationships and sexuality are discussed.     

Erotophobia‐erotophilia and sexual behavior during pregnancy and postpartum

This research examined the relation of erotophobia‐erotophilia, the disposition to respond to sexuality with negative‐to‐positive affect, and sexual behavior during pregnancy and postpartum. During late pregnancy, 50 couples responded to questionnaire assessments of their erotophobia‐erotophilia and sexual behavior; during the postpartum period, 25 of these couples responded to a follow‐up assessment of their sexual behavior following the birth of their child. Results indicated that eroto‐philic (versus erotophobic) women showed more sexual interest, activity, and satisfaction during pregnancy; they reported more sexual interest and an earlier resumption of coitus in the postpartum period; and they were more likely to breastfeed their child. Erotophilic (versus erotophobic) men reported more sexual activity both during pregnancy and the postpartum period, and they were more likely to have been present at the delivery of their child. Results are discussed in terms of confirming and broadening the construct validity of erotophobia‐erotophilia and in terms of applications for identifying and assisting those who may be likely to experience sexual difficulties during pregnancy and the postpartum period.     

Who Does What When Partners Become Parents:

Forty-seven couples who were first-time parents were assessed in late pregnancy and again at 6 and 18 months postpartum. Fifteen couples not yet decided about having a baby were assessed at equivalent times. Actual involvement in household, decision-making, and childcare roles was determined by responses to a 36-item "Who Does What?" questionnaire. Psychological involvement in parent, partner, and worker roles was also determined, as was each partner's satisfaction with behavioral and psychological involvement in each domain. On the basis of global analyses, previous studies have suggested that new parents adopt more traditional roles. Item analyses indicated that men's and women's roles change in both traditional and nontraditional ways during the transition to parenthood, depending on the item and the time of assessment. Measures of individual and couple adaption were also obtained: self-esteem, parenting stress, and marital satisfaction. Men's involvement in family tasks was correlated with their own or their wives adaption in pregnancy but became linked with adaptation at 6 months postpartum. However, at 18 months after birth husbands' involvement in family tasks was correlated only with wives' adaptation. For both parents, satisfaction with family task arrangements becomes correlated with self-esteem, parenting stress and marital quality after childbirth; these measures of adaptation are more closely linked with role satisfaction than with actual sharing of family work.     

Limited Role of Body Satisfaction and Body Image Self-Consciousness in Sexual Frequency and Satisfaction in Pregnant Women

This cross-sectional study examined the role of maternal body image and body image self-consciousness in sexual satisfaction and intercourse frequency during pregnancy when controlling for satisfaction with partnership. Pregnant women in their third trimester of pregnancy (N = 150) participated in the study. Body image was measured by the Body Areas Satisfaction Scale (BASS) and Body Image Self-Consciousness Scale (BISC), while relationship satisfaction was measured by different subscales of the Perceived Quality of Marital Relationship (PQMR) Scale. Sexual satisfaction was also measured by one of the subscales of the PQMR (Intimate Relationship). The sexual behavior questionnaire comprised questions about frequency of sexual intercourse, desire, and other aspects of sexual functioning as well as the reasons that might prevent women from having intercourse during pregnancy. Findings suggested that satisfaction with body image and body image self-consciousness were related to sexual satisfaction. Nevertheless, other aspects of partnership, such as communication, appeared to be much more important predictors of sexual satisfaction than body image variables. The best predictor of sexual frequency was fear that intercourse might harm the fetus. Implications for education about sexuality issues in pregnancy are discussed.     

The Impact of Pregnancy and Childbirth on Sexual Behaviors: A Systematic Review

The purpose of this review was to examine and synthesize the available quality evidence to provide researchers, educators, and clinicians an overview of what is known about sexual behaviors during pregnancy and the year after childbirth. Search engines were used to identify peer-reviewed, English-language articles that met the inclusion criteria. A total of 56 prospective, retrospective, and qualitative studies published after 1996 were reviewed. A gradual decline in vaginal intercourse from prepregnancy to first trimester to third trimester was found. Most couples resume vaginal intercourse by eight weeks after childbirth, but this behavior does not occur at prepregnancy frequencies until closer to 12 months postchildbirth. Future studies should consider assessing sexual behaviors beyond vaginal intercourse and increase efforts in recruitment of diverse samples including non-White, nonheterosexual pregnant individuals, and partners of pregnant individuals.     

Menopause and sexual desire: the role of testosterone

The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 μg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.     

Male and Female Sexuality During Pregnancy:

We studied male and female sexual behavior and satisfaction during pregnancy. Expectant fathers were less emotionally satisfied than their wives through the pregnancy. Relative to their husbands, women experienced more conflict and guilt, but reported feeling peaceful and fulfilled in pregnancy, more self-accepting sexually, and derived more pleasure from sex. Both women and men underestimated how attractive their partner found the woman's pregnant body, with men finding their wives more attractive. There were no significant differences in level of sexual desire or sexual satisfaction between men and women. A series of multiple regressions identified a number of variables as predictive of male and female sexual satisfaction. Comparing pregnant couples expecting their first child with normative da:a, we found that expectant couples were less satisfied with the frequency of sex and also derived less sexual pleasure than nonpregnant couples.     

The lives and voices of highly sexual women

American women who experience very strong and frequent sexual desire have often been either ignored or stigmatized. This exploratory study of 44 highly sexual women ages 20 to 82, which used a convenience sample and a semi-structured in-depth interview method, allowed participants to describe their lives and how their sexuality has affected them. Highly sexual women reported that their lives have been strongly affected by their sexuality. First, the participants internally sensed demand for sexual excitement and satisfaction is too intense to be ignored. For some it was a major organizing principle of their time and energy. Second, their lives are lived in a society that often defines highly sexual women in pejorative ways. Women reported experiencing struggles and challenges in almost every area of their lives because of their sexuality, including feelings about themselves and their relationships with partners, female friends, and acquaintances.     

Is High Sexual Desire a Risk for Women’s Relationship and Sexual Well-Being?

Historically, women’s sexual desire has been deemed socially problematic. The growing popularity of the concept of hypersexuality—which lists high sexual desire among its core components—poses a risk of re-pathologizing female sexual desire. Data from a 2014 online survey of 2,599 Croatian women aged 18–60 years was used to examine whether high sexual desire is detrimental to women’s relationship and sexual well-being. Based on the highest scores on an indicator of sexual desire, 178 women were classified in the high sexual desire (HSD) group; women who scored higher than one standard deviation above the Hypersexual Disorder Screening Inventory mean were categorized in the hypersexuality (HYP) group (n = 239). Fifty-seven women met the classification criteria for both groups (HYP&HSD). Compared to other groups, the HSD was the most sexually active group. Compared to controls, the HYP and HYP&HSD groups—but not the HSD group—reported significantly more negative consequences associated with their sexuality. Compared to the HYP group, women with HSD reported better sexual function, higher sexual satisfaction, and lower odds of negative behavioral consequences. The findings suggest that, at least among women, hypersexuality should not be conflated with high sexual desire and frequent sexual activity.     

Body Image in Dyadic and Solitary Sexual Desire: The Role of Encoding Style and Distracting Thoughts

This study explored the link between body image and desire to engage in sexual activity (dyadic and solitary desire) in adult women living in a long-term couple relationship. Moreover, it considered two psychological factors that may underlie such a link: the occurrence of body-related distracting thoughts during sexual activity and encoding style (i.e., the tendency to rely on preexisting internal schemata versus external information at encoding). A total of 53 women (29 to 47 years old) in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), body image, body-related distracting thoughts during sexual activity, and encoding style. Results showed that poor body image was associated with low dyadic and solitary sexual desire. Body-related distracting thoughts during sexual activity mediated the link between body image and solitary (but not dyadic) sexual desire. Finally, the mediation of body-related distracting thoughts between body image and solitary sexual desire was moderated by encoding style. A negative body image promoted the occurrence of body-related distracting thoughts during sexual activity, especially in internal encoders. Our study highlights the importance of body image, distracting thoughts, and encoding style in women’s solitary sexuality and suggests possible factors that may reduce the impact of those body-related factors in dyadic sexual desire.     

The Impact of Aging on Human Sexual Activity and Sexual Desire

This article empirically studies how much aging modifies human sexual activity and sexual desire, and what the most important determinants in this change are. The analyses are based on 2 representative national sex surveys conducted in Finland in the 1990s. As a result of female widowhood, aging men had a higher incidence of sexual intercourse compared with aging women; and in relationships, women were more likely than men to report lack of sexual desire. In regression analysis, age was a predictor of sexual activity but not of sexual desire, when controlling for the impact of other factors. Relationship duration did not play an important role in sexual activity or sexual desire when controlling for a number of other variables. Sexual desire, valuing sexuality, and a healthy partner were important to female sexual activity; and high sexual self-esteem, good health, and active sexual history were important to male sexual activity. To keep up their sexual desire, both men and women needed good health, good sexual functioning, positive sexual self-esteem, and a sexually skilful partner.     

Initiating a Caregiving Relationship: Pregnancy and Childbirth Factors as Predictors of Maternal Sensitivity

The aim of this study was to investigate the relations between pregnancy and childbirth factors and subsequent quality of maternal interactive behavior in a sample of 116 full‐term infants and their mothers. Mothers reported on the conditions of childbirth when infants were 6–8 months of age, and their interactive behavior was observed during a home visit at 12 months. Results showed that mothers who did not report health problems during pregnancy and who had longer pregnancies, shorter hospital stays, natural deliveries, and infants with greater birthweight were found to be more sensitive during interactions with infants at 12 months. All these relations held after accounting for socio‐economic factors and maternal psychological distress, except for the effect of type of delivery. This pattern of results, however, was almost exclusively due to mothers who already had at least one other child. Very few such relations were found among primiparous mothers.     

Sensual and sexual marital contentment in parents of small children--a follow-up study when the first child is four years old

This follow-up study explored parents' (N = 452) intimate relationships when their firstborn child was 6 months old and then 4 years later. The measurement used was a modified version of the Dyadic Adjustment Scale, DAS. The present results show that most parents responding were content sensually at 6 months postpartum in 2002 and 4 years later, in 2006. More parents had changed from being sensually content in 2002 to discontent in 2006, than the contrary, however, and the sexual contentment remained low. The average sexual frequency was low both at 6 months and at 4 years for both parents with and without additional children. Experiencing tiredness as a hindrance to having sex was perceived as a greater problem among those parents without additional children. Prospective regression analyses indicated that sexuality was significantly related to both sensual and sexual contentment 4 years later. Sexuality was also one of the most significant covariates in the cross-sectional regression analysis for sensual contentment. Since sexuality plays a central role in partner well-being, it may be an important target for helping parents with small children.     

Different Ways to Get There: Evidence of a Variable Female Sexual Response Cycle

Research has suggested women’s sexual response cycle may vary more than previously thought. We asked 769 sexually active women between the ages of 18–70 to report on their sexual desire and arousal patterns during their last sexual experience. Using a latent class mixture model from retrospective sexual response data, we found six classes of desire and arousal patterns (Low, Middle Steady, High Fluctuation, Low Fluctuation, Upper Steady, High). We examined how these patterns were related to demographics, outcomes during the sexual experience, and outcomes for the global relationship. The Low sexual response class (8% of women) was significantly different from other classes in duration of the sexual experience, orgasms, and overall satisfaction with the sexual experience. Most sexual response patterns were associated with healthy relational and sexual outcomes. All classes except for the Low arousal and desire class showed associations with a neutral or positive sexual satisfaction evaluation. The non-problematic variation of women’s sexual experience is an important concept to consider as it impacts determinations of dysfunction and women’s self-evaluations. Not all women need to experience high levels of arousal throughout the sexual experience or to have desire at the outset in order to have positive sexual experiences and sexual outcomes.     

Implicit and Explicit Sexual Attitudes: How Are They Related to Sexual Desire and Sexual Satisfaction in Men and Women?

This article examines individual variability in sexual desire and sexual satisfaction by exploring the relation between these sexual aspects and sexual attitudes (implicit and explicit) and by taking gender into account, as this has been shown to be an influential factor. A total of 28 men and 33 women living in heterosexual relationships completed questionnaires assessing sexual desire (dyadic, solitary), sexual satisfaction, and explicit sexual attitudes. An adapted version of the Affect Misattribution Procedure was used to assess implicit sexual attitudes. Results showed higher levels of dyadic and solitary sexual desire in men than in women. No gender differences were found regarding sexual satisfaction or sexual attitudes. High dyadic sexual desire was associated with positive implicit and explicit sexual attitudes, regardless of gender. However, solitary sexual desire was significantly higher in men than women and was associated, in women only, with positive implicit sexual attitudes, suggesting that solitary sexual desire may fulfill different functions in men and women. Finally, sexual satisfaction depended on the combination of explicit and implicit sexual attitudes in both men and women. This study highlights the importance of considering both implicit and explicit sexual attitudes to better understand the mechanisms underlying individual variability in sexual desire and satisfaction.     

Women's Erotic Rape Fantasies: An Evaluation of Theory and Research

In an online study, measures of subjective sexual experiences in one's current relationship were compared across four groups: Men and women in mixed-sex (i.e., heterosexual) and same-sex (i.e., homosexual) relationships. Results indicated far more similarities than differences across the four groups, with groups reporting almost identical sexual repertoires, and levels of sexual communcation with partner. Men reported experiencing somewhat more sexual desire than women, while women reported slightly higher levels of general sexual satisfaction than men. Those in same-sex relationships reported slightly higher levels of sexual desire than those in mixed-sex relationships. Compared to the other three groups, heterosexual men reported deriving somewhat less satisfaction from the more tender, sensual, or erotic sexual activities. Implications of these findings for sex therapists are discussed.     

Women's sexual experience during the menstrual cycle: identification of the sexual phase by noninvasive measurement of luteinizing hormone

Imprecise measures of ovulation obscure the relationship between women's sexuality and the menstrual cycle, as does studying women with different contraceptive goals in different social contexts. Here we present a novel noninvasive method to precisely pinpoint the preovulatory surge of Luteinizing Hormone (LH), demarcating hormonally distinct cycle phases with greater than 95% reliability. Women were more sexually active on days prior to and including the preovulatory (LH) surge. This pattern was evident only when women initiated sexual activity and not when their partners did, indicating an increase in women's sexual motivation rather than attractiveness. A second study replicated the 6-day increase in sexual activity beginning 3 days before the LH surge, accompanied by stronger sexual desire and more sexual fantasies. We propose the term 'sexual phase' of the cycle, since follicular phase is over inclusive and ovulatory phase is not sufficient. These findings are striking because the women were avoiding pregnancy and were kept blind to the hypotheses, preventing expectation bias. The sexual phase was more robust in women with regular sexual partners, although the increase in sexual desire was just as great in nonpartnered women, who also reported feeling less lonely at this time. We use these results to evaluate potential neuroendocrine mechanisms underlying women's sexual motivation and activity.     

Timetable of effects of testosterone administration to hypogonadal men on variables of sex and mood

Introduction.?The effects of testosterone have been extensively characterized, but little attention has been given to the timetable of occurrence of the various effects of testosterone.

Methods.?The timetables of effects on sexual and psychological variables in 40 hypogonadal men receiving treatment with either parenteral testosterone enanthate (TE) or undecanoate (TU).

Results.?Sexual thoughts/fantasies and sexual interest/desire/spontaneous morning erections emerged quickly and plateaued after 3 weeks. Total erections rose to a maximum over 9 weeks and then plateaued. Ejaculations per week/satisfaction with sex life rose over the first 3 weeks, increasing steadily to a plateau at 12 weeks. Depression scores decreased to reach a plateau after 6 weeks. Aggressiveness did not change. Scores of concentration improved and reached a plateau after 3 weeks in the group treated with TE and after 9 weeks in the group treated with TU. Good mood improved after 6–9 weeks. Positive effects on self-confidence appeared between 3–6 weeks and on fatigue after 9–12 weeks.

Conclusion.?Insight into the emergence of effects may be useful information for the patient and for the attending physician in monitoring clinical effects of testosterone treatment of hypogonadal men.     

Sexual expression in later life: a review and synthesis

In the past decade, researchers have begun to study the sexual functioning of typical older persons. This review summarizes literature on the sexuality of men and women over age 50 as researched by social and health scientists. Research on the relationship of biological factors (changes accompanying aging), health (physical, mental, and medication use), psychological factors (attitudes, information about sex), relationship factors (status, satisfaction), and sexual functioning (desire, dysfunctions, treatment) to sexual behavior is reviewed. The review suggests that (a) men and women remain sexually active into their 70s and 80s, (b) aging-related physical changes do not necessarily lead to decline in sexual functioning, and (c) good physical and mental health, positive attitudes toward sex in later life, and access to a healthy partner are associated with continued sexual activity. In turn, regular sexual expression is associated with good physical and mental health. Progress in understanding later life sexuality requires development of comprehensive theoretical models, a broad focus on intimacy, attention to measures and samples, and research on couples. Progress in understanding is especially important, given the aging of populations.