Gender Similarities and Differences in Sexual Arousal,Desire, and Orgasmic Pleasure in the Laboratory

Relatively little is known about gender differences in the orgasm experience. The objectives of this study were to compare men's and women's patterns of sexual arousal and desire before and after orgasm, and the predictors of their orgasmic pleasure. Using their typical technique, where masturbation enjoyment was similar to that experienced at home, 38 men and 38 women masturbated to orgasm in the laboratory. Physiological sexual arousal (genital temperature) and subjective sexual arousal and desire measurements were taken at baseline, after masturbation almost to orgasm, and immediately and 15 minutes after orgasm. In both genders, all measures increased significantly during masturbation, with a greater buildup leading to a more pleasurable orgasm. After orgasm, however, sexual arousal and desire decreased more quickly and consistently in men than in women, thereby replicating Masters and Johnson's (1966 Masters , W. H. , &; Johnson , V. E. ( 1966 ). Human sexual response . Boston , MA : Little, Brown . [Google Scholar]) observations. More men than women exhibited resolution of subjective sexual arousal and sexual satiation; their genital temperature also decreased more than women's but did not return to baseline. Women's orgasmic pleasure was related to a postorgasmic decrease in genital temperature but, unexpectedly, the maintenance of subjective sexual arousal and desire. Future studies should explore whether this pattern explains gender differences in the pursuit of additional orgasms.     

What is Sexual Satisfaction? Thematic Analysis of Lay People's Definitions

Sexual satisfaction is an important indicator of sexual health and is strongly associated with relationship satisfaction. However, research exploring lay definitions of sexual satisfaction has been scarce. We present thematic analysis of written responses of 449 women and 311 men to the question “How would you define sexual satisfaction?” The participants were heterosexual individuals with a mean age of 36.05 years (SD = 8.34) involved in a committed exclusive relationship. In this exploratory study, two main themes were identified: personal sexual well-being and dyadic processes. The first theme focuses on the positive aspects of individual sexual experience, such as pleasure, positive feelings, arousal, sexual openness, and orgasm. The second theme emphasizes relational dimensions, such as mutuality, romance, expression of feelings, creativity, acting out desires, and frequency of sexual activity. Our results highlight that mutual pleasure is a crucial component of sexual satisfaction and that sexual satisfaction derives from positive sexual experiences and not from the absence of conflict or dysfunction. The findings support definitions and models of sexual satisfaction that focus on positive sexual outcomes and the use of measures that incorporate items linked to personal and dyadic sexual rewards for both men and women.     

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.     

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.     

Women With Hypoactive Sexual Desire Disorder Versus Sexual Interest/Arousal Disorder: An Empirical Test of Raising the Bar

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published with a major revision to the sexual dysfunction categories, and the diagnosis of female hypoactive sexual desire disorder (HSDD) was replaced with female sexual interest/arousal disorder (SIAD). Since being introduced, concern has been expressed that SIAD inappropriately “raises the bar” for diagnosis. To address these concerns, we sought to evaluate the number of women with a diagnosis of HSDD who also met criteria for SIAD. In a sample of 151 women, we found that 73.5% of women with a diagnosis of HSDD met criteria for SIAD. The two groups were compared on the Sexual Interest/Desire Inventory, and women who met criteria for both HSDD and SIAD consistently scored lower on sexual desire frequency and satisfaction, satisfaction with sex, receptivity, positive sexual thoughts, reactions to erotica, arousal frequency, ease, continuation, and orgasm ease/achievement, and higher on distress. In addition, women meeting criteria for HSDD only tended to have mild symptoms across the six SIAD criteria compared to those meeting criteria for both HSDD and SIAD. These findings suggest that the SIAD criteria does not unduly raise the bar for diagnosis.     

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.     

A Dyadic Approach to Understanding the Link Between Sexual Functioning and Sexual Satisfaction in Heterosexual Couples

Researchers have demonstrated that several dimensions of sexual functioning (e.g., sexual desire, arousal, orgasm) are associated with the sexual satisfaction of individuals in a committed mixed-sex (male–female) relationship. We extended this research by comparing a dyadic model that included both own (i.e., actor effect) and partner (i.e., partner effect) domains of sexual functioning to an individual model that included only actor effects. Participants were 124 mixed-sex couples who completed online measures of sexual functioning and sexual satisfaction. Data analysis using the actor–partner interdependence model (APIM) and structural equation modeling (SEM) indicated that the dyadic model had a better fit than the individual model. Women’s sexual desire and orgasm and men’s erectile functioning were significant positive predictors of both own and partner’s sexual satisfaction. These results are discussed in terms of the importance of taking a dyadic approach to research and clinical work related to sexual satisfaction.     

“Feeling frumpy”: The relationships between body image and sexual response changes in midlife women

This study investigated the relationships between self‐rated attractiveness and self‐reported sexual response changes (over the past decade) and current sexual satisfaction in 307 heterosexual, midlife women. Results indicated that regardless of the woman's specific age, she was more likely to consider herself more attractive when she was 10 years younger, and her self‐perceived attractiveness did not significantly differ based on her menopausal status. The more a woman perceived herself as less attractive than before, the more likely she was to report a decline in sexual desire or frequency of sexual activity. The more she perceived herself as attractive, the more likely she was to experience an increase in sexual desire, orgasm, enjoyment, or frequency of sexual activity. There were no significant statistical relationships between a woman's perception of her own attractiveness as she aged and her current sexual satisfaction.     

Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems

The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.     

Couples’ Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis

Research and clinical data have shown that couples with sexual problems report a lack of sexual communication. However, no published meta-analyses have evaluated the relationship between sexual communication and sexual function. This meta-analysis examines the correlation between couples’ sexual communication and dimension of sexual function across 48 studies. Sexual communication was positively associated with sexual desire (r = .16), sexual arousal (r = .21), lubrication (r = .17), orgasm (r = .23), erectile function (r = .19), less pain (r = .12), and overall sexual function (r = .35). The effect sizes for sexual desire (r = .21; r = .12) and orgasm (r = .26; r = .16) were higher for women than for men. For overall sexual function, studies with married participants (r = .47) had a larger effect size than studies with participants with multiple relationship types (r = .31) or than studies with dating participants (r = .11). Effect sizes were larger for studies conducted outside of the United States (r = .39) compared to studies conducted in the United States (r = .12). We discuss the importance of addressing the relationship between sexual communication and sexual function, as well as future directions for research in this area.     

Comment

In several anonymous questionnaire studies of college students, marijuana use has been reported to affect sexual behavior. In general, these studies show that marijuana smoking enhances sexual pleasure and increases sexual desire. Marijuana use has also been associated with more frequent sexual activity and an increased number of sexual partners. The purpose of this study was to determine the perceived effects of marijuana use on the sexual behavior and sexual practices of a sample of regular marijuana .users. In contrast to other studies, subjects were not drawn exclusively from college student populations and were interviewed rather than given a questionnaire. Results, in general, confirm results of previous studies. Subjects were primarily heterosexual and sexually active. Men were more likely than women to have had multiple sexual partners. Over two thirds reported increased sexual pleasure and satisfaction with marijuana. Increased desire for a familiar sexual partner was reported by about one half. The sensations of touch and taste were particularly enhanced by marijuana. Many felt marijuana was an aphrodisiac. Marijuana use in relation to initiation of sexual activity was also assessed. Although drug use occurred prior to first intercourse for about one third of the men and women, alcohol, not marijuana, was most frequently used in this context. Most had used marijuana as a preparation for intercourse on occasion, and 20% did this on a regular basis. Possible explanations for these effects are briefly discussed.     

The sexual experience and marital adjustment of genitally circumcised and infibulated females in the Sudan

In a study conducted over a 5‐year period, the author interviewed over 300 Sudanese women and 100 Sudanese men on the sexual experience of circumcised and infibulated women. Sudanese circumcision involves excision of the clitoris, the labia minora and the inner layers of the labia majora, and fusion or infibulation of the bilateral wound. The findings of this study indicate that sexual desire, pleasure, and orgasm are experienced by the majority of women who have been subjected to this extreme sexual mutilation, in spite of their also being culturally bound to hide these experiences. These findings also seriously question the importance of the clitoris as an organ that must be stimulated in order to produce female orgasm, as is often maintained in Western sexological literature.     

The Effects of Gender and Relationship Context Cues on Responsive Sexual Desire in Exclusively and Predominantly Androphilic Women and Gynephilic Men

Sexual desire may be “responsive,” emerging from sexual arousal to sexually competent cues. Cues that elicit sexual arousal and desire differ, however, by gender and direction of sexual attractions. Further, relationship context cues are thought to be important for responsive desire, but this has not been tested directly. The current study examined gynephilic men’s (n = 27) and exclusively (n = 23) and predominantly (n = 17) androphilic women’s dyadic and solitary responsive sexual desire, as well as genital and self-reported arousal, to audio narratives varying by gender (male, female) of the sexual partner and relationship context (stranger, friend, long-term relationship). Consistent with previous literature, gynephilic men’s solitary and dyadic desire were gender-specific (greater to female than to male sexual partners). Exclusively androphilic women’s dyadic desire differentiated less to cues of gender than gynephilic men’s, and their solitary desire did not differentiate by gender cues at all, replicating previous research. Androphilic women with some gynephilia reported a gender-nonspecific pattern of dyadic and solitary desire (i.e., responsive desire to both male and female narratives). No effect of relationship context was found for any groups. Results suggest that responsive sexual desire may be more closely associated with self-reported than genital arousal patterns.     

Condom Use Completeness,Perceptions, and Sexual Quality at Most Recent Sexual Event: Results from a U.S. Nationally Representative Probability Sample

Abstract

Objectives: To explore perceptions of condoms associated with complete use and evaluate relationships between condom perceptions, condom use, and sexual quality.

Methods: Using data from a U. S. nationally representative probability sample, we assessed individuals’ condom use perceptions and related characteristics of their most recent sexual event through bivariate and regression analyses (n?=?234).

Results: Most participants reported complete condom use and neutral or positive perceptions of condoms. Though incomplete use was associated with orgasm among women, arousal and pleasure did not differ by gender or duration of condom use.

Conclusions: We found no evidence that delayed application or early condom removal increased sexual arousal or pleasure, which may help sexual health promotion interventions address negative cultural ideas about condoms.     

Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction

The differences on sexual beliefs presented by men and women with sexual dysfunction and their sexually functional counterparts were investigated. A total of 488 participants (160 females and 232 males without sexual problems and 47 females and 49 males with a DSM-IV diagnosis of sexual dysfunction) answered the Sexual Dysfunctional Beliefs Questionnaire. Findings showed that, although effects have only reached statistical significance for the female group, both dysfunctional men and women endorsed more sexual dysfunctional beliefs than functional. Women presented significantly more age related beliefs (after menopause women loose their sexual desire, as women age, the pleasure they get from sex decreases) and body image beliefs (women who are not physically attractive cannot be sexually satisfied). Additionally, sexually dysfunctional males presented higher scores (not statistically significant) on 'macho' belief (a real man has sexual intercourse very often) and the beliefs about women satisfaction (the quality of the erection is what most satisfies women). Overall, findings support the idea that sexual beliefs may play a role as vulnerability factors for sexual dysfunction.     

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.     

Power, desire, and pleasure in sexual fantasies

One hundred and sixty-two participants (ages 21-45) wrote open-ended sexual fantasies and completed self-report measures of rape myth acceptance, adversarial sexual beliefs, and attitudes toward women. We coded fantasies using a newly developed scoring system that includes themes of dominance, submission, sexual pleasure, and sexual desire. Men fantasized about dominance more than women did; they also tended to focus more on the desire and pleasure of their partner. Desire and pleasure were more closely linked in the fantasies of men than in the fantasies of women, for whom the two were distinct constructs. Although fantasies of submission were not associated with problematic attitudes for either gender, men's fantasies of dominance were associated with greater acceptance of rape myths. For women, greater rape myth acceptance was associated with emotional and romantic fantasy themes.     

Power,desire, and pleasure in sexual fantasies

One hundred and sixty‐two participants (ages 21–45) wrote open‐ended sexual fantasies and completed self‐report measures of rape myth acceptance, adversarial sexual beliefs, and attitudes toward women. We coded fantasies using a newly developed scoring system that includes themes of dominance, submission, sexual pleasure, and sexual desire. Men fantasized about dominance more than women did; they also tended to focus more on the desire and pleasure of their partner. Desire and pleasure were more closely linked in the fantasies of men than in the fantasies of women, for whom the two were distinct constructs. Although fantasies of submission were not associated with problematic attitudes for either gender, men's fantasies of dominance were associated with greater acceptance of rape myths. For women, greater rape myth acceptance was associated with emotional and romantic fantasy themes.     

When,If, and How: Young Women Contend With Orgasmic Absence

While cultural ideas about “healthy” and “fulfilling” sexuality often include orgasm, many young women do not experience orgasm during partnered sex. The current study examined how women described this absence of orgasm in their sexual experiences with male partners. We examined interviews (N = 17) with women ages 18 to 28 and focused on their ideas about orgasm and their explanations concerning when and why they do not orgasm. We explored three themes that illustrate the strategies young women use to contend with orgasmic absence: (1) What’s the big deal?; (2) It’s just biology; and (3) Not now, but someday. We found that young women’s explanations allowed them to reduce feelings of abnormality and enabled them to distance themselves from sexual expectations regarding the perceived value of orgasm. In analyzing the complicated gender and sexual dynamics surrounding orgasm, we turned to Fahs’ (2014) work on sexual freedom and the importance of articulating freedom from sexual obligations as a key intervention in critical sexuality research. In our discussion, we examine the implications of our findings for critical researchers looking to better understand the role of sexual norms in how young women imagine and discuss the role of pleasure in their own sexual lives.