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- The impact of childbirth on female sexualityPublication . Leal, Isabel Maria Pereira; Lourenço, Sílvia; Oliveira, Raquel V.; Carvalheira, Ana Alexandra; Marôco, João PauloObjective: To compare variables related to sexual functioning, namely: sexual desire, arousal, orgasm, pain, sexual satisfaction and sexual function in women during the pregnancy and 3 months after delivery. Methods: This is an exploratory and descriptive, quantitative study. A non-probability, convenience sample of 62 women in the first stage, and of 52 women in the second stage, was used. The two groups were not significantly different regarding socio-demographic aspects. The main outcome measures used were the female sexual function as assessed by the Female Sexual Function Index (FSFI) and a Socio-demographic and Clinical Questionnaire. Results: The women presented higher mean levels of sexual satisfaction after birth, than during the pregnancy presenting statistically significant differences. Also they had lower mean levels of sexual desire, sexual arousal and vaginal lubrication after delivery. Regarding the orgasm, they presented higher mean levels in the postpartum period. The overall sexual function after childbirth did not present significant differences when comparing the pregnancy period to the postpartum, but presented higher mean levels during the pregnancy. Pain levels were higher during the pregnancy. Conclusion: We found no significant differences between the two groups, in most of the studied variables. However, Sexual Arousal and Sexual Satisfaction presented statistically significant differences.
- Predictors and correlates of sexual avoidance among partnered older adults among Norway, Denmark, Belgium, and PortugalPublication . Carvalheira, Ana; Graham, Cynthia; Stulhofer, Aleksandar; Traen, BenteResearch on sex in later life has been concerned with documenting that older people continue to have sex and establishing the links between good health and sexual activity. Although sexual avoidance is common in clinical and nonclinical populations of older adults, little attention has been given to the motives for sexual avoidance. To address gaps in the literature on sexual avoidance, the present study explored the self-reported reasons for, and correlates of, sexual avoidance in older partnered individuals with probability samples of 60–75-year-olds in four European countries (Norway, Denmark, Belgium, and Portugal). Results revealed significant differences between men and women in sexual avoidance, with women reporting more avoidance than men. The main reasons reported for avoiding sex were sexual difficulties, health problems, partner’s sexual difficulties, and lack of sexual interest. Among men, significant predictors of sexual avoidance were age, relationship intimacy (the only relational predictor), physical health, and own and partner’s sexual problems. In women, significant predictors of sexual avoidance were age, relationship duration, relationship satisfaction, relationship intimacy, physical and mental health, and own and partner’s sexual problems. Thus, in men, health-related factors were more important predictors of sexual avoidance than relationship factors. In women, relationship factors were as important as health-related factors. These findings provide insight into an under-researched area. They also have important implications for health care and could inform the development of tailored sexual health interventions in older adults. Keywords Older adults · Sexual avoidance · Relationship intimacy · Relationship
- The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countriesPublication . Kvalem, Ingela Lundin; Graham, Cynthia; Hald, Gert Martin; Carvalheira, Ana; Janssen, Erick; Stulhofer, AleksandarBody image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60–75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further.
- The relevance of the SESII-W/M in establishing a relationship between sexual difficulties and sexual excitation/inhibitionPublication . Paul, Victoria; Carvalheira, AnaAims: The main purpose of this study is to analyse the relationship between sexual difficulties and factors of sexual arousal, excitement, and sexual inhibition among men and women. Method: A total of 1,878 participants, of whom 983 were men (52%) and 895 were women (48%), with a mean age of 35.9 years (SD = 11.9; range = 18-79), were recruited online. The study’s instruments included a socio-demographic questionnaire, a questionnaire about sexual difficulties, and the Sexual Excitation/Sexual Inhibition Inventory for Women and Men (SESII-W/M). Results: Women with and without sexual difficulties differed significantly on all subscales of the SESII-W/M. Men with sexual difficulties scored significantly higher in the dimensions of Inhibitory Cognitions and the Dyadic Elements of the Sexual Interaction than men without difficulties. Inhibitory Cognitions was the strongest predictor of sexual difficulties for both men and women. Relationship Importance was also a strong predictor of sexual difficulties in women. Conclusions: Sexual inhibition serves as a predictor of sexual difficulties. The SESII-W/M seems to work better in determining the factors of sexual inhibition as predictors of sexual difficulties among women, than in identifying causes of sexual difficulties among men.
- The impact of relational factors on sexual satisfaction among heterosexual and homosexual menPublication . Carvalheira, Ana; Costa, Pedro AlexandreThis study analyzed the correlates of sexual satisfaction among exclusively heterosexual and homosexual men. Analyses were carried out using data from a 2011 web survey about male sexual interest in two European countries. A total of 2968 men with exclusive heterosexual behavior and 285 men with exclusive homosexual behavior in the previous five years from Portugal and Croatia, participated in this study. Hierarchical multiple regressions were performed in order to explore which variables predicted sexual satisfaction. Among heterosexuals, in step one, both age and sexual difficulties emerged as highly significant predictors, and in step two, the frequency of intercourse and the number of sexual partners also emerged as significant predictors. Finally, in the third step, the intimacy and the length of the relationship emerged as highly significant predictors of sexual satisfaction. Among homosexuals, in step one, sexual difficulties and country were significant predictors, in step two, only the frequency of sexual intercourse was a significant predictor, and in step three, both relational variables (relationship length and relationship intimacy) were significant predictors. The findings suggest that relational factors, particularly couple intimacy were the strongest predictors of sexual satisfaction for both heterosexual and homosexual men.
- Adherence to phosphodiesterase type 5 Inhibitors in the treatment of frectile dysfunction in long-term users: How Do Men Use the Inhibitors?Publication . Carvalheira, Ana Alexandra; Forjaz, Vera; Pereira, Nuno MonteiroThe high effectiveness of phosphodiesterase type 5 inhibitors (PDE5-i) in the treatment of erectile dysfunction (ED) has been demonstrated. However, previous research shows that PDE5-i treatments have high discontinuation rates.
- Seeking help for sexual difficulties: findings from a study with older adults in four European countriesPublication . Hinchliff, Sharron; Carvalheira, Ana; Stulhofer, Aleksandar; Janssen, Erick; Hald, Gert Martin; Træen, BenteSexual well-being is an important part of life for many people aged 60 and older. However, older adults often face barriers to seeking and receiving help for sexual difficulties. This study used data from a probability survey (n = 3820) on sexuality and ageing to examine help-seeking in 60–75-year-olds in Norway, Denmark, Belgium, and Portugal. More men (12.2%) than women (6.8%) had sought professional help for a sexual difficulty in the past 5 years. The main reason for help-seeking was that sex was important to the participant and/or their relationship. The main source of professional help was the primary care physician. Of those who had sought professional help, 48% were satisfied or very satisfied with the help received, 31.6% were neither satisfied nor dissatisfied, and 20.4% were dissatisfied or very dissatisfied. Others had sought help from informal sources, particularly partners, friends, or websites. The main reasons for not seeking professional help included not being distressed by the symptoms, and thinking that the difficulty would clear up on its own. Multivariable regression analysis revealed that significant correlates of seeking professional help for women and men were level of distress about the sexual difficulty. With regard to women, those who were married, and/or from Portugal were more likely to have sought help. And regarding men, those who attended religious services were more likely to have sought professional help. These results have important implications for healthcare and can be used to inform the development and delivery of services for older adults who experience sexual difficulties.
- A adesão ao duplo padrão sexual em jovens adultos em função do género e da orientação sexualPublication . Almeida, Ricardo; Carvalheira, Ana; Costa, Pedro Alexandre
- Sexual function in women after delivery: Does episiotomy matter?Publication . Leal, Isabel Maria Pereira; Lourenço, Sílvia; Oliveira, Raquel; Carvalheira, Alexandra; Marôco, JoãoObjective: Despite the fact that a restrictive use of episiotomy has proven to be beneficial, it continues to be widely used in vaginal births. Our aim was to compare women with episiotomy, to women with an intact perineum, 3 months after delivery, regarding several sexual variables, namely: sexual desire, arousal, orgasm, pain, sexual satisfaction and sexual function. Methods: An exploratory, descriptive and quantitative study using a non-probabilistic, convenience sample of 147 Portuguese women, of which 54 belonged to a control group, was performed. The groups were not significantly different regarding sociodemographic aspects. Three instruments were used: the Female Sexual Function Index, a Socio-demographic and Clinical Questionnaire and the Female Sexual Function Questionnaire. Results: Most women mentioned a moderate level of sexual interest. Women with episiotomy present higher pain intensity, less sexual satisfaction, greater changes regarding the orgasm’s duration and intensity, lower levels of sexual arousal and total sexual function, than women with intact perineum. Discussion: We found no significant differences between women with episiotomy and women with an intact perineum in most variables. However, women with episiotomy presented higher levels of pain and a lower sexual satisfaction, being these significant differences.
- The Impact of body dissatisfaction on distressing sexual difficulties among men and women: The mediator role of cognitive distractionPublication . Carvalheira, Ana; Godinho, Leonor Figueiredo; Costa, Pedro AlexandreResearch has demonstrated a negative impact of cognitive distraction on sexual activity, and body dissatisfaction has been associated with less satisfying and fewer sexual activities. In the current study we examined the extent to which cognitive distraction, based on body appearance and sexual performance, mediated the impact of body dissatisfaction on sexual difficulties among women and men. A sample of 493 women (Mage = 30.61) and 595 men (Mage = 37.90) completed an online survey. Women reported significantly higher levels of distressing sexual difficulties, significantly more body dissatisfaction, and greater cognitive distraction based on appearance than men. In contrast, men reported higher cognitive distraction based on performance than women. A path analysis model indicated that, for men, only cognitive distraction based on performance mediated the effects of body dissatisfaction on distressing sexual difficulties, and the mediation was only partial as body dissatisfaction had a significant direct effect on distressing sexual difficulties. In contrast, among women, both appearance-based cognitive distraction and performance-based cognitive distraction fully mediated the effects of body dissatisfaction on distressing sexual difficulties.