The development and bicultural validation of the New Sexual Satisfaction Scale (NSSS)--a 20 item, multidimensional, composite measure of sexual satisfaction--is presented. The development of the scale was based on a five-dimension, conceptual model that emphasized the importance of multiple domains of sexual behavior including sexual sensations, sexual awareness and focus, sexual exchange, emotional closeness, and sexual activity. Scale construction and validation were carried out using seven independent samples with over 2,000 participants aged 18 to 55 in Croatia and the United States. Primary data collection was completed using online survey tools. Analyses did not confirm the proposed conceptual framework but suggested a two-dimensional structure focusing on self ("ego-centered") and the other (a "partner- and sexual activity-centered" factor) domains, each containing items representing all five conceptual dimensions. Scale reliability (k = 20) was satisfactory for all samples, and construct validity was confirmed in both cultures. The NSSS was also found to have acceptable one-month stability. It is suggested that the NSSS may be a useful tool for assessing sexual satisfaction regardless of a person's gender, sexual orientation, and relationship status.

Introduction Recent epidemiological studies reported high prevalence rates of erectile dysfunction (ED) among younger heterosexual men (≤40). It has been suggested that this “epidemic” of ED is related to increased pornography use. However, empirical evidence for such association is currently lacking. Aim This study analyzes associations between pornography use and sexual health disturbances among younger heterosexual men using four large-scale online samples from three European countries. Methods The analyses were carried out using a 2011 cross-sectional online study of Croatian, Norwegian, and Portuguese men (Study 1; N = 2,737) and a 2014 cross-sectional online study of Croatian men (Study 2; N = 1,211). Chi-square test and multivariate logistic regression were used to explore the associations between pornography use and sexual difficulties. Main Outcome Measures In Study 1, erectile difficulties, inability to reach orgasm, and a lack of sexual desire were measured using the Global Study of Sexual Attitudes and Behavior indicators. In Study 2, ED was measured with the abridged International Index of Erectile Function (IIEF-5). Delayed ejaculation and a decrease of sexual desire were assessed with one-item indicators. Results In Study 1, only the relationship between pornography use and ED among Croatian men was statistically significant (χ2[2] = 18.76, P < 0.01). The association was small and inconsistent. Compared with infrequent use of pornography, moderate but not high frequency of pornography use increased the odds of reporting ED (adjusted odds ratio = 0.53, P < 0.01). In Study 2, no significant associations both between either the frequency or the recent dynamics of pornography use and male sexual dysfunctions were observed. Conclusion We found little evidence of the association between pornography use and male sexual health disturbances. Contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men's desire, erectile, or orgasmic difficulties.

The aim of this article was to describe partnered and non-partnered sexual activity and sexual satisfaction in older men and women from Norway, Denmark, Belgium, and Portugal, and to explore sociodemographic correlates of sexual activity and satisfaction. Data were collected in 2016 using postal, anonymous questionnaires in probability samples of the population aged 60-75 years recruited by phone registers in Norway (676 men, 594 women), Denmark (530 men, 515 women), Belgium (318 men, 672 women), and Portugal (236 men, 273 women). In men, the percentage of sexually active participants in the past year ranged from 83% in Portugal to 91% in Norway. In women, the percentage of sexually active participants during the last year ranged from 61% in Belgium to 78% in Denmark. Regarding frequency of sexual intercourse activity during the past month, men in Norway, Denmark, and Belgium (23-24%) most often reported 2-3 times per month, whereas most men in Portugal (29%) reported 1-3 times per week. Masturbation was most commonly reported among Norwegian men (65%) and women (40%), and least commonly in Portugal. Concerning sexual satisfaction, across all countries, 40-60% of participants reported that they were sexually satisfied. Portuguese men and Danish women reported being most sexually satisfied. Having a partner was the most important positive predictor of sexual activity and sexual satisfaction in all subgroups except Portuguese men. In conclusion, partnered sexual activity was more frequent in the south of Europe, and solitary sexual activity more frequent in Northern Europe.

Previous research on exposure to different types of pornography has primarily relied on analyses of millions of search terms and histories or on user exposure patterns within a given time period rather than the self-reported frequency of consumption. Further, previous research has almost exclusively relied on theoretical or ad hoc overarching categorizations of different types of pornography, when investigating patterns of pornography exposure, rather than latent structure analyses of these exposure patterns. In contrast, using a large sample of 18- to 40-year-old heterosexual and nonheterosexual Croatian men and women, this study investigated the self-reported frequency of using 27 different types of pornography and statistically explored their latent structures. The results showed substantial differences in consumption patterns across gender and sexual orientation. However, latent structure analyses of the 27 different types of pornography assessed suggested that although several categories of consumption were gender and sexual orientation specific, common categories across the different types of pornography could be established. Based on this finding, a five-item scale was proposed to indicate the use of nonmainstream (paraphilic) pornographic content, as this type of pornography has often been targeted in previous research. To the best of our knowledge, no similar measurement tool has been proposed before.

We examined the interplay between husbands' and wives' positive and negative nonsexual interpersonal behaviors, frequency of sexual intercourse, sexual satisfaction, and feelings of marital satisfaction. To do this, we conducted an in-depth face-to-face interview and completed a series of telephone diaries with 105 couples during their second, third, and fourteenth years of marriage. Consistent with the argument that women's sexual response is tied to intimacy (Basson, 2000), multilevel analyses revealed that husbands' positive interpersonal behaviors directed toward their wives-but not wives' positivity nor spouses' negative behaviors (regardless of gender)-predicted the frequency with which couples engaged in intercourse. The frequency of sexual intercourse and interpersonal negativity predicted both husbands' and wives' sexual satisfaction; wives' positive behaviors were also tied to husbands' sexual satisfaction. When spouses' interpersonal behaviors, frequency of sexual intercourse, and sexual satisfaction were considered in tandem, all but the frequency of sexual intercourse were associated with marital satisfaction. When it comes to feelings of marital satisfaction, therefore, a satisfying sex life and a warm interpersonal climate appear to matter more than does a greater frequency of sexual intercourse. Collectively, these findings shed much-needed light on the interplay between the nonsexual interpersonal climate of marriage and spouses' sexual relationships.

Compliance with Ethical Standards All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained, and participants were informed about the study, its content, and volunarity of participation. Responses were anonymized and stored in anonymous form on a secure server. The Study was approved by the Danish Data Protection Agency. The study was exempt from further ethical evaluations following the rules and regulations as set forth by the Scientific Ethical Committees of Denmark.

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Sexual 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.