Which are the male factors associated with female sexual dysfunction (FSD)?

Abstract

SUMMARYIt has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r = À0.327; p < 0.0001), whereas no significant correlation was found between FSFI and erectile dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald = 9.196, p = 0.002), arousal (Wald = 7.893, p = 0.005), lubrication (Wald = 5.042, p = 0.025), orgasm (Wald = 9.293, p = 0.002), satisfaction (Wald = 12.764, p < 0.0001), and pain (Wald = 6.492, p = 0.011) domains. Partner's HSD was also significantly associated with somatized anxiety, low frequency of intercourse, low partner's care for the patient's sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p = 0.041); the correlation disappeared if the patient also experienced HSD.In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD, as determined by FSFI scores; conversely, women's sexuality seems to be mostly impaired by the perceived reduction in their partner's sexual interest.

Fecundability in reproductive aged women at risk of sexual dysfunction and associated risk factors: a prospective preconception cohort study

“…Biologic mechanisms by which FSD could influence fecundability are uncertain. We postulate that the reduced fecundability in women with low FSF may be related to the low coital frequency due to unpleasant sexual experience and difficulties with intimacy [ 7 , 9 ]. Psychological distress resulting from FSD may also induce an inflammatory response [ 37 ], whilst stress-related glucocorticoid changes mediate disruption in reproductive hormonal balance such as luteinizing hormone and melatonin, which in turn can interfere with ovulation [ 38 , 39 ], contributing to the delayed TTP [ 24 ].…”

“…This is commonly reported by infertile couples who experience infertility-related stress after attempting to conceive for a long period of time, resulting in the need for fertility treatment [ 7 , 8 ]. There is also evidence showing that attempts to conceive are positively associated with FSF in subfertile women, where the desire for pregnancy could prevail over emotional stress [ 9 ]. Taken together, these contradictory findings of the impact of subfertility on FSF may reflect varying responses (i.e.…”

Validation of a Visual Analogue Scale to measure the subjective perception of orgasmic intensity in females: The Orgasmometer-F

“…Factors such as anatomy [ 7 , 8 , 16 , 17 , 42 – 44 ], hormonal levels [ 45 ], age and sexual experience [ 46 ], self-awareness [ 11 , 47 , 48 ], sexual autonomy (i.e. the extent to which one feels that one’s sexual behaviors are self-determined) [ 49 ], ability to lose control during sexual activity [ 50 ] and partner-related sexual dysfunctions [ 51 ] are closely linked with orgasmic function. However, lacking so far a specific and dedicated psychometric tool, all these studies are not showing qualitative data on female orgasm.…”

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction

“…Another representation is anorgasmia [ 161 ], severe dyspareunia or vaginismus [ 162 ], where impossible penetration frequently reduces the patient’s self-esteem and self-confidence in his ability to obtain and maintain an erection. Similarly, it may also occur for impairments in the sexual desire [ 148 , 163 ].…”