Further study is needed into whether
sexual dissatisfaction leads to lower
wellbeing or vice versa, according to the
researchers.
Image: iStockphoto

Pre- and post-menopausal women who self-rated themselves as being sexually satisfied had a higher overall psychological wellbeing score and scores for "positive wellbeing" and "vitality," compared with sexually dissatisfied women in a study of 295 women sexually active more than twice a month.

The study, published on 29 September in The Journal of Sexual Medicine, also uncovered a positive association between age and wellbeing, but a negative association for general health.

The most commonly reported sexual problems in the area of consensual sexuality in women relate to sexual desire and interest, pleasure and satisfaction, and for most women these are part of the overall sexual experience, and are inextricably related. In contrast to studies of interventions for male erectile dysfunction, benefit of treatment in women with sexual dysfunction cannot be measured simply by the frequency of sexual events, as women frequently continue to be sexually active despite a high level of sexual dissatisfaction. Thus the frequency of self-reported satisfactory sexual events has been used as the primary outcome in recent studies.

To assess whether there was a correlation between sexual satisfaction and wellbeing, the team of Australian researchers recruited women from the community aged 20-65 who self-identified as being satisfied or dissatisfied with their sexual function. Participants were also asked questions which identified whether they were pre- or post menopausal, with recruitment closed when there was an equal number of women in each of the four subgroups.

"We wanted to explore the links between sexual satisfaction and wellbeing in women from the community, and to see if there was any difference between pre- and postmenopausal women," said lead author Dr Sonia Davison, of the Women's Health Program at Monash University, Australia. "We found that women who were sexually dissatisfied had lower wellbeing and lower vitality. This finding highlights the importance of addressing these areas as an essential part of women's healthcare, because women may be uncomfortable discussing these issues with their doctor."

"The problem with interpreting this finding is that it is impossible to determine if dissatisfied women had lower wellbeing because they were sexually dissatisfied, or if the reverse is true, such that women who started with lower wellbeing tended to secondarily have sexual dissatisfaction," added Davison. "As such, pharmacotherapies aimed to treat sexual dysfunction may have secondary effects on wellbeing, and the reverse may be true."

As over 90 per cent of women in this study reported their sexual activity involved a partner, and was initiated by the partner at least 50 per cent of the time, the sexual activity of the women may have been affected by partner presence (or absence), partner health, and sexual function, which were not addressed in this study. "The fact that women who self-identified as being dissatisfied maintained the level of sexual activity reported most likely represents established behaviour and partner expectation," said Professor Susan Davis, senior author of this study, also based at the Women's Health Program at Monash University, Australia. "It also reinforces the fact that frequency of sexual activity in women cannot be employed as a reliable indicator of sexual wellbeing."

"We are proud to publish this extremely important study in women's sexual health" said Dr. Irwin Goldstein, Editor-in-Chief of The Journal of Sexual Medicine. "This large study performed in the community emphasizes the role and importance of women's sexual health in women's overall health and wellbeing. Previous criticism equated physicians' efforts to improve a woman's satisfaction with her sexual life as medicalization. Dr. Davison's and co-workers' research will help health care professionals appreciate the need for overall women's healthcare to include women's sexual health care."