What should we be studying? Research priorities according to women and gender-diverse individuals with sexual interest/arousal disorder and their partners.

BACKGROUND: Sexual interest/arousal disorder (SIAD) is one of the most common sexual problems for women. In clinical research, there are often misalignments between the research priorities of patients and researchers, which can negatively impact care, and gender-diverse individuals are often excluded from research. Inclusion of patient perspectives when establishing research priorities may help to reduce these gaps; however, the research priorities of couples coping with SIAD remain unclear. AIM: Identify the research priorities of women and gender-diverse individuals with SIAD and their partners. METHODS: In an online survey, couples coping with SIAD provided consent and responded to an open-ended question asking them to list the top 3 things they think are important for researchers to focus on related to couples coping with low sexual desire. A team-based content analysis was conducted to identify themes and their frequency of endorsement. OUTCOMES: An author-developed open-ended question. RESULTS: Analysis of 1279 responses (n = 667 from women and gender-diverse individuals with SIAD, n = 612 from partners) resulted in our identification of 6 main themes: general causes, general treatment and coping, biophysiological, relationship, psychological, and environmental/contextual. Additionally, we identified 4 sub-themes within each of the latter 4 main themes: general, cause, treatment, and impact. For women and gender-diverse individuals with SIAD, their partners, and specifically gender-diverse participants, the 3 most endorsed themes were psychological general factors (24.3%, 21.2%, 24.3%; eg, stress and the link between SIAD and anxiety), relationship general factors (15.7%, 13.2%, 18.6%; eg, relationship length and communication on sexual desire), and biophysiological general factors (12.3%, 12.4%, 14.3%; eg, research on medications and hormones). CLINICAL IMPLICATIONS: Clinical researchers should consider the research priorities of couples coping with SIAD to ensure their work aligns with the needs of the affected population. STRENGTHS AND LIMITATIONS: This study is the first to identify the research priorities of both women and gender-diverse individuals with SIAD and their partners. Most participants identified as heterosexual, North American, and of middle to high socioeconomic status; results may not generalize. Responses were sometimes brief and/or vague; interpretation of these responses was therefore limited and may have required more contextual information. CONCLUSION: Findings suggest that women and gender-diverse individuals with SIAD, their partners, and gender-diverse participants have similar research priorities that are consistent with a biopsychosocial approach to research. Heterogeneity of responses across themes supports a multidisciplinary, patient-oriented approach to SIAD research.

A Longitudinal Examination of Common Dyadic Coping and Sexual Distress in New Parent Couples during the Transition to Parenthood.

New parents experience significant disruption to their sexual relationships such as lower desire and sexual frequency relative to prepregnancy. Little is known about the sexual distress new parents feel related to these changes, how sexual distress evolves over time, or how coping with stress relates to this distress. New parent couples who engage in more adaptive, joint coping with mutual stressors-common dyadic coping (CDC)-may be better able to manage distress related to their sexuality and thus, experience less sexual distress at 3-months postpartum and experience more marked improvement over time. In 99 first-time parent couples, we examined the link between CDC measured at 3-months postpartum and trajectories of sexual distress across 3-, 6-, and 12-months postpartum. Analyses used dyadic latent growth curve modeling informed by the actor-partner interdependence model. Mothers' sexual distress at 3-months postpartum was clinically elevated and higher than their partner's. Mothers' sexual distress declined significantly over time, whereas partners' sexual distress remained low and stable. An individual's higher perceptions of CDC was significantly associated with their own (but not their partner's) lower sexual distress at 3-months postpartum. No significant associations were found between CDC and change in sexual distress over time. How new parents jointly cope with stressors early in the postpartum period may lessen the distress they have about their sexuality at a time when most couples have just resumed sexual activity. Results identify CDC as a possible novel target for interventions aimed at helping couples manage sexual distress during the transition to parenthood.

Los padres recientes sufren una alteración significativa de sus relaciones sexuales, como menos deseo y frecuencia sexual, en comparación con el periodo anterior al embarazo. Se sabe muy poco acerca del distrés sexual que sienten los padres recientes en relación con estos cambios, cómo evoluciona el distrés sexual con el tiempo o cómo el afrontamiento del estrés se relaciona con este distrés. Las parejas de padres recientes que participan en un afrontamiento conjunto más adaptativo de los factores desencadenantes de estrés mutuos -afrontamiento diádico común - pueden ser más capaces de manejar el distrés relacionado con su sexualidad y, por lo tanto, sufrir menos distrés sexual tres meses después del parto, así como tener mejoras más marcadas con el tiempo. En 99 parejas de padres primerizos, analizamos la conexión entre el afrontamiento diádico común medido tres meses después del parto y las trayectorias de distrés sexual a lo largo de los 3, los 6 y los 12 meses después del parto. En los análisis se utilizó el modelo de curva de crecimiento latente diádico orientado por el modelo de interdependencia actor-pareja. El distrés sexual de las madres tres meses después del parto fue clínicamente elevado y mayor que el de sus parejas. El distrés sexual de las madres disminuyó considerablemente con el tiempo, mientras que el distrés sexual de sus parejas se mantuvo bajo y estable. Las percepciones más elevadas de una persona con respecto al afrontamiento diádico común estuvieron asociadas considerablemente con su propio distrés sexual más bajo (pero no con el de sus parejas) tres meses después del parto. No se hallaron asociaciones significativas entre el afrontamiento diádico común y el cambio en el distrés sexual con el tiempo. La manera en la que los padres recientes afrontan conjuntamente los factores desencadenantes de estrés a principios del periodo de posparto puede disminuir el distrés que tienen por su sexualidad en un momento cuando la mayoría de las parejas acaban de reanudar su actividad sexual. Los resultados reconocen el afrontamiento diádico común como posible objetivo nuevo para las intervenciones orientadas a ayudar a las parejas a manejar el distrés sexual durante la transición a la paternidad.

A Comparison of the Sexual Well-Being of New Parents With Community Couples.

BACKGROUND: Changes in sexual well-being are common for new mothers and their partners after the birth of a baby. However, most research has sampled mothers not couples, assessed only one aspect of sexual well-being, and has not included a control sample of couples. AIM: This study aimed to compare the sexual well-being (ie, sexual frequency, sexual satisfaction, sexual desire, sexual distress) of first-time mothers and their partners in the transition to parenthood (first 12-month postpartum) to community couples who are not actively in this transition. We also compared the sexual well-being within couples (eg, mothers to their partners). METHODS: Couples in the transition to parenthood (n = 99) completed measures of sexual satisfaction, sexual desire, sexual distress, and sexual frequency at 3, 6, and 12 months postpartum, and community couples (n = 104) completed the measures at a single time point. OUTCOMES: Measures included the following: (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index and International Index of Erectile Function sexual desire subscale; (iii) Female Sexual Distress Scale-Revised; and (iv) checklist of sexual behaviors. RESULTS: Compared with community controls, new parents reported lower sexual satisfaction, lower sexual desire, and higher sexual distress at all time-points; however, these group differences became less pronounced by 12 months postpartum. By 6 months postpartum, there was no difference in sexual frequency between postpartum couples and the control group. Mothers experienced persistently lower sexual desire relative to their partners throughout the 12 months postpartum. Between 39% and 59% of mothers reported clinically low sexual desire, and 47-57% reported significant sexual distress at all time points. There were no significant differences reported in sexual satisfaction, sexual desire, or sexual distress between women and their partners in the community sample. CLINICAL IMPLICATIONS: Clinicians should be aware that sexual well-being may be compromised in new parents, and some of these challenges are still present for new parents at 12 months postpartum. Findings can be used to educate new parents regarding their expectations about postpartum sexual well-being. STRENGTHS & LIMITATIONS: The strengths of the present study are the dyadic approach, assessing multiple aspects of sexual well-being in new parents over time, and the comparison with a community sample. An important limitation is that the control sample was not followed up over time. CONCLUSION: Education regarding postpartum sexual well-being should be incorporated in routine perinatal and postnatal healthcare practices to support new parents in developing realistic expectations about changes during the transition to parenthood, potentially preventing undue distress. Schwenck GC, Dawson SJ, Muise A, et al. A Comparison of the Sexual Well-Being of New Parents With Community Couples. J Sex Med 2020;17:2156-2167.

Attraction Toward One's Partner is Associated with Sexual Desire, Satisfaction, and Distress Among Couples Coping with Sexual Interest/Arousal Disorder.

The sexual incentive motivation model suggests that attractive stimuli activate the sexual response system. Attraction toward one's partner has been linked to greater sexual satisfaction, but no quantitative studies have examined its links to sexual desire or distress among those with sexual dysfunction. We examined associations between daily attraction toward one's partner and sexual satisfaction, desire, and distress for individuals with Sexual Interest/Arousal Disorder (SIAD) and their partners. Participants (N = 227 couples) completed daily online surveys measuring attraction for one's partner, sexual desire, satisfaction, and distress. Multilevel models showed that on days when women and gender diverse individuals with SIAD reported higher attraction for their partner, they and their partners reported higher sexual satisfaction and desire, and their partners reported lower sexual distress. On days when partners reported higher attraction, both they and participants with SIAD reported higher sexual desire and partners reported lower sexual distress; however, women and gender diverse individuals with SIAD reported higher sexual distress. Daily fluctuations in attraction may be important for daily fluctuations in sexual wellbeing among couples coping with SIAD. Findings may inform novel treatment targets for SIAD.

Comparing Responses to Sexual Rejection and Sexual and Relationship Well-Being in Couples Coping with Sexual Interest/Arousal Disorder and Community Couples.

Four distinct partner responses to sexual rejection - sexual advances that are declined by a partner - have been identified. This study assessed the frequency of these responses between and within North American couples coping with Sexual Interest/Arousal Disorder (SIAD) and community couples and - in line with the Interpersonal Emotion Regulation Model - compared the associations between responses to sexual rejection and sexual and relationship well-being across the two samples. Individuals with SIAD and their partners (n = 241) and community couples (n = 105) completed online measures of sexual rejection responses, sexual satisfaction, sexual desire, sexual distress, sexual frequency, and relationship satisfaction. Results showed that after accounting for sexual rejection frequency, individuals with SIAD and their partners reported greater resentful and insecure partner responses to sexual rejection than individuals in the community sample, and individuals with SIAD perceived less understanding responses than their own partners reported. For both groups, more understanding and less resentful and insecure responses were associated with greater sexual and relationship well-being. Clinicians might encourage couples to reflect on their rejection responses and to shift to more helpful ways of responding to sexual rejection.