SUMMARY
The aim of this cross-cultural study was to examine predictors of sexual satisfaction. For the present analysis, we used a large-scale sample database that included 8821 individuals from 4 countries. All participants completed the same questionnaires, which were designed to capture numerous important variables that have been shown to correlate with sexual satisfaction. According to our results, predictors of sexual satisfaction were classified into four general categories (demographic factors, psychological factors, sociocultural factors, and pathophysiological factors). Our international study found statistically significantly higher satisfaction among homosexual participants, participants aged 18 to 23 years, those with a higher level of education, in a relationship, with a current sexual partner, in a current partnered (unmarried) relationship, and without a diagnosed sexual or mental disorder. At the same time, we found that the correlation between sexual satisfaction and the different predictors varieed considerably across countries, which calls for further research.
Key words: sexual satisfaction, sexual health, predictors
Introduction
Sexual satisfaction is an important indicator of sexual health and is closely related to relationship satisfaction (1). Sexual satisfaction is essential for both the physical and emotional health and well-being of individuals and families and for the social and economic development of communities and countries (2). In general, the term sexuality encompasses the right of all people to have the knowledge and ability to lead safe and enjoyable sexual lives (3). However, the ability of men and women to achieve sexual health and well-being depends on access to sexual information, knowledge of the risks they face, vulnerability to the negative consequences of sexuality, access to quality sexual health care, and environments that promote sexual health (4). Sexual health encompasses individuals and couples of all sexual orientations, pleasurable sex, concerns about fertility and reproduction, and includes issues such as sexual dysfunction, disability, and sexual violence. The latter suggests that sexual health is a broader concept than reproductive health (5), with sexual health defined as a state of physical, emotional, mental, and social well-being related to sexuality rather than merely the absence of disease, disorder, or defect (2). Effective sexual health requires a positive and respectful approach to sexuality and sexual relationships and the opportunity for an enjoyable and safe sexual experience that is free from coercion, discrimination, and violence (2). Sexual satisfaction is an essential component of sexual health and well-being, but we know little about what factors contribute to it among homosexual and bisexual people. Respect for the sexual rights of all people must be achieved and maintained (3). The definition of sexuality can be summarized as a central aspect of human existence throughout the lifespan and includes gender, sexual identity and role, sexual orientation, eroticism, pleasure, intimacy, and reproduction. Sexuality is an experience expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, roles, and partnerships (6).
Most authors note that many women suffer from disorders of sexual desire, arousal, vaginal hydration, orgasm, dissatisfaction, dyspareunia, and vaginismus (7-9). Sexual dysfunction also occurs in men: erectile dysfunction (ED) occurs in 26 cases per 1,000 men/year. The prevalence of ED ranges from 13% to 81% in different populations (10). ED increases with age and shows a strong association with economic status and comorbid conditions (11). It should be noted that 5% of men worldwide also suffer from orgasmic disorders (12).
Factors consistently associated with adult satisfaction may not have the same effect on sexual satisfaction in young people who are just beginning to have sex. These factors include age (13), frequency of sexual activity and orgasm, relationship stability and level of intimacy, harmonious psychological well-being, or depression (14). Other factors that have been studied in young people include sexual guilt, especially in young women (15), and goal setting (16).
In addition, studies have not documented possible associations between sexual well-being and other more traditional indicators of sexual satisfaction, such as condom use and contraception. The prevalence of sexual dysfunction in both sexes is also influenced by risk factors such as diabetes, cardiovascular disease, urinary tract disease, mental disorders, sociodemographic conditions, smoking, hormonal factors, and drug use (17).
Our research in factors affecting sexual satisfaction was divided into four general categories, and subgroups were formed for each class. These categories were named as follows: demographic factors, psychological factors, sociocultural factors, and pathophysiological factors. The first category included factors such as age, marital status, education, sexual orientation, and number of children. The second category included factors called psychological factors. Psychological disorders such as depression, anxiety, and mental health were identified as important factors in sexual satisfaction. The third category included interpersonal communication skills, beliefs, and attitudes (the number of sexual contacts per month, faked female orgasm, and total number of sexual partners in their lives, as well as the number of current sexual partners). Finally, the fourth category considered a factor such as pain during and after sexual intercourse.
Based on our previous studies, the theoretical model was composed of several dimensions. The first dimension was the woman’s mood before intercourse/activity. The second was the woman’s mood during intercourse/activity. The third dimension was the man’s mood during intercourse/activity, and the fourth dimension was balance during intercourse/activity. The autonomous variable was mood after sexual activity.
The aim of our study was to examine the predictors of sexual satisfaction in the context of different sexual orientations and countries. Based on the theoretical background, we hypothesized that some of the variables could be positive or negative predictors. Based on previous studies (18-20), we hypothesized that there would be a significant inverse relationship between age and sexual satisfaction and that couples who were in a relationship (unmarried) would have higher sexual satisfaction than most other groups (21). We also hypothesized that higher levels of education would be associated with higher sexual satisfaction. The status of gay men and lesbian women is problematic in countries where there have been and continue to be numerous violations of their rights that can lead to serious negative sexual consequences.
Patients and Methods
Participants and Procedure
The questionnaire was fully completed by 8821 representatives from all participating countries: women (n=4544; 51.5%) and men (n=4277; 48.5%) aged 18 to 60 years and older M = 4.56, SD = 2.013) from four countries (Slovenia (n=6903; 78.3%), Croatia (n=698; 7.9%), Bosnia and Herzegovina (n=573; 6.5%), and Romania (n=647; 7.3%).
Most of them lived in heterosexual (n=8235; 93.4%), bisexual (n=325; 3.7%), and homosexual (n=219; 2.5%) relationships. The inclusion criterion was age greater than 18 years. The exclusion criterion of a diagnosed sexual and/or mental disorder was not used because of possible correlations with independent variables. A brief explanation of the purpose of the survey was provided for the participants in the introductory section of the questionnaire. Participation was voluntary and anonymous; an individual was free to discontinue participation at any time without giving a reason. Only the questionnaire administrator had access to the online questionnaire. Secure access was possible via a personal e-mail and password from the administrator.
Survey questionnaire
The Sexual Satisfaction Scale survey questionnaire (22) served as the basis of the study.
Demographic factors included age, marital status, education, sexual orientation, and number of children.
Mental disorders such as psychological and sexual disorders were identified as important factors in sexual satisfaction. No special test was used to measure mental and sexual disorders. The question for both was: no (no mental/sexual disorder present), yes (yes, mental/sexual disorder present).
The woman’s mood before sexual intercourse/sexual activity (α=0.920) as the first dimension. The second was the woman’s mood during intercourse/sexual activity (α=0.824). The third was the partner’s mood during intercourse/sexual activity (α=0.945), and the fourth was balance during intercourse/sexual activity (α=0.845). The independent variable was mood after sexual activity. The measurement was based on the theoretical dimensions of the variables in the questionnaire:
Sociocultural factors included the number of sexual intercourses per month (1 to 2; M = 3.06; SD = 1.849), feigned female orgasm (never; n = 2414; M = 1.85; SD = 1.067), and total lifetime number of sexual partners (1 to 2; M = 3.04; SD = 2.175), as well as the number of current sexual partners (one; M = 1.96; SD = 0.474).
The questionnaire had been previously used in Slovenia and validated and approved by the Medical Ethics Committee of the Republic of Slovenia (0120-200/2020/6). Due to the focus of the survey, we added questions that did not affect validity. The New Sexual Satisfaction Scale (NSSS – 20 items) questionnaire was originally intended for the female population only (22). With minor corrections, we adapted some items so that the questionnaire could be completed by heterosexual women, men, and heterosexual couples as well as homosexual women, men, and couples. We used a quantitative method of data collection with an adapted questionnaire. Using a questionnaire for women and men, we determined the prevalence of factors affecting sexual satisfaction. We identified possible differences between the male and female populations.
Pathophysiological factors were pain sensations during and after sexual intercourse. The question was for both: no (pain), yes (pain)
Statistical methods
We applied the quantitative method and used the SPSS 26.0 statistical computer program for the analysis. The following statistical analyses were performed: two-dimensional frequency tables (bivariate analysis, chi-square statistics); the method for determining internal consistency (Cronbach’s alpha) was used to evaluate the reliability of the items; the determination of the correlation between the proposed control variables was based on F-tests and linear regression analyses.
Results
Descriptive statistics
The demographic statistics of the sample are presented in Table 1.
Table 1. Demographic statistics.
| Participants characteristics | ||||||
|---|---|---|---|---|---|---|
| n | % | n | % | |||
| Age | Level of education | |||||
| from 18 to 23 | 1686 | 19.1 | completed elementary school | 91 | 1.0 | |
| from 24 to 29 | 1497 | 17.0 | completed secondary school | 2055 | 23.3 | |
| from 30 to 35 | 1383 | 15.7 | completed high school | 736 | 8.3 | |
| from 36 to 41 | 1462 | 16.6 | completed 1st level of university education | 1901 | 21.6 | |
| from 42 to 47 | 1233 | 14.0 | completed 2nd level of university education | 2734 | 31.0 | |
| from 48 to 53 | 776 | 8.8 | completed 3rd level of university education | 365 | 4.1 | |
| from 54 to 59 | 457 | 5.2 | I am still a student | 939 | 10.6 | |
| from 60 to 65 | 195 | 2.2 | Total | 8821 | 100 | |
| 66 years and more | 132 | 1.5 | ||||
| Total | 8821 | 100 | ||||
| n | % | n | % | |||
| Marital status | Sexual orientation | |||||
| single | 1392 | 15.8 | heterosexual relationship | 8235 | 93,4 | |
| married | 3235 | 36.7 | homosexual relationship | 219 | 2.5 | |
| widower | 40 | 0.5 | bisexual relationship | 325 | 3.7 | |
| divorced | 192 | 2.2 | other | 42 | 0.5 | |
| in a relationship (unmarried) | 3962 | 44.9 | Total | 8821 | 100 | |
| Total | 8821 | 100 | ||||
| n | % | n | % | |||
| No. of children | No. of total sexual partners | |||||
| 0 (zero) | 4083 | 46.3 | 1 do 2 | 3075 | 34.9 | |
| 1 | 1290 | 14.6 | 3 do 4 | 1703 | 19.3 | |
| 2 | 2347 | 26.6 | 5 do 6 | 1145 | 13.0 | |
| 3 | 809 | 9.2 | 7 do 8 | 658 | 7.5 | |
| 4 and more | 292 | 3.3 | 9 do 10 | 577 | 6.5 | |
| Total | 8821 | 100 | 11 do 12 | 260 | 2.9 | |
| 13 and more | 1403 | 15.9 | ||||
| Total 8821 | 100 | |||||
| n | % | n | % | |||
| No. of current sexual partners | No. of sexual intercourses per month | |||||
| 0 (zero) | 1015 | 11.5 | 1 do 2 | 2620 | 29.7 | |
| 1 | 7327 | 83.1 | 3 do 4 | 1515 | 17,2 | |
| 2 | 310 | 3.5 | 5 do 6 | 1283 | 14.5 | |
| 3 and more | 169 | 1.9 | 7 do 8 | 1052 | 11.9 | |
| Total | 8821 | 100.0 | 9 do 10 | 804 | 9.1 | |
| 11 and more | 1547 | 17.5 | ||||
| Total | 8821 | 100.0 | ||||
| n | % | n | % | |||
| Diagnosis of mental disorder | Diagnosis of sexual disorder | |||||
| no | 8295 | 94.0 | no | 8677 | 98.4 | |
| yes | 526 | 6.0 | yes | 144 | 1.6 | |
| Total | 8821 | 100.0 | Total | 8821 | 100.0 | |
Women were able to achieve one orgasm (n = 2082; 23.6%), two (n = 1164; 13.2%), three (n = 446, 5.1%), and four or more (n = 394; 4.5%). But 454 (5.1%) failed to achieve orgasm.
Most of the female representatives did not fake orgasm (n = 2414; 27.4), some rarely (n = 975; 11.1%), sometimes (n= 682; 7.7%), several times (n = 369; 4.2%), and always (n =100; 1.1%).
In the sample, most women found it easier to experience orgasm during masturbation (n = 2093; 23.7%), and 1998 representatives (22.7%) found it easier to experience with their partner. But 244 (2.8%) were unable to achieve orgasm with their partner and/or during masturbation.
Male and female representatives were asked to give their opinions on the reasons why women fake orgasms and the reasons why they do not have orgasms, according to sexual orientation (Table 2, Table 3).
Table 2. The reasons for faking female orgasms by sexual orientation.
| Heterosexual | Homosexual | Bisexual | ||||
|---|---|---|---|---|---|---|
| Claims | n | % | n | % | n | % |
| She wants the sex to end as soon as possible | 1514 | 18.4 | 37 | 16.9 | 101 | 31.1 |
| She does not want her partner to be disappointed | 2647 | 32.1 | 64 | 29.2 | 134 | 41.2 |
| She has never experienced an orgasm | 545 | 6.6 | 13 | 5.9 | 40 | 12.3 |
| She wants to feed the partner’s ego | 1194 | 14.5 | 34 | 15.5 | 88 | 27.1 |
| She does not enjoy sexual intercourse | 700 | 8.5 | 25 | 11.4 | 69 | 21.2 |
| She has no suitable sexual partner | 701 | 8.5 | 27 | 12.3 | 80 | 24.6 |
| Her partner does not know how to satisfy her | 952 | 11.6 | 41 | 18.7 | 93 | 28.6 |
Table 3. Common factors for not experiencing female orgasm by sexual orientation.
| Heterosexual | Homosexual | Bisexual | ||||
|---|---|---|---|---|---|---|
| Claims | n | % | n | % | n | % |
| Foreplay too short | 2094 | 25.4 | 45 | 20.5 | 117 | 36.0 |
| Sexual intercourse too short | 1348 | 16.4 | 29 | 13.2 | 79 | 24.3 |
| Disinterest of the partner | 1199 | 14.6 | 34 | 15.5 | 99 | 30.5 |
| Too little passion | 1726 | 21.0 | 34 | 15.5 | 97 | 29.8 |
| Ignorance of the partner | 1326 | 16.1 | 44 | 20.1 | 115 | 35.4 |
| She does not know how to enjoy | 734 | 8.9 | 11 | 5.0 | 38 | 11.7 |
| She does not allow to enjoy | 1469 | 17.8 | 32 | 14.6 | 83 | 25.5 |
| She does not know her body well | 1350 | 16.4 | 28 | 12.8 | 87 | 26.8 |
| She has no sexual desire for her partner | 1099 | 13.3 | 34 | 15.5 | 70 | 21.5 |
The male and female participants were also asked to give their opinion on the causes of the lack of erection (Table 4).
Table 4. Common factors for not experiencing erection by sexual orientation.
| Heterosexual | Homosexual | Bisexual | |||||
|---|---|---|---|---|---|---|---|
| Claims | n | % | n | % | n | % | |
| Foreplay too short | 742 | 9.0 | 17 | 7.8 | 47 | 14.5 | |
| Sexual intercourse too short | 1694 | 20.6 | 25 | 11.4 | 101 | 31.1 | |
| Disinterest of the partner | 1632 | 19.8 | 24 | 11.0 | 83 | 25.5 | |
| Too little passion | 754 | 9.2 | 14 | 6.4 | 49 | 15.1 | |
| He does not know how to enjoy | 484 | 5.9 | 12 | 5.5 | 27 | 8.3 | |
| He does not allow to enjoy | 870 | 10.6 | 18 | 8.2 | 50 | 15.4 | |
| He does not know his body well | 513 | 6.2 | 15 | 6.8 | 37 | 11.4 | |
| He has no sexual desire for his partner | 2041 | 24.8 | 53 | 24.2 | 118 | 36.3 | |
Women occasionally experienced pain sensations during and after vaginal intercourse (Table 5, Table 6).
Table 5. Pain sensation during and after vaginal intercourse by sexual orientation.
| During | After | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Heterosexual | Heterosexual | Bisexual | Heterosexual | Heterosexual | Bisexual | |||||||
| Claims | n | % | n | % | n | % | n | % | n | % | n | % |
| Never | 2424 | 29.4 | 59 | 26.9 | 116 | 35.7 | 2979 | 36.2 | 63 | 28.8 | 144 | 44.3 |
| A few times (less than half the time) |
778 | 9.4 | 10 | 4.6 | 42 | 12.9 | 437 | 5.3 | 14 | 6.4 | 26 | 8.0 |
| Sometimes (about half the time) | 232 | 2.8 | 7 | 3.2 | 12 | 3.7 | 105 | 1.3 | 2 | 0.9 | 7 | 2.2 |
| Most of the time (more than half the time) |
79 | 1.0 | 3 | 1.4 | 6 | 1.8 | 37 | 0.4 | 0 | 0.0 | 3 | 0.9 |
| Almost always or always | 86 | 1.0 | 79 | 36.1 | 6 | 1.8 | 41 | 0.5 | 0 | 0.0 | 2 | 0.6 |
Table 6. Location of pain sensation during and after sexual intercourse within sexual orientation.
| During | After | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Heterosexual | Heterosexual | Bisexual | Heterosexual | Homosexual | Bisexual | ||||||||
| Locations | n | % | n | % | n | % | n | % | n | % | n | % | |
| Just at the entrance to the vagina | 439 | 5.3 | 4 | 1.8 | 27 | 8.3 | 238 | 2.9 | 4 | 1.8 | 18 | 5.5 | |
| All over the vagina | 111 | 1.3 | 3 | 1.4 | 7 | 2.2 | 96 | 1.2 | 2 | 0.9 | 5 | 1.5 | |
| Lower half of the vagina (from the entrance to the half of the vagina) |
207 | 2.5 | 4 | 1.8 | 12 | 3.7 | 96 | 1.2 | 3 | 1.4 | 7 | 2.2 | |
| Upper half of the vagina (from half of the vagina to the cervix) |
168 | 2.0 | 3 | 1.4 | 8 | 2.5 | 42 | 0.5 | 2 | 0.9 | 2 | 0.6 | |
| Only in the upper part of the vagina (cervix) |
230 | 2.8 | 3 | 1.4 | 20 | 6.2 | 55 | 0.7 | 219 | 100.0 | 5 | 1.5 | |
| In the lower abdomen | 355 | 4.3 | 6 | 2.7 | 20 | 6.2 | 206 | 2.5 | 6 | 2.7 | 18 | 5.5 | |
We found a strong correlation between the theoretical dimensions and the variables. Male gender correlated strongly with balance in sex/activities. Female gender correlated with their mood before intercourse/activities, partner’s mood during intercourse/activities, and balance during intercourse/activities (Table 7).
Table 7. Correlation between gender and variables.
| Dimensions | F | p | Gender | |||
|---|---|---|---|---|---|---|
| 1 | Evaluate your sexual desire to the partner | 63.380 | 0.001 | female | ||
| 4 | The intensity of my sexual arousal | 10.280 | 0.001 | male | ||
| The intensity of my orgasms | 97.523 | 0.001 | ||||
| 2 | During sexual activity I indulge in sexual pleasure | 31.128 | 0.001 | |||
| 3 | Evaluation of the partner sexual activity | 641.565 | 0.001 | female | ||
| 4 | Evaluation of pleasure provided to my partner | 64.825 | 0.001 | |||
| The balance between what I give and receive during sexual | 154.421 | 0.001 | ||||
| The diversity of my sexual activity | 176.996 | 0.001 | ||||
| The frequency of my sexual activities | 166.982 | 0.001 | ||||
| 3 | My partner indulges in sexual pleasure | 581.273 | 0.001 | |||
| The way my partner takes care of my sexual needs | 566.231 | 0.001 | ||||
| My partner is sexually creative | 611.838 | 0.001 | ||||
| My partner is sexually available | 753.474 | 0.001 | ||||
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between age and variables
The age group from 18 to 23 correlated with mood before and during intercourse/sexual activity, partner’s mood during intercourse/sexual activity, balance during intercourse/sexual activity, and mood after sexual activity. The age groups from 30 to 35 and from 42 to 47 correlated only with mood in intercourse/sexual activity (Table 8).
Table 8. Correlation between age and variables.
| Dimensions | F | p | Age | |
|---|---|---|---|---|
| 1 | Evaluate your sexual desire to the partner | 44.934 | 0.001 | from 18 to 23 |
| 1 | The intensity of my sexual arousal | 21.585 | 0.001 | |
| 2 | The intensity of my orgasms | 9.247 | 0.001 | from 30 to 35, and from 42 to 47 |
| 2 | During sexual activity I indulge in sexual pleasure | 6.637 | 0.001 | from 18 to 23 |
| 3 | Evaluation of the partner sexual activity | 72.055 | 0.001 | |
| 1 | My sexual arousal to the partner | 31.951 | 0.001 | |
| 1 | My sexual response to my partner | 28.334 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 12.160 | 0.001 | |
| 5 | My mood after sexual activity | 10.616 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 28.897 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 26.950 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 64.650 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 71.225 | 0.001 | |
| 3 | My partner is sexually creative | 53.609 | 0.001 | |
| 3 | My partner is sexually available | 76.309 | 0.001 | |
| 2 | The diversity of my sexual activity | 35.004 | 0.001 | |
| 4 | The frequency of my sexual activities | 38.729 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between marital status and variables
The status “in a relationship” (“unmarried”) correlated with all five dimensions. With regard to the sensation of pain during vaginal intercourse, a strong correlation was found with single women (Table 9).
Table 9. Correlation between marital status and variables.
| Dimensions | F | p | Marital status | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 43.395 | 0.001 | in a relationship (unmarried) |
| 1 | The intensity of my sexual arousal | 19.620 | 0.001 | |
| 2 | The intensity of my orgasms | 43.533 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 27.788 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 48.085 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 27.351 | 0.001 | |
| 1 | My sexual response to my partner | 24.111 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 61.802 | 0.001 | |
| 5 | My mood after sexual activity | 38.097 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 28.036 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 26.694 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 45.706 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 42.980 | 0.001 | |
| 4 | My partner is sexually creative | 38.772 | 0.001 | |
| 4 | My partner is sexually available | 53.675 | 0.001 | |
| 4 | The diversity of my sexual activity | 23.980 | 0.001 | |
| 4 | The frequency of my sexual activities | 52.302 | 0.001 | |
| Pain sensation during vaginal intercourse | 8.916 | 0.001 | single |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between educational level and variables
Student status correlated with mood before and during intercourse/sexual activity, partner’s mood during intercourse/sexual activity, balance during intercourse/sexual activity, and mood after sexual activity. Completion of the 3rd level of university education correlated with mood before intercourse/sexual activity and mood after sexual activity. Elementary school education correlated with pain perception during and after vaginal intercourse (Table 10).
Table 10. Correlation between the level of education and variables.
| Dimensions | F | p | Level of education | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 15.664 | 0.001 | I am still a student |
| 1 | The intensity of my sexual arousal | 7.867 | 0.001 | completed 3rd level of univ. educ. |
| 2 | The intensity of my orgasms | 4.429 | 0.001 | still a student |
| 2 | During sexual activity I indulge in sexual pleasure | 4.187 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 25.832 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 13.589 | 0.001 | |
| 1 | My sexual response to my partner | 12.948 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 4.141 | 0.001 | |
| 5 | My mood after sexual activity | 5.809 | 0.001 | completed 3rd level of univ. educ., and still a student |
| 4 | Evaluation of pleasure provided to my partner | 8.644 | 0.001 | still a student |
| 4 | The balance between what I give and receive during sexual | 9.916 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 20.776 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 24.421 | 0.001 | |
| 3 | My partner is sexually creative | 20.564 | 0.001 | |
| 3 | My partner is sexually available | 26.442 | 0.001 | |
| 4 | The diversity of my sexual activity | 17.191 | 0.001 | |
| 4 | The frequency of my sexual activities | 19.414 | 0.001 | |
| Pain sensation during vaginal intercourse | 7.672 | 0.001 | completed elementary school | |
| Pain sensation after vaginal intercourse | 8.256 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between sexual orientation and variables
Sexual orientation as homosexual relationships correlated with all five dimensions (Table 11).
Table 11. Correlation between sexual orientation and variables.
| Dimensions | F | p | Sexual orientation | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 9.159 | 0.001 | homosexual relationship |
| 1 | The intensity of my sexual arousal | 3.212 | 0.022 | |
| 2 | The intensity of my orgasms | 2.183 | 0.088 | |
| 2 | During sexual activity I indulge in sexual pleasure | 4.988 | 0.002 | |
| 3 | Evaluation of the partner s sexual activity | 7.693 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 7.190 | 0.001 | |
| 1 | My sexual response to my partner | 7.650 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 7.330 | 0.001 | |
| 5 | My mood after sexual activity | 12.426 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 6.148 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 2.685 | 0.045 | |
| 3 | My partner indulges in sexual pleasure | 7.791 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 7.356 | 0.001 | |
| 4 | My partner is sexually creative | 5.712 | 0.001 | |
| 4 | My partner is sexually available | 8.326 | 0.001 | |
| 4 | The diversity of my sexual activity | 4.314 | 0.005 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood within sexual intercourse/activities, 3-My partner mood within sexual intercourse/activities, 4-My balance within sexual intercourse/activities, 5-My mood after sexual activity
Correlation between number of children and variables
In the sample, having 0 (zero) children correlated with all five dimensions. Having three children correlated with mood before intercourse/sexual activity, and having four or more children correlated with mood before and during intercourse/sexual activity and mood after sexual activity. Pain sensations during and after vaginal intercourse were found in women with no children (Table 12).
Table 12. Correlation between number of children and variables.
| Dimensions | F | p | No. of children | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 32.634 | 0.001 | 0 (zero) |
| 1 | The intensity of my sexual arousal | 14.349 | 0.001 | 3 and 4 and more |
| 2 | The intensity of my orgasms | 5.146 | 0.001 | 0 (zero) |
| 3 | Evaluation of the partner s sexual activity | 82.211 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 23.012 | 0.001 | |
| 1 | My sexual response to my partner | 21.836 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 8.583 | 0.001 | 4 and more |
| 5 | My mood after sexual activity | 4.678 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 18.691 | 0.001 | 0 (zero) |
| 4 | The balance between what I give and receive during sexual | 23.521 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 68.934 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 83.786 | 0.001 | |
| 3 | My partner is sexually creative | 70.854 | 0.001 | |
| 3 | My partner is sexually available | 96.205 | 0.001 | |
| 4 | The diversity of my sexual activity | 44.669 | 0.001 | |
| 4 | The frequency of my sexual activities | 53.519 | 0.001 | |
| Pain sensation during vaginal intercourse | 20.330 | 0.001 | ||
| Pain sensation after vaginal intercourse | 13.164 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between the total number of lifetime sexual partners and variables
The number of 1 to 2 lifetime sexual partners correlated with mood before and during intercourse/sexual activity and with partner mood during intercourse/sexual activity. Having 11 to 12 sexual partners correlated with mood during intercourse/sexual activity, partner’s mood during intercourse/sexual activity, and balance during intercourse/sexual activity. Pain sensations during vaginal intercourse were observed in women who had 1 to 2 sexual partners in their lifetime (Table 13).
Table 13. Correlation between the total number of lifetime sexual partners and variables.
| Dimensions | F | p | Total number of sexual partners | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 5.032 | 0.001 | 1 to 2 |
| 2 | The intensity of my orgasms | 4.994 | 0.001 | 11 to 12 |
| 2 | During sexual activity I indulge in sexual pleasure | 3.094 | 0.005 | |
| 3 | Evaluation of the partner s sexual activity | 4.981 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 2.300 | 0.032 | 1 to 2 |
| 2 | My emotional commitment during sexual activity | 6.854 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 7.970 | 0.001 | |
| 3 | My partner is sexually creative | 4.479 | 0.001 | |
| 3 | My partner is sexually available | 3.805 | 0.001 | |
| 4 | The frequency of my sexual activities | 3.041 | 0.006 | 11 to 12 |
| Pain sensation during vaginal intercourse | 4.229 | 0.001 | 1 to 2 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Having one current number of sexual partners correlated with mood before sexual intercourse/activity and mood after sexual activity. Having two current sexual partners correlated with mood before sexual intercourse/activity, and having with 3 or more correlated with mood before and during sexual intercourse/activity and with mood of the partner during sexual intercourse/activity (Table 14).
Table 14. Correlation between the current number of sexual partners and variables.
| Dimensions | F | p | Current number of sexual partners | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 131.374 | 0.001 | 1 |
| 1 | The intensity of my sexual arousal | 51.592 | 0.001 | 3 and more |
| 2 | The intensity of my orgasms | 105.589 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 75.208 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 49.709 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 88.149 | 0.001 | 2 |
| 1 | My sexual response to my partner | 80.432 | 0.001 | 3 and more |
| 2 | My emotional commitment during sexual activity | 119.662 | 0.001 | 2 |
| 5 | My mood after sexual activity | 101.419 | 0.001 | 1 |
| 4 | Evaluation of pleasure provided to my partner | 64.652 | 0.001 | 3 and more |
| 4 | The balance between what I give and receive during sexual | 65.937 | 0.001 | 1 |
| 2 | My partner indulges in sexual pleasure | 53.008 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 39.074 | 0.001 | 3 and more |
| 3 | My partner is sexually creative | 24.514 | 0.001 | |
| 3 | My partner is sexually available | 34.195 | 0.001 | |
| 4 | The diversity of my sexual activity | 53.822 | 0.001 | |
| 4 | The frequency of my sexual activities | 119.447 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between the number of sexual intercourses per month and variables
Eleven or more sexual contacts per month correlated with all five dimensions. With regard to the sensation of pain during and after vaginal intercourse, we found a correlation with women who had intercourse 1 to 2 times per month (Table 15).
Table 15. Correlation between the number of sexual intercourses per month and variables.
| Dimensions | F | p | Number of sexual intercourses per month | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 405.100 | 0.001 | 11 and more |
| 1 | The intensity of my sexual arousal | 230.107 | 0.001 | |
| 2 | The intensity of my orgasms | 168.977 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 215.498 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 488.593 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 283.491 | 0.001 | |
| 1 | My sexual response to my partner | 268.057 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 200.900 | 0.001 | |
| 5 | My mood after sexual activity | 209.853 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 241.373 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 338.412 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 391.265 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 460.640 | 0.001 | |
| 3 | My partner is sexually creative | 358.922 | 0.001 | |
| 3 | My partner is sexually available | 538.684 | 0.001 | |
| 4 | The diversity of my sexual activity | 430.952 | 0.001 | |
| 4 | The frequency of my sexual activities | 1200.577 | 0.001 | |
| Pain sensation during vaginal intercourse | 25.042 | 0.001 | 1 to 2 | |
| Pain sensation after vaginal intercourse | 11.961 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between the mental and sexual disorders and variables
We did not find correlations with dimensions in individuals suffering from a mental disorder. However, we found a correlation between mental disorders and pain perception during (F = 19.361; p = 0.000) and after (F = 26.870; p = 0.000) vaginal intercourse. We also found no correlations with the dimensions in those who suffered from sexual disorders, but we found a correlation with sexual disorders and pain perception during (F = 46.129; p = 0.000) and after (F = 38.463; p = 0.000) vaginal intercourse.
Correlation between achieved orgasm during sexual intercourse/activities and variables
For female participants who could achieve 4 or more orgasms during intercourse/activity, we found correlations with all five dimensions. Achieving up to 3 orgasms correlated with partner mood during intercourse/activity. In terms of pain perception during vaginal intercourse, we found a correlation with women who could not reach orgasm (Table 16).
Table 16. Correlation between achieved orgasm during sexual intercourse/activities and variables.
| Dimensions | F | p | Achieved orgasm | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 99.112 | 0.001 | 4 and more |
| 1 | The intensity of my sexual arousal | 128.168 | 0.001 | |
| 2 | The intensity of my orgasms | 444.080 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 193.229 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 69.771 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 111.253 | 0.001 | |
| 1 | My sexual response to my partner | 109.631 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 96.092 | 0.001 | |
| 5 | My mood after sexual activity | 162.408 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 50.084 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 120.031 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 55.234 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 101.487 | 0.001 | 3 |
| 3 | My partner is sexually creative | 74.133 | 0.001 | |
| 3 | My partner is sexually available | 44.553 | 0.001 | 3, and 4 and more |
| 4 | The diversity of my sexual activity | 79.276 | 0.001 | 4 and more |
| 4 | The frequency of my sexual activities | 51.181 | 0.001 | |
| Pain sensation during vaginal intercourse | 53.412 | 0.001 | can’t reach orgasm at all |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between faked orgasm and variables
We found no correlations in the participants who never faked orgasm. Regarding pain sensation during vaginal intercourse, we found a correlation with participants who always faked orgasm (Table 17).
Table 17. Correlation between faked orgasm and variables.
| Dimensions | F | p | Faked female orgasm | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 34.601 | 0.001 | never |
| 1 | The intensity of my sexual arousal | 30.009 | 0.001 | |
| 2 | The intensity of my orgasms | 114.160 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 64.737 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 30.164 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 26.683 | 0.001 | |
| 1 | My sexual response to my partner | 27.366 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 30.089 | 0.001 | |
| 5 | My mood after sexual activity | 50.114 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 19.147 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 49.202 | 0.001 | |
| 3 | My partner indulges in sexual pleasure | 27.658 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 46.138 | 0.001 | |
| 3 | My partner is sexually creative | 38.219 | 0.001 | |
| 3 | My partner is sexually available | 22.815 | 0.001 | |
| 4 | The diversity of my sexual activity | 24.933 | 0.001 | |
| 4 | The frequency of my sexual activities | 20.026 | 0.001 | |
| Pain sensation during vaginal intercourse | 35.702 | 0.001 | always | |
| Pain sensation after vaginal intercourse | 36.395 | 0.001 |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
Correlation between achieving orgasm with the partner or alone with masturbation and variables
In women who could reach orgasm with their partner, a correlation was found with all five dimensions. In terms of pain sensation during vaginal intercourse, we found a correlation with women unable to reach orgasm with their partner and/or with masturbation and/or others (Table 18).
Table 18. Correlation between achieved orgasm with the partner or alone with masturbation and variables.
| Dimensions | F | p | Reached female orgasm | |
|---|---|---|---|---|
| 1 | Rate your sexual desire to partner | 102.241 | 0.001 | with a partner |
| 1 | The intensity of my sexual arousal | 103.437 | 0.001 | |
| 2 | The intensity of my orgasms | 241.007 | 0.001 | |
| 2 | During sexual activity I indulge in sexual pleasure | 142.856 | 0.001 | |
| 3 | Evaluation of the partner s sexual activity | 92.560 | 0.001 | |
| 1 | My sexual arousal in relation to my partner | 108.988 | 0.001 | |
| 1 | My sexual response to my partner | 106.286 | 0.001 | |
| 2 | My emotional commitment during sexual activity | 95.680 | 0.001 | |
| 5 | My mood after sexual activity | 121.513 | 0.001 | |
| 4 | Evaluation of pleasure provided to my partner | 57.765 | 0.001 | |
| 4 | The balance between what I give and receive during sexual | 142.368 | 0.001 | |
| 2 | My partner indulges in sexual pleasure | 73.299 | 0.001 | |
| 3 | The way my partner takes care of my sexual needs | 127.599 | 0.001 | |
| 3 | My partner is sexually creative | 103.086 | 0.001 | |
| 3 | My partner is sexually available | 71.021 | 0.001 | |
| 4 | The diversity of my sexual activity | 98.682 | 0.001 | |
| 4 | The frequency of my sexual activities | 97.139 | 0.001 | |
| Pain sensation during vaginal intercourse | 22.124 | 0.001 | not with the partner and not with masturbation |
Legend: 1-My mood before sexual intercourse/activities, 2-My mood in sexual intercourse/activities, 3-My partner mood in sexual intercourse/activities, 4-My balance in sexual intercourse/activities, 5-My mood after sexual activity
To determine a possible correlation between the theoretical model and sexual orientation, we calculated a regression model and used a stepwise model. Most correlations were found in the heterosexual sexual orientation (Table 19). Table 19 shows that the predictors that determine the criterion of heterosexuality in the first dimension are age, number of children, number of sexual partners, diagnoses of mental disorders, as well as the number of orgasms experienced and the number of false orgasms. The second dimension of heterosexuality was determined by the place of residence, marital status, number of current sexual partners, diagnoses of mental disorders, as well as the number of orgasms experienced and the number of false orgasms. The third dimension of heterosexuality was determined by age, level of education, total number of sexual partners, current number of sexual partners, number of orgasms experienced, and number of fake orgasms. The fourth dimension of heterosexuality was determined by age, level of education, total number of sexual partners, current number of sexual partners, number of orgasms experienced, and number of fake orgasms. Predictors that determine homosexuality in the first dimension were age; in the second dimension predictors of homosexuality were age, number of children and age. The third dimension of homosexuality was determined by level of education, number of children, and age, while the fourth dimension was determined by the number of experienced female orgasms. The first dimension of bisexuality was determined by the diagnosis of sexual disorders and the number of false disorders. The second dimension of bisexuality was determined by the number of fake orgasms. The third dimension of bisexuality was determined by the number of fake orgasms and age, while the fourth dimension of bisexuality was determined by age.
Table 19. Regression model of sexual orientation and theoretical dimensions.
| Heterosexual | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | ||||||
| β | Sig. | β | Sig. | β | Sig. | β | Sig. | ||
| Country | .031b | 0.037 | -.041b | 0.007 | -.010b | 0.493 | .010b | 0.465 | |
| Age | -.150b | 0.001 | -.027b | 0.079 | -.094b | 0.001 | -.064b | 0.001 | |
| Marital status | .016b | 0.291 | .049b | 0.002 | .024b | 0.109 | .000b | 0.988 | |
| Level of education | .020b | 0.173 | .018b | 0.240 | .038b | 0.009 | .033b | 0.017 | |
| No. of children | -.085b | 0.001 | .019b | 0.219 | -.011b | 0.455 | -.002b | 0.895 | |
| No. of total sexual partners | -.058b | 0.001 | -.007b | 0.673 | -.110b | 0.001 | -.068b | 0.001 | |
| No. of current sexual partners | .020b | 0.201 | .065b | 0.001 | .046b | 0.002 | .056b | 0.001 | |
| Mental disorder diagnoses | -.068b | 0.001 | -.096b | 0.001 | -.058b | 0.001 | -.081b | 0.001 | |
| Sexual disorder diagnoses | -.002b | 0.870 | -.017b | 0.280 | .003b | 0.823 | -.002b | 0.914 | |
| No. of achieved female orgasms | -.071b | 0.001 | -.159b | 0.001 | -.068b | 0.001 | -.068b | 0.001 | |
| No. of faked orgasms | -.139b | 0.001 | -.252b | 0.001 | -.172b | 0.001 | -.157b | 0.001 | |
| Homosexual | |||||||||
| β | Sig. | β | Sig. | β | Sig. | β | Sig. | ||
| Age | -.173b | 0.091 | -.245b | 0.021 | -.147b | 0.158 | -.177b | 0.075 | |
| Marital status | .042b | 0.675 | .126b | 0.230 | -.030b | 0.774 | -.012b | 0.900 | |
| Level of education | .115b | 0.261 | .124b | 0.243 | .209b | 0.042 | .120b | 0.226 | |
| No. of children | -.140b | 0.167 | -.224b | 0.032 | -.232b | 0.023 | -.175b | 0.075 | |
| No. of total sexual partners | -.004b | 0.969 | .045b | 0.670 | .002b | 0.987 | -.034b | 0.732 | |
| No. of current sexual partners | -.100b | 0.323 | .010b | 0.927 | -.123b | 0.229 | -.134b | 0.171 | |
| Mental disorder diagnoses | .086b | 0.410 | .135b | 0.211 | .200b | 0.057 | .082b | 0.419 | |
| Sexual disorder diagnoses | .038b | 0.707 | -.098b | 0.349 | .021b | 0.838 | -.073b | 0.458 | |
| No. of achieved female orgasms | -.094b | 0.348 | -.097b | 0.353 | -.184b | 0.070 | -.217b | 0.025 | |
| No. of faked orgasms | -.029b | 0.776 | -.021b | 0.842 | .018b | 0.858 | -.001b | 0.990 | |
| Age | -.231b | 0.020 | -.335b | 0.001 | -.319b | 0.001 | -.254b | 0.008 | |
| Bisexual | |||||||||
| β | Sig. | β | Sig. | β | Sig. | β | Sig. | ||
| Age | .030b | 0.661 | -.044b | 0.524 | .002b | 0.972 | .022b | 0.744 | |
| Marital status | -.055b | 0.424 | -.015b | 0.827 | -.096b | 0.163 | .023b | 0.731 | |
| Level of education | -.017b | 0.811 | .039b | 0.585 | .066b | 0.365 | .034b | 0.621 | |
| No. of children | -.010b | 0.890 | .007b | 0.914 | .042b | 0.545 | .079b | 0.237 | |
| No. of total sexual partners | -.005b | 0.943 | -.030b | 0.661 | -.061b | 0.375 | .036b | 0.590 | |
| No. of current sexual partners | .008b | 0.915 | -.058b | 0.424 | -.138b | 0.060 | .005b | 0.944 | |
| Mental disorder diagnoses | -.039b | 0.588 | -.092b | 0.200 | -.081b | 0.264 | .004b | 0.951 | |
| Sexual disorder diagnoses | -.144b | 0.035 | -.127b | 0.063 | -.062b | 0.371 | -.091b | 0.169 | |
| No. of achieved female orgasms | -.096b | 0.161 | -.112b | 0.102 | -.003b | 0.961 | -.064b | 0.328 | |
| No. of faked orgasms | -.182b | 0.008 | -.170b | 0.012 | -.176b | 0.010 | -.070b | 0.289 | |
| Age | -.107b | 0.119 | -.272b | 0.000 | -.156b | 0.023 | -.163b | 0.012 | |
Legend: b. Predictors in the Model: (Constant), How_much_sexual_intercourse_do_you_have_per_month
The regression model (method: stepwise) was used to compare female pain perception during and after sexual intercourse and the independent variables. Except for marital status, educational level, and number of children, we found a correlation during and after sexual intercourse (Table 20).
Table 20. Regression model of female pain sensation during and after sexual intercourse.
| Heterosexual | Homosexual | Bisexual | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Independent variables | During | After | During | After | During | After | During | After | During | After | During | After |
| β | Sig. | β | Sig. | β | Sig. | β | Sig. | β | Sig. | β | Sig. | |
| Country | .157b | 0.001 | .116b | 0.001 | .133b | 0.201 | .169b | 0.111 | -.056b | 0.448 | .044b | 0.590 |
| Age | -.137b | 0.001 | -.071b | 0.001 | -.185b | 0.074 | -.204b | 0.053 | .031b | 0.668 | .038b | 0.611 |
| Marital status | .017b | 0.309 | -.030b | 0.071 | .096b | 0.363 | -.004b | 0.971 | .000b | 1.000 | .124b | 0.094 |
| Level of education | .015b | 0.378 | .013b | 0.430 | .048b | 0.647 | -.067b | 0.520 | .079b | 0.275 | -.018b | 0.861 |
| No. of children | -.153b | 0.001 | -.084b | 0.001 | -.019b | 0.853 | .019b | 0.858 | .074b | 0.311 | -.104b | 0.193 |
| No. of total sexual partners | -.075b | 0.001 | -.036b | 0.031 | .007b | 0.947 | .014b | 0.896 | -.088b | 0.223 | -.038b | 0.625 |
| No. of current sexual partners | -.037b | 0.031 | -.050b | 0.003 | .146b | 0.159 | .245b | 0.019 | -.049b | 0.500 | -.095b | 0.198 |
| Mental disorder diagnoses | .045b | 0.006 | -.074b | 0.001 | -.134b | 0.196 | .037b | 0.727 | -.105b | 0.147 | .077b | 0.303 |
| Sexual disorder diagnoses | .086b | 0.001 | .073b | 0.001 | .248b | 0.020 | .009b | 0.933 | .027b | 0.714 | .118b | 0.109 |
| No. of achieved female orgasms | .132b | 0.001 | .093b | 0.001 | .087b | 0.405 | .083b | 0.426 | .042b | 0.565 | .077b | 0.296 |
| No. of faked orgasms | .140b | 0.001 | .111b | 0.001 | .054b | 0.602 | .167b | 0.113 | .174b | 0.017 | .123b | 0.095 |
Legend: Heterosexual, during: b. Predictors in the Model: (Constant), How_much_sexual_intercourse_do_you_have_per_month; Hetrerosesual, after: b. Predictors in the Model: (Constant), Have_you_ever_faked_an_orgasm; Homosexual, during: b. Predictors in the Model: (Constant), Have_you_been_diagnosed_with_a_mental_disorder; Homosexual, after: b. Predictors in the Model: (Constant), Have_you_ever_faked_an_orgasm; Bisexual, during: b. Predictors in the Model: (Constant), Have_you_been_diagnosed_with_a_sexual_disorder; Bisexual, after: b. Predictors in the Model: (Constant), Age
Table 20 shows that heterosexuals showed significant correlation results after measurement, determined by predictors of place of residence, age, number of children, total number of sexual partners, current number of sexual partners, diagnosis of mental disorders, diagnosis of sexual disorders, number of female orgasms experienced, and number of fake orgasms. The criterion of homosexuality showed a statistically significant association after measurement for the predictor of the current number of sexual partners, while a statistically significant association in the criterion of bisexuality was observable after measurement for the predictor of the number of false orgasms.
Discussion
According to our results, the predictors that influence sexual satisfaction were classified into four general categories or groups of factors and determinants.
Demographic determinants
According to on our results, there was a significant inverse relationship between age and sexual satisfaction. Our international survey found statistically significant higher satisfaction among participants in the 18 to 23 age group after six main questions were asked for nine groups of different ages. The age group of 18 to 23 correlated with mood before and during intercourse/sexual activity, partner’s mood during intercourse/sexual activity, balance during intercourse/sexual activity, and mood after sexual activity. And the age groups from 30 to 35 and from 42 to 47 correlated only with mood during sexual intercourse/sexual activity. The results of some studies support this finding that the lower the age of the participants, the greater the sexual satisfaction (19, 20). Aulander (18) found that 85% of adolescents and young adults reported a sense of satisfaction in their sexual relationships (18). It appears that adolescents’ sexual activity is influenced by new commitments in their lives as they age, such as having a job or being involved in the care of for their children and other family and social responsibilities. The results of our study are at odds with those of Jalili’s study. He believed that husbands gradually learn to make love and these changes can lead to higher sexual satisfaction.
In this survey, the six main questions were asked in five groups of participants (single, married, divorced, widowed, and in a relationship). The results show that couples who were in a relationship (unmarried) had higher sexual satisfaction than most other groups. Divorced, single, and widowed women had lower scores than married and unmarried (in a relationship) women. “In a relationship (unmarried)” status correlates with all five dimensions. In terms of pain perception during vaginal intercourse, a strong correlation was found with single women. Moreover, the results show that marriage as such does not contribute to sexual satisfaction. In fact, the baseline model in Table 7 shows that married couples perform relatively poorly in this regard. Thus, it appears that it is not marriage that promotes sexual satisfaction, but rather the fact of having a partner. Since the correlation between marital status and sexual satisfaction was not as strong, it is possible that older couples have less desire or ability to perform sexually. The length of their relationship underscores a diminishing marginal effect, as shown by several longitudinal studies examining other effects of marriage over time (21).
This study examined the association between different levels of education and sexual satisfaction among women from different countries. It was predicted that higher levels of academic education would be associated with higher sexual satisfaction. Student status correlated with mood before and during intercourse/sexual activity, partner mood during intercourse/sexual activity, balance during intercourse/sexual activity, and mood after sexual activity. Completion of the third level of the university correlated with mood before intercourse/sexual activity and mood after sexual activity, but not during intercourse. Pain perception during and after vaginal intercourse correlated with women who completed elementary school. It appears that women with less schooling reported greater pain intensity and psychosocial distress compared with pain-free women.
Ji and Norling (23) also found a positive correlation between education and sexual satisfaction. They argue that education can influence economic stability. When couples are educated, they have a greater chance of achieving economic stability and thus higher marital and sexual satisfaction than couples with less formal education achieve. Although this is consistent with most previous studies, the study by Abdoly and Pourmousavi (24) found that the correlation between education level and sexual satisfaction was linear only for the under-doctoral group, while surprisingly, in the doctoral and post-doctoral groups, women’s sexual satisfaction scales decreased. They speculate that this lower sexual satisfaction could be caused by some factors, such as higher education, pressure on daily activity and increasing age; stressful conditions for students in obtaining a university degree, and greater efforts by women in obtaining a university degree.
The aim of the present study was to examine sexual satisfaction in the context of different sexual orientations. Because most research on sexual satisfaction has focused exclusively on heterosexual samples, we also examined homosexual and bisexual samples. In our study, homosexual sexual orientation correlated with all five dimensions.
However, it would be incorrect to claim that most homosexual people in most societies have excellent sexual health. Homosexual men and women are also subject to a system of inequality, and in many countries sexual orientation determines access to valued resources more than gender does. In almost every society, there are groups such as minorities, homosexuals, and transsexuals. The status of gay men and lesbian women is problematic in countries where there have been and continue to be numerous violations of their rights that have resulted in serious negative physical, psychological, and sexual consequences. Among gay men, sexual satisfaction was predicted by positive relationships characterized by emotionally intimate and loving relationships with others. This finding supports previous research by Deenen et al. (25), who found that intimacy, not frequency of sexual contact, determined sexual satisfaction among gay men. Taken together, these findings refute the stereotype that gay men prefer relationship-free sex to committed sexual relationships.
Additionally, in the study by Henderson et al. (26), the authors conducted an Internet survey of married heterosexual women and lesbian/bisexual women in committed same-sex relationships. Their results showed that for a similar constellation of factors (depressive symptoms, relationship satisfaction, sexual functioning, and social support) was related to sexual satisfaction both groups of women. For lesbian/bisexual women, internalized homophobia was an additional factor.
The present global study examined the association between sexual satisfaction and the number of children in an international sample. We found that the number of children was a significant negative predictor of sexual satisfaction. In the sample, having 0 (zero) children correlated with all five dimensions. Having three children correlated with mood before intercourse/sexual activity, and having four or more children correlated with mood before and during intercourse/sexual activity and mood after sexual activity. Pain sensations during and after vaginal intercourse were observed in women with no children. Our results are consistent with other studies (27) that have shown that the number of children can be considered a global negative correlate of sexual satisfaction. Parents with more children reported lower levels of sexual satisfaction. Previous studies have shown that parents from Western countries, generally considered more individualistic, experience lower marital and sexual satisfaction after the birth of their children (28). Therefore, we hypothesized that higher levels of individualistic values might be related to sexual satisfaction and number of children. Lalwani et al. (29) found that collectivists are more likely to engage in deception and socially desirable responses to maintain good relationships with others. In contrast, individualists are portrayed as open and sincere because individualism encourages people to “be themselves”. The authors assume that people with both types of cultural orientations and backgrounds engage in desirable behavior, albeit in different ways.
Sociocultural factors
Satisfaction in a sexual relationship requires interpersonal communication skills and attitudes, social skills, and conflict resolution. These skills lead to higher self-esteem, self-confidence, and self-concept in couples and are critical for a successful relationship and subsequent sexual intimacy. Teaching appropriate and satisfying life skills in the area of sexual activity in life leads to higher sexual satisfaction (4).
We also examined the correlation between the total number of sexual partners in life and the variables. Having 1 to 2 lifetime sexual partners correlated with mood before and during sex/ sexual activity and with partner mood during sex/sexual activity. Having 11 to 12 lifetime sexual partners correlated with mood during intercourse/sexual activities, mood of partner during intercourse/sexual activities, and balance during intercourse/sexual activities. Pain sensations during vaginal intercourse were observed in women who had 1 to 2 lifetime sexual partners.
The correlation between the number of sexual contacts per month and the variables showed that 11 or more sexual contacts per month correlated with all five dimensions. Regarding the sensation of pain during and after vaginal intercourse, we found a correlation with women who had intercourse 1 to 2 times per month.
The correlation between feigned orgasm and the variables showed no correlations regarding the participants who had never feigned orgasm. Regarding pain sensation during vaginal intercourse, we found a correlation with female subjects who always faked orgasm.
Psychological determinants
In the sample, we found 526 (6%) individuals with a diagnosed mental disorder and 144 (1.6%) with a sexual disorder. We found no correlations with the dimensions in individuals who were suffering from a mental disorder. However, we found a correlation between mental disorders and pain perception during and after vaginal intercourse. We also found no correlations with the dimensions in those who suffered from a sexual disorder, but we found a correlation with sexual disorders and pain perception during and after vaginal intercourse.
Overall, participants with mental and sexual disorders reported higher levels of sexual dissatisfaction. One of the most important determinants of sexual satisfaction is mental health (30, 31). In most studies, mental health is cited as the strongest determinant of sexual satisfaction. Thus, mental health refers to the fact that what people think and feel about their lives in general and in specific areas such as sex, interpersonal relationships, and physical and mental health depends on personal standards (31). Mental health, as a determinant that most strongly affects sexuality, and in particular sexual satisfaction, is defined as a person’s positive and rational evaluation of various aspects of life that balances positive feelings such as happiness, willpower, self-confidence, and a positive self-image with negative emotions such as anxiety, stress, and depression. People with mood, anxiety, and substance use disorders have elevated scores for sexual dissatisfaction, even when relevant confounding factors are accounted for. Sexual satisfaction appears to be most strongly influenced by alcohol, drug dependence, and bipolar disorder. Once the substance use disorder is overcome, there is still an association with current sexual dissatisfaction (32).
Pathophysiological determinants and pain
Dyspareunia, more recently referred to as Genito-Pelvic Pain/Penetration Disorder (GPPPD), is considered a negative factor affecting a couple’s sexual satisfaction and health. Reporting painful sex was closely related to other sexual function problems, particularly vaginal dryness, anxiety, and lack of sexual desire.
In our study, perceptions of pain during and after vaginal intercourse correlated with single women, women with less education, women who had only 1 to 2 lifetime sexual partners, and women who had intercourse 1 to 2 times per month.
However, we found a correlation between mental disorders and pain perception during and after vaginal intercourse. We also found a correlation between sexual disorders and pain perception during and after vaginal intercourse. We found a correlation with women who cannot achieve orgasm and those who always fake orgasm. The prevalence of pain in the population worldwide is estimated to range from 3% to 18%, and lifetime estimates range from 10% to 28%. The wide range reflects considerable heterogeneity in the methods used in prevalence studies (33). Underlying conditions are often difficult to diagnose and treat, and etiologic factors are complex and poorly understood. For this reason, among others, sexual pain disorders are often overlooked or poorly treated, which greatly increases patient distress (34, 35). Reporting painful sex was closely related to other problems of sexual function, particularly vaginal dryness, anxiety, and lack of pleasure from sex.
Study Limitations
The results of the present study should be interpreted in the context of its limitations. One limitation is the cross-sectional design of our study, which does not allow us to establish causality. Challenges in obtaining accurate measures of self-reported sexual behavior, such as recall error, bias due to social desirability, and poor understanding of survey questions, are well-documented in the literature35. The self-report questions used in the current study were translated by members of the research team, but they were not validated with samples from each country. In addition, the perception that God views sex negatively and high religious commitment could be sources of bias and threats to the validity of self-reported measures of sexual satisfaction in our study. Future research should incorporate measures of religiosity in longitudinal data to ensure that these associations are independent of religion and robust over time. Furthermore, we were aware that there was a possibility that respondents gave socially desirable answers. Lalwani et al. (29) found that collectivists are more likely to engage in deception and socially desirable responses to maintain good relationships with others. In contrast, individualists are portrayed as candid and sincere because individualism encourages people to “be yourself.” The authors propose that people with both types of cultural orientations and backgrounds engage in desirable responding albeit in distinct ways (29). The obtained results agree with previously published studies on the sexual satisfaction of respondents in the same and comparable populations (36, 37).
Conclusion
Sexual satisfaction is one of the physiological needs of humans that can be said to be more complex and yet more difficult to achieve than other needs. Our international study found statistically significantly higher satisfaction among homosexual individuals, participants aged 18 to 23 years, those with a higher level of education, with a current sexual partner, in a current partnered (unmarried) relationship, with 11 or more sexual contacts per month, and without a diagnosed mental and sexual disorder. At the same time, we found that the relationship between sexual satisfaction and the different determinants varied across countries, which calls for further research.
Ethical statement
We have received ethical approval for the study (Slovenia – ZF DEK 374/2021, Bosnia and Herzegovina – 0105-11761/21, Croatia – 251-379-10-21-02, Romania – No. 3320 (15.10.2021)).
Footnotes
Conflict of interests:
The authors declare no conflict of interests.”
Funding:
None.
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