Validation of the Orgasm Rating Scale in Context of Sexual Relationships of Gay and Lesbian Adults

Currently, no validated instrument exists for assessing the subjective experience of orgasm in the gay population. The Orgasm Rating Scale (ORS), previously validated in the heterosexual population, comprises four dimensions: Affective, Sensory, Intimacy, and Rewards. This study validated it for sexual relationships in the gay population by obtaining its factorial invariance by sexual orientation and sex, its internal consistency reliability, and evidence of validity in its relationship with other variables. We assessed 1600 cisgender Spanish adults–heterosexuals, gays, and lesbians–divided into 4, sex-based groups of 400 each, according to the Kinsey scale scores. Participants reported recent experiences of orgasm in the context of sexual relationships and responded to the ORS and other scales assessing attitude toward sexual fantasies and sexual functioning. The ORS structure showed a strict multigroup-level invariance by sexual orientation and sex, confirming its four-dimensional structure. The subjective orgasm intensity was associated with a positive attitude toward sexual fantasies and sexual functioning. Scores obtained on the Affective, Intimacy, and Rewards dimensions confirmed the ability to discriminate between gay people with and without orgasmic difficulties. The ORS’s Spanish version presents good psychometric properties as a validated scale to evaluate the subjective experience of orgasm in the gay population.

Associations Between Pornography Consumption, Sexual Flexibility, and Sexual Functioning Among Austrian Adults

To date, only a few studies have examined the associations between pornography consumption and sexual functioning. The Acquisition, Activation, Application Model (3AM) indicates that the frequency of pornography consumption and the perceived realism of pornography may influence whether sexual scripts are acquired from viewed pornography. Having sexual scripts that are alternative to their preferred sexual behaviors may help people switch to alternative sexual behavior when sexual problems arise. The current study analyzed whether frequent pornography consumption was associated with greater sexual flexibility and greater sexual functioning. Additionally, the perceived realism of pornography consumption was tested as a moderator of those associations. At an Austrian medical university, an online cross-sectional questionnaire study was conducted among 644 medical students (54% women and 46% men; Mage = 24.1 years, SD = 3.8). The participants were asked about their pornography consumption, partnered sexual activity, sexual flexibility, perceived realism of pornography, and sexual functioning. Manifest path analyses revealed direct and indirect associations between frequent pornography consumption and greater sexual functioning through greater sexual flexibility in women but not in men. Perceived realism did not moderate those associations. In conclusion, our study was in line with previous studies that found no significant associations between men’s pornography consumption and sexual functioning in men. However, some women may expand their sexual scripts and learn new sexual behaviors from pornography consumption, which may help with their sexual functioning.

Frailty and Differences in Self-Reported Sexual Functioning Among Older Females and Males in National Social life, Health and Aging Project

Objective To understand the association of frailty with females’ and males’ self-reported sexual functioning. Methods Logistic regression on 5 domains of sexual function by frailty status (robust, pre-frail, frail) were analyzed from 2058 respondents to National Social Life, Health, and Aging Project (2010–2011). Results Females had similar frailty profiles to males, but more often reported low overall sexual functioning (12.9% v. 4.0%). Compared to robust, pre-frail and frail males had higher odds of sexual function-related: anxiety (pre-frail OR 1.91 95% CI [1.33, 2.74]; frail OR 2.13 95% CI [1.03, 4.41]), negative changes (pre-frail: OR 1.40, 95% CI [1.00, 1.96]; frail: OR 2.42, 95% CI [1.51, 3.89]), and erectile dysfunction (pre-frail: OR 1.81, 95% CI [1.23,2.68]; frail: 2.00, 95% CI [1.00,4.02]); frail females had 1.69 times higher odds (95% CI [1.16,2.48]) of negative changes. Discussion Frailty may be a clinical indicator of sexual functioning decline for males more than females.

A sexual rehabilitation intervention for women with gynaecological cancer receiving radiotherapy (SPARC study): design of a multicentre randomized controlled trial

Background Sexual problems are frequently reported after treatment with radiotherapy (RT) for gynaecological cancer (GC), in particular after combined external beam radiotherapy and brachytherapy (EBRT+BT). Studies demonstrate that psychosexual support should include cognitive behavioural interventions and involvement of the patient’s partner, if available. Therefore, we developed a nurse-led sexual rehabilitation intervention, including these key components. The intervention was previously pilot-tested and results demonstrated that this intervention improves women’s sexual functioning and increases dilator compliance. The objective of the current study is to investigate the (cost-)effectiveness of the intervention compared to optimal care as usual (CAU). We expect that women who receive the intervention will report a statistically significant greater improvement in sexual functioning and – for women who receive EBRT+BT – higher compliance with dilator use, from baseline to 12 months post-RT than women who receive optimal care as usual (CAU). Methods/design The intervention is evaluated in the SPARC (Sexual rehabilitation Programme After Radiotherapy for gynaecological Cancer) study, a multicentre, randomized controlled trial (RCT). The primary endpoint is sexual functioning. Secondary outcomes include body image, fear of sexual activity, sexual-, treatment-related- and psychological distress, health-related quality of life and relationship satisfaction. A cost-effectiveness analysis (CEA) will be conducted in which the costs of the intervention will be related to shifts in other health care costs and the impact on patient outcome. The study sample will consist of 220 women with GC treated with RT in specialized GC treatment centres (N = 10). Participants are randomized to either the intervention- or CAU control group (1:1), and within each centre stratified by type of radiotherapy (EBRT+BT vs. EBRT only) and having a partner (yes/no). All women complete questionnaires at baseline (T1) and at 1, 3, 6, and 12 months post-RT (T2, T3, T4 and T5, respectively). Discussion There is a need to improve sexual functioning after RT for GC. This RCT will provide evidence about the (cost-)effectiveness of a nurse-led sexual rehabilitation intervention. If proven effective, the intervention will be a much needed addition to care offered to GC survivors and will result in improved quality of life. Trial registration ClinicalTrials.gov, NCT03611517. Registered 2 August 2018.