Delayed Ejaculation: Lasting Too Long

Those numerous men having trouble getting and keeping their erections may pray for their recalcitrant member to bisect the horizon from dawn till dusk and then some. But watch for what you pray for. There is a segment of the brotherhood of men who have been there and wish they could be done with it. Men who are unable to ejaculate during intercourse or in some cases, during any sexual activity in the presence of a partner, can suffer such frustration and embarrassment that they may wind up turned off to sex altogether.

A recent large survey found that 8% of men surveyed acknowledged having the experience of not being able to reach orgasm during intercourse at least once in the preceding year with many of those stating that it is an ongoing problem. An occasional misfire is a blip on the screen of one's sexual life -- no big deal. But when you keep lighting the fuse and don't get the fireworks -- well it's a problem. So what is a guy to do?

Never fear -- this is a problem with solutions. First, which head needs to be treated? If you can ejaculate during masturbation then there's a pretty good chance that the plumbing is hooked up and working right -- right? If you are having problems, even on your own, then there are some things to consider to help you sort out possible physical and psychological factors -- and you may need some professional help to do this.

Do you have a medical condition, such as diabetes, high blood pressure, or allergies? Are you taking medications for these or for anxiety or depression? Sometimes medications to treat such conditions have side effects that result in delayed ejaculation. If your problem coincided with the start of a new medication then make a beeline to your physician to discuss possibilities of substituting your medications for ones which mess less with the equipment.

Have you had prostate surgery? If so, you may remember being warned about the possibility of a "dry" or retrograde ejaculation. In this case, the ejaculatory fluid goes into the bladder instead of out the urethra. Although this is a permanent condition orgasms are still possible. A thorough evaluation and discussion with your physician or a medical specialist, such as a urologist, can either help you rule out or begin making health decisions that are sex-friendly.

If you have not had any health changes and/or this has been a longstanding (so to speak) problem, that has slowly gotten worse, then a different strategy is called for. In that case, your Energizer Bunny imitation (goes on and on and on) may be caused by any number of anxiety-related concerns. Some men have conscious and unconscious worries that block their ejaculations. They may worry about hurting the woman, about pregnancy, or they may have guilt about having sexual pleasure (often religious injunctions). They may have difficulties with intimacy and/or commitment. They may also be haunted by that nemesis of sexual dysfunctions -- performance anxiety. In other words, they are just plain trying too hard. In these instances, the man is so concerned about giving his partner pleasure that he loses track of his own.

Some men have a need for more vigorous touch to have an orgasm than is offered by the ever so pleasurable but soft and yielding vagina. These situations can be remedied with the following exercises. But sometimes when the problem has been around for a long time or the couple is locked in chronic patterns and impasses, the guidance of an experienced sex therapist that help the couple explore these issues and help them focus on pleasure, arousal and nondemanding touch.

The following five-step set of exercises should help you on your way. If you are asking how much time to spend on each step or how long others take to "finish" the steps see the above reference to performance anxiety. Each person and each couple has a unique pace. The goal is to be able to build trust, lower anxiety, and relax with your partner -- you have a lifetime to get to know and give pleasure to each other.

Step 1. The resolution begins with you talking with your partner about your concerns and admitting that it's a problem. It's amazing how frequently a man who has not ejaculated with his partner for years has somehow convinced her, and even himself, that the status quo is just fine. Orgasm may not be everything -- but it is also not nothing!

Step 2. After acknowledging and discussing the situation, the next major step is just as critical, and can be just as embarrassing -- masturbating to ejaculation with your partner present (which, as noted above, is possible in the vast majority of non-medical cases). After you are successful with that the rest is cake.

Step 3. Once you can relax enough to ejaculate with her present, simply substitute her hand for yours (i.e., allowing someone else to have that control).

Step 4. The next stage involves gradually ejaculating closer and closer to the vaginal opening.

Step 5. Finally, when you are comfortable with this and ready for the final stage tell your partner to pick a time, without telling you, and wait until you are very close to orgasm then she should insert the penis and let nature take its course. Voila!

A few final tips to maximize your success. First, do not masturbate without your partner once you start this sequence, because as you know, the more you ejaculate the lower your urgency and need becomes. Second, many men report that tensing and relaxing the muscles in their buttocks as they near orgasm can help trigger the contractions of ejaculation, so dust off the old Buttmaster. Next use a lot of lubrication both pre- and post-penetration. Finally, if the reason for you confronting this problem is to get your partner pregnant, agree to put off conceiving a child until at least three months following your completion of the above sequence. For many men there is nothing that immobilizes that sperm like the prospect of Daddyhood.

It may be hard to admit there is a problem with delayed ejaculation but it is a problem that rarely resolves by itself. Don't delay.

Dr. Al Cooper, clinical director at the San Jose Marital and Sexuality Centre, runs the training program for Counseling and Psychological Services at Stanford University. Dr. Cooper is internationally known for his work in sexuality and is freqently interviewed by the media. He currently writes a column in Men's Health Magazine.

Dr. Coralie Scherer coordinates online services for the Centre and specializes in sexual trauma, women's issues, and marital therapy.

APA Reference
Staff, H. (2021, December 26). Delayed Ejaculation: Lasting Too Long, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/delayed-ejaculation-lasting-too-long

Last Updated: March 26, 2022

Secrets to a Lasting Relationship

From "The Six Secrets to a Lasting Relationship."

  1. Time doesn't heal; truth heals.
  2. Ecstasy cannot last but it can carve a channel for something lasting.
  3. It is much easier to be alone before you've been in love than after.
  4. Marriage is our last best chance to grow up.
  5. Sex is a conversation carried out by other means.
  6. What you don't talk through grows into a wall you cannot break through.
  7. One of the greatest turn-ons is removing a turn-off.
  8. There is no greater or keener pleasure than that of bodily love.
  9. Cheat in a marriage by having an affair with your spouse.
  10. Maturity is doing the right thing even if you feel like doing the wrong thing.
  11. Parents only die to more effectively meddle in their children's affairs.
  12. Earn your own respect and you will earn your partner's too.
  13. Experience is a hard teacher because she gives the tests first and the lessons afterward.
  14. Take action when you fall out of like, and you won't fall out of love.
  15. The firmer you resolve to enjoy, the less you need to resolve.
  16. The rebel can never find peace.
  17. Think of what matters to them ahead of time, and you will matter to them all the time.
  18. Without emotional trust, you can't have emotional intimacy.
  19. Trust too much and you end up hurt; trust too little and you end up alone.
  20. Trust is in the eye of the beholder and in the behavior of the beheld.
  21. Trust but verify.
  22. After you've been hurt, the wrong lesson is don't trust again - the right lesson is to trust wisely.
  23. When you have earned forgiveness and your partner still won't forgive you, you are not unforgivable - they are unforgiving.
  24. Men and women are not from different planets. They are both from the planet earth.
  25. You can't put yourself in someone else's shoes and step on their toes at the same time.
  26. A successful marriage/relationship is an edifice that must be rebuilt every day.
  27. The truth is that everything you say and do, and everything you don't say and do, counts for something.

APA Reference
Staff, H. (2021, December 26). Secrets to a Lasting Relationship, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/relationships/healthy-relationships/secrets-to-a-lasting-relationship

Last Updated: February 2, 2022

Sexual Addiction Self Tests

If you answer yes to some of the 30 questions below, you may have a sexual addiction problem. The more yes answers, the more likely the problem is. If you would like more information about getting professional help to determine if you have a sexual addiction problem, visit our treatment section.

Remember, this test is for your own benefit and not intended to provide any type of professional diagnosis. You need to see a doctor about that.

YES -- NO

Yes No 1. Do you frequently fantasize or think about sex?
Yes No 2. Have you made promises to yourself or others to change or stop some of your sexual behavior, and then broken these promises?
Yes No 3. Does your sexual desire cause you to associate with people you wouldn't normally be with or do things you wouldn't usually do?
Yes No 4. Has frequenting sex sites on the internet for sexual stimulation become a habit for you?
Yes No 5. Do you frequently engage in sexual chat in sexually oriented chat rooms on the internet?
Yes No 6. Is masturbation a frequent activity for you?
Yes No 7. Do you have or have you had an extensive collection of pornography or other X-rated material?
Yes No 8. Have you gotten rid of a pornography collection and then started collecting it again?
Yes No 9. Do you with some regularity rent (or buy or make your own) X-rated videos?
Yes No 10. Do you like to "channel cruise" on TV to find sexually stimulating scenes, or do you subscribe to cable in order to view sexually explicit programs? Or do you stare at scrambled (blocked) sex channels for the occasional fragments of clear images of sexual material?
Yes No 11. Are you attracted to phone sex?
Yes No 12. Do you frequent topless clubs?
Yes No 13. Do you frequent modeling studios for sex?
Yes No 14. Do you go to massage businesses where you are able to obtain sexual massages?
Yes No 15. Do you frequent adult bookstores for sexual excitement or sexual activity?
Yes No 16. Do you frequent, or have you frequented X-rated movie theatres?
Yes No 17. Do you frequent other sexually-oriented businesses?
Yes No 18. Does your regular sex partner frequently complain about the amount of sex or the type of sex you desire with him or her? If you really think about it, could your demands of your partner be excessive or outside normal limits? Or, do you suspect that your regular sex partner submits to your requests that may be excessive but doesn't tell you?
Yes No 19. Have you violated your marriage or other relationship by having sex or affairs with others?
Yes No 20. Are you especially excited by sexual behavior that includes a risk of being caught?
Yes No 21. Do you get a sexual thrill from exposing your private body parts to unsuspecting onlookers?
Yes No 22. Do you have a habit of trying to get forbidden looks at people that give you sexual excitement?
Yes No 23. Is anonymous sex with others a frequent indulgence you seek, or one you periodically return to?
Yes No 24. Do you take advantage of opportunities to touch people sexually that you find attractive by touching them in a way that makes it seem accidental?
Yes No 25. Are you an adult who engages in sexual activity with children?
Yes No 26. Are you an adult who forces other adults to have sex with you against their will?
Yes No 27. Have you been, or could you be arrested because of some of your sexual behavior?
Yes No 28. Does some of your sexual activity cause you to have a secret life hidden from significant others?
Yes No 29. Does your sexual behavior or fantasy sometimes make you feel hopeless or depressed?
Yes No 30. Have you been told by someone that your sexual behavior is excessive, inappropriate, or out of control?

If you answered yes to more than one of these questions, we would encourage you to seek out additional literature as a resource or to attend a Sex Addicts Anonymous meeting to further assess your needs.


A Useful Tool for Self-Assessment

Answer these twelve questions to assess whether you may have a problem with sexual addiction.

Remember, this test is for your own benefit and not intended to provide any type of professional diagnosis. You need to see a doctor about that.

Yes No 1. Do you keep secrets about your sexual or romantic activities from those important to you? Do you lead a double life?
Yes No 2. Have your needs driven you to have sex in places or situations or with people you would not normally choose?
Yes No 3. Do you find yourself looking for sexually arousing articles or scenes in newspapers, magazines, or other media?
Yes No 4. Do you find that romantic or sexual fantasies interfere with your relationships or are preventing you from facing problems?
Yes No 5. Do you frequently want to get away from a sex partner after having sex? Do you frequently feel remorse, shame, or guilt after a sexual encounter?
Yes No 6. Do you feel shame about your body or your sexuality, such that you avoid touching your body or engaging in sexual relationships? Do you fear that you have no sexual feelings, that you are asexual?
Yes No 7. Does each new relationship continue to have the same destructive patterns which prompted you to leave the last relationship?
Yes No 8. Is it taking more variety and frequency of sexual and romantic activities than previously to bring the same levels of excitement and relief?
Yes No 9. Have you ever been arrested or are you in danger of being arrested because of your practices of voyeurism, exhibitionism, prostitution, sex with minors, indecent phone calls, etc.?
Yes No 10. Does your pursuit of sex or romantic relationships interfere with your spiritual beliefs or development?
Yes No 11. Do your sexual activities include the risk, threat, or reality of disease, pregnancy, coercion, or violence?
Yes No 12. Has your sexual or romantic behavior ever left you feeling hopeless, alienated from others, or suicidal?

If you answered yes to more than one of these questions, we would encourage you to seek out additional literature as a resource or to attend a Sex Addicts Anonymous meeting to further assess your needs.

APA Reference
Staff, H. (2021, December 25). Sexual Addiction Self Tests, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/sexual-addiction/sexual-addiction-self-tests

Last Updated: March 26, 2022

12-Step Programs For Sexual Addiction

Programs for Sex Addicts

Sex Addicts Anonymous (SAA)
For people interested in recovery from their sexual addiction. (Some meetings are for men only, some for women only, and some mixed.)

Phone: (713) 869-4902
Address: International Service Organization of SAA (or ISO of SAA)
P.O. Box 70949
Houston, TX 77270
saa-recovery.org

Sex and Love Addicts Anonymous (SLAA)
For people wanting recovery from patterns of addictive relationships where love, romance, and sex are the addictive focus.

Address: The Augustine Fellowship, SLAA
1550 NE Loop 410, Ste. 118
San Antonio, TX. 78209
Website: www.slaafws.org

Sexaholics Anonymous (SA)
For sexually addicted people looking for a recovery program with a more specific definition of what recovery is. (Seems to appeal particularly to heterosexual men.)

Phone: (615) 331-6230
Address: P. O. Box 111910
Nashville, TN 37222-1910
Website: https://www.sa.org/

Sexual Compulsives Anonymous (SCA)
For sexually compulsive people seeking recovery. (Founded by gay men and open to people of all sexual orientations. Web site has online meetings.)

Phone: 1-800-977-4325 ( 1-800-977-HEAL) International: +1 212 606 3778
Address: P. O. Box 1585, Old Chelsea Station
New York, NY 10011-0935
www.sca-recovery.org/

Programs for Partners of Sex Addicts

Codependents of Sexual Addiction (COSA)
For those whose lives have been affected by another person's compulsive sexual behavior and who seek support and recovery from their own addictive patterns with their sexually addicted partners or others. (Majority of meetings usually women's meetings, though isolated mixed and men's meetings may be found.)

COSA ISO
PO Box 14537
Minneapolis MN 55414
U.S.A.
Phone: (763) 537-6904
E-mail: info@cosa-recovery.org

http://www.cosa-recovery.org/face2face.html

Co-Sex and Love Addicts Anonymous (CO-SLAA)
For partners of sex and love addicted people seeking support and recovery from their own addictive patterns with their sex and love addicted partners.
Phone: (617) 332-1845
Address: P. O. Box 650010
West Newton, MA 02165-0010

Programs for Couples

Recovering Couples Anonymous
For couples in which addiction (not just sex addiction) and codependency exist, who desire recovery from their addictive behavior with each other.

Phone: (314) 830-2600
Address: P. O. Box 11872
St. Louis, MO 63105
Website: https://recovering-couples.org/

APA Reference
Staff, H. (2021, December 25). 12-Step Programs For Sexual Addiction, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/sexual-addiction/12-step-programs-for-sexual-addiction

Last Updated: March 26, 2022

Psychological Factors and the Sexuality of Pregnant and Postpartum Women

Sexual desire in the majority of women generally decreases during pregnancy, although there may be a wide range of individual responses and fluctuating patterns (e.g., Barclay, McDonald, & O'Loughlin, 1994; Bustan, Tomi, Faiwalla, & Manav, 1995; Hyde, DeLamater, Plant, & Byrd, 1996). By the third trimester of pregnancy, approximately 75% of primigravidae report a loss of sexual desire (Bogren, 1991; Lumley, 1978.) A decrease in the frequency of sexual intercourse during pregnancy is generally associated with a loss of sexual desire (e.g., Bogren, 1991; Lumley, 1978). By the third trimester, between 83% (Bogren, 1991) and 100% (Lumley, 1978) of primigravidae reported a decrease in the frequency of sexual intercourse.

The general conclusion from empirical studies and clinical impressions is that many postpartum women continue to report a decline in sexual interest, desire, or libido (Fischman, Rankin, Soeken, & Lenz, 1986; Glazener, 1997; Kumar, Brant, & Robson, 1981). Women's loss of sexual desire generally leads to less sexual activity, and to loss of sexual satisfaction, although the association between these facets is far from linear (Lumley, 1978). Hyde et al. (1996) found that 84% of couples reported reduced frequency of sexual intercourse at 4 months postpartum. Enjoyment of sexual intercourse tends to return gradually after childbirth. Lumley (1978) found that there was a linear increase in the percentage of women who found intercourse enjoyable after birth, from nil at 2 weeks to about 80% at 12 weeks. Similarly, Kumar et al. (1981) found that, at 12 weeks after childbirth, about two-thirds of the women found sex "mostly enjoyable," although 40% complained of some difficulties.

It is clear from the above studies that a significant proportion of women experience reduced sexual desire, frequency of intercourse, and sexual satisfaction over the perinatal period. However, less attention has been given to the magnitude of those changes, or to the factors that may contribute to them. This is the focus of this study.

LITERATURE REVIEW

A review of the literature suggests that six factors may be related to reduced sexual desire, frequency of sexual intercourse, and levels of sexual satisfaction during the postpartum period. These factors appear to be an adjustment to changes in social roles (work role, mother role) of women during the transition to parenthood, marital satisfaction, mood, fatigue, physical changes associated with the birth of the child and breastfeeding. The role of each of these factors will be discussed in turn.

The perceived quality of social roles has been found to influence individual well-being and relationships (e.g., Baruch & Barnett, 1986; Hyde, DeLamater, & Hewitt, 1998). However, the impact of social roles on women's sexuality over the transition to parenthood has not been the subject of extensive empirical research. Only two published studies were located which examined the influence of women's paid employment on their sexuality during pregnancy and the early postpartum period (Bogren, 1991; Hyde et al., 1998). Bogren (1991) found no relationship between work satisfaction and sexual variables during pregnancy. However, insufficient information was provided regarding how work satisfaction was measured, nor were separate analyses reported for women and men. The larger study of Hyde et al. (1998) found that there were no significant differences between groups of homemakers, women employed part-time, and women employed full time in their frequency of decreased sexual desire, nor in overall frequency of intercourse, nor sexual satisfaction at 4 or 12 months postpartum. Women's positive work-role quality was associated with a greater frequency of sexual intercourse during pregnancy, and greater sexual satisfaction and less frequent loss of sexual desire at 4 months postpartum. Nonetheless, work-role quality predicted relatively small amounts of variance in the sexual outcomes.

For most women, motherhood is a very positive experience (Green & Kafetsios, 1997). Recent mothers have reported that the best things about being a mother were watching a child's development, the love they received from children, being needed and responsible for the child, giving love to the child, helping to shape the child's life, having the child's company, and feeling contented (Brown, Lumley, Small, & Astbury, 1994).

The negative aspects of the mother role included confinement or lacking uninterrupted time and freedom to pursue personal interests (Brown et al., 1994). Other concerns were not having an active social life, needing a break from the demands of the child, inability to control or define the use of time, loss of confidence, and difficulties in coping with their infants' feeding and sleeping patterns. By 6 months postpartum, many infants' sleeping and feeding difficulties have been resolved. However, other aspects of infants' behaviors become more challenging (Koester, 1991; Mercer, 1985).

There is little empirical evidence that difficulties in the mother role are directly related to women's sexual functioning in the postpartum. Pertot (1981) found some evidence to tentatively suggest that problems in women's postpartum sexual responsiveness were related to difficulties with the mother role since one of the adoptive mothers reported definite loss of sexual desire. It was expected that difficulties in the mother role would affect women's sexuality due to a general diminution of their well-being and disruption to their relationship with their partners.

A large body of research has demonstrated that the addition of the first child to the parental dyad results in a decrease in marital quality (see a review by Glenn, 1990). Evidence supporting a marital satisfaction decline across the transition to parenthood has been found in studies from many different countries (Belsky & Rovine, 1990; Levy-Shift, 1994; Wilkinson, 1995). After an initial "honeymoon" period in the first postpartum month, the trend to lower marital satisfaction becomes stronger by the third month postpartum (Belsky, Spanier, & Rovine, 1983; Miller & Sollie, 1980; Wallace & Gotlib, 1990). Different aspects of the marital relationship are reported to decline. By 12 weeks postpartum, there is evidence of a reduction in women's reported love for their partners (Belsky, Lang, & Rovine, 1985; Belsky & Rovine, 1990), and a decline in affectional expression (Terry, McHugh, & Noller, 1991).

Relationship satisfaction has been associated with measures of women's sexuality in the postpartum (Hackel & Ruble, 1992; Lenz, Soeken, Rankin, & Fischman, 1985; Pertot, 1981). However, none of the studies examined provided clear evidence of the relative contribution of relationship satisfaction to the prediction of changes in women's sexual desire, sexual behavior, and sexual satisfaction during pregnancy and after childbirth.

The extent to which the above changes in sexuality are due to changes in mood has received little attention. Evidence from self-report depressive symptom rating scales has consistently found higher scores antenatally than postnatally, although little is known about the relative severity of antenatal depression (see a review by Green & Murray, 1994).

Childbirth is known to increase women's risk of depression (Cox, Murray, & Chapman, 1993). A meta-analysis indicated that the overall prevalence rate of postnatal depression (PND) is 13% (O'Hara & Swain, 1996). An estimated 35% to 40% of women experience depressive symptoms in the postpartum which fall short of meeting the criteria for a diagnosis of PND, yet they experience considerable distress (Barnett, 1991).

Difficulty in the marital relationship is an established risk factor for PND (O'Hara & Swain, 1996). PND is also associated with women's loss of sexual desire after childbirth (Cox, Connor, & Kendell, 1982; Glazener, 1997), and infrequent intercourse at 3 months postpartum (Kumar et al., 1981). Elliott and Watson (1985) found an emerging relationship between PND and women's decreased sexual interest, enjoyment, frequency, and satisfaction by 6 months postpartum, which reached significance by 9 and 12 months postpartum.

Fatigue is one of the most common problems women experience during pregnancy and the postpartum (Bick & MacArthur, 1995; Striegel-Moore, Goldman, Garvin, & Rodin, 1996). Fatigue or tiredness and weakness are almost universally given by women as reasons for loss of sexual desire during late pregnancy and in the postpartum (Glazener, 1997; Lumley, 1978). Similarly, at approximately 3 to 4 months postpartum, fatigue was frequently cited as a reason for infrequent sexual activity or sexual enjoyment (Fischman et al., 1986; Kumar et al., 1981; Lumley, 1978). Hyde et al. (1998) found that fatigue accounted for considerable variance in postpartum women's decreased sexual desire, although at 4 months postpartum fatigue did not significantly add to the prediction of decreased desire after depression had been first entered into regression analysis.

The physical changes associated with birth and the postpartum may influence women's sexuality. During childbirth, many women experience tearing or episiotomy and perineal pain, particularly when they have had an assisted vaginal delivery (Glazener, 1997). Following childbirth, dramatic hormonal changes cause the vaginal wall to become thinner and to lubricate poorly. This commonly causes vaginal soreness during intercourse (Bancroft, 1989; Cunningham, MacDonald, Leveno, Gant, & Gistrap, 1993). Dyspareunia may persist for many months after childbirth (Glazener, 1997). Perineal pain and dyspareunia due to childbirth morbidity and vaginal dryness have been shown to be related to women's loss of sexual desire (Fischman et al., 1986; Glazener, 1997; Lumley, 1978). Experiencing pain or discomfort with sexual intercourse is likely to discourage women from desiring sexual intercourse on subsequent occasions, and to reduce their sexual satisfaction.

Strong evidence indicates that breastfeeding reduces women's sexual desire and frequency of intercourse in the early postpartum period (Forster, Abraham, Taylor, & Llewellyn-Jones, 1994: Glazener, 1997; Hyde et al., 1996). In lactating women, high levels of prolactin, maintained by the baby's suckling, suppress ovarian estrogen production, which results in reduced vaginal lubrication in response to sexual stimulation.

The principal aim of this study was to examine influences of psychological factors on changes from prepregnancy levels of women's sexual desire, frequency of intercourse, and sexual satisfaction during pregnancy and at 12 weeks and 6 months postpartum.

It was expected that during pregnancy and at 12 weeks and 6 months postpartum women would report a significant decrease in sexual desire, frequency of sexual intercourse, and sexual satisfaction compared to their pre-pregnancy levels. It was expected that women's reported relationship satisfaction would not change during pregnancy, but would decrease at 12 weeks and 6 months postpartum compared to their pre-pregnancy levels. Lower role quality and relationship satisfaction and higher levels of fatigue and depression were expected to predict changes to women's levels of sexual desire, frequency of sexual intercourse, and sexual satisfaction during pregnancy and at 12 weeks and 6 months postpartum. Dyspareunia and breastfeeding were also expected to have a negative influence on women's sexuality in the postpartum.

METHOD

Participants

One hundred and thirty-eight primigravidae who were recruited at antenatal classes at five sites participated in the study. The participants' ages ranged from 22 to 40 years (M = 30.07 years). The partners of the women were aged from 21 to 53 years (M = 32.43 years). Data from four women were excluded from the analyses during pregnancy, as they were not yet in the third trimester. Responses were received from 104 women from this original group at 12 weeks postpartum, and 70 women at 6 months postpartum. It is unknown why there was a decline in response rate over the course of the study, but given the demands of caring for a young baby, it is likely that a substantial level of the attrition was related to a preoccupation with this task.

Materials

Participants completed a questionnaire package in the third trimester of pregnancy, and at 12 weeks and 6 months postpartum, which elicited the following information.

Demographic data. Date of birth, country of birth, occupation of both women and partners, the women's education level, and date of completion of the questionnaire were collected on the first questionnaire. The first questionnaire asked the expected date of the birth of the child. The second questionnaire asked the actual date of birth, and whether the mother experienced tearing or episiotomy. The second and third questionnaires asked whether sexual intercourse had been resumed following the birth. Participants who had resumed intercourse were asked "Are you currently experiencing physical discomfort with sexual intercourse which was not present before the birth?" Response choices ranged from 0 (None) to 10 (Severe). The second and third questionnaires asked whether the woman was currently breastfeeding.

Role quality scales. Work-role and Mother-role scales developed by Baruch and Barnett (1986) were used to determine role quality. Several questions on Baruch and Barnett's Mother-role scale were adjusted from those used for midlife women to make the scale more relevant to the anticipated role and actual role as the mother of an infant. Each scale lists an equal number of reward and concern items. The Work-role reward and concern subscales each contained 19 items, and the Mother-role subscales each contained 10 items. Participants used a 4-point scale (from Not at all to Very) to indicate to what extent items were rewarding or a concern. Each participant received three scores per role: a mean reward score, a mean concern score, and a balance score that was calculated by subtracting the mean concern score from the mean reward score. The balance score indicated role quality. The alpha coefficients for the six scales were reported to range from .71 to .94. In the current study, the alpha coefficients for the Work-role scale were .90 during pregnancy, .89 at 12 weeks postpartum, and .95 at 6 months postpartum. The alpha coefficients for the Mother-role scale were .82 during pregnancy, .83 at 12 weeks postpartum, and .86 at 6 months postpartum.

Depression scale. The 10-item Edinburgh Postnatal Depression Scale (EPDS) (Cox, Holden, & Sagovsky, 1987) is widely used as a community screening tool for postpartum depression. Each item is scored on a 4-point scale according to severity of symptoms, with a potential range from 0 to 30. The EPDS has been validated for antenatal use (Murray & Cox, 1990). The EPDS has increasingly been used for research as a linear indicator of dysphoria or distress (Green & Murray, 1994). The alpha coefficients for the EPDS in the current study were .83 during pregnancy, .84 at 12 weeks postpartum, and .86 at 6 months postpartum.

Fatigue scale. The 11-item self-rating Fatigue Scale was developed by Chalder et al. (1993) to measure the severity of subjective perceptions of fatigue. Respondents choose one of four responses to each item: better than usual, no more than usual, worse than usual, and much worse than usual. Scale scores potentially range from 11 to 44. In the current study, the scale had a coefficient alpha of .84 during pregnancy, .78 at 12 weeks postpartum, and .90 at 6 months postpartum.

Relationship satisfaction scale. Nine items from the 12-item Quality of Relationship subscale from the Sexual Function Scale (McCabe, 1998a) were administered for each wave of data collection. On the first administration, participants were asked to recall how items applied before conception, and also "now, during pregnancy." Items were measured on a 6-point Likert Scale ranging from 0 (Never) to 5 (Always). The 12-item Quality of Relationship subscale is reported to have a test-retest reliability of .98, and a coefficient alpha of .80 (McCabe, 1998a). In the current study, the scale had a coefficient alpha of .75 for baseline (before conception) and .79 during pregnancy, .78 at 12 weeks postpartum, and .83 at 6 months postpartum.

Sexual desire scale. Nine items asking about level of sexual desire were drawn from an earlier version of the Sexual Function Scale (SFS) (McCabe, 1998a). Desire is defined as "interest in or wish for sexual activity." Items referred to frequency of desire for sexual activity, frequency of sexual thoughts, strength of desire in different situations, the importance of fulfilling sexual desire through activity with a partner, and desire for masturbation. Three items asking about frequency of desire provided for a range of responses from 0 (Not at all) to 7 (More than ... or Many times a day). Six items sought a response on a 9-point Likert Scale, ranging from 0 to 8. Item scores were summed to provide a score ranging from 0 to 69. On the first administration, participants were asked to recall how items applied before conception and "now, during pregnancy." No previous psychometric data were available on the scale: however, the questions have face validity, and in the current study had an acceptable coefficient alpha of .74 at baseline, .87 during pregnancy, .85 at 12 weeks postpartum, and .89 at 6 months postpartum.

Frequency of sexual intercourse. In the first administration, respondents were asked to recall how often they typically had intercourse before conception (not just when they were trying to conceive), and during pregnancy and at 12 weeks and 6 months postpartum they were asked "How often do you typically have intercourse?". Respondents chose one of six fixed categories: rarely, not often (1-6 times a year), now and then (once per month), once a week, several times a week, or daily or more.

Sexual satisfaction scale. Nine items relating to female sexual satisfaction drawn from the Sexual Dysfunction Scale (McCabe, 1998b) were administered at each wave of data collection. Baseline required retrospective recall of how items applied before conception. Items included how often sexual activity with the partner was enjoyable, the partner's sensitivity as a lover, and the woman's own sexual responses. Items were measured on 6-point Likert Scale ranging from 0 (Never) to 5 (Always). Five items were reverse scored. Responses on these nine items were summed to provide a score which ranged from 0 to 45. The items all had face validity; however, no data were available on reliability for this subscale. In the current study, the scale had a coefficient alpha of .81 at baseline, .80 during pregnancy, .81 at 12 weeks postpartum, and .83 at 6 months postpartum.

Procedure

Written permission was obtained from four Melbourne metropolitan hospitals and one independent childbirth educator to recruit women attending antenatal classes to participate in the study. The study was approved by the Ethics Committees of each of the hospitals. In an endeavor to obtain a sample from a diverse socioeconomic group, a large public hospital group with a number of different childbirth education sites and three smaller private sector hospitals were included.

The researcher briefly addressed the classes, explained the purpose and requirements of the study, handed out a printed outline of the study, and answered questions about the study. The criteria for inclusion in the study were that each woman be over the age of 18, expecting her first child, and cohabiting with a male partner. Those who wished to participate were provided with a questionnaire package in an unsealed envelope. Return postage was prepaid and responses were anonymous. Informed Consent forms were sent back in the separate self-addressed envelopes provided. Informed Consent forms sought the names and addresses of participants and the anticipated dates of the babies' births so that follow-up questionnaires could be sent out at approximately 2 and 5 months after the birth. Responses to the later questionnaires were matched by the dates of birth of women and their partners, which were included in each wave of data collection.

At approximately 2 months after the expected date of birth, questionnaires were mailed requesting the completion of the questionnaires at 12 weeks after the birth. Responses were received from 104 women, a response rate of 75%. The periods since birth of the completed questionnaires ranged from 9 weeks to 16 weeks, mean = 12.2 weeks, SD = .13.

At 5 months postpartum, questionnaires were sent to 95 of the 138 women who participated in the first wave of data collection, and who met the criteria for inclusion in the postpartum studies. The remainder were omitted because at the time limit for collection of data for the current study they had not reached 6 months postpartum. Responses were received from 70 women, a response rate of 74%. Multivariate analyses of variance indicated that there were no significant differences between responders and nonresponders on any of the demographic variables at 12 weeks and 6 months postpartum, nor on the dependent or independent variables assessed at both prepregnancy and during pregnancy.

RESULTS

To determine whether women reported significant decreases in sexual desire, frequency of sexual intercourse, relationship satisfaction, and sexual satisfaction during pregnancy and at 12 weeks and 6 months postpartum compared to their recalled prepregnancy levels, a series of repeated measures MANOVA analyses were conducted with levels of time (prepregnancy, pregnancy, 12 weeks postpartum, and 6 months postpartum) as the independent variable, and sexual desire, frequency of sexual intercourse, sexual satisfaction, and relationship satisfaction as the dependent variables.

Comparing prepregancy to pregnancy (n = 131), there was a significant effect for time, F (4,127) = 52.41, p < .001. Univariate tests revealed significant differences for sexual desire [t(1,130) = - 8.60, p < .001], frequency of sexual intercourse [t(1,130) = - 12.31, p < .001], and sexual satisfaction [t(1,130) = - 6.31, p < .001]. In each of these variables, there were decreases from prepregnancy. However, for relationship satisfaction, there was a significant increase [t(1,130) = 3.90, p < .001] from prepregnancy to pregnancy.

Data from women who had not resumed sexual intercourse following childbirth were excluded from the postpartum analyses. At 12 weeks postpartum, the overall effect of time was significant, F(4,86) = 1290.04, p < .001. Univariate planned contrasts revealed that at 12 weeks postpartum compared with prepregnancy, women reported decreased sexual desire [t(1,79) = -8.98, p < .001], frequency of sexual intercourse [t(1,79) = - 6.47, p < .001], sexual satisfaction [t(1,79) = -3.99, p < .001], and relationship satisfaction [t(1,79) = 2.81, p < .01]. At 12 weeks postpartum compared with pregnancy, sexual desire [t(1,79) = 2.36, p < .05] and relationship satisfaction [t(1,79) = - 5.09, p < .001] were reduced, but frequency [t(1,79) = 5.58, p < .001] and sexual satisfaction [t(1,79) = 3.13, p < .01] had increased.

At 6 months postpartum, the overall effect of time was significant, F(4,47) = 744.45, p < .001. Comparing 6 months postpartum with prepregnancy, women reported decreased sexual desire [t(1,50) = -6.86, p .05]. The mean scores of the sexual and predictor variables are provided in Table 1.

To test the prediction that psychological and relationship variables would account for women's sexual functioning during pregnancy and at 12 weeks and 6 months postpartum, a series of nine standard regressions (sexual desire, frequency of sexual intercourse, and sexual satisfaction at pregnancy, 12 weeks and 6 months postpartum as the dependent variables) were performed with role-quality, relationship satisfaction, depression, and fatigue as the independent variables.

For sexual desire during pregnancy, [R.sup.2] = .08, F(5,128) = 2.19, p > .05. For frequency of sexual intercourse during pregnancy, [R.sup.2] = .10, F(5,128) = 2.97, p < .05, with the major predictor being fatigue. For sexual satisfaction during pregnancy, [R.sup.2] = .21, F(5,128) = 6.99, p < 001, with the major predictor being relationship satisfaction (see Table 2).

For sexual desire at 12 weeks postpartum, [R.sup.2] = .22, F(4,99) = 6.77, p < .001, with the major predictors being relationship satisfaction and fatigue. For frequency of sexual intercourse at 12 weeks postpartum, [R.sup.2] = .13, F(4,81) = 2.92, p < .05, with the major predictor being depression (women who reported more depressive symptoms reported less frequency of sexual intercourse). For sexual satisfaction at 12 weeks postpartum, [R.sup.2] = .30, F(4,81) = 8.86, p < .001, with the major predictor being fatigue (see Table 2).

For sexual desire at 6 months postpartum, [R.sup.2] = .31, F(4,65) = 7.17, p < .001, with the major predictors being depression, relationship satisfaction, and mother role. For frequency of sexual intercourse at 6 months postpartum, [R.sup.2]= .16, F(4,60) = 2.76, p < .05, with the major predictors being depression and mother role. For sexual satisfaction at 6 months postpartum, [R.sup.2] = .33, F(4,60) = 7.42, p < .001, with the major predictor being mother role (see Table 2).

To test the prediction that psychological and relationship variables would account for some of the changes in women's sexual functioning during pregnancy a series of three hierarchical regressions (sexual desire, frequency of sexual intercourse, and sexual satisfaction as the dependent variables) were performed with the baseline measures of each of the sexual variables entered on the first step, and role-quality, relationship satisfaction, depression, and fatigue entered on the second step.

For sexual desire during pregnancy, on step 1, [R.sup.2] = .41, F(1,132) = 91.56, p .05. For frequency of sexual intercourse during pregnancy, after step 1, [R.sup.2] = .38, F(1,132) = 81.16, p < .001. After step 2, F change (6,127) = 2.33, p < .05. The major predictor of change to frequency of sexual intercourse during pregnancy was fatigue. For sexual satisfaction during pregnancy, after step 1, [R.sup.2] = .39, F(1,132) = 84.71, p < .001. After step 2, F change (6,127) = 3.92, p < .01. Depression was the major predictor of change to sexual satisfaction during pregnancy (see Table 3).

To test the prediction that psychological, relationship, and physical variables would account for changes in women's sexual functioning at 12 weeks and 6 months postpartum, a series of six hierarchical regressions were performed with the baseline measures of each of the sexual variables (sexual desire, frequency of sexual intercourse, and sexual satisfaction) entered on the first step, and breastfeeding, dyspareunia, mother-role quality, relationship satisfaction, depression, and fatigue entered on the second step. (Breastfeeding was a dummy variable, with currently breastfeeding coded 1, not breastfeeding coded 2). Work-role quality could not be included in regression analyses as only 14 women had resumed work at 12 weeks postpartum, and 23 at 6 months postpartum.

At 12 weeks postpartum, for sexual desire at step 1, [R.sup.2]= .32, F(1,102) = 48.54, p < .001. After step 2, F change (6,96) = 4.93, p .05. After step 2, F change (6,78) = 4.87, p < .01. Breastfeeding and relationship satisfaction were the main predictors of frequency of sexual intercourse at 12 weeks postpartum after the baseline frequency of sexual intercourse was taken into account. That is, women who were breastfeeding reported a greater reduction in frequency of sexual intercourse compared with their prepregnancy baseline. For sexual satisfaction, at step 1, [R.sup.2] = .46, F (1,84) = 72.13, p < .001. After step 2, F change (6,78) = 4.78, p < .001. Dyspareunia, breastfeeding, and fatigue were the major predictors of women's sexual satisfaction at 12 weeks postpartum (see Table 4).

At 6 months postpartum, for sexual desire at step 1, [R.sup.2] = .50, F(1,68) = 69.14, p < .001. After step 2, F change (6,62) = 4.29, p < .01. Dyspareunia and depression contributed significantly to the prediction of the change to sexual desire. However, the contribution of depression was not in the direction expected, likely because of the group of women who scored very low on the EPDS and who reported low sexual desire. For frequency of sexual intercourse, at step 1 [R.sup.2] = . 12, F(1,63) = 8.99, p < .01. After step 2, F change (6,57) = 3.89, p < .001. Dyspareunia was the main predictor of change to frequency of sexual intercourse at 6 months postpartum. For sexual satisfaction at step 1, [R.sup.2] = .48, F(1,63) = 58.27, p < .001. After step 2, F change (6,57) = 4.18, p < .01. Dyspareunia and mother role were the major predictors of change to sexual satisfaction (see Table 5).

DISCUSSION

Our results support previous findings that during the third trimester of pregnancy women generally report reduced sexual desire, frequency of intercourse, and sexual satisfaction (Barclay et al., 1994; Hyde et al., 1996; Kumar et al., 1981). An interesting finding from the current study is that the quantum of change in women's sexual functioning, although statistically significant, was generally not of great magnitude. Very few women reported a total loss of sexual desire and sexual satisfaction or complete avoidance of sexual intercourse during the third trimester of pregnancy.

Relationship satisfaction also increased slightly during pregnancy (Adams, 1988; Snowden, Schott, Awalt, & Gillis-Knox, 1988). For most couples, the anticipation of the birth of their first child is a happy time, during which there is likely to be an increased emotional closeness as they prepare their relationship and their home for the arrival of their baby.

Women who were more satisfied with their relationships reported higher sexual satisfaction; however, relationship satisfaction did not appear to directly influence changes to any of the sexual measures during pregnancy. However, it must be noted that women with higher relationship satisfaction were more positive about their anticipated mother role, and had lower rates of fatigue and depressive symptomatology.

Work-role quality was largely unrelated to women's sexual functioning during pregnancy. The differences between the findings in this study and that of Hyde et al. (1998), who found a small association between women's work-role quality and their frequency of intercourse in mid-pregnancy, may be due to the larger sample size surveyed by Hyde et al. (1998). Women surveyed by Hyde et al. (1998) were also at an earlier stage of pregnancy, when potential deterrents to intercourse may differ from those in the third trimester.

By 12 weeks postpartum, the majority of women had resumed sexual intercourse; however, many experienced sexual difficulties, particularly dyspareunia and lowered sexual desire (Glazener, 1997; Hyde et al., 1996). Relationship satisfaction was at a low point at 12 weeks postpartum (Glenn, 1990), and more than half of the women reported lower relationship satisfaction at this time than during pre-pregnancy. However, the level of change in relationship satisfaction was small and consistent with previous research (e.g., Hyde et al., 1996): most women were moderately satisfied with their relationships.

Relationship satisfaction influenced women's level of sexual desire, and those with higher relationship satisfaction reported less decrease in sexual desire and frequency of intercourse. Depression was also associated with a lower frequency of intercourse, and fatigue negatively affected women's sexual functioning at 12 weeks postpartum (Glazener, 1997; Hyde et al., 1998; Lumley, 1978). Women with higher levels of dyspareunia also reported greater decreases in sexual desire, frequency of intercourse, and sexual satisfaction compared with prepregnancy (Glazener, 1997; Lumley, 1978). Similarly, women who were breastfeeding reported greater decreases in each of these sexual variables than women who were not breastfeeding (Glazener, 1997; Hyde et al., 1996). The reason for this reduction should be explored in future research. It is possible that breastfeeding provides sexual fulfillment for some women, which may generate guilt feelings in these women and lead to decreased level of sexual functioning in their relationship.

These results would suggest that there are a broad range of factors that have a detrimental impact on sexuality at 12 weeks postpartum--most particularly depression, fatigue, dyspareunia, and breastfeeding. This appears to be a stage of adjustment for many mothers, and depending upon adjustments in the above areas, they may or may not experience a fulfilling sexual relationship.

At 6 months after childbirth, women continued to report significantly decreased sexual desire, frequency of intercourse, and sexual satisfaction compared to their levels prior to conception satisfaction (Fischman et al., 1986; Pertot, 1981). The most marked reduction was in level of sexual desire.

By the time babies are 6 months old, their presence and aspects of women's mother role have a considerable impact on the sex lives of their parents. Many women have greater difficulty with the mother role at 6 months postpartum than at 12 weeks postpartum, due to their infants' more difficult behaviors (Koester, 1991; Mercer, 1985). Babies are well into the process of attachment, usually preferring to be cared for by their mothers; most can move around by crawling or sliding, and need considerable attention. In the cross-sectional analyses, mother-role quality was the strongest predictor of each of the sexual measures. Women with higher mother-role quality also had higher relationship satisfaction and less depression and fatigue at 6 months postpartum. This is consistent with research which has shown various associations between mother-role quality, infant difficulty, lower marital satisfaction, fatigue, and postnatal depression (Belsky & Rovine, 1990; Milligan, Lenz, Parks, Pugh & Kitzman, 1996). It may be that by 6 months postpartum the interaction between infant temperament and the parental relationship has been amplified.

Depression appeared to exert an unexpected positive influence on women's sexual desire at 6 months postpartum. These findings differ from those of Hyde et al. (1998), who found that depression was a highly significant predictor of loss of sexual desire of employed women at 4 months postpartum. This discrepancy may be due to problems with the sample in this wave of our study. The low rate of postnatal depression suggests a lower response rate in this study from women who may have become depressed after childbirth. The distribution of sexual desire by depression scores at 6 months postpartum was unusual, in that there was a cluster of women who were very low in both depression and sexual desire, and this cluster may have unduly influenced results for the sample as a whole.

Dyspareunia continued to have a strong influence on women's sexuality at 6 months postpartum, although the average level of dyspareunia at the later period was less than at 3 months earlier. It is possible that by this stage the expectation of pain with sexual intercourse for some women may have started a cycle in which they become less aroused sexually, which perpetuates vaginal dryness and discomfort with intercourse. Although dyspareunia may commence as a physical factor, it may be maintained by psychological factors. This relationship needs to be explored further in future research.

A major limitation of the current study is that only women were surveyed, and not their partners. An additional limitation is that before-conception measures required retrospective recall, and that prepregnancy and pregnancy measures were collected at the same time. It would have been preferable to take baseline measures earlier in the pregnancy. Ideally, baseline measures would be taken before conception. Further there was some attrition in participants throughout the study (25% between time 1 and time 2, and a further 26% between time 2 and time 3). This may have limited the generalizability of the findings.

In addition, the sample in the current study appeared to be biased to better educated women of higher professional status, like samples in many previous studies (e.g., Bustan et al., 1996; Glazener, 1997; Pertot, 1981). This is a problem which is not easily overcome, although multidisciplinary collaboration between gynaecological and mental health professionals may assist (Sydow, 1999).

The findings from the current study have important implications for the well-being of women, their partners, and the family. It is clear that a range of factors influence sexual responses during pregnancy and postpartum, and that these factors vary at different stages of the process of adjusting to childbirth. Fatigue is a constant factor influencing sexual responses during pregnancy and at 12 weeks and 6 months postpartum. Other variables assume significance at different stages of the pregnancy and postpartum periods. Providing couples with information about what sexual changes they may expect, the duration of those changes, and the possible influences on those changes, may help couples avoid making unfounded harmful assumptions about their relationship.

Table 1. Means, Score Ranges and Standard Deviations of Variables

Variable Mean Standard
Deviation
Range
Sexual desire
Baseline 35.06 8.16 12-55
Pregnancy 27.96 12.57 0-62
12 weeks postpartum 25.85 11.39 0-56
6 months postpartum 27.39 11.77 2-46
Frequency of sexual intercourse
Baseline 4.38 .91 1-6
Pregnancy 3.28 1.29 0-6
12 weeks postpartum 3.65 .78 1-5
6 months postpartum 3.97 .93 2-6
Sexual satisfaction
Baseline 32.05 5.70 17-45
Pregnancy 29.19 6.64 12-45
12 weeks postpartum 30.09 6.50 11-43
6 months postpartum 29.56 7.13 16-42
Relationship satisfaction
Baseline 33.16 5.31 19-45
Pregnancy 34.14 5.77 16-45
12 weeks postpartum 31.65 6.13 5-42
6 months postpartum 31.94 6.75 11-43
Work-role
Pregnancy 1.21 .81 -.90-2.63
12 weeks postpartum 1.47 .74 .42-2.68
6 months postpartum 1.35 1.03 -1.00-2.74
Mother role
Pregnancy 1.22 .69 -40-2.70
12 weeks postpartum 1.90 .68 -.45-3.00
6 months postpartum 1.94 .73 -.40-2.90
Depression
Pregnancy 7.94 4.26 0-19
12 weeks postpartum 6.92 4.24 0-18
6 months postpartum 6.29 4.50 0-23
Fatigue
Pregnancy 29.06 4.31 21-42
12 weeks postpartum 26.10 5.45 11-39
6 months postpartum 25.44 5.21 15-37

 

 

Table 2. Multiple Regression Analyses Predicting Sexual Variables

 

Sexual Desire

Frequency of Sexual
Intercourse
Predictor Beta [R.sup.2] Beta [R.sup.2]
    During pregnancy
Fatigue -.05 .08 -.31 ** .10 *
Depression -.09   .21 *  
Relationship
satisfaction
.09   .14  
Work-role .03   .04  
Mother-role .15   -.07  
   

At 12 weeks postpartum

Fatigue -.25 * .22 ** -.10 .13 *
Depression .16   -.30 *  
Relationship
satisfaction .32 **   .18  
Mother-role .17   -.01  
   

At 6 months postpartum

Fatigue -.10 .31 *** .03 .16 *
Depression .39 **   .23 *  
Relationship
satisfaction
.34 **   .17  
Mother-role .39 **   .40 *  
  Sexual satisfaction    
Predictor Beta [R.sup.2]    
  During pregnancy    
Fatigue -.14 .21 ***    
Depression -.11      
Relationship
satisfaction
.29 **      
Work-role .07      
Mother-role .05      
    At 12 weeks postpartum
Fatigue -.39 ** .30 ***    
Depression .08      
Relationship
satisfaction
.20      
Mother-role .16      
    At 12 months postpartum
Fatigue -.13 .33 ***    
Depression .24      
Relationship
satisfaction
.23      
Mother-role .46 **      
* p < .05. ** p < .01. *** p < .001.

Table 3. Multiple Regression Analyses Predicting Changes to Sexual Variables During Pregnancy

  Sexual desire
Step and predictor Beta [R.sup.2]
Step 1    
Sexual baseline .64 *** .41 ***
Step 2    
Sexual baseline .63 *** .45 ***
Fatigue -.01  
Depression -.18 *  
Relationship satisfaction -.03  
Work-role -.03  
Mother-role .07  
Change to [R.sup.2]   .04
 

Frequency of sexual intercourse

Step and predictor Beta [R.sup.2]
Step 1
Sexual baseline .62 *** .38 ***
Step 2    
Sexual baseline .61 *** .43 ***
Fatigue -.19 *  
Depression -.00  
Relationship satisfaction .07  
Work-role -.03  
Mother-role -.13  
Change to [R.sup.2]   .05 *
  Sexual satisfaction
Step and predictor Beta [R.sup.2]
Step 1    
Sexual baseline .63 *** .39 ***
Step 2    
Sexual baseline .57 *** .47 ***
Fatigue -.02  
Depression -.24 **  
Relationship satisfaction .07  
Work-role .02  
Mother-role .02  
Change to [R.sup.2]   .08 **
* p < .05. ** p < .01. *** p < .001.

Table 4. Multiple Regression Analyses Predicting Changes to Sexual
Variables at 12 Weeks Postpartum

  Sexual desire
Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .57 *** .32 ***
Step 2    
Baseline sexual measure .44 *** .48 ***
Dyspareunia -.16 *  
Breastfeeding .22 **  
Fatigue -.12  
Depression .08  
Relationship satisfaction .22 **  
Mother-role .06  
Change to [R.sup.2]   .16 ***
  Frequency of sexual intercourse
Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .21 .04
Step 2    
Baseline sexual measure .25 * .30 ***
Dyspareunia -.12  
Breastfeeding .36 **  
Fatigue .15  
Depression -.26  
Relationship satisfaction .25 *  
Mother-role -.09  
Change to [R.sup.2] .26 ***  
  Sexual satisfaction
Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .68 *** .46 ***
Step 2    
Baseline sexual measure .52 *** .61 ***
Dyspareunia -.19 *  
Breastfeeding .17 *  
Fatigue -.22 *  
Depression .05  
Relationship satisfaction .09  
Mother-role .03  
Change to [R.sup.2]   .15 ***
* p < .05. ** p < .01. *** p < .001.

Table 5. Multiple Regression Analyses Predicting Changes to Sexual
Variables at 6 Months Postpartum

  Sexual desire
Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .71 *** .50 ***
Step 2    
Baseline sexual measure .60 *** .65 ***
Dyspareunia -.18 *  
Breastfeeding .04  
Fatigue -.16  
Depression .35 ***  
Relationship satisfaction .12  
Mother-role .20  
Change to [R.sup.2] .15 **  

Frequency of sexual intercourse

Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .35 *** .13 ***
Step 2    
Baseline sexual measure .34 ** .38 ***
Dyspareunia -.39 **  
Breastfeeding .10  
Fatigue .01  
Depression .20  
Relationship satisfaction .07  
Mother-role .21  
Change to [R.sup.2]   .25 ***
 

Sexual satisfaction

Step and predictor Beta [R.sup.2]
Step 1    
Baseline sexual measure .69 *** .48 ***
Step 2    
Baseline sexual measure .53 *** .64 ***
Dyspareunia -.23 *  
Breastfeeding .04  
Fatigue -.07  
Depression .12  
Relationship satisfaction -.10  
Mother-role .25 *  
Change to [R.sup.2]   .16 **
* p < .05. ** p < .01. *** p < .001.

 

 

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Lenz, E. R., Soeken, K. L., Rankin, E. A., & Fischman, S. H. (1985). Sex role attributes, gender, and postpartal perceptions of the marital relationship. Advances in Nursing Science, 7, 49-62.

Levy-Shift, R. (1994). Individual and contextual correlates of marital change across the transition to parenthood. Developmental Psychology, 30, 591-601.

Lumley, J. (1978). Sexual feelings in pregnancy and after childbirth. Australian and New Zealand Journal of Obstetrics and Gynaecology, 18, 114-117.

McCabe, M. P. (1998a). Sexual Function Scale. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Sexuality related measures: A compendium (Vol. 2, pp. 275-276). Thousand Oaks, CA: Sage Publications.

McCabe, M. P. (1998b). Sexual Dysfunction Scale. In C. M. Davis, W. L. Yarber, R. Bauserman, G. Schreer, & S. L. Davis (Eds.), Sexuality related measures: A compendium (Vol. 2, pp. 191-192). Thousand Oaks, CA: Sage Publications.

Mercer, R. (1985). The process of maternal role attainment over the first year. Nursing Research, 34, 198-204.

Miller, B. C., & Sollie, D. L. (1980). Normal stresses during the transition to parenthood. Family Relations, 29, 459-465.

Milligan, R., Lenz, E. R., Parks, P. L., Pugh, L. C., & Kitzman, H. (1996). Postpartum fatigue: Clarifying a concept. Scholarly Inquiry for Nursing Practice, 10, 279-291.

Murray, D., & Cox, J. L. (1990). Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). Journal of Reproductive and Infant Psychology, 8, 99-107.

O'Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression: A meta-analysis. International Review of Psychiatry, 8, 37-54.

Pertot, S. (1981). Postpartum loss of sexual desire and enjoyment. Australian Journal of Psychology, 33, 11-18.

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Margaret A. De Judicibus and Marita P. McCabe Deakin University, Victoria, Australia

Source: Journal of Sex Research, May 2002, Margaret A. De Judicibus, Marita P. McCabe

Source: Journal of Sex Research,

 

next: Keep Sex Life Sweet Despite Menopause

APA Reference
Staff, H. (2021, December 25). Psychological Factors and the Sexuality of Pregnant and Postpartum Women, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/women/psychological-factors-and-the-sexuality-of-pregnant-and-postpartum-women

Last Updated: March 26, 2022

Menopause and Sex

A famous New Yorker cartoon depicts a middle age couple walking together. The husband says "Now that the kids are grown and out of the house, do you think we could start having sex again?" While myths and misconceptions abound about menopausal women and libido, supermodel -and super role model- Lauren Hutton says this is a great time for women to explore and enjoy their sexuality. Dr. Donnica Moore, well-known ob-gyn and women's health expert, explains some of the physiologic and psychological issues surrounding menopause and sex. You may be pleasantly surprised!

While menopause marks the end of a woman's reproductive cycle, it does not signal the end of her sexuality. The once popular phrase "finished at fifty" is history. Some women actually feel liberated after menopause when they no longer have to worry about pregnancy or when their child-rearing responsibilities decrease. Yet, for other women, menopause brings about a decrease in sexual interest and activity. While the physical changes associated with menopause may contribute to a decline in sexual activity, it is difficult to say that they are the only factors that may affect sexual activity. Relationship and psychological status play an important role in both sex drive (libido) and sexual satisfaction.

Declining hormone levels are responsible for many physical changes that may lead to a decrease in libido and sexual satisfaction in menopausal women. Without estrogen, the vagina is less well lubricated and the vaginal lining thins. Lower estrogen levels also decrease the blood supply to the vagina and the surrounding nerves making the vagina drier. These symptoms may contribute to painful intercourse.

Other menopausal symptoms that may affect sexual desire include hot flashes, night sweats, insomnia, bladder and urinary tract problems, sleeplessness and fatigue, mood changes, and general irritability. For some women, these changes may translate into a decrease in self-esteem and eventually a loss in sexual desire.

As with any age group, relationship status may also affect sexual activity. Communication is the most important success factor for any relationship. Yet menopausal women may face other relationship issues, especially women without partners. For example, at age 65, women outnumber men by 25 percent. In addition, as men age, the male sex hormone testosterone diminishes causing a decline in their sexual desire and performance capabilities.

In no other arena is the saying "don't worry, be happy" more applicable than in the sexual arena. Many sex therapists find that concerns, worries and fears about sex are usually bigger problems than any physical or sexual changes themselves. Whatever the biological problem, your attitude will be the most important determinant of how well you and your partner cope. At this point in life, the brain remains the most important sexual organ. And common sense goes a long way in resolving sexual issues related to decreased libido or decreased sexual satisfaction.

For example, a healthy lifestyle, in general, can boost confidence and improve sexual desire. Physical or mental illness may slow sexual response, whatever its cause. As with most conditions, regular exercise, regular sleep, and eating a balanced diet can improve outcomes- as can stopping smoking (it's never too late!) and limiting alcohol intake. Alcohol may help you get "lucky" getting into bed, but it won't help you once you're there!

While truly menopausal women are no longer at risk for unintended pregnancy from unprotected intercourse, a dangerous myth is that menopausal women are no longer at risk for sexually transmitted diseases (STD's). This isn't true. Menopausal women may be less likely to get pelvic inflammatory disease (PID) than younger women, but they are still at risk for virally transmitted STD's such as HIV/AIDS, herpes, genital warts and hepatitis B. Condoms are still recommended for any sexual intercourse outside of a mutually monogamous relationship.

Another prevailing myth about menopause is that it is associated with "empty nest syndrome" and causes depression. Research has shown that the incidence of depression in women actually peaks in the 30's; on the contrary, many women in their 50's experience what Margaret Mead termed "postmenopausal zest". Menopause is a risk factor for depression in certain women however, women who have had a previous history of depression (including postpartum depression), women with any other psychiatric illness, women with a family history of menopausal depression, and women with a history of premenstrual dysphoric disorder (PMDD, otherwise known as "PMS"). Depression can also be a symptom of numerous other medical disorders, from hypothyroidism to heart disease to infectious conditions; any menopausal women with depression should consult their physician, rather than assume it's "normal" to become depressed when one enters menopause. What if your doctor's diagnosis is depression? Remember- it is treatable. Depression is not only a major cause of decreased libido and sexual satisfaction but decreased libido and decreased sexual satisfaction are early symptoms of depression.

Unfortunately, some of the common medicines used to treat depression may also impact your sex drive- or your partner's. Other common medications such as medicines for high blood pressure may have the same effect. Talk with your physician about this; there may be simple changes that can be made which can have very positive outcomes. It's also important-although it may be embarrassing--to talk with your physician about any physical difficulties you may be having related to menopause that may impair your sexual activity. Many of these difficulties can be improved or resolved with medical therapy, such as hormone replacement therapy (HRT), vaginal lubricants, aids for incontinence, or making changes to existing medication regimens.


It is clear that HRT has a positive benefit on treating menopausal symptoms in the short term (less than 5 years), which in turn may improve sexual desire and satisfaction. Some studies have also shown that a combination of estrogen and testosterone, the male hormone that women normally manufacture, may improve sexual desire. All medical treatments have advantages and disadvantages, however. Results from the Women's Health Initiative indicated that women whose average age was 63.5 who took a combined estrogen-progesterone combination therapy had an increased risk of invasive breast cancer, heart attacks, strokes, and blood clots. The estrogen-testosterone replacement may also reduce the cholesterol benefits that estrogen alone provides and have other side effects. More studies are needed to evaluate fully the benefits/risks of combined estrogen-testosterone therapy, as are studies to elucidate the benefits of estrogen or its alternative therapies on menopausal sexuality in general. Only your physician can give you individual recommendations as to what's best for you given the information we now have and your own personal risk profile.

One approach to learning more about menopause and sexuality is to ask menopausal women themselves. According to a recent survey of 1001 women by Yankelovich Partners (sponsored by Wyeth-Ayerst Laboratories), a majority of women ages 50-65 say their sexual desire and interest in sex is just as robust or has increased since before menopause. Menopausal women surveyed cite greater overall balance in life (77%), less child-rearing responsibilities (61%), and decreased risk of pregnancy (52%) as key reasons for maintaining their sexual energies. Another interesting finding was that of this group, women taking hormone replacement therapy (HRT) reported greater sexual activity than their counterparts not on HRT.

The findings of the survey make sense medically -- HRT can relieve the symptoms caused by reduced estrogen levels that can make sex uncomfortable for many women after menopause, including hot flashes, sleeplessness, night sweats and vaginal dryness. According to the survey, women who have partners but are not on HRT cited menopausal symptoms and low sex drive as reasons they may be having less sex now than before menopause, which may explain why more women on HRT are enjoying sex more.

Contrary to "conventional wisdom" -i.e. myths- surrounding menopause, more than 87% of the women surveyed have a positive attitude toward menopause. These women also play an active role in managing their health-they indicated that good nutrition (98%), exercise (95%), and plenty of rest and sleep (91%) are some of the keys to remaining healthy and vital during and after menopause. Of the women surveyed, 80% reported feeling more independent and in control of their lives since entering menopause.

When comparing sex before and after menopause, 82% of women taking HRT said that their sex life improved or has stayed the same, whereas only 68% of women not taking HRT feel the same way. The women on HRT cited comfort with their partner, physical fitness, no fear of pregnancy, and HRT as the top four reasons for their satisfying sex life. Perhaps most interestingly, the majority of women on HRT said that their HRT (60%) is more important than sexy lingerie (35%) to maintaining their satisfying sex life.

There is so much that women can, and should, do to protect their health-physical, emotional, psychological, and sexual--during and after menopause. Exercise, nutrition, good relationships and a positive attitude will all help women live vital and healthy lives. Sex is just one part of the equation. Women entering menopause and even those already in menopause should speak with their doctors-and their partners--about what's best for them.

 

APA Reference
Staff, H. (2021, December 25). Menopause and Sex, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/women/menopause-and-sex

Last Updated: March 26, 2022

Early Adolescent Sexuality: What is Your Child Going Through

If you want to make parents anxious, lock them in a room with their thirteen-year-old child, and tell them they must talk to their teenager about sex. It's an issue that few parents feel comfortable and ready to discuss. And yet most parents know that they should, because of the importance of sex and intimacy in adult relationships, and because of the sexually charged environment we all live in. If kids don't hear about sex from their parents, they are going to hear about it from somebody else.

What are young adolescents going through? Below, two adolescent health experts explore this question.

Many parents don't think that children ten to thirteen years old are sexual beings yet. Are they?

DAVID BELL, MD: We are all sexual beings. Our kids are learning from us about good touch and loving relationships from almost day one. There are many exploratory behaviors that happen early in children. Parents need to be comfortable talking about sexuality with their children early on, and info adolescence.

JENNIFER JOHNSON, MD: I completely agree with Dr. Bell that sexuality is part of every human being's life, whether we're conscious of it or not, and that does include young children. But I think when kids are actually approaching puberty or have already reached it, they need some concrete information about what's happening to their bodies and what's going to happen.

Cognitively, I don't think that seven or eight-year-olds are ready to handle that information yet. It's just too hard for them to understand.

DAVID BELL, MD: I don't disagree with you. I think it's a developmentally appropriate conversation, and that as the child grows older, your way of talking with that child changes.

What are the markings of puberty?

DAVID BELL, MD: Some of the first changes for females are breast development, and one of the first changes is breast bud development. One of the later changes that people notice and appreciate more is the start of their first menstrual cycle.

For guys, it's sometimes a lot less noticeable, since the first change is growth in testicular size, and then, much later on, hair and muscle development. The growth spurt happens much later for males.

And there's a great degree of variation?

JENNIFER JOHNSON, MD: Yes, there is. In fact, for girls, the first sign-the development of breast buds-can occur as early as eight-years-old. It can also occur at age twelve or thirteen.

There is a big difference in the age of onset of puberty for both boys and girls. But what's interesting is that once that process is started, it's a relatively consistent period of time from the beginning of puberty until its completion.

When do teenagers begin to have sexual feelings?

JENNIFER JOHNSON, MD: Puberty is the result of sex hormones developed by the body, and these hormones affect the development of organs like the breasts or the penis.

Those hormones are also acting on the brain and causing the beginnings of sexual desires that the child will not have experienced earlier, at least not in that same way.

We don't really understand completely what triggers sexual feelings and behaviors, and how the hormones work, but definitely, once the hormones are on board, then the desire is increasing.

At what age is masturbation fairly common?

DAVID BELL, MD: For males, age ten to thirteen.

JENNIFER JOHNSON, MD: Girls probably don't really begin experimenting with masturbation until they're more towards middle adolescence. I think that early adolescents are just kind of overwhelmed with what's happening to their bodies.

They're also making big transitions in their lives, going to a new, big school and being expected to perform very adult things cognitively and in their social world. I think they're just sitting there saying, "Okay, what's coming today?"

DAVID BELL, MD: Psychologically, they aren't quite there in early adolescence to experiment with sexuality. They may talk about it more. I know that, for females, since they are developing faster or at an earlier time, their desires are there, they're talking more about boys. And at that same period, boys are not talking about girls, usually. They're waiting.


But there are girls and boys having sex in these early adolescent years. What does it mean?

JENNIFER JOHNSON, MD: In my clinical practice, and in the literature, it's very well documented that girls who have consensual sex before the age of thirteen are at much higher risk of having been sexually abused in their childhoods then girls who don't start having sex until they're thirteen and older. So whenever I have a patient who has had sex and she's under thirteen years old, that's when I really am careful in my questioning about possible sexual abuse. I ask that of every girl and every guy that I see, but it's the young girls who are having sex that I really have a red flag out for.

Is there a good way for parents to begin a conversation about sex?

JENNIFER JOHNSON, MD: Absolutely. Any kind of opener that a parent can use to start talking about sexuality is one that they should jump at. Menstruation is a great opportunity, for example. But I think that parents are more comfortable talking about the concrete processes of reproduction, or even the concrete aspects of having sex, than they are talking about sexuality itself.

Why do you think parents are reluctant to have this conversation?

DAVID BELL, MD: I think that they often aren't comfortable with saying the words "penis" and "vagina." They aren't comfortable having conversations about sexual feelings. They have the idea that talking about sexuality sort of encourages sexuality. I think it's important to emphasize that talking and sharing your values about sex and sexuality does not encourage sex and sexual behaviors in teenagers.

JENNIFER JOHNSON, MD: As a society, we are not generally very comfortable talking about sex with each other, either. It's something that lots of husbands and wives don't talk about. They have sex, but they may not discuss what feels good or what doesn't.

Sexuality is kind of taboo in our society, and so I think it's all the more frightening for parents to talk about it with their kids, even for parents who say sex is a normal, wonderful, healthy thing.

If a parent doesn't feel confident about having this conversation, should they find someone else who might be able to do a better job?

DAVID BELL, MD: I think that's a healthy choice.

JENNIFER JOHNSON, MD: Yes. And another approach is books. Anybody who goes into a bookstore is going to find a big selection of books written about sexuality for teenagers, and about reproduction and contraception for teenagers. What I suggest that parents do is just choose a couple of books that they like and give them to their child. My daughter has her collection in her bedroom, and we've looked at a few of them together. It was really fun, because one of them actually asked questions about both the mothers' and fathers' experiences in puberty. That was a great opportunity to bring my husband into it.

What do kids want to know?

JENNIFER JOHNSON, MD: I don't think ten to thirteen-year-olds are certain that they really want to know too much about sex, because especially the younger ones still have that childhood view that sex is something kind of yucky and messy. But they do want reassurance that what their body is going through is normal.

I think probably the number one health concern for early adolescents altogether is, "Am I normal?" One breast is bigger than the other: is that normal? And they want the facts about what's happening, but they're not very interested in talking about contraception and stuff like that in detail yet.

APA Reference
Staff, H. (2021, December 25). Early Adolescent Sexuality: What is Your Child Going Through, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/teen-sex/early-adolescent-sexuality-what-is-your-child-going-through

Last Updated: March 26, 2022

Opening the Channels for 'The Sex Talk' With Your Teenager

Teenagers really want guidance from their parents about sex and sexuality," says pediatrician Dr. Jennifer Johnson. "Sex education gives kids fantastic knowledge, but it doesn't necessarily help them when it comes to their own personal decision-making about whether or not to have sex. That's where parents come in..."

As the Chair of the Section on Adolescent Health of the American Academy of Pediatrics, and a mother of two young teenagers, Dr. Johnson knows more than most about American teenagers. Below, she discusses the role that parents can play in supporting and guiding children during the years of their budding sexuality.

Why don't parents talk with their kids about sex more often?

Most parents are just not comfortable with it, even now. The parents are made aware that there's going to be a sex education class in their kid's school, and some schools require the parents to sign a permission slip for their kids to participate in the class...but there's no concerted effort to help the parents teach their kids about sex and sexuality.

Do parents generally know what kind of sexual behavior their kids are involved in?

Most of the time it turns out that parents already suspect if their kids are sexually active. Parents notice things. They notice stains on underwear, for example. But a lot of parents don't know how to raise the subject. The best time to talk about when it's right to have sex, I think, is when a child is in the early teen years. Pre-teens think sex is yucky. Some kids start having sex in their mid-teen years. If parents haven't given their children guidance by then, it may be too late to impact behavior.

Personally, I think parents need to send two clear messages to their kids. First, they need to tell them when, in their opinion, it's appropriate for a young person to have sex. Second, if their teenager does decide to have sex, I think it's vital that parents express how important it is to protect themselves, and their partners, from pregnancy, sexually transmitted infections, and emotional hurt.

But some parents are just very uncomfortable talking with their kids about sexuality. I had a mother bring her daughter in for a physical exam. As I was going into the room to see her daughter she handed me a note that said, "Please get Mary on the pill."

Can you predict which parents will have a tough time talking about sex with their kids?

I think that parents' communication with their kids about sexuality to a considerable extent reflects their larger relationship with their kids.

The parents who are okay talking with their kids about sex are also going to be okay talking with their kids about other tough topics. It may be, for example, how to manage a fight with a friend at school, or how to get along with a difficult teacher. It goes back to the principle of open communication.

What about parents who are very categorical about what is right and wrong? Does this sort of approach work with teenagers when talking about sex?

Parents sometimes have very clear views of what's right and what's wrong. And when that is expressed to the kids, it can actually be very helpful to them. They want to have guidance and they want to have standards and they want someone to tell them, "I think this is right. I think this is wrong."

But I think it's important to explain the rationale so that the adolescent can then think it through on his own and decide, "Yeah, you know, that makes sense to me," or, "No, it doesn't."

So acknowledging that the teenager has a valid opinion is important.

Absolutely. One of the most important things parents can do is to ask their kids their opinions about things and to listen to them. Teenagers are deciding what right and wrong is, and they're testing things a little bit. They'll think over their parents' ideas, and in most cases, they actually accept their parents' standards of what's right and what's wrong, but they have to have the right to make those decisions.

That's why parenting an adolescent is so tricky, because a lot of parents don't realize that for the adolescent to grow up in a healthy manner, their relationship with their adolescent has to change. By the time that child turns 21, the relationship should be closer to that of an adult than a child. The beginning of that gradual separation is adolescence.


If parents don't know what their teenagers are doing, and aren't willing to talk with them, how can they make sure that they're getting good information about sex?

I recommend that the parent go to the library or to the health section in their favorite bookstore and look at a few of the books that are designed to teach teenagers about their bodies. There are some really great ones out there. Some are just about sex, and some are about your changing body, which is the approach I choose to take, because changes in your sex organs are only part of what happens in puberty.

Then parents can just leave the books around the house. Or point them out to the kid and say, "Here, I've got these books for you. You might want to look at them sometime." And then sometime, if the parent wants to, they can say, "Well, did you get a chance to look at those books, and did it tell you anything new?" or, "What are you learning in school?" Parents can do that even without the books. They can simply ask their kids what they have been taught at school about sex or whatever the parent is concerned about.

Then good communication also depends on time spent with the kids?

Yes, and one of my big concerns, both for my kids and for the generation of kids who are growing up now, is the issue of latchkey kids. It's definitely the after-school hours when kids who are unsupervised are likely to, quote, "get into trouble." Statistically, those after school hours are when a lot of the teen risk behavior takes place. So I would urge parents to find organized after school activities for their children to be involved with if they themselves can't be on hand.

What does a teenager need from a parent after school?

Availability. And that doesn't mean playing with them or even necessarily doing things with them. It means being there, providing supervision, and being available, both physically and emotionally. If I'm home when my daughter gets home at 4:15, she generally doesn't feel like talking. But she's always happy to have me make a snack! She knows I'm there, and that she can come up to me and ask me a question, or talk about her day, or whatever it may be.

And I think that parental availability is probably a big issue for parents right now.

Do you think parents are often too distracted by work when they're home?

Well, I've noticed in myself how much emotional energy I use up at work. The time you spend when you're washing dishes worrying about how to prepare for tomorrow's meeting or what happened at today's meeting -- that eats up a lot of your emotional availability at home. So when you're home, you're not really home.

So do you have any practical advice for those parents who would like to talk more openly with their kids?

Well, another mother shared a bit of common wisdom with me years ago. She told me that time in the car with your kids is time well spent. And I've got to say, it works for me and my kids. Teenagers talk much more easily about things when they're in the car with you, because they're not looking at you face to face. Or when you're hanging out with them somewhere away from home, somehow it's not as intense. It takes a little bit of the pressure off.

APA Reference
Staff, H. (2021, December 25). Opening the Channels for 'The Sex Talk' With Your Teenager, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/teen-sex/opening-the-channels-for-the-sex-talk-with-your-teenager

Last Updated: March 26, 2022

Understanding Human Ambivalence About Sex: The Effects of Stripping Sex of Meaning

Birds do it, Bees do it, Even educated fleas do it ...
Cole Porter

Despite its potential for immense physical pleasure and the crucial role that it plays in propagating the species, sex nevertheless is sometimes a source of anxiety, shame, and disgust for humans, and is always subject to cultural norms and social regulation. We (Goldenberg, Pyszczynski, Greenberg, & Solomon, 2000) recently used terror management theory (e.g., Greenberg, Pyszczynski, & Solomon, 1986) to lay out a theoretical framework to explain why sex is so often a problem for human beings. We argue that sex is threatening because it makes us acutely aware of our sheer physical and animal nature. Although others (e.g., Freud, 1930/1961) have also suggested that human beings are threatened by their creatureliness, following Rank (1930/1998) and Becker (1973), we suggest that this motivation is rooted in a more basic human need to deny mortality.

Consistent with this view, Goldenberg, Pyszczynski, McCoy, Greenberg, and Solomon (1999) showed that neurotic individuals, who are especially likely to find sex threatening, rated the physical aspects of sex as less appealing when reminded of their mortality and showed an increase in the accessibility of death-related thoughts when primed with thoughts of the physical aspects of sex; no such effects were found among individuals low in neuroticism. If this framework is to provide a general explanation for human discomfort with sexuality, two critical questions must be addressed: (a) under what conditions would people generally (independent of level of neuroticism) show such effects, and (b) what is it about sexuality that leads to these effects? The present research was designed to address these questions by investigating the role of concerns about creatureliness in the link between thoughts of physical sex and thoughts of death.

Terror Management Theory and Research

Building on the ideas espoused by Ernest Becker (e.g., 1973), terror management theory (TMT; e.g., Greenberg et al., 1986) begins with a consideration of how humans are similar to and different from other animals. Humans share with other animals a collection of inborn behavioral proclivities that serve ultimately to perpetuate life and thereby propagate genes, but can be distinguished from all other species by more sophisticated intellectual capacities. One byproduct of this intelligence is the awareness of the inevitability of death--and the potential for paralyzing terror associated with this awareness. TMT posits that humankind used the same sophisticated cognitive capacities that gave rise to the awareness of the inevitability of death to manage this terror by adopting symbolic constructions of reality, or cultural worldviews (CWV). By meeting or exceeding the standards of value associated with their CWVs, humans elevate themselves above mere animal existence and attain a sense of symbolic immortality by connecting themselves to something larger, more meaningful, and more permanent than their individual lives.

In support of this view, over 100 studies (for a recent review, see Greenberg, Solomon, & Pyszczynski, 1997) have shown that reminding people of their own death (mortality salience or MS) results in attitudinal and behavioral defense of the CWV. For example, MS causes experimental participants to dislike (e.g., Greenberg et al., 1990) and aggress against (McGregor et al., 1998) individuals who disagree with participants' views. Research has also shown that MS leads to increased estimates of social consensus for culturally significant attitudes (Pyszczynski et al., 1996), heightened conformity to cultural standards (Simon et al., 1997), and greater discomfort when performing behavior that violates cultural standards (Greenberg, Porteus, Simon, Pyszczynski, & Solomon, 1995). Further, the effects of MS are specific to reminders of death: thoughts about giving a speech, taking or failing an exam in an important class, experiencing intense physical pain, being socially excluded, or becoming paralyzed do not produce the same defensive responses as do thoughts of one's own mortality (e.g., Greenberg, Pyszczynski, Solomon, Simon, & Breus, 1994).

Creatureliness, Death, and the Regulation of Sexuality

If humans manage the terror associated with death by clinging to a symbolic cultural view of reality, then reminders of one's corporeal animal nature would threaten the efficacy of this anxiety-buffering mechanism. As argued by Becker (1973; see also Brown, 1959; Kierkegaard 1849/1954; Rank, 1930/1998), the body and its functions are therefore a particular problem for humans. How can people rest assured that they exist on a more meaningful and higher (and hence longer lasting) plane than mere animals, when they sweat, bleed, defecate, and procreate, just like other animals? Or as Erich Fromm expressed it, "Why did man not go insane in the face of an existential contradiction between a symbolic self, that seems to give man infinite worth in a timeless scheme of things, and a body that is worth about 98 cents?" (Fromm, 1955, p. 34). From the perspective of TMT, then, the uneasiness surrounding sex is a result of existential implications of sexual behavior for beings that cope with the threat of death by living their lives on an abstract symbolic plane.

Consistent with this analysis, there is a long philosophical and religious tradition of elevating humans above the rest of the animal kingdom to a higher, more spiritual plane by valuing and preaching control over one's body, emotions, and desires (e.g., Aristotle, 1984; Plato, 1973; St. Augustine, 1950). Among the Ancient Greeks, the body and sexuality were viewed as obstacles in the pursuit of higher spiritual and intellectual goals. Early Christian figures, such as Saint Augustine (354-430 A.D.), suggested strict regulations of man's sexual nature (e.g., he suggested that people not make love on Wednesday, Friday, Saturday, Sunday, or during the 40-day periods of fasting before Easter and Christmas and after Whitsuntide; Kahr, 1999). Origen of Alexandria (182-251 A.D.), another distinguished father of the early Christian Church, worded so much about the sinfulness of sex that he castrated himself in order to become more completely abstinent (Kahr, 1999). In the 4th and 5th centuries A.D., handfuls of men and women rejected burgeoning Christian customs and joined "cults of virginity" in which men and women lived apart and dedicated themselves to lives of celibacy (e.g., Rousselle, 1983). More recently, Victorian puritanical attitudes towards sex were backed by medical professionals: Blindness and insanity were reported consequences of too much sexual activity, and preventative measures, such as toothed penile rings and avoidance of oysters, chocolate, and fresh meats, were recommended (Kahr, 1999). Even in a modern liberated culture such as our own, sex toys are outlawed in a number of states, debates roar about pornography and sex education, and the sexual antics of President Clinton were recently headline news.

The controversy surrounding sex is by no means specific to Western Judeo-Christian tradition. All the world's major religions restrict sex, usually condoning it only for procreation in the sanctity of heterosexual marriage. Eastern religions, such as Hinduism and Buddhism, sometimes incorporate sex into religious practice, such as in Tantrism, but to do so sex is elevated to a divine plane; even in these religions, however, celibacy is practiced by the most holy members (Ellwood & Alles, 1998). In some Hindu groups, sex is forbidden during certain phases of the moon (the first night of the new moon, the last night of the full moon, and the 14th and 8th night of each half of the month are considered particularly unlucky; Gregersen, 1996). A tradition common among some Islamic followers, although not prescribed by the religion itself, involves a painful and dangerous procedure in which the clitoris is removed and the vagina is stitched up to assure chastity prior to marriage (a permanent alternative to the metal chastity belts of the Middle Ages of European culture; Toubia, 1993).

There are a number of other theoretical perspectives that provide insight into the human propensity for regulation of sex. Indeed, Becker (1962) argued that strict sexual regulation became critical for harmony and cooperation among our primate ancestors because, with a monthly estrous cycle and group living, there were always receptive ovulating females and potential conflict over access to them. From a similar evolutionary perspective, Trivers (1971) and Buss (1992) have suggested and empirically investigated a number of evolved psychological mechanisms that serve to promote reproductive success by restricting procreative behavior. It has also been suggested that sex is regulated, especially among women, for reasons such as social power and control (e.g., Brownmiller, 1975; de Beauvoir, 1952).

Undoubtedly these factors do contribute to the human propensity for sexual regulation; however, we suggest that mortality concerns also play a significant role. The terror management perspective seems particularly useful for understanding many of the cultural taboos and strategies we have just discussed because they typically focus on denying the more creaturely aspects of sex and sustaining faith in the idea that humans are spiritual beings. Of course, the most definitive support for the role of mortality concerns in attitudes toward sex should come from experimental evidence, and the present research was designed to add to a growing body of research supporting such a role.

Love and Other Meaningful Views of Sex

Of course, regardless of celibacy vows and other restrictions on sexual behavior, sex happens (or none of us would be here!). How then are the threatening aspects of sex "managed"? We suggest that the answer involves embedding sex within the context of one's meaning-conferring CWV. Whereas some of the body's creaturely functions are denied by confining them to private quarters (e.g., bathrooms and menstrual huts) and finding them disgusting (e.g., Haidt, Rozin, McCauley, & Imada, 1997), sex, because of its very strong positive appeal, is often transformed by embracing it as part of a profound and uniquely human emotional experience: romantic love. Love transforms sex from an animal act to a symbolic human experience, thereby making it a highly meaningful part of one's CWV and obscuring its threatening links to animality and mortality. Indeed, research has shown that sex and love often accompany one another (e.g., Aron & Aron, 1991; Berscheid, 1988; Buss, 1988; Hatfield & Rapson, 1996; Hendrick & Hendrick, 1997), sexual arousal often leads to increased feelings of love for one's partner (Dermer & Pyszczynski, 1978), and, at least among Americans, sex is legitimized by viewing it as an expression of romantic love (e.g., Laumann, Gagnon, Michaels, & Stuart, 1994). Furthermore, Mikulincer, Florian, Birnbaum, and Malishkevich (2002) have recently shown that close relationships can actually serve a death-anxiety buffering function.

In addition to romantic love, there are other ways in which sex can be elevated to an abstract level of meaning beyond its physical nature. CWVs provide various other meaningful contexts for sex; for example, sexual prowess can serve as a source of self-esteem, sexual pleasure can be used as a pathway to spiritual enlightenment, and we would even argue that some of the so-called sexual deviations can be understood as making sex less animalistic by making it more ritualistic or transforming the source of arousal from the body to an inanimate object, such as a high heel shoe (see Becker, 1973). In these ways, sex becomes an integral part of a symbolic CWV that protects the individual from core human fears.

Sex, Death, and Neurosis

This perspective implies that people who have difficulty sustaining faith in a meaningful CWV would be particularly troubled by their corporeality, and in particular, by both sex and death. Clinical theorists from Freud on have suggested that neuroses and many other psychological disturbances are associated with an inability to successfully manage anxiety associated with death and sexuality (e.g., Becket, 1973; Brown, 1959; Freud, 1920/1989; Searles, 1961; Yalom, 1980). Following Becket (1973), we believe that neuroticism arises in part out of difficulties with the transition during socialization from living as a mere physical creature to existing as a symbolic cultural entity (Goldenberg, Pyszczynski, et al., 2000). (1) We suggest that because of their insecure attachment to the CWV (which offers the possibility of transcendence over the physical realities of existence), neurotics are especially troubled by physical activities that can remind them of their mortality. Consistent with this view, empirical researchers have shown a consistent pattern of correlations between neuroticism and (a) concerns about death (e.g., Hoelter & Hoelter, 1978; Loo, 1984), (b) disgust sensitivity (e.g., Haidt, McCauley, & Rozin, 1994; Templer, King, Brooner, & Corgiat, 1984; Wronska, 1990), and (c) worry about sex, including the tendency to view sex as disgusting (e.g., Eysenck, 1971).

We (Goldenberg et al., 1999) recently reported three experiments that we believe to be the first empirical demonstration of an association between sex and mortality concerns among individuals high in neuroticism. In Study 1, high-neuroticism participants expressed decreased attraction to the physical aspects of sex subsequent to reminders of their own death. In a more direct test (Study 2), thoughts of either the physical or romantic aspects of sex were primed and the accessibility of death-related thoughts was then measured. Thoughts of physical sex increased the accessibility of death-related thoughts for high- but not low-neuroticism participants. This finding was replicated in a third experiment that added a condition in which thoughts of either love or a control topic were primed after the physical sex prime. Thinking about love but not about another pleasant topic (a good meal) after the physical sex prime eliminated the increased death-thought accessibility that thoughts of physical sex otherwise produced among neurotic participants. These findings suggest that at least for neurotics, love obscured the deadly connotations of sex by transforming creaturely copulations into meaningful amorous adventures.

The Present Research: The Role of Creatureliness in the Sex-Death Connection

As suggested at the outset of this paper, the present research was designed to answer two questions: (a) Under what conditions would people generally (independent of level of neuroticism) show such sex-death effects, and (b) what is it about sexuality that leads to these effects? The hypothesized relationship between sex and death has thus far been established only for individuals scoring high in neuroticism. We have suggested that these effects have been limited to neurotic individuals because such individuals lack the soothing balm of meaning imparted by sustained faith in a meaningful CWV, and thus, we propose that sex will be more generally a problem when people lack a meaningful cultural context in which to embed sex and elevate it above a mere physical activity. Although the previous research is consistent with this theoretical framework, it has yet to be explicitly shown that a concern about creatureliness underlies the sex-death connection.

The present research was designed to show just that by testing the proposition that sex is threatening because it has the potential to undermine our efforts to elevate humans to a higher and more meaningful plane of existence than mere animals. Whereas neurotics are especially troubled by the connection between sex and death because they have difficulty embedding sex in the context of a system of cultural meaning, our conceptualization implies that the physical aspects of sex would be threatening to anyone when sex is stripped of its symbolic meaning; one way to do this is to make creatureliness especially salient. Conversely, when individuals are able to embed themselves in a meaningful cultural system, sex should not pose such a threat.

A recent set of studies examining the tendency for humans to distance themselves from other animals offers a possible way to make creatureliness especially salient. Goldenberg et al. (2001) hypothesized that MS would intensify disgust reactions because, as Rozin, Haidt, and McCauley (1993) have argued, such reactions assert that we are different from and superior to mere material creatures. In support of this reasoning, Goldenberg et al. found that MS led to increased reactions of disgust to animals and bodily products. More direct evidence was provided by a follow-up study showing that MS (but not thoughts of dental pain) led people to express strong preference for an essay describing people as distinct from animals over an essay emphasizing the similarity between humans and animals (Goldenberg et al., 2001). This latter study suggests that these essays might be useful for increasing or decreasing concerns about creatureliness, which should then affect the extent to which physical sex reminds people of death. Study 1 was designed specifically to test this hypothesis.

STUDY 1

In Study 1, we assessed the impact of thoughts of physical sex on the accessibility of death-related thoughts after creatureliness had been primed. Participants were primed with creatureliness reminders via the essays used in Goldenberg et al. (2001) that discussed the similarity or dissimilarity between humans and other animals. Participants then completed the physical or romantic sex subscales used in Goldenberg et al. (1999), followed by a measure of death accessability. We hypothesized that when participants were reminded of their similarity to other animals, sex would be stripped of its meaning, and consequently, death thoughts would be more accessible following the physical sex prime than following the romantic sex prime. However, when the special position of humans in the animal kingdom was fortified, we did not expect the physical sex prime to increase death-thought accessibility. Because of the hypothesized impact of the creatureliness prime manipulation, we expected neuroticism to play a diminished role in the current experiment.

Method

Participants

Participants were 66 females and 52 males enrolled in introductory psychology classes at three Colorado universities who participated in exchange for course credit. Ages ranged from 17 to 54, M = 24.08, SD = 8.15.

Materials and Procedure

Materials were administered in a classroom setting. After obtaining informed consent, the experimenter instructed participants to work through the packets at their own pace and assured them that all responses would be held in strictest confidence. The packets took approximately 25 minutes to complete. Participants were then extensively debriefed.

Neuroticism. To categorize participants as high or low in neuroticism, we administered the neuroticism subscale of the Eysenck Personality Inventory (Eysenck & Eysenck, 1967), embedded second among several filler measures (in order of presentation, Rosenberg, 1965; Noll & Fredrickson, 1998; Franzoi & Sheilds, 1984) to maintain the cover story of a "personality assessment." Neuroticism scores were computed by summing the number of affirmative responses on the 23-item measure.

Creatureliness prime. To prime or buffer creatureliness, we provided participants with an essay with one of two themes: the similarity of humans to other animals or the uniqueness of humans as compared with other animals (Goldenberg et al., 2001). The former essay claimed that "the boundary between humans and animals is not as great as most people think" and "what appears to be the result of complex thought and free will is really just the result of our biological programming and simple learning experiences." The latter essay, on the other hand, stated that "Although we humans have some things in common with other animals, human beings are truly unique ... we are not simple selfish creatures driven by hunger and lust, but complex individuals with a will of our own, capable of making choices, and creating our own destinies." Both essays were described as written by honors students at a local university and were entitled "The most important things that I have learned about human nature." Students were instructed to read the essay carefully because they were to be asked several questions about the essay at the end of the packet.

Sexual prime manipulation. We used the measure developed by Goldenberg et al. (1999) to make salient either the physical or romantic aspects of the sexual experience. The measure consists of 20 items, 10 of which reflect physical aspects of sex (e.g., "feeling my genitals respond sexually" and "feeling my partner's sweat on my body") and 10 of which reflect the romantic or personal connection aspect of sex (e.g., "feeling close to my partner" and "expressing love for my partner"). Because romantic items reflect the aspects of the sexual experience that are symbolic and unique to humans, they should not be threatening. For this study (as in Goldenberg et al., 1, Study 2), participants were provided with one of the two subscales. The instructions for the physical sex subscale were as follows: "Please take a few moments and think about what it is about having sex that appeals to you. You need not have experienced the actual behaviors listed below, nor do you need to currently have a partner. Please rate how appealing each experience would be at this moment and respond with the first answer that comes to mind." For the romantic subscale the words "having sex" were replaced with "making love." The measures were not scored, but were used only to prime thoughts of physical or romantic sex.

Negative affect. The Positive and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988), a 20-item mood measure, followed the sexual prime manipulation. A negative affect score was calculated by computing the mean of the 10-item subscale. The PANAS was included to confirm that the effects of our manipulation were specific to death accessibility and were not caused by negative affect.

Death word accessibility measure. The dependent measure for this study consisted of the word-fragment completion task used in Goldenberg et al. (1999) and other terror management studies, and was based on similar measures used in other research (e.g., Bassili & Smith, 1986). Participants were provided with 25 word fragments, 5 of which could be completed with either a death-related word or a neutral word. For example, COFF_ _ could be completed as "coffin" or "coffee." Death thought accessibility scores consisted of the number of death-related responses.

Essay evaluation. At the end of the packet we included the six items used by Goldenberg et al. (2001) to assess participants' reactions to the essay. Specifically, participants were asked, "How much do you think you would like this person?," "How intelligent do you believe this person to be?," "How knowledgeable do you believe this person to be?," "Is this person's opinion well-informed?," "How much do you agree with this person's opinion?," and "From your perspective, how true do you think this person's opinion is of the topic they discussed?" All items were responded to on 9-point scales, with 1 reflecting the most negative evaluation and 9 reflecting the most positive. We computed a composite measure of reactions to the essays by taking the mean of the responses to the six items (Cronbach's Alpha = .90).

Results

Essay Evaluations

A one-tailed t test confirmed that people had more negative reactions to the humans are animals essay compared to the humans are unique essay, t (112) = -1.81, p = .035, Ms = 5.36 (SD = 1.57) and 5.88 (SD = 1.51), respectively.

Death Thought Accessibility

Although we had no a priori hypotheses concerning gender, we included gender as a variable in a preliminary analysis. The results revealed that there were no main effects of gender, nor did gender interact with any of the other variables. Further, identical patterns of significant results were obtained on the other independent variables with or without gender. Therefore, gender was dropped from the analysis.

A 2 (creatureliness prime) X 2 (sex prime) X 2 (neuroticism) ANOVA was then performed on death-thought accessibility scores. Neuroticism was dichotomized into a high-neuroticism group--those scoring at or above the median of 10--and a low-neuroticism group--those scoring below 10. There were no effects involving neuroticism in the ANOVA, nor were there any effects of neuroticism when we followed this test up with hierarchical regression analyses (Cohen & Cohen, 1983) treating neuroticism as a continuous variable (all ps > .13).

As predicted the analysis revealed the predicted creatureliness X sex prime interaction, F (1, 110) = 5.07, p = .026. Means and standard deviations are reported in Table 1. Tests for simple main effects within the humans are animals condition revealed more death-related words after the physical sex prime than after the romantic sex prime, F (1,110) = 4.57, p = .035, whereas in the humans are unique condition the difference was in the opposite direction but was not statistically significant (p = .28). No other pair-wise comparisons were significant.

An ANOVA on the negative affect scale of the PANAS revealed a main effect for neuroticism, F (1, 108) = 7.30, p = .008. High neuroticism participants (M = 1.77, SD = .65) reported more negative affect than low neuroticism participants (M = 1.47, SD = .73). The analysis also revealed an interaction between creatureliness and sex primes, F (1, 108) = 5.15, p = .025. Tests for simple main effects revealed that when participants in the humans are animals condition responded to the romantic sex prime they revealed greater negative affect than both participants primed with physical sex, F (1, 108) = 4.18, p = .043, and those primed with romantic sex after reading the humans are unique essay, F (1, 108) = 8.19, p = .005 (see Table 2). This pattern of means contrasts with the death access findings in which physical sex resulted in greater death access than did romantic sex after the creatureliness prime, suggesting that death access is indeed distinct from more general negative affect. Of course, because the findings for negative affect were unanticipated, they should be interpreted with caution.

To directly test the possibility that negative affect was mediating the effects of worldview threat and sex condition on death accessibility, an ANOVA was conducted on death access scores with negative affect as covariate. This analysis revealed that including negative affect as covariate did not alter the creatureliness X sex prime interaction, F (1, 107) = 6.72, p = .011. We also tested for mediation using the multiple regression technique as outlined by Baron and Kenny (1986). The results revealed no evidence of mediation or partial mediation by negative affect.

Discussion

The results of Study 1 provided initial support for the role of concerns about creatureliness in the relationship between thoughts of physical sex and thoughts of death. Regardless of level of neuroticism, after being reminded of their links to other animals (i.e., their creatureliness), participants led to think of physical sex exhibited elevated death-thought accessibility. Conversely, after being reminded of how different they were from other animals, participants thinking about physical sex did not reveal heightened accessibility of death-related thought.

While the finding that people high in neuroticism were higher in negative affect is consistent with our previous findings (Goldenberg et al., 1999), it is not clear why the creatureliness prime in conjunction with romantic love resulted in heightened negative effect. Perhaps the juxtaposition of the two ideas produced a state of uncomfortable dissonance (cf. Festinger, 1957). However, these findings, along with the mediational analysis, provide discriminate validity of the death-accessibility results. That is, after being primed with creaturely thoughts, physical sex resulted in increased death accessibility, independent of any general negative affective response.

Although we might have predicted a 3-way interaction with high neurotics exhibiting the most death accessibility in response to physical sex after the creaturely prime, and we did in fact test for such an outcome, the analyses revealed that neuroticism did not moderate our results. We view these findings as theoretically consistent with our intended manipulation, and with our proposition that general ambivalence towards sex can be explained by a threat associated with our physical nature, and that often, individuals high in neuroticism are apt to be particularly threatened by this association. Therefore, in the present study, we hypothesized that priming thoughts of humans' similarities to other animals would likely cause people to respond with an especially salient association between death and sex. Perhaps more surprising, the condition in which people were primed with the idea that they were distinct from animals appeared to serve as an antidote for this threat, even among people high in neuroticism. Although neuroticism was not our primary focus in this paper, the fact that neurotics in this condition were not threatened by thoughts about death tentatively suggests that reminders of the specialness of humans may have some particular therapeutic value for neurotic individuals.

Further support for the role of creatureliness in human ambivalence about sex would be obtained if, in addition to affecting the accessibility of death-related thought, these reminders of creatureliness or uniqueness also moderated the effects of MS on the appeal of physical sex. Recall that previous research has shown that individuals high but not low in neuroticism responded to MS by viewing the physical aspects of sex as less appealing. If the results for the high neurotics resulted from their inability to view sex as a meaningful rather than a creaturely activity, then reminding people of their creaturely nature should lead them to find the physical aspects of sex less appealing, independent of their level of neuroticism.

STUDY 2

A theory designed to explain why people are ambivalent about sex should be able to specify factors that affect people's attitudes toward sex. In Study 2 we therefore hypothesized that a creatureliness reminder should lead mortality-salient participants to find physical sex less appealing. In contrast, the uniqueness reminder should mitigate an effect of MS on the appeal of physical aspects of sex. To test these hypotheses, prior to being reminded of their own death or another aversive topic, individuals were again randomly assigned to read an essay that discussed either the relative similarity or dissimilarity between humans and the rest of the animal kingdom. The appeal of the physical and romantic aspects of sex was then measured. Once again, we assessed whether neuroticism moderated the effects, but based on the findings of Study 1 and our intentions to manipulate factors that play a role in sexual ambivalence among the general population, we hypothesized that our manipulations would have these predicted effects regardless of level of neuroticism.

Method

Participants

Participants were 129 university students, 74 females and 52 males (3 students declined to report gender) enrolled in two introductory psychology classes, who participated voluntarily for course credit. Ages ranged from 16 to 54 years old, M = 20.09, SD = 5.63.

Materials and Procedure

The procedure was the same as in Study 1. The content and order of the questionnaires are described below.

Neuroticism. To categorize participants as high or low in neuroticism, they were given the neuroticism measure (Eysenck & Eysenck, 1967) embedded in the same filler items as in Study 1.

Creatureliness prime. Participants read the same essay used in Study 1 describing humans as either similar to or distinct from animals.

Mortality salience. As in previous studies (e.g., Greenberg et al., 1990), MS was manipulated with two open-ended questions that reminded participants of either their death or another aversive topic. Both questionnaires were described as an "innovative personality assessment" and consisted of two items with space provided below each for freely written response. The death questionnaire contained the items "Please briefly describe the emotions that the thought of your own death arouses in you" and "What do you think happens to you as you physically die and once you are physically dead?" The control questionnaire asked parallel questions about failing an important exam.

Negative affect. As in Study 1, the PANAS (Watson et al., 1988) was administered to address the alternative explanation that negative affect mediates the effects of our manipulations on the primary dependent measure.

Word search delay. A word search puzzle was included to provide a delay and distraction because previous research has shown that MS effects occur when death-related thoughts are highly accessible but not in current focal attention (e.g., Greenberg et al., 1994). Participants were asked to search for 12 neutral words embedded in a matrix of letters. Approximately 3 minutes were needed to complete the word search.

Appeal of physical sex. To measure the appeal of physical aspects of sex, we used the same scales used by Goldenberg et al. (1999) that were also employed to manipulate the salience of different aspects of sex in Study 1. However, in contrast to Study 1, participants responded to the entire 20-item measure. The instructions were identical to those in Study 1; however, rather than describe the behaviors as "having sex" or "making love," the more general phrase "sexual experience" was employed. An appeal of the physical aspects of sex score was calculated as the mean response on the physical sex items, with 1 representing the least appealing and 7 the most appealing response to each item. The romantic subscale served as an anchor for the physical items and also as a comparison to show that the effects of MS and the essay were specific to the physical aspects of sex. In the present study, the inter-item reliability was satisfactorily high (Cronbach's alpha = .92 for the physical sex subscale, and Cronbach's alpha = .93 for the romantic sex subscale).

Essay evaluation. As in Study 1, we used six questions to assess reactions to the essay (Cronbach's Alpha = .89).

Results

Essay Evaluation

As in Study 1, a one-tailed t test on reactions to the essays confirmed that participants who read the essay suggesting that humans were similar to animals reacted more negatively to the essay than did participants who were reminded that they were unique compared to animals, t (123) = 3.06, p < .001. Means were 5.69 (SD = 1.63) compared to 6.47 (SD = 1.21), respectively, with higher numbers reflecting more positive evaluations. (2)

Appeal of Physical Sex

Once again, we conducted a preliminary analysis with gender in the model. Although there was a main effect revealing that males found the physical aspects of sex more appealing than females, F (1,110) = 23.86, p < .0005 (M = 5.11, SD = 1.39 vs. M = 3.78, SD = 1.51, respectively), there was no hint of an interaction with the other independent variables, nor did including gender in our analyses change any of the other effects. Gender was therefore dropped from the analysis.

We next proceeded with a 2 (creatureliness prime) X 2 (MS) X 2 (neuroticism) ANOVA on the appeal of physical sex scale. Once again we performed a median split on neuroticism scores, yielding a high-neuroticism group with scores above 9 and a low-neuroticism group with scores of 9 and below. Although the median was 10 in Study 1 and 9 in Study 2, the groups were split at the same point in the distribution, because in Study 1 participants scoring on the median were put in the high-neuroticism group and in Study 2 they were put in the low-neuroticism group. The results of the ANOVA and hierarchical regression revealed no effects involving neuroticism (all ps > .42).

The analysis did, however, reveal the predicted creatureliness prime x MS interaction on the appeal of physical sex, F (1,121) = 7.19, p = .008. Means and standard deviations are reported in Table 3. Tests for simple main effects within the humans are animals condition revealed that participants found physical sex less appealing after reminders of death compared to the control condition, F (1, 121) = 4.67, p = .033, whereas in the humans are unique condition this difference did not approach statistical significance (p > .10). Also, within the mortality-salience condition, participants in the humans are animals condition reported finding physical sex less appealing than did those in the humans are unique condition, F (1,121) = 5.83, p = .017; there was no difference in the control condition (p >. 17).

As expected, a parallel 2 x 2 x 2 ANOVA on the appeal of romantic sex scores revealed no effects approaching significance; there was no indication that when participants were reminded of their creatureliness (humans are animals essay condition), mortality salience reduced the appeal of romantic sex (p = .64). We also ran the analyses with physical versus romantic aspects of sex as a repeated-measures variable. The repeated-measures ANOVA produced the same pattern of results with the additional 3-way interaction between mortality salience, essay condition, and physical versus romantic sex. The results confirmed that the effects are specific to the physical aspects of sex; there were no significant effects within the romantic sex condition (ps > .31). Not unexpectedly, there was also a main effect of the repeated-measures variable; there was a clear preference for the romantic compared to the physical aspects of sex, F (1, 121) = 162.96, p < .0005.

We did consider the possibility that such a threat might actually increase the appeal of romantic sex. However, as with prior research (Goldenberg, McCoy, Pyszczynski, Greenberg, & Solomon, 2000; Goldenberg et al., 1999), these data revealed a strong ceiling effect for responses on the romantic items (mode = 7, M = 6.02, SD = 1.08), attesting to the tremendous value that nearly all of our participants placed on romantic aspects of the sexual experience.

Negative Affect

A 2 (creatureliness prime) X 2 (MS) X 2 (neuroticism) ANOVA performed on the negative affect scale of the PANAS revealed only a main effect for neuroticism, F (1, 121) = 5.67, p = .019. High neuroticism participants (M = 1.90, SD = .74) reported more negative affect than low neuroticism participants (M = 1.61, SD = .69). To assess the possibility that negative affect was mediating the interaction of creatureliness and MS on appeal of physical sex, we used the Baron and Kenny (1986) multiple regression technique and found that there was no mediation or partial mediation. Additionally, an analysis of covariance (ANCOVA) on appeal of sex scores with negative affect as covariate did not alter the significant creatureliness X MS interaction, F (1, 120) = 7.25, p = .008, or any of the simple effects.

Discussion

Study 2 provided additional support for the role of creatureliness in the sex-death link, and demonstrated that people's attitudes toward the physical aspects of sex could be influenced by theoretically relevant variables. Specifically, when human creatureliness was salient, MS reduced the appeal of physical aspects of sex. However, when human uniqueness was salient, MS had no such effect; within the uniqueness condition, mortality-salient participants reported nonsignificantly higher appeal of physical sex than their exam-salient counterparts. Consistent with our reasoning, romantic aspects of sex--aspects imbedded in a meaningful view of sexual behavior--were not affected by the creatureliness and MS manipulations.

GENERAL DISCUSSION

The present findings support the view that the awareness of one's self as a mere physical creature plays a role in the threat associated with the physical aspects of sex, and further, that this threat is rooted in mortality concerns. The data reveal that MS reduces the appeal of physical sex and that thoughts of physical sex increase the accessibility of death-related thoughts when sex is stripped of its symbolic cultural meaning by activating concerns about human creatureliness. In both studies, when concerns about creatureliness were assuaged by reading an essay that elevated humans above other animals, MS and thoughts of physical sex had no such effects.

We view the dichotomous manipulation--creatureliness reminder or creaturely buffer--as two ends of a continuum. People highly focused on the similarities between humans and animals should be especially threatened by physical aspects of sex, whereas people focused on human distinctiveness should not. Most likely because of the directness and strength of the conditions we created, neuroticism did not moderate these effects as it did in the prior studies in which we did not direct participants to focus on or away from their creatureliness. In fact, we designed this study as we did to manipulate a critical factor that we believe may have distinguished the high and low neurotics in our previous research. Although this work was not designed to test this assumption directly, we did find that in the control condition (in Study 2, when mortality was not salient), neuroticism was associated with a tendency to perceive the humans are animals essay as accurate, r (32) = .29, p = .097, whereas it was not similarly associated with acceptance of the humans are unique essay, r (32) = -.05. (3) Of course, further research examining this assumption is needed.

Because we didn't include a no essay or neutral essay condition, we cannot be sure we would have replicated the prior evidence of moderation by neuroticism. This is an unfortunate limitation of the present studies. However, the prior effects regarding neuroticism were highly significant in three studies, and so there is good reason to believe they are replicable.

Although we are left with some uncertainty regarding that issue, we do not believe that the lack of a condition in which neuroticism moderates these effects undermines the contribution of this research. Rather, the present results extend our earlier findings beyond the exclusive realm of high neurotics. This is a critical step if our theorizing is to provide a general account of humankind's ambivalence and difficulties with sexuality. However, because the current research drew its sample from a homogenous population of college students (who were mostly white and Christian), this is clearly only a first step in such a conclusion. It is unclear whether our findings would generalize to older adults, and also whether these findings would be relevant to other cultures with different religious influences. For example, it is possible that older people, through greater experience, are better able to come to terms with the creaturely aspects of sex. Clearly, further research with a variety of samples and with other operationalizations of the theoretically relevant variables is needed.

Cultural Variability

Although virtually all cultures restrict and disguise sexual behavior in some ways, some seem more restrictive than others. Similarly, some cultures seem to go to great lengths to distance humans from other animals, whereas others do not. Often, however, cultures that do not engage in distancing confer spiritual status--a soul--to all living creatures. This fits with the terror management position because the connection between humans and other animals is only threatening if animals are viewed as material mortal creatures. Anthropological and cross-cultural evidence exploring whether closer-to-nature cultures are less anxious about the physical aspects of sex would help inform our position.

Implications Regarding Sexual Regulation

Although social scientists from Freud on have viewed ambivalence about sex as a byproduct of cultural mores, the present research supports an opposite causal sequence. The findings suggest rather that rules and restrictions for sexual behavior protect individuals from confrontation with their underlying animal nature that frightens us because of our knowledge that all creatures must someday die. We do not mean to imply that cultures regulate sex solely for this reason. Certain restrictions most definitely serve other functions, as evolutionary and sociological perspectives suggest, and these functions are even probably the primary reason for some restrictions. A terror management perspective, however, provides unique insight into just why cultural conceptions and regulations of sexuality so often seem designed to deny the animal nature of sexuality and imbue it with symbolic meaning.

Pornography

Although mainstream culture outwardly frowns on pornography, many individuals privately enjoy erotic entertainment. At first blush this may appear to contradict our perspective, since pornographic representations are often explicitly physical in nature. Of course, we are not saying that sex is not appealing, or that physical aspects of it don't contribute to that appeal; they most certainly do. However, it is relevant that pornographic images for the most part are not entirely creaturely, but rather seem consistent with the hypothesized ambivalence associated with the body and sex. The images are sexual, but at the same time the models, usually women, are neutralized or objectified: their bodies are augmented, manicured, shaved, and often airbrushed to perfection. It is the uncommon case that images are outright creaturely, but as many researchers have noted, such demeaning representations, again usually of women, can serve to make the consumer, usually male, feel powerful (e.g., Dworkin, 1989). Our analysis does not predict that people will avoid the physical aspects of sex, but rather that there is the potential for threat associated with physical sex, that the threat is associated with concerns about our creatureliness and our own mortal nature, and that people implement strategies to make it less threatening. No doubt, however, there is a very strong appeal of physical sex, for many obvious reasons, but even in pornography there is evidence of symbolic strategies (e.g., objectification and sexual prowess) that may help deflect the threat.

Other Creaturely Behaviors

If our conceptual analysis is correct, sex should not be the only domain of human behavior that is threatening because of its creaturely aspects. Other behavior associated with the physical body should also be potentially threatening when not cloaked in cultural meaning. Accordingly, research has shown that the body and its functions and byproducts are considered the primary objects of disgust across a wide range of cultures (Angyal, 1941; Haidt et al., 1997; Rozin & Fallon, 1987; Rozin et al., 1993). And as mentioned previously, when reminded of their mortality people report being more disgusted by body products and animal reminders, suggesting that the disgust response itself may serve as a defense against mortality concerns (Goldenberg et al, 2001). Leon Kass' (1994) observation that eating is refined and civilized by a host of customs that not only regulate what people eat, but also where, when, with whom, and how, makes a similar point. In a related vein, we have recently suggested that a diverse array of things people do to try to attain bodily perfection (cf. Fredrickson & Roberts, 1997) may be another attempt to meet the same end (Goldenberg, McCoy, et al., 2000; Goldenberg, Pyszczynski, et al., 2000).

Clinically Significant Sexual Problems

Clinical research suggests that anxiety often plays a leading role in sexual dysfunction (Masters, Johnson, & Kolodny, 1982/1985). From a terror management perspective, concerns about the psychological sources of meaning and value that function to protect individuals from such anxiety may often become so prominent as to interfere with healthy and pleasurable sexual experience. For example, males with performance anxiety may be suffering because they are over-invested in sexual behavior as a basis of self-worth (Chesler, 1978; Masters et al., 1982/1985). Similarly, women who have difficulty deriving pleasure from sex or those more generally inhibited about sex may be troubled with constant self-monitoring of their body's appearance or "proper" demeanor during such experience (Masters et al., 1982/1985; Wolf, 1991). The finding of Goldenberg et al. (1999) that thoughts of love eliminate the connection of thoughts of sex and thoughts of death among neurotic individuals is consistent with this possibility. From a therapeutic perspective, an awareness of the functions that such concerns serve could lead to either more adaptive strategies for attaching meaning and value or attempts to confront the source of one's anxiety (i.e., mortality and physicality concerns) as worthy approaches to pursue in helping individuals with such problems (see Yalom, 1980).

CONCLUSION

In sum, the research reported in the present article may help explain why humans exhibit so much ambivalence toward sexuality. Although we have focused on the threat associated with the physical aspects of sex, there is no question that human being are inherently drawn to the physical aspects of sex for many reasons, most notably reproduction and pleasure. Yet, there is evidence that our attitude toward sex is not all approach but also avoidance. In this work we have outlined some existential factors that increase avoidance. Specifically, we demonstrated that when individuals were likely to associate the physical aspects of sex with an animal act, thinking about physical sex served to prime thoughts about death, and thinking about death decreased the appeal of physical sex. From the perspective of TMT, the association between sex and our animal nature interferes with our attempt to elevate ourselves above the rest of the natural world and thus deny our ultimate mortality. Recognizing the conflict between our animal and symbolic natures in the domain of human sexuality may shed light on a myriad of problems associated with this most pleasurable aspect of human existence.

Table 1. Mean and Standard Deviation Death Accessibility
Scores as a Function of Creatureliness Prime and Sex Condition

     

Sex condition

 
      Physical Romantic
Essay theme M SD N M SD N
Humans are animals 1.61 .95 31 1.13 .72 31
Humans are unique 1.26 .76 27 1.48 .98 29

Note. Higher values reflect higher levels of death thought accessibility.

Table 2. Mean and Standard Deviation Negative Affect Scores as a Function of Creatureliness Prime and Sex Condition

     

Sex condition

 
      Physical Romantic
Essay theme M SD N M SD N
Humans are animals 1.52 .60 31 1.90 .87 31
Humans are unique 1.65 .70 27 1.40 .49 27

Note. Higher values reflect higher levels of negative affect.

Table 3. Scores as a Function of Creatureliness Prime and Scores as a Function of Creatureliness Prime and Mortality Salience

     

Mortality salience

 
      Death Exam
Essay theme M SD N M SD N
Humans are animals 3.77 1.66 32 4.68 1.36 33
Humans are unique 4.78 1.41 33 4.13 1.79 31

(1) Our analysis of neuroticism does not preclude the possibility of a genetic or biological predisposition toward this condition. For a variety of reasons, there may be some people who are constitutionally impaired in their ability to become securely embedded in a symbolic conception of reality.

(2) Although one might be tempted to predict an interaction between MS and essay (as was found in Goldenberg et al., 2001), we did not hypothesize an interaction in this study because the evaluation of the essay occurred after participants were provided an opportunity to defend via responses to the physical sex items, and as has been shown previously (McGregor et al., 1998), defending in one manner eliminates the need to defend in another (i.e., dishing out hot sauce to an individual with a stomach ulcer eliminates negative evaluations). As expected, therefore, an ANOVA revealed no hint of interaction between MS and essay condition (p > .51).

(3) To assess whether the essays were perceived as accurate, we formed a composite item by averaging responses on the last three items on the measure assessing reactions to the essays (see description in text). Whereas the first three items reflect reactions to the author, the last three assess the validity of the ideas expressed in the essays. The three items showed high internal validity (Cronbach's Alpha = .90).

by Jamie L. Goldenberg, Cathy R. Cox, Tom Pyszczynski, Jeff Greenberg, Sheldon Solomon

 

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Manuscript accepted June 12, 2002

Jamie L. Goldenberg Boise State University

Cathy R. Cox and Tom Pyszczynski University of Colorado at Colorado Springs

Jeff Greenberg University of Arizona

Sheldon Solomon Brooklyn College This research was supported by National Science Foundation grants (SBR-9312546, SBR-9601366, SBR-9601474, SBR-9731626, SBR-9729946).

Address correspondence to Jamie Goldenberg, Department of Psychology, Boise State University, Boise, ID 83725-1715

APA Reference
Staff, H. (2021, December 25). Understanding Human Ambivalence About Sex: The Effects of Stripping Sex of Meaning, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/articles/understanding-human-ambivalence-about-sex

Last Updated: March 26, 2022

How to Improve Your Body Image

Statistics show that the majority of women are unhappy with their bodies. Negative body image can impact your self-esteem and throw a damper on your sex life. Some of us have been harboring visions of svelte bodies for our entire lives, but it's time to question whether that vision is necessary, productive, or realistic! Here are a few suggestions for improving your body image:

  • Start a list of all the attributes you like about your body. Keep it somewhere and add to it. Share it with a partner.
  • Strip down to your birthday suit, stand in front of the mirror and get used to looking at your body. Tell yourself what you like & appreciate your body's uniqueness. If you get good at this, you may end up with some hot erotica!
  • Listen to compliments people give you and try to accept and believe them.
  • Seek out images that show a greater variety of body types. The Web and some magazines and catalogs are attempting to showcase greater diversity in body type.
  • Talk to a close friend & share your anxieties as well as what you admire about yourselves and each other. Try exploring where some of your attitudes originated.
  • Change something about your physical appearance that will boost self-esteem & new clothes, hairstyle, glasses. If you're bound and determined to diet, be realistic. Set reasonable goals, eat nutritiously and get plenty of exercise.
  • Learn how to give and receive massage. This can enhance your appreciation and enjoyment of your body and of others.
  • Read some self-help books about body image and self-esteem.
  • Visit a nude beach or a spa to surround yourself with ordinary people comfortable in their nudity.
  • Make a conscious effort not to verbalize your criticisms (especially if you're around impressionable young girls!).

APA Reference
Staff, H. (2021, December 25). How to Improve Your Body Image, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/body-image/how-to-improve-your-body-image

Last Updated: March 26, 2022