What Does a Pregnancy Loss Mean for Sex? Comparing Sexual Well-Being Between Couples With and Without a Recent Loss.

It is unclear whether sexual well-being, which is an important part of individual and relational health, may be at risk for declines after a pregnancy loss given the limits of prior work. Accordingly, in a cross-sectional study, we used structural equation modeling to (1) compare sexual well-being levels-satisfaction, desire, function, distress, and frequency-of both partners in couples who had experienced a pregnancy loss in the past four months (N = 103 couples) to their counterparts in a control sample of couples with no history of pregnancy loss (N = 120 couples), and (2) compare sexual well-being levels of each member of a couple to one another. We found that gestational individuals and their partners in the pregnancy loss sample were less sexually satisfied than their control counterparts but did not differ in sexual desire, problems with sexual function, nor sexual frequency. Surprisingly, we found that partners of gestational individuals had less sexual distress than their control counterparts. In the pregnancy loss sample, gestational individuals had lower levels of sexual desire post-loss than their partners but did not differ in sexual satisfaction, problems with sexual function, nor sexual distress. Our results provide evidence that a recent pregnancy loss is associated with lower sexual satisfaction and greater differences between partners in sexual desire, which may be useful information for clinicians working with couples post-loss. Practitioners can share these findings with couples who may find it reassuring that we did not find many aspects of sexual well-being to be related to pregnancy loss at about three months post-loss.

Sexual growth and destiny beliefs: Longitudinal associations with dyadic coping among couples seeking medically assisted reproduction.

BACKGROUND: Medically assisted reproduction is a vulnerable time for couples' sexual health. Believing that sexual challenges can be worked through (i.e., sexual growth beliefs) or that these challenges indicate incompatibility (i.e., sexual destiny beliefs) may be related to dyadic coping-the strategies couples use to cope-with the physical and psychological stressors of medically assisted reproduction. AIM: In the current study we aimed to examine the longitudinal associations between typical (i.e., average) levels of sexual growth and destiny beliefs and positive and negative facets of dyadic coping and how greater than typical levels of these constructs predicted each other across time. METHODS: Couples (n = 219) seeking medically assisted reproduction were recruited for an online longitudinal, dyadic study. OUTCOMES: Couples completed online measures of sexual growth and destiny beliefs and positive and negative dyadic coping at baseline, 6-and 12-months. RESULTS: Random intercept cross-lagged panel models demonstrated that at the within-person level, reporting higher sexual growth beliefs at baseline, relative to their average across time points, was associated with lower negative dyadic coping at 6 months. Higher negative dyadic coping at 6 months, relative to their average, was linked to lower sexual growth beliefs at 12-months. When individuals reported higher sexual destiny beliefs at 6-months, relative to their average, they and their partners reported higher negative dyadic coping at 12 -months. At the between-person level, higher overall levels of sexual destiny beliefs were related to higher overall levels of negative dyadic coping. No associations with positive dyadic coping were identified. CLINICAL IMPLICATIONS: Couples may benefit from identifying and reducing unhelpful beliefs about sex and negative dyadic coping. STRENGTHS AND LIMITATIONS: Strengths of this study include our large, inclusive sample, engagement of community partners, and novel analytical approach to assess change over time. However, following couples in 6-month increments and not using questionnaires specific to medically assisted reproduction may have limited our ability to detect nuanced changes that couples experience during this time. CONCLUSION: Lower sexual growth and higher sexual destiny beliefs may promote couples' engagement in less adaptive coping behaviors as they seek medically assisted reproduction.

Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction.

Introduction: Medically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together. Methods: In line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status-that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model. Results: An individual's greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner's lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive. Discussion: Clinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.

Associations between New Mothers' Partner-Oriented Sexual Values and Sexual Distress in the Transition to Parenthood.

Women commonly experience heightened sexual distress in pregnancy and postpartum, and there is limited knowledge of protective factors. Women report declines in the importance of sexuality during this time, suggesting that valuing sexuality could be a relevant individual difference factor. It may be particularly protective for women to feel successful in living in line with their sexual values. In a longitudinal study, we examined associations between the extent to which women valued their role as a sexual partner, and their success living in line with this partner-oriented sexual value, with their sexual distress. Women (N = 367) reported the importance of their role as a sexual partner, success living according to this value, and sexual distress during pregnancy (18-20 weeks) and at 3, 6, 12 and 24-months postpartum. More strongly valuing one's role as a sexual partner was associated with more sexual distress, both between-person (i.e., across women) and within-person (i.e., variation within women over time). Above and beyond these effects, greater success at living in line with one's partner-oriented sexual value was associated with less sexual distress. Finding ways to live in line with one's sexual values may protect against sexual distress for new mothers in the transition to parenthood.

Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners.

BACKGROUND: Postpartum sexual concerns are associated with depressive symptoms, distress, and lower relationship satisfaction, and are commonly reported by both mothers and their partners. Previous studies have examined changes in postpartum sexual concern using aggregate scores and have not examined patterns of change for unique concerns, thus ignoring that the initial levels and trajectories of a variety of distinct, postpartum sexual concerns may differ from one another and may differ between mothers and partners. AIMS: The aims of the current study were to (i) examine how a variety of postpartum sexual concerns change from 3 to 12 months postpartum for mothers and their partners using a sample of first-time parents, and (ii) examine how mothers and their partners may differ in their initial levels and subsequent changes in postpartum sexual concerns. METHODS: First-time mothers and their partners (N = 203 couples) independently completed a measure of 21 postpartum sexual concerns at 3, 6, 9, and 12 months postpartum. OUTCOMES: Postpartum Sexual Concerns Questionnaire RESULTS: Growth modeling indicated that twelve of mothers' and 6 of partners' postpartum sexual concerns declined over time from 3 to 12 months postpartum, only one concern of mothers' and none of partners' concerns increased over time, and the remaining 8 and 15 concerns were stable for mothers and partners, respectively. At 3 months postpartum, mothers had higher levels of 11 postpartum sexual concerns than partners, while partners had higher levels than mothers on 4 concerns. Compared to partners, from 3 to 12 months postpartum, mothers showed both steeper decreases in concern about body image changes and steeper increases in concern about returning to work. CLINICAL IMPLICATIONS: Various postpartum sexual concerns do not all follow the same pattern of change over time, and mothers and their partners share similarities and differences in these patterns. Clinicians should use a checklist to discuss a range of postpartum sexual concerns with both new mothers and their partners. STRENGTHS AND LIMITATIONS: This is the first study, to our knowledge, to examine how a variety of postpartum sexual concerns change over time and how mothers and partners both differ and are similar in their experiences. Most couples were in mixed-sex relationships, identified as White, and were relatively affluent; results may not generalize. CONCLUSION: A variety of postpartum sexual concerns follow different patterns of change from 3 to 12 months postpartum, and mothers and partners share similarities and differences in these patterns. Allsop DB, Impett EA, Vannier SA, et al. Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners. J Sex Med 2022;19:1366-1377.

Variable Sexual Satisfaction in Pregnancy: A Latent Profile Analysis of Pregnant Wives and Their Husbands.

Although not all couples achieve high levels of sexual satisfaction during pregnancy, evidence of variability in couple sexual satisfaction during pregnancy indicates that sexual dissatisfaction in pregnancy does not apply to all. Subsequently, the current study examined whether a nationally representative U.S. sample of wives and husbands (N = 523 couples) fell into subgroups in terms of their sexual satisfaction during pregnancy and to what degree biopsychosocial factors distinguish potential subgroups. Latent profile analyses, adjusted for pregnancy-related biological factors, indicated that couples could be classified into two subsets - a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset - the only significant group membership predictor among a variety of other factors. Implications include notions that couples and practitioners should consider women's depressive symptoms throughout pregnancy in addition to the perinatal period, and that most U.S. newly married pregnant couples do well navigating sexual satisfaction challenges during pregnancy.

Mindfulness and Sexual Mindfulness as Moderators Between Conflict Resolution and Sexual and Relationship Satisfaction.

Mindfulness has shown positive links with conflict resolution. Additionally, couples skilled in conflict resolution report greater sexual and relationship satisfaction. However, no research has examined the moderating effect of mindfulness, specifically sexual mindfulness, between conflict resolution and sexual and relationship satisfaction. We used 1,627 couples from wave III of the Couple Relationships and Transition Experiences (CREATE) study. Sexual mindfulness moderated the association between conflict resolution and sexual satisfaction, even after controlling for attachment. Wives higher in sexual mindful awareness may rely less on conflict resolution for their sexual satisfaction. Karremans and colleagues' (2017) model of mindfulness and romantic relationships provides a framework for testing whether, when, and how mindfulness increases positive romantic relationship processes and outcomes. Under this framework, mindfulness may provide a mechanism to help couples achieve sexual and relationship satisfaction. Mindfulness and sexual mindfulness may provide a useful mechanism for therapists, educators, social workers, and couples to enhance satisfaction within the romantic and sexual relationship even without partner buy-in.

How Empathy Moderates Associations Between Sexual and Relational Satisfaction.

Those with low sexual satisfaction tend to have low relational satisfaction. However, literature provides examples of those who maintain satisfying relationships despite low sexual satisfaction yet provides few clues as to what factors protect these individuals. Using U.S. nationally representative data from 1569 newlywed couples, we investigated if empathy for one's partner buffers individuals and couples from low relational satisfaction due to low sexual satisfaction. The positive connection between sexual satisfaction and relational satisfaction was weak for those reporting high empathy but was strong for those reporting low empathy. Empathy may protect against poor relational satisfaction when sexual satisfaction is low.

Perspectives from Highly Religious Families on Boundaries and Rules About Sex.

We investigated the intersection of religion and boundaries placed around sex using qualitative data from 198 highly religious Muslim, Christian, and Jewish families. Coding performed by two researchers resulted in six core themes that provide insight into the connection between these two domains. Frequency counts of the core themes, participant quotes, and implications are presented-including the benefits of practitioners inquiring into how clients' faith affects sexual behavior and scripts, how fidelity and vows might serve a protective function for the relationships of highly religious couples, and how religion may empower women in terms of sexual boundary setting.

How Gender Differences in Emotional Cutoff and Reactivity Influence Couple's Sexual and Relational Outcomes.

We evaluated gender differences in differentiation of self, specifically addressing aspects of emotional cutoff (EC) and emotional reactivity (ER), and their association with relational and sexual satisfaction and sexual desire. Midlife U.S. men and women (N = 334 married heterosexual couples; 50% female; 85% Caucasian, mean age 47.4 years) completed online surveys. Men reported higher levels of EC compared to women after accounting for control variables-a medium effect (Cohen's d = .48) which negatively predicted their own relationship and sexual satisfaction as well as partner relationship satisfaction. Women's EC was also negatively associated with their own relationship satisfaction. Women reported higher levels of ER compared to men after accounting for control variables-a small effect (Cohen's d = .18). No associations with ER and outcome variables were found and no other partner effects were found. For couples in which the woman was higher on ER, the association between women's T1 emotional reactivity and men's T2 sexual desire was positive and significant (B = .31, p < .05). These findings underscore the influence of emotional cutoff on relationship satisfaction and sexual desire and the importance of staying engaged even through relational conflict.

Forgiveness and Gratitude: Links Between Couples' Mindfulness and Sexual and Relational Satisfaction in New Cisgender Heterosexual Marriages.

The association of mindfulness with couples' relational and sexual satisfaction may be mediated by forgiveness and gratitude. Although forgiveness and gratitude have individually been shown to play a role in couples' relational and sexual satisfaction, we use an integrated model. This study included 1,360 couples recruited through a nationwide two-stage cluster stratification. Using an actor-partner interdependence model, we found significant indirect effects (ß = 0.01, 0.08, p < .01), indicating that forgiveness and gratitude mediated many of the associations between couples' mindfulness and their sexual and relational satisfaction. This may provide useful information for clinicians and therapists when addressing marital issues.

Associations of mindfulness with adolescent outcomes and sexuality.

INTRODUCTION: Using an online survey, we evaluated how adolescent trait and state mindfulness was associated with positive adolescent outcomes in non-sexually active and sexually active adolescents. Additionally, we evaluated a newly developed measure, the Sexual Mindfulness Measure (SMM), with adolescents. METHODS: We asked 2000 U.S. adolescents (half boys/girls; 1/3 low, medium, and high incomes) aged 13-18 (one group 13-15, another 16-18) about trait mindfulness, sexual state mindfulness, and adolescent outcomes. Using Confirmatory Factor Analysis and structured equation modeling, we evaluated the reliability and validity of the SMM and its associations with adolescent outcomes. RESULTS: Using a trait mindfulness measure, we found that mindful adolescents with no sexual experience, showed positive associations with self-efficacy, body-esteem, and disclosure with both fathers and mothers. Evaluating adolescents who were sexually active, we confirmed that the SMM had a two-factor structure and demonstrated acceptable reliability for both male and female adolescents. We found that the SMM was associated with positive sexual attitudes, body image, self-efficacy, and disclosure to parents above and beyond trait mindfulness. CONCLUSIONS: Trait mindfulness was associated with positive self-assessments and parental disclosure. The SMM provided an important assessment of how sexually active adolescents' ability to remain aware and non-judgmental during sexual experiences may be positively associated with outcomes such as sexual consent, positive body image, self-efficacy, disclosure to parents, and negatively associated with sexual shame and sexual anxiety above and beyond trait mindfulness.