Fundamentals of Mental Health

Fundamentals of Mental Health

What is going on inside me? Lived experience of married women exhibiting hypoactive sexual desire disorder in long-term relationships: A qualitative study

Document Type : Research Paper

Authors
Parisa Ziaee 1
Zohreh Sepehri Shamloo 2
Ali Mashhadi 3
Hossein Shareh 4
1 Ph.D. student of psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.
2 Associate Professor, Department of Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.
3 Professor, Department of Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.
4 Department of Educational Sciences, Associate professor of Letters and Humanities of Hakim Sabzevari University, Sabzevar, Iran.
10.22038/jfmh.2022.20994
Abstract
Introduction: Sexual satisfaction, as a basic human need, has a determining effect on human health, and its absence can cause physical and mental pressures that will threaten individuals' health. Low sexual desire is a common disorder affecting married women and can greatly influence their well-being and disrupt their everyday life. This study aimed to analyze the lived experiences of married women suffering from hypoactive sexual desire disorder in long-term relationships considering cultural drivers.
 
Materials and Methods: This qualitative study (2019-2020) in Mashhad-Iran, was conducted based on the descriptive phenomenology approach. The research data were collected through 20 in-depth and semi-structured interviews and then they were analyzed using Colaizzi's method of data analysis. The participants were also selected through purposive sampling. A mean score of 22.6±2.9 was obtained for full-scale score of Female Sexual Function Index (FSFI) and 107.11±3.2 for Marital Conflict Questionnaire-Revised (MCQ-R).
 
Results: The four core themes extracted from the data were (1) incessant everyday life in long-term relationships, (2) de-sexualized roles, (3) traces of old wounds, and (4) misinterpretation of religious teachings.
 
Conclusion: Personal conflicts and neglected foreplay priorities were the primary causes of married women's low sexual desire in long-term relationships. Couples workshops aimed at preserving and revitalizing relationships and individual treatment of affected women are some potential solutions for alleviating the suffering of this group of women.
Keywords
Hypoactive sexual desire disorder
Marriage
Qualitative research
Women
  1. Eshghi R, Bahrami F, Fatehizadeh M, Keshavarz A. [Studying the effectiveness of couples's sexual cognitive-behavioral therapy on improvement of women's hypoactive sexual desire disorder in Isfahan]. Quarterly journal of consultancy researches 2015; 14: 111-30. (Persian)
  2. Ortigue S, Bianchi-Demicheli F. The Chrono architecture of human sexual desire: a high-density electrical mapping study. Neuroimaging 2008; 43(2): 337-45.
  3. Frost R, Donovan C. A qualitative exploration of the distress experienced by long-term heterosexual couples when women have low sexual desire. Sex Relation Ther 2019; 6(3): 9-16.
  4. Sungur MZ, Gündüz A. A Comparison of DSM-IV-TR and DSM-5 definitions for sexual dysfunctions: Critiques and challenges. Sex Med 2014; 11(3): 64-73.
  5. Kingsberg SA, Woodard T. Female sexual dysfunction focus on low desire. Am J Obstet Gynecol MFM 2015; 125(4): 77-86.
  6. Basson R, Berman J, Whipple B. Report of the International Consensus Development Conference on Female Dysfunction. J Surg Urol 2000; 163(8): 88-93.
  7. Ramezani MA, Ahmadi K, Ghaemmaghami A, Marzabadi EA, Pardakhti F. Epidemiology of sexual dysfunction in Iran: A systematic review and metaanalysis. Int J Prev Med 2015; 6: 43.
  8. Mansourian A. [An epidemiology study of sexual disorders in men and women referring to Saya Counseling Center from 2004 to 2007 in Damghan]. Proceedings of the Third National Congress of Family and Sexual Health. Tehran: Center for Cultural-Artistic Creations, 2007. (Persian)
  9. Shafti V. [A study of the prevalence and effective factors in sexual function disorders in women aged 20 to 60 referring to the clinic affiliated with Shahid Rajaei Hospital in Tonekabon]. Proceedings of the Third National Congress of Family and Sexual Health. Tehran: Center for Cultural-Artistic Creations, 2007. (Persian)
  10. Akbari A, Ozgoli G, Simbar M, Besharat MA. Women’s perceptions and feelings about loss of their sexual desire: A Qualitative Study in Iran. Int J Community Based Nurs Midwifery 2018; 6(2): 167-74.
  11. Traeen B. When sex becomes a duty. Sex Relation Ther 2008; 23(1): 61-84.
  12. Nobre P, Pinto-Gouveia J. Differences in automatic thoughts presented during sexual activity between sexually functional and dysfunctional males and females. J Cognit Ther Res 2004; 32: 37-49.
  13. Nobre P, Pinto-Gouveia J. Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction. J Sex Res 2006; 43: 68-75.
  14. Zahiroddin A, Faridhosseini F, Zamani A, Shahini N. Comparing the efficacy of bupropion and amantadine on sexual dysfunction induced by a selective serotonin reuptake inhibitor. Iranian Red Crescent Med J 2015; 17(12): e24998.
  15. Dürr E. Women's experience of lack of sexual desire in relationships, and implications for intervention. Social Work 2009; 45: 256-74.
  16. Abedi HA, Hosseini N, Shahriari M, Kazemi M, Keshvari M. [Research methodology in nursing and midwifery]. 1st Isfahan: Hasht Behesht; 2008: 256. (Persian)
  17. Saanei A, Nikbakht Naserabady A. [Qualitative methodology in medical sciences]. Tehran: Farda; 2002. (Persian)
  18. Corbin J, Shtraus A. [Principles of qualitative study]. 3rd Afshar E. (translator). Tehran: Ney; 2012: 81-122. (Persian)
  19. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26: 191-208.
  20. Nobre PJ, Pinto-Gouveia J, Gomes FA. Sexual Dysfunctional Beliefs Questionnaire: An instrument to assess sexual dysfunctional beliefs as vulnerability factors to sexual problems. Sex Relation Ther 2003; 18: 171-204.
  21. Wylomanski S, Bouquin R, Philippe H-J, Poulin Y, Hanf M, Dréno B, et al. Psychometric properties of the French Female Sexual Function Index (FSFI). Qual Life Res 2014; 23(7): 2079-87. 
  22. Ibrahim ZM, Ahmed MR, Sayed Ahmed WA. Prevalence and risk factors for female sexual dysfunction among Egyptian women. Arch Gynecol Obstet 2013; 7(11): 73-80.
  23. Wiegel M, Meston C, Rozen R. The female sexual function index (FSFI): Cross validation and development of clinical cutoff scores. J Sex Marital Ther 2005; 31(1): 1-20.
  24. Meston CM. Validation of Female Sexual Function Index (FSFI) in the women with female orgasmic disorder and in women with hypoactive sexual desire disorder. J Sex Marital Ther 2003; 29(1): 39-49.
  25. Mohammadi KH, Heydari M, Faghihzadeh S. [The validity of Persian version of Female Sexual Function Index (FSFI) as a female sexual functioning indicator]. Payesh 2007; 7(2): 269-78. (Persian)
  26. Sanai B. [Family and marriage scales]. 1st Tehran: Besat; 2000: 57-63. (Persian)
  27. Bernz S, Gero N. [Nursing research methodology: Performance, review and application]. Dehghanniravi N, Silany K, Movahhedi AF, Babamohammadi H. (translators). Tehran: Lofty Ideas; 2000: 912. (Persian)
  28. Emami Sigaroud A, Dehghan Nayeri N, Rahnavard Z, Nouri Saeed A. Qualitative research methodology: Phenomenology. Journal of holistic nursing and midwifery 2013; 22(2): 56-63. (Persian)
  29. Guba EG, Linkoln YS. Fourth generation evaluation. 2nd California: Sage; 1989: 45-96.
  30. Wilson H, McAndrew S. Sexual Health: foundations for practice.4th London: Bailliere Tindall; 2000: 25-48.
  31. Fisher WA, Donahue KL, Long JS, Heiman JR, Rosen RC, Sand MS. Individual and partner correlates of sexual satisfaction and relationship happiness in midlife couples: dyadic analysis of the international survey of relationships. Arch Sex Behav 2015; 44(6): 1609-20.
  32. Karen E, Meana M. Why did passion wane? A qualitative study of married women's attributions for declines in sexual desire, J Sex Marital Ther 2010; 36(4): 360-80.
  33. Quinn-Nilas C, Benson L, Milhausen RR, Buchholz AC, Goncalves The relationship between body image and domains of sexual functioning among heterosexual, emerging adult women. Sex Med 2016; 4: e182-9.
  34. Hinchliff S, Gott M, Wylie K. Holding onto womanhood: A qualitative study of heterosexual women with sexual desire loss. Health 2009; 13: 449-65.
  35. Ramezani Tehrani F, Farahmand M, Mehrabi Y, Malekafzali H, Abedini M. [Sexual dysfunction and affecting factors: population-based study among women living in urban areas in the four provinces of Iran]. Payesh 2012; 11(6): 869-75. (Persian)
  36. Metts S, Cupach WR. The influence of relation beliefs and problem solving responses on satisfaction in romantic relationships. Hum Commun Res 1990; 17: 170-85.
  37. Nobre PJ, Pinto-Gouveia J. Cognitive schema activation in sexual context: A questionnaire to assess cognitive schemas activated in sexual failure situations. J Sex Res 2008; 8(4): 87-96.
  38. Ziaee P, Sepehri Shamlou Z, Mashhadhi A. [The effectiveness of sexual education focused on cognitive schemas on the improvement of sexual functioning among female married students]. MS. Dissertation. Mashhad: Ferdowsi University of Mashhad, Faculty of Educational Sciences and Psychology, 2012: 89-122. (Persian)
  39. Hartmann AJ, Crockett EE. When sex isn’t the answer: Examining sexual compliance, restraint, and physiological stress. Sex Relation Ther 2016; 31(3): 312-24.
  40. Nekoolaltak M, Keshavarz Z, Simbar M, Nazari AM. Sexual talk with the spouse: Sarcastic or soothing? Hum Commun Res 2016; 3(13): 31-49.
Fundamentals of Mental Health
Volume 24, Issue 5
September and October 2022
Pages 291-302