Smoking is Unrelated to Female Sexual Function

Background. Previous research shows that smoking status is unrelated to female sexual difficulties. However, degree of nicotine dependence has not been measured, and the assessment of sexual functioning has not specified penile-vaginal intercourse (henceforth, intercourse), which is more clearly impaired by sexual difficulties than other sexual behaviors. Objectives. To test if smoking status is associated with poorer female sexual function during intercourse, and if nicotine dependence rather than smoking status is related to poorer female sexual function. Methods. During 2012, 129 Portuguese community women reported their smoking status, and completed the Fagerstrom Test for Nicotine Dependence, the Female Sexual Function Index (FSFI), and an adaptation of the FSFI to assess sexual functioning specifically during intercourse, as well as the desire thereof. Results. Smokers reported higher desire for intercourse and were more likely to have actually engaged in it in the past 4 weeks. Among the coitally active women in the preceding 4 weeks, nicotine dependence correlated with lower desire for intercourse. Smoking status and nicotine dependence were unrelated to arousal, lubrication, orgasm, satisfaction, pain. Conclusions. The findings are consistent with many studies that fail to demonstrate an increased risk of sexual difficulties among female smokers. However, nicotine dependence, rather than smoking status per se, might be associated with lower libido. The results suggest the possibility of an inverse U-shaped relationship between smoking and libido with a moderate use of tobacco being associated with higher sexual desire.