Sexual Desire in Women: An Integrative Approach Regarding Psychological, Medical, and Relationship Dimensions

Introduction. Sexual desire depends on the balance between biologic, psychological, and cultural values. Therefore, conceptualizations of female sexual desire difficulties should consider the interrelated role of those factors. Aim. The aim of this study was to test a conceptual model regarding factors often implicated on female sexual desire, in order to understand the way those factors interact in sexual interest. Moreover, we intended to evaluate the mediation role of cognitive-emotional factors between sexual desire and other dimensions such as age, medical problems, psychopathology, or dyadic adjustment. Methods. Two hundred and thirty-seven women from the general population participated in the study. We evaluated psychopathology, dysfunctional sexual beliefs, automatic thoughts and emotions during sexual activity, dyadic adjustment, and presence of medical problems. Main Outcome Measures. Psychopathology measured by the Brief Symptom Inventory, dysfunctional sexual beliefs measured by the Sexual Dysfunctional Beliefs Questionnaire, thoughts and emotions in sexual context measured by the Sexual Modes Questionnaire, dyadic adjustment measured by the Dyadic Adjustment Scale, medical condition measured by the Medical History Formulation, and sexual desire measured by the Sexual Desire subscale of the Female Sexual Function Index. Results. Results from the proposed conceptual model suggest that cognitive factors (mainly automatic thoughts during sexual activity) were the best predictors of sexual desire. In a more specific way, age, failure/disengagement thoughts, and lack of erotic thoughts during sexual activity, showed a significant direct effect on reduced sexual desire. Furthermore, sexual conservatism beliefs, and medical factors showed indirect effects, acting on sexual desire via the presence of lack of erotic thoughts, and failure/disengagement sexual thoughts, respectively. Conclusions. Results from this integrative approach support the need to include cognitive dimensions in the assessment and treatment of sexual desire problems, considering their implication as vulnerability or resilient factors regarding deficient sexual interest in women. Carvalho J, and Nobre P. Sexual desire in women: An integrative approach regarding psychological, medical, and relationship dimensions. J Sex Med 2010;7:1807-1815.