The Impact of COVID-19 on Sexual Health: A Preliminary Framework Based on a Qualitative Study With Clinical Sexologists

Abstract

Introduction In recent months, some attempts were made to understand the impact of COVID-19 on sexual health. Despite recent research that suggests COVID-19 and lockdown measures may eventually impact sexual response and sexually related behaviors, we are missing clinical sexologists’ perspectives on the impact of COVID-19 in sexual health. Such perspectives could inform a preliminary framework aimed at guiding future research and clinical approaches in the context of COVID-19. Aim To explore the perspectives of clinical sexologists about the impact of COVID-19 on their patients’ sexual health, as well as the professional challenges they have faced during the current pandemic. Findings are expected to inform a preliminary framework aimed at understanding the impact of COVID-19 on sexual health. Methods We conducted an online qualitative exploratory survey with 4 open-ended questions with 39 clinical sexologists aged between 32 and 73 years old. The survey was advertised among professional associations’ newsletters. We performed a Thematic Analysis using an inductive, semantic, and (critical) realist approach, leading to a final thematic map. Main Outcome Measures The outcome is the thematic map and the corresponding table that aggregates the main themes, subthemes, and codes derived from participants’ answers and that can serve as a preliminary framework to understand the impact of COVID-19 on sexual health. Results The final thematic map, expected to serve as a preliminary framework on the impact of COVID-19 in sexual health, revealed 3 main themes: Clinical Focus, Remapping Relationships, and Reframing Technology Use. These themes aggregate important interrelated issues, such as worsening of sexual problems and dysfunctions, mental health, relationship management, the rise of conservatism, and the use of new technology that influences sexuality and sexual health-related services. Conclusion The current study allowed us to develop a preliminary framework to understand the impact of COVID-19 on sexual health. This framework highlights the role of mental health, as well as the contextual nature of sexual problems, and subsequently, their relational nature. Also, it demonstrates that the current pandemic has brought into light the debate of e-Health delivery within clinical sexology.

Women’s Sexual Health During the Pandemic of COVID-19: Declines in Sexual Function and Sexual Pleasure

“…Solo sex activities increased: 14.6% reported using sex toys more often and 26.0% reported masturbating more often Culha et al [ 41 ] Turkey Quantitative May 2–May 26, 2020 89 women 96 men in healthcare 30.65 ± 5.99; [ 18 – 53 ] FSFI [ 26 ] IIEF [ 77 ] Sexual desire, sexual intercourse/masturbation frequency, duration of foreplay, and duration of sexual intercourse decreased during the pandemic. Participants privileged non-face to face sexual positions Daneshfar et al [ 39 ] Iran Quantitative - 296 married women 33.68 ± 6.47; [ 18 – 27 , 29 – 46 ] FSFI [ 26 ] Sexual dysfunction impacted quality of life and was related with lower marital satisfaction. Feng et al [ 46 ] China Quantitative May 27–June 6, 2020 150 women 134 men 27.04 ± 4.72; 27.35 ± 4.23; [ 18 – 27 , 29 – 45 ] Ad hoc questionnaire 43.3% of participants reported a decrease in sexual frequency during the pandemic.…”

“…Participants privileged non-face to face sexual positions Daneshfar et al [ 39 ] Iran Quantitative - 296 married women 33.68 ± 6.47; [ 18 – 27 , 29 – 46 ] FSFI [ 26 ] Sexual dysfunction impacted quality of life and was related with lower marital satisfaction. Feng et al [ 46 ] China Quantitative May 27–June 6, 2020 150 women 134 men 27.04 ± 4.72; 27.35 ± 4.23; [ 18 – 27 , 29 – 45 ] Ad hoc questionnaire 43.3% of participants reported a decrease in sexual frequency during the pandemic. Higher sexual satisfaction predicted higher relationship satisfaction (or “intimacy”) Fuchs et al [ 31 ] Poland Quantitative March–April, 2020 764 women 25.1 ± 4.3; [ 18 – 27 , 29 – 41 ] FSFI [ 26 ] Frequency of intercourse, sexual desire, arousal, lubrication, orgasm, satisfaction, and pain decreased during the pandemic.…”

“… Feng et al [ 46 ] China Quantitative May 27–June 6, 2020 150 women 134 men 27.04 ± 4.72; 27.35 ± 4.23; [ 18 – 27 , 29 – 45 ] Ad hoc questionnaire 43.3% of participants reported a decrease in sexual frequency during the pandemic. Higher sexual satisfaction predicted higher relationship satisfaction (or “intimacy”) Fuchs et al [ 31 ] Poland Quantitative March–April, 2020 764 women 25.1 ± 4.3; [ 18 – 27 , 29 – 41 ] FSFI [ 26 ] Frequency of intercourse, sexual desire, arousal, lubrication, orgasm, satisfaction, and pain decreased during the pandemic. The women who did not work experiencing the highest decreases Gillespie et al [ 56 ] UK Quantitative April 19 – April 21, 2020 522 women 257 men 5 non-binary 30.56 ±9.59 [18–59] Coping using sex inventory [ 79 ] Coping using sex did not increase during the pandemic: 30% of participants reported increases, 29% reported decreases, and 41% did not report any changes Gouvernet & Bonierbale [ 37 ] France Quantitative April 27–May 11, 2020 741 women 338 men Mdn = 31 Sexual Modes Questionnaire [ 80 ] 1/3 of participants reported a decrease in frequency of sexual activity and sexual satisfaction.…”

Analysis on the spatio-temporal characteristics of COVID-19 in mainland China

“…Since the outbreak of COVID-19, researchers worldwide have been carrying out a lot of research works on it. These researches can be mainly divided into the following six categories: (1) to study the impact of COVID-19 on human physical and mental health from a biomedical perspective ( Tsamakis et al, 2020 , Xiong et al, 2020 , Pascoal et al, 2021 ); (2) to study the impact of COVID-19 on human production, life, and social and economic development from a sociological perspective ( Takyi and Bentum-Ennin, 2020 , Qian et al, 2021 , Shang et al, 2021 , Beiderbeck et al, 2021 , Jiang et al, 2021 ); (3) to creatively propose new mathematical models or revise some existing models based on relevant data for predicting and analyzing the development of the epidemic in a specific area ( Vianello et al, 2021 , Willis et al, 2021 , Mun and Geng, 2021 , Al-qaness et al, 2021 , Manenti et al, 2020 , Hu et al, 2020 , Cao et al, 2020 , Mojjada et al, 2020 , Yang et al, 2020 ); (4) to analyze the spatial-temporal characteristics of the epidemic in a specific area ( Lv and Cheng, 2020 , Feng et al, 2020 ); (5) to explore related factors which may affect the development of the epidemic ( Hu et al, 2021 ); (6) to evaluate the effects of different epidemic prevention measures ( Leung et al, 2020 , Hasnain et al, 2020 ). In terms of the research purpose and content, the third, the fourth, and the fifth categories are more relevant to the work carried out in this paper.…”

Physical and Psychological Effects of Gender-Affirming Hormonal Treatment Using Intramuscular Testosterone Enanthate in Japanese Transgender Men

“…Sexual dysfunction can arise from stresses and disruptions in any of the interrelated psychological, biological, or social domains responsible for sexual health including many of which may be caused by the global pandemic [8]. Indeed, a recent study of clinical sexologists and their patients' sexual health during the pandemic highlighted the role of mental health issues as precursors of sexual difficulties [9].…”