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Try out PMC Labs and tell us what you think. Learn More. Research and clinical data have shown that couples with sexual problems report a lack of sexual communication. However, no published meta-analyses have evaluated the relationship between sexual communication and sexual function. Effect sizes were larger for studies conducted outside of the U. We address the importance of addressing the relationship between sexual communication and sexual function as well as future directions for research in this area.

Research demonstrates that couples with sexual difficulties have more sexual communication problems than couples without sexual concerns e. It may be that sexual problems make communication more challenging.

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However, the reverse could also be true; couples that have trouble speaking openly about their concerns, both sexual and non-sexual, may be more likely to develop sexual difficulties. Either way, it is likely that sexual function and sexual satisfaction are both directly impacted by sexual self-disclosure, which may protect against future sexual dysfunction Reese et al. Metts and Cupach defined sexual communication as the combination of sexual self-disclosure, the quality of the sexual communication, and the frequency of the communication.

Frequency of sexual communication captures how often couples discuss different aspects of their sexual relationships. There are numerous potential pathways though which sexual communication may be linked to sexual function. MacNeil and Byershypothesized that two key pathways link sexual communication to sexual satisfaction, which some researchers believe to be an important aspect of sexual function. This pathway is important for several reasons; 1 partners differ in their sexual preferences e.

Importantly, this pathway provides an avenue for altering sexual behavior, thereby potentially addressing sexual function and sexual satisfaction. The second pathway, labeled the expressive pathway, assumes that sexual communication le to greater sexual well-being by enhancing intimacy.

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This enhanced intimacy facilitates sexual communication, creating a positive feedback loop. When partners fail to communicate their sexual needs and preferences, these pathways cannot operate effectively, which in sexual difficulties. Although MacNeil and Byers do not explicitly connect sexual communication to other domains of sexual function, they and others have found empirical support for both the instrumental and the expressive pathways.

According to MacNeil and Byersdisclosure of sexual preferences enables the reconciliation of disparate preferences, maximizes sexual rewards, and minimizes sexual costs, as long as partners respond to the disclosed preferences. The expressive pathway suggests that greater sexual self-disclosure le to greater emotional intimacy, which in turn facilitates increased sexual satisfaction.

Perhaps for that reason, intimacy and love are not often the primary focus of empirical research; however, they are critical ingredients of healthy sexual function for many individuals and couples McCabe et al.

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It is therefore likely that, by increasing emotional intimacy, sexual communication also improves other aspects of sexual function e. Although research suggests a relationship between poor sexual communication and sexual problems, a meta-analysis addressing the strength of the association between these two variables, and specifically the strength of the relationship between sexual communication and specific domains of sexual function, has yet to be published. Although there are relatively consistent findings that speak to the link between sexual communication and sexual function, a synthesis of the findings will allow for a more systematic understanding of this association for different domains of sexual function.

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Further, identification and analysis of the moderators will elucidate how the association between sexual communication and dimensions of sexual function vary by study characteristics. Finally, the findings from our meta-analysis will help identify gaps in the literature and areas to target in future research. Each dimension of sexual function likely has a unique relationship with sexual communication. Sexual problems are multifaceted and complex; a lack of desire or decreased arousal may require a different form of communication between partners than would sexual pain.

Similarly, the relationships between specific sexual concerns and sexual communication may differ between men and women, as different diagnoses pertain to these two groups. In order to elucidate the relationship between communication and different types of sexual problems, it is important to examine each domain of sexual function separately. Sexual desire refers to the motivation to engage in or be receptive to a sexual event, whether partnered or alone. Narratives in popular media frequently portray men as having high or unwavering levels of sexual desire, which may make it difficult for men to report low sexual desire.

Psychological treatments for low desire often highlight the importance of open dialogue and enhancing communication between partners Greenberg, Sexual arousal is an emotional or motivational state characterized by physiological and mental changes in response to an internal or external stimulus Althof et al. In a study that examined factors associated with sexual arousal in women, several participants noted that partner-level variables e. Similarly, communication between partners about erectile function may improve arousal in men.

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Lubrication is distinct from but highly related to sexual arousal in women. No studies have directly assessed the relationship between the quantity of natural lubrication and sexual communication, but research that correlates the six domains of the Female Sexual Function Index Rosen et al. In men, ejaculation is the discharge of semen that is usually accompanied by an orgasm, though they are not always linked. Sex education and communication skills training are often included in the treatment of orgasm disorders. Kelly, Strassberg, and Turner found that women who were unable to achieve orgasm reported more problematic sexual communication with their partners and increased discomfort when talking about sexual issues compared to women without orgasm concerns.

Similarly, a ificant positive correlation between poor sexual communication and premature ejaculation has been reported e. Taken together, there is limited, but consistent evidence that communication or lack thereof about sexual needs can be an important factor in facilitating or inhibiting orgasm. Some women experience ificant genital pain upon or following penetrative intercourse.

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Clinically ificant distress caused by any one of these four symptoms is sufficient to warrant a diagnosis. There is great variability in the severity, location, and initiation i.

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By definition, only women receive this diagnosis, but several studies suggest that men may experience similar problems e. Findings on the relationship between sexual communication and sexual pain are mixed. Perhaps women with better sexual communication are able to adapt sexual activities to for their pain. We examined the following potential moderators of the link between sexual communication and sexual function to understand factors that weaken or strengthen the relationship.

By nature, studies that recruit clinical samples typically report more severe sexual dysfunction symptoms compared to those that recruit non-clinical samples.

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Furthermore, couples in which one partner has a sexual problem also tend to report worse sexual communication compared to couples with no such problems e. Thus, it is possible that the association between sexual communication and sexual function differs between clinical and non-clinical samples. Sometimes, sexual minority populations are included in studies on sexual function, but they are often subsumed in the general population without consideration for potential differences. Sometimes, sexual orientation is simply not assessed.

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Thus, we examined whether effect sizes differ based on the inclusion, lack of inclusion, or inattention to sexual minorities. There were a of variables that we tested as moderators that may be interrelated and may change over time: relationship status, relationship length, age, and year of publication. For example, satisfaction with sexual communication follows a curvilinear pattern over the course of a relationship Wheeless et al.

Specifically, satisfaction with sexual communication increases as a relationship moves towards more commitment, with the highest scores occurring when individuals enter committed relationships. This trajectory may impact the effect size of the association between sexual communication and sexual function, as commitment should be greater in longer relationships or marriages. In both longer relationships and marriages, the link between sexual communication and sexual function may be stronger than in shorter or dating relationships. It is possible that, as relationships develop, sexual needs and desires may change; communication would be necessary to meet new needs.

We therefore examined age as a potential moderator. Lastly, as the self-report instruments that assess sexual communication and sexual function have changed between the oldest and most recent studies included in our analysis, we tested publication year as another potential moderator.

Although direct comparisons of cultural differences in sexual communication are scarce, it is generally accepted that values about sexuality and communication between partners vary from culture to culture Hofstede, Therefore, we examined the effect of the country in which a study was conducted on the relationship between sexual communication and sexual function. Used in over 1, studies Forbes et al. Given the strong psychometric properties of the FSFI, we examined whether the relationship between sexual communication and sexual function differs between studies that used the FSFI and studies that used other tools to measure sexual function.

We investigated the relationship between sexual communication and separate dimensions of sexual function, both un-stratified by gender and for men and women separately i. Both published and unpublished i.

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It was required that studies a measured at least one of the following: sexual desire, arousal, erectile function, lubrication, orgasm, ejaculation, pain, or overall sexual function; b be published in English; c include sufficient information to calculate at minimum one effect size; d include a majority of participants who were currently in a relationship; and e include a measure of interpersonal sexual communication that did not focus on sexual risk. Database searches were conducted for articles between and May Two searches were conducted to maximize the of included studies.

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A database search was then conducted i. The database search returned 1, articles for the specific search. After removing duplicates, abstracts were screened. The screening process resulted in 41 articles.

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The authors reviewed the references lists of the 41 articles and identified any other articles that may have not been captured in the database searches. This search process produced an additional eight articles See Figure 1 for a summary of article selection process. Ultimately, 48 articles were included in this review. In total, these articles included 12, participants, and they led to the calculation of effect sizes see Table 1 for of effect sizes and studies for each dimension of sexual function. For the un-stratified models, we used a three-level model with effect sizes nested within gender, nested within study.

For the gender stratified models, we could not nest the effect sizes within gender, so a two-level model was used. We were interested in evaluating the relationship between sexual function and interpersonal communication.

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There are a few sexual communication scales that measure what we would call intrapsychic sexual communication, which we believe to be distinct from interpersonal communication. It is important to disentangle these two types of sexual communication for several specific reasons.

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First, it is unclear from an assessment of individual willingness or desire to communicate if any direct communication has taken place within the context of a partnership. Second, most studies that use intrapsychic measures focus on the individual and therefore document individual outcomes. We were interested in the dyadic nature of sexual communication and its association with sexual function, so measures that capture shared or interpersonal sexual communication were more appropriate for this analysis.

Because one of the searches relied on the names of the psychometric tools that measured sexual communication, the scales were identified a priori so that we could determine which dimension of sexual communication they assessed. Each of the measures described below were deed to specifically assess one of the three aspects of interpersonal sexual communication sexual self-disclosure, quality of the communication, or frequency of the communication or contain a subscale that assessed sexual communication.

For the sake of brevity, we only discuss the measures that were included in the meta-analysis.

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The SSDQ inquires about the degree to which a person has shared his or her sexual likes and dislikes of six behaviors e. The SSDS-R has 24 subscales with three items each that assess the degree to which partners have discussed specific sexual topics. This measure is unique in that it asks about emotional aspects of sexual communication e.

A detailed code sheet was developed to collect relevant information for the meta-analysis.

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