FACTORS ASSOCIATED WITH SEXUAL DISSATISFACTION AMONG COUPLES IN KINSHASA, DEMOCRATIC REPUBLIC OF THE CONGO
DOI:
https://doi.org/10.46827/ejphs.v9i2.263Keywords:
sexual dissatisfaction, couple relationships, genital aesthetics, cosmeto-gynecology, Democratic Republic of CongoAbstract
Background: Sexual satisfaction is a key component of individual well-being and harmony in a couple. However, sexual dissatisfaction remains underexplored in sub-Saharan Africa, particularly in the Democratic Republic of Congo. This study aimed to identify factors associated with sexual dissatisfaction among couples in Kinshasa. Methods: A community-based cross-sectional study was conducted over a 15-day period in six randomly selected neighborhoods of Kinshasa. Adults aged 18–64 years living in marital or cohabiting relationships were included using a two-stage probabilistic sampling method. Sexual satisfaction was assessed using the Index of Sexual Satisfaction (ISS). Independent variables included sociodemographic, medical, psychological, relational, sociocultural, and aesthetic factors. Data were collected through face-to-face interviews using a structured questionnaire. Multivariable logistic regression analysis was performed to identify independent factors associated with sexual dissatisfaction. Adjusted odds ratios (aORs) with 95% confidence intervals were reported. Results: A total of 454 participants were included, of whom 56.6% were women. The median age was 34 years (IQR: 28–43). The prevalence of sexual dissatisfaction was 20%. In multivariable analysis, factors significantly associated with sexual dissatisfaction included poor sexual communication (aOR = 14.31; p < 0.001), moderate communication (aOR = 15.78; p < 0.001), high stress levels (aOR = 2.78; p = 0.002), infidelity (aOR = 2.01; p = 0.032), and sexual conflicts (aOR = 5.28; p < 0.001). Among women, key determinants included sociocultural stigma, shame associated with sexuality (aOR= 4.41; p=0.035), negative beliefs about contraception (aOR=3.99: p=0.041) and vulvar aesthetic concerns (aOR = 14.85), while the fact that women could speak out about sexual desire was protective (aOR = 0.13). Concerning male-related factors, premature ejaculation (aOR = 3.48; p = 0.028) and interest in genital cosmetic surgery (aOR = 4.56; p = 0.005) were significantly associated with dissatisfaction in couples. Conclusion: Sexual satisfaction among couples in Kinshasa is strongly influenced not only by relational and psychosocial factors but also by genital aesthetic concerns, particularly among women. These findings highlight the need to integrate vulvar body image, sociocultural norm deconstruction, and sexual education into comprehensive care.
References
Joung M, et al. The determinants of marital satisfaction. J Fam Psychol. 2000.
Ziaei T, et al. Sexual satisfaction and its relation with marital satisfaction in married women. Iran J Public Health. 2014.
Haavio-Mannila E, Kontula O. Sexual satisfaction and dissatisfaction in Finland and Sweden. J Sex Res. 1997.
World Health Organization. Working definition of sexual health. Geneva: WHO; 2005.
Lawrance K, Byers ES. Sexual satisfaction in long-term heterosexual relationships. J Sex Res. 1995.
Sánchez-Fuentes MM, et al. The relationship between sexual satisfaction and subjective well-being. J Sex Res. 2014.
Oldsworth E, et al. Sexual satisfaction and psychological well-being in adults. J Health Psychol. 2018.
Ji Y, et al. Sexual dissatisfaction and marital conflict in Chinese couples. Arch Sex Behav. 2017.
Tayebi N, et al. Association between sexual satisfaction and mental health. Iran Red Crescent Med J. 2011.
Jurado A, et al. Cultural factors influencing female sexual dissatisfaction. Sexologies. 2020.
Da Silva MF, et al. Male sexual dissatisfaction and body image: a systematic review. J Mens Health. 2024.
Alves MT, et al. Prevalence of sexual dysfunctions and associated factors. Rev Saude Publica. 2008.
Rosen R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument. J Sex Marital Ther. 1997;23(2):191–208.
Lo SST, et al. The International Index of Erectile Function (IIEF): validation and use. Int J Impot Res. 2019.
Schulz MS, et al. Evaluating sexual satisfaction and therapeutic strategies: a review. J Sex Med. 2024.
Dosch A, et al. Maudsley Global Sexual Satisfaction Scale and sexual well-being. Arch Sex Behav. 2016.
Haavio-Mannila E, Kontula O. Sexual trends in the Baltic Sea area. Helsinki: Population Research Institute; 1997.
Kishor S. Married women's risk of sexually transmitted infections in developing countries. Violence Against Women. 2012;18(7):829–53.
Lindau ST, Schumm LP, Laumann EO, et al. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762–74.
IFOP. Les Françaises et leur vie sexuelle. Paris: Institut Français d’Opinion Publique; 2021.
Rahmani A, et al. Sexual satisfaction and its relation to marital happiness. Iran J Public Health. 2009;38(4):77–82.
Smith AMA, et al. Sexual and emotional satisfaction in relationships. Aust Fam Physician. 2012;41(10):770–4.
Zegeye B, Woldeamanuel GG, Negash W, Shibre G. Sexual satisfaction among married women in Northern Ethiopia. BMC Womens Health. 2023;23(1):112.
Olatayo AA, Kubwa OO, Adekunle AE. Sexuality in Nigerian older adults. Pan Afr Med J. 2015;22:315.
Amidu N, Owiredu WK, Gyasi-Sarpong CK, Woode E, Quaye L. Sexual dysfunction among married couples in Ghana. BMC Urol. 2011;11:3.
Zihalirwa J, et al. Conflits conjugaux liés à la sexualité à Goma. J Afr Sociol. 2018.
Mulenga J, Mbuyi L, et al. Influence of penile size on sexual satisfaction in Congolese couples. Afr J Reprod Health. 2019;23(4):101–8.
Loos A, Kabeya C, et al. Penile perception and partner satisfaction in Central Africa. Int J Sex Health. 2023;35(2):143–50.
Abu-Rayya HM, Abu-Rayya MH, et al. Sociocultural determinants of sexual satisfaction. J Psychol Hum Sex. 2007;19(3):53–74.
Shahghaibi S, Faizi S, Gharibi F. Effect of colporrhaphy on sexual dysfunction. Pak J Med Sci. 2013;29(1):157–60.
Laumann EO, Paik A, Rosen R. Sexual dysfunction in the United States. JAMA. 1999;281(6):537–44.
Nicolosi A, Laumann EO, Glasser DB, et al. Sexual behavior and sexual dysfunction in Europe and the US. Eur Urol. 2006;50:1012–18.
Oladiji JO, et al. Sexual dysfunction among women in Nigeria. Afr Health Sci. 2009;9(3):150–6.
Abdo C, et al. Prevalence of sexual dysfunction in Ethiopia. BMC Womens Health. 2016;16:82.
Khasakhala AA. Sexual dissatisfaction among Kenyan couples. Afr J Reprod Health. 2012;16(1):66–76.
Byers ES. Relationship satisfaction and communication. J Sex Marital Ther. 2005;31:193–209.
MacNeil S, Byers ES. Role of sexual communication. Arch Sex Behav. 2009;38:619–25.
Bancroft J, et al. Stress and sexual dysfunction. J Sex Res. 2003;40:266–72.
Amoateng AY, et al. Infidelity and marital satisfaction in Ghana and SA. Afr Soc Rev. 2017;21(2):5–25.
Barrett G, et al. Sexual health after childbirth. BJOG. 2000;107:186–95.
McDonald EA, et al. Mode of delivery and sexual function. Obstet Gynecol. 2014;123:771–8.
Malein G, et al. Pelvic floor trauma and sexual function. Int Urogynecol J. 2016;27:1669–75.
Herbenick D, et al. Genital self-image in women. J Sex Med. 2011;8:3339–49.
Kibret G, et al. Female genital self-image and sexual function in East Africa. Int J Gynaecol Obstet. 2019;147:310–6.
Tchokote H, et al. Sexual norms and beliefs in Cameroon. Pan Afr Med J. 2018;29:120.
Tamene A, et al. Shame and sexual dysfunction in Ethiopian women. Reprod Health. 2017;14:110.
Matondo PM. Sexual taboos in DR Congo. J Afr Cult Stud. 2019;31(3):325–36.
McMahon CG. Premature ejaculation. Lancet. 2004;361:761–73.
Serefoglu EC, et al. Burden of premature ejaculation globally. World J Urol. 2014;32:1359–66.
Ferenidou F, et al. Sexual dysfunction in African men. J Sex Med. 2008;5:1442–8.
Veale D, et al. Body dysmorphic disorder and genital concerns in men. Body Image. 2014;11:246–53.
Jewkes R, Morrell R. Sexual norms and gender inequality in Africa. Lancet. 2010;375:1680–7.
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