(026) LOWER SEXUAL FUNCTIONING AND, IN PARTICULAR, SEXUAL PAIN IS ASSOCIATED WITH MORE FREQUENT USE OF ALCOHOL AND RECREATIONAL SUBSTANCES WITH SEXUAL ACTIVITY IN YOUNG WOMEN
Authors: Jones H , Lorenz T 
Published: June 2024

Abstract

Introduction
Research on the relationship between alcohol use and women’s sexual functioning has varied, with some studies showing that alcohol use increases self-reported sexual arousal and others showing alcohol-induced decreases in genital arousal (George, 2019). As such, expectancies tend to be self-fulfilling for subjective effects of alcohol, regardless of the physiological effects (Lee et al., 2014). Most research on sexual functioning and alcohol use has failed to look at the intentional use of alcohol to enhance sexual activity, despite the common use of recreation substances with sexual activity (sex-linked substance use, SLSU) in college age populations (Willis et al., 2021; Herbenick et al., 2018). One study found that while drinking was related to fewer problems with sexual function, SLSU was associated with lower sexual functioning for arousal, lubrication, orgasm, and satisfaction but not sexual pain (Witting et al., 2008). It has been proposed that women may engage in SLSU for different reasons such as to overcome inhibitions or to increase pleasure; however, it is unclear how these intentions are related to sexual dysfunction and relationship status.

Objective
To investigate how patterns of SLSU for different purposes are related to different dimensions of women’s sexual function.

Methods
We surveyed 701 women (mean age 20.42, SD = 2.55) in the Midwestern US. Participants reported their frequency of SLSU within the last month to “feel less sexually inhibited”, “increase your sexual desire or arousal” and “increase your sexual pleasure, or to make it easier to have an orgasm”. SLSU was measured as a total factor across the three intentions and as individual subfactors. Participants also completed the Female Sexual Function Index (FSFI; Rosen et al., 2000) and demographic measures including relationship status. Using independent multivariate general linear models, we examined how subfactors of the FSFI, particularly pain, were related to frequency of SLSU.

Results
Our results indicate that among young adult women, higher use of SLSU broadly was associated with FSD as measured by the FSFI. Specifically, lower sexual functioning was associated with more frequent SLSU to feel less sexually inhibited and to increase sexual desire/arousal, but not SLSU to increase sexual pleasure/have an orgasm. Additionally, when considering relationship status, there was an interaction between SLSU and FSD such that women in a relationship without FSD reported the lowest SLSU compared to women in a relationship with FSD and compared to single women without FSD. Single women who did not meet criteria for FSD reported the highest levels of SLSU. When investigating subfactors of the FSFI and SLSU intentions, contrary to prior findings, women with more sexual pain reported more frequent SLSU to feel less sexually inhibited and to increase sexual pleasure/have an orgasm, but not to increase sexual desire/arousal.

Conclusions
Our results indicate that sexual functioning and in particular, sexual pain functioning, are related to frequency of SLSU. Further, our results suggest that both sexual function and relationship status interact in relation to SLSU. Clinically, these findings reinforce the value of discussing sexual pain and dysfunction alongside substance use intentions, particularly among young college aged women.

Disclosure
No.