Lack of sexual privacy affects psychological and marital domains of male sexual dysfunction

INTRODUCTION: Sexual dysfunctions (SDs) are dictated by predisposing, precipitating, maintaining, and contextual factors, the latter of which can help sexual problems to emerge. Even if the lack of sexual privacy is one of the most common contextual issues, it has not been extensively studied. AIM: Investigation of sexual privacy in a large sample of men consulting for SD was the aim of this study. METHODS: A consecutive series of 3,736 men, attending the outpatient clinic for SD for the first time, was retrospectively studied. Privacy during sexual intercourse was investigated with the following question, "During the last three months, have you had enough privacy during your sexual activity?" and rated 0 = yes, 1 = sometimes, 2 = rarely, and 3 = never. MAIN OUTCOME MEASURES: Several clinical, biochemical, and psychological (Middlesex Hospital Questionnaire [MHQ]) parameters were studied. RESULTS: Among the 3,736 patients studied, 83.9% reported enough privacy during sexual intercourse, while 8.6%, 5.7%, and 1.7% declared a decrease of sexual privacy of increasing severity. Lack of sexual privacy was associated with ejaculatory dysfunctions and with the inability to maintain an erection during intercourse. Subjects reporting lack of sexual privacy had a higher risk of relational and intrapsychic impairments, as well as psychopathology at MHQ questionnaire, even after adjusting for confounders. Fatherhood was associated with sexual privacy issues only in the lowest quartiles. In subjects without children, the absence of cohabitation with the partner was associated with an increasing risk of not having enough privacy (hazard ratio [HR] = 1.837 [1.269-2.659], P = 0.001); data confirmed, after stratification for age, only in the youngest subjects (I quartile HR = 2.159 [1.211-3.848], P = 0.009). CONCLUSIONS: This study indicates that sexual privacy is often a poorly investigated item, which is important to evaluate in male SD.