Advertisement

Sexuality & Culture

, Volume 19, Issue 3, pp 543–560 | Cite as

The Intimate World of Men’s Sexual Problems: Portuguese Men’s and Women’s Narratives Explicated Through a Mixed Methods Approach

  • Violeta AlarcãoEmail author
  • Luis Roxo
  • Ana Virgolino
  • Fernando Luís Machado
Original Paper

Abstract

This study used a mixed methods approach to investigate the intimate world of men’s sexual problems in Portugal, and particularly erectile dysfunction, focusing on the interplay between individual, societal and relational factors. First, a community-based survey was designed, with 323 primary health care users, to investigate how sociocultural factors influence experiences and representations of sexual problems. Second, a qualitative study, involving in-depth interviews with a subsample of ten heterosexual men, complemented by five heterosexual women’s narratives, concerning men’s sexual problems, was carried out to understand the meaning of sexual problems from a lay perspective. Statistical analysis of quantitative data was carried out through logistic regressions to evaluate the sociodemographic predictors of lay representations of sexual problems. Qualitative data were analyzed using an empirically grounded typology. The role of individuals in the construction of sexual dysfunctions, particularly erectile dysfunction, was explored using sexual script theory. Key findings revealed the impact of sexual problems on daily life. Gender analysis results contributed to the understanding of how men and women challenge the definition of sexual problems as normal changes versus dysfunctional changes. Specific patterns of change in sexual experiences and sexual problems were identified in the Portuguese gendered society, which can possibly be applied to other nations and cultures.

Keywords

Sexual problems Erectile dysfunction Sexual narratives Sexual scripts Gender relations Portugal 

Notes

Acknowledgments

We thank all the men and women who kindly participated in the study. We are grateful to the research team, especially Ana Beato, Ana Marques, Filipe Leão Miranda, Rui Simões, and Professor Galvão-Teles.

Conflict of interest

The authors declare that they have no conflict of interest. This research received no specific Grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical standard

This study has been approved by the appropriate ethics committees (Lisbon Faculty of Medicine and Lisbon Regional Health Administration) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Also, permission from the Portuguese Protection Data Authority was obtained. All persons gave their informed consent prior to their inclusion in the study. To preserve anonymity, participants were attributed a code number in the survey and only pseudo names were used in the writing of the research.

References

  1. Aboim, S. (2010). Plural masculinities: The remaking of the self in private life. Aldershot: Ashgate Publishing Company.Google Scholar
  2. Aboim, S. (2013). Sexualidade dos Portugueses. Lisboa: Fundação Francisco Manuel dos Santos.Google Scholar
  3. Alarcão, V., Ribeiro, S., Miranda, F. L., Carreira, M., Dias, T., Garcia e Costa, J., & Galvao-Teles, A. (2012). General practitioners’ knowledge, attitudes, beliefs, and practices in the management of sexual dysfunction-results of the Portuguese SEXOS study. Journal of Sexual Medicine, 9(10), 2508–2515.CrossRefGoogle Scholar
  4. Bury, M. (1991). The sociology of chronic illness: A review of research and prospects. Sociology of Health and Illness, 13(4), 451–468.CrossRefGoogle Scholar
  5. Bury, M. (2001). Illness narratives: Fact or fiction? Sociology of Health and Illness, 23(3), 263–285.CrossRefGoogle Scholar
  6. Carpenter, L. M. (2010). Gendered sexuality over the life course: A conceptual framework. Sociological Perspectives, 53(2), 155–177.CrossRefGoogle Scholar
  7. Clarke, A. E., Shim, J. K., Mamo, L., Fosket, J. R., & Fishman, J. R. (2003). Biomedicalization: Technoscientific transformations of health, illness, and US biomedicine. American Sociological Review, 68(2), 161–194.CrossRefGoogle Scholar
  8. Connell, R. W. (2002). Gender. Cambridge: Polity Press.Google Scholar
  9. Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365–388.CrossRefGoogle Scholar
  10. Crawford, M., & Popp, D. (2003). Sexual double standards: A review and methodological critique of two decades of research. Journal of Sex Research, 40(1), 13–26.CrossRefGoogle Scholar
  11. Davidson, C. R. (2009). Transcription: Imperatives for qualitative research. The International Journal of Qualitative Methods, 8(2), 35–52.Google Scholar
  12. Fasula, A. M., Carry, M., & Miller, K. S. (2012). A multidimensional framework for the meanings of the sexual double standard and its application for the sexual health of young black women in the US. Journal of Sex Research, 51(2), 1–14.Google Scholar
  13. Ferreira, P. M., & Cabral, M. V. (Eds.). (2010). Sexualidades em Portugal: Comportamentos e riscos. Lisboa: Bizâncio.Google Scholar
  14. Freire, I. (2010). Amor e sexo no tempo de Salazar. Lisboa: A Esfera dos Livros.Google Scholar
  15. Gagnon, J. H., Rosen, R. C., & Leiblum, S. R. (1982). Cognitive and social aspects of sexual dysfunction: Sexual scripts in sex therapy. Journal of Sex and Marital Therapy, 8(1), 44–56.CrossRefGoogle Scholar
  16. Gerstenberger, E. P., Rosen, R. C., Brewer, J. V., Meston, C. M., Brotto, L. A., Wiegel, M., & Sand, M. (2010). Sexual desire and the female sexual function index (FSFI): A sexual desire cutpoint for clinical interpretation of the FSFI in women with and without hypoactive sexual desire disorder. Journal of Sexual Medicine, 7(9), 3096–3103.CrossRefGoogle Scholar
  17. Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Stanford: Stanford University Press.Google Scholar
  18. Giddens, A. (1992). The transformation of intimacy: Sexuality, love and eroticism in modern societies. Cambridge: Polity Press.Google Scholar
  19. Goffman, E. (1959). The presentation of self in everyday life. New York: Anchor Books and Random House.Google Scholar
  20. Grace, V., Potts, A., Gavey, N., & Vares, T. (2006). The discursive condition of viagra. Sexualities, 9(3), 295–314.CrossRefGoogle Scholar
  21. Katz, S., & Marshall, B. L. (2004). Is the functional ‘normal’? Aging, sexuality and the bio-marking of successful living. History of the Human Sciences, 17(1), 53–75.CrossRefGoogle Scholar
  22. Kimmel, M. S. (2000). The gendered society. Oxford: Oxford University Press.Google Scholar
  23. Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Bloomington: Indiana University Press.Google Scholar
  24. Kluge, S. (2000). Empirically grounded construction of Types and typologies in qualitative social research [14 paragraphs]. Forum qualitative sozialforschung/Forum: Qualitative social research, 1(1), Art 14. http://nbn-resolving.de/urn:nbn:de:0114-fqs0001145.
  25. Lewis, R. W., Fugl-Meyer, K. S., Corona, G., Hayes, R. D., Laumann, E. O., Moreira, E. D., et al. (2010). Definitions/epidemiology/risk factors for sexual dysfunction. Journal of Sexual Medicine, 7(4), 1598–1607.CrossRefGoogle Scholar
  26. Loe, M. (2001). Fixing broken masculinity: Viagra as a technology for the production of gender and sexuality. Sexuality and Culture, 5(3), 97–125.CrossRefGoogle Scholar
  27. Loe, M. (2004a). Sex and the senior woman: Pleasure and danger in the viagra era. Sexualities, 7(3), 303–326.CrossRefGoogle Scholar
  28. Loe, M. (2004b). The rise of viagra: How the little blue pill changed sex in America. New York: NYU Press.Google Scholar
  29. Marshall, B. L. (2010). Science, medicine and virility surveillance: ‘Sexy seniors’ in the pharmaceutical imagination. Sociology of Health and Illness, 32(2), 211–224.CrossRefGoogle Scholar
  30. Masters, N. T., Casey, E., Wells, E. A., & Morrison, D. M. (2013). Sexual scripts among young heterosexually active men and women: Continuity and change. Journal of Sex Research, 50(5), 409–420.CrossRefGoogle Scholar
  31. Mitchell, K. R., King, M., Nazareth, I., & Wellings, K. (2011a). Managing sexual difficulties: A qualitative investigation of coping strategies. Journal of Sex Research, 48(4), 325–333.CrossRefGoogle Scholar
  32. Mitchell, K. R., Wellings, K., Nazareth, I., King, M., Mercer, C. H., & Johnson, A. M. (2011b). Scripting sexual function: A qualitative investigation. Sociology of Health and Illness, 33(4), 540–553.CrossRefGoogle Scholar
  33. Pearce, L. D. (2012). Mixed methods inquiry in sociology. American Behavioral Scientist, 56(6), 829–848.CrossRefGoogle Scholar
  34. Peixoto, M. M., & Nobre, P. (2015). Prevalence and sociodemographic predictors of sexual problems in Portugal: A population-based study with women aged 18 to 79 years. Journal of Sex & Marital Therapy, 41(2), 169–180. doi: 10.1080/0092623X.2013.842195.CrossRefGoogle Scholar
  35. Petersen, J. L., & Hyde, J. S. (2011). Gender differences in sexual attitudes and behaviors: A review of meta-analytic results and large datasets. Journal of Sex Research, 48(2–3), 149–165.CrossRefGoogle Scholar
  36. Policarpo, V. (2011). Sexualidades em construção: entre o público e o privado. In A. N. de Almeida (Ed.), História da vida privada em Portugal (pp. 48–79). Lisboa: Círculo de Leitores.Google Scholar
  37. Potts, A., Gavey, N., Grace, V. M., & Vares, T. (2003). The downside of viagra: Women’s experiences and concerns. Sociology of Health and Illness, 25(7), 697–719.CrossRefGoogle Scholar
  38. Potts, A., Grace, V., Gavey, N., & Vares, T. (2004). “Viagra stories”: Challenging ‘erectile dysfunction. Social Science and Medicine, 59(3), 489–499.CrossRefGoogle Scholar
  39. Potts, A., Grace, V. M., Vares, T., & Gavey, N. (2006). ‘‘Sex for life’? Men’s counter-stories on ‘erectile dysfunction’, male sexuality and ageing’. Sociology of Health and Illness, 28(3), 306–329.CrossRefGoogle Scholar
  40. Quinta Gomes, A. L., & Nobre, P. J. (2014). Prevalence of sexual problems in Portugal: Results of a population-based study using a stratified sample of men aged 18 to 70 years. Journal of Sex Research, 51(1), 13–21.CrossRefGoogle Scholar
  41. Rosen, R. C., Revicki, D. A., & Sand, M. (2014). Commentary on “critical flaws in the FSFI and IIEF”. Journal of Sex Research, 51(5), 492–497.CrossRefGoogle Scholar
  42. Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49(6), 822–830.CrossRefGoogle Scholar
  43. Simon, W., & Gagnon, J. H. (1986). Sexual scripts: Permanence and change. Archives of Sexual Behavior, 15(2), 97–120.CrossRefGoogle Scholar
  44. Simon, W., & Gagnon, J. (2003). ‘Sexual scripts: Origins influences and changes’. Qualitative Sociology, 26(4), 491–497.CrossRefGoogle Scholar
  45. Tiefer, L. (2006). The viagra phenomenon. Sexualities, 9(3), 273–294.CrossRefGoogle Scholar
  46. Tolman, D. L., & Szalacha, L. A. (1999). Dimensions of desire: Bridging qualitative and quantitative methods in a study of female adolescent sexuality. Psychology of Women Quarterly, 23(1), 7–39.CrossRefGoogle Scholar
  47. Veronelli, A., Mauri, C., Zecchini, B., Peca, M. G., Turri, O., Valitutti, M. T., et al. (2009). ‘Sexual dysfunction is frequent in premenopausal women with diabetes, obesity, and hypothyroidism, and correlates with markers of increased cardiovascular risk. A preliminary report’. Journal of Sexual Medicine, 6(6), 1561–1568.CrossRefGoogle Scholar
  48. Wentzell, E. (2013a). Aging respectably by rejecting medicalization: Mexican men’s reasons for not using erectile dysfunction drugs. Medical Anthropology Quarterly, 27(1), 3–22.CrossRefGoogle Scholar
  49. Wentzell, E. (2013b). Maturing masculinities: Aging, chronic illness, and viagra in Mexico. Durham and London: Duke University Press.CrossRefGoogle Scholar
  50. Wentzell, E., & Salmeron, J. (2009). You’ll “get viagraed”: Mexican men’s preference for alternative erectile dysfunction treatment. Social Science and Medicine, 68(10), 1759–1765.CrossRefGoogle Scholar
  51. Williams, S. (2000). Chronic illness as biographical disruption or biographical disruption as chronic illness? Reflections on a core concept. Sociology of Health and Illness, 22(1), 40–67.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Violeta Alarcão
    • 1
    Email author
  • Luis Roxo
    • 1
  • Ana Virgolino
    • 1
  • Fernando Luís Machado
    • 2
  1. 1.Institute of Preventive Medicine and Public Health, Faculty of MedicineUniversity of LisbonLisbonPortugal
  2. 2.Centre for Research and Studies in Sociology (CIES-IUL)University Institute of Lisbon, ISCTE-IULLisbonPortugal

Personalised recommendations