For Better or Worse: The Relation between Sexual Functioning and Sexual Behavior Frequency during the SARS-CoV-2 Pandemic and Social Distancing Measures in a Chilean Sample

doi:10.21203/rs.3.rs-5006077/v1

Download PDF

Research Article

For Better or Worse: The Relation between Sexual Functioning and Sexual Behavior Frequency during the SARS-CoV-2 Pandemic and Social Distancing Measures in a Chilean Sample

https://doi.org/10.21203/rs.3.rs-5006077/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

The global pandemic of SARS-CoV-2 significantly impacted various aspects of human life, including sexual health and behavior. To date, systematic reviews and meta-analyses, have reported declines in sexual function and variations in sexual behavior during the pandemic, with women generally experiencing a more pronounced negative impact than men. Despite the fact different studies have shown their variations amid the pandemic, a study has yet to establish more detailed on how variations in sexual behavior frequencies correlate with sexual function dimensions. At the same time, there is no account of how the pandemic affected these measures in the Chilean population. Therefore, the present cross-sectional study evaluated how variations in partnered and solo sexual behavior frequencies during the pandemic and their relation with sexual function among 2,555 adult Chilean men, women, and gender non-binary individuals. Results showed decreases in partnered sexual behaviors, like intercourse and dating, were linked to lower sexual function scores, particularly in satisfaction and desire. For women, reduced frequency of most sexual behaviors (i.e., sexting, foreplay, sexual fantasies, masturbation, and sexual intercourse) significantly increased the risk of sexual dysfunction, especially in desire, arousal, and satisfaction. For men, decreased foreplay and intercourse were associated with a higher likelihood of erectile dysfunction and reduced overall sexual satisfaction. In contrast, only men whose frequency of foreplay, sexual fantasies, pornography consumption, and sexual intercourse increased experienced a significantly better sexual function. The magnitude of these changes varied from small to moderate across findings. This research contributes to the growing body of literature on the sexual health consequences of the pandemic, particularly within the Chilean context, and underscoring its value and the preparation of future pandemics.

Psychology

Sexual Dysfunction

Erectile Dysfunction

Female Sexual Dysfunction

SARS-CoV-2

Covid-19

Chile

The pandemic of the Severe Acute Respiratory Syndrome-related Coronavirus type 2 (SARS-CoV-2) was first notified in December 2019, and almost six years later, we are still understanding its consequences. Many aspects of people's livelihoods were affected not only by the direct and indirect consequences of the infection (Mehta et al., 2021; Viner et al., 2021), but also by the social distancing measures taken in order to prevent the spread of the virus (Bazant & Bush, 2021). Despite their effectiveness (Courtemanche et al., 2020; Jarvis et al., 2020), and given the restrictive nature of the most common social distancing measures, these took an undeniable toll on people's mental health (Marroquín et al., 2020), hindering their day-to-day social interaction, where sexual health, wellbeing, and behaviors were not the exception (Mourikis et al., 2022).

Several scoping and systematic reviews, as well as meta-analyses have demonstrated a mostly negative impact on several aspects of people' sexual health, function, well-being, and behaviors (Abreu et al., 2024; Masoudi et al., 2022; Mourikis et al., 2022; Qaderi et al., 2023; Quintana, 2022; Voutskidou et al., 2023; Zalpour et al., 2023). For instance, Fuchs et al. (2020) observed a meaningful decrease in female sexual function scores from before the pandemic to during the pandemic, with a 19% increase of women at risk of sexual dysfunction, while De Rose et al. (2021) also demonstrated a negative impact in men sexual function, where men scored significantly lower than women in satisfaction and desire. Whereas there was significant heterogeneity across studies measuring the impact of the SARS-CoV-2 pandemic on people' sexual function (Mourikis et al., 2022), systematic reviews and meta-analyses have consistently shown a hindered sexual function, less partnered and more solo sexual behaviors, while also a larger impact in women than in men (Masoudi et al., 2022; Mourikis et al., 2022; Qaderi et al., 2023; Zalpour et al., 2023).

Studies assessing the pandemic impact on different sexual behaviors have shown mixed results, where their frequency remained either unaffected, decreased, or increased. (Mitchell et al., 2023). For instance, Lehmiller et al. (2021) showed that while half of their sample experienced a decline in their sexual lives (e.g., less frequent sexual behaviors), one in five participants resorted to expanding their sexual repertoire incorporating new behaviors such as sexting, new sexual positions, sharing sexual fantasies, amongst others. Particularly, the higher the impact of social distancing measures, the more willing young adults were to engage in sexting (Thomas et al., 2022). Moreover, a global analysis of pornographic material searches during the pandemic comparing January 9^th to May 25^th of 2020 showed that almost every keyword (e.g., porn, pornhub) increased from January to May, particularly in those nations with more stringent social distancing rules (e.g., China, Italy, Spain, and France; Zattoni et al., 2021). Still, a recent review stated that there is no evidence to believe there was a relation between pornography consumption surge during the pandemic and sexual dysfunction (Fotinos et al., 2024). Overall, while some partnered sexual behaviors (e.g., intercourse) were more frequently reported to have decreased in frequency during the pandemic, others like solo (e.g., masturbation) and remote sexual behaviors (e.g., sexting) followed the opposite trend (Hammoud et al., 2020; Holt et al., 2023; Mercer et al., 2022; Mitchell et al., 2023; Toldam et al., 2022). Indeed, a cross-cultural study conducted in 26 countries also corroborated the same trend, yet also demonstrated that other affectionate non-sexual behaviors such as hugging, kissing, and cuddling also increased during the pandemic (Hensel et al., 2023).

Several studies have demonstrated that many variables have been found to modulate these changes in sexual function and behaviors, such as age (Mitchell et al., 2023), gender (Mourikis et al., 2022), relationship and work status (Vieira et al., 2023), socio-economical factors (Hensel et al., 2023), pregnancy status (Hidalgo & Dewitte, 2021), infection status (Zak et al., 2024), compliance with social distancing measures (Maxwell et al., 2023), knowledge associated to the covid-19 infection (Qaderi et al., 2023) practice masturbation or sex as leisure (Berdychevsky, 2023a, 2023b), affective disorder symptomatology (Dion et al., 2023; Mollaioli et al., 2021), infection status (Seehuus et al., 2023) to mention a few. Clearly, the relation between sexual function and different sexual behavior frequency is highly contextual. However, even though different studies have shown their variations amid the pandemic, a study is yet to establish more systemically how variations in sexual behavior frequencies correlate with sexual function dimensions. Moreover, there is simply no account of the Chilean population as to how the pandemic affected these sexual measures. Therefore, the present study aimed to evaluate the relation between variations in sexual behavior frequency during the pandemic—whether more frequent, unchanged, or less frequent—and Chilean men's and women's sexual function during the SARS-CoV-2 pandemic. We expect to find a generalized decrease in sexual function scores, where both men's and women' sexual satisfaction scores will be the most hindered. Moreover, regarding sexual behaviors, we expect to see either an increase, a lack of change, or an increase in their frequencies, where the former would be the most common effect amid the pandemic. Particularly, we also expect to see an increase in solo sexual behaviors, and a decrease in partnered sexual behaviors.

Study design

This study is part of a larger research initiative titled Chilean Study of Sex and Sexuality (CSSS), aiming to update and expand the literature on Chilean sex and sexuality, which has a cross-sectional design.

Participants

The study sample consisted of 2555 Chilean adults over 18 years old (M_age = 32.13; SD_age = 11.90; 18–91 years old). The sampling was non-probabilistic and stratified by the country's macro-zones (i.e., north, central, and south), from all 16 provinces of the country, with the majority being from the northern and central zones. Whereas the CSSS gathered a sample of gender non-binary individuals (N = 95; M_age = 26.35; SD_age = 9.83; 18–68 years old), the active sexual functioning filter (see Procedure) led to many empty cells and unbalanced groups limiting our capacity to make reliable comparisons. Therefore, only their descriptive statistics were included as supplementary material (see Supplementary Tables 4, 5, 6). The majority of the participants were women (n = 1905; 74.6%), heterosexual (n = 2238; 87.6%), in a relationship (n = 1642; 64.3%), with at least a university-level education (n = 2229; 87.2%). Other socio-demographic details are shown in Table 1, whereas the full CSSS sample description can be found in (Quintana, 2024).

Table 1

*Participants Socio-Demographic Characteristics*
N = 2555	Men		Women			Men		Women
N = 2555	n (M)	% (SD)	n (M)	% (SD)		n (M)	% (SD)	n (M)	% (SD)
Age	(33.91)	(11.97)	(32.19)	(10.15)	Work/Study hrs/week	(35.55)	(22.29)	(33.03)	(20.40)
Age	(33.91)	(11.97)	(32.19)	(10.15)	Working/Studying status
Civil Status					Unemployed	25	4%	149	8%
Single	229	35%	684	36%	Working	388	60%	959	50%
In a relationship	421	65%	1221	64%	Studying	105	16%	379	20%
Level of education					Working & Studying	132	20%	418	22%
Secondary or below	7	1%	11	1%	Political orientation
High school	156	24%	388	20%	No political affiliation	261	40%	783	41%
University	391	60%	1276	67%	Left wing affiliation	239	37%	778	41%
Postgraduate	96	15%	230	12%	Centrist	40	6%	96	5%
Religion					Right wing affiliation	110	17%	248	13%
Atheist or none	337	52%	824	43%	Sexual Orientation
Catholic	196	30%	719	38%	Heterosexual	605	93%	1633	86%
Other religions	117	18%	362	19%	Homosexual (gay o lesbian)	0	0%	3	0%
Socio-Economical Level					Others	45	7%	269	14%
Low SES	395	61%	1278	67%	Ethnicity
Middle SES	209	32%	573	30%	Non-Identified	519	80%	1577	83%
High SES	46	7%	54	3%	Self-identified	131	20%	328	17%
Note.
N = Sample size. n = group size; % = Percentage; M = Mean; SD = Standard deviation.

Insert Table 1

Procedure

The sample was collected through a 30–40 minute online self-report survey using the Google Form platform between June 2022 and March 2023. Participants were anonymized and consented to participate in the study; they were informed about the characteristics and implications of the study, and specific instructions were provided in case they required medical assistance. The study was approved by the ethics committee of the University of the first author, and is pre-registered on the open science platform (OSF; https://osf.io/7yve8/), although we modified it by removing one variable (i.e., drug consumption) for a more streamline proposal.

This study only included participants 18 years old or older who lived in Chile at the time of the study. Furthermore, given that we used sexual function scales, we filtered the CSSS total sample (n = 3901) by those who were sexually active during the last 4 weeks before answering the questionnaire, since including those who do not tends to inflate the estimates of sexual dysfunction (Meston et al., 2019).

Measures

Sociodemographic

Sociodemographic variables measured are described in Table 1.

Sexual behaviors

The CSSS included several questions specific to people' sexual preferences and experiences. The following study utilized questions related to people' sexual behaviors during the pandemic, and how these may have been affected: "During the pandemic, how did the following aspects of your intimate life change?", which included four answer options (i.e., 0 = "does not apply"; 1 = "had less"; 2 = "not affected"; 3 = "had more"), related to the following behaviors; dates, erotic messages (i.e., sexting), foreplay, sexual fantasies, masturbation, watching pornographic content, and sexual intercourse. The alternative "does not apply" was included for those who do/did not practice that particular behavior, yet, these answers were filtered out from the analyses.

Sexual function

We queried participants in order to orient them to the correct sexual function questionnaire using the following statement: "If you prefer to have sexual relations equally with people with a penis or vulva, choose the alternative that best represents your genitals". The question had four alternatives that included responses related to external and internal genitals (i.e., male or female) and those with whom they prefer to have sexual relations (see Supplementary material of Quintana et al., submitted-a; Quintana et al., submitted-b). The research team acknowledges the limitation for those who are intersex or have ambiguous external genitals (i.e., intersex). Although modified questionnaires used to measure sexual function in underrepresented gender individuals were included in the CSSS study, these subjects were not included in the analyses, as their proportion was insufficient to conduct analysis segregated by the variable of interest.

International Index of Erectile Function (IIEF). Developed by Rosen et al. (1997). The scale evaluates male sexual function and dysfunction through 15 items that explore five dimensions: erectile function (6 items), satisfaction with intercourse (3 items), orgasmic function (2 items), sexual desire (2 items), and overall satisfaction (2 items). The items are scored on a 6-point Likert scale (with different alternatives depending on the item), where higher scores reflect better sexual function. Nine items contain a zero scoring option indicating the absence of sexual activity, used to filter out all those with, at least, one zero answer in any of these items. The IIEF has recently been validated in the Chilean population by the CSSS (https://doi.org/10.17605/OSF.IO/HQWE9).

Female Sexual Function Index (FSFI). Also developed by Rosen et al. (2000). The index consists of 19 items that explore six dimensions: desire (2 items), arousal (4 items), lubrication (4 items), orgasm (3 items), satisfaction (3 items), and pain (3 items). Its latent structure is consistent with conceptualizations of female sexual dysfunction in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (APA, 2013). The items are scored on a 5-point Likert scale (1=" Never"; 5=" Always"), while 15 of them contain a zero scoring option indicating the absence of sexual activity, used to filter individuals who score zero in any of these items. Scores on each dimension are summed and multiplied by a specific factor to give equal weight to each dimension when obtaining the total scale score. Higher scores indicate greater sexual function. The instrument has been recently validated in the Chilean population by the CSSS (https://doi.org/10.21203/rs.3.rs-3903081/v1).

Analysis Plan

Following recommendations favoring imputation over listwise deletion (Buhi et al., 2008; Schafer & Graham, 2002), missing data patterns were analyzed across the entire CSSS project sample. Therefore, the CSSS applied multiple imputations to address missing data, with detailed information available on the NSSS OSF page (https://osf.io/2f3j8/). Particularly, the FSFI items exhibited minimal missing values (1.12%), seemingly distributed at random as confirmed by Little's MCAR Test (Little, 1988; χ2 = 71.6, df = 72, p = .491), while the IIEF had fewer missing cases (.07%; χ² = 37.61, df = 42, p = .664).

The normality of distribution was evaluated through Kolmogorov-Smirnov and Shapiro-Wilk tests, revealing that none of the variables met the normality assumption (ps < .001; see Supplementary Tables 1). Despite this, ANOVA is known to be robust for non-normally distributed samples, particularly in large samples (Blanca et al., 2017). Furthermore, Levene's tests were used to assess variance homogeneity. FSFI score distributions violated homogeneity assumptions for almost all variables and FSFI dimensions (ps < .001), while IIEF score distributions demonstrated the opposite trend (ps > .001; see Supplementary Tables 2). Therefore, ANOVA F-tests with eta square (η²) as effect size measures were used for IIEF scores, with Games-Howell and Bonferroni corrections for post-hoc comparisons. Meanwhile, Kruskal-Wallis H-tests with epsilon square (ε²) as effect size measures were used for FSFI scores, with Bonferroni corrections for post-hoc comparisons. Finally, we also conducted correlation analyses using Spearman rank coefficient between sexual function dimensions scores and all sexual behaviors.

Regarding effect sizes, we followed Cohen's guidelines for Cohen’s d and η² effect sizes (Cohen, 1988). Cohen's d of groups with unequal sample sizes were d = .2–.4 are a small; .5–.7 intermediate; and ≥ .8 large effects. A η² .01–.05 are small, .06–.13 intermediate, and ≥ .14 large effects. Furthermore, Spearman rank correlations of |≥ .70| were very strong, |.40–.69| were strong, |.30–.39| were moderate, |.20–.29| were weak, and |.01–.19| were negligible (Dancey & Reidy, 2004). An ε² = 0–.04 is a small; .05–.16 intermediate; .17–.36 relatively large; .37–.64 large; and .65–1 a very large effect (Rea & Parker, 1992). Finally, we compared those at risk of experiencing FSD or ED vs. those who are not, using Cramer's V effect size statistic with one degree of freedom, where values ≤ .29 were considered small, .30–.49 intermediate, and ≥ .50 large effect sizes, respectively (Cramer, 1946). All analyses were conducted using SPSS v.27.

Table 2. presents variations in sexual behaviors during the SARS-CoV-2 pandemic by gender in Chilean people. Findings demonstrate that there were shifts in various sexual behaviors in both men and women. Chilean men and women either experienced a decrease, an increase, or remained the same in the frequency of their sexual behaviors, in comparison to before the pandemic. For both men and women, “Sexual intercourse” (≥ 52.0–54.3%) and “Dating” (≥ 67.0–67.7%) showed the largest decrease in frequency, meanwhile “Masturbation” (≥ 41.6–47.6%) and “Watching pornography” (≥ 34.2–45.8%) showed the largest increase. In addition to that, there were some differences in trends between men and women, although many patterns are consistent across genders.

Table 2

*Variations in Sexual Behaviors during the SARS-CoV-2 Pandemic by Gender*
	Men		Women
	n	%	n	%
Dating
Had less	504	67.7	1127	67.0
Not affected	176	23.7	423	25.2
Had more	64	8.6	131	7.8
Sexting
Had less	272	33.5	636	34.0
Not affected	228	28.0	618	33.0
Had more	313	38.5	616	32.9
Foreplay
Had less	370	39.0	787	34.9
Not affected	426	44.9	1021	45.3
Had more	152	16.0	445	19.8
Sexual fantasies
Had less	255	26.8	584	26.8
Not affected	394	41.4	866	39.7
Had more	303	31.8	729	33.5
Masturbation
Had less	128	12.0	529	22.6
Not affected	429	40.4	840	35.9
Had more	506	47.6	974	41.6
Watching porn
Had less	151	15.3	454	29.0
Not affected	382	38.8	576	36.8
Had more	451	45.8	535	34.2
Sexual intercourse
Had less	547	54.3	1248	52.0
Not affected	283	28.1	628	26.2
Had more	178	17.7	523	21.8
Note.
Subjects responded to each of these behaviors while answering the question "During the pandemic, how did the following aspects of your intimate life change?".
n = Group size; % = Percentage.

Table 3 presents women's and men' sexual function sample scores.

Table 3

*Women's and Men' Sexual Function Scores for the Total Sample during the SARS-CoV-2 Pandemic*
	M	SD
Female Sexual Function (FSFI)
Desire	4.38	1.12
Arousal	5.08	0.89
Lubrication	5.26	0.89
Orgasm	4.74	1.23
Satisfaction	4.88	1.10
Pain	5.22	1.02
Total Score	29.56	4.47
Male Sexual Function (IIEF)
Erectile Function	26.71	3.57
Orgasm Function	8.87	1.69
Sexual Desire	8.13	1.55
Intercourse Satisfaction	11.72	2.41
Overall Satisfaction	8.07	1.78
Total Score	63.50	8.36
M = Mean; SD = Standard deviation.

Pairwise comparisons through Cohen's d effect sizes demonstrated that women who had a lower frequency of “Sexting” (d = .50), “Foreplay” (d = .52), and “Sexual fantasies” (d = .51) had a lower score on “Satisfaction” than those whose frequency remain unaffected. Similarly, women who had a lower frequency of “Sexual intercourse” (d = .52), and “Foreplay” (d = .62), had a lower score on “Satisfaction” than those whose frequency increased. Finally, women who had a lower frequency of “Masturbation” had a lower score on “Desire” than those whose frequency remain unaffected (d = .50), and those whose frequency increased (d = .65), whereas women who also had a lower frequency of “Masturbation” had a lower score on “Desire” than those whose frequency increased (d = .51).

Table 4. presents women' sexual function scores by changes in sexual behaviors during the SARS-CoV-2 pandemic. In contrast to the total sample FSFI scores, almost all FSFI dimensions showed statistically significant differences across almost all sexual behaviors when comparing them across those whose frequency decreased, remained the same, or increased amid the pandemic (Hs ≥ 6.89; ps ≤ .05; ε²s ≤ .05). However, the majority of these comparisons effect sizes were considered small (ε²s = .005–.047), while only a handful were considered intermediate. The “intermediate” effect size effects for the main effect were found for FSFI “Total score” for all sexual behaviors (ε²s = .105–.161), yet also in FSFI “Satisfaction” for “Sexual intercourse” (ε² = .063), and in FSFI “Desire” for “Sexual fantasies” (ε² = .051).

Table 4

*Women' Sexual Function Scores (FSFI) by Changes in Sexual Behaviors during the SARS-CoV-2 Pandemic*
	Had less (1)		Not affect (2)		Had more (3)		H†	ε²	Cohen's d
	M	SD	M	SD	M	SD	H†	ε²	1 vs. 2	1 vs. 3	2 vs. 3
Dating	n = 741		n = 328		n = 107
Desire	4.46•*	1.11	4.57	1.05	4.73•*	1.13	8.11*	0.032	0.10	0.24	0.15
Arousal	5.05•*	0.89	5.26•*	0.75	5.15	0.82	13.66*	0.015	0.25	0.11	0.14
Lubrication	5.22	0.91	5.38	0.74	5.25	0.94	5.30	0.007	0.19	0.03	0.16
Orgasm	4.58•*	1.26	4.93•*	1.09	4.55	1.41	18.80*	0.006	0.29	0.02	0.32
Satisfaction	4.80•*	1.09	5.21•▫*	0.88	4.81▫*	1.22	37.19*	0.016	0.40	0.01	0.41
Pain	5.18	1.03	5.24	0.93	4.93	1.27	2.99	0.016	0.06	0.24	0.30
Total Score	29.31•*	4.50	30.62•*	3.86	29.44	4.75	21.12*	0.136	0.31	0.03	0.29
Sexting	n = 409		n = 513		n = 475
Desire	4.31•*	1.18	4.47	1.03	4.60•*	1.07	15.27*	0.033	0.15	0.26	0.12
Arousal	4.93•▫*	0.95	5.20•*	0.76	5.20▫*	0.85	24.06*	0.023	0.32	0.30	0.00
Lubrication	5.15•▫*	0.91	5.34•*	0.81	5.28▫*	0.90	14.55*	0.011	0.22	0.14	0.07
Orgasm	4.54•▫*	1.30	4.88•*	1.18	4.74▫*	1.23	18.50*	0.009	0.28	0.16	0.12
Satisfaction	4.55•▫*	1.20	5.08•*	0.95	5.02▫*	1.04	59.68*	0.025	0.50	0.42	0.06
Pain	5.16	1.05	5.29	0.96	5.20	1.04	3.66	0.006	0.13	0.04	0.09
Total Score	28.66•▫*	4.65	30.28•*	4.03	30.06▫*	4.41	35.34*	0.120	0.38	0.31	0.05
Foreplay	n = 503		n = 866		n = 373
Desire	4.30	1.16	4.43	1.07	4.47	1.08	5.56	0.013	0.12	0.15	0.04
Arousal	4.82•▫*	0.97	5.19•*	0.81	5.25▫*	0.76	68.83*	0.041	0.42	0.49	0.08
Lubrication	5.11•▫*	0.96	5.33•*	0.81	5.32▫*	0.85	20.81*	0.014	0.25	0.23	0.01
Orgasm	4.44•▫*	1.28	4.88•*	1.16	4.90▫*	1.14	50.88*	0.021	0.37	0.38	0.02
Satisfaction	4.44•▫*	1.22	5.05•*	0.97	5.13▫*	0.95	114.95*	0.048	0.52	0.62	0.08
Pain	5.11•*	1.04	5.28•*	0.98	5.26	0.97	12.37*	0.007	0.17	0.15	0.02
Total Score	28.24•▫*	4.59	30.18•*	4.13	30.35▫*	4.09	80.00*	0.130	0.45	0.48	0.04
Sexual fantasies	n = 393		n = 654		n = 538
Desire	4.07•▫*	1.17	4.49•‾*	1.05	4.65▫‾*	1.03	62.45*	0.051	0.38	0.51	0.15
Arousal	4.84•▫*	0.99	5.21•*	0.79	5.19▫*	0.82	46.92*	0.027	0.43	0.39	0.03
Lubrication	5.15•▫*	0.97	5.33•*	0.80	5.30▫*	0.84	9.93*	0.014	0.21	0.17	0.04
Orgasm	4.53•▫*	1.29	4.86•*	1.23	4.79▫*	1.15	23.08*	0.006	0.26	0.22	0.06
Satisfaction	4.51•▫*	1.20	5.06•*	0.99	4.94▫*	1.05	66.03*	0.018	0.51	0.39	0.12
Pain	5.12•*	1.07	5.30•*	0.96	5.20	1.00	7.67*	0.007	0.18	0.08	0.10
Total Score	28.24•▫*	4.73	30.28•*	4.05	30.10▫*	4.22	58.71*	0.136	0.47	0.42	0.04
Masturbation	n = 359		n = 640		n = 690
Desire	3.92•▫*	1.12	4.45•‾*	1.04	4.63▫‾*	1.07	96.24*	0.046	0.50	0.65	0.17
Arousal	4.83•▫*	0.96	5.20•*	0.79	5.11▫*	0.87	39.48*	0.024	0.43	0.31	0.11
Lubrication	5.10•▫*	0.94	5.34•*	0.84	5.29▫*	0.85	19.78*	0.014	0.27	0.22	0.06
Orgasm	4.60•*	1.27	4.89•▫*	1.14	4.68▫*	1.23	15.74*	0.006	0.24	0.06	0.18
Satisfaction	4.69•*	1.10	5.04•▫*	0.97	4.76▫*	1.18	30.33*	0.010	0.34	0.06	0.26
Pain	5.10•*	1.06	5.30•*	0.99	5.23	1.01	11.13*	0.010	0.20	0.13	0.07
Total Score	28.27•▫*	4.70	30.25•▫‾*	4.14	29.72▫‾*	4.28	48.18*	0.128	0.46	0.33	0.13
Watching porn	n = 314		n = 441		n = 382
Desire	4.16•▫*	1.12	4.52•*	1.06	4.66▫*	1.09	36.81*	0.027	0.33	0.45	0.13
Arousal	4.99•*	0.91	5.15•*	0.86	5.11	0.86	7.48*	0.014	0.18	0.14	0.05
Lubrication	5.23	0.86	5.29	0.91	5.35	0.77	2.94	0.009	0.07	0.15	0.07
Orgasm	4.66•*	1.24	4.77•*	1.24	4.72	1.21	2.56	0.005	0.09	0.05	0.04
Satisfaction	4.80	1.09	4.95	1.03	4.71	1.22	6.89*	0.008	0.14	0.08	0.21
Pain	5.22	1.01	5.24	1.05	5.26	0.97	0.49	0.004	0.04	0.04	0.02
Total Score	29.08•*	4.53	29.94•*	4.38	29.83	4.14	8.05*	0.105	0.19	0.17	0.03
Sexual intercourse	n = 860		n = 501		n = 470
Desire	4.20•▫*	1.15	4.43•‾*	1.07	4.67▫‾*	1.01	52.83*	0.032	0.21	0.43	0.23
Arousal	4.91•▫*	0.95	5.19•*	0.77	5.30▫*	0.74	63.18*	0.047	0.32	0.44	0.15
Lubrication	5.16•▫*	0.94	5.32•*	0.81	5.39▫*	0.81	25.13*	0.019	0.18	0.26	0.09
Orgasm	4.54•▫*	1.29	4.99•*	1.06	4.92▫*	1.14	55.24*	0.028	0.37	0.31	0.06
Satisfaction	4.63•▫*	1.15	5.06•‾*	0.95	5.19▫‾*	0.95	109.06*	0.063	0.40	0.52	0.14
Pain	5.11•▫*	1.07	5.31•*	0.93	5.33▫*	0.96	18.71*	0.015	0.20	0.21	0.02
Total Score	28.58•▫*	4.68	30.32•*	3.96	30.82▫*	3.89	101.39*	0.161	0.39	0.51	0.13
Note.
Symbols •, ▫, ‾ were used to denote means being compared whose difference reached statistical significance below p < 0.05, using Bonferroni correction.
* = p ≤ .05; † = All tests using the H-test had 2 degrees of freedom.
M = Mean; SD = Standard deviation; n = group size; H = Kruskal-Wallis H-test; ε² = Epsilon square effect size.

Pairwise comparisons through Cohen's d effect sizes demonstrated that men who had a lower frequency of “Foreplay” had a lower score on “Sexual desire” (d = .68), “Intercourse satisfaction” (d = .61), and “Total score” (d = .52) than those whose frequency remain unaffected. Similarly, men who had a lower frequency of “Sexual fantasies” had a lower score on “Intercourse satisfaction” (d = .58) than those whose frequency increased. Moreover, men who had a lower frequency of “Foreplay” had a lower score on “Sexual desire” (d = .53), “Intercourse satisfaction” (d = .73), “Overall satisfaction” (d = .69), and “Total score” (d = .59) than those whose frequency increased. Likewise, men who had a lower frequency of “Sexual fantasies” had a lower score on “Sexual desire” (d = .59) than those whose frequency increased, whereas men who had a lower frequency of “Sexual intercourse” had a lower score on “Intercourse satisfaction” (d = .56), “Overall satisfaction” (d = .64), and “Total score” (d = .53) than those whose frequency increased.

Table 5. presents men' sexual function scores by changes in sexual behaviors during the SARS-CoV-2 pandemic. In contrast to the total sample FSFI scores, all IIEF dimensions showed statistically significant differences across several sexual behaviors when comparing them across those whose frequency decreased, remained the same, or increased amid the pandemic (Fs ≥ 3.22; ps ≤ .05; η²s ≤ .070). However, the majority of these comparisons' effect sizes were considered small (η²s = .002–.050), while only a handful were considered intermediate. “Intermediate” effect size effects for the main effect were found for IIEF “Intercourse satisfaction,” “Overall satisfaction,” and “Total score” in “Foreplay” (η² = .070; η² = .059; η² = .059, respectively) and “Sexual intercourse” (η² = .064; η² = .069; η² = .052, respectively). Furthermore, whereas most correlations were negligible, some of them showed a positive and significant weak relationship between sexual function dimension scores and sexual behaviors. Particularly, for both IIEF and FSFI, the more “Foreplay” and “Sexual intercourse” people had during the pandemic, the higher the satisfaction they experienced (rs = .23–.26; see Supplementary Table 3).

Table 5

*Men' Sexual Function Scores (IIEF) by Changes in Sexual Behaviors during the SARS-CoV-2 Pandemic*
	Had less (1)		Not affect (2)		Had more (3)		F†	η²	Cohen's d
	M	SD	M	SD	M	SD	F†	η²	1 vs. 2	1 vs. 3	2 vs. 3
Dating	n = 240		n = 126		n = 40
Erectile Function	26.17	3.86	26.97	3.53	26.75	3.56	2.01	0.010	0.21	0.15	0.06
Orgasm Function	8.65	1.86	9.00	1.70	8.82	1.53	1.65	0.008	0.19	0.09	0.11
Sexual Desire	8.00	1.55	8.18	1.58	8.43	1.47	1.51	0.007	0.12	0.28	0.16
Intercourse Satisfaction	11.22•*	2.57	12.33•*	2.28	12.08	2.29	9.07*	0.043	0.45	0.34	0.11
Overall Satisfaction	7.78•*	1.87	8.49•*	1.65	8.32	1.46	7.24*	0.035	0.40	0.30	0.11
Total Score	61.82•*	8.67	64.97•*	8.50	64.40	7.90	6.18*	0.030	0.37	0.30	0.07
Sexting	n = 140		n = 155		n = 189
Erectile Function	26.15	3.70	26.92	3.71	26.90	3.21	2.32	0.010	0.21	0.22	0.01
Orgasm Function	8.73	1.78	8.92	1.70	8.81	1.77	0.46	0.002	0.11	0.05	0.06
Sexual Desire	7.99	1.67	8.07	1.56	8.24	1.48	1.13	0.005	0.05	0.16	0.11
Intercourse Satisfaction	10.94•▫*	2.49	11.92•*	2.31	11.99▫*	2.40	8.92*	0.036	0.41	0.43	0.03
Overall Satisfaction	7.80	1.93	8.15	1.78	8.25	1.65	2.77	0.011	0.19	0.25	0.06
Total Score	61.61•▫*	8.42	63.99•*	8.67	64.20▫*	7.94	4.48*	0.001	0.28	0.14	0.03
Foreplay	n = 163		n = 316		n = 115
Erectile Function	25.91•▫*	3.85	26.95•*	3.45	27.20▫*	2.91	6.24*	0.021	0.29	0.37	0.08
Orgasm Function	8.49•▫*	1.95	9.00•*	1.61	9.14▫*	1.23	6.86*	0.023	0.29	0.39	0.10
Sexual Desire	7.25•*	1.68	8.31•*	1.43	8.10	1.53	7.23*	0.024	0.68	0.53	0.14
Intercourse Satisfaction	10.69•▫*	2.69	12.10•*	2.11	12.10▫*	2.21	22.26*	0.070	0.61	0.73	< 0.01
Overall Satisfaction	7.45•▫*	1.97	8.19•‾*	1.64	8.65▫‾*	1.35	18.43*	0.059	0.42	0.69	0.29
Total Score	60.29•▫*	9.30	64.55•*	7.59	65.18▫*	6.72	18.65*	0.059	0.52	0.59	0.09
Sexual fantasies	n = 139		n = 260		n = 163
Erectile Function	26.21	3.24	27.03	3.49	26.83	3.65	2.53	0.009	0.24	0.24	0.06
Orgasm Function	8.68	1.60	9.03	1.57	8.80	1.88	2.27	0.008	0.22	0.07	0.14
Sexual Desire	7.63•▫*	1.63	8.18•*	1.49	8.51▫*	1.38	13.22*	0.045	0.36	0.59	0.23
Intercourse Satisfaction	10.86•▫*	2.29	12.19•*	2.31	11.69▫*	2.47	14.59*	0.050	0.58	0.35	0.21
Overall Satisfaction	7.74•*	1.75	8.20•*	1.66	8.13	1.88	3.27*	0.012	0.27	0.21	0.04
Total Score	61.12•▫*	7.61	64.63•*	8.00	63.96▫*	8.66	8.81*	0.031	0.45	0.35	0.08
Masturbation	n = 74		n = 283		n = 254
Erectile Function	25.97	3.75	26.89	3.64	26.71	3.46	1.94	0.006	0.25	0.21	0.05
Orgasm Function	8.74	1.70	9.11•*	1.49	8.63•*	1.91	5.51*	0.018	0.24	0.06	0.28
Sexual Desire	7.80	1.74	8.05	1.52	8.32	1.53	3.93*	0.013	0.16	0.33	0.18
Intercourse Satisfaction	11.45	2.80	11.92•*	2.29	11.41•*	2.46	3.24*	0.011	0.20	0.02	0.22
Overall Satisfaction	7.95	2.01	8.31•*	1.59	7.78•*	1.87	6.05*	0.020	0.21	0.09	0.31
Total Score	61.91	9.59	64.28	8.26	62.85	8.22	3.26*	0.011	0.28	0.11	0.17
Watching porn	n = 93		n = 243		n = 219
Erectile Function	26.41	3.47	26.81	3.62	26.79	3.43	0.47	0.002	0.11	0.11	0.01
Orgasm Function	8.80	1.78	9.02	1.52	8.71	1.91	2.02	0.007	0.14	0.05	0.12
Sexual Desire	7.81•*	1.60	8.04▫*	1.50	8.43•▫*	1.56	6.63*	0.023	0.15	0.39	0.26
Intercourse Satisfaction	11.49	2.46	11.95	2.37	11.53	2.49	2.19	0.008	0.19	0.02	0.17
Overall Satisfaction	8.13	1.81	8.21	1.68	7.83	1.86	2.77	0.010	0.05	0.16	0.22
Total Score	62.63	9.01	64.02	8.39	63.28	8.22	1.03	0.004	0.16	0.08	0.09
Sexual intercourse	n = 262		n = 216		n = 145
Erectile Function	26.23•*	3.70	26.87	3.52	27.26•*	3.27	4.35*	0.014	0.18	0.32	0.13
Orgasm Function	8.58•▫*	1.96	9.12•*	1.36	9.10▫*	1.41	7.96*	0.025	0.32	0.29	0.01
Sexual Desire	7.94	1.70	8.24	1.47	8.28	1.33	3.22*	0.010	0.19	0.22	0.03
Intercourse Satisfaction	11.03•▫*	2.48	12.15•*	2.19	12.35▫*	2.14	21.03*	0.064	0.48	0.56	0.09
Overall Satisfaction	7.57•▫*	1.91	8.31•*	1.62	8.68▫*	1.36	22.97*	0.069	0.42	0.64	0.36
Total Score	61.34•▫*	8.78	64.68•*	7.87	65.68▫*	6.99	16.89*	0.052	0.40	0.53	0.13
Note.
Symbols •, ▫, ‾ were used to denote means being compared whose difference reached statistical significance below p < 0.05, using Bonferroni correction.
* = p ≤ .05; † = All tests using the F-test had 2 degrees of freedom.
M = Mean; SD = Standard deviation; n = group size; F = Omnibus F test; η² = Eta square effect size.

Women whose frequency of “Dating,” “Sexting,” “Foreplay,” “Sexual fantasies,” “Masturbation,” and “Sexual intercourse” decreased had a statistically significantly higher risk of experiencing FSD than those whose frequency remained unaffected (χ²s ≥ 9.75; ps ≤ .05). Similarly, men whose “Sexting”, “Foreplay”, “Sexual fantasies”, “Masturbation,” and “Sexual intercourse” decreased had a statistically significantly higher risk of experiencing FSD than those whose frequency increased (χ²s ≥ 18.83; ps ≤ .05). Only those women whose frequency of “Dating” and “Masturbation” increased had a statistically significantly higher risk of experiencing FSD than those whose frequency remained unaffected (χ²s ≥ 5.3; ps ≤ .05). All these differences, nevertheless, were of a small effect size (Vs ≤ .197).

Table 6. and 7. Presents the female sexual dysfunction and erectile dysfunction by changes in sexual behaviors during the SARS-CoV-2 pandemic, respectively.

Table 6

*Female Sexual Dysfunction (FSFI) by Changes in Sexual Behaviors during the SARS-CoV-2 Pandemic*
	Had less (1)		Not affect (2)		Had more (3)		χ²			Cramer's V
	n	%	n	%	n	%	1 vs. 2	1 vs. 3	2 vs. 3	1 vs. 2	1 vs. 3	2 vs. 3
Dating
No FSD	576	77.73	282	85.98	81	75.70	9.75*	0.22	6.17*	0.096	0.016	0.119
FSD	165	22.27	46	14.02	26	24.30	9.75*	0.22	6.17*	0.096	0.016	0.119
Sexting
No FSD	286	70.10	424	82.65	392	82.53	20.08*	18.83*	< 0.01	0.148	0.146	0.002
FSD	122	29.90	89	17.35	83	17.47	20.08*	18.83*	< 0.01	0.148	0.146	0.002
Foreplay
No FSD	341	67.79	721	83.26	317	84.99	43.73*	33.87*	0.57	0.179	0.197	0.022
FSD	162	32.21	145	16.74	56	15.01	43.73*	33.87*	0.57	0.179	0.197	0.022
Sexual fantasies
No FSD	266	67.68	546	83.49	447	83.09	35.21*	30.04*	0.03	0.183	0.180	0.005
FSD	127	32.32	108	16.51	91	16.91	35.21*	30.04*	0.03	0.183	0.180	0.005
Masturbation
No FSD	247	68.80	537	83.91	545	78.99	31.07*	13.24*	5.3*	0.176	0.112	0.063
FSD	112	31.20	103	16.09	145	21.01	31.07*	13.24*	5.3*	0.176	0.112	0.063
Watching porn
No FSD	234	74.76	354	80.27	304	79.58	3.15	2.22	0.06	0.065	0.056	0.009
FSD	79	25.24	87	19.73	78	20.42	3.15	2.22	0.06	0.065	0.056	0.009
Sexual intercourse
No FSD	617	71.74	427	85.23	402	85.53	32.22*	32.25*	0.02	0.154	0.156	0.004
FSD	243	28.26	74	14.77	68	14.47	32.22*	32.25*	0.02	0.154	0.156	0.004
Note.
FSD = Female sexual dysfunction.
* = p ≤ .05; † = All contrasts had 1 degrees of freedom.
n = group size; % = Percentage; χ² = Chi-square test.

Men whose frequency of “Foreplay,” “Sexual fantasies,” and “Sexual intercourse” decreased had a statistically significantly higher risk of experiencing ED than those whose frequency remained unaffected (χ²s ≥ 4.17; ps ≤ .05). Similarly, men whose “Foreplay” and “Sexual intercourse” decreased had a statistically significantly higher risk of experiencing ED than those whose frequency increased (χ²s ≥ 6.17; ps ≤ .05). Likewise, all these differences were considered of a small effect size (Vs ≤ .149).

Table 7

*Erectile Dysfunction (IIEF) by Changes in Sexual Behaviors during the SARS-CoV-2 Pandemic*
	Had less (1)		Not affect (2)		Had more (3)		χ²			Cramer's V
	n	%	n	%	n	%	1 vs. 2	1 vs. 3	2 vs. 3	1 vs. 2	1 vs. 3	2 vs. 3
Dating
No ED	161	67.08	93	73.81	29	72.50	1.76	0.46	0.03	0.069	0.041	0.013
ED	79	32.92	33	26.19	11	27.50	1.76	0.46	0.03	0.069	0.041	0.013
Sexting
No ED	95	67.86	115	74.19	138	73.02	1.44	1.04	0.06	0.07	0.056	0.013
ED	45	32.14	40	25.81	51	26.98	1.44	1.04	0.06	0.07	0.056	0.013
Foreplay
No ED	105	64.42	235	74.37	90	78.26	5.17*	6.17*	0.69	0.104	0.149	0.04
ED	58	35.58	81	25.63	25	21.74	5.17*	6.17*	0.69	0.104	0.149	0.04
Sexual fantasies
No ED	92	66.19	197	75.77	123	75.46	4.17*	3.15	0.01	0.102	0.102	0.004
ED	47	33.81	63	24.23	40	24.54	4.17*	3.15	0.01	0.102	0.102	0.004
Masturbation
No ED	48	64.86	212	74.91	186	73.23	2.99	1.96	0.20	0.092	0.077	0.019
ED	26	35.14	71	25.09	68	26.77	2.99	1.96	0.20	0.092	0.077	0.019
Watching porn
No ED	64	68.82	175	72.02	162	73.97	0.34	0.87	0.22	0.032	0.053	0.022
ED	29	31.18	68	27.98	57	26.03	0.34	0.87	0.22	0.032	0.053	0.022
Sexual intercourse
No ED	172	65.65	164	75.93	115	79.31	5.99*	8.38*	0.57	0.112	0.143	0.04
ED	90	34.35	52	24.07	30	20.69	5.99*	8.38*	0.57	0.112	0.143	0.04
Note.
ED = Erectile dysfunction.
* = p ≤ .05; † = All contrasts had 1 degrees of freedom.
n = group size; % = Percentage; χ² = Chi-square test.

Multiple studies have demonstrated the variability of effects the SARS-CoV-2 pandemic and its social distancing measure had on people' sexual function and behaviors. In understanding how these two interacted with each other during this period, the present study sought to evaluate the relation between variations in sexual behavior frequencies and men's and women' sexual function.

Our study results corroborated global trends such as that the frequency of coupled sexual behaviors decreased, whereas single sexual behaviors increased (Hammoud et al., 2020; Holt et al., 2023; Mercer et al., 2022; Mitchell et al., 2023; Toldam et al., 2022), and that overall people' sexual behavior frequencies either decreased, remained the same, or increased (Arafat et al., 2020), while the decrease was of a larger magnitude for women than for men (Hensel et al., 2023; Qaderi et al., 2023). However, our results showed new nuances to the relation between the well studied sexual behaviors and sexual function dimensions.

The Chilean government's response to the pandemic did not differ significantly from that of other governments (Camara de Diputados y Diputadas, 2021), not believed to have been as stringent as the ones imposed by countries like China or Italy. However, to date, the following study constitutes the only account of Chilean people sexual function and behaviors. Reports on mental health consequences amid the pandemic demonstrated that Chilean people had a rather similar outlook than the rest of the world (Barrientos et al., 2021). Therefore, the present study helps better understand the relation between variations in sexual behavior frequency during the pandemic, but also expands our understanding of other least studied populations in sex research such as Latam countries and the Global South (Baker, 2023; Binnie, 2004; Claes, 2016; Klein et al., 2021; Reidpath & Pascale, 2019).

Amongst the explored sexual behaviors, our data showed that dating was the one that experienced the largest decrease and lowest increase during the pandemic for women and men. Indeed, given the nature of infection and its spread (Synowiec et al., 2021), social distancing measures vastly restricted in-person interactions, thus limiting dating. Dating new partners remained low and stable across the first two years of the pandemic as shown in US adults (Rushmore et al., 2024). Still, it appears that relationship status, online dating, or sexting did not vary significantly comparing before vs. during the pandemic (Coombe et al., 2021; Yarger et al., 2021) despite the surge in the use of online dating technologies at the beginning of the pandemic (Wiederhold, 2021). Whereas these technologies offered an opportunity to seek or maintain sexual dating behaviors and were used by many (Choi et al., 2022), paradoxically they led to a higher dissatisfaction likely due to the limitations of social distancing still in place, as well as due to the exposition of unwanted and invasive content sharing and requests, emotional distress, and judgement from others (Anderson & Ross, 2024; Setty & Dobson, 2024). This would corroborate the larger sexual satisfaction and a lesser risk of experiencing sexual dysfunction in men and women whose “dating” frequency remained unaffected in comparison to those for whom it decreased or increased. Although the effect was much larger in women.

Sexting was also affected by the pandemic. Our findings demonstrated that men and women who had a lesser frequency of sexting experienced a lower sexual satisfaction than those for whom these remained unaffected. Sexting represented either an alternative or a new way to engage intimately and sexually with people during the pandemic (Lehmiller et al., 2021), especially as social distancing measures became more stringent (Thomas et al., 2022). Amongst those willing to share this content, a higher frequency of sexting was associated with a higher arousal and relational affirmation needs, as well as stress regulation, a relationship moderated by gender and relationship status (Maes & Vandenbosch, 2022). Likewise, in comparison to those who did not engage in sexting during the second wave of the pandemic, adult women those who engaged in sexting during isolation scored higher on intimacy, passion, couple satisfaction (Bonfanti et al., 2023). Indeed, sexting was able to modulate the relationship between loneliness and sexual satisfaction during the pandemic (Bonfanti et al., 2023), thus providing an effective coping strategy while in isolation. Given the varied motivations for sexting and differing attitudes towards it (Klettke et al., 2014), those who sexted less frequently might have been with a partner who had a negative attitude towards sexting, leading to lower sexual satisfaction. Sexting is often considered an expected part of relationships (Weisskirch & Delevi, 2011), and individuals who were single during the pandemic may have refrained from sexting due to the lack of a partner or because common motives, such as alleviating boredom or seeking intimacy, were not applicable in their circumstances (Kopecký, 2012).

Regarding foreplay, our findings demonstrated that men and women who had a lesser frequency of foreplay experienced a lower sexual satisfaction than those for whom these remained unaffected. Meanwhile, only women who had less foreplay were at a higher risk of experiencing sexual dysfunction, whereas only men whose foreplay frequency increased experienced a significantly higher overall satisfaction than those for whom it remained unaffected. When assessing the association between the risks of experiencing sexual dysfunction for women in relationships, “too little foreplay” is commonly amongst the most common complaints in women (Hisasue et al., 2005; Shaeer et al., 2020; Witting et al., 2008). During the pandemic, as shown in the general population and healthcare workers, foreplay duration decreased significantly (Güzel & Döndü, 2022; Narkkul et al., 2022). Culha et al. (2021) found that people not only preferred less foreplay but also favored more non-face-to-face sexual positions, likely as a strategy to reduce close physical contact and minimize infection risk. Fewer foreplay practices may have reduced sexual satisfaction more for those who particularly needed it but were unable to engage in it due to pandemic constraints. Conversely, men who increased their foreplay frequency may have found it a compensatory behavior for the lack of other forms of intimate contact, addressing a need that is often underestimated in men (Miller & Byers, 2004). This suggests that the frequency of foreplay during the pandemic played a significant role in modulating sexual satisfaction, with gender differences highlighting varied needs and responses to changes in sexual behavior.

Sexual fantasies are one of the least explored sexual behaviors amid the pandemic. Our results indicated that women reported a larger increase than men did and, compared to those whose sexual fantasies remained unaffected or experienced more, women who experienced less sexual fantasies scored meaningfully lower in sexual arousal and satisfaction and were at a higher risk of sexual dysfunction. In contrast, men scored meaningfully lower in sexual desire and intercourse satisfaction. These results corroborate other findings where a bit more than 30% of people sexually fantasized more during the lockdown, where more women more frequently reported this change, and that this increase in sexual fantasies correlated with an increase in solitary sexual practices (Ballester-Arnal et al., 2021; Cascalheira et al., 2021). It is likely that the increased sexual fantasy frequency and lower sexual function scores in men and women are in part explained by the lower sexual intercourse frequency, which are indeed explained by constant worries, stress levels, being locked up at home, etc., amid the pandemic (Ballester-Arnal et al., 2021). Although, other studies have shown that people expanded their sexual repertoire into trying new positions, sex technologies, and sharing sexual fantasies (Bowling et al., 2021; Lehmiller et al., 2021). These differences can be explained by the attitude toward sexual fantasies, which in turn have been found to predict several dimensions of both female and male sexual function (Sierra et al., 2021).

Solo sexual activities such as masturbation and watching pornography saw the most consistent increase and lesser decrease in frequency during the pandemic amongst sexual behaviors, more distinctly in men than in women. Our results also demonstrated that women whose frequency of masturbation and watching pornography decreased during the pandemic had a meaningfully lower sexual desire and arousal and were at a higher risk of experiencing sexual dysfunction, whereas men in the same situation had a meaningfully lower sexual desire. Indeed, several studies have shown how the pandemic fostered both an increase and decrease in sexual desire and arousal (Bowling et al., 2021; Hammoud et al., 2020; Holt et al., 2023; Mercer et al., 2022; Mitchell et al., 2023; Toldam et al., 2022), which, in turn, would explain an increase or decrease, respectively, in these behaviors. Whereas some studies showed a significant positive effect of masturbation and watching pornography during the pandemic, even as a coping mechanism, which in turn predicted a better sexual function (Berdychevsky, 2023a, 2023b), a decrease in these behaviors has also been associated with the opposite, where the larger decrease effect on women would explain why they could have had a significant higher risk of experiencing sexual dysfunction (Masoudi et al., 2022; Mourikis et al., 2022; Qaderi et al., 2023).

Sexual intercourse was the most widely studied behavior during the pandemic. Our results corroborated the global trends showing the highest decrease of a similar magnitude for men and women. Similarly, a decrease in sexual intercourse frequency was associated with a meaningfully lower desire, arousal, orgasm, and satisfaction, as well as a higher risk of sexual dysfunction for both men and women, where the largest decrease was found in the satisfaction dimensions. Nevertheless, only in men, an increase of sexual intercourse was associated with a meaningful increase in overall satisfaction. Indeed, most studies showed that partnered sexual behaviors, such as sexual intercourse, experience more frequently a decreased in frequency during the pandemic (Hammoud et al., 2020; Holt et al., 2023; Mercer et al., 2022; Mitchell et al., 2023; Toldam et al., 2022). Several factors have more commonly been found to be associated with these fluctuations, such as personal and family-related (Hensel et al., 2023; Mitchell et al., 2023; Mourikis et al., 2022), work-related (Karsiyakali et al., 2020; Vieira et al., 2023), covid-19-related (Qaderi et al., 2023; Zak et al., 2024), social distancing-related (Maxwell et al., 2023; Seehuus et al., 2023), mental health-related (Bhambhvani et al., 2021; Dion et al., 2023; Mollaioli et al., 2021; Szuster et al., 2021).

Across all examined sexual behaviors, there is a consistent and more pronounce effect on sexual satisfaction, which was meaningfully lower across studies, similarly as reported through systematic reviews and meta-analyses (Masoudi et al., 2022; Mourikis et al., 2022; Qaderi et al., 2023; Zalpour et al., 2023). There are two main hypotheses to explain changes in sexual function and behaviors during stressful situations such as the SARS-CoV-2 pandemic. The terror management theory (Greenberg & Pyszczynski, 1986) suggests that anxiety triggered by mortality and imminent threats can heighten the desire for intimacy and closeness, thereby influencing sexual desire. For instance, studies have shown that the desire for casual sex increased among men when reminded of their mortality, whereas sexual desire increased in both genders when the encounter had romantic connotations (Birnbaum et al., 2011). Alternatively, the dual control model of sexual response (Bancroft et al., 2009) differentiates between individuals whose reaction to stimulation tends toward either excitation or inhibition. While some may experience a decrease in sexual desire due to stress, others might experience an increase in sexual drive (Masoudi et al., 2022). Factors such as social distancing and boredom may also contribute to compulsive sexual behaviors as individuals seek to avoid negative emotions. Men, in particular, appear to exhibit stronger sexual desire compared to women, which could explain a greater increase in their sexual behaviors in response to the pandemic (Baumeister et al., 2001). Finally, it is worth considering that social distancing measures imposed many people to the confinement within their homes, with known consequences hindering people' sexual behaviors and function (Zalpour et al., 2023), still depending on the psychological adjustment (Carvalho et al., 2021).

Limitations and future research

A few caveats should be acknowledged. The study was conducted online, skewing the participation to those with access to social media and more educated people, yet also less likely to include vulnerable populations, who have had a worse experience during the pandemic (Li et al., 2023; Weill et al., 2020). Our study was vastly limited in terms of gender-diverse people. Whereas the CSSS sample included a gender non-binary, this was far too low to conduct a meaningful comparison and reliable statistical analyses.

Abreu RL, Barrita AM, Martin JA, Sostre J, Gonzalez KA (2024) Latinx LGBTQ Youth, COVID-19, and Psychological Well-Being: A Systematic Review. J Clin Child Adolesc Psychol 53(1):98–113. https://doi.org/10.1080/15374416.2022.2158839
Anderson BE, Ross PDS (2024) Looking for Lockdown Love Online: A Literature Review on Virtual Partner Selection During the COVID-19 Pandemic. Sexuality Culture-an Interdisciplinary J 28(3):1289–1310. https://doi.org/10.1007/s12119-023-10173-0
APA (2013) Diagnostic and statistical manual of mental disorders: DSM-5™, 5th edn. American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596. 10.1176/appi.books.9780890425596]
Arafat SMY, Alradie-Mohamed A, Kar SK, Sharma P, Kabir R (2020) Does COVID-19 pandemic affect sexual behaviour? A cross-sectional, cross-national online survey. Psychiatry Res 289:113050. https://doi.org/https://doi.org/10.1016/j.psychres.2020.113050
Baker S (2023) North–south publishing data show stark inequities in global research. Nature 624(7991):S1–S1. https://doi.org/https://doi.org/10.1038/d41586-023-03901-x
Ballester-Arnal R, Nebot-Garcia JE, Ruiz-Palomino E, Giménez-García C, Gil-Llario MD (2021) INSIDE Project on Sexual Health in Spain: Sexual Life During the Lockdown Caused by COVID-19. Sexuality Res Social Policy 18(4):1023–1041. https://doi.org/10.1007/s13178-020-00506-1
Bancroft J, Graham CA, Janssen E, Sanders SA (2009) The dual control model: current status and future directions. J Sex Res 46(2–3):121–142. https://doi.org/10.1080/00224490902747222
Barrientos J, Guzmán-González M, Urzúa A, Ulloa F (2021) Psychosocial impact of COVID-19 pandemic on LGBT people in Chile. Sexologies 30(1):e35–e41. https://doi.org/https://doi.org/10.1016/j.sexol.2020.12.006
Baumeister RF, Catanese KR, Vohs KD (2001) Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence. Personality Social Psychol Rev 5(3):242–273. https://doi.org/10.1207/S15327957PSPR0503_5
Bazant MZ, Bush JWM (2021) A guideline to limit indoor airborne transmission of COVID-19. Proc Natl Acad Sci USA 118(17) Article e2018995118. https://doi.org/10.1073/pnas.2018995118
Berdychevsky L (2023a) Sex as leisure approach during the COVID-19 pandemic and its impacts on the quantity and quality of sex life. Leisure Stud 42(4):497–513. https://doi.org/10.1080/02614367.2022.2115113
Berdychevsky L (2023b) Sexual Coping Mechanisms During the COVID-19 Pandemic and Their Determinants of Use, Usefulness, and Effects on Sex Life. Sexuality Res Social Policy 20(4):1568–1591. https://doi.org/10.1007/s13178-023-00811-5
Bhambhvani HP, Chen T, Kasman AM, Wilson-King G, Enemchukwu E, Eisenberg ML (2021) Female Sexual Function During the COVID-19 Pandemic in the United States. Sex Med 9(4):100355–100355. https://doi.org/10.1016/j.esxm.2021.100355
Binnie J (2004) The Globalization of Sexuality https://doi.org/10.4135/9781446218341
Birnbaum G, Hirschberger G, Goldenberg J (2011) Desire in the face of death: Terror management, attachment, and sexual motivation. Personal Relationships 18(1):1–19. https://doi.org/10.1111/j.1475-6811.2010.01298.x
Blanca MJ, Alarcón R, Arnau J, Bono R, Bendayan R (2017) Non-normal data: Is ANOVA still a valid option? Psicothema 29(4):552–557. https://doi.org/10.7334/psicothema2016.383
Bonfanti RC, Garro M, Lavanco G, Ruggieri S (2023) The role of sexting in couple wellbeing for Italian women during the second wave of the COVID-19 pandemic. Front Psychol 14:1105556. https://doi.org/10.3389/fpsyg.2023.1105556
Bowling J, Montanaro E, Guerrero-Ordonez S, Joshi S, Gioia D (2021) Perceived Changes in Sexuality during the COVID-19 Pandemic among Adults in the United States. Sexes 2(3):331–344. https://doi.org/10.3390/sexes2030026
Buhi ER, Goodson P, Neilands TB (2008) Out of sight, not out of mind: strategies for handling missing data. Am J Health Behav 32(1):83–92. https://doi.org/10.5555/ajhb.2008.32.1.83
Camara de Diputados y Diputadas (2021) Anexo 3. Medidas adoptadas para enfrentar la pandemia de COVID-19. Retrieved from https://www.camara.cl/estado_excepcion/Anexo%203/Anexo%203.%20Medidas%20adoptadas%20para%20enfrentar%20la%20pandemia%20de%20COVID-19.pdf
Carvalho J, Campos P, Carrito M, Moura C, Quinta-Gomes A, Tavares I, Nobre P (2021) The Relationship Between COVID-19 Confinement, Psychological Adjustment, and Sexual Functioning, in a Sample of Portuguese Men and Women. J Sex Med 18(7):1191–1197. https://doi.org/10.1016/j.jsxm.2021.04.007
Cascalheira CJ, McCormack M, Portch E, Wignall L (2021) Changes in Sexual Fantasy and Solitary Sexual Practice During Social Lockdown Among Young Adults in the UK. Sex Med 9(3) Article 100342. https://doi.org/10.1016/j.esxm.2021.100342
Choi EPH, Hui BPH, Kwok JYY, Chow EPF (2022) Intimacy during the COVID-19 pandemic: an online survey examining the impact of COVID-19 on the sexual practices and dating app usage of people living in Hong Kong. Sex Health 19(6):574–579. https://doi.org/10.1071/sh22058
Claes T (2016) The Sexual History of the Global South: Sexual Politics in Africa, Asia and Latin America. J Int Netw Sex Ethics Politics 4:111–116. https://doi.org/10.3224/insep.v2i1.25773
Coombe J, Kong FYS, Bittleston H, Williams H, Tomnay J, Vaisey A, Malta S, Goller JL, Temple-Smith M, Bourchier L, Lau A, Chow EPF, Hocking JS (2021) Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual health of people living in Australia. Sex Transm Infect 97(5):357. https://doi.org/10.1136/sextrans-2020-054688
Courtemanche C, Garuccio J, Le A, Pinkston J, Yelowitz A (2020) Strong Social Distancing Measures In The United States Reduced The COVID-19 Growth Rate. Health Aff 39(7):1237–1246. https://doi.org/10.1377/hlthaff.2020.00608
Cramer H (1946) Mathematical Methods of Statistics. Princeton University Press
Culha MG, Demir O, Sahin O, Altunrende F (2021) Sexual attitudes of healthcare professionals during the COVID-19 outbreak. Int J Impot Res 33(1):102–109. https://doi.org/10.1038/s41443-020-00381-9
Dancey C, Reidy J (2004) Statistics Without Maths for Psychology
De Rose AF, Chierigo F, Ambrosini F, Mantica G, Borghesi M, Suardi N, Terrone C (2021) Sexuality during COVID lockdown: a cross-sectional Italian study among hospital workers and their relatives. Int J Impot Res 33(1):131–136. https://doi.org/10.1038/s41443-020-00393-5
Dion J, Hamel C, Prévost B, Bergeron-Leclerc C, Pouliot E, Maltais D, Grenier J, Dubé M, Ouellet-Plamondon C, Vaillancourt-Morel MP (2023) Stressed and distressed: how is the COVID-19 pandemic associated with sexual frequency, sexual satisfaction, and relationship satisfaction? J Sex Med 20(2):152–160. https://doi.org/10.1093/jsxmed/qdac041
Fotinos K, Sansone A, Greifenberger A, Katzman MA, Jannini TB, Reisman Y, Limoncin E, Jannini EA (2024) Pornography and sexual function in the post-pandemic period: a narrative review from psychological, psychiatric, and sexological perspectives. Int J Impot Res. https://doi.org/10.1038/s41443-023-00812-3
Fuchs A, Matonóg A, Pilarska J, Sieradzka P, Szul M, Czuba B, Drosdzol-Cop A (2020) The Impact of COVID-19 on Female Sexual Health. Int J Environ Res Public Health 17(19). https://doi.org/10.3390/ijerph17197152
Greenberg J, Pyszczynski T (1986) The causes and consequences of a need for self-esteem: a terror management theory. Public Private Self, 189–192
Güzel A, Döndü A (2022) Changes in sexual functions and habits of healthcare workers during the ongoing COVID-19 outbreak: a cross-sectional survey study. Ir J Med Sci 191(3):1013–1021. https://doi.org/10.1007/s11845-021-02691-3
Hammoud MA, Maher L, Holt M, Degenhardt L, Jin F, Murphy D, Bavinton B, Grulich A, Lea T, Haire B, Bourne A, Saxton P, Vaccher S, Ellard J, Mackie B, Batrouney C, Bath N, Prestage G (2020) Physical Distancing Due to COVID-19 Disrupts Sexual Behaviors Among Gay and Bisexual Men in Australia: Implications for Trends in HIV and Other Sexually Transmissible Infections. J Acquir Immune Defic Syndr 85(3):309–315. https://doi.org/10.1097/qai.0000000000002462
Hensel DJ, Mark KP, Abdelhamed A, Burns S, Esho T, Hendricks J, Fischer VJ, Ivanova O, Marks M, Michelsen K, Nimby F, Strizzi J, Tucker J, Uhlich M, Erausquin JT (2023) Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries. Int J Sex Health 35(3):459–480. https://doi.org/10.1080/19317611.2023.2224777
Hidalgo DA, Dewitte M (2021) Individual, Relational, and Sociocultural Determinants of Sexual Function and Sexual Satisfaction in Ecuador. Sex Med 9(2):100307–100307. https://doi.org/10.1016/j.esxm.2020.100307
Hisasue S, Kumamoto Y, Sato Y, Masumori N, Horita H, Kato R, Kobayashi K, Hashimoto K, Yamashita N, Itoh N (2005) Prevalence of female sexual dysfunction symptoms and its relationship to quality of life: A Japanese female cohort study. Urology 65(1):143–148. https://doi.org/10.1016/j.urology.2004.08.003
Holt L, Hollowell A, Truong T, Bentley-Edwards K, Myers E, Erkanli A, Chen EL, Swartz J (2023) Reported changes in romantic and sexual behavior among college and graduate students during COVID-19. J Am Coll Health. https://doi.org/10.1080/07448481.2023.2283747
Jarvis CI, Van Zandvoort K, Gimma A, Prem K, Klepac P, Rubin GJ, Edmunds WJ, Grp CC-W (2020) Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK. BMC Med 18(1) Article 124. https://doi.org/10.1186/s12916-020-01597-8
Karsiyakali N, Sahin Y, Ates HA, Okucu E, Karabay E (2020) Evaluation of the Sexual Functioning of Individuals Living in Turkey During the COVID-19 Pandemic: An Internet-Based Nationwide Survey Study. Sex Med 9(1):100279–100279. https://doi.org/10.1016/j.esxm.2020.10.007
Klein V, Savaş Ö, Conley T (2021) How weird and androcentric is sex research? Global inequities in study populations. Journal of Sex Research, No Pagination Specified-No Pagination Specified. https://doi.org/10.1080/00224499.2021.1918050
Klettke B, Hallford DJ, Mellor DJ (2014) Sexting prevalence and correlates: A systematic literature review. Clin Psychol Rev 34(1):44–53. https://doi.org/10.1016/j.cpr.2013.10.007
Kopecký K (2012) Sexting among Czech Preadolescents and Adolescents. New Educational Rev 28:39–48
Lehmiller JJ, Garcia JR, Gesselman AN, Mark KP (2021) Less Sex, but More Sexual Diversity: Changes in Sexual Behavior during the COVID-19 Coronavirus Pandemic. Leisure Sci 43(1–2):295–304. https://doi.org/10.1080/01490400.2020.1774016
Li LL, Taeihagh A, Tan SY (2023) A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 14(1). Article 599. https://doi.org/10.1038/s41467-023-36267-9
Little RJA (1988) A Test of Missing Completely at Random for Multivariate Data with Missing Values. J Am Stat Assoc 83(404):1198–1202. https://doi.org/10.1080/01621459.1988.10478722
Maes C, Vandenbosch L (2022) Physically distant, virtually close: Adolescents' sexting behaviors during a strict lockdown period of the COVID-19 pandemic. Comput Hum Behav 126., Article 107033. https://doi.org/10.1016/j.chb.2021.107033
Marroquín B, Vine V, Morgan R (2020) Mental health during the COVID-19 pandemic: Effects of stay-at-home policies, social distancing behavior, and social resources. Psychiatry Res 293:113419. https://doi.org/10.1016/j.psychres.2020.113419
Masoudi M, Maasoumi R, Bragazzi NL (2022) Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis. BMC Public Health 22(1):189. https://doi.org/10.1186/s12889-021-12390-4
Maxwell KJ, Bosó Pérez R, Reid D, Freeman L, Menezes D, Sonnenberg P, Field N, Mitchell KR (2023) Balancing risk, intimacy and (non)compliance: a qualitative study of sex across household during COVID-19 social restrictions. Cult Health Sex 25(5):582–598. https://doi.org/10.1080/13691058.2022.2078507
Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT (2021) Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front Public Health 8:582932. https://doi.org/10.3389/fpubh.2020.582932
Mercer CH, Clifton S, Riddell J, Tanton C, Freeman L, Copas AJ, Dema E, Bosó Pérez R, Gibbs J, Macdowall W, Menezes D, Ridge M-C, Bonell C, Sonnenberg P, Field N, Mitchell KR (2022) Impacts of COVID-19 on sexual behaviour in Britain: findings from a large, quasi-representative survey (Natsal-COVID). Sex Transm Infect 98(7):469–477. https://doi.org/10.1136/sextrans-2021-055210
Meston CM, Freihart BK, Handy AB, Kilimnik CD, Rosen RC (2019) Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med 17(1):17–25. https://doi.org/10.1016/j.jsxm.2019.10.007
Miller SA, Byers ES (2004) Actual and desired duration of foreplay and intercourse: discordance and misperceptions within heterosexual couples. J Sex Res 41(3):301–309. https://doi.org/10.1080/00224490409552237
Mitchell KR, Shimonovich M, Bosó Pérez R, Dema E, Clifton S, Riddell J, Copas AJ, Tanton C, Macdowall W, Bonell C, Sonnenberg P, Mercer CH, Field N (2023) Initial Impacts of COVID-19 on Sex Life and Relationship Quality in Steady Relationships in Britain: Findings from a Large, Quasi-representative Survey (Natsal-COVID). J Sex Res 60(1):1–12. https://doi.org/10.1080/00224499.2022.2035663
Mollaioli D, Sansone A, Ciocca G, Limoncin E, Colonnello E, Di Lorenzo G, Jannini EA (2021) Benefits of Sexual Activity on Psychological, Relational, and Sexual Health During the COVID-19 Breakout. J Sex Med 18(1):35–49. https://doi.org/10.1016/j.jsxm.2020.10.008
Mourikis I, Kokka I, Koumantarou-Malisiova E, Kontoangelos K, Konstantakopoulos G, Papageorgiou C (2022) Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis. Front Psychiatry 13:941557. https://doi.org/10.3389/fpsyt.2022.949077
Narkkul U, Ng JJ, Saraluck A (2022) Impact of the COVID-19 Pandemic on the Female Sexual Function Index and Female Behavioral Changes: A Cross-Sectional Survey Study in Thailand. Int J Environ Res Public Health 19(23). Article 15565. https://doi.org/10.3390/ijerph192315565
Qaderi K, Yazdkhasti M, Zangeneh S, Behbahani BM, Kalhor M, Shamsabadi A, Jesmani Y, Norouzi S, Kajbafvala M, Khodavirdilou R, Rahmani N, Namadian M, Ezabadi SG, Alkatout I, Mehraeen E, Rasoal D (2023) Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis. Sex Med 11(2):qfad005. https://doi.org/10.1093/sexmed/qfad005
Quintana G (2022) The Impact of the SARS-CoV-2 Pandemic on Reproduction, Sexual Function and Behaviors: A Review of the Main Trends and Findings. Int J Sex Health 34(3):351–365. https://doi.org/10.1080/19317611.2022.2053921
Quintana GR (2024) Baseline Report of the National Sex and Sexuality Study through a Chilean Conglomerate Sample. Interdisciplinaria
Quintana GR, Ponce FP, Escudero-Pastén J, Santibáñez-Palma FJ, Consortium CSSSR, Barrientos J (submitted-a). Psychometric properties of the Female Sexual Function Index (FSFI) in a Chilean representative sample. Archives of Sexual Behavior. https://doi.org/https://doi.org/10.17605/OSF.IO/YP792
Quintana GR, Ponce FP, Escudero-Pastén J, Santibáñez-Palma FJ, Consortium CSSSR, Barrientos J (submitted-b). Psychometric properties of the International Index of Erectile Function (IIEF) in a Chilean representative sample. Journal of Sexual Medicine. https://doi.org/https://doi.org/10.17605/OSF.IO/HQWE9
Rea LM, Parker RA (1992) Designing and conducting survey research: A comprehensive guide. Jossey-Bass
Reidpath D, Pascale A (2019) The problem of ‘trickle-down science’ from the Global North to the Global South. BMJ Global Health 4(4):e001719. https://doi.org/10.1136/bmjgh-2019-001719
Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, Ferguson D, D'Agostino R Jr. (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208. https://doi.org/10.1080/009262300278597
Rosen RC, Riley A, Wagner G, Osterloh IH, 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. https://doi.org/https://doi.org/10.1016/S0090-4295(97)00238-0
Rushmore J, Copen CE, Schneider J, Lamuda P, Taylor BG, Kirkcaldy RD, Learner ER, Bernstein KT (2024) Changes in Partner-Seeking and Sexual Behavior Among US Adults During the First 2 Years of the COVID-19 Pandemic. Sex Transm Dis 51(8):527–533. https://doi.org/10.1097/olq.0000000000001979
Schafer JL, Graham JW (2002) Missing data: our view of the state of the art. Psychol Methods 7 2:147–177
Seehuus M, Fertig M, Handy AB, Clifton J, Stanton AM (2023) The impact of COVID-19 and long COVID on sexual function in cisgender women. J Sex Med. https://doi.org/10.1093/jsxmed/qdad155
Setty E, Dobson E (2024) Young Love Locked Down: Adolescent and Young Adult Perspectives on Sexting During the Covid-19 Pandemic in England. Arch Sex Behav 53(2):481–495. https://doi.org/10.1007/s10508-023-02734-z
Shaeer O, Skakke D, Giraldi A, Shaeer E, Shaeer K (2020) Female Orgasm and Overall Sexual Function and Habits: A Descriptive Study of a Cohort of US Women. J Sex Med 17(6):1133–1143. https://doi.org/10.1016/j.jsxm.2020.01.029
Sierra JC, Gómez-Carranza J, Álvarez-Muelas A, Cervilla O (2021) Association of Sexual Attitudes with Sexual Function: General vs. Specific Attitudes. International Journal of Environmental Research and Public Health, 18(19), 10390. https://www.mdpi.com/1660-4601/18/19/10390
Synowiec A, Szczepański A, Barreto-Duran E, Lie LK, Pyrc K (2021) Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection. Clin Microbiol Rev 34(2). 10.1128/cmr.00133 – 00120
Szuster E, Kostrzewska P, Pawlikowska A, Mandera A, Biernikiewicz M, Kałka D (2021) Mental and Sexual Health of Polish Women of Reproductive Age During the COVID-19 Pandemic – An Online Survey. Sex Med 9(4):100367–100367. https://doi.org/10.1016/j.esxm.2021.100367
Thomas MF, Binder A, Matthes J (2022) Love in the Time of Corona: Predicting Willingness to Engage in Sexting During the First COVID-19-Related Lockdown. Arch Sex Behav 51(1):157–168. https://doi.org/10.1007/s10508-022-02292-w
Toldam NE, Graugaard C, Meyer R, Thomsen L, Dreier S, Jannini EA, Giraldi A (2022) Sexual Health During COVID-19: A Scoping Review. Sex Med Rev 10(4):714–753. https://doi.org/10.1016/j.sxmr.2022.06.005
Vieira AS, Santos HC, Pereira J, Madeira L (2023) Changes in sexuality and couple relationship during the COVID-19 lockdown in Portugal: findings from an online survey. Sex Relatsh Therapy. https://doi.org/10.1080/14681994.2023.2258102
Viner RM, Ward JL, Hudson LD, Ashe M, Patel SV, Hargreaves D, Whittaker E (2021) Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Arch Dis Child 106(8):802–807. https://doi.org/10.1136/archdischild-2020-320972
Voutskidou A, Kirkou G, Dagla M, Orovou E, Sarella A, Palaska E, Iliadou M, Antoniou E (2023) COVID-19 Pandemic and Its Impact on the Quality of Women's Sexual Life: A Systematic Review. Healthcare 11(2) Article 185. https://doi.org/10.3390/healthcare11020185
Weill JA, Stigler M, Deschenes O, Springborn MR (2020) Social distancing responses to COVID-19 emergency declarations strongly differentiated by income. Proc Natl Acad Sci USA 117(33):19658–19660. https://doi.org/10.1073/pnas.2009412117
Weisskirch RS, Delevi R (2011) Sexting and adult romantic attachment. Comput Hum Behav 27(5):1697–1701. https://doi.org/https://doi.org/10.1016/j.chb.2011.02.008
Wiederhold BK (2021) How COVID Has Changed Online Dating—And What Lies Ahead. Cyberpsychology, Behavior, and Social Networking, 24(7), 435–436. https://doi.org/10.1089/cyber.2021.29219.editorial
Witting K, Santtila P, Varjonen M, Jern P, Johansson A, von der Pahlen B, Sandnabba K (2008) Female Sexual Dysfunction, Sexual Distress, and Compatibility with Partner. J Sex Med 5(11):2587–2599. https://doi.org/10.1111/j.1743-6109.2008.00984.x
Yarger J, Gutmann-Gonzalez A, Han SR, Borgen N, Decker MJ (2021) Young people's romantic relationships and sexual activity before and during the COVID-19 pandemic. BMC Public Health 21(1). Article 1780. https://doi.org/10.1186/s12889-021-11818-1
Zak K, Starek E, Korga-Plewko A, Rasoul-Pelinska K, Abramiuk M, Michalczuk M, Rajtak A, Kotarski J, Frankowska K, Bis L, Ostrowska-Lesko M, Bobinski M (2024) Assessment of the Impact of SARS-CoV-2 Infection on the Sexual Function of Women, Levels of Oxytocin and Prolactin: A Prospective Cohort Study. J Clin Med 13(8) Article 2230. https://doi.org/10.3390/jcm13082230
Zalpour A, Zare E, Nasiri M (2023) Effect of COVID-19 Pandemic on Female Sexual Function: A Systematic Review and Meta-analysis. Iran J Psychiatry Behav Sci 17(3) Article e135905. https://doi.org/10.5812/ijpbs-135905
Zattoni F, Gül M, Soligo M, Morlacco A, Motterle G, Collavino J, Barneschi A, Moschini M, Dal Moro F (2021) The impact of COVID-19 pandemic on pornography habits: a global analysis of Google Trends. Int J Impot Res 33:1–8. https://doi.org/10.1038/s41443-020-00380-w

The authors declare no competing interests.

SupplementaryMaterial.docx
Supplementary Tables

Download PDF

Version 1

posted

You are reading this latest preprint version

For Better or Worse: The Relation between Sexual Functioning and Sexual Behavior Frequency during the SARS-CoV-2 Pandemic and Social Distancing Measures in a Chilean Sample

Status:

Version 1

Abstract

Introduction

Method

Study design

Participants

Procedure

Measures

Sociodemographic

Sexual behaviors

Sexual function

Analysis Plan

Results

Discussion

Limitations and future research

References

Additional Declarations

Supplementary Files

Status:

Version 1