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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 24  |  Issue : 1  |  Page : 53-58

Survey of physician self-reported sexual satisfaction in a tertiary hospital at Enugu, South East Nigeria: A preliminary report


1 Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
2 Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
3 Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
4 Mental Health Unit, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria
5 Department of Family Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria

Date of Web Publication1-Aug-2019

Correspondence Address:
Dr. Rita I Igwilo
Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmh.IJMH_5_19

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  Abstract 

Background: Self-reported sexual dissatisfaction is a recognized contributor to poor quality of life and can affect productivity in the workplace. Aim: This was a preliminary survey of a cohort of physicians in Enugu metropolis, South East Nigeria investigating self-reported sexual satisfaction and its association with sociodemographic variables. Materials and Methods: Physicians’ self-report of sexual well-being as well as any impact thereof was assessed using an online-delivered structured questionnaire in September 2018. Informed consent was obtained. Results obtained were analyzed using the International Business Machine–Statistical Package for the Social Sciences (IBM-SPSS) version 20. Results: The participants, 62.0% males, were mostly married (82%) and young (mean age 38.2 ± 9.7). Majority (81.5%) of the participants were satisfied with their current sexual lives, 30.7% of them used sex enhancements, and 14.8% of the participants were willing to seek professional help over sexual health problems. Males were five times more likely than females to have sexual encounters outside current relationship (P = 0.003). Conclusion: The findings of this study shows that majority of the physicians are satisfied with their sexuality. The study also observed age and gender-related differences in the physicians’ sexual behaviors. The implication of the finding that most doctors are still reluctant to seek help for sexual health issues calls for a robust public health education with emphasis on sexual health.

Keywords: Physicians, sexual satisfaction, South East Nigeria


How to cite this article:
Igwilo RI, Onwuekwe IO, Odimegwu CL, Onu JU, Onwuekwe CJ. Survey of physician self-reported sexual satisfaction in a tertiary hospital at Enugu, South East Nigeria: A preliminary report. Int J Med Health Dev 2019;24:53-8

How to cite this URL:
Igwilo RI, Onwuekwe IO, Odimegwu CL, Onu JU, Onwuekwe CJ. Survey of physician self-reported sexual satisfaction in a tertiary hospital at Enugu, South East Nigeria: A preliminary report. Int J Med Health Dev [serial online] 2019 [cited 2019 Aug 21];24:53-8. Available from: http://www.ijmhdev.com/text.asp?2019/24/1/53/263547




  Introduction Top


Semantically, “sexual health” was initially conceptualized as sexually transmitted infections, unintended pregnancies, and other unintended consequences, but has grown to encompass indicators of sexual well-being.[1] This is evident in the World Health Organization (WHO) definition of sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality, and not merely the absence of disease, dysfunction or infirmity.”[2] It further affirmed that sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy, and reproduction. It is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles, and relationships. Although sexuality can include all of these dimensions, not all of them are always experienced or expressed.[2],[3] From the forgoing, it is clear that sexuality is intrinsically interwoven into man’s very existence and affects the individual on a physiological, biological, psychological, social, economic, political, cultural, ethical, historical, legal, spiritual, and religious level.

Physicians contribute, in no small measure, to national growth and development by ensuring a healthy citizenry. The world over, the ratio of doctors to patients is not ideal, with the patients at the heavier end of the balance.[3] This places a strain on these healthcare providers with its attendant physical and mental health implications. There are other determinants of physicians’ well-being and productivity including proper remuneration, fair work schedules, appropriate social support, and the often neglected factor—optimum sexual health. The physician oftentimes is swamped with his busy work schedule, family and social responsibilities, and other personal engagements.

Generally, in Nigeria and much of Africa, the open discussion of sex is culturally considered a taboo. Despite the WHO’s definition of sexual health as a state of well-being, virtually no public health research has examined sexual well-being outcomes including sexual satisfaction.[4] Studies on this topic appear to be scarce, and it is not known, for instance, to what degree physicians are satisfied with their sexuality. It is, therefore, important to determine whether the physician is sexually satisfied. Sexual satisfaction is directly related to satisfaction within relationships, life happiness, and better quality of life. These, in turn, ensure a healthy work environment, better care of patients, less errors, and overall improved productivity.

This study investigated this group of people who, by virtue of their profession, are in most contact with other members of the society and who contribute greatly to society’s overall health. It studied an aspect of a doctor’s life that affects physical and mental health as well as capacity for healthcare delivery.


  Materials and Methods Top


Ethical considerations

Approval for this study was obtained from the Health Research and Ethics Committee of the University of Nigeria Teaching Hospital Enugu. International ethical norms and standards were strictly adhered to. Participants were given details of the study and were also informed that completing the online survey is an indication of consent to participate in the study. Participation was voluntary.

Study population

Medical doctors of all cadres in the employment of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, were studied. There were about 500 doctors in the services of the hospital during the study period of September 2018.

Sampling technique

Using the various UNTH doctors’ groups in the online platform WhatsApp™, the first 100 respondents to complete an online survey on the Survey Monkey™ platform were recruited. This was a pilot survey.


  Instruments Top


Study questionnaire

A structured online questionnaire was designed by the authors to both obtain basic sociodemographic data of respondents and examine their knowledge, attitude, and practice toward their sexual health and well-being. It was pre-tested to ensure clarity and adequacy.

Statistical analysis

Analysis was done using International Business Machine–Statistical Package for the Social Sciences (IBM-SPSS) version 20 (Chicago, Illinois). Normality of distribution of continuous data (e.g., age) was established using Kolmogorov-Smirnov test. Descriptive statistics were used to compute means and standard deviations for numerical variables as well as frequencies for nominal variables. The associations between participants’ gender, marital status, their satisfaction with current sexual partner, and use of sexual enhancements were analyzed using chi-square test or Fisher’s exact test as appropriate. In all statistical tests, a value of P < 0.05 was considered significant.


  Results Top


[Table 1] shows the sociodemographic characteristics of the 100 participants. They were mostly young adults (mean age 38.2 ± 9.7); majority (62.0%) were males and 82.0% were married. As shown in [Table 2], most of the participants (81.5%) were satisfied with their current relationships, 62.6% had no sexual encounter outside current partner, and 57.0% of the participants compared with 43% would prefer their partner to be adventurous during sexual encounters. Majority of the study participants (85.2%) neither sought nor were willing to seek help for sexual problems.
Table 1: Sociodemographic characteristics of the study participants

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Table 2: Description of sexual satisfaction, perception, and other practices among the participants

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The relationship between sociodemographic variables with other variables measuring sexual satisfaction, perception, and practices is shown in [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]. It showed that older participants were significantly more likely to be satisfied with their current relationship compared with younger participants (P = 0.005). Gender was significantly associated with sexual encounters outside the current partner such that males were five times more likely to have sexual encounters outside their current relationship when compared with females (odds ratio, 5.4, 95% confidence interval [1.8–16.5]). Males were two times more likely to prefer their partner to be more adventurous; however, this was not statistically significant (P = 0.124).
Table 3: The relationship between sociodemographic factors and satisfaction with current relationship

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Table 4: The relationship between sociodemographic factors and sexual encounter outside current partner

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Table 5: The relationship between sociodemographic factors and preference of adventurous partner

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Table 6: The relationship between sociodemographic factors and use of sex enhancement

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Table 7: The relationship between sociodemographic factors and willingness to seek help

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  Discussion Top


The study was aimed at describing the sexual behaviors of physicians working in a Nigerian tertiary hospital, with a view to highlighting the sociodemographic factors associated with the various sexual behaviors among this population.

The highlights of the study findings are as follows: (1) the majority of the physicians were satisfied with their sexuality; (2) there were age and gender-related differences in certain sexual behaviors among physicians. Older physicians were more likely to be satisfied with their sexuality. Males were five times more likely than females to have sexual encounters outside their current relationships. (3) Most physicians (85.2%) neither sought nor were willing to seek help from professionals for sexual difficulties.

From the study, the mean age of doctors was relatively young at 38.2 years and more than two-thirds were married. The age is lower than that of doctors in a US survey,[5] which was 52.33 years. The age differences in the two studies may be due to selection bias or because younger doctors are more likely to complete the online questionnaire due to their familiarity with the use of the Internet. It is also possible that with westernization, younger doctors are more likely to discuss freely contents with sexual themes than the older physicians. The study also found that 82% of the respondents were married. This finding is similar to that observed by Goldacre et al.[6] wherein by the age of 33 years, 75% of both male and female doctors were living with a spouse or partner, compared with 68% of women and 61% of men aged 33 years in the general population.

Despite the high rate of sexual satisfaction reported in this study, we observed that 37.4% of the doctors admitted sexual encounters outside their current partners. This is in keeping with the findings of several commentators on relationship that cheating/infidelity is not restricted to unhappy sexual relationships.[7],[8],[9] Other indicators of sexual dissatisfaction in our study were the finding that some doctors desired for their partners to be more adventurous and the use of sexual enhancements. These findings are similar to results obtained in another US survey where four in 10 men (40%) wanted more adventurous partners and between 20% and 30% of respondents had used various forms of enhancements such as sexually stimulating videos and objects.[10]

Our study found a relationship between the ages of the respondents and sexual satisfaction. Older physicians were more likely to be satisfied with their sexuality than younger physicians. As noted by Dr Justin Lehmiller[11] in his popular blog, “Sex and Psychology,” age and relationship lengths usually have some relationship with sexual satisfaction. Strikingly, as was found in our study, Lehmiller notes that, although sexual satisfaction seems to decline as we age, older individuals and couples still report satisfaction with sex life. He also highlights the result of an Israeli study in which 313 Israeli adults were surveyed,[12] all of whom were heterosexual and married for at least a year. It was found that the longer a couple had been together, the more likely it was that they were thinking of cheating. Sexual satisfaction increased throughout the first year of a relationship but typically started to decline after that. For men, this relationship was linear, that is, a steady decline in satisfaction with current partner and increasing tendency to cheat. For women, however, it was curvilinear, with the greatest likelihood of cheating in intermediate marriages (6–10 years) and lower odds in short- and long-term marriages.

Interestingly, being married or single did not have any significant effect on sexual satisfaction. Lower levels of satisfaction were anticipated in the singles group as a result of possible feelings of guilt that come with engaging in premarital sex. Societal mores and values, especially in Africa, often influence one’s actions and color experiences. Similarly, fairly equal percentages of both married and single doctors reported sexual encounters outside current partners. Similarities in behaviors and outcomes between the single and married groups were also seen in responses to “preference for a more adventurous partner” and “use of sexual enhancements.”

Although slightly more female doctors reported dissatisfaction with current relationship (20% vs 17.5%), male doctors were three times as likely to seek satisfaction with someone other than their partner. This ratio is more than that seen in the same US poll where 21% of men and 11% of women admitted to sex outside their current partners (a ratio of 2:1).[11] Perhaps, because these male doctors realize the importance of sexual well-being to sanity and productivity and/or experience more emotional and physical conflicts as a result, they seek quick-fix measures to make up for the lack. For female doctors, however, although a slightly higher percentage compared to the women in the US survey (15% vs 11%) have sought satisfaction elsewhere,[11] it is still significantly lower than their male counterparts. Cultural factors certainly play a contributory role. In this part of the world with a patriarchal society, it is regarded as a taboo for the woman to be unfaithful. The man, oftentimes, is allowed to be polygamous.

Also, more than half of our female respondents did not prefer their partners to be more adventurous (greater than 60% of male doctors definitely wanted more adventurous partners). This further buttresses the role of the African societal influence that often inhibits or stifles the female sex. In contrast, in more advanced societies, “women are more open to sexual experimentation and more likely to have experiences in fantasy sharing and explicit conversations during sex.”[13] However slightly more women than men (33% vs. 29%) admitted to use of sexual enhancements. This is most likely because these aids, for example, dildos, vibrators, videos, and erotic articles, are used privately and do not necessarily involve the partner/spouse.

There are a number of factors postulated as to why people who have some form of sexual dysfunction or are not satisfied with their relationships are unwilling to seek help. Some of these factors include feelings of embarrassment, guilt, or shame; belief that they should be able to sort out their problems themselves (this is especially true of medical doctors); fear about confidentiality; and belief that they just have to live with the problem.[14] Dr George Atkinson[15] stated, “Thinking about discussing sex is more frightening than actually doing it, and the reactions we are often fearful of very rarely occur.” Increasing age and severity of the condition are associated with greater likelihood to discuss these sexual problems. In our study of doctors who reported sexual dissatisfaction, a huge proportion (85.2%) had neither sought help nor was willing to seek professional help. Broadly speaking, there was no significant impact of marital status, age, and gender on this behavior. Looking closely, however, we see a slightly greater inclination of single doctors than married doctors toward seeking professional help (23% vs. 13%). As was earlier noted, this reflects the increased trend of acceptance of sex and sexuality among the young without fear of societal norms or inhibitions.


  Conclusion Top


The findings of the study demonstrate that majority of the physicians are satisfied with their sexuality. We also observed age and gender differences in the physicians’ sexual satisfaction and sexual encounter outside the current partner. Older physicians were more likely to report satisfaction with current sexual relationships. Males were more likely to have sexual encounters outside their current partner. The study represents a good basis for future studies in this area. For instance, it is important to examine the physicians’ characteristics that predict sexual satisfaction and the possible effect on the physicians’ approach to patient care.


  Limitations Top


One of the limitations of this study was the small sample size and the one-institution-based samples; although it saved cost and time, as a preliminary study, the findings will need validation from larger, multicenter studies. Second, although the nonprobability sampling method utilized in the study is adequate for such an online survey, it may not represent the general population of doctors in the institution. This could lead to selection bias.

Acknowledgement

The authors are grateful to all the medical doctors in the University of Nigeria Teaching Hospital, Enugu, Nigeria, who accepted to be part of this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Sandfort TG, Ehrhardt AA Sexual health: a useful public health paradigm or a moral imperative? Arch Sex Behav 2004;33:181-7.  Back to cited text no. 1
    
2.
World Health Organization. Sexual and reproductive health: defining sexual health. 2018. Retrieved from http://www.who.int/reproductivehealth/topic/sexualhealth/sh_definitions/en/  Back to cited text no. 2
    
3.
World Health Organization. Global atlas of the health workforce. Geneva: World Health Organization, 2010.  Back to cited text no. 3
    
4.
Higgins JA, Mullinax M, Trussell J, Davidson JK Sr, Moore NB Sexual satisfaction and sexual health among university students in the United States. Am J Public Health 2011;101: 1643-54.  Back to cited text no. 4
    
5.
Statista. Distribution of United States’ physicians by age group in 2018. Retrieved from https://www.statista.com/statistics/415961/share-of-age-among-us-physicians/#0  Back to cited text no. 5
    
6.
Goldacre MJ, Davidson JM, Lambert TW Doctors’ age at domestic partnership and parenthood: cohort studies. J Royal Soc Med 2012;105:390-9.  Back to cited text no. 6
    
7.
Alfonso VC, Alison DB, Dunn GM Sexual fantasy and satisfaction: a multidimensional analysis of gender differences. Int J Sex Health 1992;5:19-37.  Back to cited text no. 7
    
8.
Leitenberg H, Hicks TV Sexual fantasies about one’s partner versus someone else: gender differences in incidence and frequency. J Sex Res 2001;38:43-50.  Back to cited text no. 8
    
9.
Boros L Why do people in good relationship cheat? Washington Post, October, 17, 2017.  Back to cited text no. 9
    
10.
Langer G, Arnedt C, Sussman D The American sex survey: A peek beneath the sheets. 2004. Available at https://www.google.com/url?sa=t&source=web&rct=j&url=https://abcnews.go.com/images/Politics/959a1AmericanSexSurvey. pdf&ved=2ahUKEwiWjsPkucjiAhUSJTQIHVitCv8QFj AAegQIBRAB&usg=AOvVaw2lLyeuCV0hryN5ovNjtHL2  Back to cited text no. 10
    
11.
Lehmiller JJ When are married couples most likely to cheat? The link between infidelity and relationship length. Sex and Psychology 2018. Available from: https://www.lehmiller.com/blog/2018/9/3/when-are-married-couples-most-likely-to-cheat-the-link-between-infidelity-and-relationship-length  Back to cited text no. 11
    
12.
Ziv I, Lubin OB, Asher S “I swear I will never betray you”: factors reported by spouses as helping them resist extramarital sex in relation to gender, marriage length, and religiosity. J Sex Res 2018;55:236-51.  Back to cited text no. 12
    
13.
Good in Bed. Relationship boredom. Good in Bed Surveys. 2011. Available from: https://www.goodinbed.com/sex_trends/2011/07/good-in-bed-survey-on-relationship-boredom/  Back to cited text no. 13
    
14.
Anon. Why is talking to clients about sex important? Retrieved from https://sexualrespect.com/docs/page1-8.pdf  Back to cited text no. 14
    
15.
Miller E Asking about your sex life isn’t vulgar, it’s vital. Evidently Cochrane 2017. Available from: https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.evidentlycochrane.net/asking-about-your-sex-life-isnt- vulgar-its-vital/&ved=2ahUKEwih29a_vcjiAhXZHzQIHdkfAMgQFjAAegQIARAB&usg= AOvVaw2Jg8rJUXHCqTf2_20J_ZHo  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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Abstract
Introduction
Materials and Me...
Instruments
Results
Discussion
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Limitations
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