Sexual functioning and its relationship with sleep, vulvar pain, and mental health
| PhD ceremony: | C.F. (Carlotta) Oesterling |
| When: | June 05, 2025 |
| Start: | 14:30 |
| Supervisor: | prof. dr. P.J. (Peter) de Jong |
| Co-supervisor: | C. (Charmaine) Borg, Dr |
| Where: | Academy building RUG / Student Information & Administration |
| Faculty: | Behavioural and Social Sciences |
This dissertation explores the complex interplay between sexual health, mental well-being, intimacy, and sleep through a biopsychosocial lens. Three research lines were investigated: (1) the relationship between sexual activity and sleep, (2) psychosocial factors in vulvar pain and sexual distress, and (3) the association between depression, anxiety, and sexual dysfunction.
Findings from sleep studies showed that partnered sex with orgasm improves sleep latency and quality more consistently than masturbation. Crucially, intimacy—not just orgasm—emerged as a key factor. Emotional closeness, connection, and non-sexual intimacy (e.g., cuddling, mindful bathing) also promoted better sleep, underscoring the relevance of relational dynamics.
The second part of the dissertation revealed that many women experience vulvar pain and continue sexual activity despite it, often without communicating discomfort. Low sexual agency, restrictive sexual scripts, and the prioritization of partner pleasure were linked to sexual distress and pain. Promoting sexual agency, self-esteem, and broader definitions of sex may alleviate distress and improve well-being. This may require a certain degree of psychoeducation and self-exploration in order to be aware of own needs and desires - to then be able to communicate them.
The third research line demonstrated strong links between depression, anxiety, and sexual dysfunction/distress. Depression emerged as the primary predictor across genders, while anxiety was especially linked to distress in women. Sleep may act as a mediating factor in this relationship.
Collectively, the findings highlight the need to address mental health, gender norms, communication, and intimacy in sexual health research and care. Promoting agency, emotional connection, and individualized sexual scripts may reduce distress and dysfunction while enhancing overall well-being. The dissertation provides a foundation for integrated interventions and future research on the interdependencies of sexuality, sleep, and mental health.