Association between Covid-19 vaccination, fear of COVID-19 and female sexual satisfaction among a sample of Lebanese women: A pilot study

Main Article Content

Beatrice Hawila
Diana Malaeb
Souheil Hallit
Sahar Obeid


COVID-19 vaccine, female, sexual satisfaction, Lebanon


Objectives: Sexual satisfaction is a sign of a healthy sex life, and is associated with global well-being, personal, and interpersonal factors. No previous research studying the association of fear of COVID-19 and coronavirus vaccine with female sexual satisfaction has been found in Lebanon. The main objective of our study was to assess the association between COVID-19 vaccination, fear of COVID-19, and female sexual satisfaction. Methods: This was a cross-sectional study conducted between June 2021 and February 2022 using a sample of community dwelling participants. 239 Lebanese women aged 18 to 45, residing in Lebanon participated in the study. Due to the restrictions on gatherings and the risky side of face-to-face interviews, we created the survey on Google forms. The link was shared among the participants and sent to all governorates of Lebanon (Beirut, Mount Lebanon, North, South, and Bekaa) using the snowball technique. Results: After adjusting the correlations over all variables, being ever infected by COVID-19 did not show a significant correlation with the sexual satisfaction scale score. However, the intake of the COVID-19 vaccine was significantly associated with more contentment (r=0.13). Older age was significantly associated with less communication (r=-0.12) and less overall sexual satisfaction (r=-0.12), whereas being married was significantly associated with more contentment (r=0.25), communication (r=0.20), compatibility (r=0.16), relational concern (r=0.28), personal concern (r=0.25) and overall sexual satisfaction (r=0.27) scores. Higher household crowding index (lower socioeconomic status) was significantly associated with lower overall sexual satisfaction score (r=-0.14) and lower subscales scores (except contentment). Higher anxiety was significantly associated with lower relational concern (r=-0.17) and personal concern (r=-0.16) scores. Conclusion: Our study is the first that shows an association between COVID-19 vaccination and sexual satisfaction. Although correlation does not imply causation, further research on female sexuality in the Arab world is encouraged.

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1. Shahhosseini Z, Gardeshi ZH, Pourasghar M, et al. A review of affecting factors on sexual satisfaction in women. Materia Sociomedica. 2014;26(6):378.
2. Byers ES, Rehman US. Sexual well-being. 2014. 
3. Blumenstock SM, Quinn-Nilas C, Milhausen RR, et al. High emotional and sexual satisfaction among partnered midlife Canadians: Associations with relationship characteristics, sexual activity and communication, and health. Archives of Sexual
Behavior. 2020;49(3):953-967.
4. Lopes GP, Vale FBC, Vieira I, et al. COVID-19 and sexuality: reinventing intimacy. Archives of Sexual Behavior. 2020;49(8):2735- 2738.
5. Bhattacharjee A, Saha M, Halder A, et al. Therapeutics and vaccines: strengthening our fight against the global pandemic COVID-19. Current Microbiology. 2021;78(2):435-448.
6. World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Available from: 2022 
7. Ornell F, Schuch JB, Sordi AO, et al. “Pandemic fear” and COVID-19: mental health burden and strategies. SciELO Brasil; 2020;42(3):232-235.
8. Danchin M, Biezen R, Manski-Nankervis J-A, et al. Preparing the public for COVID-19 vaccines: How can general practitioners build vaccine confidence and optimise uptake for themselves and their patients? Australian Journal of General Practice.
9. Dolan M, Reyes-Velarde A. Sex, travel, peace of mind, how life is changing for some of the fully vaccinated. Retrieved from 2021.
10. Petca A, Borislavschi A, Zvanca ME, et al. Non-sexual HPV transmission and role of vaccination for a better future. Experimental and Therapeutic Medicine. 2020;20(6):1.
11. Andersson K, Vardas E, Niccolai L, et al. Anticipated changes in sexual risk behaviour following vaccination with a low-efficacy HIV vaccine: survey results from a South African township. International Journal of STD and AIDS. 2012;23(10):736-741. 
12. Carcedo RJ, Fernández-Rouco N, Fernández-Fuertes AA, et al. Association between sexual satisfaction and depression and anxiety in adolescents and young adults. International Journal of Environmental Research and Public Health. 2020;17(3):841.
13. Bradford A, Meston C. Women’s Sexual Health: Sexual Outcomes and Satisfaction with Hysterectomy: Influence of Patient Education. The Journal of Sexual Medicine. 2007;4(1):106-114.
14. Khandker M, Brady SS, Vitonis AF, et al. The influence of depression and anxiety on risk of adult onset vulvodynia. Journal of Women’s Health. 2011;20(10):1445-1451.
15. Kfoury M, Barakat H, Hallit S, Saliba S. Association between endometriosis and sexual satisfaction among a sample of lebanese women. BMC Womens Health. 2023 Apr 6;23(1):164. doi: 10.1186/s12905-023-02323-1.
16. Hamdanieh M, Ftouni L, Al Jardali B, et al. Assessment of sexual and reproductive health knowledge and awareness among single unmarried women living in Lebanon: a cross-sectional study. Reproductive Health. 2021;18(1):1-12. https://doi.
17. Kasrine Al Halabi C, Obeid S, Sacre H, et al. Attitudes of Lebanese adults regarding COVID-19 vaccination. BMC Public Health. 2021;21(1):1-7.
18. Alidost F, Pakzad R, Dolatian M, et al. Sexual dysfunction among women of reproductive age: A systematic review and metaanalysis. International Journal of Reproductive Biomedicine. 2021;19(5):421.
19. Panahi R, Anbari M, Javanmardi E, et al. The effect of women’s sexual functioning on quality of their sexual life. Journal of Preventive Medicine and Hygiene. 2021;62(3):E776.
20. Toorzani ZM, Zahraei RH, Ehsanpour S, et al. A study on the relationship of sexual satisfaction and common contraceptive methods employed by the couples. Iranian Journal of Nursing and Midwifery Research. 2010;15(3):115.
21. Zhang Q, Lu H, Li F, et al. The impact of COVID-19 on sexual behaviors of young women and men: A protocol for systematic review and meta analysis. Medicine. 2021;100(8):e24415.
22. Meston C, Trapnell P. Outcomes assessment: development and validation of a five‐factor sexual satisfaction and distress scale for women: the sexual satisfaction scale for women (SSS‐W). The Journal Of Sexual Medicine. 2005;2(1):66-81.
23. Melki I, Beydoun H, Khogali M, et al. Household crowding index: a correlate of socioeconomic status and inter-pregnancy spacing in an urban setting. Journal of Epidemiology and Community Health. 2004;58(6):476-480.
24. Alyami M, Henning M, Krägeloh CU, et al. Psychometric evaluation of the Arabic version of the Fear of COVID-19 Scale. International Journal of Mental Health and Addiction. 2021;19(6):2219-2232.
25. Ahorsu DK, Lin C-Y, Imani V, et al. The fear of COVID-19 scale: development and initial validation. International Journal of Mental Health and Addiction. 2022;20(3):1537-1545.
26. Kroenke K, Spitzer RL, Williams JB. The PHQ‐9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-13.
27. Sawaya H, Atoui M, Hamadeh A, et al. Adaptation and initial validation of the Patient Health Questionnaire–9 (PHQ-9) and the Generalized Anxiety Disorder–7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample.
Psychiatry Research. 2016;239:245-252.  
28. Hallit S, Obeid S, Haddad C, et al. Construction of the Lebanese anxiety scale (LAS-10): a new scale to assess anxiety in adult patients. International Journal of Psychiatry in Clinical Practice. 2020;24(3):270-277.
29. Malaeb D, Farchakh Y, Haddad C, et al. Validation of the Beirut Distress Scale (BDS‐10), a short version of BDS‐22, to assess psychological distress among the Lebanese population. Perspectives in Psychiatric Care. 2022;58(1):304-313. https://doi.
30. George D. SPSS for windows step by step: A simple study guide and reference, 17.0 update, 10/e: Pearson Education India; 2011.
31. Funder DC, Ozer DJ. Evaluating effect size in psychological research: Sense and nonsense. Advances in Methods and Practices in Psychological Science. 2019;2(2):156-168.
32. Kaya Y, Kaya C, Tahta T, et al. Examination of the effect of COVID‐19 on sexual dysfunction in women. International Journal of Clinical Practice. 2021;75(3):e13923.
33. Panzeri M, Ferrucci R, Cozza A, et al. Changes in sexuality and quality of couple relationship during the Covid-19 lockdown. Frontiers in Psychology. 2020;11:2523.
34. Yukser B, Ozgor F. Efecto de la pandemia de COVID-19 sobre el comportamiento sexual femenino. Int J Gunecol Obstet. 2020. 
35. Karagöz MA, Gül A, Borg C, et al. Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey. International Journal of Impotence Research. 2020;33(8):1-9.
36. Baran O, Aykac A. The effect of fear of covid‐19 transmission on male sexual behaviour: A cross‐sectional survey study. International Journal of Clinical Practice. 2021;75(4):e13889.
37. Chen S, Aruldass AR, Cardinal RN. Mental health outcomes after SARS-CoV-2 vaccination in the United States: A national crosssectional study. Journal of Affective Disorders. 2022;298(Pt A):396-399.
38. Koltai J, Raifman J, Bor J, et al. COVID-19 vaccination and mental health: A difference-in-difference analysis of the understanding America study. American Journal of Preventive Medicine. 2022;62(5):679-687.
39. Khalil RB, Dagher R, Zarzour M, et al. The impact of lockdown and other stressors during the COVID-19 pandemic on depression and anxiety in a Lebanese opportunistic sample: an online cross-sectional survey. Current Psychology. 2022;1-11. https://doi.
40. Rodrigues DL, Lehmiller JJ. COVID-19 and sexual desire: Perceived fear is associated with enhanced relationship functioning.
The Journal of Sex Research. 2021;59(4):1-10. 
41. Dèttore D, Pucciarelli M, Santarnecchi E. Anxiety and female sexual functioning: An empirical study. Journal of Sex & Marital Therapy. 2013;39(3):216-40.
42. Balsis S, Carpenter B. Sexual experience across midlife: Results from the MIDUS survey. The Gerontologist. 2004;44:269-270. 
43. Tomic D, Gallicchio L, Whiteman M, et al. Factors associated with determinants of sexual functioning in midlife women.
Maturitas. 2006;53(2):144-157.
44. Corona G, Lee DM, Forti G, et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). The Journal of Sexual Medicine. 2010;7(4):1362-1380.
45. Beckman N, Waern M, Östling S, et al. Determinants of sexual activity in four birth cohorts of Swedish 70‐year‐olds examined 1971–2001. The Journal of Sexual Medicine. 2014;11(2):401-410.
46. Thomas HN, Hess R, Thurston RC. Correlates of sexual activity and satisfaction in midlife and older women. The Annals of Family Medicine. 2015;13(4):336-342.
47. Waetjen LE, Crawford SL, Chang P-Y, et al. Factors associated with developing vaginal dryness symptoms in women transitioning through menopause: a longitudinal study. Menopause (New York, NY). 2018;25(10):1094.
48. Trompeter SE, Bettencourt R, Barrett-Connor E. Sexual activity and satisfaction in healthy community-dwelling older women. The American Journal of Medicine. 2012;125(1):37-43.
49. Forbes MK, Eaton NR, Krueger RF. Sexual quality of life and aging: A prospective study of a nationally representative sample. The Journal of Sex Research. 2017;54(2):137-148.
50. Hardy SA, Willoughby BJ. Religiosity and chastity among single young adults and married adults. Psychology of Religion and Spirituality. 2017;9(3):285.
51. Regis P. A natural history of the romance novel. A Natural History of the Romance Novel: University of Pennsylvania Press; 2013.
52. Stroope S, McFarland MJ, Uecker JE. Marital characteristics and the sexual relationships of US older adults: an analysis of national social life, health, and aging project data. Archives of Sexual Behavior. 2015;44(1):233-247.
53. Ramezani TF, Farahmand M, Mehrabi Y, et al. Prevalence of female sexual dysfunction and its correlated factors: a population based study. 2012.
54. Yoo H, Bartle-Haring S, Day RD, et al. Couple communication, emotional and sexual intimacy, and relationship satisfaction. Journal of Sex and Marital Therapy. 2014;40(4):275-293.
55. Afzali M, Khani S, Hamzehgardeshi Z, et al. Investigation of the social determinants of sexual satisfaction in Iranian women. Sexual Medicine. 2020;8(2):290-296.
56. del Mar Sánchez-Fuentes M, Santos-Iglesias P, Sierra JC. A systematic review of sexual satisfaction. International Journal of Clinical and Health Psychology. 2014;14(1):67-75.

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