Sexual Fantasies and Their Role in Sexual Satisfaction and Quality of Life Among Men with Sexual Dysfunction

Background: This study examines the relationship between sexual fantasies, sexual dysfunction (SD), and sexual well-being, focusing on individuals with SD group compared to healthy controls. Methods: Participants included patients with sexual health concerns diagnosed with erectile dysfunction (ED) or premature ejaculation (PME) and healthy controls. Assessment tools included the Arizona Sexual Experience Scale (ASEX-M), Wilson’s Sex Fantasy Questionnaire (WSFQ), sexual quality of life (SQoL) scale, and subjective sexual satisfaction (SSS) scale. Data were analysed using descriptive statistics, correlation coefficients, and two-way ANOVA tests. Results: Socio-demographic profiles of the cases and controls were matched for age, marital status, sexual activity, education, and religion, with a mean age of 30 years. With regards to WSFQ scores, no significant difference in total fantasy scores between the SD group and controls was found. Significant differences in intimate and impersonal fantasy domains were present. The SD group scored significantly poorer than controls in sexual satisfaction, ASEX, and SQoL. The correlation studies showed positive correlations between WSFQ and SSS, WSFQ and SQoL, and a negative correlation between WSFQ and ASEX in controls. No significant correlations in the SD group. ANOVA Studies revealed significant main effects of SD on SSS (F = 165.38, η 2 = 0.465, P = .001 variance), SQoL (F = 84.651, P < .001, η 2 = 0.308), and ASEX (F = 170.566, P < .001, η 2 = 0.473). Sexual fantasies also contributed to the variance in SSS (F = 4.592, P = .001, η 2 = 0.088), and SQoL (F = 3.746, P = .006, η 2 = 0.073). Conclusions: This study highlights the differential impact of sexual fantasies on individuals with and without SD. While fantasies positively affect sexual satisfaction and quality of life in healthy individuals, this effect is diminished in those with SD. The findings emphasize the need for a nuanced approach to addressing sexual fantasies in clinical practice, particularly for patients with SD.