Association of Problematic Pornography Consumption and Motivation in Iranian Women's Sexual Compatibility in 2022 - 2023

Background: Problematic pornography consumption, driven by varying motivations among married women in culturally restrictive societies, is a growing concern in reproductive health and relationship dynamics due to its potential impact on sexual compatibility. Objectives: This study aimed to examine the associations between problematic pornography consumption, motivations for use, and sexual compatibility in Iranian women. Methods: An online cross-sectional study was conducted among 1,421 Iranian women living in Tehran (2022 - 2023). Data were collected via convenience sampling through the "PorsLine platform", ensuring anonymity. Validated scales were used: The Hurlbert Index of Sexual Compatibility (HISC), Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and Pornography Use Motivation Scale (PUMS). Relationships between variables were analyzed using Spearman’s correlation, univariate, and multiple linear regression models. Results: Participants’ mean age was 30.31 ± 6.91 years (spouses: 33.91 ± 7.64). Most pornography use motivations correlated negatively with sexual compatibility: Sexual pleasure (r = -0.17, P < 0.001), fantasy (r = -0.25, P < 0.001), boredom avoidance (r = -0.21, P < 0.001), lack of sexual satisfaction (r = -0.46, P < 0.001), emotional distraction (r = -0.26, P < 0.001), stress reduction (r = -0.17, P < 0.001), and self-exploration (r = -0.18, P < 0.001), except sexual curiosity (r = -0.002, P > 0.05). Higher viewing frequency (r = -0.14, P < 0.001) and longer duration of use (r = -0.11, P < 0.05) were associated with lower compatibility. Solitary use significantly reduced compatibility (r = -0.16, P < 0.001), whereas joint use with a spouse showed no association (r = 0.03, P > 0.05). Conclusions: Problematic pornography consumption negatively impacts the sexual quality of life, particularly through reduced sexual compatibility, especially with frequent, solitary use. Clinicians should assess both frequency and motivations for pornography use when addressing marital sexual dissatisfaction.