Sexual well-being Framework

Iranian couples most often follow androcentric doctrines, especially in their sex lives [14]. The androcentric doctrine primarily focuses on the male perspective and refers to women as “passive objects”, seeing women’s sexuality as an accessory rather than a partner [14]. Due to these cultural beliefs, Iranian women are often taught to prioritize their husband’s needs over their own, which leads them to think less of their sexual priorities. As around 98% of the people in Iran follow Islam, traditional customs and beliefs run strong, with girls and boys being taught gender role scripts from young ages [14]. However, they also stated that their ability not to prioritize sex as much as their husbands do makes them feel powerful in their marriage [12]. Iranian women have stated that they feel strong and dominant when their husbands show their sexual desires for them but they stay covert and hide their own sexual desires [12]. This is influenced by the sexual scripts they are taught; that men should be the ones to initiate sex and cultural practices of shaming women who initiate sex [12]. When men show their need for their wives by initiating their sexual desires, Iranian women feel important in their role as the wife. 

For comfort and strength with the sex dimension, Iranian women frequently report having less pleasure and not attaining an orgasm during sexual activity, which results in a less fulfilling sex life. Although a lot of research suggests that this uneasiness is exacerbated by unfavorable attitudes toward sex, there are potential ways to enhance sex comfort for Iranian women [8][15][16]. Firstly, enhancing sexual satisfaction and mitigating symptoms of sexual dysfunction, such as pain, are possible outcomes of psycho-educational and cognitive-behavioral treatment. After educating Iranian women about sex knowledge and information about sexual dysfunctions, many Iranian women feel sex comfort during sexual behaviors [15]. 

Sexual resilience is a crucial component of exploring sexual dysfunction in Iranian women. It is defined as the “maintenance of equilibrium in response to sexual stress, dysfunction, midwives adversity, or trauma” and can be operationalized as having someone to talk to openly about your sex life or the recovery period after a sexual trauma [16]. In the context of Iranian women who may face cultural and societal barriers to sexual expression such as stigma, shame, and limited access to sexual health resources, understanding sexual resilience is essential for addressing the challenges women face in achieving healthy sexual lives. Current research suggests that Iranian women demonstrate great resilience in navigating sexual issues by utilizing coping strategies like seeking social support, adapting to cultural norms, and accessing sexual health information and resources. For example, a study examined the effectiveness of psycho-educational group therapy on sexual function and marital satisfaction in Iranian couples [22]. This highlights the willingness of these women to seek out education and support for their sexual dysfunction and the study concluded that psychoeducational therapy has a positive impact on sexual health. Similarly, it was found that Iranian women engage in sexual reconstruction through the Internet and thus gain education and empowerment [25]. Through online platforms, women could access resources and information that were otherwise unavailable to them due to cultural and societal constraints [25]. Iranian women were both able to adapt to their cultural norms and take their sexual well-being into their own hands by utilizing online interactions to empower themselves. 

Research indicates that Iranian women frequently struggle to express their sexual autonomy within marriage due to societal and cultural expectations that emphasize submission and obedience to their husbands [11]. Fear of consequences such as extramarital affairs, the imperative to be obedient, and the obligation to satisfy their husbands'  sexual needs often prevent women from rejecting their husbands' sexual advances. Cultural norms and expectations surrounding sexuality in Iran, largely shaped by religious doctrines,  further influence women's sexual behavior [11]. These doctrines uphold gender norms that may favor male dominance and control over women's bodies and sexuality. Consequently, women may feel compelled to prioritize their husbands' desires over their own autonomy and preferences, limiting their ability to make independent choices about their sexual partners [11]. This dynamic not only impacts women's sexual health and satisfaction but also reinforces gender inequities within the marital relationship. However, recognizing and addressing these cultural and religious influences presents an opportunity for positive change. By fostering open discussions about sexual health and autonomy, and promoting gender equality, there is potential to enhance the sexual well-being and overall empowerment of women in Iran [6]. Encouraging education and awareness about sexual rights and health can lead to more balanced and respectful relationships, where both partners’ needs and preferences are acknowledged and valued. This shift can contribute to a healthier and more equitable society, benefiting not only women but the community as a whole.

In the context of sexual well-being, respect is defined as an informed, pleasant, and safe sexual life, focusing on mutual satisfaction and positive expression of sexual needs [9]. However, cultural and societal norms often pressure Iranian women to prioritize their husbands' sexual needs over their own. Participants reported feeling obligated to tolerate sex even when unwilling, due to commitments to obey in their sexual relationship, preserve their marriage, or fulfill their husband's sexual needs. These commitments negatively affect their sexual motivation and contribute to a viewpoint that prioritizes male satisfaction [11]. Consequently, women often adopt strategies such as sexual sacrifice and pretending to be satisfied to maintain marital harmony [10]. Despite the high prevalence of sexual dysfunction, many women feel compelled to uphold these norms to prevent their husbands from seeking satisfaction elsewhere. Education plays a crucial role in shifting these attitudes, promoting shared responsibility and open communication about sexual issues, thereby fostering a more respectful and fulfilling sexual relationship [9].