Exploring Iranian married working women's experiences regarding sexual health challenges.

BACKGROUND: Considering that the quality of personal life and the quality of sexual life of working women interact with each other and considering that job as one of the dimensions that can play a direct role in the quality of life and also due to increasing women's participation in professional activities in today's society, this study was designed and conducted to explain the experiences of working women considering sexual health challenges.
MATERIALS AND METHODS: This research was a qualitative study that the information of which was obtained through face-to-face interviews with semi-structured and open-ended questionnaires. Interviews were conducted with 32 working women working in public and private offices in Tehran, Iran, to explore their experiences of the role of jobs in sexual challenges. The sampling method was purposive. Data analysis was performed using a qualitative content analysis method with a conventional approach by MAXQDA software version 10, and to establish the reliability and validity of findings, Graneheim and Lundman criteria were considered.
RESULTS: Data analysis from 32 interviews resulted in the formation of 223 primary inferential codes and 1 main category and 4 subcategories. The results of data analysis were presented in one main category, including sexual health challenges among working women. This main category consisted of four subcategories such as sexual problems due to employment, job harassment, the essential needs for sexual relationship, need for the better job management, and married sex life.
CONCLUSIONS: Explaining the experiences of working women showed that sexual problems due to employment and job harassment are among the factors that cause sexual health challenges in working women. It also seems that meeting the essential needs for sexual relationship and the better management of job and married sex life can interact with the sex lives of working women. Copyright:

Introduction

Sexual life means sexual activity and behavior throughout life and is affected by many factors including physical, psychological, social, economic, cultural, and religious factors. Sexual life is usually measured in many ways, one of which is marital satisfaction.[12] Marriage and starting a sexual life is a way in which couples exchange their thoughts and feelings and achieve life satisfaction and marital satisfaction.[34] Many factors play a role in creating marital satisfaction, and one of these factors is quality of life, which is an important factor in predicting marital satisfaction and marital success.[4]

A study conducted on married employees confirms that there is a significant relationship between marital satisfaction and the dimensions of quality of life, and quality of life plays an important role in predicting marital satisfaction.[5] One of the most important aspects of people's lives is their employment and profession.[6] This is especially important for working women who have many responsibilities at home and outside the home that they have to deal with.[7] Furthermore, a study has shown that reducing work–family conflict can improve marital satisfaction, and this confirms the relationship between work life and sex life.[8] Having a job outside the home can greatly affect women's sexual function. These effects can both have a positive effect on the couple's sexual life process and can have negative effects on this issue.[9] The employment rate of women in today's societies is increasing, from 37% to 41%, and increasing women's participation in social and professional activities is inevitable due to socioeconomic conditions.[1011] On the other hand, there are many challenges and problems in women's sexuality and marital satisfaction related to employment, and this confirms that the sexual issues of working women need to be investigated.[712] Therefore, due to the importance of the relationship between women's jobs and their sex lives, we decided to explain the lived experience of working women about working conditions and its impact on sex lives and to explore the sexual challenges posed by employment in women.

Materials and Methods

In this qualitative study, the experiences of 32 married women working in public and private offices (selected government departments and organizations in 5 regions north, south, west, east, and center of Tehran) and selected private companies (selected to cover almost all areas of Tehran) were analyzed using the qualitative content analysis with a conventional approach. Furthermore, it was conducted a purposive and convenience sampling method among the married women (in reproductive age) working in public and private offices of Tehran, Iran, from August 2019 to April 2020 with the maximum variation in terms of age, academic rank, and work experience. Eligible people for the research were those who met the criteria such as married working women living in Tehran; age 15–45 years; having at least literacy in Persian; not having a known underlying disease; no history of pharmacological and psychological psychiatric interventions; not having a stressful event during the past month (such as death of relatives, divorce, recent surgery, and hospitalization); no history of pelvic surgery; no uterine prolapse, cystocele, rectocele, and genital infections; no history of depression and anxiety (based on trusting the self-expression of the samples); no consumption of alcohol, drugs, and cigarettes (based on trusting the self-expression of the samples); and having a desire to participate in the study, and exclusion criteria were reluctance to continue the interview or unwillingness to disclose the interview.

The validity and reliability of the research were done through reviewing the interview manuscript and extracted codes by two members of the research team for confirming the nomination of the categories, similarities, differences, and accuracy of codes.[1314] Simultaneously, with the data analysis, a summary of the researchers’ interpretation of the findings was provided to show the participants and so that they could confirm or correct the results. Furthermore, the validity of the research was increased by selecting participants with the highest diversity and collecting the data up to the saturation level in all the concepts. The reliability of the research was also achieved by presenting the resulting codes and categories to the experts who did not participate in the extraction and their approval.

Before each interview, the researcher explained the study objectives to the participants and, through obtaining their consent, assigned the time and place for the first meeting. Some samples chose their own place of work during off-peak hours (N: 27 people), and some preferred a public place close to their place of work in the after-hours, such as the cultural center (N: 5 people), and the interviewer was the first author of the article.

The data were collected through semi-structured and open-ended questions, with face-to-face interviews and voice recording, taking notes, and observation in the field. The entire participant's rights regarding leaving the study were explained based on their willingness without giving any reason. The duration of each interview was 40–60 min. The asking open question could help the participant to remember more details about the issue.[13] The interview started with these general questions: (1) Does women's employment affect their sexual lives? (2) Can job characteristics and conditions affect their sex life? And it was continued with this question: What strategies do you suggest to improve the sex life of working women?

The sampling was continued until data saturation and new code was not generated. The manuscripts of the interviews were analyzed using the Graneheim and Lundman implementation method so that the manuscript of each interview was read several times by the research team to gain a full understanding of the whole interview.

Data analysis was performed by MAXQDA software version 10. The whole interview and the observations obtained from the experiences of the married working women were considered as the unit of the analysis and the semantic unit was determined, which included words, sentences, and paragraphs that were related to each other semantically which these units came together by considering their concept. Then, the semantic units were summarized and followed by tagged with codes. The codes obtained were compared in terms of differences and similarities and categorized and subcategorized. Then, the categories created were surveyed and discussed by two researchers, and by comparing the categories and paying attention to the meaning, the theme was obtained. The researchers tried to avoid any presuppositions so that the data would appear. Ethical considerations made during the study included signing a consent form to participate in the study and allowing participants to leave the study if they did not wish to continue the interview or did not wish to publish the interview after the interview (of course, none of this happened).

Results

The participants of the study included 32 married and sexually active working women in the reproductive age. The demographic characteristics of the participants are shown in Table 1.

Table 1

Demographic characteristics of married women working

Code	Age	Job rankings	Working hours	How to hire	Number of years of marriage	Bedroom condition	Number of children	economic status	education
1	23	Simple employee	Full-time	≥5	<5	Yes	1	Good	Diploma
2	23	Simple employee	Part-time	<5	<5	No	1	Weak	Bachelor’s degree
3	24	Simple employee	Full-time	≥5	<5	Yes	2	Good	Bachelor’s degree
4	24	Middle manager	Full-time	≥5	<5	Yes	1	Average	Diploma
5	24	Simple employee	Part-time	<5	≥5	No	1	Weak	Bachelor’s degree
6	25	Middle manager	Part-time	<5	≥5	No	2	Average	Bachelor’s degree
7	26	Middle manager	Full-time	≥5	<5	Yes	0	Good	Bachelor’s degree
8	26	Simple employee	Part-time	<5	≥5	No	1	Weak	Diploma
9	26	Middle manager	Part-time	<5	≥5	No	0	Average	Bachelor’s degree
10	27	Simple employee	Full-time	≥5	<5	Yes	2	Average	Diploma
11	27	Simple employee	Part-time	<5	≥5	Yes	1	Average	Postgraduate studies
12	29	Simple employee	Part-time	<5	<5	No	1	Weak	Bachelor’s degree
13	29	Middle manager	Full-time	<5	<5	Yes	2	Good	Diploma
14	31	Simple employee	Full-time	<5	<5	No	2	Weak	Postgraduate studies
15	31	Simple employee	Part-time	≥5	<5	No	1	Weak	Postgraduate studies
16	31	Middle manager	Part-time	≥5	<5	Yes	1	Average	Postgraduate studies
17	33	Senior manager	Full-time	≥5	≥5	Yes	2	Good	Diploma
18	34	Simple employee	Part-time	<5	≥5	No	0	Average	Bachelor’s degree
19	34	Middle manager	Full-time	≥5	≥5	Yes	2	Average	Bachelor’s degree
20	35	Simple employee	Part-time	<5	≥5	Yes	1	Good	Bachelor’s degree
21	36	Simple employee	Full-time	≥5	≥5	Yes	1	Average	Postgraduate studies
22	37	Senior manager	Part-time	≥5	<5	Yes	1	Good	Diploma
23	37	Simple employee	Part-time	≥5	≥5	Yes	1	Average	Bachelor’s degree
24	39	Senior manager	Full-time	≥5	≥5	No	2	Average	Bachelor’s degree
25	39	Simple employee	Full-time	≥5	≥5	No	2	Average	Postgraduate studies
26	40	Simple employee	Full-time	≥5	<5	Yes	1	Average	Bachelor’s degree
27	41	Middle manager	Full-time	≥5	<5	Yes	1	Average	Postgraduate studies
28	42	Simple employee	Full-time	≥5	≥5	Yes	2	Average	Bachelor’s degree
29	43	Senior manager	Part-time	≥5	≥5	Yes	1	Good	Bachelor’s degree
30	44	Senior manager	Full-time	≥5	≥5	Yes	1	Good	Postgraduate studies
31	45	Middle manager	Full-time	≥5	≥5	Yes	1	Good	Postgraduate studies
32	45	Middle manager	Full-time	≥5	≥5	Yes	2	Good	Postgraduate studies

According to Table 1, it can be seen a variety of basic variables (such as age, job condition, working hours, how to hire, number of years of marriage, bedroom condition, number of children, economic status, and education) related to the job and characteristics of the interviewees.

Data analysis from 32 interviews resulted in the formation of 223 primary inferential codes and 1 main category and 4 subcategories. As shown in Table 2, the results of data analysis can be presented in one main category, including sexual health challenges among working women. This main category consisted of four subcategories, each of which addressed specific aspects of the sexual health challenges of working women [Table 2].

Table 2

Main, subcategories, and code of extracted from married working women interviews

Main categories	Subcategories	Code
Sexual health challenges among working women	Sexual problems due to employment	Decreased sexual desire due to job fatigue
		Effects of job stress on sexual satisfaction
	Job harassment	Distinctive job conditions
		Different working hours between couples
	The essential needs for sexual relationship	Consider the right time for sex according to your job circumstances
		Creating balance in occupational and sexual life
	Need for the better management of job and married sex life	Empowering skills to solve job problems
		Not allowing work problems to enter into the family environment

Sexual problems due to employment

The participants identified the sexual problems due to employment as an important factor in the increase of the sexual challenges; they considered factors such as (1) decreased sexual desire due to job fatigue and (2) effects of job stress on sexual satisfaction that cause sexual dysfunction and consequently sexual and marital challenges.

Decreased sexual desire due to job fatigue

One of the subcategories in explaining the sexual challenges is the sexual problems due to employment. The codes (decreased sexual desire due to job fatigue and effects of job stress on sexual satisfaction) were emphasized by the Interviewees more than others, which we will discuss them in detail.

A 41-year-old woman, a simple employee with a hiring contract pointed to the reduce her sexual desire due to job fatigue, said: “Every time I come home from work, I'm very tired and sometimes I feel like I need more sleep at night than sex.”

Another woman (39 years old, a simple employee with formal employment) said, “My job is hard and it really makes me tired every day. I have to go to bed for an hour after work. Fatigue from work has reduced the number of sexual relationships.”

A 27-year-old woman, a simple employee with a hiring contract, said: “I believe there is a lot of tiredness about homework and it's not just about working outside the home. Working outside, it makes women tired and makes them feel the tenderness decrease femininity of women, and that definitely takes away the quality and satisfaction of sex from both of couple.”

Effects of job stress on sexual satisfaction

Some participants emphasized the effects of job stress on sexual satisfaction that should be considered as an important factor in this regard. In fact, the job stress can affect people's personal and sexual lives and cause sexual disorders. Some of the participants described her experiences in this regard as follows: A 39-year-old woman, a middle manager, with a formal job, said: “In my work conditions, there is a lot of stress and tension. Certainly the problems I have may not have a working woman who has a calmer job. So what your job is, it affects everything, and it certainly affects our sexual and marital satisfaction.”

The 45-year-old senior manager, with formal employment, said: ”My job has changed a lot since I came in 5 years ago. My life is much better than it was then. I've gotten better. And I'm more stable and my job stress has been greatly reduced. I think I can see how much work can affect my life. Sometimes I would have a hard time with my wife because of the longer working hours and the stress of my job, and our marital relationship would be affected.”

Job harassment

Furthermore, the participants specified the job harassment and special working conditions as an affecting factor could be a reason for sexual challenges; they declared factors such as (1) distinctive job conditions and (2) different working hours between couples that, if mismanaged, can cause problems in family relationships and marital relationships and cause sexual challenges.

Distinctive job conditions

The participants believed that some job characteristics and traits can cause differences in the family environment, which definitely needs enough attention to prevent more serious problems; on the contrary, some good working conditions can have a good effect on family life.

Here are some of the statements made by the interviewees:

The 49-year-old woman, a simple employee with a formal job, pointed to the issue of working at night. ”I am an airport security guard and I have to work at night once a month. It's true that only once a month, but I and my husband and my child mourn when the time comes and we can't get used to it at all. Because my husband and child are alone and definitely until two or three days later, I have that tiredness of staying up at night and I'm not feeling well, and often during this time my patience and the power of my sexual relationship diminishes.”

Moreover, the 41-year-old woman, a simple employee with a hiring contract, said, “Look, I'm a teacher. I always wake up at 7 in the morning and I'm at home at 13 o'clock. And my work environment is friendly and my co-workers are good. All of this has had a positive effect on my family and sex life, but others may not be as lucky as I am.”

Different working hours between couples

A number of working women also mentioned the issue of different working hours between couples and identified that this situation can cause conflict and challenges between couples. Selected items from the participants’ items are as follows: A 27-year-old woman, a simple employee with a contract, said this: ”Our work shifts are different. And we are often alone at home. I am alone in the mornings and he in the evenings. We are only together at home at night when I rest, and I am often tired because I have worked all evening.”

The 35-year-old, middle manager, with officially hired woman also spoke about this issue and said: ”My husband Work in the night shift and I work in the morning. This bothers me. We have very little opportunity to see each other. He himself is upset and wants to do something.” Moreover, the 31-year-old, simple employee with a formal job said: ”I have to be on night shift for 5 days a month. Even though I do all the housework, when I return home after night shift, I see my wife upset and protesting why you weren't there at night. The dishes are cluttered and the house is messy. This can destroy our sexual satisfaction.”

The essential needs for sexual relationship

Most of the interviewees believed that a working woman should consider the following points in order to better manage housework and marriage. These tips included: (1) Consider the right time for sex according to your job circumstances and (2) creating balance in occupational and sexual life. They stressed that noncompliance with these cases plays an effective role in creating sexual challenges.

Consider the right time for sex according to your job circumstances

Paying attention to allocating a certain amount of time for sex was one of the issues mentioned by many working women. They referred to the following statements in this regard: a 28-year-old woman, a simple employee with a contract, said: ”My wife and I need to really dedicate some more time to ourselves. For example, the weekend is very good. We are away from any worries and we can dedicate this time to our sexual and marital issues.”

Another 35-year-old woman, a simple employee with formal employment, explained: ”The two of us, especially my husband, are very busy with planning for each of our weekends. On weekends, when we both don't go to work and stay at home from morning to night, we consider it for our sexual relationship. Because the problems of working days can take away our peace of mind and we can't calm down our sexual issues. Failure to pay attention to this issue will ruin our sex life.”

Moreover, the 42-year-old woman, the senior manager, officially hired explained: ”My husband always tells me that it's better to do sexual behavior when we are not worry and busy, and it's easier to dedicate our time to this, and it's better that do sexual relationship with high quality not high quantity, I agree more, and fortunately I like it more.”

Creating balance in occupational and sexual life

Another thing that was discovered in interviews with working women was that they pointed to the appropriate balance between professional and professional life and family and sexual life. By stating these sentences and phrases, the 24-year-old, simple employee with a contract said: ”I'm trying to balance in my career and sex life. But if I see a time, my job is ruining my sexual life, my husband and my children, I will leave my work.”

The 45-year-old woman, a senior manager, officially hired also spoke: ”Of course, married life is more important than my professional life. Now I am no longer a former single girl, and first of all, my family is important to me. I do not let my work harm my sex life by creating balance.” The 34-year-old woman, a simple employee with a formal job, also mentioned the same things as before ”I agree that sex life is more important than my job, but it's so good and comfortable to have both together that I don't see the need to demarcate it. Look, family and sex life is very important, but I've had no problems all these years. I had a job and a married life without any problems, and with the right and balanced behavior, we can keep both together.”

Moreover, another 40-year-old woman, a simple employee, formal job, pointed out: “we shouldn't let to put sexual issues, under the shadow of work and fade away from its initial excitement. Let both observe balance.”

Need for the better management of job and married sex life

One of the most frequently heard words of working women was the need to better manage their working conditions and sex lives. To better manage their multiple responsibilities, they cited two more than others: (1) empowering skills to solve job problems and (2) not allowing work problems to enter into the family environment.

Empowering skills to solve job problems

The empowerment of couples, especially women working in life skills, was the case that was most pronounced: a 25-year-old woman, a simple employee, formal job, told: ”In the mornings, I go to work earlier than my wife to comeback home earlier than my wife to take care of the house and the child. Of course, the type of my work allows me to do that.”

Moreover, the 45-year-old woman, middle manager, the official job said: ”Women need to balance between promoting their careers and their sexual–marital life. Women love career advancement, but they need to know that it should not be at the expense of themselves, their husbands, children and their sex life.”

Not allowing work problems to enter into the family environment

Furthermore, some of the working women also said that not bringing work problems into the home environment is one of the most important issues that should be paid much attention to; otherwise, it will damage the couple's interpersonal relationships, including sexual relations. The selected phrases of the participants were as follows: a 44-year-old woman, a senior manager, with a formal hire said: ”I learned to balance my hair problems and to deal with them if I couldn't. Before I was inexperienced, I used to bring my work problems to my home. I cried and I was in a bad mood and upset everyone. It had a bad effect on our sexual relationship certainly.” Moreover, the 36-year-old woman, a simple employee with a contract, dedicated: ”I had night shifts in my previous job and there was a lot of stress in my work. I saw that my work conditions effect on my mood at home, unintentionally and had a bad effect on my family. Sometimes I could refuse marital relationships because of my job inconvenience condition. I change my job. I was paid less, but we're both satisfied now.”

Discussion

Based on the experiences of the working women in the present study, the factors affecting in the creation of sexual challenges include forth subcategories: sexual dysfunction due to employment including decreased sexual desire for job fatigue and effects of job stress on sexual satisfaction; special working conditions including distinctive job conditions and different working hours between couples; the essential needs for sexual relationship including consider the right time for sex according to your job circumstances and creating balance in occupational and sexual life; and need for the better management of job and married sex life including empowering skills to solve job problems and not allowing work problems to enter into the family environment which will be discussed in the following.

In the present study, one of the subcategories in the creation of sexual challenges was sexual dysfunction due to employment which itself included decreased sexual desire for job fatigue and effects of job stress on sexual satisfaction. In the area of job fatigue and sexual life, one study found that working women often face a dual role in the workplace and at home, resulting in more fatigue among working women due to multiple responsibilities, which affects their sex lives that it can play a role in reducing marital satisfaction.[7]

The second case in this subcategory was effects of job stress on sexual satisfaction. Lee also points out that employee's administrator should assist working women in confronting work stress via positive adjustment, which is associated with their sexual harmony, and quality of life,[15] and it has been emphasized that it is necessary paying more attention to job stress and its effects on sexual satisfaction and marital intimacy.[16]

Another subcategory is special working conditions that contain two cases: distinctive job conditions and different working hours between couples. Regarding job conditions, one study found that marital dissatisfaction is a common problem among working women, and working conditions and characteristics of women's work environment are effective in creating marital dissatisfaction. It is very important to pay attention to the relationship between working condition and marital satisfaction of working women because improving working condition will improve the quality of life and sexual life of working women. Working environment and patterns of work schedules may play a role in sexual dysfunction, however, it has been difficult to specify in what extent they contribute to sexual dysfunction development.[1718] Furthermore, on the subject of different working hours between couples, documents from other studies also show that women's social conditions such as the number of working hours, the type of job, hard work, and conflict between work and family are some of the factors that affect the quality of life of couples and consequently the marital satisfaction of individuals. However, it seems that there is a need for studies to examine in more detail the working conditions of both working couples and its impact on sexual life.[181920]

Another subcategory of this study is “the essential needs for sexual relationship” that consist of: (1) consideration of the right time for sex according to your job circumstances and (2) creating balance in occupational and sexual life.

About the subject of consideration of the right time for sex according to your job circumstances, one of the qualitative studies emphasizes that there are much needs to be done on the part of organizations, society, family, and women themselves for working women to have the desired level of work–family balance. One of the most important things to consider in family life is sex life and attention to sexual satisfaction and marital satisfaction that people need to have the necessary planning according to their individual circumstances.[2122] In addition, the findings of the interview were mentioned to the issue of creating balance in occupational and sexual life that the findings of one study emphasize the importance of creating balance in the family and professional life too and identified that an important step can be taken to reduce the problems of working women and increase their quality of life.[23] The last subset of the findings from interviews with working women was “need for the better management of job and married sex life” that it included the following two cases: (1) empowering skills to solve job problems and (2) not allowing work problems to enter into the family environment.

Empowering skills which were expressed in women's statements is an issue that has been addressed in many articles and all of which indicate the positive impact of these skills on sex life and marital satisfaction[2425] Problem-solving skills and not bringing problems into the family environment are life skills that have been addressed in studies of working women. These studies show that problem-solving ability will improve women's quality of life.[2627]

One of the limitations of the present study was the lack of interviews with the husbands of working women. It is suggested that in another study, men with working women be interviewed and their experience be examined, and another limitation of the study is that the findings cannot be generalized given the nature of the research method selected.

Conclusion

Explaining the experiences of working women showed that the employment is the factor that can cause sexual health challenges among working women. Job fatigue can reduce sexual desire and job stress can affect sexual satisfaction. Furthermore, job harassment such as distinctive job conditions and different working hours between couples are the factors that can cause sexual challenges in working women. It seems that meeting the essential needs for sexual relationship including consideration of the right time for sex according to job circumstances and creating balance in occupational and sexual life is necessary. And for better management of the sexual life of working women, the empowering skills to solve job problems and not allowing work problems to enter into the family environment should be considered.

Financial support and sponsorship

This study was supported by the Deputy of Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Conflicts of interest

There are no conflicts of interest.