Cisgender men and women report different patterns of sexual arousal and orgasm during masturbation and sexual relationships.

Studies comparing sexual function between the contexts of masturbation and sexual relationships are scarce. This investigation analyzed the effects of sex (male vs. female), sexual context (solitary masturbation vs. sexual relationships), and the interaction effect between both variables on sexual arousal and orgasm. From October 2023 to May 2024, the Arizona Sexual Experience Scale (ASEX) was used to evaluate the sexual arousal and orgasm of one thousand heterosexual cisgender Spanish adults (433 men and 567 women), aged 18-77 years, in both contexts. A multivariate analysis of covariance (MANCOVA) and an analysis of variance (ANOVA) were conducted. Men reported better sexual function as measured by the ASEX questions than women did (p values between < 0.001 and 0.021). With respect to sexual context, men's arousal and ability to reach orgasm varied, with greater arousal in sexual relationships (p < 0.042) and a greater ability to reach orgasm during masturbation (p < 0.022). Finally, the sex x sexual context interaction was significant (p < 0.001), so men and women presented different patterns in arousal, penile erection/vaginal lubrication, ability to reach orgasm and satisfaction with orgasm (p values between < 0.001 and 0.034) when the contexts of solitary masturbation and sexual relationships were compared. This study highlights the importance of attending to sex and sexual context when assessing sexual function in both clinical and research settings.