Anneli Miettinen

Determinants of female sexual orgasms

Background The pursuit of sexual pleasure is a key motivating factor in sexual activity. Many things can stand in the way of sexual orgasms and enjoyment, particularly among women. These are essential issues of sexual well-being and gender equality. Objective This study presents long-term trends and determinants of female orgasms in Finland. The aim is to analyze the roles of factors such as the personal importance of orgasms, sexual desire, masturbation, clitoral and vaginal stimulation, sexual self-esteem, communication with partner, and partner’s sexual techniques. Design In Finland, five national sex surveys that are based on random samples from the central population register have been conducted. They are representative of the total population within the age range of 18–54 years in 1971 (N=2,152), 18–74 years in 1992 (N=2,250), 18–81 years in 1999 (N=1,496), 18–74 years in 2007 (N=2,590), and 18–79 years in 2015 (N=2,150). Another dataset of 2,049 women in the age group of 18–70 years was collected in 2015 via a national Internet panel. Results Contrary to expectations, women did not have orgasms that are more frequent by increasing their experience and practice of masturbation, or by experimenting with different partners in their lifetime. The keys to their more frequent orgasms lay in mental and relationship factors. These factors and capacities included orgasm importance, sexual desire, sexual self-esteem, and openness of sexual communication with partners. Women valued their partner’s orgasm more than their own. In addition, positive determinants were the ability to concentrate, mutual sexual initiations, and partner’s good sexual techniques. A relationship that felt good and worked well emotionally, and where sex was approached openly and appreciatively, promoted orgasms. Conclusion The findings indicate that women differ greatly from one another in terms of their tendency and capacity to experience orgasms. The improvements in gender equality and sexual education since the 1970s have not helped women to become more orgasmic. Neither has the major increase in masturbation habits (among women in general). One challenge for future studies is to understand why women value their partner’s orgasms more than their own.

Women’s housework decreases fertility Evidence from a longitudinal study among Finnish couples

Changes in the gendered divisions of domestic work are often assumed to influence couples’ childbearing behaviour, but existing evidence is mixed and mostly limited to cross-sectional data. We study how the amount and division of housework and childcare predict subsequent childbearing among Finnish couples using Finnish Time Use Survey 1999–2000 (FTUS1999) time diary data linked with register data on subsequent births. Results show that women’s housework hours were negatively associated with the likelihood of having children at all parities. Men’s contribution to domestic tasks, measured in relative terms, had no impact on childbearing. However, a higher male share of childcare time slightly increased the couple’s likelihood of having a second child. Results are markedly robust to the inclusion of socioeconomic factors. We conclude that while women’s excessive domestic work in itself may decrease fertility, men’s housework share is not associated with continued childbearing.

Anticipated impact of family policies on fertility behaviour among the childless and among one-child parents

The fertility level has fallen to clearly below replacement level in most European countries. However, not many European governments have put low fertility on the political agenda. The development of family policies is still scattered; there is no consensus as to which policy measures to pursue, and governments’ expectations vary regarding the impact of family policies. In this article, we look at expectations as to the impact of the introduction of preferred family policy measures on fertility behaviour from the point of view of the national populations themselves. Do Europeans think that if new or better policies are implemented, they might have their desired child sooner, or that they might increase their number of children? And do these expectations vary across European countries, and between socio-demographic groups within each country? Using PPA survey data, we examine the anticipated impact of family policies on fertility behaviour among the two groups with the highest intention to have a(nother) child: childless people and one-child parents. Furthermore, in order to obtain insight into inter-country differences, three country groups are considered, based on their recent fertility development: Lowest-, low-, and moderate-fertility countries. Our results show that there is considerable scope for governments to persuade people to bring forward the timing of childbearing, or to have more children, by introducing specific family policies. While minor differences in the anticipated impact of family policies do exist between socio-demographic groups, there is considerable variation between the TFR country groups: The anticipated impact is especially large in those countries in which fertility is currently lowest.

Short- and long-term health consequences and current satisfaction levels for altruistic anonymous, identity-release and known oocyte donors

STUDY QUESTION What are the short- and long-term health consequences and current satisfaction of altruistic oocyte donors? SUMMARY ANSWER Donating oocytes in the majority (>90%) of donation cycles is not associated with harmful long-term general or reproductive health effects. WHAT IS KNOWN ALREADY Knowledge of long-term health effects of oocyte donation on donors is sparse and follow-up studies have usually been carried out on commercial donors. Thus far, no major long-term harmful effects have been demonstrated. Most studies have reported a high level of donor satisfaction, but also less favorable experiences have been published. STUDY DESIGN, SIZE AND DURATION A retrospective cross-sectional survey of all women who had donated oocytes between 1990 and 2012 at three fertility clinics was carried out in spring 2013. A self-administered questionnaire was sent out to a total of 569 former oocyte donors. PARTICIPANTS, SETTING, METHODS In all, 428 past donors answered the questionnaire assessing donors demographic characteristics, short- and long-term medical and psychological experiences and satisfaction related to donations. Of the donors, 87% (371/428) were unknown and 13% (57/428) were known to the recipient. The mean follow-up time after the donation was 11.2 years (range from 0.5 to 23 years) and the mean age of the respondents was 42 years at the time of the study. To learn whether the demographic profile of donors was affected by the Finnish Assisted Reproduction Technology (ART) Act of 2007, we divided the 428 respondents into two groups: (i) women whose first donation took place between 1990 and 2007 (79% of the respondents) and (ii) women whose first donation took place between 2008 and 2012 (21% of the respondents). Before 2008, donors were non-identifiable (anonymous) but after 2008 persons born as a result of gamete donation could, from the age of 18, receive on request information identifying the donor. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 75% (428/569). The mean age of the donors did not differ between the two time periods, but there was a higher proportion of donors in the youngest age group (20-24 years) and more childless donors (P < 0.05) after 2008 than between 1990 and 2007. Immediate complications occurred in 7.2% (42/582) of the donation cycles and the most common complication was ovarian hyperstimulation syndrome (OHSS) in 5.0% (29/582) of the treatments. There were no reports of ovarian or uterine cancer and only one case of breast cancer. After the donation, 11.5% of the donors experienced unsuccessful attempts to become pregnant. Almost all donors (99%) were satisfied or very satisfied with their decision to donate and 95% would warmly recommend it to other women. There were no differences between the known and unknown donors in this respect, or between the two time periods (before or after the ART Act in 2008). Four donors (1%) had regretted donation, and 7% would have wanted to have more support before and 14% after the donation. LIMITATIONS, REASON FOR CAUTION Although the response rate was high, 25% of all former donors in the three participating clinics could not be included due to lack of response. The results are based on self-reported assessment of the experiences of former donors, and it is not possible to estimate the influence of recall bias. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the largest study of health consequences and satisfaction levels on oocyte donors. Data from this study can be used to inform donor candidates about the medical aspects involved in the treatment and it provides information on how to support these women during and after the donation. STUDY FUNDING/COMPETING INTERESTS This study was supported by grants from the Medical Society Life and Health, and from the Otto A. Malm Foundation. There are no competing interests to report.

Family policies: financial or institutional measures?

The ageing of European societies is shifting governments’ focus towards means to influence families and fertility. However, increased attention towards family policies is combined with increasing demands to cut public spending in many countries. There are requests to introduce means-testing, or otherwise to restrict eligibility to financial benefits, which have traditionally been the core of government support for families. Increasing attention to the relationship between women’s employment and childbearing is also shifting the emphasis towards institutional measures which address reconciliation of work and family. To what extent is public opinion in agreement with these changes? What policies do people themselves prefer? Using data from the Population Policy Acceptance Survey, we examine public preferences concerning family policy measures and their improvement in the DIALOG countries. We examine the preferences towards financial and institutional measures among childless persons and parents who have one child, as these two groups are likely to be those among whom family policy measures can be expected to influence childbearing choices. We analyse the opinions in three groups of countries based on their recent fertility development (lowest, low and moderate fertility). While there is marked variation between country groups as to how different measures are valued, some of the variety in the opinions is also related to individual level socio-demographic factors. In addition, we find that expectations towards government are not always in agreement with existing policies.

Childlessness in Finland

For decades, the level of lifetime childlessness in Finland has been among the highest in Europe. Moreover, the shares of Finnish men and women who have no children have increased markedly in recent years: Currently, around 20 % of women and 25 % of men in their forties are childless. The percentage of less educated women who are childless is also higher in Finland than in the other Nordic countries. Using register data, we analyse how childlessness is associated with marriage and with educational levels among Finnish men and women born in 1940–1965. In addition, using data from a national survey about fertility intentions, combined with follow-up data on births, we examine the prevalence of voluntary and involuntary childlessness and the factors that influence the transition to parenthood. The results show that childlessness is increasing within unions, and among the least educated men and women. We also find that while voluntary childlessness is rare, less than half of childless individuals who said they intended to have a child within 2 years were able to do so. Although Finland has some of the most generous family policies in the world, it appears that additional measures are needed to support men and women who want to start a family.