Job-Related Strain and Sexual Health Difficulties among Heterosexual Men from Three European Countries: The Role of Culture and Emotional Support


Aleksandar Štulhofer, PhD, Sexology Unit, Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lucica 3, Zagreb 10000, Croatia. Tel: +385 1 6120 007; Fax: +385 1 615 6879; E-mail:


Introduction.  Epidemiological evidence for the association between job-related stress and sexual difficulties in men is largely lacking. Little is known about the factors that may mediate or moderate this relationship.

Aim.  This study analyzes the association between job-related difficulties and men's sexual difficulties.

Main Outcome Measures.  Job-related difficulties were measured by 10 yes/no questions that addressed a range of adverse workplace situations. The experience of sexual difficulties in the past 12 months was assessed by using seven dichotomous indicators developed in the National Study of Sexual Attitudes and Lifestyles (NATSAL) 2000.

Method.  Analyses were carried out using data from a 2011 online study of Portuguese, Croatian, and Norwegian men (N = 2,112). Multivariate logistic regression and mediation analysis were used to test the hypothesized association.

Results.  Men with job-related concerns reported lower sexual satisfaction than men without such concerns did (F = 7.53, P < 0.001). Multivariate analysis confirmed the association between job-related and sexual health concerns. The odds of experiencing one or more sexual health difficulties in the past 12 months were about 1.8 times higher among men who reported the highest levels of workplace difficulties than among men who experienced no such difficulties. The odds of reporting sexual health difficulties were significantly reduced by a higher income (adjusted odds ratio [AOR] = 0.87, P < 0.01), emotional intimacy with one's partner (AOR = 0.93, P < 0.001), having children (AOR = 0.62–0.66, P < 0.01), and country-specific effects (AOR = 1.98–2.22, P < 0.001). In all three countries, the relationship between job-related and sexual health difficulties was mediated by anxiety and depression.

Conclusions.  The findings suggest that negative mood is the mechanism behind the association between workplace strain and sexual difficulties. Emotional support, such as couple intimacy and fatherhood, can reduce—independently from sociocultural and socioeconomic factors—the risk of sexual health concerns. Štulhofer A, Træen B, and Carvalheira A. Job-related strain and sexual health difficulties among heterosexual men from three European countries: The role of culture and emotional support. J Sex Med 2013;10:747–756.