Table 3 Item-level semantic analysis of the female sexual distress scale.

Sexual distress and dissatisfaction

Q4. This item has the highest factor loading, suggesting it is the most significant indicator of sexual distress within this scale. It implies that feelings of frustration are central to women’s experiences of sexual dissatisfaction.

Q5. With a strong loading, this item indicates that stress related to sexual experiences is also a prominent feature of sexual distress. This suggests that anxiety surrounding sexual performance or encounters significantly contributes to overall distress.

Q2. This item reflects general unhappiness in sexual relationships, showing a moderate correlation with the construct. It highlights that relational satisfaction plays a role in sexual distress.

Q1. This item indicates a direct acknowledgment of distress regarding one’s sex life, reinforcing the notion that overall dissatisfaction is an important aspect of sexual health.

Q8. Feelings of inadequacy in sexual performance or appeal are captured here, suggesting that self-perception significantly impacts distress levels.

Q9. This item indicates that regrets concerning one’s sexual experiences or choices contribute to distress, reflecting on the psychological burden associated with past decisions.

Q13. While this item has a lower loading compared to others, it still signifies that issues related to desire can contribute to feelings of distress, albeit to a lesser extent than other factors.

Q11. Similar to Q2, this item emphasizes dissatisfaction but with slightly less impact on the overall construct of sexual distress.

Sexual well-being distress

Q3. Feeling guilty about difficulties indicates guilt from perceived failures in meeting expectations or norms, leading to distress and anxiety.

Q7. Worrying about encounters or performance stems from concerns about ability, partner satisfaction, or the implications of dysfunction, adding to overall distress.

Q12. Anger about life reflects frustration from unmet expectations, dissatisfaction, or relational issues, creating a significant emotional burden.

Q6. Feeling inferior due to problems affects self-esteem and body image, reinforcing negative perceptions about oneself as a partner and impacting mental health.

Q10. Embarrassment about problems leads to avoidance of discussing health issues and reluctance to seek help, worsening distress.