Background: Sexual fantasies (SFs) are defined as any thought or imagined scenario that is experienced as sexually arousing to a person.

Patients and methods: Participants in this study were 257 women divided into 2 groups (unmarried and married) who responded to a self-report questionnaire. The questionnaire included questions about demographic data, questions dealing with SFs, and questions dealing with the sexual life in married women.

Results: The commonest fantasy scenes were romantic scenes (66.7% for group I and 55.0% for group II). A significant difference between the 2 groups was found in percentage of women fantasizing about a complete intercourse (4.8% for group I Vs 28.2% for group II). The most common frequency of SFs was once daily for group I (15.9%) and 2-3 times/week in group II (21.4%). Reaction to SFs in 78.6% of group I was doing nothing while 56.5% of group II have intercourse. The person imagined in SFs was most commonly a present or a future husband in both groups (68.3% and 85.5% respectively). The person imagined in SFs was always a woman as reported by 20.6% of group I and 0.8% of group II.

Conclusion: A vast majority admitted that SFs occur at least rarely. They are more common among women aged 20-29 and among married women. The most common theme is a romantic scene with husbands. Frequency of SFs increases with active sexual behavior in marriage and with higher educational level. Female genital cutting at least does not have an effect on SFs.

Keywords: daydreams, fantasies, women, married, husbands, sexual, aged, frequency, imagined, daily

Sexual fantasies (SFs) are generally defined as any thought, mental image, or imagined scenario that is experienced as erotic or sexually arousing to the individual.¹ Even in the absence of physical stimulation, erotic thoughts can create subjective arousal, as well as the various physiological reactions associated with sexual excitement.² Subjective arousal during fantasy can be classified as sexual arousal, even in the absence of detectible physiological responses.³

Sexual fantasy as a facet of females' sexual activity has not been a major component of past prominent studies of sexual behavior.⁴ However, SFsare very important in revealing an individual’s sexual orientation and sexual attraction, even more than are sexual behaviors. This is because behaviors are constrained by social norms and by the sexual partner (potential or desired), and thus are necessarily more inhibited than what can be imagined. In direct contrast to the widely accepted view of sexual fantasy as a reflection of one’s underlying desire, there is evidence that SFs based on themes that the individual would not wish to experience in real life, such as rape fantasies, are common among women (as high as 57%). It may be that there is a sex difference in this regard such that SFs may be a clearer indicator of men’s underlying desires.^5,6

One reason for considering the study of sexual fantasy important is that aside from the simple fact that SFs are nearly universally experienced, they can affect later sexual behavior as well as reflect past experience.⁷ In other words, what people do sexually with other people can sometimes be influenced by their fantasies, and, in turn, people's fantasies are affected by what they have previously done, seen, or read about. In addition, it has been suggested that because SF are private and do not depend on the participation of a partner, they may be more revealing than actual behavior of gender differences in sexuality.⁸ In fantasy one can imagine anything one likes, however unrealistic, without experiencing embarrassment or rejection or societal and legal restrictions. SFs, therefore, may provide a unique insight into the different scripts that may underlie sexual behavior in men and women.⁹ SFs are also considered important because they are thought to play a significant role in the commission of sexual offenses such as exhibitionism, rape, and child sexual abuse.¹⁰ In addition, lack of SFs or guilt about SFs may contribute to sexual dysfunction.¹¹ In the 1960s some trials^12–14 were used to treat sexual deviants through changing deviant SFs but the results showed a modest success. Information about SFs in Egyptian women is non-existing, probably due to the sensitivity of such a subject in a relatively conservative society. The present work aims to study prevalence, frequency and content of SFs among a sample of Egyptian women with evaluation of the relation between SFs and sexual activity.

The current study is a cross-sectional observational study. Administrative approval included the research ethics committee in Benha Faculty of Medicine (dated October 17^th, 2016). Participants were college students in the University Campus and married women attending the obstetrics & gynecology clinic in Benha university hospital. So, Participants were divided into 2 groups: Group I including unmarried women and Group II including married women currently in regular coital activity. Illiterate women were excluded from the study due to their inability to fill the questionnaire confidentially. The tool used in the study was a self-report questionnaire designed by the researchers guided by 2 previous works.^15,16 It was given to participants after obtaining their consent. The questionnaire included demographic data, questions dealing with sexual fantasy, and questions dealing with the sexual life in married women. To ensure that all gathered information will be kept confidential and the subject will be anonymous, each questionnaire was handed in an open envelope and after filling it, the subject sealed the envelope and put it in a basket containing other sealed envelopes.

Data management

The clinical data were recorded on a report form. These data were tabulated and analyzed using the computer program SPSS (Statistical package for social science) version 20.

Three hundred questionnaires were distributed. Obtained usable questionnaires were 257 with a rejection rate of 14.3%. Participants were divided into 2 groups: group I included 126 unmarried women while group II included 131 married women.

Demographic data

Table 1 show that age group 21-29 years was the most common age group in both groups I and II. Also, most women had a university degree, lived in rural areas and were genitally cut. Most women in group I were students while most women in group II were employed.

Sexual fantasies data

Romantic scenes represented the most common contents in SFs of both groups (66.7% for group I and 55.0% for group II). A significant difference between the 2 groups was found in percentage of women fantasizing about a complete intercourse (4.8% for group I Vs 28.2% for group II). Most of the sample reported that SFs occur rarely and 11 women (4.3%) never had SFs. The most common frequency of SFs was once daily for group I (15.9%) or 2-3 times/week in group II (21.4%). Thinking about a loved person was the most common cause of FSs in both groups (43.9% and 45.9% respectively). Getting lubrication during SF does not occur in most women of group I (42.1%) but it occurred sometimes in (42.5%) of group II women. Reaction to SFs in 78.6% of group I was doing nothing while 56.5% of group II have intercourse. The person imagined in SFs was most commonly a present or a future husband in both groups (68.3% and 85.5% respectively). The person imagined in SFs was always a woman as reported by 20.6% of group I and 0.8% of group II (Table 2).

Correlation between some demographic data and fantasies frequency

In group I, the frequency of SFs was significantly correlated with age group 21-29. Having a university degree and genital cutting tended to be correlated with frequency of SFs but with no statistical significance. Same results were obtained in group II but with statistical significance in educational level only (Table 3).

Correlation between some demographic data and fantasies contents

Table 4 shows that there was no correlation between content of SFs and demographic data measured in our sample with the exception of a statistically significant correlation between the content of SFs and being genitally cut.

Correlation between some sexual activities and fantasies frequency

Table 5 shows that the only statistically significant correlation was between frequency of unprovoked desire and SF frequency.

Correlation between some sexual activities and fantasies content

Table 6 shows a statistically significant positive correlation between SFs contents (especially romantic scenes) and coital frequency and frequency of unprovoked desire. The same findings were also shown in the correlation between SF contents and both frequency of orgasm and satisfaction with sexual life in group II.

SFssay a lot about the emotional places we go to in our minds.¹⁷ everybody daydreams and fantasizes, at least some of the time. Fantasies can be about anything escape to beautiful places, money, revenge, fame but probably the most intriguing, if not most common, fantasies concern romance and sex.¹ The commonest contents of SFs in our participants were romantic scenes followed by having complete intercourse for married women. In a Canadian study by Joyal¹⁶ the commonest 5 scenes for women were: having sex in an unusual place (e.g., in the office; public toilets) (81.7%), taking part in fellatio/cunnilingus (78.5%), being masturbated by partner (71.4%), masturbating a partner (68.1%), having sex with someone other than husband (66.3%). Like the study of Hass¹⁸ women in our sample who had experienced intercourse were more likely to fantasize about intercourse.

It has been largely accepted that SFs are a common experience for most men and women.^19–21 During intercourse, SFs can occur in 84% of men and women¹¹ and approximately 86% of men and 69%of women report fantasizing during masturbation.¹ The prevalence of SFs reported in our study was 95.7%. In a Chinese study,²² only 36% of 1,403 University students admitted having SFs. The authors said that these results may be explained by socially desirable responding. Stigma continues to be associated with female autoerotic behaviors in different Chinese communities; therefore, women may underreport rates of different aspects of sexual behavior. On the contrary, almost all of the respondents in a Spanish survey²³ had fantasized about sex at one time or another. The SFs frequency reported in our study is less than that reported in an American²⁴ and a Portuguese²⁵ study. Cultural constrains may explain this difference and maybe some participants were not sure about confidentiality of the information given.

Do SFs differ according to gender? This is a controversial issue. While some researchers^21,26 found no gender differences, others found differences in frequency and content. American teenage boys are nearly twice as likely as teenage girls to fantasize about sex once a day or more.²⁴Japanese college men reported six times the number of fantasies that women did.²⁷ In Great Britain Wilson²⁸ indicates that only 5% of men but 12% of women do not have SFs. Gender differences in content of SFs also exist. Knafo & Jaffe²¹ noted that the fantasy reported most frequently during intercourse for women was "I imagine that I am being overpowered or forced to surrender." Pelletier & Herold ²⁹ found that 51% of their female sample reported fantasies of being forced to submit sexually. In another study³⁰ men's SFs were more sexually explicit than women's while women's SFs were more emotional and romantic than men's. In addition, men's fantasies involved more interactions with multiple partners than did women's. Likewise, Birnbaum³¹ found that women were more likely than men to report romantic fantasies but their SFs were less frequent than men. Also, fantasy themes and contents reported by Gil³² showed that romantic non-sexual themes were reported by 10 women but only 2 men. Dawson³³ studied the effect of the menstrual cycle on SFs and claim that the frequency and arousability of SFs increased significantly at ovulation. The number of males in the fantasies increased during the most fertile period, with no such change for the number of females. Fantasy content during ovulation, focused more on emotions rather than explicit sexual content. we could not find any study dealing with the effect of religiosity on SFs in Muslims while Nicholas³⁴ found that in a predominantly young Christian sample, those who were more religious reported greater enjoyment of SFs about heterosexual intercourse (relative to those about oral sex) but less actual experience of sexual intercourse. Ahrold³⁵ assessed the effect of religiosity on SFs in 1413 college students where 69% of them were women. They belonged to 6 different religious groups: agnostics, atheists, Christians, Jews, Buddhists, and Hindus. Female atheists and agnostics reported significantly more SFs than women of all other religious groups. The most commonly imagined person in our sample was a present or future to be husband. Among 66 conservative women studied by Gil³² only 5 (6.6%) fantasized to have intercourse with husband while 17 women (25.8%) reported having intercourse with non-husband. After watching erotic film clips, Carvalho³⁶ asked 28 women to fantasize about one’s real-life partner vs. fantasizing about someone else. Their findings indicate that instruction to fantasize about one’s partner resulted in stronger subjective sexual arousal than the instruction to fantasize about someone else. Also, extra dyadic fantasies were reported by 80% of women during the previous 2 months and their proportion was correlated to the length of relationship.³⁷ An intriguing finding in our study was that having sex with a woman was relatively common. Among 245 women who reported about the person seen in their SFs, 34 participants (13.9%) chose "always a woman" or "a man or a woman". We cannot confirm that their sexual orientation was homosexual or bisexual because asking about sexual orientation in our community is considered an insult. Also, Joyal¹⁶ found that the percentages of women fantasizing about homosexual activities significantly exceeded the percentages of declared bisexuality or homosexuality. In our study, it was noted that SFs were more frequent in married women than in unmarried ones. The findings of Person³⁸ were similar. They stated that low sexual activity and low levels of sexual fantasy go together, whereas more sexual experience is connected to a greater range of sexual fantasy. Consequently, erotic fantasies cannot be viewed as compensation for lack of sexual outlet. Instead, there is a positive correlation between the two domains of SFs and sexual behaviors.

Age group 20-29 was the most common age group to report SFs. This is similar to the finding of Brown & Hart.⁴ Also, the current study showed a significant correlation between SFs and both of coital frequency and unprovoked desire (desire not provoked by sexual stimulation). This may suggest that sexually active women will have more SFs. Also, SFs in genitally cut women were significantly more frequent than in none genitally cut women. This may indicate that libido (at least) is not affected by FGC. On their work on FGC, Shaeer & Shaeer³⁹ found that more males were in favor of FGC than were females, and that44.1% of participants believed FGC is necessary/highly necessary for chastity, with far more certaintythan the 3.7% who perceived FGC as areligious mandate. Our results indicate that chastity comes from a pure heart not from a short clitoris.

Illiterate women were excluded from the study because the questionnaire had to be filled by the participating women themselves to keep their identity anonymous. This excludes a substantial percentage of Egyptian women; limiting the ability of the study results to represent a large sector of women. Also, social constrains limited our ability to expose participants to more variable SFs scenes that are not acceptable in our locality.

SFs are common in our sample, they are more common among women aged 20-29 and among married women. The most common theme is a romantic scene with the husband. Frequency of SFs increases with active sexual behavior in marriage and with higher educational level. Female genital cutting at least does not have an effect on SFs.

None.

The authors declare that there is no conflicts of interest.

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