Wartime Stress and Sexual Well-Being: A Longitudinal Study of Cohabitating Adults in Israel.

This longitudinal study explored how sexual well-being changed over time among cohabiting Israeli adults during the 2023 Israel-Hamas War, focusing on sexual function problems, sexual distress, and sexual satisfaction. Using data from 921 participants collected at three time points, before the war (retrospectively), one month into the conflict, and five months later, the study identified significant changes in sexual well-being, shaped by gender and acute stress symptoms. Linear mixed model analyses showed that sexual function worsened early in the war, with partial improvement by the later stage, while sexual satisfaction dropped initially but returned to baseline levels. Sexual distress remained relatively stable across all time points. Gender significantly moderated these patterns, with women showing greater vulnerability to stress-related sexual disruptions than men. Acute stress symptoms also emerged as a key moderator: individuals with higher stress levels experienced more pronounced declines and slower recovery in sexual functioning and satisfaction. However, there was no significant three-way interaction between time, gender, and stress. These findings emphasize that war-related stress has substantial, but varied, impacts on sexual health, highlighting the importance of considering individual differences in gender and stress response when addressing sexual well-being during crises. The results also underscore the partial resilience of the population, with some recovery over time despite persistent challenges. This research contributes to a limited but growing body of the literature on civilian sexual well-being during wartime, offering valuable implications for clinical care, public health planning, and future research targeting sexual and psychological support in conflict settings.