there are other barriers such as a higher prevalence of sexual abuse and assault. These crimes often remain underreported. There remains a lack of "dialogue around this population's human right to consensual sexual expression, undertreatment of menstrual disorders, and legal and systemic barriers". Women with ID may lack sexual health care and sex education. They may not recognize sexual abuse. Consensual sexual intercourse is not always an option for some. Those with ID may have limited knowledge and access to contraception, screening for sexually transmitted infections and cervical cancer. Social effects Adults Sexual intercourse may be for reproductive, relational, or recreational purposes. It often plays a strong role in human bonding. In many societies, it is normal for couples to have sexual intercourse while using some method of birth control, sharing pleasure and strengthening their emotional bond through sexual activity even though they are deliberately avoiding pregnancy. In humans and bonobos, the female undergoes relatively concealed ovulation so that male and female partners commonly do not know whether she is fertile at any given moment. One possible reason for this distinct biological feature may be formation of strong emotional bonds between sexual partners important for social interactions and, in the case of humans, long-term partnership rather than immediate sexual reproduction. Sexual dissatisfaction due to the lack of sexual intercourse is associated with increased risk of divorce and relationship dissolution, especially for men. Some research, however, indicates that general dissatisfaction with marriage for men results if their wives flirted with, erotically kissed or became romantically or sexually involved with another man (infidelity), and that this is especially the case for men with a lower emotional and composite marital satisfaction. Other studies report that the lack of sexual intercourse does not significantly result in divorce, though it is commonly one of the various contributors to it. According to the 2010 National Survey of Sexual Health and Behavior (NSSHB), men whose most recent sexual encounter was with a relationship partner reported greater arousal, greater pleasure, fewer problems with erectile function, orgasm, and less pain during the event than men whose last sexual encounter was with a non-relationship partner. For women, there is often a complaint about the lack of their spouses' sexual spontaneity. Decreased sexual activity among these women may be the result of their perceived failure to maintain ideal physical attractiveness or because their sexual partners' health issues have hindered sexual intercourse.