the world health organization ( who ) defined sexual health as the integration and coordination between mind , emotions , and body that drives the social and rational aspects of human toward personality development and leads to formation of communication and love . sexual issues are among the most important issues in martial life , and adaptation in sexual relationship is counted as the element that influences happiness . one of the current issues in the domain of sexual relationship is sexual self - esteem which is among the dimensions of general self - esteem . one of these factors is sexual self - esteem , which refers to individuals ' emotional reaction toward the evaluation of their own thoughts , emotions , and sexual behaviors . defined sexual self - esteem as the self - value that the individuals consider for themselves as a sexual person . sexual self - esteem plays a pivotal role in individuals ' ability to preserve close relationship with their spouses and enjoy having sex with them . oattes and offman concluded that general self - esteem and sexual self - esteem could predict more ability of making satisfactory sexual communication , and hierarchical regression showed that sexual self - esteem was a unique index for the quality of sexual relationship , and most of all , general self - esteem . zarbakhsh et al . also showed that sexual self - esteem and all its dimensions had a positive significant association with marital satisfaction among athletic women . zeanah and schwarz believed that individuals ' emotional reaction toward their mental evaluation forms the basis of sexual self - esteem and its five components . these components include  skill and experience ,  the ability to enjoy with the sexual partner ;  attractiveness ,  believing in self - beauty and attractiveness ;  control ,  the ability to manage one 's thoughts , emotions , and sexual behavior ;  ethical judgment ,  the ability to self - evaluate thoughts , emotions , and sexual behavior ; and finally ,  adaptability ,  the ability to adapt personal sexual behavior experiences with others ' personal goals . low sexual self - esteem leads to women 's concern about their sexual ability , underestimation of their personal rights in sexual relationship , and fighting against their sexual identity . shortage of research in this field is assumed to be associated with the new concept of sexual self - esteem and its exiting ambiguity . one of the effective factors in all fields of human life and social communications is individuals ' personality trait that directly influences partners ' communicational processes . personality is defined as the internal organization of affective , emotional , cognitive , and conceptual systems determining humans ' unique reactions toward the environment . this personality model categorizes the individuals ' traits into five categories of neuroticism , extroversion , openness , agreeableness , and conscientiousness . each individual can have specific attitude and desire toward different aspects of life based on their personality traits . neuroticism refers to the tendency to experience anxiety , tension , selfishness , hostility , impulsivity , shyness , irrational thinking , and depression . extroversion refers to the tendency to experience positive emotions , excitement seeking , kindness , and sociability . openness refers to the tendency to have curiosity , imagination , esthetics , wisdom , enlightenment , and innovation . agreeableness refers to the tendency to forgiveness , personality traits , and various dimensions of sexual and marital relationship . there are few studies on the association between personality dimensions and sexual self - esteem as an effective factor in sexual relationship . with regard to the role of sexual self - esteem in improvement of sexual relationship and more joyfulness , the importance of such an issue therefore , the present study aimed to investigate the relationship between personality traits and sexual self - esteem in women referring to health care centers in mashhad . this is a correlation study that was conducted on 127 married women who referred to health care centers in mashhad in 2015 . the least sample size was calculated based on the sample selection formula of correlation studies and with respect to the findings of a primary pilot study conducted on 15 women . with consideration of confidence interval of 95% and test power of 80% , the highest sample size ( n = 120 ) was obtained as the final sample size . selection of the health care centers for sampling was done in sequential steps . in the first step , next , with regard to the number of urban health care centers covered by each mother health care center , 10 health care centers were selected through lotto draw and considered as a cluster . then , based on the number of clients referring to family planning unit , the related portion was determined . next , the researcher obtained the approval of ethics committee of mashhad university of medical sciences ( no : ir . rec.1392.801 ) and a written introduction letter from the nursing and midwifery school as well as the needed permissions from health care centers ' authorities . the researcher referred to these centers and selected the subjects from the women referring for flaming planning through convenient sampling . the goal of the study was explained to the subjects and written informed consents were obtained from them . inclusion criteria were having literacy of reading and writing , living at least 1 year with the spouse , and no polygamy . exclusion criteria were : subject or her spouse having sexual diseases , experiencing a mental crisis within 3 months prior to the study , history of mental disorders , and chronic diseases in the subject or her spouse . in the end , incompletely filled questionnaires were excluded . to collect data , a demographic characteristics questionnaire , neo personality questionnaire ( brief form ) , and zeanah and schwarz sexual self - esteem questionnaire were adopted . demographic characteristic form contained information of subjects , their spouses , and their family characteristics and marital life related information . neo personality questionnaire included 60 items ( 12 items for each personality major factor ) that measured extroversion , agreeableness , commitment , neuroticism , and openness . the items were scored by a five - point likert 's scale ( absolutely disagree = 0 , absolutely agree = 4 ) . this questionnaire has 81 items in a six - point likert 's scale ( absolutely agree = 6 , absolutely disagree = 1 ) . scores range between 81 and 481 and higher scores show higher sexual self - esteem . this questionnaire has five sub - scales of  experience and skill  ( 18 items ) ,  attractively  ( 17 items ) ,  control  ( 16 items ) ,  ethical judgment  ( 15 items ) , and  addictiveness conscientiousness was confirmed by rubinstein and strul by cronbach alphas of 0.88 , 0.85 , 0.70 , 0.84 , and 0.62 , respectively . in iran , its validity and reliability were confirmed by garousi et al . in the present study , reliability of its all sub - scales . reliability of sexual self - esteem questionnaire was confirmed by cronbach alpha over 0.85 by rubinstein and strul . in iran , its validity and reliability were confirmed by content validity and cronbach alpha over 0.70 . in the present study , description of subjects ' baseline characteristics was done by descriptive statistical tests . with regard to normal distribution of personality dimensions and sexual self - esteem variables , stepwise regression model was also adopted to investigate the role of each personality dimension in prediction of sexual self - esteem . this study was approved by the ethics committee of mashhad university of medical sciences and all ethical considerations including subjects ' volunteer participation and confidentiality of their data were respected . this study was approved by the ethics committee of mashhad university of medical sciences and all ethical considerations including subjects ' volunteer participation and confidentiality of their data were respected . subjects ' and their spouses ' mean ages were 27.44 ( 6.24 ) and 34.29 ( 28.54 ) years , respectively . subjects ' mean marriage length was 6.52 ( 5.31 ) years in the study group , and 40.9% of the subjects had one child [ table 1 ] . mean scores of neuroticism , extroversion , openness , agreeableness , and conscientiousness of personality were 24.61 ( 6.52 ) , 29.44 ( 5.52 ) , 23.53 ( 4.66 ) , 28.67 ( 4.94 ) , and 32.39 ( 5.65 ) , respectively . mean score of women 's sexual self - esteem was 331.26 ( 49.25 ) out of its range ( 81481 ) . in addition , mean scores of skill and experience , attractiveness , control , ethical judgment , and addictiveness dimensions were 74.84 ( 10.41 ) , 66.05 ( 13.04 ) , 62.29 ( 12.25 ) , 65.34 ( 11.22 ) , and 62.72 ( 10.81 ) , respectively . pearson correlation coefficient used in investigation of the association between personality dimensions score and sexual self - esteem in all studied women showed an inverse significant association between neuroticism and sexual self - esteem and all its dimensions ( p < 0.05 ) . there was a direct significant association between the dimensions of extroversion , agreeableness , and conscientiousness , and sexual self - esteem and its dimensions scores ( p < 0.05 ) . there was no association between openness and sexual self - esteem ( p > 0.05 ) . meanwhile , the association between this personality dimension , and the dimensions of attractiveness and sexual self - esteem control was significant ( p < 0.05 ) [ table 2 ] . in order to predict the variance of women ' s sexual self - esteem based on personality dimensions , stepwise regression was adopted , which showed that agreeableness , neuroticism , and extroversion were capable of predicting 27% of sexual self - esteem variance ( p = 0.001 ) [ table 3 ] . distribution of personal variables the correlation coefficients matrix for personality dimensions and sexual self - esteem and its components stepwise regression summary for prediction of sexual self - esteem according to personality dimensions concerning the dimensions of personality and sexual self - esteem , an inverse significant association was observed between scores of neuroticism , and women 's sexual self - esteem and all its dimensions . this personality trait includes sensitivity to having unreal beliefs , poor control of desires , and the tendency to experience psychological disorder in the form of anxiety , anger , depression , shyness , hatred , and a range of negative emotions . higher scores in neuroticism are accompanied by lack of emotional stability and negative emotions such as fear , sorrow , being at a loss , anger , feeling guilty , and hatred . such persons are more likely to have illogical beliefs and have less control on their desires and impulses . consequently , all these factors result in reduction of persons ' ability to enjoy having sex with their partners , inappropriate perception of their attractiveness , a reduction in management of sexual behaviors , incorrect evaluation of their thoughts and sexual behaviors , and consequently , a reduction in adaptability of their sexual experiences with others ' personal goal , which eventually lead to a reduction in sexual self - esteem . in this direction , costa et al . reported an inverse significant association between neuroticism dimension of personality , and women 's sexual knowledge level and body image . as body image is , in fact , the sub - scale of attractiveness in sexual self - esteem , costa 's results are consistent with the present study . in line with these findings , nouri et al . also reported an inverse significant association between the score of women 's neuroticism and their satisfaction with their body image . davis et al . also showed that the persons with higher scores of neuroticism are more concerned with their appearance . fisher and mcnulty , in a study on 72 newly married couples , concluded that neuroticism of the couple at the very beginning of marriage predicts less sexual and marital satisfaction in the coming year . reported an inverse significant association between personality dimension of neuroticism and marital satisfaction among male and female employees of governmental offices in ahwaz , iran . reported a significant association between sexual self - esteem and all its dimensions , and the score of marital satisfaction , which is in line with the present study . the association between extroversion , and sexual self - esteem and all its dimensions was positive and significant in the present study . john and srivastava explain that extroversion reflects the existence of an energetic approach toward monetary and social world in individuals that includes traits such as socialization , activeness , decisiveness , and dare . extroversion is associated with positive emotions such as good temper , optimism , love , and friendship . those who attain a high score in extroversion usually manifest their emotions and feelings conveniently and have less ability of avoidance . among those with lower extroversion , these persons have more tendency to keep away and be formal with others , even with their sexual partner . the significant association between extroversion dimension of personality and marital satisfaction was also reported in the study of attari et al . meanwhile , an insignificant association between this dimension of personality with two other dimensions of sexual relationship ( experience and sexual satisfaction ) was reported in the study of costa et al . menard and offman reported a significant association between sexual self - esteem and sexual satisfaction ; therefore , the results of costa are assumed to be inconsistent with the present study . nouri et al . also reported a significant association between extroversion and body satisfaction , which is in line with the results of the present study concerning the association between extroversion and attractiveness dimension of sexual self - esteem . previous studies show that women and men with high openness have more information about sexual relationships , have more sexual experiences , more sexual instinct , and a broader attitude toward sexual action and a wider sexual attitude , while openness was not significantly correlated with sexual self - esteem in the present study . consistent with the present study , the associations between openness and marital adaptation in the study of cook et al . and marital satisfaction in the study of ahadi et al . , mccrae reported a significant association between women 's high level of openness ( not men 's ) with their sexual satisfaction in married couples , possibly due to the fact that these women have a high tendency to discover new sexual experiences , which may lead to couple 's satisfaction . in addition , costa et al . reported that women with higher scores of openness have higher sexual knowledge and activity and a better body image . mccrae and costa believe that among the five basic factors of personality , openness is the most sophisticated one whose perception and detection are not easy . therefore , with regard to this sophistication , the existing ambiguity and controversy concerning the association between openness and sexual relationship dimension reveal the need for further studies to detect and perceive such associations . meanwhile , the association between openness and the dimensions of attractiveness and control of sexual self - esteem was significant , which is consistent with the significant association between openness and women 's body image , reported by nouri et al . the association between agreeableness and sexual self - esteem and its dimensions was significant in the present study . agreeableness reflects the appropriate and social approach versus hostility approach toward others that includes altruism , amiability , trust , and humility . persons with higher agreeableness can talk about their sexual needs and pleasures with each other . it results in a more positive mutual understanding between the couples , and consequently , a more sexual self - esteem to express sexual needs . nouri et al . also reported a significant association between agreeableness and satisfaction with body image , which is consistent with the present study . the association between conscientiousness and score of sexual self - esteem and its five dimensions was significant in the present study . nouri et al . also reported a significant association between conscientiousness and satisfaction with body that is in line with the present study . attari et al . also reported a positive and significant association between loyalty and marital satisfaction . reported no significant association between conscientiousness and sexual satisfaction , but between conscientiousness and body image in their study , possibly due to the fact that higher sexual self - esteem is more dependent on individuals ' personal and existence - related traits while sexual satisfaction is influenced by numerous factors . for instance , one of the effective factors is the partner 's sexual behavior and traits which reveals the fact that more important factors affect sexual satisfaction , compared to just personality traits . in addition to the observed associations between personality traits and sexual self - esteem , stepwise regression model showed that agreeableness , neuroticism , and extroversion were able to predict 27.3% of sexual self - esteem variance . shakerian , in a study on prediction of marital adaptation based on personality dimensions , showed that neuroticism , openness , and conscientiousness were able to predict 26.7% of marital adaptation score variance in the last step of stepwise regression . it shows that their ability in prediction of sexual self- esteem and marital adaptation is approximately similar . overall , the results showed an association between most of the personality traits and sexual self - esteem as well as the capability of these dimensions in prediction of women 's sexual self - esteem . as sexual self - esteem is one of the most important factors in couples ' sexual relationship and martial life satisfaction , adaptation of neo personality before marriage counseling for those who have no previous sexual problems can help the counselors to detect high - risk women or those with low sexual self - esteem and suggest them appropriate strategies . despite our obtained results , this study had limitations including the subjects ' reluctance to complete sexual self - esteem questionnaire with respect to iranian cultural background . among the strong points of the present study is high capability of generalization of the findings with regard to sampling from the general population of married women who can be proper representatives of the women at fertility age . as most of the studies have investigated a specific class of society , for instance , the students or employees of a specific organization , further studies on other races and in other provinces of iran with regard to their local culture are suggested .
background : women 's sexual self - esteem is one of the most important factors that affect women 's sexual satisfaction and their sexual anxiety . various aspects of sexual life are blended with the entire personality . determining the relationship between personality traits and self - concept aspects such as sexual self - esteem leads to better understanding of sexual behavior in people with different personality traits and helps in identifying the psychological variables affecting their sexual performance . 
 the aim this study was to determine the relationship between personality traits and sexual self-esteem.materials and methods : this correlation study was performed on 127 married women who referred to selected health care centers of mashhad in 20142015 . 
 data collection tools included neo personality inventory dimensions and zeanah and schwarz sexual self - esteem questionnaire . 
 data were analyzed through pearson correlation coefficient test and stepwise regression model.results:the results of pearson correlation test showed a significant relationship between neuroticism personality dimension ( r = 0.414 ) , extroversion ( r = 0.363 ) , agreeableness ( r = 0.420 ) , and conscientiousness ( r = 0.364 ) with sexual self - esteem ( p < 0.05 ) . 
 the relationship between openness with sexual self - esteem was not significant ( p > 0.05 ) . 
 in addition , based on the results of the stepwise regression model , three dimensions of agreeableness , neuroticism , and extraversion could predict 27% of the women 's sexual self - esteem variance.conclusions:the results showed a correlation between women 's personality characteristics and their sexual self - esteem . paying attention to personality characteristics 
 may be important to identify at - risk group or the women having low sexual self - esteem in premarital and family counseling .