Monogamy and Nonmonogamy: Evolutionary Considerations and Treatment Challenges

IntroductionFew topics generate such controversy and emotional reactivity as the nature of human mating behavior. Unfortunately, and potentially to the detriment of good patient care, sexual medicine practitioners have largely avoided this matter. An understanding of the scientific literature can empower practitioners to more effectively confront the inevitable monogamy and nonmonogamy challenges present in research and clinical practice.AimTo review and summarize relevant scientific literature as a context to evaluate the more common myths and misunderstanding relating to the practice of monogamy and nonmonogamy in humans. This review also is intended to promote a discussion of the ways human mating strategies may impact sexual function and dysfunction for the individual and couple.MethodsA review of English written peer-reviewed evolutionary, anthropological, neuropsychiatric, zoological research, and other scholarly texts was conducted. Work published between 2000 and 2016 concentrating on evolutionary theory, long- and short-term mating strategies in primates and most specifically in humans, and consensual nonmonogamy was highlighted.Main Outcome MeasuresMain outcomes included a brief explanation of evolutionary theory and a review of relevant literature regarding long- and short-term mating behaviors and consensual nonmonogamy.ResultsSerial sexual and social monogamy is the norm for humans. Across time and cultures, humans have adapted both long- and short-term mating strategies that are used flexibly, and sometimes simultaneously, based on unique personal, social, and environmental circumstances.ConclusionHuman mating behavior is individualistic, the result of numerous biopsychosocial influences. The clinician cannot assume that an individual presenting as a patient maintains a monogamy-valued view of his or her intimate relationship. Patients may experience conflict between the cultural monogamous ideal and their actual sexual behaviors. This conflict may be critical in understanding a patient's sexual concerns and in treatment planning. Awareness of these issues will aid the practitioner in sexual medicine.