Hamadan University of Medical Sciences Journal of Education and Community Health 2820-896X 13 1 2026 03 31 Investigating the Relationship Between Sexual Health Literacy, Sexual Self-Care, and Marital Satisfaction in Women in Zahedan, Eastern Iran 51 58 10.34172/jech.8246 EN Zahra Arab Borzu Fatemeh Limoparvar Mahdieh Bakhtiari Mohammad Hassan Amiri Moghadam Maryam Seraji https://orcid.org/0000-0001-8392-9306 Journal Article 10.34172/jech.8246 2026 02 22 2026 03 22 Introduction: Marital satisfaction constitutes a fundamental determinant of both family cohesion and the psychological welfare of individuals. This study aimed to investigate the relationship between sexual health literacy (SHL), sexual self-care, and marital satisfaction in married women attending health centers in Zahedan, 2024. Methods: This cross-sectional study included 460 married women selected by multi-stage sampling. Data were collected using the SHELA questionnaire, the female sexual health self-care questionnaire, and the Enrich marital satisfaction questionnaire. Data were analyzed using Chi-square, t-test, ANOVA, and hierarchical linear regression in SPSS version 22. Results: The mean age of the participants was 33±7.2 years. Education, occupation, number of children, and marriage age were significantly associated with SHL and self-care (P=0.001). Hierarchical regression showed demographic factors explained 31% of the variance in marital satisfaction. Adding SHL increased it to 48% (ΔR²=0.17), and including self-care brought it to 63% (ΔR²=0.15). Promoting sexual health (β=0.56) and preventing unwanted pregnancy (β=0.57) were the strongest predictors. Conclusion: Enhancing SHL and sexual self-care practices significantly contributes to women’s marital satisfaction. Targeted educational programs and counseling interventions are recommended to strengthen marital relationships and family well-being.