Female genital image: is there a relationship with body image?

The association of genital self-image during pregnancy with the attitude toward sexuality

AIM

Genital self-image is one of the significant components of sexual health. Changes in the female body during pregnancy occur also in genital organs and affect the pregnant woman's genital self-image. In this respect, this study aimed to evaluate the genital self-image during pregnancy and its association with the attitude toward sexuality.

METHODS

This is descriptive and correlational research. The research data were collected at antenatal polyclinics of a university hospital from November 2022 to January 2023. A total of 319 pregnant women who were married, sexually active, and healthy were included in the study. The Survey Form, the Female Genital Self-Image Scale (FGSIS), and the Attitude Scale toward Sexuality during Pregnancy (AStSdP) were used in the collection of research data.

RESULTS

The mean scores obtained by pregnant women from the FGSIS and the AStSdP were successively 14.50 ± 4.15 and 88.01 ± 14.46 points. The factors affecting the attitude toward sexuality during pregnancy were the genital self-image and the duration of marriage.

CONCLUSIONS

In the study, it was discerned that pregnant women had a negative genital self-image and held negative attitudes toward sexuality during pregnancy. Also, it was found that genital self-image and the duration of marriage affected the attitude toward sexuality during pregnancy. Therefore, in pregnancy follow-ups, women's genital self-image and attitudes toward sexuality should be identified, and training programs and consultancy services on these topics should be offered to women.

The relationship between genital self-image and sexual quality of life in obese women

OBJECTIVE

This study was carried out to evaluate the relationship between genital self-image and sexual quality of life in obese women.

METHODS

This is a descriptive and correlational study. A personal information form, the Female Genital Self-Image Scale, and the Sexual Quality of Life-Female Questionnaire were used to collect the data.

RESULTS

The mean total Genital Self-Image Scale score of the participants was 20.73±4.53, and their mean total Sexual Quality of Life Questionnaire score was 87.22±16.75. A strong positive relationship was determined between genital self-image and sexual quality of life.

CONCLUSION

Healthcare professionals should evaluate the sexual quality of life of obese women, along with their genital self-image, so that appropriate sexual counseling and holistic care can be provided to them.

Clitoral reconstruction and psychosexual care after female genital mutilation/cutting: Assessment of multidisciplinary care

BACKGROUND

Multidisciplinary care following female genital mutilation/cutting (FGM/C) can consist of surgical interventions such as clitoral reconstruction (CR) in combination with individualized psychosexual care (PC). Evidence on both treatments, alone or in association, is limited.

OBJECTIVES

To investigate the overall satisfaction with PC only or PC in combination with CR.

DESIGN

Cross-sectional study of women who attended the FGM/C outpatient clinic under study and asked for CR between January 2013 and November 2021.

METHODS

Data were collected through questionnaire-based interviews on motivations for asking for CR, psychological well-being (World Health Organization-Five Well-Being Index), sexual response (Female Sexual Function Index), vulvar pain, genital self-image (Female Genital Self-Image Scale), overall satisfaction with the care received, and, in the case of CR, postoperative complications.

RESULTS

The 20 women included underwent therapy primarily to feel repaired or reconstructed and to improve their sexual function. Mean overall satisfaction with the care was rated 8.95/10 ± 1.39. Twelve (60%) received CR in combination with PC. Eight (40%) received PC only. Women who received combined therapy reported higher overall satisfaction (9.17 versus 8.57), psychological well-being (17.8 versus 9.25), sexual response (31.22 versus 21.56), and genital self-image (25.60 versus 17.60) in comparison with those who only received PC. The main surgical complications were minor postoperative bleeding and one painful wound infection triggering a relapse of posttraumatic stress disorder.

CONCLUSION

Tailored PC and CR after FGM/C seem to improve psychosexual health, well-being, body image, and pain.Registration: ClinicalTrials.gov (NCT05026814).

The Importance of Patient-Reported Outcome Measures (PROMs) in Oncological Vulvoperineal Defect Reconstruction: A Systematic Review

BACKGROUND

Patient-reported outcome measures (PROMs) have gained increased importance in assessing outcomes after reconstructive surgery. This also applies to the reconstruction of vulvoperineal defects after resection of gynecological or colorectal cancers in women. The objective of this study is to analyze the current state of PROM tool use within this patient population.

METHODS

By systematic literature searches in Embase, Medline, and Web of Science, English-language studies published after 1980, including randomized controlled trials, cohort studies, and case series reporting on vulvoperineal defect reconstruction, which were included if they also analyzed quality of life (QoL) and/or PROMs. The PROM tools used by each study were extracted, analyzed, and compared.

RESULTS

The primary search yielded 2576 abstracts, of which 395 articles were retrieved in full text. Of these, 50 reported on vulvoperineal defect reconstruction, among which 27 studies analyzing QoL were found. Of those, 17 met the inclusion criteria for this systematic review. After full-text screening, 14 different PROM tools and 5 individual, non-standardized questionnaires were identified. Only 22% of studies used a validated PROM tool.

CONCLUSION

Far too few studies currently use PROM tools to assess outcomes in oncological vulvoperineal defect reconstruction. Less than half of the used PROMs are validated. No PROM was designed to specifically measure QoL in this patient population. The standardized implementation of a validated PROM tool in the clinical treatment of this patient population is an essential step to improve outcomes, enable the comparison of research, and support evidence-based treatment approaches.

Predictors of genital self-image in Iranian women: a cross-sectional study

BACKGROUND AND AIM

Several factors influence women's perception of their genitalia. Understanding the elements associated with genital self‑image (GSI) can significantly contribute to enhancing women's sexual experiences. Therefore, the present study aimed to identify the predictors of GSI in Iranian women.

MATERIALS AND METHODS

This online cross-sectional study was conducted on 722 healthy married reproductive-aged women with records in Amol-Iran health centers during 2022. Participants were selected using a random sampling method from all the healthcare centers. Data were collected through a checklist of socio-demographic and obstetrics information, the Female Genital Self-Image Scale (FGSI), the 6-item Female Sexual Function Index (FSFI-6), the Female Sexual Distress Scale - revised (FSDS-R), and the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ) for assessing sexual esteem and sexual satisfaction. The general linear model was employed to assess the impact of each independent variable (socio-demographic and obstetrics characteristics, sexual function, sexual distress, sexual esteem, and sexual satisfaction) on the dependent variable (GSI).

RESULTS

The mean score of GSI was 21.70 ± 3.82. Based on the Pearson correlation test, there were significant correlations between GSI and sexual function, sexual esteem, sexual satisfaction, and sexual distress (r = 0.20, r = 0.43, r = 0.42, r = -0.28 respectively; p < 0.001). Using the adjusted general linear model, with the increasing scores of sexual esteem and sexual satisfaction, the GSI score also increased (β = 0.19, 95% CI: 0.10 to 0.27, β = 0.14, 95% CI: 0.06 to 0.22, respectively; p < 0.001). Additionally, age, abnormal vaginal discharge, genital feedback from partners, and satisfaction with body image were identified as other predictors of GSI.

CONCLUSION

Based on the study results, it was observed that sexual esteem, sexual satisfaction, and certain socio-demographic variables served as predictors of GSI. Consequently, considering the potential impact of GSI on various aspects of women's lives, healthcare providers can enhance their counseling techniques to improve GSI by gaining an appropriate understanding of the factors that influence it.

Genital self-image and sexual function in Iranian women from pregnancy to postpartum: a cohort study

BACKGROUND

Genital self-image is among the factors affecting women's sexual function.

AIM

The present study aimed to determine changes in the genital self-image and its relationship with women's sexual function in the third trimester of pregnancy and postpartum.

METHODS

The participants of this prospective cohort study included 301 eligible pregnant women chosen through stratified random sampling with proportional allocation from comprehensive health centers in Gorgan, Iran. The Persian version of the 7-item Female Genital Self-Image Scale, the 6-item Female Sexual Function Index, and Depression Anxiety and Stress Scale 21 were filled in a self-report manner on 2 occasions: (1) 30 to 37 weeks of pregnancy and (2) 12 to 16 weeks (± 2 weeks) postpartum. Finally, the data were analyzed using SPSS 24 software.

OUTCOMES

Outcomes included Female Genital Self-Image Scale and Female Sexual Function Index changes from pregnancy to postpartum according to the childbirth mode.

RESULTS

The mean age of participants was 29.66 ± 5.27 years. These values for the genital self-image scores of women during pregnancy (19.18 ± 3.25) and postpartum (19.43 ± 3.57) were not significantly different (P = .30). Also, this difference was not statistically significant regarding the mode of delivery in 2 groups of women with vaginal birth (P = .62) and cesarean section (P = .14). The mean Female Sexual Function Index scores during pregnancy (15.15 ± 6.73) and postpartum (17.52 ± 6.46) were significantly different (P = .001). In addition, this difference was significant in women with vaginal birth (P = .004) and cesarean section (P = .001).

CLINICAL IMPLICATIONS

Clinicians should inform women/couples about changes in female sexual function and address genital self-image as a factor involved in female sexual function during pregnancy and postpartum.Strengths and Limitations: Because the participants of this study were women in the third trimester of pregnancy, the obtained results may not be generalized to pregnant women in the first and second trimesters of pregnancy or even to different postpartum periods (ie, midterm and long term).

CONCLUSION

The results showed that the female genital self-image is not significantly different during pregnancy and postpartum, or with the mode of delivery. However, the female sexual function score in postpartum is higher than in pregnancy, regardless of the mode of delivery.

Do complaints related to vitiligo affect sexual quality of life and marital adjustment?

The authors aimed at evaluating the effect of vitiligo on female sexual function and Dyadic Adjustment in a hospital-based study as gender negatively affected the marital quality of vitiligo patients, more in women. A total of 153 patients who applied to the dermatology outpatient clinic of a tertiary university hospital were interviewed. However, 120 vitiligo patients who were married and had a sexually active partner and suitable the inclusion criteria were included in the study. It is seen that the mean score of the DAC is 43.13±5.11, and the mean score of the SQOL-F is 52.57±5.39. Vitiligo has a negative effect on a woman's sexual life and Dyadic Adjustment. Early identification of sexual problems in vitiligo patients and planning their future course of management can aid in improving the marital adjustment and quality of life.

Female genital self-image and body appreciation in Turkish women: a mixed methods study

The study investigated negative genital self-image in women and determined the effect of education on natural/normal female genital appearance diversity on the change in women's genital self-image. The type of research is a mixed method descriptive study. The participants were 259 women living in Turkey. In the first stage of the study, female genital self-image levels and body appreciation levels were evaluated. In the second stage of the study, women were interviewed thoroughly about negative female genital self-image, and then, visual education presentation was made on natural/normal female genital diversity. One week after the presentation, the women's genital self-image levels were re-evaluated. In the first phase of the study, the mean Female Genital Self-Image Scale (FGSIS) total score was 22.07 ± 4.07 and the mean Body Appreciation Scale (BAS) total score was 42.40 ± 8.13 of the women. Higher FGSIS and BAS scores showed an increase in women's positive genital self-image and body appreciation. The relationship between the FGSIS and the BAS scale scores of the women was found to be significantly correlated (r = 0.401, p < 0.001). In the second stage of the study, four main themes were examined as "positive thoughts," "size and image," "metaphors related to genital organs," and "negative thoughts." In conclusion, in the first phase, it was determined that women's feeling of discomfort with their sexual organs during sexual intercourse, comparing their genital organs with other women's genital organs, thinking of genital organ aesthetic surgery, and BAS scores were associated with FGSIS scores. In the second phase, women's positive or negative feelings and thoughts about their genital self-image were revealed.

The relationship between women's mode of delivery, body image, self-respect, and genital self-image

INTRODUCTION AND HYPOTHESIS

Many factors affect women's genital self-image. This study was conducted to investigate the relationship between women's mode of delivery, body image, self-esteem, and genital self-image.

METHODS

The research was carried out in two public hospitals between 15 January 2022 and 30 June 2022. The study sample consisted of a total of 197 multiparous women in the early postpartum period. They were asked to fill out a Personal Information Form, the Rosenberg Self-Esteem Scale (RSES), the Body-Esteem Scale (BES), and the Female Genital Self-Image Scale (FGSIS), based on self-report. The Chi-squared, Pearson's correlation, and multiple linear regression analysis were used.

RESULTS

Of the participants, 49.50% had a vaginal delivery, and 50.50% had a cesarean section. Their mean scores were 0.64 ± 0.62 on the RSES, 155.01 ± 24.40 on the BIS, and 20.97 ± 4.39 on the FGSIS. As the women's age increased, their mean FGSIS score also increased. There was negative correlation between women's mean RSES and FGSIS scores. A positive, significant correlation was found between the mean FGSIS and BES scores of the women. Of the variables included in the multiple linear regression model, age, self-esteem, and body image were statistically significant predictors 19.5% of the FGSIS score (p < 0.005).

CONCLUSIONS

Mode of delivery was not a predictor of female genital self-image in the early postpartum period. Women with high self-esteem had a positive body image and genital self-image. Age, self-esteem, and body image were influential on female genital self-image. On the other hand, age, self-esteem, and body image predicted about 19.5% of female genital self-image according to multiple linear regression.

Preferred mode of delivery association with the body image and genital image in pregnant women - a cross-sectional study

BACKGROUND

Pregnant women experience several changes in their appearance, body shape and body image. In some studies, there has been a relationship between these changes and the type of delivery. This study aimed to investigate the relationship of the prenatal body image and genital image with the mode of delivery preferred by pregnant women in Gorgan in 2020.

METHODS

In this cross-sectional study, 334 pregnant women were selected by stratified sampling. The Prenatal Body Image Questionnaire (PBIQ), Female Genital Self-Image Scale (FGSIS), pregnant women's preferences for mode of delivery questionnaire (PPMDQ) and DASS-21 were completed on line. The data was analyzed using Spearman test and linear regression.

RESULTS

The average score of PBIQ, FGSIS, and PPMDQ was 68.24 (standard deviation = 17.71), 19.25 (standard deviation = 3.3), and 63.12 (standard deviation = 3.3) respectively. Vaginal delivery as a preferred mode of delivery was inversely correlated with dissatisfaction with body image (r=-0.32, P < 0.001), and directly correlated with satisfaction with the genital image (r = 0.19, P < 0.001). There was a significant inverse correlation between prenatal body image dissatisfaction and genital image satisfaction (r=-0.32, P < 0.001). While FGSIS score could not predict PPMDQ, PBIQ score could.

CONCLUSIONS

Satisfaction with the prenatal body image or genital image is associated with the choice of vaginal delivery. These results can be the basis for prenatal care and childbirth counselling.

Exploration of Women’s Experiences of Sexual Function after Female Genital Cosmetic Surgery: A Phenomenological Descriptive Study

Background:

Female genital cosmetic surgery (FGCS) consists of a set of design approaches to recover or strengthen the vulva. These cosmetic procedures are conducted to relieve functionality problems such as vaginal looseness and sexual dissatisfaction. The external genital tract is shaped cosmetically. Its results could be better judged through understanding the direct experience of women who underwent surgery. Therefore, this study aimed to explain the experiences of women regarding FGCS through phenomenological methods.

Methods:

In a phenomenological study with purposive sampling, semistructured in-depth interviews were conducted on women who experienced FGCS. Then, the interviews were entered into the Word software and were analyzed by the Colaizzi 7-step method. To ensure the correctness of the data, the Guba’s criteria were used. Data were analyzed using MAXQDA software version 10.

Results:

The results showed that 15 women aged between 23-49 years old and with a mean age of 34 years old, mostly married and housewives as well as with diploma educational level participated in the study, three themes and eight subthemes were excluded from the analysis of participants’ interview. Participants presented their experiences on their sexual function after FGCS as sexual satisfaction, high-quality life, and willingness for surgery.

Conclusion:

The studies showed those women’s experiences with FGCS were positive, resulting in sexual satisfaction and higher quality of life. Therefore, the assessment of women to perform cosmetic surgery should be prioritized, and the women should be supported to make a decision regarding such surgery.

Genital whitening with topical Cyperus rotundus Oil enhance sexuality and quality of life

BACKGROUND

Cyperus Rotundus Essential Oil (CREO) is an anti-inflammatory and depigmenting agent that helps treat hyperpigmentation.

OBJECTIVES

The purpose of this study was to evaluate the depigmenting effect of CREO on genital hyperpigmentation to that of arbutin (ARB), as well as to evaluate the association between genital lightening, genital self-image, sexual performance, and life quality.

MATERIAL AND METHODS

Three hundred and eight healthy people were categorized into 3 groups: the CREO group, the ARB group, and the cold cream group (CC). In genital pigmentation, the tristimulus colorimeter is used to assess erythema and pigmentation. Additionally, we aided in the development of the female genital self-image scale (FGSIS-4), the female sexual function index (FSFI), and the dermatology life quality index (DLQI).

RESULT

The reduction in genital hyperpigmentation was significantly greater in the CREO and ARB groups than in the CC group; in physician global assessment and patients' self-assessment, the results in treated bikini with the CREO and ARB groups were excellent when compared to the CC. Furthermore, no adverse effects were found in the CREO group, but mild irritation was found in the ARB group; additionally, the percentage of hair growth, color and luminance reduction, and hair thickness were significantly reduced in the CREO group only. In addition, there were significantly different in FGSIS, FSFI, and DLQI between the CREO and ARB groups and the CC group.

CONCLUSION

CREO is equivalently efficacious in decreasing pigmentation, inflammation, and hair growth in the genital area. Positive changes boost female genital self-image, self-esteem, and sexual performance. Improving sexual health has a positive impact on quality of life.

A Standardized Evaluation Method for Assessing Patients With Genital Dyschromia

Objective

The population's ever-growing concern with genital aesthetic dysfunctions reflects an increasing demand in the field of intimate aesthetics. For this reason, as well as the lack of a standardized evaluation, this paper aims to develop a form that facilitates the initial investigation of aesthetic genital dysfunctions. 

Methods

An evaluation form for female and male genital dyschromia was developed between July and November 2018. Following initial development, the form was evaluated for quality and was updated by a panel of specialists (a psychologist, two pelvic dysfunction physiotherapists, and two dermato-functional physiotherapists) via email and through a content validity questionnaire. The face validity of the form was assessed by five physiotherapy and medical students who were randomly selected. The students answered a questionnaire evaluating the proposed form. The reliability of the form was established through the test-retest procedure by evaluating its reproducibility over time.

Results

The “Genital Dyschromia Evaluation Form'' (composed of identification, anamnesis, and physical examination sections) was approved by the specialist panel. They suggested questions to be added in the anamnesis (dermatological lesions or fungal and bacterial infections) and physical examination (hyperemia, edema in the perianal and internal thigh region) sections. As for the image analysis, an increase in quality, resolution, and sharpness was suggested. Lastly, for the cutaneous phototype evaluation, the DoctorSkinFototipo® digital analyzer device was chosen since it is small, portable, easily positioned on the genital area, and can be readily cleaned between patients. 

Conclusion

The “Genital Dyschromia Evaluation Form” is a questionnaire approved by specialists and could represent a suitable option for health professionals.