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Body Image and Genital Self-image in Pre-menopausal Women with Dyspareunia

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Abstract

With a prevalence of 15–21 %, dyspareunia is one of the most commonly reported sexual dysfunctions in pre-menopausal women under the age of 40. Studies to date have focused primarily on clinical samples, showing that women with dyspareunia report overall sexual impairment, anxiety, and feelings of sexual inadequacy. However, little is known about their body image and genital self-image and few studies have sampled women exclusively from the general population. The aim of the present, controlled study was to investigate body image and genital self-image in a community sample of pre-menopausal women with self-reported dyspareunia. In total, 330 women completed an online survey, of which 192 (58 %) had dyspareunia and 138 (42 %) were pain-free control women. In comparison to pain-free control women, women with dyspareunia reported significantly more distress about their body image and a more negative genital self-image. Moreover, findings from a logistic regression, in which trait anxiety was controlled for, showed that a more negative genital self-image was strongly and independently associated with an increased likelihood of reporting dyspareunia. These results suggest that, in women with dyspareunia, body image and genital self-image are significantly poorer and would benefit from more attention from both clinicians and researchers.

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References

  • Aikens, J. E., Reed, B. D., Gorenflo, D. W., & Haefner, H. K. (2003). Depressive symptoms among women with vulvar dysesthesia. American Journal of Obstetrics and Gynecology, 189, 462–466.

    Article  PubMed  Google Scholar 

  • Algars, M., Santtila, P., Jern, P., Johansson, A., Westerlund, M., & Sandnabba, N. (2011). Sexual body image and its correlates: A population-based study of Finnish women and men. International Journal of Sexual Health, 23, 26–34.

    Article  Google Scholar 

  • Ayling, K., & Ussher, J. M. (2008). “If sex hurts, am I still a woman?” The subjective experience of vulvodynia in hetero-sexual women. Archives of Sexual Behavior, 37, 294–304.

    Article  PubMed  Google Scholar 

  • Berman, L., Berman, J., Miles, M., Pollets, D., & Powell, J. A. (2003). Genital self-image as a component of sexual health: Relationship between genital self-image, female sexual function, and quality of life measures. Journal of Sex and Marital Therapy, 29, 11–21.

    Article  PubMed  Google Scholar 

  • Binik, Y. M. (2005). Should dyspareunia be retained as a sexual dysfunction in DSM-V? A painful classification decision. Archives of Sexual Behavior, 34, 11–21.

    Article  PubMed  Google Scholar 

  • Binik, Y. M., Reissing, E., Pukall, C., Flory, N., Payne, K. A., & Khalife, S. (2002). The female sexual pain disorders: Genital pain or sexual dysfunction? Archives of Sexual Behavior, 31, 425–429.

    Article  PubMed  Google Scholar 

  • Brauer, M., Laan, E., & ter Kuile, M. M. (2006). Sexual arousal in women with superficial dyspareunia. Archives of Sexual Behavior, 35, 191–200.

    Article  PubMed  Google Scholar 

  • Brauer, M., ter Kuile, M. M., Laan, E., & Trimbos, B. (2009). Cognitive-affective correlates and predictors of superficial dyspareunia. Journal of Sex and Marital Therapy, 35, 1–24.

    Article  PubMed  Google Scholar 

  • Cash, T. F. (2002). Beyond traits: Assessing body image states. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 163–170). New York: Guilford.

    Google Scholar 

  • Connor, J. J., Robinson, B., & Wieling, E. (2008). Vulvar pain: A phenomenological study of couples in search of effective diagnosis and treatment. Family Process, 47, 139–155.

    Article  PubMed  Google Scholar 

  • Crombez, G., Vlaeyen, J. W., Heuts, P. H., & Lysens, R. (1999). Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80, 329–339.

    Article  PubMed  Google Scholar 

  • Daker-White, G. (2002). Reliable and valid self-report outcome measures in sexual (dys)function: A systematic review. Archives of Sexual Behavior, 31, 197–209.

    Article  PubMed  Google Scholar 

  • Danielsson, I., Eisemann, M., Sjoberg, I., & Wikman, M. (2001). Vulvar vestibulitis: A multi-factorial condition. BJOG: An International Journal of Obstetrics & Gynaecology, 108, 456–461.

    Article  Google Scholar 

  • Demaria, A. L., Hollub, A. V., & Herbenick, D. (2011). Using genital self-image, body image, and sexual behaviors to predict gynecological exam behaviors of college women. Journal of Sexual Medicine, 8, 2484–2492.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R., Rosen, R., Leiblum, S., Burnett, A., & Heiman, J. (2002). The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. Journal of Sex and Marital Therapy, 28, 317–330.

    Article  PubMed  Google Scholar 

  • Desrochers, G., Bergeron, S., Landry, T., & Jodoin, M. (2008). Do psychosexual factors play a role in the etiology of provoked vestibulodynia? A critical review. Journal of Sex and Marital Therapy, 34, 198–226.

    Article  PubMed  Google Scholar 

  • Desrosiers, M., Bergeron, S., Meana, M., Leclerc, B., Binik, Y. M., & Khalife, S. (2008). Psychosexual characteristics of vestibulodynia couples: Partner solicitousness and hostility are associated with pain. Journal of Sexual Medicine, 5, 418–427.

    Article  PubMed  Google Scholar 

  • Donaldson, R. L., & Meana, M. (2011). Early dyspareunia experience in young women: Confusion, consequences, and help-seeking barriers. Journal of Sexual Medicine, 8, 814–823.

    Article  PubMed  Google Scholar 

  • Gates, E. A., & Galask, R. P. (2001). Psychological and sexual functioning in women with vulvar vestibulitis. Journal of Psychosomatic Obstetrics and Gynaecology, 22, 221–228.

    Article  PubMed  Google Scholar 

  • Goossens, M. E., Kindermans, H. P., Morley, S. J., Roelofs, J., Verbunt, J., & Vlaeyen, J. W. (2010). Self-discrepancies in work-related upper extremity pain: Relation to emotions and flexible-goal adjustment. European Journal of Pain, 14, 764–770.

    Article  PubMed  Google Scholar 

  • Granot, M., & Lavee, Y. (2005). Psychological factors associated with perception of experimental pain in vulvar vestibulitis syndrome. Journal of Sex and Marital Therapy, 31, 285–302.

    Article  PubMed  Google Scholar 

  • Herbenick, D., & Reece, M. (2010). Development and validation of the Female Genital Self-Image Scale. Journal of Sexual Medicine, 7, 1822–1830.

    Article  PubMed  Google Scholar 

  • Herbenick, D., Schick, V., Reece, M., Sanders, S., Dodge, B., & Fortenberry, J. D. (2011). The Female Genital Self-Image Scale (FGSIS): Results from a nationally representative probability sample of women in the United States. Journal of Sexual Medicine, 8, 158–166.

    Article  PubMed  Google Scholar 

  • Hopwood, P., Fletcher, I., Lee, A., & Al Ghazal, S. (2001). A body image scale for use with cancer patients. European Journal of Cancer, 37, 189–197.

    Article  PubMed  Google Scholar 

  • Jantos, M., & White, G. (1997). The vestibulitis syndrome. Medical and psychosexual assessment of a cohort of patients. Journal of Reproductive Medicine, 42, 145–152.

    PubMed  Google Scholar 

  • Kaler, A. (2006). Unreal women: Sex, gender, identity, and lived experience of vulvar pain. Feminist Review, 82, 50–75.

    Article  Google Scholar 

  • Khandker, M., Brady, S. S., Vitonis, A. F., Maclehose, R. F., Stewart, E. G., & Harlow, B. L. (2011). The influence of depression and anxiety on risk of adult onset vulvodynia. Journal of Women’s Health, 20, 1445–1451.

    Article  PubMed  Google Scholar 

  • Kindermans, H. P., Huijnen, I. P., Goossens, M. E., Roelofs, J., Verbunt, J. A., & Vlaeyen, J. W. (2011). “Being” in pain: The role of self-discrepancies in the emotional experience and activity patterns of patients with chronic low back pain. Pain, 152, 403–409.

    Article  PubMed  Google Scholar 

  • Landry, T., & Bergeron, S. (2009). How young does vulvo-vaginal pain begin? Prevalence and characteristics of dyspareunia in adolescents. Journal of Sexual Medicine, 6, 927–935.

    Article  PubMed  Google Scholar 

  • Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544.

    Article  PubMed  Google Scholar 

  • Masheb, R. M., Brondolo, E., & Kerns, R. D. (2002). A multidimensional, case-control study of women with self-identified chronic vulvar pain. Pain Medicine, 3, 253–259.

    Article  PubMed  Google Scholar 

  • Masheb, R. M., Lozano-Blanco, C., Kohorn, E. I., Minkin, M. J., & Kerns, R. D. (2004). Assessing sexual function and dyspareunia with the Female Sexual Function Index (FSFI) in women with vulvodynia. Journal of Sex and Marital Therapy, 30, 315–324.

    Article  PubMed  Google Scholar 

  • McPhilips, K., Braun, V., & Gavey, N. (2001). Defining (hetero)sex: How imperative is the “coital imperative”? Women’s Studies International Forum, 24, 229–240.

    Article  Google Scholar 

  • Meana, M., & Binik, Y. M. (1994). Painful coitus: A review of female dyspareunia. Journal of Nervous And Mental Disease, 182, 264–272.

    Article  PubMed  Google Scholar 

  • Meana, M., Binik, Y. M., Khalife, S., & Cohen, D. R. (1997). Biopsychosocial profile of women with dyspareunia. Obstetrics and Gynecology, 90, 583–589.

    Article  PubMed  Google Scholar 

  • Meana, M., Binik, Y. M., Khalife, S., & Cohen, D. (1999). Psychosocial correlates of pain attributions in women with dyspareunia. Psychosomatics, 40, 497–502.

    Article  PubMed  Google Scholar 

  • Meana, M., & Lykins, A. (2009). Negative affect and somatically focused anxiety in young women reporting pain with intercourse. Journal of Sex Research, 46, 80–88.

    Article  PubMed  Google Scholar 

  • Morley, S. J., & Eccleston, C. (2004). The object of fear of pain. In G. J. Asmundson, J. W. Vlaeyen, & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 163–188). Oxford: Oxford University Press.

    Google Scholar 

  • Nobre, P. J., & Pinto-Gouveia, J. (2006). Dysfunctional sexual beliefs as vulnerability factors to sexual dysfunction. Journal of Sex Research, 43, 68–75.

    Article  PubMed  Google Scholar 

  • Nobre, P. J., & Pinto-Gouveia, J. (2008). Cognitive and emotional predictors of female sexual dysfunctions: Preliminary findings. Journal of Sex and Marital Therapy, 34, 325–342.

    Article  PubMed  Google Scholar 

  • Nunns, D., & Mandal, D. (1997). Psychological and psychosexual aspects of vulvar vestibulitis. Genitourinary Medicine, 73, 541–544.

    PubMed  Google Scholar 

  • Nylanderlundqvist, E., & Bergdahl, J. (2003). Vulvar vestibulitis: Evidence of depression and state anxiety in patients and partners. Acta Dermato-Venereologica, 83, 369–373.

    Article  PubMed  Google Scholar 

  • Payne, K. A., Binik, Y. M., Amsel, R., & Khalife, S. (2005). When sex hurts, anxiety and fear orient attention towards pain. European Journal of Pain, 9, 427–436.

    Article  PubMed  Google Scholar 

  • Payne, K. A., Binik, Y. M., Pukall, C. F., Thaler, L., Amsel, R., & Khalife, S. (2007). Effects of sexual arousal on genital and non-genital sensation: A comparison of women with vulvar vestibulitis syndrome and healthy controls. Archives of Sexual Behavior, 36, 289–300.

    Article  PubMed  Google Scholar 

  • Pujols, Y., Seal, B. N., & Meston, C. M. (2010). The association between sexual satisfaction and body image in women. Journal of Sexual Medicine, 7, 905–916.

    Article  PubMed  Google Scholar 

  • Pukall, C. F., Binik, Y. M., Khalife, S., Amsel, R., & Abbott, F. V. (2002). Vestibular tactile and pain thresholds in women with vulvar vestibulitis syndrome. Pain, 96, 163–175.

    Article  PubMed  Google Scholar 

  • Reed, B. D., Advincula, A. P., Fonde, K. R., Gorenflo, D. W., & Haefner, H. K. (2003). Sexual activities and attitudes of women with vulvar dysesthesia. Obstetrics and Gynecology, 102, 325–331.

    Article  PubMed  Google Scholar 

  • Reissing, E. D., Binik, Y. M., Khalife, S., Cohen, D., & Amsel, R. (2003). Etiological correlates of vaginismus: Sexual and physical abuse, sexual knowledge, sexual self-schema, and relationship adjustment. Journal of Sex and Marital Therapy, 29, 47–59.

    PubMed  Google Scholar 

  • Rosen, N. O., Bergeron, S., Lambert, B., & Steben, M. (2013). Provoked vestibulodynia: Mediators of the associations between partner responses, pain, and sexual satisfaction. Archives of Sexual Behavior, 42, 129–141.

    Article  PubMed  Google Scholar 

  • Rosen, R., Brown, C., Heiman, J., Leiblum, S., Meston, C., Shabsigh, R., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208.

    Article  PubMed  Google Scholar 

  • Sackett, S., Gates, E., Heckman-Stone, C., Kobus, A. M., & Galask, R. (2001). Psychosexual aspects of vulvar vestibulitis. Journal of Reproductive Medicine, 46, 593–598.

    PubMed  Google Scholar 

  • Seal, B. N., & Meston, C. M. (2007). The impact of body awareness on sexual arousal in women with sexual dysfunction. Journal of Sexual Medicine, 4, 990–1000.

    Article  PubMed  Google Scholar 

  • Smith, J. A., & Osborn, M. (2007). Pain as an assault on the self: An interpretative phenomenological analysis of the psychological impact of chronic benign low back pain. Psychology and Health, 22, 517–534.

    Article  Google Scholar 

  • Spielberger, C. D., Gorsuch, R. L., & Lushene, R. (1983). Manual for the state-trait anxiety inventory STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Sutherland, O. (2012). Qualitative analysis of heterosexual women’s experience of sexual pain and discomfort. Journal of Sex and Marital Therapy, 38, 223–244.

    Article  PubMed  Google Scholar 

  • Sutton, K. S., Pukall, C. F., & Chamberlain, S. (2009). Pain, psychosocial, sexual, and psychophysical characteristics of women with primary vs. secondary provoked vestibulodynia. Journal of Sexual Medicine, 6, 205–214.

    Article  PubMed  Google Scholar 

  • ter Kuile, M. M., Brauer, M., & Laan, E. (2006). The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS): Psychometric properties within a Dutch population. Journal of Sex and Marital Therapy, 32, 289–304.

    Article  PubMed  Google Scholar 

  • ter Kuile, M. M., Brauer, M., & Laan, E. (2009). De Female Sexual Function Index (FSFI) en de Female Sexual Distress Scale (FSDS): Psychometrische eigenschappen in een Nederlandse populatie. Tijdschrift voor Seksuologie, 33, 207–222.

    Google Scholar 

  • van der Ploeg, H. M. (2000). Handleiding bij de Zelf Beoordelings Vragenlijst (ZBV) [Test Manual Dutch State Trait Anxiety Inventory]. Lisse, The Netherlands: Swets & Zeitlinger.

  • van Lankveld, J. J., Granot, M., Weijmar Schultz, W. C., Binik, Y. M., Wesselmann, U., Pukall, C. F., et al. (2010). Women’s sexual pain disorders. Journal of Sexual Medicine, 7, 615–631.

    Article  PubMed  Google Scholar 

  • van Lankveld, J. J., Weijenborg, P. T., & ter Kuile, M. M. (1996). Psychologic profiles of and sexual function in women with vulvar vestibulitis and their partners. Obstetrics and Gynecology, 88, 65–70.

    Article  PubMed  Google Scholar 

  • Waters, S. J., Keefe, F. J., & Strauman, T. J. (2004). Self-discrepancy in chronic low back pain: Relation to pain, depression, and psychological distress. Journal of Pain and Symptom Management, 27, 251–259.

    Article  PubMed  Google Scholar 

  • Weijmar Schultz, W., Basson, R., Binik, Y., Eschenbach, D., Wesselmann, U., & van Lankveld, J. (2005). Women’s sexual pain and its management. Journal of Sexual Medicine, 2, 301–316.

    Article  PubMed  Google Scholar 

  • Woertman, L., & van den Brink, F. (2012). Body image and female sexual functioning and behavior: A review. Journal of Sex Research, 49, 184–211.

    Article  PubMed  Google Scholar 

  • Zolnoun, D., Park, E. M., Moore, C. G., Liebert, C. A., Tu, F. F., & As-Sanie, S. (2008). Somatization and psychological distress among women with vulvar vestibulitis syndrome. International Journal of Gynaecology and Obstetrics, 103, 38–43.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Development and Regeneration, Institute for Family and Sexuality Studies, KU Leuven, Kapucijnenvoer 33 bus 7001, 3000, Leuven, Belgium

    Els Pazmany & Paul Enzlin

  2. Department of Psychology, Université de Montréal, Montreal, QC, Canada

    Sophie Bergeron

  3. Department of Clinical and Experimental Medicine, Translational Research Centre for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium

    Lukas Van Oudenhove

  4. Department of Gynaecology, KU Leuven, Leuven, Belgium

    Johan Verhaeghe

  5. Context - Centre for Couple, Family and Sex Therapy, UPC KU Leuven, Leuven, Belgium

    Paul Enzlin

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  1. Els Pazmany
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  2. Sophie Bergeron
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  3. Lukas Van Oudenhove
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  4. Johan Verhaeghe
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Correspondence to Els Pazmany.

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Pazmany, E., Bergeron, S., Van Oudenhove, L. et al. Body Image and Genital Self-image in Pre-menopausal Women with Dyspareunia. Arch Sex Behav 42, 999–1010 (2013). https://doi.org/10.1007/s10508-013-0102-4

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  • DOI: https://doi.org/10.1007/s10508-013-0102-4

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