Relationships Between Body Image, Body Composition, Sexual Functioning, and Sexual Satisfaction Among Heterosexual Young Adults

The impact of male genital self-image on depression, anxiety and sexual functions

AIM

This study aims to examine the relationship between male genital self-perception and sexual functioning and depression anxieties.

METHOD

The study included male patients who were referred to the andrology outpatient clinic between March 2022 and June 2022. Demographic data of the patients were recorded. Cigarette and alcohol consumption was also noted. The Male Genital Self Image Scale (MGSIS) questionnaire was used for the Genital Self Image(GSI) assessment, which consists of 7 questions. The International Index of Erectile Function (IIEF), composed of 15 questions, was used to evaluate sexual function. STAI-I, STAI-II, and BECK scales were used for depression and anxiety. The penis size of the patients was measured in a flask and stretched condition, and the midpenile circumference was recorded. Patients were compared with respect to GSI, depression, anxiety, and sexual functioning.

RESULTS

A total of 75 patients were included in the study. The mean age of the patients was 46.69 ± 11.32 (26-72), and the mean BMI was 27.82 ± 3.79 (22.46-40.40) kg/m2. A slightly positive correlation was found between the patients' flask penis size and MGSIS-total scores (r = 0.260, p = .024) and IIEF-SF scores (r = 0.240, p = .038). There was a moderately positive correlation between the stretched penis size and IIEF-OS (r = 0.403, p < .001) and IIEF-SF (r = 0.354, p = .002). While the MGSIS-total score and the STAI-I and STAI-II scores had a moderate negative correlation, there was an advanced negative correlation between the MGSIS-total score and the BECK score.

CONCLUSION

Disruption of men's genital self-perception is moderately related to their susceptibility to depression and anxiety. This situation affects the person's sexual performance and causes orgasm problems to increase.

Early traumatic experiences are linked to hypersexual behavior and erectile dysfunction in men through the mediation of body uneasiness and general psychopathology

BACKGROUND

Childhood traumatic experiences have been associated with hypersexuality and sexual dysfunctions. However, the mediators of the interactions between these variables should be clarified in men.

AIM

This study aimed to investigate the interaction of early traumatic experiences, psychopathology, and sexuality with respect to erectile dysfunction (ED) and hypersexual behavior. The hypothesized model expected that traumatic experiences would be associated with hypersexual behavior and reduced sexual functioning through the mediation of body uneasiness and psychological distress.

METHODS

The study was cross-sectional and observational. A total of 317 men were enrolled. Male patients with a primary complaint of ED and an indication for psychiatry referral represented the clinical sample (n = 116; mean ± SD age, 42.82 ± 16.89 years). Clinical classification was assessed with the Structured Interview on Erectile Dysfunction. The second sample (n = 201, 30.82 ± 11.94 years) was recruited from the general population. All participants were administered the following questionnaires: Brief Symptom Inventory, Childhood Trauma Questionnaire-Short Form, Hypersexual Behavior Inventory, Body Uneasiness Test-A, and 5-item International Index of Erectile Function.

OUTCOMES

Psychopathology and sexual functioning were assessed by a dimensional approach, and a multivariate model was computed by structural equation model analysis.

RESULTS

When compared with the sample from the general population, the clinical sample exhibited a higher prevalence of early traumatic experiences, as measured by scores on the Childhood Trauma Questionnaire-Short Form (45.08 ± 14.25 vs 39.03 ± 10.22, F = 17.63, P < .001), and a higher tendency to engage in hypersexual behaviors (34.63 ± 13.55 vs 30.79 ± 12.44, F = 6.97, P < .01). Structural equation model analysis showed excellent fit indices indicating that early traumatic experiences predicted hypersexual behaviors and ED through the exacerbating mediating effect of body uneasiness and psychopathology.

CLINICAL IMPLICATIONS

Clinicians should not limit their attention to the behavioral level when assessing sexual dysfunction in men; rather, they should also consider the complex psychopathologic consequences of childhood trauma. Integrated treatments that address the potential presence of childhood trauma with its wider psychological correlates (eg, emotion dysregulation, body uneasiness) might improve treatment response.

STRENGTHS AND LIMITATIONS

The study reports novel data on the relationship among childhood maltreatment, male sexuality, and psychopathologic mediators with a dimensional assessment. However, the assessment was cross-sectional, and causality was mainly derived from previous studies.

CONCLUSION

The present study enriches the current literature, strengthening the hypothesis that childhood traumatic experiences significantly shape development and sexuality. Body uneasiness and psychopathology can both tax sexual functioning, as assessed by erectile functioning or hypersexuality.

Reasons for Genital Dissatisfaction in a Sample of Brazilian Men

Genital self-image (GSI) involves subjective perceptions, experiences, and feelings of individuals regarding their genitalia. A negative GSI contributes to lower sexual esteem and, consequently, negative sexual experiences and sexual dysfunction. In men, self-perception may be influenced by several factors, including penis size or shape, personal experiences, body image, general health status, sex education, and even the media they consume. This study aimed to understand the reasons that lead to dissatisfaction with GSI among Brazilian men. With a mixed approach, we present male perceptions regarding dissatisfaction with GSI captured from the following question: "If you are dissatisfied with your genitals, tell us for what reason(s)? (Optional)," which integrated the last questionnaire element of the original survey. Brazilian men over 18 years of age from different Brazilian states were eligible. In this analysis, 376 responses were obtained. The data were analyzed using thematic content analysis. The participants expressed the reasons for dissatisfaction, which were grouped into two categories: (1) anatomical aspects and beliefs in the construction of GSI and (2) functional aspects. The results offer an understanding of men's perceptions of their genitals and may aid in clinical practice and research on how Brazilian men perceive their genitals. It is possible to improve knowledge about sexual health and increase positivity regarding genital perception by providing information about the reasons that lead to dissatisfaction with the genitals.

Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study

PURPOSE

This study was conducted to determine the dyadic adjustment between individuals with SCI and their spouses and the relationship between their sexual self-consciousness and sexual life and to evaluate it according to the objectification theory.

METHOD

This descriptive and cross-sectional study was conducted with 131 married individuals with SCI registered in the physical therapy and rehabilitation outpatient clinic of a university hospital between February 2020 and April 2021. The data of the study were collected using a Descriptive Information Form, the American Spinal Injury Association Impairment Scale (ASIA), the Dyadic Adjustment Scale (DAS), the Sexual Self-Consciousness Scale (SSCS), and the Arizona Sexual Experiences Scale (ASEX). In the study, the predictors of the sexual life of individuals with SCI were evaluated with the Stepwise Multiple Linear Regression analysis. In addition, predictors of sexual dysfunction in individuals with SCI were evaluated by the logistic regression analysis. The results were discussed within the framework of objectification theory.

RESULTS

According to the results of the study, .67.2% of the individuals with spinal cord injuries experienced sexual functionality problems; increased age, falling injuries, and being in ASIA grade A increased sexual self-awareness and sexual dysfunction; and being a male with SCI increased sexual focus. It was found that the adjustment between individuals with SCI and their spouses was a predictor that significantly reduced sexual embarrassment, sexual self-consciousness, and sexual dysfunction and that the strong adjustment between couples was an important factor for the prevention of sexual dysfunction development.

CONCLUSION

It was found that most individuals with spinal cord injuries experienced sexual dysfunction. The importance of dyadic adjustment and sexual self-consciousness has come to the fore in the sexual life of these individuals.

Factors Associated with Satisfaction with Male Genital Self-Image in Brazil

Male genital self-image (GSI) refers to how men feel about their genitals. Studies suggest that GSI is influenced by several psychosocial and physical factors, such as frequency of sexual activities, anxiety, and sexual dysfunctions. In Brazil, no studies have investigated the factors associated with satisfaction with male GSI. This is a cross-sectional and online study conducted with Brazilian men over 18 years of age. The Male Genital Self-Image Scale (MGSIS), Body Appreciation Scale-2 (BAS-2), and International Index of Erectile Function (IIEF) were used. Body appreciation and frequency of sexual activity were included as confirmatory variables and other variables were explored as factors associated with GSI. Data were analyzed by binary logistic and multiple linear regression, according to the MGSIS cut-off point for satisfaction with male GSI and total score of MGSIS, respectively. A total of 1,235 men (M = 26.14, SD = 7.28 years) participated in the study. The mean of the total MGSIS score was 23.02 (SD = 4.45; absolute range, 7-28) points, with 62.11% of men being classified as satisfied with GSI. Men satisfied with GSI were more likely to have a partner, higher body appreciation, lower body mass index (BMI), and not have phimosis (excess skin covering the penis, making it difficult to expose the glans). Satisfaction with GSI of Brazilian men was associated with relationship status, body appreciation, BMI, and phimosis.

Why Do Women with Disordered Eating Engage in Sex? The Mediating Role of Sexual Motivations in the Association Between Disordered Eating Behaviors and Attitudes and Sexual Dysfunction

Although there is growing evidence of an association between disordered eating and sexual dysfunction, the mechanism underlying this association is still unclear. In the current study, we sought to examine the mediating role of sexual motivation between disordered eating and sexual dysfunction. We used a multi-path mediation model to examine the mediating role of sexual motivation between disordered eating and sexual functioning among a sample of 341 non-clinical women in a steady relationship. Analysis revealed two significant mediation paths associating disordered eating with sexual functioning: (1) a high level of disordered eating was significantly linked with higher motivation for partner approval via sex and sexuality which, in turn, was associated with lower sexual functioning and (2) a high level of disordered eating was significantly linked with lower enhancement sexual motivation which, in turn, was associated with lower sexual functioning. This study extends the existing knowledge by offering an explanation for the relation between disordered eating and sexual dysfunction via sexual motives. Findings from the current study suggest women with disordered eating utilized sex for self-affirmation, for coping with negative emotions, for partner approval, and to increase intimacy. Also, these women were not likely to engage in sex for enhancement reasons.

Positive body perception and its link to sexual satisfaction in aging women - findings from the Women 40+ Healthy Aging Study

Research on the relation between physical appearance and sexual satisfaction in aging women is scarce. This study uniquely links attractiveness, body perception, and sexual satisfaction in 124 healthy aging women. Two-thirds reported being highly sexually satisfied. BMI and fat mass correlated significantly with sexual satisfaction. Weight and shape concerns moderated this relationship, affecting sexual satisfaction beyond the effect of body size and composition. Given the "unattractive stereotype" of older women related to the enduring social beauty ideal of a youthful and thin body, positive body perceptions in light of age-associated bodily changes should be promoted.

Body Image and Sex: A Dyadic Examination of Body Esteem and Sexual Inhibition, Obsession, and Harmony

How each individual within a relationship views their body may play a role in how they experience their sexual interactions. Previous research found associations between body image and sexual well-being at an individual level, but very little research has examined a dyadic association between body image and sexual and relational well-being. Using a nationally representative sample of 2,177 newlywed couples, this study used an Actor-Partner Interdependence Mediation Model (APIMeM) to estimate actor and partner associations between body esteem and relationship satisfaction, using sexual styles - inhibited, obsessed, or harmonious - as potential mediators. Findings showed both actor and partner effects. Body esteem was positively associated with own and partner's sexual harmony. Both men's and women's body esteem were negatively associated with women's sexual inhibition. A positive association between body esteem and own relationship satisfaction remained even when accounting for sexual mediators. Additional findings are discussed. These findings indicate that an individual's comfort with the body may be associated with sexual and relational well-being for both partners.

Small Intestinal Submucosa for corporeal body grafting in patients with proximal hypospadias and severe chordee: Long term follow-up assessing erectile function and genital self-perception

BACKGROUND

Proximal hypospadias and severe ventral chordee are often challenging to repair. To preserve penile length in chordee repair, Small Intestinal Submucosa (SIS) corporal grafting is often performed with potential long-term complications including recurrent curvature and erectile dysfunction (ED). There is a paucity of data evaluating sexual function in mid, late and post-pubertal patients.

OBJECTIVE

We aimed to assess long-term outcomes of genital self-perception and erectile function in mid, late and post-pubertal patients who underwent single-layer (1-ply) SIS corporal body grafting for correction of severe chordee.

STUDY DESIGN

Patients with proximal hypospadias who underwent correction of severe chordee using SIS grafting between 2001 and 2015 were retrospectively identified. Patients were evaluated for erectile and sexual function using the modified erection hardness score (mEHS) and the modified sexual health inventory for men (mSHIM). Perceived function and straightness were measured with Hypospadias Objective Scoring Evaluation (HOSE). Penile self-perception was assessed using the Pediatric Penile Perception Score (PPPS). Results were compared to an age-matched healthy control group. Categorical variables were analyzed using Fisher's exact test, and continuous variables using paired and unpaired t-test and ANOVA.

RESULTS

Nineteen patients with proximal hypospadias who underwent correction of severe chordee using SIS grafting and 18 controls participated in the study with a median age of 17 years for both groups. In the mEHS, 12 (63.2%) hypospadias-patients and 14 (87.5%) controls rated their erections as completely hard and very rigid. In the mSHIM, 1 (5.2%) hypospadias-patient was classified as having moderate ED. A total of 16 hypospadias-patients (84%) and 16 controls (88.9%) reported being very satisfied or satisfied with the straightness of their penis. No significant difference was observed in the mEHS, mSHIM and PPPS between groups (p < 0.05). The straightness of the erection was rated lower by participants, than by the pediatric urologist. In the HOSE, 12 (63.2%) hypospadias-patients and 16 (88.9%) controls obtained an acceptable score.

DISCUSSION

Our findings indicate favorable long-term outcomes in ED and genital self-perception; only 5% of our population reported having a mild-moderate to moderate presentation of ED, and there were no reports of severe ED. The overall PPPS satisfaction rates were statistically similar for the control and hypospadias groups. The small sample population limits the significance of our findings.

CONCLUSION

Corporal body grafting with 1-ply SIS suggests positive long-term outcomes in genital self-perception and erectile function, with mid, late and post-pubertal patients who underwent hypospadias repair having comparable results to age-matched healthy controls.

Demographic and sociocultural predictors of sexuality-related body image and sexual frequency: The U.S. Body Project I

Body image is a critical component of an individual's sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one's body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.

Does fat talk affect relationship and sexual satisfaction?: Adults' perceptions of fat talk in a fictional romantic relationship

Little is known about how fat talk - a verbal expression of body image concerns - functions within romantic relationships. This study used vignettes about a fictional couple to examine how varied levels of a woman's fat talk were perceived by participants as affecting a fictional couple's relationship and sexual satisfaction. Participants were recruited from Amazon Mechanical Turk and included 239 heterosexual people (127 men, 112 women) with long-term relationship experience. Using a 3 (Level of Body Talk: Excessive vs. Minimal Fat Talk vs. Self-Accepting Talk) × 2 (Participant Gender: Male vs. Female) × 2 (Perspective: Husband vs. Wife) between-subjects design, participants read a vignette where the target woman used varying levels of body talk when speaking with her partner. Afterwards, participants completed a series of questionnaires to report on their perceptions of the couple's relationship and sexual satisfaction. Supporting hypotheses, results indicated that participants in the Excessive Fat Talk condition perceived lower relationship and sexual satisfaction levels than the Minimal Fat Talk and Self-Accepting Body Talk conditions. No differences emerged between those exposed to the Self-Accepting and Minimal Fat Talk vignette dialog. Male participants reported lower perceived relationship quality and sexual satisfaction than women participants. Research in this area is in its infancy, and more is needed (especially with actual couples) to better understand how fat talk, as a behavioral function of poor body image, impacts relationship functioning.

An Acceptance and Commitment Therapy Prototype Mobile Program for Individuals With a Visible Difference: Mixed Methods Feasibility Study

Background

Mobile apps may offer a valuable platform for delivering evidence-based psychological interventions for individuals with atypical appearances, or visible differences, who experience psychosocial appearance concerns such as appearance-based social anxiety and body dissatisfaction. Before this study, researchers and stakeholders collaboratively designed an app prototype based on acceptance and commitment therapy (ACT), an evidence-based form of cognitive behavioral therapy that uses strategies such as mindfulness, clarification of personal values, and value-based goal setting. The intervention also included social skills training, an established approach for increasing individuals’ confidence in managing social interactions, which evoke appearance-based anxiety for many.

Objective

In this study, the authors aim to evaluate the feasibility of an ACT-based app prototype via the primary objectives of user engagement and acceptability and the secondary feasibility objective of clinical safety and preliminary effectiveness.

Methods

To address the feasibility objectives, the authors used a single-group intervention design with mixed methods in a group of 36 participants who have a range of visible differences. The authors collected quantitative data via measures of program use, satisfaction ratings, and changes over 3 time points spanning 12 weeks in outcomes, including selected ACT process measures (experiential avoidance, cognitive defusion, and valued action), scales of appearance concerns (appearance-based life disengagement, appearance-fixing behaviors, appearance self-evaluation, and fear of negative appearance evaluation), and clinical well-being (depression and anxiety). Semistructured exit interviews with a subsample of 12 participants provided qualitative data to give a more in-depth understanding of participants’ views and experiences of the program.

Results

In terms of user engagement, adherence rates over 6 sessions aligned with the upper boundary of those reported across mobile mental health apps, with over one-third of participants completing all sessions over 12 weeks, during which a steady decline in adherence was observed. Time spent on sessions matched design intentions, and engagement frequencies highlighted semiregular mindfulness practice, mixed use of value-based goal setting, and high engagement with social skills training. The findings indicate a good overall level of program acceptability via satisfaction ratings, and qualitative interview findings offer positive feedback as well as valuable directions for revisions. Overall, testing for clinical safety and potential effectiveness showed encouraging changes over time, including favorable changes in appearance-related life disengagement, appearance-fixing behaviors, and selected ACT measures. No iatrogenic effects were indicated for depression or anxiety.

Conclusions

An ACT-based mobile program for individuals struggling with visible differences shows promising proof of concept in addressing appearance concerns, although further revisions and development are required before further development and more rigorous evaluation.

Male Genital Self-Image Scale (MGSIS): Cutoff Point, Cultural Adaptation and Validation of Measurement Properties in Brazilian Men

BACKGROUND

Concerns about genital self-image (GSI) can influence sexual function and quality of life, and instruments that assess male GSI, such as the Male Genital Self-Image Scale (MGSIS), need to be adapted and validated in different cultures.

AIMS

To culturally adapt and validate the measurement properties of MGSIS in Brazilian men, according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline, and to create a cutoff point for satisfaction with male GSI.

METHODS

We assessed the validity of content through a committee of experts and cognitive interviews. The internal consistency and test-retest reliability were assessed using Cronbach's α and Intraclass Correlation Coefficient (ICC). We also calculate measurement errors using the Bland and Altman graph. The structural validity was investigated through exploratory and confirmatory factor analysis. The hypothesis test for construct validity was assessed using Spearman correlation from MGSIS with the International Index of Erectile Function (IIEF), Body Appreciation Scale (BAS-2) and Rosenberg Self-Esteem Scale (RSES). To create a cutoff point for satisfaction with the GSI, the item response theory and the classic test theory were used.

OUTCOMES

Male's (i) GSI, (ii) sexual function, (iii) body appreciation, and (iv) self-esteem were assessed.

RESULTS

In this study, 518 men with a mean age of 33.90 (±13.83) years participated. The Brazilian version of MGSIS demonstrated good content validity and a single factor that explained 64.57% of the variance. Cronbach's α and ICC values were 0.905 and 0.806, respectively. By assessing measurement errors, we found no systematic bias in the sample. MGSIS showed a moderate to weak correlation with IIEF, BAS-2 and RSES. A cut-off point of 23 in the MGSIS total score was found to rate satisfaction with the GSI.

CLINICAL TRANSLATION

MGSIS is a valid and reliable measurement instrument for measuring male GSI in Brazil.

STRENGTHS AND LIMITATIONS

This study evaluated the measurement properties of MGSIS according to COSMIN, which is a powerful and useful guideline for measurement properties. However, due to the lack of a gold standard for measuring the GSI, we have not assessed the criterion validity.

CONCLUSION

MGSIS is valid, reliable and can be useful to assess the GSI and classify the satisfaction with the GSI of Brazilian men. de Arruda GT, da Silva EV, Braz MM. Male Genital Self-Image Scale (MGSIS): Cutoff Point, Cultural Adaptation and Validation of Measurement Properties in Brazilian Men. J Sex Med 2021;18:1759-1767.

Transcultural Adaptation and Validation of the Spanish Version of the Sexual Satisfaction Scale for Women (SSS-W-E)

Background: Sexual satisfaction is a complex and multidimensional concept. It encompasses physical, emotional, relational and cultural dimensions, and constitutes an essential component of sexual health, as well as an indicator of quality of life and wellbeing. The Sexual Satisfaction Scale for Women (SSS-W) was designed in the United States, and it is a valid and reliable tool to measure women’s sexual satisfaction. Aim: The aim of this study was to culturally adapt and translate the SSS-W into Spanish and analyze its psychometric properties. Methods: First, the original instrument was culturally adapted and translated from English to Spanish. Then, we tested the psychometric properties of the instrument in its Spanish version in a sample of 316 women who attended a family planning clinic in Logroño, Spain. Internal consistency reliability of the whole scale and each subscale separately was measured using Cronbach’s alpha. Factorial validity of the SSS-W in its Spanish version was analyzed using exploratory factor analysis through the Kaiser–Meyer–Olkin measure of sample adequacy and Bartlett’s Sphericity test. Results: The Cronbach’s alpha coefficients of the total scale and each subscale were satisfactory (>0.7). Exploratory factor analysis confirmed the five hypothetical dimensions of the scale in its Spanish version. The five dimensions (contentment, communication, compatibility, relational concern, and personal concern) explained 60% of the total variance of the scale; factor analysis using varimax rotation revealed strong loads in each of the five components. Conclusions: The SSS-W in its Spanish version is a valid and reliable tool to assess sexual satisfaction in Spanish women of reproductive age and, therefore, can be used both in clinical practice and for the investigation of sexual health.

Internalization of body shape ideals and body dissatisfaction: A systematic review and meta-analysis

OBJECTIVE

The present meta-analysis summarizes existing evidence on the relationship between the internalization of body shape ideals (IBSI) and body dissatisfaction.

METHOD

Pooled effect sizes (r) were computed using a random-effects model. The robustness of the results was examined using influence analyses. Potential predictors of effect heterogeneity were examined using subgroup analysis and univariable/multivariable meta-regressions. Publication bias was examined using the three-parameter selection model (3PSM).

RESULTS

A total of 141 effect-sizes from 78 studies (N = 39,491) were retrieved. Results revealed medium (r = .25; muscular/athletic-ideal internalization) to very large (r = .43, general attractiveness-ideal internalization; and r = .45, thin-ideal internalization) relationships, all these being largely similar in male and female individuals.

DISCUSSION

IBSI and body dissatisfaction were strongly linked: (a) in younger individuals (general attractiveness-ideal internalization); (b) when IBSI was operationalized in terms of endorsement rather than mere awareness of appearance ideals; (c) in studies of lower methodological quality (muscular/athletic-ideal internalization); and (d) when IBSI was assessed using instruments involving social comparisons. Given the largely cross-sectional nature of data included in this meta-analysis, further testing in prospective and experimental studies is needed to confirm hypotheses about causality of observed associations. Such findings would have impact for prevention and intervention studies.

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress

INTRODUCTION

Appearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction.

AIM

This study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction.

METHODS

A large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey.

OUTCOMES

Participants reported on their experience of five different sexual problems and associated level of distress.

RESULTS

We found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations.

CLINICAL TRANSLATION

These findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment.

STRENGTHS AND LIMITATIONS

Strengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales.

CONCLUSION

The study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;XX:XXX-XXX.

Sexual Anxiety Mediates Dyadic Associations Between Body Satisfaction and Sexual Quality in Mixed-Sex Couples

Body satisfaction predicts sexual quality among women and men; however, mechanisms of the association are largely unknown. We hypothesized that sexual anxiety would mediate average associations over 1 year between individuals' body satisfaction and their own and their partner's sexual quality, which is comprised of their sexual satisfaction and dissatisfaction, in 123 mixed-sex cohabiting couples. Results of Actor-Partner Interdependence Models extended to Mediation (APIMeM) and tested via multilevel modelling partially supported the hypotheses. Specifically, individuals' body satisfaction indirectly predicted their own and their partner's sexual satisfaction through individuals' sexual anxiety, and indirectly predicted their own, but not their partner's sexual dissatisfaction through individuals' sexual anxiety. Thus, when individuals are relatively less satisfied with their bodies, they may experience anxiety during sexual encounters, which then interferes with their own and their partner's sexual quality.

High satisfaction on genital self-perception and sexual function in healthy Norwegian male adolescents

BACKGROUND

Genital self-perception and self-reported outcome on sexual function represent important information in studies focusing on male adolescents born with a genital malformation. Normal data from an age-matched control group are essential for comparison and more knowledge is needed concerning age after puberty and before entering adulthood.

OBJECTIVE

To investigate the self-reported outcome on genital perception and sexual outcome of healthy male adolescents aged 16 and 17 years.

STUDY DESIGN

Sixty-one individuals were included in this cross-sectional study. The assessment tools included the adolescents' self-report on genital perception and sexual function measured by the Pediatric Penile Perception Score (PPPS) and their responses to a semi-structured interview. In addition, we added information on mental health and psychosocial functioning measured by the Strengths and Difficulties Questionnaire, and health-related quality of life (HRQoL) measured by the Pediatric Quality of Life Inventory. Body satisfaction and self-esteem were also measured by the Global Self-Worth and Physical Appearance subscales of the revised version of the Self-Perception Profile for Adolescents (SPPA).

RESULTS

Of the 73 individuals invited, a total of 61 participated. The adolescents reported high satisfaction on genital self-perception and sexual function with a score close to 10 on the overall PPPS score (maximum overall score is 12). Participants who were dissatisfied with their genitals reported penile length, alongside foreskin, as their main concern. More than 90% reported satisfaction on sexual function, concerning erection, masturbation, ejaculation, and orgasm. Results showed a higher score on body satisfaction, self-esteem, mental health and psychosocial functioning and a lower score on HRQoL compared to the normative Norwegian data. The small numbers of individuals that scored more negatively on genital self-perception and sexual function also scored more negatively in all items studied.

DISCUSSION

A key finding in our study was their high satisfaction on the overall PPPS score and reported sexual function. The results are comparable to other studies related to healthy male adolescents and the sample studied deviate little from a representative Norwegian sample. A comparison group of age-matched adolescents from the normative population is important to determine long-term outcomes on genital appearance and sexual function of patients born with a genital malformation and operated on in early childhood. Limitations of this study are the small sample-size and the lack of information on non-participants.

CONCLUSIONS

Our results show generally positive genital self-perception and sexual function in a healthy group of Norwegian male adolescents, aged 16 and 17.

Satisfaction with appearance and sexual satisfaction in women with severe burn injuries

Burn, particularly in women, can cause a variety of difficulties. Women's feelings of themselves and of life satisfaction are affected by their body dimensions and satisfaction with appearance, which can be significant predictors of their sexual satisfaction. Therefore, this study aimed to investigate the relationship between satisfaction with appearance and sexual satisfaction among female patients with severe burn. The present study, adopted a descriptive-analytic approach and used a convenience sampling technique, to select 180 female patients Data collection instruments included a demographic questionnaire, the index of sexual satisfaction (ISS), and the satisfaction with appearance scale (SWAP). The results of this study showed that about 82% of women with severe burn injuries, had a lower level of sexual satisfaction. It was observed that satisfaction with appearance had a significant negative relationship with sexual satisfaction in women with burns (P < 0.001). According to the results of the present study, in order to improve appearance satisfaction and consequently sexual satisfaction, intervention attempts are essential. The findings of this study may have practical applications in the formulation of plans for patients with burn injuries.

Cross-Cultural Analysis of Sexual Response and Relationship Satisfaction in Women With and Without Orgasmic Difficulty During Partnered Sex

Objective To investigate how orgasmic difficulty may impact women's sexual/relationship quality depending upon their cultural origin. Method: We used a cross-sectional, multinational survey designed to assess orgasmic difficulty during partnered sex and other sexual/relationship factors in 88 Pakistani and 188 U.S. women. Results: Pakistani women reported less orgasmic difficulty than U.S. women, but those Pakistani women having orgasmic difficulty reported lower relationship satisfaction, less interest in sex, and greater difficulty becoming sexually aroused compared to U.S. respondents with orgasmic difficulty. Conclusions: The presence of orgasmic difficulty affected sexual and relationship factors more in Pakistani women than U.S. women.

Empirical Evaluation of Rainbow Reflections: A Comic Book Anthology on Body Image for Queer Men

Gay, bisexual, and queer (GBQ) men are at higher risk of negative body image. As having a negative body image is related to negative mood, sexual, and health outcomes, identifying and providing community-friendly tools for GBQ men is important. This paper describes the creation and evaluation of Rainbow Reflections, a comic anthology developed to promote awareness of and communication about body image. Rainbow Reflections includes comics from 38 trans- and cis-GBQ artists who drew inspiration from personal narratives based on pre-determined themes in the empirical literature and interactive inserts based on evidence-based practice. To evaluate Rainbow Reflections, 167 trans- and cis-GBQ men completed pre-post measures before/after viewing a selection of comics and responded to an open-ended question about their experience. Overall, participants rated the comic book positively, with a majority (61.1%) indicating that they would recommend the book to a friend. After viewing the comics, participants reported greater comfort with initiating conversations about body image, greater satisfaction with their bodies, and reported higher estimates of how common body image concerns are for queer men. Themes that emerged from open-ended responses included participants reflecting on personal struggles (~ 30%), relating with the stories of others (~ 22%), reflecting on the standards of queer men (~ 18%), recognizing cis-privilege (~ 11%), reflecting on others' struggles (~ 9%), negative feedback about the comics (~ 7%), and balancing masculine and feminine (~ 3%). Results of the study provide preliminary evidence for Rainbow Reflections as an effective community-friendly tool to promote awareness of and communication about body image for GBQ men.

Gender differences in sexual health impairment in hidradenitis suppurativa: A systematic review

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis characterized by painful nodules, sinus tracts, and scarring, with a predilection for intertriginous areas. HS is particularly prevalent in women of childbearing age and can have varying psychological and physical consequences. The chronic and debilitating nature of this disease can lead to significant impairments in patients' sexual health and overall quality of life. This systematic review examines gender differences in the impact of HS on sexual health. In addition, we review gaps in the management of sexual health for patients with HS and outline recommendations to adequately address sexual concerns and optimize care.

Sexual satisfaction among italian university students

This paper examines the determinants of sexual satisfaction among Italian young men and women at the beginning of their adulthood, taking into account the different stages of sentimental and sexual transitions. We based the analyses on the data collected in 2017 by the SELFY Survey on a sample of 7842 university students in Italy. Results of the logistic regression models highlight that, above all, sexual satisfaction is positively associated with the frequency of intercourse within a stable and exclusive relationship. Furthermore, results highlight the essential role of all transitions, sexual and sentimental, in enhancing sexual satisfaction, both in a positive and negative direction. Religion has a positive effect too, but only among students who have not yet had intercourse, expressing a protective effect of the adherence to beliefs. Significant differences between young men and women emerged mainly concerning performance, other conditions being equal.

Sexual function in hook-up culture: The role of body image

Hook-up mobile apps are increasing in popularity and research suggests sexual function may be lower among those who hook-up compared to those who have sex in a longer-term relationship. Sexual function is an important predictor of well-being; however, we know little about the psychosocial antecedents of sexual function, such as body image, among those who use hook-up apps. The current study aims to examine two measures of positive body image and one measure of body image self-consciousness during intimate activity among a sample of adult women and men who have hooked up in the previous month using a hook-up mobile app (N = 243). Our results suggest that higher body image self-consciousness during intimate activity was related to lower sexual function composite score and several specific domains (i.e., pain, arousal, orgasm, and lubrication) among women. Higher body appreciation was related to higher sexual satisfaction among women. Higher body image self-consciousness during intimate activity was related to higher erection difficulty, but not ejaculation difficulty, among men. These findings highlight the nuanced nature of body image and sexual function and provide further evidence that interventions for women and men aiming to improve some body image constructs may improve sexual function as well.

Exploring Determinants of Sexual Satisfaction in a Chilean Representative Sample

This article examines the relationship between sexual satisfaction and gender, age, social status, being in stable relationships, intercourse frequency, and satisfaction with physical attractiveness (physical appearance and sex appeal). A self-report questionnaire was applied in a representative sample of 767 residents of Santiago (Chile), over 18 years old and that have had, at least, one sexual relation (with penetration) during their lives. Higher sexual satisfaction was predicted negatively by age and positively by higher satisfaction with sex appeal, higher intercourse frequency and having a stable relationship. Among women, the principal predictors are satisfaction with sex appeal and intercourse frequency. Among men to the above, it is necessary to add satisfaction with physical appearance and having a stable relationship - at odds with supposed higher relevance for women of body satisfaction and sensibility to social relationships. Discussion emphasizes the controversial nature of the gender differences found regarding the Latin American culture.

Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction

Introduction

This study explored the role of body image dissatisfaction on orgasmic response during partnered sex and masturbation and on sexual relationship satisfaction. The study also described typologies of women having different levels of body image satisfaction.

Methods

A sample of 257 Norwegian women responded to an online survey assessing body image dissatisfaction, problems with orgasm, and sexual relationship satisfaction. Using structural equation modeling and factor mixture modeling, the relationship between body image dissatisfaction and orgasmic response was assessed, and clusters of sexual response characteristics associated with varying levels of body image dissatisfaction were identified.

Main Outcome Measure

Orgasmic function during partnered sex and masturbation, along with sexual relationship satisfaction, were assessed as a function of body image.

Results

Body image dissatisfaction, along with a number of covariates, predicted higher levels of “problems with orgasm” during both partnered sex and masturbation, with no significant difference in the association depending on the type of sexual activity. Varying levels of body image dissatisfaction/satisfaction were associated with differences in orgasmic incidence, difficulty, and pleasure during partnered sex; with one orgasmic parameter during masturbation; and with sexual relationship satisfaction.

Conclusion

Body image dissatisfaction and likely concomitant psychological distress are related to impaired orgasmic response during both partnered sex and masturbation and may diminish sexual relationship satisfaction. Women with high body image dissatisfaction can be characterized by specific sexual response patterns.

Horvath Z, Smith BH, Sal D, et al. Body Image, Orgasmic Response, and Sexual Relationship Satisfaction: Understanding Relationships and Establishing Typologies Based on Body Image Satisfaction. Sex Med 2020;8:740–751.

The role of body image in sexual satisfaction among partnered older adults: a population-based study in four European countries

Body image issues can affect all domains of sexual functioning. The aim of this study was to examine how, in a sociocultural context where physical and sexual attractiveness is equated with young and slim body ideals, appearance dissatisfaction and importance are related to sexual satisfaction in older adults in four European countries. A cross-sectional survey with probability samples of the population aged 60-75 years was used. Only respondents with a partner were included in this paper, and the countries included Norway (n = 957), Denmark (n = 846), Belgium (n = 612), and Portugal (n = 367). Sexual satisfaction, appearance dissatisfaction, and importance were assessed, and frequency of intercourse/kissing and cuddling, relationship satisfaction, age, and body mass index were all used as control variables. Belgian men scored significantly lower on sexual satisfaction, while there was no difference in sexual satisfaction in women. Appearance dissatisfaction was lower in Scandinavian women and men, and in Belgian men, and appearance salience was lower in Norwegian men and women, and in Portuguese women. Linear regression analysis revealed that, adjusting for confounders, appearance dissatisfaction was significantly related to sexual satisfaction in Scandinavian women and men, as well as in Belgian men. Compared to research on younger adults, appearance evaluation appeared to play an equally important role in sexual satisfaction in older adults in our study. The variation in appearance dissatisfaction in older adults across European countries is a novel finding that needs to be examined further.

Examining University Men's Psychobiological and Behavioral Response-Recovery Profile From a Social-Evaluative Body Image Threat

Negative body image, which often results from social-evaluative body image threats, is common in young men and related to many harmful outcomes. Using social self-preservation theory (SSPT), the present study investigated the psychobiological (i.e., shame and cortisol) and behavioral (e.g., submission) response-recovery profile to a social-evaluative body image threat in university men. Participants (N = 69; M_age = 20.80 years, SD = 1.84) were randomly assigned to a high-threat (n = 34) or low-threat condition (n = 35). Men in the high-threat condition reported greater post-threat body shame, had greater post-threat cortisol levels, and exhibited more shame-relevant behaviors than men in the low-threat condition. There were no significant differences between conditions for body shame or cortisol at the final post-threat time point (after resting for 30 min). These findings are consistent with SSPT and suggest that men respond to, and recover from, body image threats relatively efficiently.

Experiential avoidance and cognitive fusion mediate the relationship between body evaluation and unhelpful body image coping strategies in individuals with visible differences

Psychological flexibility, the capacity to be open to any internal stimuli and act in accordance with valued ends, has been identified as an explanatory variable in how people cope with body concerns. The role of psychological flexibility is unexplored in adults with an atypical appearance due to a health condition, injury, or medical treatment (collectively visible difference), who often encounter multiple day-to-day body image threats. Testing two core components of psychological flexibility, namely experiential avoidance (a desire to avoid or get rid of unpleasant internal experiences) and cognitive fusion (taking thoughts literally), can also provide a more precise theoretical model, with clearer implications for psychological intervention. This survey study investigated whether each psychological flexibility component mediated the relationship between body evaluation and two unhelpful body image coping strategies (behavioural avoidance and appearance-fixing behaviours) in 220 adults with various causes of visible difference. Controlling for demographic variables and subjective noticeability of visible difference, results suggest that cognitive fusion partially mediated the relationship for both body image coping strategies, and experiential avoidance partially mediated behavioural avoidance but not appearance-fixing behaviours. Cognitive fusion may be a particularly important cognitive process in the mechanisms underpinning unhelpful body image coping strategies in this population.

A review of research linking body image and sexual well-being

The link between body image and sexual well-being is intuitive and increasingly supported by psychological research: individuals, particularly women, with greater body satisfaction and body appreciation tend to report more positive sexual experiences. Although both perceptions of one's body and one's sexual life are central to most adults' experiences, this area of research has remained somewhat understudied. In this review, we discuss the findings that are available and suggest directions for future research and applied implications of this work. We highlight Thomas Cash's contributions to this area of study, given his significant contributions to moving our understanding of body image and sexual well-being forward.

Late-onset hypogonadism (LOH), masculinity and relationship and sexual satisfaction: are sexual symptoms of LOH mediators of traditional masculinity on relationship and sexual satisfaction?

Background Late-onset hypogonadism (LOH) is characterised by significant changes in the male life cycle, and may increase the likelihood of experiencing sexual difficulties. Further, it is assumed that traditional gender roles (masculinity) can affect the experience of sexual difficulties. The aim of this study was to evaluate the effect of masculinity on sexual symptoms of LOH, as well as on sexual and relational satisfaction.

METHODS

A community sample of 460 Portuguese men aged between 40 and 91 years (mean (± s.d.) 51.64 ± 8.03 years) was collected. Correlation and moderation analyses were conducted to investigate relationships among the variables being studied.

RESULTS

There was an association between the sexual symptoms of LOH, masculinity and sexual and relationship satisfaction. Moderation analysis revealed direct relationships between masculinity and sexual and relationship satisfaction, as well as direct relationships between sexual symptoms of LOH and sexual and relationship satisfaction. However, sexual symptoms of LOH did not significantly moderate the relationships between masculinity and sexual and relationship satisfaction.

CONCLUSIONS

These findings indicate the existence of a direct effect of both masculinity and sexual symptoms of LOH on sexual and relational satisfaction, although masculinity did not have an effect on sexual symptoms of LOH. The implications of these findings are discussed. Instrumentality as an indicator of masculinity was associated with relational and sexual satisfaction, suggesting the importance of involving a man's partner in sexual dysfunction interventions.

Virtual Reality and Sex Therapy: Future Directions for Clinical Research

Rapidly growing new technologies are revolutionizing the field of mental health, in terms of both understanding and treating mental disorders. Among these, virtual reality (VR) is a powerful tool providing clients with new learning experiences benefiting their psychological well-being. This article offers an overview of the current literature on VR in psychotherapy, highlighting its relevance to sexual dysfunction (SD) treatment.A literature review of PubMed and Google Scholar databases was used to provide a description of the theoretical frameworks and clinical indications associated with VR use in psychotherapy and SD treatment. The effectiveness of VR exposure-based therapy has been empirically validated for several mental disorders, notably anxiety disorders. The emerging combined use of VR and mindfulness tends to focus on chronic pain treatment. Experimental research examining the use of immersive technologies in the treatment of SDs is lacking.Given the shortcomings of conventional SD treatments, exploring and developing specialized VR interventions may prove beneficial. VR offers promising avenues in sex therapy, particularly for the treatment of genital pain disorders or SDs in which anxiety plays a significant etiological role.

Body Image Development and Sexual Satisfaction: A Prospective Study From Adolescence to Adulthood

The aim of the current study was to explore whether developmental trajectories of body satisfaction from adolescence to young adulthood predicted measures of sexual satisfaction in young adulthood, even when controlling for important covariates such as gender, weight development, relationship status, mental health, and frequency of sexual intercourse and masturbation. Data were collected from a population-based prospective cohort of Norwegian adolescents (n = 2,587) over a period of 13 years in four waves (1992, 1994, 1999, and 2005; mean age = 14.9 in 1992, 57.3% women). Latent growth curves were estimated for body satisfaction and body mass index (BMI). Men reported higher sexual satisfaction, sexual activity, baseline body satisfaction, and BMI than women. The developmental trajectories revealed a slight increase in body satisfaction and BMI from adolescence to young adulthood in both genders. Moreover, structural equation models showed that baseline body satisfaction in both genders predicted sexual satisfaction as a young adult, independent of relationship status and frequency of sexual activity. Neither the development of BMI nor of body satisfaction predicted sexual satisfaction. The results elucidate the vital role of body satisfaction in sexual satisfaction in adults and the importance of addressing body dissatisfaction in childhood.

Sexual Dysfunction and Satisfaction in Kidney Transplant Patients

INTRODUCTION

10% of the world's population suffers from chronic kidney disease. Kidney transplants provide an improvement in the quality of life of those patients. Sexual dysfunction is common after kidney transplantation, and its etiology is presumed to be multifactorial. It has a negative impact on sexual satisfaction and health-related quality-of-life. The integration of a new organ into the body can imply an adjustment of body image, which may eventually have a negative influence on intimacy and sexual behaviors.

AIM

To evaluate male sexual function, sexual satisfaction, and body image satisfaction among a convenience sample of patients who have had a kidney transplant.

METHODS

This is a cross-sectional study that included 460 patients, from a single healthcare center, who had undergone a kidney transplant procedure >4 weeks ago. A total of 112 respondents (mean = 55.5 years, SD = 11.4) answered the questionnaires properly.

MAIN OUTCOME MEASURES

All recruited patients answered a self-reported sociodemographic questionnaire, in addition to the International Index of Erectile function, the New Scale of Sexual Satisfaction, the Brief Symptom Inventory, and the Body Image Scale.

RESULTS

A correlation was found between sexual function and sexual satisfaction (r = 0.598, P < .001, n = 112), as well as between body image satisfaction and sexual function (r = -0.193, P = .042, n = 112). The length of time after a kidney transplant (≤ or >36 months) was not associated with a difference in sexual functioning or sexual satisfaction.

CLINICAL IMPLICATIONS

This study showed the obvious implications of sexual function on sexual satisfaction, which should alert healthcare professionals to the importance of identifying and managing sexual dysfunction in patients with chronic kidney disease, to optimize their global and sexual health satisfaction.

STRENGTH & LIMITATIONS

This study identified a high prevalence of sexual dysfunction among kidney transplant recipients. This should reinforce the need for the medical community to evaluate the quality-of-life domains of patients with chronic disease. There is still a lack of information concerning any longitudinal evaluation of kidney transplant patients' sexual function and the effects that this surgery has on sexuality.

CONCLUSIONS

This study corroborated the severe effects that kidney transplant patients often report regarding their sexuality. Among the patients who participated in the study, sexual function proved to be relevant in relation to sexual satisfaction. Mota RL, Fonseca R, Santos JC, et al. Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med 2019;16:1018-1028.

The Relationship Between Body Image and Sexual Functioning Among Gay and Bisexual Men

Gay and bisexual men report high body dissatisfaction compared to heterosexual counterparts, but no studies to date have examined how this may impact their sexual functioning. The present study investigated body image domains as predictors of sexual functioning problems (inhibited desire, erectile dysfunction, and premature ejaculation) among an online community sample of 185 gay and bisexual men, ages 18-40. Participants reported moderate to high body image satisfaction and sexual functioning consistent with previous literature with nonclinical male samples. Overall, the total variance accounted for by regression models was low. Body image variables were not predictive of sexual desire. However, increased drive for muscularity and lower affective body esteem were predictive of erectile difficulties. Additionally, negative behavioral body image in sexual situations and evaluative body dissatisfaction were associated with premature ejaculation. Understanding this relationship may have implications for gay and bisexual men's health and wellbeing. Future research directions are discussed.

Genital Self-Image: Associations with Other Domains of Body Image and Sexual Response

Genital self-image is an emerging aspect of body image relevant to sexual functioning and sexual satisfaction. The aims of the present study were to (1) examine the association between body image and genital self-image with a broad range of sexuality-related outcomes; (2) explore whether genital self-image is a more salient influence on sexual satisfaction and functioning than body image and (3) determine whether this would hold true for both men and women. The analytic sample (6,228 cis-gendered, heterosexual men and women between the ages of 18 and 40) was recruited from reddit.com online communities. Participants completed a survey that assessed genital self-image, body image, sexual satisfaction, and sexual functioning. Among women and men, positive genital self-image was associated with positive feelings about one's body overall and reduced body-related concerns specific to sexual encounters (e.g., sexual performance). In female respondents, as genital self-image increased, so did sexual satisfaction. Although genital self-image did not significantly predict sexual satisfaction among men, exploratory analysis indicated a mediating relationship with body image concerns. Findings from the current study may inform interventions to facilitate the development of a healthy sexual self-concept as well as a more positive outlook on genital appearance among men and women.

Understanding the relationship between BMI and sexual dysfunction: Can DSM-5 shed light into this topic?

INTRODUCTION

The links between body weight and sexuality, notably sexual dysfunction (SD), are intricate and not yet fully understood. A more individual-focused evaluation of sexual difficulties, as recently provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), contributes to improve precision in SD diagnosis and has the potential to advance our knowledge on the association between body weight and SD.

OBJECTIVES

To identify gender differences in sexual behaviors and SD among Portuguese men and women within different classes of body mass index (BMI); and to explore the association between BMI and SD by using the new DSM-5 criteria.

MATERIAL AND METHODS

Face-to-face interviews followed by self-completed questionnaires of primary healthcare users in Portugal (n=323). Data on sociodemographic variables, BMI, sexual behaviors and SD were collected. DSM-5 criteria were used to assess sexual dysfunction. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) for men and women, respectively, were used for comparison purposes.

RESULTS

Overweight and obese women reported less sexual partners, less satisfaction with sexual frequency and rated sexual life as less important. These differences were not found among men. Normal weight men and women had a higher score of IIEF and FSFI, respectively, than those overweight and obese. No significant effects of BMI scale on SD following DMS-5 were detected.

CONCLUSIONS

Women's sexual function is more impacted by BMI than men's. Individual-orientated approaches, as proposed in DSM-5, may allow a better understanding on the relation between body size and sexuality in both genders.

Appearance Dissatisfaction, Body Appreciation, and Sexual Health in Women Across Adulthood

Risk and protective factors are equally important to the promotion of sexual health. Yet, in body image and sexuality research, most of the focus has been placed on the deleterious effects of appearance dissatisfaction and body mass index (BMI) at the expense of more adaptive dimensions. Furthermore, although age can affect appearance and sexual function, little is known regarding the experience of older women. Therefore, this study was aimed at comparing how positive body image (operationalized as body appreciation) and negative body image (operationalized as appearance dissatisfaction) each contribute to indicators of sexual health when controlling for BMI in a sample of age-varied women. Cross-sectional data were collected online from 215 heterosexual women aged 18-88 years. Results showed that body appreciation was a unique predictor of sexual function, satisfaction, and distress, above and beyond the effect of BMI and appearance dissatisfaction. Body appreciation was not found to fluctuate with age. Further, body appreciation moderated the relationship between age and sexual satisfaction, but not sexual distress. Post hoc analyses showed that high body appreciation may serve as a buffer against age-related changes in sexual satisfaction only in women with clinically significant sexual function difficulties. Increasing body appreciation may be a promising clinical intervention in the treatment of sexual problems in older adult women.

Negative Body Attitudes and Sexual Dissatisfaction in Men: The Mediating Role of Body Self-Consciousness During Physical Intimacy

Previous research indicated that negative attitudes about the body and appearance are common among men and demonstrated that negative body attitudes are associated with negative sexual experiences. The present study investigated the association between body attitudes and sexual dissatisfaction and the mediating role of body self-consciousness during physical intimacy. In a cross-sectional design, 201 Dutch men completed an online survey regarding body attitudes toward muscularity, body fat, height, and genitals, body self-consciousness during physical intimacy, and sexual dissatisfaction. Hypotheses were tested using correlation analyses and a mediation analysis with body attitudes as predictors, body self-consciousness as mediator, and sexual dissatisfaction as outcome. Correlation analyses showed that negative body attitudes and body self-consciousness during physical intimacy were significantly related to sexual dissatisfaction. The mediation analysis revealed that negative attitudes toward muscularity, body fat, and genitals had indirect effects on sexual dissatisfaction through body self-consciousness during physical intimacy. Negative attitudes toward genitals additionally had a direct effect on sexual dissatisfaction. These findings indicate that body image interventions focused on male body attitudes may be beneficial in improving men's body image, which may ultimately increase sexual satisfaction.

Sexual satisfaction following bariatric surgery: A prospective exploratory study

INTRODUCTION

Bariatric surgery improves sexual function in obese individuals, although the extent to which sexual satisfaction is improved following surgery is unknown. The aims of this study were 1) to describe sexual satisfaction in severely/morbidly obese men and women candidates for bariatric surgery; 2) to assess the effects of bariatric surgery on sexual satisfaction at 12-months follow-up; and 3) to assess whether weight changes at follow-up following bariatric surgery are associated with changes in sexual satisfaction.

METHODS

We conducted a prospective observational study from February 2011 to June 2014. A total of 44 patients with severe/morbid obesity participated in the study. Sexual satisfaction was assessed (at baseline and 12-months follow-up) through the Index of Sexual Satisfaction (ISS) questionnaire.

RESULTS

Of 44 patients who completed the ISS at baseline (mean age 40.3 [SD=9.4] years and BMI 46.9 [SD=6.2] kg/m²), 17 were lost to follow-up. The baseline ISS total scores were 32.0 (SD=20.1) in women and 24.4 (SD=16.0) in men (P>0.05). The proportion of sexually satisfied men and women at baseline was 62.5% and 46.4%, respectively (P=0.360). At follow-up, sexual satisfaction improved significantly in women (average difference 13.7 units; P=0.032) but not in men (average difference 3.6 units; P=0.717). The percentage of women with sexual satisfaction problems was reduced by 33% at follow-up (P=0.038).

CONCLUSIONS

A relatively large percentage of severely/morbidly obese women and men present clinically significant sexual satisfaction problems before undergoing bariatric surgery. Sexual satisfaction improves significantly 12 months following bariatric surgery, particularly in women.

Investigating the Relation between Women's Body Image and Unconsummated Marriage

BACKGROUND

Unconsummated marriage is considered to be one of the complicated sexual issues that lead to multiple complications and problems for couples as well as the society. It is thought that this disorder is more common in traditional cultures and some religions such as Islam, Hinduism, and Judaism. The aim of this study was to determine the relation between women's body image and unconsummated marriage.

MATERIALS AND METHODS

This was a case-control study which was conducted among 50 women who had an unconsummated marriage (case group) and 100 women who had a consummated marriage (control group) in Isfahan, Iran during 2015-2016. Data were collected using the Multidimensional Body-Self Relations Questionnaire (MBSRQ). The data were analyzed using descriptive and inferential statistical tests.

RESULTS

The total score of body image and all its components had no significant difference between both the groups of the case and the control (P > 0.05).

CONCLUSIONS

Considering that no relation was found between body image and unconsummated marriage and the religious culture of the Iranian society with conservative sexual norms, investigating unconsummated marriage with emphasis on cultural factors is recommended. Hence, such sexual disorders would be avoided and the number of affected people and challenges can be decreased.

Repressive coping among British college women: A potential protective factor against body image concerns, drive for thinness, and bulimia symptoms

Repressive coping, as a means of preserving a positive self-image, has been widely explored in the context of dealing with self-evaluative cues. The current study extends this research by exploring whether repressive coping is associated with lower levels of body image concerns, drive for thinness, bulimic symptoms, and higher positive rational acceptance. A sample of 229 female college students was recruited in South London. Repressive coping was measured via the interaction between trait anxiety and defensiveness. The results of moderated regression analysis with simple slope analysis show that compared to non-repressors, repressors reported lower levels of body image concerns, drive for thinness, and bulimic symptoms while exhibiting a higher use of positive rational acceptance. These findings, in line with previous evidence, suggest that repressive coping may be adaptive particularly in the context of body image.