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da Silva EV, Braz MM, Pivetta HMF. Reasons for Genital Dissatisfaction in a Sample of Brazilian Men. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1463-1471. [PMID: 38396167 DOI: 10.1007/s10508-024-02818-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 01/15/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
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.
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Affiliation(s)
- Erisvan Vieira da Silva
- Postgraduate Program in Movement and Rehabilitation Sciences, Federal University of Santa Maria, Avenida Roraima, 1000, Camobi, Santa Maria, Rio Grande Do Sul, 97105-900, Brazil.
| | - Melissa Medeiros Braz
- Department of Physiotherapy and Rehabilitation, Federal University of Santa Maria, Santa Maria, Rio Grande Do Sul, Brazil
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Koçak V, Aksoy YE. Female genital self-image and body appreciation in Turkish women: a mixed methods study. Arch Womens Ment Health 2024; 27:219-232. [PMID: 38006426 DOI: 10.1007/s00737-023-01397-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
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.
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Affiliation(s)
- Vesile Koçak
- Nursing Faculty, Necmettin Erbakan University, Konya, Turkey.
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Kvalem IL, Dahr Nygaard IM, Træen B, Ivanova A, Dahlgren CL. Menstrual attitudes in adult women: A cross-sectional study on the association with menstruation factors, contraceptive use, genital self-image, and sexual openness. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241249553. [PMID: 38682834 PMCID: PMC11060024 DOI: 10.1177/17455057241249553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Menstruation is a central part of the everyday life of most women, and menstrual attitudes may impact health and well-being. OBJECTIVES This article aimed to map menstrual attitudes among adult women and examine factors associated with these attitudes, such as aspects of menarche and current menstruation, and rarely studied factors, such as genital self-image and sexual openness. STUDY DESIGN A cross-sectional online survey. METHOD A sample of 1470 women, aged 18-50 years, were recruited through social media sites. The Menstrual Self-Evaluation Scale was used to measure three different attitudes: menstruation as natural, shameful, and bothersome. Multiple linear regression analysis was used to investigate the relationship between each attitude and factors related to menarche and current menstruation, contraceptive use, genital self-image (assessed by Female Genital Self-Image Scale), and sexual openness (Personal Comfort with Sexuality Scale). Sociodemographic variables were included into the models as covariates. RESULTS Agreeing with the attitude of menstruation as something natural was predicted primarily by positive emotions at menarche, experiencing less menstrual pain, using no or nonhormonal contraception, and having a positive genital self-image. Perceiving menstruation as bothersome was predicted by a lower educational level, experiencing stronger menstrual pain, having more perimenstrual psychological symptoms, and using hormonal contraceptives. Menstruation as something shameful was chiefly predicted by lower sexual openness and a negative genital self-image. CONCLUSION Many women held attitudes about menstruation as both something natural and bothersome. Menarche and current menstruation experiences, and contraceptive method, played central roles in shaping attitudes toward menstruation as natural and bothersome. Viewing menstruation as shameful stood out from other attitudes by indicating a triad of self-objectified shame that includes menstruation, sexuality, and genital self-image. Further research into the relationships between menstruation, contraceptive use, sexuality, and body image is needed to enhance our understanding of women's menstrual health.
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Affiliation(s)
| | | | - Bente Træen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Anna Ivanova
- Department of Psychology, University of Oslo, Oslo, Norway
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Acar Bektaş H, Öcalan D. The relationship between women's mode of delivery, body image, self-respect, and genital self-image. Int Urogynecol J 2023; 34:2885-2892. [PMID: 37530801 DOI: 10.1007/s00192-023-05610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023]
Abstract
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.
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Affiliation(s)
- Hatice Acar Bektaş
- Faculty of Health Science, Midwifery Department, Tokat Gaziosmanpaşa University, Tokat, Turkey.
| | - Dilek Öcalan
- Faculty of Health Science, Midwifery Department, Tokat Gaziosmanpaşa University, Tokat, Turkey
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Alavi-Arjas F, Goodman MP, Simbar M, Alavi Majd H, Nahidi F. The strength of correlation between female genital self-image and sexual function: a systematic review and meta-analysis. J Sex Med 2023; 20:1376-1383. [PMID: 37814530 DOI: 10.1093/jsxmed/qdad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/24/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Mounting evidence indicates that female genital aesthetic complaints impact sexual relationships. AIM The study sought to determine the strength of the correlation between genital self-image and sexual function. METHODS Electronic databases were comprehensively searched including PubMed, Web of Science, Scopus, PsycINFO, Embase, and the Cochrane Library from January 2000 to December 2022. After duplicate removal, 146 articles were retrieved by searching keywords in titles and abstracts. OUTCOMES A positive correlation is noted between genital self-image and sexual function; the strength of this correlation was 0.375. RESULTS By omitting irrelevant articles according to the eligibility criteria, 16 articles remained for a total of 13 505 participants. All but 1 of them indicated a statistically significant positive correlation between genital self-image and sexual function. For a more accurate result, a meta-analysis was conducted noting a considerable heterogeneity. CLINICAL IMPLICATIONS The results of this study may be used in counseling women with sexual dysfunction who are dissatisfied with their genital appearance. STRENGTHS AND LIMITATIONS This study is the first systematic review to reveal the strength of the correlation between genital self-image and sexual function. The most important limitation of this study is the heterogeneity of the studies reported. CONCLUSION This systematic review indicates a positive correlation between genital self-image and sexual function. The results are restricted by inconsistency of the articles considered. Using different tools in different cultural contexts without considering confounding factors leads to a wide range of correlation sizes and significant heterogeneity is evident.
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Affiliation(s)
- Fatemeh Alavi-Arjas
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Michael P Goodman
- Department of Obstetrics and Gynecology, California Northstate University College of Medicine, Elk Grove CA 95757, United States
- The Labiaplasty and Vaginoplasty Training Institute of America, Winters, CA 95694, United States
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, 1971653313, Iran
| | - Fatemeh Nahidi
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, 1996835119, Iran
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Malary M, Hamzehgardeshi Z, Keramat A, Yunesian M, Farjamfar M. Psychosexual counseling intervention to improve women's genital self-image: Study protocol for a randomized controlled trial based on a multistage mixed method design. Health Sci Rep 2023; 6:e1720. [PMID: 38028697 PMCID: PMC10665641 DOI: 10.1002/hsr2.1720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background Genital self-image (GSI) is a major barrier to reproductive and sexual health for women. This practical randomized trial aims to evaluate the effect of psychosexual counseling based on a cognitive-behavioral approach to promoting GSI for reproductive-age married Iranian women. Methods Married women aged 15-49 years under the coverage of health centers will be invited to join the study. The study will be conducted using a multistage mixed method design in three phases. In the first phase, semi-structured interviews with women and key informants will be conducted to understand better the GSI concept, the factors influencing it, and the interventions promoting it. Simultaneously, a literature review will be conducted by searching electronic databases to find the factors influencing GSI and the interventions to enhance it.In the second phase, the GSI-related factors, sexual and reproductive health outcomes correlated with GSI, and intervention programs for promoting GSI in women will be extracted from the integration of qualitative study and literature review. Then, based on the expert panel's priority, a suitable program will be prepared.In the third phase, at first, a cross-sectional study will be conducted to identify women with poor GSI and the factors relating to GSI, and then psychosexual counseling intervention will be performed. For the randomized controlled trial study, participants will be randomly allocated into two groups: (1) the intervention group and (2) the control group. Data will be collected using the Female Genital Self-Image Scale and sexual and reproductive health outcomes correlated with GSI at baseline, immediate, and 2-month follow-up assessments. The impact of the intervention on the promotion of GSI will be evaluated. Discussion This study provides a counseling program for promoting GSI. If this interventional program is successful, it has practical potential to be generalized for Iranian Women with poor GSI.
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Affiliation(s)
- Mina Malary
- Student Research Committee, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| | - Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
- Department of Reproductive Health and MidwiferyMazandaran University of Medical SciencesSariIran
| | - Afsaneh Keramat
- Department of Reproductive Health and Midwifery, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| | - Masoud Yunesian
- Department of Research Methodology and Data Analysis, Institute for Environmental ResearchTehran University of Medical SciencesTehranIran
- Department of Environmental Health Engineering, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Maryam Farjamfar
- Clinical Research Development Unit, Imam Hossein HospitalShahroud University of Medical SciencesIran
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Sharp G, Fernando AN. Genital body image education in young adolescent girls: A proof of concept pilot study. Body Image 2023; 45:318-322. [PMID: 37031615 DOI: 10.1016/j.bodyim.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/12/2023] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
Our research team previously developed a brief educational video aimed at increasing adolescent girls' knowledge of the variation in cisgender female genital appearance and improving attitudes towards genital appearance. This video was efficacious with 16-18-year-old girls, but their feedback suggested that younger girls may gain greater benefit. Owing to the younger age group and sensitivity of the topic, we undertook a small pilot study, using a mixed methods approach (quantitative followed by qualitative study phase), to explore the understanding of 13-15-year-old girls of their genital anatomy and body image, and their impressions of the video. The sample (N = 6) showed, on average, low-to-moderate levels of genital anatomical knowledge and genital appearance satisfaction. In qualitative interviews, thematic analysis showed girls had received limited genital-related sexual education and had not considered genitals to be part of their concept of body image. However, after watching the video, they reported an appreciation of the diversity in genital appearance and encouraged use of the video in schools to prompt discussions about genital body image. There are broader implications of this research, namely, that the education of girls about the diversity in genital appearance could be important in improving their future gynaecological and sexual well-being.
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Affiliation(s)
- Gemma Sharp
- Department of Neuroscience, Monash University, Melbourne, Victoria 3004, Australia.
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van Dongen J, de Heus E, Eickholt L, Schrieks M, Zantingh I, Brouwer OR, Oonk MHM, Grotenhuis BA, Ezendam NPM, Duijts SFA. Challenges and controversies patients and (health care) professionals experience in managing vaginal, vulvar, penile or anal cancer: The SILENCE study. Eur J Cancer Care (Engl) 2022; 31:e13676. [PMID: 35938519 PMCID: PMC9787908 DOI: 10.1111/ecc.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/23/2022] [Accepted: 07/28/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Patients with vaginal, vulvar, penile or anal cancer experience deteriorated psychosocial functioning and decreased Quality of Life (QoL). The aims of this study were to explore (1) the challenges and controversies patients experience in managing vaginal, vulvar, penile or anal cancer; their unmet needs; and how this affects their psychosocial functioning and (2) the gaps health care professionals (HCPs) experience in providing psychosocial support and potential improvements in care. METHODS Semi-structured interviews with patients with vaginal, vulvar, penile or anal cancer and with HCPs were conducted. All interviews were transcribed verbatim and thematically analysed. RESULTS Fourteen patients (86% female; mean age 55.5) and 12 HCPs (75% female; mean age 46.4) participated. Four themes were identified: (1) recognisable symptoms but unfamiliar diagnosis, (2) 'double hit' has severe impact on psychosocial functioning, (3) personal and tailored information is important but not guaranteed and (4) all-encompassing care to improve psychosocial functioning and QoL. CONCLUSION Patients with vaginal, vulvar, penile or anal cancer encounter a lack of awareness and knowledge about their rare cancer type, difficulties regarding communication and long-term changes in body image and sexuality. Awareness of symptoms should be raised and psychosocial care should be offered on a structural basis.
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Affiliation(s)
- Jessy van Dongen
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL)UtrechtNetherlands
| | - Eline de Heus
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL)UtrechtNetherlands,Department of Medical OncologyRadboud University Medical CenterNijmegenNetherlands
| | - Lauren Eickholt
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL)UtrechtNetherlands
| | - Marga Schrieks
- Dutch Federation of Cancer Patients Organisations (Nederlandse Federatie van Kankerpatiëntenorganisaties, NFK)UtrechtNetherlands
| | - Ilaniek Zantingh
- Center for Quality of LifeThe Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital (NKI‐AvL)AmsterdamThe Netherlands
| | - Oscar R. Brouwer
- Department of UrologyThe Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital (NKI‐AvL)AmsterdamNetherlands
| | - Maaike H. M. Oonk
- Department of Obstetrics and GynecologyUniversity Medical Center GroningenGroningenNetherlands
| | - Brechtje A. Grotenhuis
- Department of Surgical OncologyThe Netherlands Cancer Institute – Antoni van Leeuwenhoek (NKI‐AvL)AmsterdamNetherlands
| | - Nicole P. M. Ezendam
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL)UtrechtNetherlands,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgNetherlands
| | - Saskia F. A. Duijts
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (Integraal Kankercentrum Nederland, IKNL)UtrechtNetherlands,Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamNetherlands
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Ozcan S. Relationship Between the Genital Self-Image and the Sexual Quality of Life of Primiparous Women in the Postpartum Period in Heterosexual Couples. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:474-482. [PMID: 38596272 PMCID: PMC10903677 DOI: 10.1080/19317611.2022.2038760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/15/2021] [Accepted: 01/31/2022] [Indexed: 04/11/2024]
Abstract
Objectives: This study was planned to investigate the relationship between the genital self-image of primiparae and their sexual quality of life in the postpartum period in heterosexual couples. Method: In this cross-sectional and correlational study, the data were collected through face-to-face interviews in the eastern part of Turkey. Results: The results demonstrated that the relationship between the genital self-image and sexual quality of life of the participants who were sexually active after birth was moderate (r = 0.52, p <.001). Both the genital self-image and sexual quality of life of the participating women were affected by the romantic relationship between them and their partners after birth (p <.01). Conclusions: Healthcare professionals should encourage and support couples to look over their relationship and problems they experience in their romantic relationship after birth.
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Affiliation(s)
- Sadiye Ozcan
- Department of Obstetrics & Gynecological Nursing, Faculty of Health Sciences, Yalova University, Yalova, Turkey
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Yüksekol ÖD, Baltaci N, Yilmaz AN, Ulucan M. Perception of genital self-image, sexual quality of life and marital adjustment in infertile women. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1998422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Özlem Doğan Yüksekol
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Nazli Baltaci
- Department of Nursing, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ayşe Nur Yilmaz
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
| | - Mihriban Ulucan
- Department of Midwifery, Faculty of Health Sciences, Firat University, Elazig, Turkey
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11
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Barrington DJ, Robinson HJ, Wilson E, Hennegan J. Experiences of menstruation in high income countries: A systematic review, qualitative evidence synthesis and comparison to low- and middle-income countries. PLoS One 2021; 16:e0255001. [PMID: 34288971 PMCID: PMC8294489 DOI: 10.1371/journal.pone.0255001] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/07/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is growing recognition of the importance of menstruation in achieving health, education, and gender equality for all. New policies in high income countries (HICs) have responded to anecdotal evidence that many struggle to meet their menstrual health needs. Qualitative research has explored lived experiences of menstruating in HICs and can contribute to designing intervention approaches. To inform the growing policy attention to support people who menstruate, here we review and synthesise the existing research. METHODS AND FINDINGS Primary, qualitative studies capturing experiences of menstruation in HICs were eligible for inclusion. Systematic database and hand searching identified 11485 records. Following screening and quality appraisal using the EPPI-Centre checklist, 104 studies (120 publications) detailing the menstrual experiences of over 3800 individuals across sixteen countries were included. We used the integrated model of menstrual experiences developed from studies in low- and middle-income countries (LMICs) as a starting framework and deductively and inductively identified antecedents contributing to menstrual experiences; menstrual experiences themselves and impacts of menstrual experiences. Included studies described consistent themes and relationships that fit well with the LMIC integrated model, with modifications to themes and model pathways identified through our analysis. The socio-cultural context heavily shaped menstrual experiences, manifesting in strict behavioural expectations to conceal menstruation and limiting the provision of menstrual materials. Resource limitations contributed to negative experiences, where dissatisfaction with menstrual practices and management environments were expressed along with feelings of disgust if participants felt they failed to manage their menstruation in a discrete, hygienic way. Physical menstrual factors such as pain were commonly associated with negative experiences, with mixed experiences of healthcare reported. Across studies participants described negative impacts of their menstrual experience including increased mental burden and detrimental impacts on participation and personal relationships. Positive experiences were more rarely reported, although relationships between cis-women were sometimes strengthened by shared experiences of menstrual bleeding. Included studies reflected a broad range of disciplines and epistemologies. Many aimed to understand the constructed meanings of menstruation, but few were explicitly designed to inform policy or practice. Few studies focused on socioeconomically disadvantaged groups relevant to new policy efforts. CONCLUSIONS We developed an integrated model of menstrual experience in HICs which can be used to inform research, policy and practice decisions by emphasising the pathways through which positive and negative menstrual experiences manifest. REVIEW PROTOCOL REGISTRATION The review protocol registration is PROSPERO: CRD42019157618.
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Affiliation(s)
- Dani Jennifer Barrington
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
- School of Civil Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
| | - Hannah Jayne Robinson
- School of Civil Engineering, University of Leeds, Leeds, West Yorkshire, United Kingdom
| | - Emily Wilson
- Irise International, Sheffield, South Yorkshire, United Kingdom
| | - Julie Hennegan
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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12
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Murina PF, Graziottin A, Bagot O, Panay N, Thamkhantho M, Shaw SW. Real-World Practices and Attitudes Towards Intimate Self- Care: Results From An International Women's Survey. J Gynecol Obstet Hum Reprod 2021; 50:102192. [PMID: 34175471 DOI: 10.1016/j.jogoh.2021.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/23/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Vulvovaginal health is important to women's overall health, fertility, sexuality, self-perception, self-confidence and intimacy. It is important to identify the existing perceptions and levels of knowledge about intimate care practices from women in different countries, and with different cultures, religions, and perspectives to help women overcome barriers to optimal intimate care. METHODS An anonymous online survey about general and intimate hygiene routines/habits was distributed across 10 countries (England, France, Germany, Italy, Portugal, Russia, China, Philippines, Taiwan, Thailand). The sample consisted of around 10,000 women (aged 18 to 60 years) recruited through an online panel. RESULTS The survey indicates that for many women, cleaning the intimate area is not just about hygiene, but also about taking care of themselves. Intimate care practices, performed daily, varies widely among the countries (from 38% to 91%). Italy, Philippines Portugal, Russia and Thailand were the countries with higher percentage. Intimate care is mainly associated with hygiene and health benefit, but interestingly women engage in intimate care more often with age. Most women worldwide are comfortable talking about female genitalia but still consider it a taboo topic, particularly among younger generations. Asian countries continue to carry negative connotations. CONCLUSIONS This survey is the first of its kind for number of women involved in this research and for multi-cultural design. Women perceive that practicing intimate care positively impacts their health and wellbeing. However, intimate care is still not one of the most frequent daily routines for many women.
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Affiliation(s)
- Prof Filippo Murina
- Lower Genital Tract Disease Unit, V. Buzzi Hospital-University of Milan, Milan, Italy.
| | - Alessandra Graziottin
- Center of Gynecology and Medical Sexology, San Raffaele Resnati Hospital, Milan, Italy
| | - Odile Bagot
- Gynecology-Obstetrics private practice, Strasbourg, France
| | - Nick Panay
- Queen Charlotte's & Chelsea and Westminster Hospitals and Imperial College, London, United Kingdom
| | - Manopchai Thamkhantho
- Family Planning and Reproductive Health Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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DeMaria AL, Rivera S, Meier S, Wakefield AL, Long LF, Miller AR. "You have to be clean:" a qualitative study of pubic hair grooming behaviours among women living in Italy. CULTURE, HEALTH & SEXUALITY 2021; 23:593-607. [PMID: 32068497 DOI: 10.1080/13691058.2020.1717631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
The majority of pubic hair and genital self-image research describes women living in the USA, UK and Australia. This may leave attitudes and behaviours across other cultures and geographic regions ambiguous. The purpose of this study was to describe pubic hair removal attitudes and behaviours among reproductive-age women living in Italy. Individual interviews were conducted with 46 women aged 18-45 years between June and July 2017, living in Florence, Italy and currently utilising the Italian healthcare system. Pubic hair removal was popular among participants. Women mainly removed pubic hair by waxing. Sexual partners influenced removal, as did cultural norms and the desire for cleanliness. Most participants indicated pubic hair removal onset during adolescence, often upon puberty. However, most participants had never discussed removal complications with providers. Pubic hair removal often related to a more positive genital self-image because of social norms surrounding hairlessness. Removal among this sample appears to differ from the literature in other contexts, with women living in Italy engaging in more frequent and earlier waxing. Findings offer opportunities for clinicians to proactively address safe pubic hair practices and women's genital concerns during consultations.
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Affiliation(s)
- Andrea L DeMaria
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Sydney Rivera
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Stephanie Meier
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | | | - Laura F Long
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Alyssa R Miller
- Department of Human Development & Family Studies, Purdue University, West Lafayette, IN, USA
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Keramat A, Malary M, Moosazadeh M, Bagherian N, Rajabi-Shakib MR. Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image. BMC Pregnancy Childbirth 2021; 21:87. [PMID: 33499805 PMCID: PMC7836496 DOI: 10.1186/s12884-021-03575-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/19/2021] [Indexed: 01/21/2023] Open
Abstract
Background Pregnancy is a unique period with the increased likelihood of psychological changes and emotional disturbances such as depression, anxiety, and stress. In this study, we investigated the factors influencing depression, anxiety, and stress in pregnancy and identify their associations with Sexual Distress (SD) and Genital Self-Image (GSI). Methods This was a descriptive, correlational, cross-sectional study performed using the two-stage cluster sampling method between September 2019 and January 2020. Overall, 295 pregnant women completed a demographics and obstetric information checklist, Depression Anxiety and Stress Scale-21 (DASS-21), Female Genital Self-Image Scale (FGSI), and Female Sexual Distress Scale-Revised (FSDS-R). Results Analysis of Variance (ANOVA) showed significant differences in the mean scores of SD between the groups with varying degrees of depression, anxiety, and stress (P < 0.001) and in the mean score of GSI between the groups with varying degrees of depression (P = 0.01) and anxiety (P < 0.001). In multivariate linear regression analysis, higher (worse) depression, anxiety, and stress scores were found in women with more advanced age and higher SD scores; however, these scores were lower (better) in those with increased gestational age. Lower depression and anxiety scores were associated with moderate satisfaction with income, moderate satisfaction with BI in pregnancy, and lower stress and depression scores were linked to planned pregnancy. Higher (better) GSI score was a predictor of lower depression score, complication in a previous pregnancy was a predictor of higher stress score, and finally, fear of fetal abortion and being a housewife were predictors of a higher anxiety score. Conclusion Various factors contribute to the development of antenatal depression, anxiety, and stress. A positive correlation was found between SD and the severity of depression, anxiety, and stress, while a negative correlation was noted between GSI and the severity of depression and anxiety. Therefore, raising awareness regarding SD and GSI through screening and counseling sessions can have beneficial effects for mothers and their fetuses. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03575-1.
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Affiliation(s)
- Afsaneh Keramat
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mina Malary
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Haft-e Tir Square, Po Box: 7394736147, Shahroud, Iran.
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.,Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nastaran Bagherian
- Midwifery Counseling, Mazandaran University of Medical Sciences, Sari, Iran
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GENITAL SELF IMAGE IN WOMEN AND AFFECTING FACTORS. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.810985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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