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Pinto J, Cera N, Pignatelli D. Psychological symptoms and brain activity alterations in women with PCOS and their relation to the reduced quality of life: a narrative review. J Endocrinol Invest 2024; 47:1-22. [PMID: 38485896 PMCID: PMC11196322 DOI: 10.1007/s40618-024-02329-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/03/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common feminine endocrine disorder, characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. The negative impact of symptoms on the quality of life (QoL) of patients is still not clear. PURPOSE The present review aimed at studying the impact of the symptoms, the psychological symptoms, and brain alterations in women with PCOS. METHODS A systematic search was undertaken for studies that assessed the impact of PCOS symptoms on QoL, psychological symptoms, and brain alterations in PCOS patients. RESULTS Most of the information about QoL came from psychometric studies, which used culture-based questionnaires. Alterations of sleep quality, body image, and mood disorders can negatively affect the QoL of the patients. Sexual satisfaction and desire were affected by PCOS. Brain imaging studies showed functional alterations that are associated with impairments of visuospatial working memory, episodic and verbal memory, attention, and executive function. CONCLUSIONS Several factors can negatively influence the quality of life of the patients, and they are directly related to hyperandrogenism and the risk of infertility. In particular, obesity, hirsutism, acne, and the fear of infertility can have a direct impact on self-esteem and sexual function. Metabolic and psychiatric comorbidities, such as mood, anxiety, and eating disorders, can affect the well-being of the patients. Moreover, specific cognitive alterations, such as impairments in attention and memory, can limit PCOS patients in a series of aspects of daily life.
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Affiliation(s)
- J Pinto
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135, Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - N Cera
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135, Porto, Portugal
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisbon, Portugal
| | - D Pignatelli
- Department of Endocrinology, Centro Hospitalar Universitário de São João, 4200-319, Porto, Portugal.
- Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal.
- Department of Biomedicine, Faculty of Medicine at University of Porto, Porto, Portugal.
- IPATIMUP Research Institute, Porto, Portugal.
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Aspis M, Gewirtz-Meydan A. I'm sexy and I know it: Exploring the moderating role of sexual motivations in the relationship between sexual self-esteem and sexual functioning in Israeli adults. JOURNAL OF SEX RESEARCH 2024:1-11. [PMID: 38315823 DOI: 10.1080/00224499.2024.2306478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This study investigated the relationship between sexual self-esteem and sexual functioning while exploring the moderating role of sexual motives, thereby contributing to a deeper comprehension of factors that affect sexual well-being. The study used a convenience sample of 781 Israeli adults with a mean age of 31.2. Participants completed the sexual self-esteem subscale of the Multidimensional Sexuality Questionnaire, Female Sexual Function Index (for women), International Index of Erectile Function (for men), and Sexual Motives Scale, which assesses motives of self-enhancement, intimacy, self-affirmation, coping, partner approval, and peer pressure. A moderation model examined the role of these sexual motives in the association between sexual self-esteem and sexual functioning. The analysis indicated that higher sexual self-esteem and motivation for intimacy and enhancement were associated with better sexual functioning. The study also revealed that participants' motivation for partner approval and peer pressure moderated the association between sexual self-esteem and sexual functioning. Participants with low motivation for partner approval showed an association between higher sexual self-esteem and greater sexual function, while participants with high motivation for partner approval did not show this association. For peer pressure, the association between higher sexual self-esteem and greater sexual function was strongest for participants who experienced high peer pressure as a sexual motive. Higher sexual self-esteem was associated with better sexual functioning, regardless of peer pressure level, but the association was stronger for participants experiencing high peer pressure. The study results shed light on the connection between sexual self-esteem, sexual motivations, and sexual functioning. Clinically, interventions for addressing sexual functioning should consider both self-esteem and sexual motivations.
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Affiliation(s)
- Michali Aspis
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa
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Moon N, Kang H, Heo SJ, Kim JH. Factors affecting the safe sexual behaviors of Korean young adults by gender: a structural equation model. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2023; 29:115-127. [PMID: 37415480 DOI: 10.4069/kjwhn.2023.06.16] [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: 02/27/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023] Open
Abstract
PURPOSE The aim of this study was to determine the factors that influence safe sexual behaviors of Korean young adults and identify differences by gender. METHODS This study aimed to determine which factors affected safe sexual behaviors based on the Theory of Planned Behavior. Data from 437 Korean young adults (in their 20s and 30s) were collected via online survey between January 3 and January 28, 2022. The questionnaire included items on sexual body image, sexual role perception, sexual attitudes, sexual socialization, sexual communication, and safe sexual behaviors. Structural equation modeling was performed. RESULTS According to the overall model fit of the hypothetical model, the final model was acceptable and explained 49% of safe sexual behaviors. Sexual attitudes (β=-.70, p<.001) and sexual communication (β=.53, p<.001) directly affected safe sexual behaviors, and sexual role perception (β=.42, p<.001) indirectly affected safe sexual behaviors in a combined model. There were gender differences in the path from sexual attitudes (β=-.94, p<.001) and sexual communication (β=.66, p<.001) to safe sexual behaviors and from sexual body image (β=.27, p<.001) to sexual communication. CONCLUSION Sexual attitudes and sexual communication were predictors of safe sexual behaviors, which differed by gender. Strategies that consider sexual attitudes, sexual communication, sexual role perception, and differences between men and women should be developed to improve the safe sexual behaviors of young adults.
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Affiliation(s)
- Nalae Moon
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Hyunjin Kang
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Su Ji Heo
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Ju Hee Kim
- College of Nursing Science, Kyung Hee University, Seoul, Korea
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Husain FS, Lulla D, Tay TKC, Lee JJM, Dhaliwal SS, Ang SB. Association between body mass index, body image and self-esteem with sexual function: A survey of young women in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:190-198. [PMID: 38904532 DOI: 10.47102/annals-acadmedsg.2022358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women. Method A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55). Results BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78). Conclusion Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.
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Affiliation(s)
- Farah Safdar Husain
- Department of Family Medicine, KK Women and Children's Hospital, Singapore
- SingHealth Polyclinics, Singapore
| | - Dypti Lulla
- Department of Family Medicine, KK Women and Children's Hospital, Singapore
| | | | - Jean-Jasmin Ml Lee
- Department of Family Medicine, KK Women and Children's Hospital, Singapore
| | - Satvinder Singh Dhaliwal
- Duke-NUS Medical School, Singapore
- Singapore University of Social Sciences, Singapore
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Western Australia, Australia
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Seng Bin Ang
- Department of Family Medicine, KK Women and Children's Hospital, Singapore
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Kong LV, Goh PH, Ting RSK. Bidimensional self-esteem and sexual functioning among Malaysian young adults: the moderating role of relationship status. PSYCHOLOGY & SEXUALITY 2022. [DOI: 10.1080/19419899.2022.2053564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Li Voon Kong
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Pei Hwa Goh
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Rachel Sing-Kiat Ting
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Spivak-Lavi Z, Gewirtz-Meydan A. Eating Disorders and Sexual Satisfaction: The Mediating Role of Body Image Self-consciousness during Physical Intimacy and Dissociation. JOURNAL OF SEX RESEARCH 2022; 59:344-353. [PMID: 34269636 DOI: 10.1080/00224499.2021.1948491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Women with eating disorders experience difficulties related to sexual activity, yet little is known about the indirect association between eating disorders and sexual satisfaction. This study examined the indirect association between eating disorders and sexual satisfaction using body image self-consciousness during physical intimacy and dissociation as mediators. Online questionnaires were answered by 985 Israeli women. Of them, 98 were identified as likely to have eating disorders (study group). A matching control group (n = 98) was selected from the remaining respondents. Participants in the study group had significantly higher body image self-consciousness and dissociation than the matched controls, as well as significantly lower sexual satisfaction. The research model revealed that body image self-consciousness during physical intimacy mediates the link between eating disorders and sexual satisfaction, while dissociation does not. Women with eating disorders have higher levels of self-consciousness about their body during sexual activity, which may distract them from their own sexual needs and desires and those of their partners, and this, in turn, is associated with sexual dissatisfaction. Findings highlight the need for improved evidenced-based assessment and management of the sexual satisfaction of women with eating disorders.Abbreviations: ED: eating disorders; AN: anorexia nervosa; BN: bulimia nervosa; BED: binge eating disorder.
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Affiliation(s)
- Zohar Spivak-Lavi
- Faculty of Social Work & Faculty of Education, Max Stern Yezreel Valley College
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Gewirtz-Meydan A, Mitchell KJ, Spivak-Lavi Z. Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women. J Sex Med 2021; 18:1245-1257. [PMID: 37057421 DOI: 10.1016/j.jsxm.2021.04.012] [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: 11/14/2020] [Revised: 04/13/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Despite studies showing that individuals with insecure attachment suffer from poor body image, and that poor body image is a main risk factor for sexual dysfunction, the mediating role of body image between attachment insecurities and sexual functioning has not been assessed. Moreover, differences in body self-consciousness among sexual minority women have not been examined, even though LGB individuals have been found to be more conscious of stigma and the disapproval of others. AIM To fill this gap, the current study examines the mediating role of body image self-consciousness between insecure attachment and sexual functioning among LGB and non-LGB women. METHODS The study sample consisted of 1,001 women; of them, 808 defined themselves as heterosexual (80.7%), and 193 (19.3%) identified as LGB. The sample was a convenience sample of women who responded to ads on social media. Participants completed an online questionnaire (via Qualtrics) about their attachment orientation, body-image self-consciousness, and sexual functioning. MAIN OUTCOME Body image self-consciousness mediated the relationship between insecure attachment and sexual dysfunction among women in general and LGB women in particular. RESULTS Results indicated that among LGB women, the relationship between attachment and sexual functioning was fully mediated by body image self-consciousness. For non-LGB women, a full model with statistically significant direct and indirect effects was revealed. Both avoidant attachment and anxious attachment were related to body image self-consciousness which was, in turn, related to sexual functioning. A statistically significant direct path from avoidant attachment to sexual functioning was also revealed. CONCLUSION The study findings contribute to the literature by revealing the mediating role that body image self-consciousness plays between insecure attachment and sexual dysfunction among women in general and LGB women in particular. CLINICAL IMPLICATIONS This study provides support for the negative relationship between body image self-consciousness and sexual functioning of women regardless of sexual orientation, and suggests that women affected by body image concerns might be prone to more sexual dysfunction. Therefore, body image self-consciousness should be brought up in sex therapy sessions and future interventions. Clinicians should also be cognizant of differences between LGB and non-LGB women in terms of this effect, taking into account the history of stigma that LGB women may have endured and how this history affects their body image. Gewirtz-Meydan A, Mitchell KJ, Spivak-Lavi Z. Attachment and Sexual Functioning: Understanding the Mediating Role of Body Image Among LGB and Non-LGB Women. J Sex Med 2021;18:1245-1257.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel. Agewirtz-@univ.haifa.ac.il
| | - Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, NH, USA
| | - Zohar Spivak-Lavi
- Faculty of Social Work & Faculty of Education, Max Stern Yezreel Valley College, Emek Yezreel, Israel
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