Relationship Involving Sexual Function, Distress Symptoms of Pelvic Floor Dysfunction, and Female Genital Self-Image

Arruda, Guilherme Tavares de; Paines, Gabrielle Peres; Silva, Bianca Rangel da; Pairé, Lauren Xavier; Pivetta, Hedioneia Maria Foletto; Braz, Melissa Medeiros; Virtuoso, Janeisa Franck

doi:10.1055/s-0043-1772474

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Revista Brasileira de Ginecologia e Obstetrícia

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Sumário

Original Article, Sexology • Rev Bras Ginecol Obstet 45 (9) • 2023 • https://doi.org/10.1055/s-0043-1772474 copy

Relationship Involving Sexual Function, Distress Symptoms of Pelvic Floor Dysfunction, and Female Genital Self-Image

Relação entre função sexual, incômodo dos sintomas de disfunção do assoalho pélvico e autoimagem genital feminina

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To assess the relationship involving sexual function (SF), the distress symptoms caused by pelvic floor dysfunction (PFD), and female genital self-image (GSI).

Materials and Methods

We assessed the GSI, SF and PFD distress symptoms by the Female Genital Self-Image Scale (FGSIS), the Female Sexual Function Index (FSFI), and the Pelvic Floor Distress Inventory (PFDI-20) respectively. Data were analyzed by multiple linear regression.

Results

Among the 216 women (age: 50.92 ± 16.31 years) who participated in the study, 114 were sexually active in the previous 4 weeks. In the total sample (p < 0.001; adjusted R² = 0.097) and among sexually active women (p = 0.010; adjusted R² = 0.162), the distress symptoms caused by pelvic organ prolapse (POP) were related to the GSI. Among sexually active women, sexual desire also was related to the GSI (p < 0.001; adjusted R² = 0.126).

Conclusion

The findings of the present study provide additional knowledge about female GSI and suggest that SF and POP distress symptoms should be investigated together with the GSI in the clinical practice.

Keywords
women; sexual function; pelvic floor dysfunction; genital self-image

Characteristics		Total sample(n = 216): mean ± SD or n (%)	Sexually active women (n = 114):mean ± SD or n (%)
Age (years)		50.92 ± 16.31	43.91 ± 14.60
Schooling (years)		10.86 ± 5.83	12.02 ± 5.21
Skin color
	White	149 (68.98)	79 (69.30)
	Black	17 (7.87)	12 (10.53)
	Brown	43 (19.91)	19 (16.67)
	Other	07 (3.24)	04 (3.50)
Body mass index (kg/m²)		27.49 ± 7.04	26.60 ± 6.75
Smoker
	No	196 (90.74)	102 (89.47)
	Yes	20 (9.26)	12 (10.53)
Number of pregnancies		2.44 ± 1.84	1.89 ± 1.52
Number of vaginal deliveries		1.40 ± 1.69	0.97 ± 1.39
Number of cesarean sections		0.70 ± 1.00	0.68 ± 0.98
Number of abortions		0.35 ± 0.68	0.26 ± 0.58
Episiotomy
	No	119 (55.09)	68 (59.65)
	Yes	95 (43.98)	46 (40.35)
Do not remember		02 (0.93)	0
Physical activity
	No	126 (58.33)	64 (56.14)
	Yes	90 (41.67)	50 (43.86)
Genital self-image		22.37 ± 4.25	22.95 ± 3.81
Sexual desire		–	3.55 ± 1.23
Arousal		–	4.21 ± 1.28
Lubrication		–	4.97 ± 1.30
Orgasm		–	4.71 ± 1.40
Sexual satisfaction		–	5.11 ± 1.23
Pain		–	5.09 ± 1.30
Overall sexual function		–	27.65 ± 6.41
Distress symptoms
	Pelvic organ prolapse	10.82 ± 17.17	9.10 ± 12.84
	Anorectal	16.07 ± 19.00	13.92 ± 16.09
	Urinary	19.79 ± 25.16	16.04 ± 21.08
	Pelvic floor dysfunction	46.69 ± 52.44	39.07 ± 39.21

		Genital self-image
		Total sample (n = 216)		Sexually active women (n = 114)
		rho	R²	rho	R²
Sexual desire		–	–	0.338^ p < 0.001.	0.114
Arousal		–	–	0.374^ p < 0.001.	0.140
Lubrication		–	–	0.089	0.008
Orgasm		–	–	0.303^* * p < 0.05;	0.092
Sexual satisfaction		–	–	0.264^* * p < 0.05;	0.070
Pain		–	–	0.275^* * p < 0.05;	0.076
Overall sexual function		–	–	0.377^ p < 0.001.	0.142
Distress symptoms
	Pelvic organ prolapse	-0.284^ p < 0.001.	0.081	-0.239^* * p < 0.05;	0.057
	Anorectal	-0.202^* * p < 0.05;	0.041	-0.131	0.017
	Urinary	-0.287^ p < 0.001.	0.082	-0.232^* * p < 0.05;	0.054
	Pelvic floor dysfunction	-0.293^ p < 0.001.	0.086	-0.241^* * p < 0.05;	0.058

			Total sample (n = 216)
Variables		Non-standardized beta	Standardized beta	t	p	R²	ΔR²
Distress symptoms
Pelvic organ prolapse		-0.079	-0.317	-4.898	< 0.001	0.097	0.101
Anorectal		-0.001	–	-0.012	0.991	0.001	–
Urinary		-0.109	–	-1.318	0.189	0.090	–
Pelvic floor dysfunction		-0.125	–	-0.976	0.330	0.67	–
				Sexually active women (n = 114)
Variables		Non-standardized beta	Standardized beta	t	p	R²	ΔR²
Sexual desire		1.059	0.343	3.976	< 0.001	0.126	–
Arousal		0.198	–	1.545	0.125	0.145	–
Orgasm		0.138	–	1.257	0.211	0.118	–
Sexual satisfaction		0.148	–	1.322	0.189	0.125	–
Pain		0.143	–	1.492	0.138	0.140	–
Overall sexual function		0.182	–	1.270	0.207	0.120	–
Distress symptoms
	Pelvic organ prolapse	-0.067	-0.226	-2.617	0.010	0.162	0.051
	Urinary	-0.099	–	-1.098	0.275	-0.104	–
	Pelvic floor dysfunction	-0.162	–	-1.818	0.072	-0.170	–

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[1] Address for correspondence Guilherme Tavares de Arruda Universidade Federal de São Carlos São Carlos, SP Brazil (e-mail: gui_tavares007@hotmail.com).