Interrelation Between Appearance Anxiety and Sexual Functions in Women: The Role of Surgical Scars, Morphologic Features, and Accompanying Depression

Abstract

IntroductionThe findings regarding the association between body mass index (BMI) and sexuality outcomes are mixed. Subjective body image has been found to be more salient in predicting sexual function than actual body size. Previous studies have demonstrated appearance anxiety to be particularly significant. AimTo evaluate the association between appearance anxiety and female sexual functions. Specific aims included the evaluation of body morphologic measurements with indicators other than BMI and determining the predictive role of surgical scars for appearance anxiety and female sexual function. MethodsSexually active women who had been in a stable heterosexual relationship for ≥6 months participated in this study. Demographic features, anthropometric measurements including BMI, skin-fold thickness (SFT) measurements from 3 regions of the body (triceps, scapula, and abdomen) and waist circumference (WC) were assessed. Finally, participants were asked to complete the Appearance Anxiety Inventory, Female Sexual Function Index, and Beck Depression Inventory. Multivariate path analyses and hierarchical multiple regression analyses were performed. Main Outcome MeasuresThe correlations of age, BMI, presence of surgical scars, and measurements of BMI, WC, and SFT as independent variables with Beck Depression Inventory, Appearance Anxiety Inventory, and Female Sexual Function Index scores were the main outcomes of the study. ResultsThe data of 329 women were analyzed. The median age of the participants was 33 (19–52) years. The mean BMI was 24.5 (SD 3.5) kg/m2. The prevalence of female sexual dysfunction was 22.8%. Multivariate analyses revealed that increased appearance anxiety (−0.45), presence of surgical scars (−0.28), accompanying depression (−0.15), SFT abdomen measurement (−0.16), and age (−0.13) were significantly associated with sexual function. Appearance anxiety was found to be associated with accompanying depression (0.56), presence of surgical scar (0.38), and measurements of the WC (0.22), BMI (0.14), SFT-abdomen (0.12), and SFT-triceps (−0.31). Clinical ImplicationsClinicians should take the strong relationship between appearance anxiety and female sexual function into consideration. Body morphologic evaluation should not be limited to BMI; surgical scars and WC and SFT measurements may play a considerable role. Strengths & LimitationsA major limitation of this study was the lack of personal distress evaluation in the participants. ConclusionSexual complaints in middle-aged women revealed the strongest correlation with appearance anxiety. Further longitudinal studies are needed to reveal its underlying factors and implications for sexuality.Cihan A, Cihan E. Interrelation Between Appearance Anxiety and Sexual Functions in Women: The Role of Surgical Scars, Morphologic Features, and Accompanying Depression. J Sex Med 2019;16:1769–1778.