Female Genital Self-Image Scale Score Research Articles

Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes

BackgroundSurgery is the optimal treatment for a severe form of clitoral phimosis (CP) that is initiated by lichen sclerosus (LS) and causes female sexual dysfunction. AimWe aimed to determine the etiology of clitoral phimosis, its influence on sexual function, and outcomes after surgical treatment. MethodsIn this prospective cohort study, we observed the occurrence of clitoral phimosis and related changes in a group of 3,650 sexually active heterosexual women with a mean age of 34.8 ± 14.9 years (20–45 years) from September 2014 to September 2016. Ultimately, we compared the changes in sexual function and distress and satisfaction with postoperative genital appearance in 9 patients with severe clitoral phimosis at 12 months after surgical treatment. Main Outcome MeasuresSexual function was evaluated using the Female Sexual Distress Scale–Revised and the Female Sexual Function Index, and the patient’s genital self-image was evaluated using the Female Genital Self-Image Scale; gynecologic examinations were performed on all patients. ResultsVarious forms of CP were found in 46 of 3,650 patients (1.3%). Severe forms of CP were found in 9 cases, but it was complicated by stenosis of vaginal introitus in only 2 cases. These 9 patients underwent circumcision, and 2 of them underwent perineoplasty. Female sexual dysfunction occurred mainly in those with LS and severe forms of phimosis. Sexual function, as indicated by the total Female Sexual Function Index score, was significantly improved at 12 months after surgery (17.9 ± 0.9 vs 26.6 ± 0.5; P < .001). The Female Genital Self-Image Scale score assessing genital perception was significantly higher after surgery than before in women who underwent clitoral circumcision (20 ± 3.0 vs 12.3 ± 3.3; P < .001). The Female Sexual Distress Scale–Revised score was significantly lower after surgery than before (21.3 ± 6.2 vs 33.8 ± 6.9; P < .001). Sexual function in 2 women with CP and stenosis of vaginal introitus improved after surgery, but the sexual distress level did not decrease significantly. Clinical ImplicationsThe results of this study will help clinicians to centralize treatment methods and advise patients on the management of clitoral phimosis. Strengths & LimitationsThis is a study evaluating postoperative results of sexual function, distress, and satisfaction with genitalia in women with severe CP, using validated questionnaires. However, the small number of patients and the absence of an appropriate control group are limitations. ConclusionSurgical treatment of clitoral phimosis can improve sexual function, but because LS—a common underlying cause—is chronic in nature, patients may experience recurrence.Chmel R, M Nováčková, Fait T, et al. Clitoral Phimosis: Effects on Female Sexual Function and Surgical Treatment Outcomes. J Sex Med 2019;16:257–266.

The Female Genital Self-Image Scale (FGSIS): cross-cultural adaptation and validation of psychometric properties within a Turkish population.

Women's perceived satisfaction from their own genital appearance is linked to genital image and sexual esteem. A comprehensive and easy to use scale to measure self-image was scarce in the literature. It was aimed in the present study to complement cross-culturally adapted and validated into Turkish version of the Female Genital Self-Image Scale (FGSIS) and to assess its psychometric properties. After cross-cultural adaptation, the Turkish version of the FGSI, Female Sexual Distress Scale-Revised (FSDS-R), and Female Sexual Function Index (FSFI) were administered to 461 female participants. Content/face validity, exploratory, and confirmatory factor analysis, internal consistency, and reliability were appropriately assessed. Predefined and specific hypotheses were formulated for construct validity. Our findings indicated excellent content/face validity, sufficient internal consistency (Cronbach's alpha 0.818), and test-retest reliability [intraclass correlation coefficient (ICC) 0.951]. Construct validity was demonstrated by proving the hypothesis that participants who have performed at least one vaginal/clitoral masturbation for the last month reported significantly higher FGSIS scores compared with those who abstained (Z -6.37, p < 0.001). Factor analyses formed one factor structure. In the proposed two-factor construct, all seven items demonstrated good to high correlations with their subdomains and lower correlations with the other domain, indicating sufficient convergent validity. The FGSIS was successfully validated for use in the Turkish population. The scale exhibited strong psychometric properties to assess perceived female genital image. It might be reliably used in genital cosmetic surgeries and in a variety of gynecologic conditions.

Sexual Life of Women With Rokitansky Syndrome After Laparoscopic Vecchietti’s Vaginoplasty

Adequate anatomy and physiology functions of genitalia are fundamental pre-requisites for sexual well-being and reproduction. Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) compromises female sexual life and makes reproduction impossible. The aim of this study is to evaluate the psycho-sexual results of vagina reconstruction in patients with MRKHS using laparoscopic Vecchietti’s technique, to determine their impact on reproductive choices. This study included 42 patients with MRKHS who underwent laparoscopic Vecchietti’s vaginoplasty. Their partners were also interviewed. Forty-five age matched healthy sexual active women as a control group were examined during the same period. A gynecological examination was performed to determine the anatomical outcome. Psycho-sexual functioning was evaluated with the revised Female Sexual Distress Scale-Revised (FSDS-R), the Female Sexual Function Index (FSFI) and semi-structured interview. Genital self-image was evaluated using the Female Genital Self-Image Scale (FGSIS). Average length of neovagina (7.0 ± 9.6 cm) for study group with MRKHS was significantly shorter than that of the control group (9.3 ± 2.5 cm). Sexual function in neovagina women was satisfactory (FSFI score 29 ± 2.7) not significantly different from the control group (P < .05) but they had significantly higher levels of stress (FSDS-R scores 14.5 ± 6.5) and were not satisfied with their genital (FGSIS scores 22.0 ± 2.4) compared to the control group. 95% of patients wish to have their own baby. Surrogate motherhood would be accepted only by 35% of women and 83% of women would think about adoption. Uterus transplantation would be accepted by 90% women and 26% of them consider it as the last option.

Sexual Life of Women With Mayer-Rokitansky-Küster-Hauser Syndrome After Laparoscopic Vecchietti Vaginoplasty.

IntroductionAdequate anatomic and physiologic functions of the genitalia are fundamental prerequisites for sexual well-being and reproduction. Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) compromises female sexual life and makes reproduction impossible.AimTo assess the psychosexual effect of vaginal reconstruction using the laparoscopic Vecchietti technique in patients with MRKHS.MethodsForty-two patients with MRKHS who underwent laparoscopic Vecchietti vaginoplasty were included. Their partners also were interviewed. A control group of 45 age-matched, childless, sexually active women were examined during the same period.Main Outcome MeasuresA gynecologic examination was performed to determine the anatomic outcome. Psychosexual function was evaluated with the Female Sexual Distress Scale–Revised (FSDS-R), the Female Sexual Function Index (FSFI), and a semistructured interview. Genital self-image was evaluated using the Female Genital Self-Image Scale (FGSIS).ResultsAverage neovagina length (7.0 ± 9.6 cm) in the MRKHS group was significantly shorter than the vaginal length in the control group (9.3 ± 2.5 cm). Women with a neovagina reported satisfactory sexual function (FSFI score = 29 ± 2.7) that was not significantly different from the control group (P < .05); however, they also had significantly higher levels of distress (FSDS-R score = 14.5 ± 6.5) and were not satisfied with their genitals (FGSIS score = 22.0 ± 2.4) compared with the control group.ConclusionSexual function in women with MRKHS can be restored successfully by vaginoplasty; however, they have higher rates of distress and are less satisfied with their genitals.Pastor Z, Fronĕk J, Nováčková M, Chmel R. Sexual Life of Women With Mayer-Rokitansky-Küster-Hauser Syndrome After Laparoscopic Vecchietti Vaginoplasty. Sex Med 2017;5:e106–e113.

RELAÇÃO DO TIPO E NÚMERO DE PARTO NA FUNÇÃO SEXUAL E AUTOIMAGEM GENITAL FEMININA: UM ESTUDO OBSERVACIONAL

Introduction: Due to the anatomical changes that pregnancy, childbirth and multiparity cause in the pelvic floor muscles (PFMs), these are risk factors for pelvic floor disorders. These changes can lead to sexual dysfunction or alteration of the perception of genital self-image. Objective: To investigate the relationship between types and number of births and sexual function and female genital self-image. Materials and Methods: Observational cross-sectional study. We analyzed 384 women aged 18-60 years, sexually active, enrolled in gyms. The exclusion criteria involved participants who have difficulty in understanding the instruments. The FSFI (Female Sexual Function Index), FGSIS (Female Genital Self-Image Scale) questionnaires and the sociodemographic data were self-reported. Higher FGSIS scores - which can range from 7 to 28 - were considered indicative of positive genital self-image and FSFI scores under 26 were considered indicative of sexual dysfunction score. Categorical variables (number and type of births) were presented in frequency and the association of FSFI and FGSIS was taken by independent t-test, p = 0.05 considered. Results: 384 women with a mean age of 34.9 ± 10.1 years and BMI of 24.1 ± 3.5 kg / m2 were evaluated. The FSFI showed changes in desire and arousal domains and the FGSIS scores did not suffer influence of the number and type of deliveries. Conclusion: The results showed that the number and type of deliveries are related to reduced female sexual function, which has not been associated togenital self-image.

The Female Genital Self-Image Scale (FGSIS): Validation among a Sample of Female College Students

Gynecological exams continue to be underused among young women, possibly due to a woman's genital self-image. The purpose of this study was to (i) examine college women's genital image using the Female Genital Self-Image Scale (FGSIS); (ii) assess the reliability, validity, and factor structure of data collected on the FGSIS; and (iii) examine the relationship between FGSIS scores and gynecological exam behaviors. Data were collected in November/December 2010 from 450 undergraduate women. Descriptive statistics were utilized to analyze demographic variables. A comprehensive psychometric assessment of the FGSIS included: (i) a reliability assessment of internal consistency; (ii) conducting a confirmatory factor analysis (CFA) to identify factor structure; and (iii) structural equation modeling and predictive discriminant analysis to asses the predictive qualities of the FGSIS on gynecological exam behavior. CFA analyses yielded a two-factor FGSIS structure: X(2) (12, N=450)=49.77; P<0.001, Root Mean Square Error of Approximation=0.08, Comparative Fit Index=0.98, Normed Fit Index=0.97. Reliability assessments indicated very good internal consistency for the scale (α=0.89), as well as for factor one (α=0.86) and factor two (α=0.82). Women who engaged in at least one gynecological exam during the past 24 months had a significantly more positive genital self-image than those who had not (t (449)=-2.501; P=0.01). Data collected using the FGSIS were found to be valid and reliable in this sample, further supporting the utility of the scale and aiding in the understanding of college women's genital image using an underlying two-factor approach. This has important implications for the development of sexual health and women's health programs and discussions. Specifically, a two-factor FGSIS can aid medical and health professionals in better understanding relationships between genital image and gynecological exam behavior.

ORIGINAL RESEARCH—OUTCOMES ASSESSMENT: Development and Validation of the Female Genital Self-Image Scale

Women's sexual function may be influenced by various factors including medical conditions, trauma or abuse, medications, relationship dynamics, relaxation, mood, and body image. However, few studies have explored the influence of a woman's genital self-image on her sexual function or behaviors. The purpose of this study was to establish a reliable and valid measure of female genital self-image, the Female Genital Self-Image Scale (FGSIS), and to assess the relationship between scores on the FGSIS and women's sexual function. The FGSIS was developed in two stages. Phase One involved an analysis of cross-sectional paper-based survey data and a review of the literature. Phase Two involved a cross-sectional internet-based administration of the scale items to a total of 1,937 women. Psychometric properties of the scale were evaluated through the use of reliability analysis, factor analysis, and score differences based on women's experience of orgasm from receiving cunnilingus or from self-masturbation with a vibrator. Correlation analysis was used to explore the relationship between female genital self-image and scores on the Female Sexual Function Index (FSFI). The scale was found to have sufficient reliability (Cronbach's alpha = 0.88) and one factor that explained 59.23% of the variance. Women who had ever experienced orgasm as a result of cunnilingus or self-masturbation with a vibrator and women who reported having had a gynecological exam in the previous 12 months had significantly higher FGSIS scores than those who had not (P < 0.001). Scores on the FGSIS were positively and significantly correlated with scores on all FSFI domains (P < 0.001), including the Total score, with the exception of the Desire domain. The FGSIS was initially found to be a reliable and valid measure though further research is needed to understand its properties in diverse populations. In addition, female genital self-image was found to be positively related to women's sexual function.