Female Genital Self-Image Research Articles

Female Genital Self-Image in Women With and Without Female Genital Mutilation/Cutting in Jeddah, Saudi Arabia.

IntroductionThe consequences of female genital mutilation/cutting (FGM/C) on female genital self-image are not known.AimTo assess whether women with and without FGM/C differed with regard to female genital self-image.MethodsA survey was administered to a group of women attending the King Abdulaziz University Hospital obstetrics and gynecology clinic from December 2016 to August 2017. 963 consecutive adult women seen at the clinic completed the survey.Main outcome measuresThe main outcome measure of this study was female genital self-image being assessed with the female genital self-image scale (FGSIS).ResultsOne-fifth (18.2%) of the women self-reported having undergone FGM/C as young girls. Women with FGM/C had a similar FGSIS score as women with no FGM/C (21.3 ± 4.6, n = 175 vs 21.6 ± 4.8, n = 756, analysis of variance, P = .37). In multivariate regression analysis, only level of education remained independently associated with the FGSIS score. Women with some university education had a greater mean FGSIS score than women with no university education (22.1 ± 4.49, n = 564 vs 20.8 ± 5.03, n = 399, P < .0001).ConclusionsWomen with and without FGM/C in a Saudi Arabian clinic generally had a similarly positive genital self-image. Only level of education was independently associated with the FGSIS score.Rouzi AA, Berg RC, Alamoudi R, et al. Female Genital Self-Image in Women With and Without Female Genital Mutilation/Cutting in Jeddah, Saudi Arabia. Sex Med 2020;8:752–756.

Clinical Features Associated with Female Genital Mutilation/Cutting: A Pilot Longitudinal Study.

(1) Background: Female genital mutilation/cutting (FGM/C) is associated with physical and psychological complications. However, there is scarce literature on how women with FGM/C respond to treatment interventions. (2) Methods: In the present pilot longitudinal study, we assessed changes in general psychopathology (Symptom Check List-90-R), sexual functioning and distress (Female Sexual Function Index, Female Sexual Distress Scale-Revised, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) female sexual dysfunction criteria), body image (Body Shape Questionnaire), and sexual body image (Female Genital Self-Image Scale) in a sample of n = 15 women with FGM/C before and after reconstructive surgery. (3) Results: Sexual distress was significantly improved following surgery. We also observed an improvement in general psychopathology and genital self-image. However, sexual function was not improved. (4) Conclusions: These results provide evidence for the benefits of reconstructive surgery on sexual distress in women with FGM/C. The impact of surgery on sexual function cannot be conclusively evaluated.

P-08-9 Female Genital Self Image Scale: Adaptation and Validation INTO Spanish

Genital image in women has been a social taboo and neglected by science till now. The main purpose of this study was adapt and validate Female Genital Self-Image Scale (Herbenick & Reece, 2010) into Spanish by cross language translation procedure. 1692 volunteers women (18-79; mean 42.3), with equivalent sample by age grouped in five years ranges, recruited in general gynecological consultation participated in this study. Exclusion criteria were active vulvar or gynecological pathology at the moment of the study. Eight public and private centers participated in the study from six different Autonomous Communities distributed along the country. All data were collected by internet survey link provided by the healthcare after recruitment. Complete original 11 items version of FGSIS was used. Exploratory and confirmatory factor analysis showed that items with higher communalities and better factorial solution were different as in English version. In short Spanish final version of FGSIS was eight items grouped in three components. Self-image conformed by items 1, 2 and 7 as dimension one, second one grouped items 3, 9 and 10 was related to Genital Exposition, and Odour component related to items 4 and 11 of the original scale. Complete scale was found enough reliability (Cronbach's alpha = .85), and for each factor, Self-Image .858, Genital Exposition .79 and Odour .86. In adition, KMO=.8 and Bartlett´s test of sphericity was significant (χ2 (28) =7179.8 p=.000) and three components explained 79.5% of the variance.

How Does Labia Minora Labiaplasty Surgery Impact Patients' Perceptions of Their Genitals? [20B

INTRODUCTION: Labia Minora Labiaplasty (LmL) surgery is sought after for comfort, function and appearance concerns but little is documented on how these surgeries affect women's perceptions of their genitals. METHODS: The impact of LmL on patients' perceptions of their genitals was evaluated using the Female Genital Self-Image Scale (FGSIS). Patients who underwent LmL were asked to fill out the FGSIS before and after surgery from August 2011 to May 2019. The Scores ranged from 7 to 28. The higher the score the more positive the perception. Pre- and Post-op scores were directly compared. Testimonials were collected. RESULTS: N=231 underwent LmL surgery and filled out the Pre-Op Questionnaires (Qs). The pre-op scores ranged from 7 to 26, mean score equaled 15.02 and the median pre-op score was 15. For N=217 who completed the Post-Op Qs, post-op scores ranged from 14 to 28 with mean post-op score of 25.45 and median score of 27. Twenty-one patients required a second procedure with higher FGSIS scores after the second procedure. The difference between the pre-op (CI 14.51, 15.52) and post-op (CI 25.02, 25.95) scores was strongly statistically significant (on the average 10 points higher) with a P-value=2.2 × 10−16. CONCLUSION: Labiaplasty surgery appears to have a positive impact on patients' perceptions of their genitalia using the FGSIS and testimonials. Labiaplasty surgery improves quality of life for women of all ages. The FGSIS can be a useful tool for practitioners to assess the success of LmL surgery.

Neovagina Creation: A Novel Improved Laparoscopic Vecchietti Procedure in Patients with Mayer-Rokitansky-Küster-Hauster Syndrome

To report a new improved laparoscopic Vecchietti vaginoplasty in patients with congenital vaginal agenesis and to investigate its efficacy and safety. A retrospective descriptive and case-control study. Single academic institution. Women who were diagnosed with Mayer-Rokitansky-Küster-Hauster (MRKH) syndrome and underwent our new improved laparoscopic Vecchietti procedure from July 2010 to June 2019 were selected as the study group. The eligible participants had congenital vaginal agenesis with normal 46,XX karyotype and ovarian function. Age-matched, nulliparous, sexually active women were selected as the control group. Women with MRKH syndrome in the study group underwent the novel improved laparoscopic Vecchietti procedure. All participants in both groups were required to complete Female Sexual Function Index and Female Genital Self-Image Scale questionnaires. The effects of our procedure, including the anatomic and functional efficacy of the neovagina, were the primary outcomes. The secondary outcomes consisted of the perioperative complications, surgical morbidities, and long-term postoperative discomfort. A total of 79 patients with MRKH syndrome underwent our new improved Vecchietti vaginoplasty, of whom 44 (55.7%) were diagnosed as Type I MRKH syndrome, whereas 35 (44.3%) were Type II MRKH syndrome. At a 30-month follow-up after surgery, an anatomic neovagina measuring 10.44 cm in length and 1.30 cm in width was achieved. All 79 patients obtained anatomic success with 92.41% of functional efficacy. Compared with 81 age-matched, nulliparous women in the control group, there was no statistical difference regardless of individual measure or total Female Sexual Function Index scores (p >.05). The Female Genital Self-Image Scale assessment showed a significantly lower score in patients undergoing the vaginoplasty (20.14 ± 3.05 vs 22.95 ± 2.12; p <.001). There were no severe perioperative complications except 1 mild bladder injury and 1 transient fever. Our novel improved laparoscopic Vecchietti vaginoplasty is a relatively safe and effective method for surgical treatment of congenital vaginal agenesis. It may be an alternative to neovagina creation for reaching satisfying anatomic and functional efficacy and improving patients' sexual function.

023 The Impact Of Obesity On Perioperative Outcomes Following Placement Of Artificial Urinary Sphincter: National Multi-institutional Analysis of the National Surgical Quality Improvement Program (NSQIP) Database

Obesity and its associated comorbidities are risk factors for post-surgical complications. However, perioperative morbidity of Artificial Urinary Sphincter (AUS) placement in obese patients is poorly reported. We utilized the National Surgical Quality Improvement Program (NSQIP) database to evaluate the impact of obesity (BMI≥30) on the rates of “any complication” within 30 days of Placement of AUS. NSQIP database was queried to identify patients underwent AUS placement. Patients were classified into groups; Obese group (OG-BMI≥30) and Non obese group (NOG-BMI <30). Patient demographics, comorbidities, American Society of Anesthesiologists (ASA) classification, operating time (OPTIME), length of stay (LOS) and complication rate were recorded and compared between the two groups using Chi-square or t tests. Multivariable analysis was performed to determine the impact of obesity on development of “any complication” adjusting for age, gender, race and ASA class. A total of 1,216 patients were identified between Female Genital Self-image 7 and 2016. Of these patients, 510 were OG and 706 were NOG. In both groups, the most common age group was 65-74 years and the majority of patients were males (98.4%) and white (77.5%). Most patients of the OG (60.3%) were ASA class III while those of NOG (51.8%) were class I/II. Hypertension and diabetes were the most prevalent comorbidities in both groups (74.7% vs 61.8% and 29% vs 18.1% for OG and NOG respectively, P<0.001). Compared to NOG, the OG showed longer mean OPTIME (97.5 (SD=41.3) vs 91.6 (SD=39.1) minutes, p=0.012) and mean LOS (2.2 (SD=4.3) vs 2 (SD=1.4) days, p=0.25). Overall, the complication rate was similar in both groups (OG: 6.08% vs NOG: 6.37%, p=0.83). Comparing OG to NOG, the rates of specific complications were: superficial/deep wound infection and wound disruption in 1.37% vs 1.84%, p=0.52, readmission 2.83% vs 5.03%, p=0.08, return to operating room 2.55% vs 2.83%, p=0.73, urinary tract infection 0.78% vs 1.84%, p=0.12 and DVT/thrombophlebitis 0.98% vs 0%, p=0.013. In a multivariable analysis, obesity was not independently associated with increased postoperative complication rate (OR=0.98 (95%CI: 0.60-1.60).

Sexual function and voiding status following one stage feminizing genitoplasty

The data on long-term outcome of feminizing genitoplasty (FG) with regardto the sexual function and voiding status is limited and nearly always retrospective, reviewing only small numbers of patients. Furthermore, most articles only looked at the success as an adequately open vagina with a feminized appearance. Success should include normal erotic sensation, lubrication, sexual satisfaction, orgasm, and intercourse without discomfort. These latter factors are just beginning to be studied OBJECTIVE: To investigate sexual function and voiding status in women who underwent vaginal reconstruction in childhood. We retrospectively reviewed medical files of patients who underwent FG at our center from 1988 to 2000. In addition, patients were asked to complete the following standardized questionnaires: Female Genital Self-Image Scale (FGSIS), dysfunctional voiding and incontinence symptoms score (DVISS), and Female Sexual Function Questionnaire (FSFI). patients underwent one-stage FG; of those, 36 with median age of 21 years (range 18-30 years) who completed the puberty period were included into this study. Of the participants, 15 (41.6%) lived in a committed partnership, and 12 (80%) had sexual intercourse on a regular basis. Total FSFI was 22.2+3.1 (mean+ SE). Domain scores were 3.9, 4.3, 4.5, 4.3, 4.9, and 4.7 for desire, arousal, lubrication, orgasm, satisfaction, and pain, respectively (Summary Figure). None of the patients reported on daytime incontinence or enuresis. Female genital self-image was found to be positive in all patients and related positively to women's sexual function. The general rate of the sexual activity of our studied population was similar to that published in the literature 80% in our study vs 60-87% published in the literature. The overall FSFI was 22, showing some evidence of the female sexual dysfunction. However, only one patient regarding pain during vaginal penetration demonstrated mild dyspareunia. At the same time, we have not found any desire, arousal, lubrication, orgasm, satisfaction problems. Furthermore none of our patients complained on lower urinary tract symptoms during questioning, while three girls with congenital adrenal hyperplasia presented during follow-up with dribbling incontinence, which resolved with introitoplasty and creation of the wide vaginal opening. Our data demonstrate that one -tage FG in childhood is a long-term effective surgical procedure that does not cause voiding dysfunction. If a secondary intervention is required prior to the sexual life, simple introitoplasty usually solves the problem. The FSFI score showed overall acceptable sexual function, whereas mild dyspareunia was a major complain.

An Exploration of Psychosocial Factors Associated with Female Genital Self-Image

Negative genital self-perceptions or female genital self-image (FGSI) is a prevalent concern for women. This is a significant problem in and of itself but also because it is associated with a variety of negative outcomes including less frequent sexual behavior, more negative cognitive-affective sexual responses, and poorer decision-making about genital health. This study examined the extent to which various psychosocial factors are associated with more negative FGSI. Two hundred cisgender women with diverse ages and relationship statuses completed an online survey that included measures of sexual health education (quality of school-based sexual health education (SHE), female genital knowledge), pornography use, sexual experiences (positive and negative partner genital feedback, frequency of sexual activity), and cognitive-affect appraisals (body image, sexual comfort). Social desirability, cognitive-affective appraisals, sexual experiences, and SHE were associated with FGSI at the bivariate level. The results of a multiple regression analysis indicated that only sexual comfort, body image, and positive genital feedback contributed uniquely to the prediction of FGSI. The results are interpreted in terms of the importance of the psychosocial context for understanding women’s genital self-perceptions as well as their implications for prevention and intervention strategies aimed at addressing the problem.

Female genital image: is there a relationship with body image?

Objective:Dissatisfaction with body image may extend to the genital region, and the most dissatisfied with their bodies are women. To analyze the relation between body image and genital image in female, and to verify demographic and/or clinical factors related to body image and genital image.Materials and Methods:This is a cross-sectional study in 421 women. The Body Shape Questionnaire-34 (BSQ-34) was used to evaluate body image perception; scores ≤110 indicate no dissatisfaction. Also, the female genital self-image scale-7 (FGSIS-7) was used to evaluate genital self-image; scores range between 7 and 28, with higher values considered to indicate a more positive genital self-image. The relation between body image and genital image was determined using the Pearson Correlation test, as well as the relation of these with body mass index (BMI) and age. The relation between these data and genital image was determined by using the ANOVA test or the independent t-test (statistical difference was accepted as p<0.05). In order to verify predictors of dissatisfaction with body image, variables with p<0.10 were inserted into the logistic regression model and checked if they remained significant (p<0.05).Results:Three hundred eighty-nine women were analyzed. The mean age was 34.7±10.2 years. The mean BMI was 24.1±3.6 kg/m², 49% were single, and the mean BSQ-34 and FGSIS scores were 83.2±30.8 and 23.8±3.4, respectively. The correlation (r=-0.24) was found between body image and genital image (p<0.001). A total of 315 women indicated to be satisfied with their body and presented an FGSIS-7 score of 24±3.3. Participants who were dissatisfied with their body had an average FGSIS-7 score of 22.6±3.3.Conclusion:Genital image, age, and BMI influence body image. Change in the perception of body image seems to have low correlation with genital self-image in women.

The Female Genital Self-image Scale in Adult Women With Vulvar Lichen Sclerosus.

There is no agreed upon standard way to measure vulvar lichen sclerosus disease severity. The Female Genital Self-Image Scale (FGSIS) is a validated survey tool assessing female genital self-image and is positively correlated with women's sexual function. A lower score represents a negative genital self-image. We evaluated the FGSIS in women with vulvar lichen sclerosus. Women with biopsy-proven lichen sclerosus and women presenting for routine gynecologic care without lichen sclerosus matched by age were surveyed with the 7-item FGSIS. National surveys of healthy women in the United States have shown the mean 7-item FGSIS score is 21. To detect one standard deviation (20% absolute difference) between groups with a power of 80% at p < .05, 15 women would are needed in each group. Sixteen women with lichen sclerosus and 16 matched controls were surveyed between February and July 2018. The mean ± SD age of women with lichen sclerosus was 56.8 ± 13.5 years, 94% were white, 69% married, 81% college educated, 69% postmenopausal, and 18% on hormone replacement therapy. None of these differences were statistically different from control women. Women with vulvar lichen sclerosus had a significantly lower median 7-item FGSIS when compared with control subjects, 18 (interquartile range = 16-21) versus 25 (interquartile range = 23-27), respectively, Mann-Whitney U test, p < .001. Women with vulvar lichen sclerosus have a lower score on the 7-item Female Genital Self-Image Scale compared with healthy controls.

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.

Sexual quality of life, female sexual function, female genital self- and body image among women requesting genital cosmetic surgery: a comparative study

ABSTRACTFemale genital cosmetic surgery (FGCS) is increasingly becoming popular among Iranian women. This study aimed to assess the relationship between sexual quality of life, female genital self-image, body image and sexual function, in women requesting genital cosmetic surgery. A sample of 50 women seeking genital cosmetic surgery without any medical indications and 100 women as comparison group participated in the study. Participants were selected by convenience sampling. Hierarchical regression analysis was performed by four steps to indicate factors that contribute to the female sexual quality of life. The results showed that education, age, duration of marriage, female genital self-image, body image, sexual function jointly accounted for 60% of the variance in sexual quality of life score between two groups. Of these, sexual function and body image showed the greatest coefficients (β = 0.493 and 0.282, respectively) and significant relationship with sexual quality of life score, p < 0.001. This study is the first investigation that examines FGCS in Iran. The findings suggest that there is association between seeking cosmetic vaginal surgery and female sexual functioning and body image, and that these are related to female sexual quality of life. Perhaps improving these factors might lead to the decreased unnecessary female genital cosmetic surgeries.

The Relationship between Sexual Satisfaction and Genital Self-image in Infertile Women

Background & aim: In most cases, infertility can have a profound impact on sexual relationship. In such a condition, individuals often have unpleasant feelings towards their bodies, lose their self-confidence, feel depressed and frustrated, and experience decreased sexual desire. Therefore, we sought to investigate the relationship between sexual satisfaction and genital self-image among infertile women. Methods: This cross-sectional study was conducted on 102 infertile women visiting Milad Infertility Center in Mashhad, Iran, during 2016. To select the participants, the convenience sampling method was used. The inclusion criteria were being Iranian and Muslim, having basic literacy, being aged 18-40 years, living with the spouse, not becoming pregnant after about one-year of regular and unprotected sexual intercourse, having a primary diagnosis of infertility as confirmed by a gynecologist, and being formally married. Moreover, the data collection instruments included a demographic form, the Female Genital Self-image Scale, and Golombok-Rust Inventory of Sexual Satisfaction. To analyze the data, Mann-Whitney U test, Chi-square test, Pearson product-moment correlation, and linear regression analysis were run in SPSS, version 16. Results: The mean scores of genital self-image and sexual satisfaction in infertile women were 47.40±9.71 and 61.03±9.81, respectively, indicating a significant correlation between genital self-image and sexual satisfaction in infertile women (r=-0.500, P

Women self-reported G-spot existence and relation with sexual function and genital perception

Objective:Aim of study to determine the existence of the G-spot from the healthy women’s point of view and to assess the relationship with sexual function and genital perception.Materials and Methods:Sexually-active healthy polyclinic patients aged between 18 and 54 years (n=309) were classified into three groups as group 1 (do not agree, n=90, 29.1%), group 2 (neutral/do not know, n=61, 19.7%) and group 3 (agree, n=158, 51.1%) with regard to participants’ responses to a question of “does the G-spot exist.” The Female Sexual Function index (FSFI) and Female Genital Self-Image scale (FGSIS) were administered to the participants.Results:Half of the patients (51.1%, n=151) indicated that the G-spot exists. The groups were statistically homogeneous in terms of body mass index, parity, marital status, number of partners, and sexual orientation (p=0.41, p=0.06, p=0.12, p=0.19, p=0.25; respectively). Women with an education level of “less than high school” reported the absence of the G-spot significantly more often than others, whereas women with an education level of “university and higher” reported the presence of the G-spot more often (p≤0.001). Sexual dysfunction was found to be more frequent in group 1 when compared with group 3 (p=0.002, 67.8%, 45.6%). The orgasm subdomain scores of the FSFI and FGSIS total scores were significantly higher in group 3 than in group 1 (p<0.001, p=0.041).Conclusion:Half of healthy women in the Turkish population believe that the G-spot exists. Those women showed better scores in sexual functioning and genital perception.

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.

Characteristics of Genital Dissatisfaction Among a Nationally Representative Sample of U.S. Women

BackgroundFemale genital self-image is an important aspect of psychosocial and sexual health. The Female Genital Self-Image Scale (FGSIS) is a validated instrument that has been used to characterize women’s level of genital dissatisfaction. AimIn this report, we assess genital dissatisfaction using the FGSIS in a nationally representative sample of U.S. women. MethodsWe conducted a nationally representative survey of non-institutionalized adults aged 18–65 years residing in the United States. The survey included questions about demographics, sexual behavior, and the FGSIS. OutcomesDemographic characteristics were found to significantly correlate to women's perceived genital dissatisfaction. ResultsIn total, 3,372 women completed the survey and 3,143 (93.2%) completed the FGSIS. The mean age was 46 years, and there was broad representation across the United States in terms of age, education, and location. On bivariate analysis, women’s genital dissatisfaction was significantly correlated to their age, race, location, and education. Women who were sexually active were less likely to report genital dissatisfaction than women who were not sexually active (76% vs 62%, respectively, P < .001). The frequency of sexual activity was negatively correlated with genital dissatisfaction (P = .002). Women who reported genital dissatisfaction were less likely than those who reported satisfaction to engage in receptive vaginal sex (83% vs 88%, respectively, P = .03). There were no other significant associations between genital dissatisfaction and types of sexual activity. On multivariate analysis, women were less likely to report genital dissatisfaction if they were older, of black race, had an education level of high school or above, and/or lived in the Northeastern or Midwestern United States. There was no association between genital dissatisfaction and relationship status or gender of sexual partner. Clinical TranslationFemale genital dissatisfaction may be related to age, race, education, and geography. ConclusionsThis is the first nationally representative sample of U.S. women focusing on genital and self-image and dissatisfaction. These data may not apply outside the United States. These data may help providers who provide information for women and manage concerns related to genital self-image.Rowen TS, Gaither TW, Shindel AW, et al. Characteristics of Genital Dissatisfaction Among a Nationally Representative Sample of U.S. Women. J Sex Med 2018;15:698–704.

An exploration of the prevalence of global, categorical, and specific female genital dissatisfaction

Genital dissatisfaction is problematic for women in and of itself but also because it is associated with poorer sexual well-being. The current study aimed to clarify the prevalence of female genital dissatisfaction, both globally (i.e., overall) and with regards to distinct genital aspects, in a sample of women of different ages and with different relationship statuses. Participants were 209 women (ages 20 to 68 years) living primarily in the United States. Participants completed an online survey that included a background questionnaire, the 7-item Female Genital Self-Image Scale, and the 30-item Specific Genital Aspects Scale. Overall, 18% (n=37) of the women were globally dissatisfied with their genitals. Between 11% and 20% (n=22−41) of the women were dissatisfied with each categorical genital aspect (i.e., appearance, smell/taste, and function). The women were significantly less likely to be dissatisfied with their genital function than with their genital appearance. Between 2% and 69% (n=4−145) of the women were dissatisfied with each of the 30 genital aspects at the specific level. More than one quarter of the women were dissatisfied with nine (of 30) specific genital aspects and these spanned all three categories of genital self-perceptions. There were no differences in the prevalence of global or categorical genital dissatisfaction across age or relationship status. The results are discussed in terms of their implications for educators, researchers, clinicians, and journalists.

Relationship between Female Genital Self-Image and Sexual Function: Cross-Sectional Study

Relationship between Female Genital Self-Image and Sexual Function: Cross-Sectional Study

Female Genital Self-Image: How Is This Measured?

A range of female genital cosmetic surgeries now exist for women who wish to correct functional or aesthetic dissatisfaction with their vulvas. To contribute to further research exploring in detail the reasons women seek labiaplasty, this study sought to identify and compare all standardized survey tools used to measure female genital self-image (FGSI). This study examined surveys which had been undertaken on adult female populations. A literature review was conducted systematically using 5 search engines (PSYCinfo, Medline [Full Text], Web of Science, Scopus, PubMed and hand-searching) and 6 variations of keywords. Once an FGSI tool was sourced, any studies found with a title or abstract containing the word ‘validation’ were further analysed. Tools were compared and contrasted. Many tools were incorrectly cited or very difficult to locate. Despite this, 18 tools purporting to measure genital image were found of which only 10 had been validated. The majority were developed between 1995 and 2015 in America and use Likert scales to measure women’s attitudes. The numbers of items ranged from 3 to 220. Tools were also compared to determine inclusion of items on a series of seven areas identified from the literature as having a role in genital self-image: smell, sexual role and appearance of a woman’s own genitals, comfort with exposing genitals to health practitioners, discomfort wearing tight clothing or exercising, attitude to own genitals in relation to other women, and understanding of her sexual anatomy.

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.