The impact of genital self-image on sexual function in women with pelvic floor disorders

Jonathan E. Handelzalts*, Tal Yaakobi, Sigal Levy, Yoav Peled, Arnon Wiznitzer, Haim Krissi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective There is conflicting evidence regarding the impact of urinary incontinence and pelvic organ prolapse on overall sexual function. However, psychological variables thought to be associated with sexual function, have not been fully explored. We assessed the sexual functioning of women with pelvic floor disorders while measuring for psychological factors such as distress and genital self-image. Study design In a cross-sectional study, 155 women in an urogynecology outpatient clinic of a tertiary health center completed a demographic questionnaire, the Brief Symptom Index-18 (BSI-18), Pelvic Floor Distress Inventory-20 (PFDI-20), Genital Self-Image Scale-20 (GSIS-20) and the Female Sexual Function Index (FSFI). Results Linear regression showed that when controlling for age and depression, GSIS significantly predicted FSFI total score (Beta = 0.38, p < 0.001) and the Desire subscale (Beta = 0.55, p < 0.001). Due to the low response rate in the GSIS and FSFI questionnaires, a preliminary analysis was conducted to characterize the responders. On univariate logistic regression, response to the GSIS was negatively correlated with age (OR = 0.94, p = 0.02) and being in a relationship (OR = 2.3, p = 0.016), yet the effect of being in a relationship was diminished in a multivariate model that included age. Conclusion The main variable associated with overall sexual function in women with pelvic floor disorders was low genital self-image. This variable is more important than self-reported symptoms, type of specific disorder or other demographic variables. Older women tended not to complete the scales concerning more intimate matters. We suggest that urogynecologists should inquire about genital self-image as well as sexual function in this population.

Original languageEnglish
Pages (from-to)164-168
Number of pages5
JournalEuropean Journal of Obstetrics, Gynecology and Reproductive Biology
StatePublished - 1 Apr 2017


  • Distress
  • Genital self-image
  • Incontinence
  • Prolapse
  • Sexual function


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