Genital self-image refers to how people perceive their genital area, affecting their sexual desire, self-esteem, and satisfaction. In women, a positive genital self-image is linked to better sexual function and more frequent gynecological exams. However, factors like genital appearance, comfort, and feedback from partners, as well as pregnancy and childbirth, can influence this self-image.
For example, changes during pregnancy, such as skin darkening and weight gain, can impact women’s perceived sexual attractiveness. The type of delivery mode (vaginal birth vs. cesarean) also affects genital self-image, though studies show mixed results. Cultural and societal beliefs, especially in conservative societies, play a role in these perceptions. A new study aimed to explore these changes and their effects on sexual function among Muslim pregnant women in Iran to enhance prenatal and postpartum sexual health care.
A total of 301 pregnant women in Gorgan, Iran were recruited to participate in this study. The participants were selected randomly according to specific inclusion and exclusion criteria. The inclusion criteria were: 30-37 weeks pregnant, able to use a smartphone, with at least 5 years of schooling, and in a stable monogamous marital relationship. Exclusion criteria included sexual dysfunction, severe psychological stress, moderate-to-severe depression, movement disabilities, stillbirth or neonatal death, baby abnormalities, postpartum disabilities, and postpartum depression.
The participants completed online questionnaires before childbirth and 12-16 weeks postpartum. The study received ethical approval and the women could withdraw at any time.
Authors of the study measured genital self-image using the 7-item Female Genital Self-Image Scale (FGSIS-7) and sexual function using the 6-item Female Sexual Function Index (FSFI-6). Mental health was assessed with the Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed using a special software, employing various statistical tests to examine relationships between variables.
Out of 301 pregnant women who initially joined the study, 232 completed it by filling out questionnaires both before childbirth and 12-16 weeks postpartum. The average participant was about 30 years old, had around 14 years of education, and most were housewives. Nearly 44% were first-time mothers, and the rest had previous children. Around 71% had cesarean sections (CS) and 29% had vaginal births (VB).
The study found no significant change in the overall genital self-image from pregnancy to postpartum. However, after childbirth, the women’s genital self-image in a personal context improved, while their concerns about how their genitalia might be viewed by others (such as their partners) increased. Sexual function scores significantly improved postpartum in both VB and CS groups, with no significant differences between them.
There was a positive correlation between genital self-image and sexual function, stronger postpartum than during pregnancy. This correlation was evident in both VB and CS groups, with the CS group showing a higher correlation after childbirth.
Ultimately, these findings indicate that women’s feelings about their genitals didn’t change significantly from late pregnancy to a few months postpartum, regardless of whether they had a vaginal birth or cesarean section. Nevertheless, the details were different: women felt better about their genital image privately (intrapersonal) but were more concerned about how others might view it (interpersonal) after childbirth.
Sexual function improved postpartum for both VB and CS groups during this time period, even though it didn’t fully return to pre-pregnancy levels. The researchers noted cultural and social factors, such as exposure to media and societal norms, influence women’s genital self-image and sexual function. There were no significant differences between the VB and CS groups in overall genital self-image and sexual function during pregnancy and postpartum. In the end, the authors emphasized the importance of counseling and educating women and their partners about changes in sexual function during and after pregnancy to improve their quality of life.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
How Does Paying Attention Improve Sexual Functioning in Women? A Review of Mechanisms
References:
Samiei, G., Mehrbakhsh, Z., Khosravi, H., & Moghasemi, S. (2024). Genital self-image and sexual function in Iranian women from pregnancy to postpartum: A cohort study. The Journal of Sexual Medicine, 21(7), 605–613. https://doi.org/10.1093/jsxmed/qdae019
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