Body Image,Sexuality, and Sexual Functioning in Cervical and Endometrial Cancer: Interrelationships and Women’s Experiences

Over 74,000 women in the United States are diagnosed annually with endometrial or cervical cancers and experience significant treatment-related difficulties with body image, sexuality, and sexual functioning. The aims of the research were to examine relationships among body image, sexuality, and sexual functioning, and to understand women’s views of these concepts. A novel theoretical framework encompassing these three concepts and contextual variables guided the research. A non-experimental cross-sectional pilot study was conducted with pre-menopausal women in an academic medical center who had stages I–III cervical or endometrial cancer, were 3–36 months post-treatment, and had no mental health comorbidities. Participants completed the Body Image Scale, Female Sexual Function Index, Female Sexuality Questionnaire, a demographic questionnaire, and open-ended questions; the researchers collected clinical data from the medical record. Twenty women participated, and most reported issues with body image, sexuality, and sexual functioning. Significant relationships were found between body image and sexuality (p?=?0.0244) and sexuality and sexual functioning (p?<?0.0003). Stages II–III disease were significantly (p?=?0.0371) associated with worse body image. Women reported issues with body image, sexuality, sexual functioning, psychosocial areas, reproduction, and communication with healthcare providers and personal caregivers. This study is one of the first to simultaneously examine relationships among body image, sexuality, and sexual functioning. Despite design and sample limitations, findings demonstrate a need for longitudinal studies using larger samples to further examine relationships among these concepts and selected contextual variables, explore communication issues, and refine the theoretical framework.

     

It’s The “Why”: Links between (Non)autonomous Sexual Motives,Sexual Assertiveness,and Women’s Orgasm in Casual Sex

Existing literature shows conflicting and inconclusive evidence regarding women’s sexual experiences in casual sex. Some studies have found negative sexual outcomes (e.g., fewer orgasms), while others have found positive sexual outcomes (e.g., more orgasms, higher sexual satisfaction) when women had casual sex. According to self-determination theory (Deci & Ryan, 1985), people’s needs are fulfilled when their choice and behavior are self-motivated and reflect their intrinsic values. We hypothesized that women’s autonomous motivation to have casual sex would be associated with higher orgasmic function, whereas nonautonomous motivation would be associated with lower orgasmic function in casual sex. We also hypothesized that sexual assertiveness would mediate the relationship between sexual motives and orgasmic function in casual sex. Participants in this study were women (N?=?401) aged 18–59 years who reported having had casual sex in the past 12 months. Participants completed an online survey reporting their motives to have casual sex, sexual assertiveness, and orgasmic function (e.g., orgasm frequency, satisfaction with orgasm) in casual sex. We focused on two motives: (a) pleasure motive and (b) insecurity (i.e., self-esteem boost and pressure) motive. Results showed that greater pleasure (autonomous) motives related to higher sexual assertiveness, which in turn related to higher orgasmic function in casual sex. In contrast, greater insecurity (nonautonomous) motives related to lower sexual assertiveness, which in turn related to lower orgasmic function in casual sex. The findings support self-determination theory, suggesting that autonomous motives are important for women’s sexual experience in casual sex.

     

The Role of Sex Guilt in the Relationship Between Culture and Women’s Sexual Desire

A large body of literature demonstrates that East Asian women report lower sexual desire than Caucasian women. Although most studies have explained these differences by referring to general culture-linked differences in sexual conservatism, none have examined the potential role of specific constructs such as sex guilt. The goals of the current study were to examine the supposition that sexual conservatism mediates the relationship between culture and sexual desire, and to explore the potential mediating role of sex guilt in the link between culture and sexual desire. Caucasian (n = 105) and East Asian (n = 137) female university students completed questionnaires online. Caucasian women reported significantly higher levels of sexual desire, significantly lower levels of sexual conservatism, and significantly less sex guilt. In the entire sample, sexual conservatism and sex guilt separately mediated the relationship between ethnicity and sexual desire such that women with more sex guilt and those who were more sexually conservative reported lower sexual desire. Among the East Asian women, sex guilt, but not sexual conservatism, mediated the relationship between mainstream acculturation (degree of westernization) and sexual desire such that women with more sex guilt reported lower sexual desire. These findings suggest that sex guilt may be one mechanism by which ethnic groups differ in sexual desire.     

The Role of Breast Size and Areolar Pigmentation in Perceptions of Women’s Sexual Attractiveness,Reproductive Health,Sexual Maturity,Maternal Nurturing Abilities,and Age

Women’s breast morphology is thought to have evolved via sexual selection as a signal of maturity, health, and fecundity. While research demonstrates that breast morphology is important in men’s judgments of women’s attractiveness, it remains to be determined how perceptions might differ when considering a larger suite of mate relevant attributes. Here, we tested how variation in breast size and areolar pigmentation affected perceptions of women’s sexual attractiveness, reproductive health, sexual maturity, maternal nurturing abilities, and age. Participants (100 men; 100 women) rated images of female torsos modeled to vary in breast size (very small, small, medium, and large) and areolar pigmentation (light, medium, and dark) for each of the five attributes listed above. Sexual attractiveness ratings increased linearly with breast size, but large breasts were not judged to be significantly more attractive than medium-sized breasts. Small and medium-sized breasts were rated as most attractive if they included light or medium colored areolae, whereas large breasts were more attractive if they had medium or dark areolae. Ratings for perceived age, sexual maturity, and nurturing ability also increased with breast size. Darkening the areolae reduced ratings of the reproductive health of medium and small breasts, whereas it increased ratings for large breasts. There were no significant sex differences in ratings of any of the perceptual measures. These results demonstrate that breast size and areolar pigmentation interact to determine ratings for a suite of sociosexual attributes, each of which may be relevant to mate choice in men and intra-sexual competition in women.     

Social Identities as Predictors of Women’s Sexual Satisfaction and Sexual Activity

While much research has examined sexual problems and dysfunction, far less research has examined intersections between sexual satisfaction and sexual activity, particularly as it relates to social identities. This study utilized secondary analysis of 1,473 women from the National Health and Social Life Survey to examine the way sexual satisfaction and sexual activity are at times misaligned. Using factor and cluster analyses, four groups of women defined by being high or low on satisfaction and activity were predicted by nine demographic variables, including socioeconomic class, racial/ethnic identity, age, marital status, education, sexual identity, geographical “coming of age” location, employment status, and number of children. Results showed that lower status women (women of color, working-class women, younger women, less educated women, women who worked full-time) reported low satisfaction and high activity. Women who reported high satisfaction and low activity represented the largest cluster of women, indicating that more women reported a disjuncture between satisfaction and activity than did those reporting a match between satisfaction and activity. Implications for clinical, sexuality, and social identity literatures are discussed.     

Women’s Sexual Responses to Heterosexual and Lesbian Erotica: The Role of Stimulus Intensity,Affective Reaction,and Sexual History

Past research has demonstrated that women do not show a “category-specific” genital response to erotic stimuli. That is, on average, heterosexual and lesbian women are indistinguishable in terms of their physiological genital responses to heterosexual versus lesbian erotica. In two studies with heterosexual women (n = 28 for Study 1; n = 30 for Study 2) and lesbians (n = 24 for Study 1; n = 25 for Study 2), results confirmed that, on average, women did not show category-specific genital responses or category-specific subjective sexual arousal. However, there was evidence of notable within-group variability; many women did respond to the stimuli in a category-specific manner. Heterosexual women were more likely than lesbian women to demonstrate category-specificity. Findings also revealed that category-specificity was associated with multiple factors, including affective responses to the erotic stimuli and sexual history. Results of this study highlight the complexity of women’s sexual identities and sexual responses.     

The Effects of Condom Availability on College Women’s Sexual Discounting

College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women’s sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.     

The Effects of Impulsivity,Sexual Arousability,and Abstract Intellectual Ability on Men’s and Women’s Go/No-Go Task Performance

While a number of studies have assessed the role of personality traits, situational variables, and drug use on sexual risk behaviors, fewer studies have employed experimental methods to examine cognitive processes that may underlie risky sexual decision making. This study used a go/no-go paradigm to examine how individual difference variables and sexual arousal influence discrimination learning and sexual and nonsexual decision making. A total of 28 men (M age = 20 years) and 25 women (M age = 19 years) completed self-report measures of impulsivity, abstract intellectual ability, and sexual excitation and inhibition and participated in a laboratory experiment. The experiment consisted of two go/no-go tasks with sexual stimuli and two tasks with neutral stimuli, preceded by either sexually arousing or sexually neutral stimulus presentations. Task performance was measured by totals of false alarms and misses. Individuals high in impulsivity and low in abstract intellectual ability committed more false alarms in conditions involving sexually arousing stimuli. Furthermore, higher sexual excitation scores were linked to more misses. These findings indicate that cognitive processes associated with decision making that occurs in the “heat of the moment” are influenced by a combination of situational and sexual and nonsexual individual difference variables.     

Body Mass Index and Mortality in a Prospectively Studied Cohort of Scandinavian Women: The Women’s Lifestyle and Health Cohort Study

Overweight and obesity increase the risk of numerous chronic diseases, including several forms of cancer. However, the association between excess body weight and all-cause mortality among young and middle-aged women is incompletely known, and the impact of menopausal status on the association has hardly been investigated. We studied prospectively a cohort comprising a population sample of 102,446 women from Norway and Sweden aged 30–50 years when they answered an extensive questionnaire in 1991/1992. During follow-up through year 2000, 1187 women in the cohort died. We used Cox proportional hazard models to estimate multivariate Hazard rate ratios (HRR) with 95% confidence intervals (CI) of death in relation to body mass index (BMI, weight (kg)/height (m²)) at start of follow-up. Both in age-adjusted models and in models adjusting for several variables (including smoking and physical activity) mortality increased with increasing BMI among premenopausal women, whereas a U-shaped relationship was seen among the postmenopausal women. Among premenopausal women obesity (BMI 30.0) doubled the mortality (HRR = 2.2, 95% CI: 1.7–3.0) when compared to women of normal weight (BMI 18.5–24.9), whilst the association was modest after menopause. Although we had limited power to analyze women who were underweight (BMI<18.5), an excess mortality of about 50% was seen among postmenopausal women. No excess risk was found for underweight premenopausal women. The data indicate that the rapidly growing prevalence of obesity in many Western countries will substantially increase premature deaths among young women.     

The Influence of Attraction to Partner on Heterosexual Women’s Sexual and Relationship Satisfaction in Long-Term Relationships

Previous research has consistently found that attraction is important in the formation of relationships though research on attraction in long-term relationships is less well understood. This article examined the predictive value of self-reported attraction to partner and change in attraction to partner on sexual and relationship satisfaction in 176 women in committed heterosexual relationships using online survey methodology. Participants’ age ranged from 21 to 56 (M = 34.5) years and their relationship length ranged from 5 to 35 (M = 11.75) years. Hierarchical multiple regression results indicated that change in attraction to partner was the most salient predictor of sexual satisfaction, with current attraction to partner also related to women’s sexual satisfaction, accounting for 20 % of the variance. Current attraction to partner was the only significant predictor of women’s relationship satisfaction, accounting for 22 % of the variance. Additionally, attraction variables accounted for variance above and beyond the impact of relationship and sexual satisfaction. These findings suggest that self-reported attraction to partner is an important contributor to women’s satisfaction outcomes in long-term relationships. Further studies in the area of attraction to partner that include couple dynamics and longitudinal data are encouraged and implications for therapists, clinicians, and educators are discussed.     

Women’s Hedonic Ratings of Body Odor of Heterosexual and Homosexual Men

Men's body odor influences women's mate choice and individual variation among traits affects hedonic perceptions of this odor (e.g., immune system characteristics). Previous research by Sergeant (2002) indicated that one such characteristic is sexual orientation: body odor from homosexual men was perceived by heterosexual women as more hedonically pleasing than that of heterosexual men. The current study re-examined the influence of men's sexual orientation on women's perceptions of body odor. Homosexual (n=10) and heterosexual (n=9) men produced samples of body odor using T-shirts under equivalent environmental conditions. Heterosexual women (n=35) rated these samples, and a set of unused T-shirts, using a series of hedonic scales. Women rated the body odor of homosexual men as being comparatively more pleasant, sexier, and more preferable than that of heterosexual men but not significantly different from the unused T-shirts. This finding was consistent with contemporary research demonstrating that an individual's sexual orientation significantly impacts their olfactory function, both in terms of body odor production and olfactory perceptions of certain compounds.     

Sexual Coercion in Intimate Relationships: A Comparative Analysis of the Effects of Women’s Infidelity and Men’s Dominance and Control

Researchers studying the proximate (or immediate) causes of sexual coercion have proposed that partner rape is motivated by a man’s attempt to dominate and control his partner and that this expression of power is the product of men’s social roles. Researchers studying the ultimate (or evolutionary) causes, in contrast, have proposed that partner rape may function as an anti-cuckoldry tactic, with its occurrence related to a man’s suspicions of his partner’s sexual infidelity. In two studies, we collected data relevant to both perspectives to explore how these variables interact with men’s sexual coercion in an intimate relationship. Regression analyses from Study 1 (self-reports from 256 men) and Study 2 (partner-reports from 290 women) indicated that men’s sexual coercion of their partners was consistently predicted by female infidelity and men’s controlling behavior, suggesting that both variables are necessary to explain men’s sexual coercion. Discussion addressed limitations of the current research and highlighted the importance of integrating multiple levels of analysis when studying men’s sexual coercion of their intimate partners.     

Association of Comorbidity with Disability in Older Women: The Women’s Health and Aging Study

There is substantial evidence that physical disability results from chronic diseases and that the number of chronic diseases is associated with the presence and severity of disability. There is some evidence that interactions between specific diseases are of import in causing disability. Beyond arthritis, however, little is known of the disease pairs that may be important to focus on in future research. This study explores the associations between multiple disease pairs and different types of physical disability, with the objective of hypothesis development regarding the importance of disease interactions. The study population comprised a representative sample of 3841 women 65 years and older living in Baltimore, screened for participation in the Women’s Health and Aging Study. The study design was cross-sectional. An interviewer-administered screening questionnaire was administered regarding self-reported physical disability in 15 tasks of daily life, history of physician diagnosis of 14 chronic diseases, and MiniMental State examination. Task difficulty was empirically grouped into six subsets of minimally overlapping disabilities, with a comparison group consisting of those with no difficulty in any task subset. Multiple logistic regression models were fit assessing the relationship of major chronic diseases and of interactions of disease pairs with each disability subtype and with any disability, adjusting for confounders. Fourteen percent of the population reported mobility difficulty only; 5%, upper extremity difficulty only; 9%, both of these difficulties but no others; 7%, difficulty in higher function but not self-care tasks; 7%, self-care task difficulty but not higher function tasks; and 15%, difficulty in both higher function and self-care (weighted data). Almost all in the latter three groups had difficulty, as well, in mobility or upper extremity tasks. In regression models, specific disease pairs were synergistically associated with different types of disability. For example, important disease pairs that recurred in their associations with different disability types were the presence of arthritis and visual impairments, arthritis and high blood pressure, heart disease and cancer, lung disease and cancer, and stroke and high blood pressure. In addition, the type of disability that a disease was associated with varied, depending on the other disease that was present. Finally, when interactions were accounted for, many diseases were no longer, in themselves, independently associated with a given type of disability. Partitioning disability into six subtypes was more informative in terms of associations than was evaluating a summary category of “any disability.” These findings provide a basis for further hypothesis development and testing of synergistic relationships of specific diseases with disabilities. If testing confirms these observations, these findings could provide a basis for new strategies for prevention of disability by minimizing comorbid interactions.     

The Association of Women’s Empowerment with Stillbirths in Nepal

Introduction

Globally, 2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Women empowerment has been defined as women’s ability to make choices in economic decision-making, household and health care decision-making. In this paper, we aimed to evaluate if women’s empowerment is associated with stillbirths.

Methods

Data from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women’s empowerment and stillbirths. Equiplots were generated to assess the distribution of stillbirths by wealth quintile, place of residence and level of maternal education using data from NHDS 1996, 2001, 2006, 2011 and 2016 data. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted.

Results

A total of 88 stillbirths were reported during the survey. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). In multivariate analysis, only maternal age 35 years and above was significant (aOR 2.42; 1.22–4.80). Education of mother (aOR 1.48; 0.94–2.33), age of husband (aOR 1.54; 0.86–2.76), household head (aOR 1.51; 0.88–2.59), poor wealth index (aOR 1.62; 0.98–2.68), middle wealth index (aOR 1.37; 0.76–2.47), decision making for healthcare (aOR 1.36; 0.84–2.21) and household purchases (aOR 1.01; 0.61–1.66) had no any significant association with stillbirths.

Conclusions

There are various factors linked with stillbirths. It is important to track stillbirths to improve health outcomes of mothers and newborn. Further studies are necessary to analyse women empowerment factors to understand the linkages between empowerment and stillbirths.

     

“It’s Better to Be Depressed Skinny than Happy Fat:” College Women’s Memorable Body Messages and Their Impact on Body Image,Self-Esteem,and Rape Myth Acceptance

ABSTRACT

This study investigated the content of memorable body messages that college women recall receiving in their childhood, and the relationship of those messages to state body image satisfaction, self-esteem, rape myth acceptance, and likelihood to report rape or sexual assault. Memorable messages were mostly about body size, body type, body parts, haptic messages, body positivity, and development. Mothers were the most frequent source of memorable body messages during childhood. Although there was no difference in any of the dependent variables based on the content of the message, there was a relationship between perceived message valence with body image, self-esteem, and rape myth acceptance. Messages that participants interpreted as more positive and beneficial were associated with higher body image satisfaction, higher self-esteem, and increased rape myth acceptance.     

Protecting Children from Medically Unnecessary Genital Cutting Without Stigmatizing Women’s Bodies: Implications for Sexual Pleasure and Pain

Archives of Sexual Behavior -     

A Qualitative Study of Heterosexual Women’s Attempts to Renegotiate Sexual Relationships in the Context of Severe Sexual Problems

Previous qualitative research on women's sexual problems has documented the ways in which they can impact psychological well-being as well as women's close interpersonal relationships. However, little attention has been paid to the ways that women with sexual problems negotiate sexual contact in the context of a relationship where sexual activity has a central role. This article draws on qualitative data from in-depth interviews with 23 heterosexual women who experienced sexual desire loss or vulvar pain. The data were analyzed within a material-discursive framework and this identified the centrality of relational and broader social factors in women's sexual negotiation. Key findings included: avoiding potentially intimate situations; engaging in intercourse when it was painful or the women had no desire to; and mentally planning and preparing themselves for sex. Other sexual activities were almost always regarded as a prelude to intercourse, yet around half of the sample had adapted their sexual repertoire to compensate for an absence of intercourse. The implications for future research and treatment in the area of women's sexual problems are discussed.     

Men’s Controlling Behaviors and Women’s Experiences of Physical Violence in Malawi

In the feminist paradigm, intimate partner violence (IPV) among heterosexual couples is gender asymmetric and largely a tactic of male control. However, research on the relationship between men’s controlling behavior and physical violence against women is limited. This study examines whether having a controlling partner is associated with women’s reports of experiencing physical violence in Malawi. Bivariate and multivariate analyses were conducted using data from 8,385 women who completed the domestic violence module of the Malawi 2004 Demographic and Health Survey. About 18 % of women reported they had experienced moderately severe physical violence and 1 % experienced very severe violence in the past 12 months. A third of women reported their partners had ever been controlling. Results from multivariable ordinal logistic regression showed that women who had controlling partners were significantly more likely to report experiencing physical violence. Other factors significantly associated with women’s experience of physical violence included women who reported initiating physical violence against their partners, women’s work status, partners’ lower education level, and partners’ alcohol consumption. Women with controlling partners were at increased risk of experiencing physical violence in the past year. However, women who reported initiating physical violence in the past year were nearly four times more likely to experience partner violence in the same time period. Future research should attempt to elucidate these two important risk factors for IPV.