Department of Family Medicine, KK Women and Children's Hospital, Singapore.
SingHealth Polyclinics, Singapore.
Ann Acad Med Singap. 2023 Apr 27;52(4):190-198. doi: 10.47102/annals-acadmedsg.2022358.
Obesity is thought to be a negative predictor of sexual function, but the relationship between body mass index (BMI) and sexual function has been inconsistent. Other factors such as body image and self-esteem may mediate this relationship. This study examined the association of BMI, body image and self-esteem with sexual function in young women.
A total of 514 sexually active women aged 21 to 35 years completed an anonymised online questionnaire that used 3 scales to assess body image, self-esteem and female sexual function: Body Image States Scale (BISS), Rosenberg Self-Esteem Scale (RSES) and Female Sexual Function Index (FSFI). Higher scores for BISS, RSES and FSFI indicate more positive body image, higher self-esteem and better sexual function, respectively. Spearman correlation assessed the association among BMI, BISS and RSES scores, and with FSFI scores. Linear and multivariable logistic regression identified risk factors associated with sexual dysfunction (FSFI <26.55).
BISS and RSES scores significantly correlated with FSFI scores (r=0.27 and r=0.32, respectively; both P<0.001), indicating that better body image and self-esteem were associated with better sexual function. Risk factors for sexual dysfunction were lower BISS and RSES scores, being married (odds ratio [OR] 1.52; 95% confidence interval [CI] 1.07-2.15), having 1 child (OR 2.45; 95% CI 1.26-4.77) and having a perceived mental condition (OR 3.02; 95% CI 1.44-6.33). Factors in lack of sexual dysfunction include being of Malay ethnicity (OR 0.38; 95% CI 0.21-0.71) and being overweight (OR 0.46; 95% CI 0.27-0.78).
Women with poorer body image and lower self-esteem were more likely to have sexual dysfunction. These perceptions and states did not correlate with being overweight, and were better predictors over BMI to identify the population at-risk.
肥胖被认为是性功能的负面预测因素，但体重指数（BMI）与性功能之间的关系一直不一致。其他因素，如身体形象和自尊，可能会影响这种关系。本研究旨在探讨年轻女性的 BMI、身体形象和自尊与性功能之间的关系。
共有 514 名年龄在 21 至 35 岁之间的活跃女性完成了一份匿名在线问卷，该问卷使用 3 种量表评估身体形象、自尊和女性性功能：身体形象状态量表（BISS）、罗森伯格自尊量表（RSES）和女性性功能指数（FSFI）。BISS、RSES 和 FSFI 的得分越高，表明身体形象越积极、自尊越高、性功能越好。Spearman 相关性评估了 BMI、BISS 和 RSES 得分之间的相关性，以及与 FSFI 得分的相关性。线性和多变量逻辑回归确定了与性功能障碍相关的危险因素（FSFI<26.55）。
BISS 和 RSES 得分与 FSFI 得分显著相关（r=0.27 和 r=0.32，均 P<0.001），表明更好的身体形象和自尊与更好的性功能相关。性功能障碍的危险因素包括较低的 BISS 和 RSES 得分、已婚（比值比[OR] 1.52；95%置信区间[CI] 1.07-2.15）、有 1 个孩子（OR 2.45；95%CI 1.26-4.77）和感知精神状况（OR 3.02；95%CI 1.44-6.33）。性功能正常的因素包括马来族裔（OR 0.38；95%CI 0.21-0.71）和超重（OR 0.46；95%CI 0.27-0.78）。
身体形象和自尊较差的女性更有可能出现性功能障碍。这些观念和状态与超重无关，是识别高危人群的更好预测指标，而不是 BMI。
