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Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses

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Abstract

Vulvar inflammatory dermatoses (VID; e.g., lichen sclerosus, lichen planus, vulvar dermatitis) can significantly impact sexual function. Both vulvar and non-vulvar inflammatory dermatoses (NVID; i.e., skin conditions not impacting vulvar skin, such as non-genital psoriasis and eczema/dermatitis) have yet to be fully characterized with regard to impact on genital self-image. A 20-min web-based survey was distributed September–November 2020 through social media ads, support groups, and online research recruitment services. Individuals in the USA over age 18 who were assigned female at birth and self-reported having been diagnosed with an inflammatory dermatosis were eligible. The primary outcome was the Female Genital Self-Image Scale (FGSIS). Secondary outcomes included the Female Sexual Function Index (FSFI), the Skindex-16 (a skin-related quality of life measure), the PROMIS Global-10 (assessing global physical/mental health), and sexual behavior histories. Participants (n = 348) reported mean age of 43.1 ± 15.5 (range = 19–81). Nearly one-third (n = 101; 29.0%) reported VID, 173 (50%) had NVID, and 74 (21%) experienced both vulvar and non-vulvar symptoms; they were analyzed as part of the VID group. The mean FGSIS score among participants with VID was 16.9 ± 4.1 and was significantly (p < .01) lower than that of participants with NVID (M = 21.2 ± 4.3), indicating lower genital self-image. Mental health (as measured by PROMIS-Global 10) was also impaired in VID. Rates of sexual dysfunction were high in both groups (> 60%). Findings suggest that in VID, lower genital self-image is correlated with poorer sexual function, quality of life, and global physical and mental health. Additional recommendations for VID management are proposed.

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Funding

Work on this manuscript was supported by internal funding from Purdue University.

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Sydney Rivera and Andrea L. DeMaria conceived of the study. Material preparation, data collection, and analysis were performed by Sydney Rivera, Anna Flood, and Andrea L. DeMaria. The first draft of the manuscript was written by Sydney Rivera. Chandler Dykstra, Debby Herbenick, Anna Flood, and Andrea L. DeMaria contributed to literature review and manuscript revision. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Sydney Rivera.

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Conflict of interest

The authors have no conflicts of interest to disclose. This research was approved by the last author’s institutional review board. Informed consent was gathered electronically from participants prior to participation in the study, through procedures approved by the institutional review board.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Purdue University (approved August 14, 2020. No. IRB-2020–812).

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Informed consent was obtained from all individual participants included in the study.

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Rivera, S., Flood, A., Dykstra, C. et al. Genital Self-Image, Sexual Function, and Quality of Life Among Individuals with Vulvar and Non-Vulvar Inflammatory Dermatoses. Arch Sex Behav 51, 3965–3979 (2022). https://doi.org/10.1007/s10508-022-02353-0

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  • DOI: https://doi.org/10.1007/s10508-022-02353-0

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