Comparative Investigation of Genital Self-image and Sexual Function in Women with and Without a History of Female Genital Cosmetic Procedures: A Cross-sectional Study

ABSTRACT Background: Despite the increasing growth of female genital cosmetic procedures, the long-term effects of these procedures are not clearly understood. This study was conducted to compare the genital self-image and sexual function in women with and without female genital cosmetic procedures. Methods: This cross-sectional study was conducted on 315 participants (210 women without a history of genital cosmetic surgery and 105 women with it) in Alborz province, Iran, from early February 2023 to mid-May 2023. The sampling was done conveniently. Data collection instruments were Female Genital Self Image Scale and Female Sexual Function Index. Statistical analysis was done in SPSS 16 software using t-test, chi-square, and logistic regression, and P<0.05 was considered statistically significant. Results: The use of laser to tighten the vagina with 77.77% and Perineoplasty with 29.2% were the main cosmetic procedures. The mean duration passed from the surgical procedures was 4.79±3.60 years, while it was 1.13±0.74 years for non-surgical procedures. Women with a history of genital procedures had a higher mean age (39.45±10.38, P=0.023). However, they were lower regarding the level of education (P<0.001), family income (P<0.001), and exercise (P<0.001). Also, they showed a higher number of pregnancies (P<0.001), deliveries (P<0.001), vaginal delivery (P<0.001), episiotomy (P<0.001), and neonates with a weight of ≥3.5 kg (P=0.002). In both groups, midwives and doctors were the most important sources of information about the appearance and function of reproductive system. However, the genital self-image and sexual function of the two groups did not differ significantly (P>0.05). Conclusion: No difference in sexual self-image and lack of difference in sexual function after cosmetic procedures show the need to pay attention to recommending and selecting these procedures. Public awareness about the diverse and natural forms of the female genitalia, education about the variety of the factors affecting sexual function, reduction of unnecessary interventions, increase in physiological births, retraining doctors and midwives, and multidimensional counseling can help to choose more appropriate candidates for cosmetic procedures.