The mediating role of genital self-perception in the relationship between attitudes toward menopause and sexual quality of life in postmenopausal women: a pilot study.

Objective: This study aimed to investigate the mediating role of genital self-image in the relationship between postmenopausal women's attitudes toward menopause and their sexual quality of life.

Method: This study is descriptive. The sample consisted of 351 postmenopausal women who met the research criteria. The data were collected online between May and December 2023 using a descriptive information form, the Attitude Towards Menopause Questionnaire, the Female Genital Self-Image Scale, and the Sexual Quality of Life Questionnaire Scale. Data were collected using descriptive statistics, Pearson correlation analysis, and structural equation modeling.

Results: The mean total scale scores of the women were 34.41 ± 9.22 for Attitude Towards Menopause Questionnaire, 16.24 ± 3.40 for Female Genital Self-Image Scale, and 44.46 ± 22.16 for Sexual Quality of Life Questionnaire Scale. Analysis revealed moderate positive relationships: between attitude toward menopause and sexual quality of life ( r = 0.451, P < 0.001); between attitude toward menopause and genital self-image ( r = 0.520, P < 0.001); and between the genital self-image and sexual quality of life ( r = 0.361, P < 0.001). When genital self-image was added as a mediator, there was a direct positive relationship between attitude toward menopause and genital self-image ( β = 0.192, P < 0.001) and between genital self-image and sexual quality of life ( β = 1.126, P < 0.05). The indirect relationship of attitude toward menopause on sexual quality of life through genital self-image was positive and significant ( β = 0.216; P < 0.05; 95% CI, 0.063-0.353). With the inclusion of genital self-image as a mediator, the combined effect of attitude toward menopause and genital self-image explained 22.5% of the variance in sexual quality of life ( R2 = 0.225). In comparison, attitude toward menopause explained 27% of the variance in genital self-image ( R2 = 0.270).

Conclusion: There is an inverse relationship between postmenopausal women's negative attitudes toward menopause and their genital self-image and quality of sexual life.