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Self-Efficacy in Managing Female Sexual Dysfunction in Interstitial Cystitis
Susanna Sutherland1, A Grace Kelly2, Elizabeth G Walsh3
1Osher Center for Integrative Medicine, Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN.
Objective:
To examine relations between clinical features and female sexual dysfunction (FSD) in a sample of women with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS), with a focus on sexual self-efficacy, or confidence in ability to manage symptoms. FSD is prevalent in IC/BPS. Several areas of sexual functioning are impacted, including experiences of pain during and after sex which is significantly disruptive to quality of life. Despite evidence that emotional health and FSD relate, less is known about how to address FSD in IC/BPS.
Methods:
Sixty-eight female participants [m = 43.89 (SD = 13.15) years] with IC/BPS reported demographics, diagnostic symptoms of IC/BPS, pain, mood, sexual self-efficacy, and sexual function. Regression explored the relation of urologic symptoms, pain and emotional distress to FSD, and the additional predictive utility of sexual self-efficacy when assessing this relationship.
Results:
While pelvic and mood symptoms effectively predicted FSD, the addition of sexual self-efficacy to the model produced significant model improvement, such that greater self-efficacy was associated with better sexual functioning, and variance in FSD was no longer predicted by pain or depression.
Conclusion:
Results emphasize the influential role that confidence in ability to manage symptoms plays in FSD, beyond known influences such as mood or symptom severity. Complementing existing treatment with education or intervention including skills-building to increase patient confidence in ability to manage sexual pain may improve sexual function in IC/BPS. A model of intervention appropriate for physician implementation in the clinical setting is discussed, and potential self-management strategies are reviewed.
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