The impact of genital self-image on sexual function: a systematic review

Genital self-image (GSI) refers to a person's perception of their genitalia, whether positive or negative. In recent years, it has become increasingly common for individuals to report dissatisfaction and insecurity regarding the appearance of their bodies and genitals. This scenario has a negative impact on both physical and psychological health, in addition to negatively influencing sexual life.

To gather information on the relationship between GSI and sexual function and to determine whether there is an association between these two factors.

A Systematic Review was carried out in the following databases: CINAHL, Embase, MEDLINE, Open Science Journal, PeDro, PubMed, Scielo, Scopus, Science Direct, Springer Link, and OpenGrey. The research question was based on the PICO strategy: "Is there an association between genital self-image and sexual function?". Observational quantitative studies were included, regardless of language and publication data. Studies that did not include the terms "Genital Self-Image", "Sexual Function", and their synonyms and/or keywords in the title, duplicated studies or with low methodological quality were excluded.

Out of 1727 initially identified studies, 10 met the inclusion criteria. These studies involved 7448 participants (2280 men and 5168 women) aged 18 to 72 years. The analysis showed a consistent association between positive GSI and better sexual function, including increased desire and satisfaction. Conditions such as premature ejaculation and pelvic floor dysfunction negatively impacted both GSI and sexual performance, suggesting a reciprocal relationship between the GSI and sexual function. Despite the growing interest in genital cosmetic surgeries, studies did not show significant differences in sexual function between women who underwent these procedures and those who did not. Sociocultural factors, including dissatisfaction with genital size, were also found to negatively affect GSI and sexual well-being, especially among men.

A positive GSI is associated with better sexual function, greater satisfaction and quality in intimate experiences. Despite this, methodological limitations and the lack of diversity in the populations studied restrict the generalization of the results. Future research should focus on addressing gaps, such as the lack of longitudinal studies and the underrepresentation of diverse populations.