Dysfunction and Sexual Self-concept in Infertile Women: A Narrative Review

INTRODUCTION

Infertility is defined as the absence of a woman’s ability to achieve pregnancy after a period of 1 year or more of sexual intercourse without the use of contraception, and can affect women as well as men.^1,2 The repercussions of infertility are varied and can include consequences at the social and individual level, especially at the psychological level.³ In women, the ongoing impact on mental health represents a factor that is closely related to sexual dysfunction.⁴

Sexual dysfunction in women tends to be a common problem with a negative impact on daily life, the problem that could trigger the situation is usually multifactorial and requires focus to be evaluated.⁵ Women with this condition experience stress and ultimately it impacts on their quality of life due to disruption of arousal, desire, pain during intercourse and/or orgasm.⁶ Lack of sexual satisfaction can affect self-esteem and self-image, as they are closely tied to self-concept, which is a person’s perception of themselves based on their interactions with others and how they interpret their own behavior. This aspect is fundamental to personality development and also as a part of the recognition of sexuality, since it influences a person’s social competence, emotions, thoughts, learning, and self-esteem, which favors self-acceptance, confidence, and attitude towards physical appearance.⁷

The condition of infertility in women represents an important factor of general affectation to sexualhealth and requires comprehensive attention by healthcare providers.⁸ In this regard, Lotfollahi et al. consider that a fundamental aspect to promote its improvement in these women is sexual self-concept and all its components, which have shown a significant association with sexual function.^9,10 In this same sense, another study concludes that sexual satisfaction and discomfort with oneself are worse in infertile women.¹¹

Infertility represents a significant personal, social, and economic challenge for many women, which has a significant impact on the sexual and reproductive health of future families, as it is not only affects the ability to conceive, but can also influence emotional and psychological aspects. Understanding how this impacts on women’s sexuality is essential to develop support strategies that address both sexual health and overall quality of life by identifying key areas, such as sexual motivation and satisfaction, that may be linked to improved sexual functioning and thus improved well-being for these women and their partners.

In this sense, the aim of this study is to summarize the scientific evidence on sexual dysfunction and self-concept in infertile women.

METHODS

A narrative review was conducted of articles indexed in PubMed in the last 10 years that addressed the issue of sexual dysfunction and self-concept in infertile women.

For the manuscript search, a search strategy included MeSH terms and Boolean operators that were created as follows: (“Female Infertility” OR “Infertile Women” OR “Infertile Woman” OR “Subfertility Female” OR “Female Subfertility” OR “Sub-Fertility Female” OR “Female Sub-Fertility” OR “Sub Fertility Female” OR “Sterility Female” OR “Female Sterility” OR “Women with Infertility” OR “Infertility”) AND (“Sexual Dysfunction” OR “Sexual Function” OR “Physiological Sexual Dysfunction” OR “Physiological Sexual Dysfunctions” OR “Female Sexual Dysfunction” OR “Sexual Disorders Physiological” OR “Physiological Sexual Disorder” OR “Physiological Sexual Disorders” OR “Sexual Disorder Physiological” OR “Sexual Dysfunctions Physiological” OR “Sex Disorders” OR “Psychosexual Dysfunction” OR “Dysfunction Psychosexual” OR “Dysfunctions Psychosexual” OR “Psychosexual Dysfunction” OR “Psychosexual Disorders” OR “Disorder Psychosexual” OR “Disorders Psychosexual” OR “Psychosexual Disorder” OR “Orgasmic Disorder” OR “Disorders Orgasmic” OR “Orgasmic Disorders”) AND (“Concept Self” OR “Self-Perception” OR “Self-Perceptions” OR “Self-Perception” OR “Perception Self” OR “Perceptions Self” OR “Self-Perceptions” OR “Sexual Self-concept” OR “Sexual Self-Perception” OR “Sexual Concept Self” OR “Sexual Perception Self”).

The selection process included original articles that addressed the issue of sexual dysfunction and self-concept in infertile women, that were published in scientific journals indexed in PubMed in the last 10 years and that were freely accessible. Articles whose study population was couples were excluded, in addition, review articles, books, book chapters, case reports, editorials, and letters to the editor were not considered.

The PubMed search was conducted on 13 October 2023, and 40 articles were identified, whose metadata were exported in. csv format for import into the online tool Rayyan. The blinded evaluation of each article was performed by two authors (Leslie Martinez Herrera and Nicole López Diaz) who were responsible for reviewing the articles independently; any discrepancies were discussed with a third author (John Barja-Ore). At the end of this process, according to the established selection criteria, four articles were included.

The data extraction process was carried out by one author (Kleider Livias-Moya), and validated by two more authors (Jhaneiza Matos Canchanya and Alejandra Lopez-Vera) in a matrix containing information on authorship, year and country of publication, study objective and sample size, study design and data collection, and finally the main findings of the selected studies (Table 1).

RESULTS

Of the 47 articles identified by the search strategy no duplicates were identified, 27 were subsequently eliminated because they were published prior to the last 10 years and 6 because they were review articles, after which 14 articles were obtained, of which 10 were excluded because they did not comply with the subject of the research. Finally, four articles were included in this review (Fig. 1).

CONCLUSION

In conclusion, infertility is a complex problem for women’s physical, psychological, and social health; specifically, sexual dysfunction represents a frequent affectation, with main affectation in the dimensions of sexual satisfaction, orgasm, and desire. This, in turn, has shown a significant relationship with the sexual self-concept of women with infertility problems. Research in this thematic area requires further investigation to generate a better understanding of sexuality in women with this problem and adequately address the challenges it represents.

REFERENCES

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