Investigating the link between severity of dyspareunia and female sexual distress among a group of women with endometriosis: the mediating role of body functionality appreciation

BACKGROUND: While existing studies have predominantly focused on negative body image and its potential link to female sexual distress in women with endometriosis, no studies have investigated how positive body image (ie, body functionality appreciation) mediates the association between dyspareunia severity and sexual distress in this population. AIM: This study aimed to investigate the mediating role of body functionality appreciation in the relationship between severity of dyspareunia and sexual distress in women living with endometriosis. METHODS: A total of 232 women with endometriosis (M = 35 years) took part in the study. Participants completed an anonymous questionnaire evaluating dyspareunia severity, functionality appreciation, female sexual distress, sociodemographic factors, and endometriosis-related clinical information. All participants were administered the following questionnaires: numerical rating scale, body functionality appreciation, female sexual distress scale. OUTCOMES: Using a mediation model, the study analyzed both the direct and indirect effects of dyspareunia severity on sexual distress, with functionality appreciation as a mediator. RESULTS: The findings suggest that the severity of dyspareunia significantly contributes to sexual distress both directly and indirectly, by diminishing the appreciation for body functionality. CLINICAL IMPLICATIONS: Clinicians should not only focus on the severity of dyspareunia when evaluating sexual distress in women; instead, they should also acknowledge the protective role of positive body image. Integrated treatments that promote body functionality appreciation could enhance treatment outcomes. STRENGTHS AND LIMITATIONS: The study is the first to examine the mediating role of body functionality appreciation in the relationship between dyspareunia severity and sexual distress in a sample of women with endometriosis; however, the assessment was cross-sectional and did not encompass other factors that may influence the connection between dyspareunia severity and sexual distress. CONCLUSION: These findings, in addition to advancing theoretical understanding of the role of positive body image in women with dyspareunia, may be valuable in guiding the design of interventions aimed at reducing sexual distress in women with high levels of dyspareunia severity.