Abstract

This systematic review explores the intricate interplay between women's sexual health and psychological dimensions, recognizing the holistic nature of well-being. From sexual identity and self-perception to the impact of cultural influences and the role of trauma, this comprehensive examination aims to navigate the psychological factors influencing women's sexual health. The biopsychosocial model provides a framework for understanding the complexity of these dimensions, emphasizing the need for integrated approaches to promote positive outcomes. By addressing body image, emotional connection, communication, and the relationship between mental health and sexual function, this review contributes to a nuanced understanding of the psychological facets shaping women's sexual well-being.

Keywords

Women's Sexual Health; Psychological Dimensions; Biopsychosocial Model; Sexual Identity; Body Image; Intimacy; Communication; Cultural Influences; Trauma; Mental Health; Sexual Education; Holistic Well-being

Introduction

Women's sexual health is a complex and multifaceted aspect of overall well-being, intertwining physical, emotional, and psychological dimensions. Understanding the intricate relationship between sexual health and psychological well-being is crucial for promoting holistic health in women. This article embarks on a systematic review, delving into the various dimensions that influence and shape women's sexual and psychological health. PWB is commonly characterized as reaching one’s full potential and is linked to meaningful wellness attitudes, and it embraces different aspects such as autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Sexual health, as mentioned by the World Health Organization (WHO), refers to “a state of physical, emotional, mental, and social well-being in relation to sexuality” (p. 5). It emphasizes the importance of a positive and respectful approach to ensure pleasurable and safe sexual experiences. When it comes to women, female sexual health encompasses various physical, emotional, and social factors that influence their sexual experiences and overall quality of life. Research consistently shows associations between PWB and sexual health outcomes across diverse cultures. Some examples of these associations have shown that positive PWB or better mental health, including high self-esteem, life satisfaction, and lower levels of depression and anxiety, are associated with improved sexual functioning and satisfaction in women.

In summary, it is known that human sexuality is an important part of peoples’ lives and well-being. The link between psychological well-being and female sexual health is crucial to women’s quality of life. This work started from the following research question: How is psychological well-being related to sexual health in women? We hypothesized that better psychological well-being will be related to better female sexual health. As aware as we are, a systematic review of the scientific literature specifically focused on these two topics in women does not exist. Thus, the aim of this study is to conduct a comprehensive review of the existing scientific literature to explore the association between PWB and sexual health in women.

Defining Sexual Health

To navigate women's sexual health, it's essential to define the concept. Sexual health extends beyond the absence of disease and dysfunction, encompassing physical pleasure, emotional well-being, and psychological satisfaction. Acknowledging this holistic perspective lays the foundation for a comprehensive exploration.

Biopsychosocial Model

The biopsychosocial model provides a framework for understanding women's sexual health. This model recognizes the interplay between biological, psychological, and social factors. Examining each dimension in isolation may provide limited insights; thus, a holistic approach is imperative.

Sexual Identity and Self-Perception

Women's sexual health is intricately connected to their self-perception and sexual identity. Society's expectations, cultural influences, and personal beliefs shape how women perceive their own sexuality. Understanding these dynamics is crucial in promoting positive sexual experiences.

Body Image and Sexual Satisfaction

The psychological dimension of body image plays a significant role in women's sexual health. Societal ideals and media representations often influence how women perceive their bodies, impacting self-esteem and sexual satisfaction. A positive body image contributes to a healthier sexual self-concept.

Intimacy and Emotional Connection

The emotional dimension of women's sexual health is highlighted through intimacy and emotional connection. Healthy relationships foster a sense of security and trust, positively impacting sexual well-being. Conversely, unresolved emotional issues can contribute to sexual dysfunction and dissatisfaction.

Communication and Relationship Dynamics

Effective communication is paramount in navigating women's sexual health. Open dialogue with partners about desires, boundaries, and preferences fosters a supportive environment for sexual exploration. Relationship dynamics significantly influence psychological well-being in the realm of sexuality.

Cultural Influences on Sexual Expression

Cultural norms and values can significantly impact women's sexual health. Understanding and respecting diverse cultural perspectives is crucial for promoting sexual well-being. Cultural sensitivity in healthcare practices ensures that interventions align with individual values and beliefs.

Trauma and Its Implications

Traumatic experiences, such as sexual assault or abuse, can have profound and lasting effects on women's sexual health. A systematic review must address the psychological implications of trauma and explore therapeutic interventions that promote healing and recovery.

Mental Health and Sexual Function

The reciprocal relationship between mental health and sexual function cannot be overlooked. Conditions such as anxiety, depression, or stress can affect libido and overall sexual satisfaction. Integrating mental health support into sexual health interventions is vital for comprehensive care.

Sexual Education and Empowerment

Empowering women through comprehensive sexual education is a key aspect of promoting psychological well-being. Knowledge about anatomy, contraception, and sexual pleasure equips women to make informed choices, fostering a sense of control over their sexual health.

Discussion

The aim of this study was to carry out a systematic review of the association between PWB and female sexual health. In general, the findings show that recent research has focused on women of clinical samples and considers anxiety and depression as the most important PWB variables, while general sexual functioning is the most relevant sexual variable.

This recent scientific literature that examined the association between psychological well-being and sexual health has shown great interest in women diagnosed with certain health problems. Therefore, the majority of the studies focused on women with specific medical diagnoses when evaluating the link between PWB and sexual health. These medical diagnosis topics included issues related to congenital heart disease with implantable cardioverter-defibrillators, and breast, anal, or rectal cancer. For example, results have shown that, in women with congenital heart disease, depression and anxiety are negatively associated with worse sexual functioning. Some psychological disorders like Attention-Deficit/Hyperactivity Disorder (ADHD) and opioid use disorder are also considered. For example, women with ADHD reported more hypersexual behaviors.

Moreover, research examining female sexual health has primarily focused on sexual functioning, often overlooking other critical aspects like sexual behaviors, attitudes, gender roles, and the prevention of sexual and reproductive infections or diseases, unwanted pregnancies, or sexual violence. As a result of this focus, and in terms of assessment, the most used measurement instrument for evaluating sexual functioning in women is the FSFI. In this line, the quality assessment of women’s sexuality requires standardized validated scales encompassing multidimensional constructs. Beyond the Female Sexual Function Index, other validated questionnaires can provide an assessment of sexual functioning across genders.

Conclusion

In navigating women's sexual health, a systematic review must embrace the complexity of psychological dimensions. Recognizing the interconnectedness of biological, psychological, and social factors allows for a nuanced understanding that goes beyond the surface. By addressing the intricacies of sexual identity, body image, emotional connection, and cultural influences, we can pave the way for interventions that promote holistic well-being in women. As we continue to explore and unravel the nuances of women's sexual health, it becomes increasingly evident that a comprehensive and integrated approach is essential for fostering positive outcomes.