Psychological and sexual correlates of sexual abuse in women with sexual dysfunction

Elisa Maseroli (IT), Irene Scavello (IT), Egidia Fanni (IT), Sarah Cipriani (IT), Enza Di Stasi (IT), Mario Maggi (IT), Linda Vignozzi (IT)

[Maseroli] Gynecological Endocrinology Research Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Scavello] Gynecological Endocrinology Research Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Fanni] Gynecological Endocrinology Research Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Cipriani] Gynecological Endocrinology Research Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Di Stasi] Gynecological Endocrinology Research Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Maggi] Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”, University of Florence, Florence, [Vignozzi] Gynecological Endo

Context: Approximately 20% of women experience sexual abuse (SA) worldwide. SA survivors are prone to experiencing psychiatric symptoms and sexual dysfunction (SD). Objective: This study aimed to evaluate the prevalence and correlates of reported SA at different ages in a sexual medicine setting. Methods: We retrospectively studied a series of women attending our clinic for SD. Patients: A series of 200heterosexual women with SD was consecutively recruited. Forty-seven women (23.5%) reported SA, which occurred in childhood, adolescence and adulthood in 9% (n=18), 7.5% (n=15) and 7% (n=14) of cases, respectively. Interventions: Retrospective analysis of the patients, who completed some validated questionnaires. Main Outcome Measures: All patients completed the Middlesex Hospital Questionnaire (MHQ), Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS) and Body Uneasiness Test (BUT). Results: SA women showed significantly higher MHQ total score (p=0.023), free-floating anxiety (MHQ-A: p < 0.0001) and phobic anxiety symptoms (p=0.043) when compared with non-SA women. SA women also showed significantly lower FSFI Orgasm domain (p=0.001), Satisfaction domain (p=0.004) and Total scores (p=0.027), and a higher FSDS total score (p=0.003). After adjusting for age and the use of psychotropic drugs, only the difference in MHQ-A (F=9.824, p=0.002), FSFI Orgasm (F=7.395, p=0.007) and FSDS total scores (F=7.208, p=0.008) retained statistical significance. When considering BUT, SA patients showed significantly higher Global Severity Index (p=0.021), Weight Phobia (p=0.025), Body Image Concerns (p=0.025), Avoidance (p=0.042), Depersonalization (p=0.032), Positive Symptom Total (p=0.045) and Positive Symptom Distress Index (PSDI) scores (p=0.022) than non-SA patients. All the differences retained statistical significance after adjusting for age, psychotropic drugs and body mass index. Significantly lower FSFI Orgasm (p=0.009) and Satisfaction domain scores (p=0.012) were found in patients reporting SA in adolescence when compared with SA in childhood, even after adjusting for confounders (F=8.577, p=0.007 and F=7.102, p=0,013 for Orgasm and Satisfaction, respectively). Conclusions: SA women show higher anxiety symptoms, sexual distress and body image concerns and a worse orgasm functioning when compared to non-SA women. SA has a greater negative impact on orgasm functioning and sexual satisfaction when perpetrated in adolescence than in childhood.