The Mediating Role of Genital Self-Perception in the Relationship Between Attitudes Toward Menopause and Sexual Quality of Life in Postmenopausal Women: A Pilot Study

Abstract

Objective This study aimed to investigate the mediating role of genital self-image in the relationship between postmenopausal women's attitudes toward menopause and their sexual quality of life. Method This study is descriptive. The sample consisted of 351 postmenopausal women who met the research criteria. The data were collected online between May and December 2023 using a descriptive information form, the Attitude Towards Menopause Questionnaire, the Female Genital Self-Image Scale, and the Sexual Quality of Life Questionnaire Scale. Data were collected using descriptive statistics, Pearson correlation analysis, and structural equation modeling. Results The mean total scale scores of the women were 34.41 +/- 9.22 for Attitude Towards Menopause Questionnaire, 16.24 +/- 3.40 for Female Genital Self-Image Scale, and 44.46 +/- 22.16 for Sexual Quality of Life Questionnaire Scale. Analysis revealed moderate positive relationships: between attitude toward menopause and sexual quality of life (r = 0.451, P < 0.001); between attitude toward menopause and genital self-image (r = 0.520, P < 0.001); and between the genital self-image and sexual quality of life (r = 0.361, P < 0.001). When genital self-image was added as a mediator, there was a direct positive relationship between attitude toward menopause and genital self-image (beta = 0.192, P < 0.001) and between genital self-image and sexual quality of life (beta = 1.126, P < 0.05). The indirect relationship of attitude toward menopause on sexual quality of life through genital self-image was positive and significant (beta = 0.216; P < 0.05; 95% CI, 0.063-0.353). With the inclusion of genital self-image as a mediator, the combined effect of attitude toward menopause and genital self-image explained 22.5% of the variance in sexual quality of life (R-2 = 0.225). In comparison, attitude toward menopause explained 27% of the variance in genital self-image (R-2 = 0.270). Conclusion There is an inverse relationship between postmenopausal women's negative attitudes toward menopause and their genital self-image and quality of sexual life.