Modeling Women's Sexual Function: The Role of Sexual Desire and Satisfaction with Body Image with the Mediation of Sexual Self-Esteem

Document Type : Research Paper

Authors

• Elahe Aslami
• akram malekzadeh

Department of psychology, Payame Noor University (PNU), Tehran, Iran

10.30495/jzvj.2025.33181.4160

Abstract

Introduction: The present study investigated the test and modeling of women's sexual function in relation to sexual desire and satisfaction with body image with the mediation of sexual self-esteem in women of Birjand City.
Methods: This research is applied in terms of purpose and descriptive-correlation in terms of data collection method. The statistical population of the research was 384 women of Birjand city and were selected by available sampling method. The research tools included Rosen et al.'s (2000) sexual performance index, Apt and Halbert's (1992) sexual desire index, Soeto and Garcia's (2002) body image satisfaction scale, and Doyle Zeanah and Schwarz's (1996) women's sexual self-esteem inventory. Structural equation method and PLS software were used for data analysis. 
Findings: According to the findings, sexual desire, Satisfaction with Body Image, and sexual self-esteem have a significant correlation with sexual function in women of Birjand city (P<0.05). Also, the results showed that sexual self-esteem has a mediating effect on the relationship between sexual desire and Satisfaction with Body Image with sexual function in women of Birjand city (p<0.05). Therefore, the fit indices of the conceptual model were acceptable and the final model was confirmed.
Conclusion: According to the findings, it can be concluded that sexual desire and Satisfaction with Body Image improve sexual function in women through the mediation of sexual self-esteem.

Keywords

• Sexual Desire
• Satisfaction with Body Image
• Sexual Function
• Sexual Self-Esteem

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References

1- Lazar A. Moderating effects of religiousness and marriage duration on the relation between sexual and marital satisfaction among Jewish women. Arch Sex Behav 2017; 46:513-523. DOI 10.1007/s10508-016-0847-7. https://link.springer.com/article/10.1007/s10508-016-0847-7

2- Hayes RD. Assessing female sexual dysfunction in epidemiological studies: why is it necessary to measure both low sexual function and sexually-related distress? Sex Health 2008; 5:215-218. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=3eff18fc5c67ecd95acb11c1f89dd4e49227e9c8

3- Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281:537-544. https://jamanetwork.com/journals/jama/fullarticle/188762

4- Hayes RD, Dennerstein L, Bennett CM, et al. Risk factors for female sexual dysfunction in the general population: Exploring factors associated with low sexual function and sexual distress. J Sex Med 2008;5:1681-1693. https://academic.oup.com/jsm/article-abstract/5/7/1681/6862309

5- Ricoy-Cano AJ, Obrero-Gaitán E, Caravaca-Sánchez F, Fuente-Robles YM. Factors Conditioning Sexual Behavior in Older Adults: A Systematic Review of Qualitative Studies. J Clin Med. 2020 Jun 3;9(6):1716. doi: 10.3390/jcm9061716. PMID: 32503157; PMCID: PMC7356633. https://www.mdpi.com/2077-0383/9/6/1716

6- Goldstein I, Kim NN, Clayton AH, DeRogatis LR, Giraldi A, Parish SJ, Pfaus J, Simon JA, Kingsberg SA, Meston C, Stahl SM. Hypoactive sexual desire disorder: International Society for the Study of Women's Sexual Health (ISSWSH) expert consensus panel review. InMayo clinic proceedings 2017 Jan 1 (Vol. 92, No. 1, pp. 114-128). Elsevier. https://www.sciencedirect.com/science/article/pii/S0025619616305961

7- McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT. Definitions of sexual dysfunctions in women and men: A consensus statement from the fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13(2):135-143. https://doi.org/10.1016/j.jsxm.2015.12.019

8- West SL, D’Aloisio AA, Agans RP, Kalsbeek WD, Borisov NN, Thorp JM. Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med. 2008;168(13):1441-1449. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414363

9- Reissing ED, Laliberté GM, Davis HJ. Young women's sexual adjustment: The role of sexual self-schema, sexual self-efficacy, sexual aversion and body attitudes. The Canadian journal of human sexuality. 2005 Jul 1;14(3/4):77. https://www.proquest.com/openview/02dd238c3cdad42eeb752494dd25b06a/1?cbl=33400&pq-origsite=gscholar

10- Aliakbari Dehkordi M. Relationship between women sexual function and marital adjustment. Journal of Behavioral Sciences. 2010, 4, 3, 199-206. https://www.behavsci.ir/article_67690_9e345fcfe74100aeb5f477a113b579ab.pdf

11- Chesli SR, Bostani Khalesi Z, Chenari SS. The role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function. Psicologia: Reflexão e Crítica. 2024 Dec;37(1):1-8. https://link.springer.com/content/pdf/10.1186/s41155-024-00303-4.pdf

12- Vowels LM, Vowels MJ, Mark KP. Uncovering the most important factors for predicting sexual desire using explainable machine learning. The journal of sexual medicine. 2021 Jul;18(7):1198-216. https://doi.org/10.1016/j.jsxm.2021.04.010

13- Torres-Obregon R, Onofre-Rodríguez DJ, Sierra JC, Granados R, Garza-Elizondo ME, Benavides-Torres RA. Factores interpersonales como predictores de la autoestima sexual en mujeres del noreste de México. Revista Internacional de Andrología. 2019 Apr 1;17(2):55-9. https://doi.org/10.1016/j.androl.2018.03.003

14- Bitzer J, Giraldi A, Pfaus J. A standardized diagnostic interview for hypoactive sexual desire disorder in women: standard operating procedure (SOP Part 2). The Journal of Sexual Medicine. 2013 Jan;10(1):50-7. https://doi.org/10.1111/j.1743-6109.2012.02817.x

15- Avalos L, Tylka TL, Wood-Barcalow N. The body appreciation scale: Development and psychometric evaluation. Body Image 2005;2:285-297. https://doi.org/10.1016/j.bodyim.2005.06.002

16- Gattario KH, Frisén A. From negative to positive body image: Men’s and women’s journeys from early adolescence to emerging adulthood. Body Image 2019;28:53-65. https://doi.org/10.1016/j.bodyim.2018.12.002

17- van den Brink F, Smeets MA, Hessen DJ, et al. Positive body image and sexual functioning in Dutch female university J Sex Med 2021;18:474e486 484 Wu and Zheng students: The role of adult romantic attachment. Arch Sex Behav 2016;45:1217-1226. file:///C:/Users/elahe506/Downloads/s10508-015-0511-7%20(1).pdf

18- Robbins AR, Reissing ED. Appearance dissatisfaction, body appreciation, and sexual health in women across adulthood. Arch Sex Behav 2018;47:703-714. https://link.springer.com/article/10.1007/s10508-017-0982-9

19- Woertman L, van den Brink F. Body image and female sexual functioning and behavior: a review. J Sex Res 2012; 49:184-211. https://doi.org/10.1080/00224499.2012.658586

20- Wu T, Zheng Y. Effect of sexual esteem and sexual communication on the relationship between body image and sexual function in Chinese heterosexual women. The Journal of Sexual Medicine. 2021 Mar;18(3):474-86. https://doi.org/10.1016/j.jsxm.2020.12.006

21- Brassard A, Dupuy E, Bergeron S, et al. Attachment insecurities and women’s sexual function and satisfaction: The mediating roles of sexual self-esteem, sexual anxiety, and sexual assertiveness. J Sex Res 2015;52:110-119. https://doi.org/10.1080/00224499.2013.838744.

22- Robbins AR, Reissing ED. Out of “objectification limelight”? The contribution of body appreciation to sexual adjustment in midlife women. J Sex Res 2018;55:758-771. https://doi.org/10.1080/00224499.2017.1372352

23- Delavar A. Theoretical and practical foundations of research in humanities. 2016, Tehran: Roshd.

24- Rosen, C. Brown, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, D. Ferguson, R. D'Agostino R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. Journal of sex & marital therapy. 2000 Apr 1;26(2):191-208. https://doi.org/10.1080/009262300278597

25- Neijenhuijs KI, Hooghiemstra N, Holtmaat K, Aaronson NK, Groenvold M, Holzner B, Terwee CB, Cuijpers P, Verdonck-de Leeuw IM. The Female Sexual Function Index (FSFI)—a systematic review of measurement properties. The journal of sexual medicine. 2019 May 1;16(5):640-60. https://doi.org/10.1016/j.jsxm.2019.03.001

26- Mohammadi Kh, Heydari M & Faqih Zadeh S. Validity of the Persian version of Female Sexual Function Index-FSFI. . Payesh. 2009, 7(3), 278-269. https://payeshjournal.ir/browse.php?a_id=658&sid=1&slc_lang=en

27- Apt CV, Hurlbert DF. Motherhood and female sexuality beyond one year postpartum: A study of military wives. Journal of Sex Education and Therapy. 1992 Jun 1;18(2):104-14. https://doi.org/10.1080/01614576.1992.11074044

28- Yosefi N, Farsani K, Shakiba Z, Hemati A, Nabavi Hesar J. Scientific-Research Journal Of Shahed University. 2014, 20, 9, 107-118. file:///C:/Users/elahe506/Downloads/4006313920911%20(3).pdf

29- Souto CM, Garcia TR. Construction and validation of a body image rating scale: a preliminary study. International Journal of Nursing Knowledge. 2002 Oct 1;13(4):117. https://www.proquest.com/openview/6aa3d9b114c076ca0251acbd568a777e/1?cbl=27194&pq-origsite=gscholar

30- Taheri Torbati H, Bolghan-Abadi M, Ghoddosi Tabar M. Preliminary Psychometric Properties of Satisfaction with Body Image Scale. J Res Behave Sci. 2014, 11(6): 522-531 Received: 12.06.2012.  http://rbs.mui.ac.ir/article-1-344-en.html

31- Doyle Zeanah P, Schwarz JC. Reliability and validity of the sexual self-esteem inventory for women. Assessment. 1996 Mar;3(1):1-5. https://doi.org/10.1177/107319119600300101

32- Farrokhi S & Sharreh H. Psychometric features of the Persian version of the short form of women's sexual self-esteem index. Iranian Journal of Psychiatry and Clinical Psychology. 2014, Vol. 20, No. 3, 252 -263. file:///C:/Users/elahe506/Downloads/52813930307%20(5).pdf

33- Davary A & Rezazadeh A. structural equation modeling with pls software. tehran: jahad daneshgahy. 2018.

34- Fredrickson BL, Roberts TA. Objectification theory: Toward understanding women’s lived experiences and mental health risks. Psychol Women 1997;21:173-206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x

35- Cash TF, Pruzinsky T. Body image: A handbook of theory, research, and clinical practice. New York: Guilford; 2004. https://www.researchgate.net/publication/224983228_Cash_TF_Pruzinsky_T_Eds_Body_Image_A_Handbook_of_Theory_Research_and_Clinical_Practice

36- Claudat K, Warren CS. Self-objectification, body selfconsciousness during sexual activities, and sexual satisfaction in college women. Body Image. https://doi.org/10.1016/j.bodyim.2014.07.006

37- Ramezani Tehrani F, Farahmand M, Mehrabi Y, Afzali HM & Abedini M. Prevalence of female sexual dysfunction and its correlated factors: a population based study. 2012, 11 (6), :869-875. https://payeshjournal.ir/article-1-407-fa.html

38- Hurlbert, D. F., Apt, C., & Rabehl, S. M. (1993). Key variables to understanding female sexual satisfaction: An examination of women in nondistressed marriages. Journal of sex & marital therapy, 19(2), 154-165. https://doi.org/10.1080/00926239308404899

39- Murphy WD, Coleman E, Hoon E, Scott C. Sexual dysfunction and treatment in alcoholic women. Sexuality and Disability. 1980 Dec;3:240-55. https://link.springer.com/article/10.1007/BF01207674

40- Matsuura AC. Interpersonal and psychosexual factors predicting HIV-related risky sex behaviors in heterosexually active women and men, 2008. https://digitalcommons.uri.edu/oa_diss/2249/

41- Santos-Iglesias P, Byers SE. The role of verbal and nonverbal communication in couples' sexual satisfaction. Journal of Sexual Medicine, vol. 8, supl. 3. 2011. https://hdl.handle.net/10216/97663

42- Peixoto MM, Amarelo-Pires I, Pimentel Biscaia MS, Machado PP. Sexual self-esteem, sexual functioning and sexual satisfaction in Portuguese heterosexual university students. Psychology & Sexuality. 2018 Oct 2;9(4):305-16. https://doi.org/10.1080/19419899.2018.1491413

43- Gillen MM, Markey CN. Body image and HIV risk among college students. Am J Health Behav 2014;38:816-822.  https://doi.org/10.5993/AJHB.38.6.3

44- Agha Babaei S, Heshmatian T, Roshanayi, GH. Rouhani Mahmoodabadi SM, Rafai M. Investigating the factors related to sexual performance in lactating women with hyposexuality who referred to health centers in Songhor city in 2017. IJOGI. 2021, 24 (2), 23-32.file:///C:/Users/elahe506/Downloads/63814000204.pdf

45- Pujols Y, Meston CM, Seal BN. The association between sexual satisfaction and body image in women. The journal of sexual medicine. 2010 Feb;7(2_Part_2):905-16. https://doi.org/10.1111/j.1743-6109.2009.01604.x