Sexual difficulties are common. National survey data have found that as many as 43% of women and 31% of men in the United States report some type of sexual dysfunction, ranging from the absence of orgasm, to painful intercourse, to difficulties with erection and vaginal lubrication [1]. Pinpointing the causes of sexual problems is complicated because biological, psychological, and social factors can all contribute. In this post, I’d like to take a look at one specific factor that has been implicated in a wide range of sexual difficulties, especially among women: body image.

What we’re talking about here is one’s overall level of body satisfaction, not just satisfaction with one specific body part. So how do women feel about their bodies, and what does this mean for their sex lives? In a survey of 3,627 women aged 14-74, 40% reported that they were at least somewhat satisfied with their bodies, with the remaining 60% reporting some level of dissatisfaction [2]. In addition, 90% reported that they were at least somewhat self-conscious about their physical appearance, and even more (95%) reported that their appearance matters a lot in their everyday interactions with others.

Women who were dissatisfied with their bodies reported less frequent sex, a lower likelihood of initiating sex with their partner, more discomfort undressing in front of one’s partner and having sex with the lights on, and less willingness to try new sexual activities. In addition, women who were less satisfied with their bodies reported having fewer orgasms and a greater likelihood of having ever faked an orgasm with their partner.

Aside from less frequent sex and only having sex under limited circumstances (e.g., with the lights off), one other way poor body image can contribute to sexual and relationship problems is by creating distractions during sex. Research has found that women with more body image concerns reporting having more distracting thoughts about their physical appearance while they’re between the sheets (e.g., they are more likely to be thinking to themselves, “How does my body look to my partner?”) [3]. Perhaps not surprisingly, women who report more such distractions report being less sexually satisfied.

In short, the less content women are with their bodies, the more sexual difficulties they tend to encounter. Of course, it is important to keep in mind that body image concerns do not always precede sexual difficulties; sometimes, having a sexual difficulty can lead one to feel worse about their body and that, in turn, can worsen existing sexual problems. Either way, it is clear that body image and sexual dysfunction and intimately intertwined and the way we feel about our bodies is likely to be an important consideration in any sex therapy program, but not just for women. Helping people of all genders learn to love their bodies can lead to better sex, and better sex can help people learn to love their bodies even more.

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[1] Laumann, E.O., Paik, A., & Rosen, R.C. (1999). Sexual dysfunction in the United States. The Journal of the American Medical Association, 281, 537-544.



[2] Ackard, D.M., Kearney‐Cooke, A., & Peterson, C.B. (2000). Effect of body image and self‐image on women's sexual behaviors. International Journal of Eating Disorders, 28, 422-429.

[3] Pujols, Y., Meston, C.M., & Seal, B.N. (2010). The association between sexual satisfaction and body image in women. The Journal of Sexual Medicine, 7(2pt2), 905-916.

Image Source: iStockphoto.com

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