Body image concerns and their association with sexual self-efficacy and function in postmenopausal women: a cross-sectional study

Objectives: To investigate the relationship between body image concerns, sexual self-efficacy, and sexual function in postmenopausal women. Methods: A total of 459 postmenopausal women aged 45-60 years were recruited from health care centers in Urmia, Iran, for this cross-sectional study using multistage cluster sampling. Data were collected using a demographic questionnaire and three validated instruments: The Body Image Concern Inventory (BICI), the Female Sexual Function Index (FSFI), and the Sexual Self-Efficacy Scale (SSE). The Spearman correlation coefficients and multiple linear regression were used for data analysis, with statistical significance set at P <0.05. Results: The mean age of the participants was 52.0±4.5 years. The mean scores were 83.85±16.25 for the BICI, 14.55±8.27 for the SSE, and 16.55±4.94 for the FSFI. Body image concern showed strong negative correlations with both sexual self-efficacy ( r =−0.876, P <0.001) and sexual function ( r =−0.707, P <0.001). A significant positive correlation was observed between sexual self-efficacy and sexual function ( r =0.635, P <0.001). All FSFI domains demonstrated significant positive correlations with the total FSFI score, with the strongest association observed for orgasm ( r =0.822, P <0.001). Conclusions: Higher body image concerns are associated with lower sexual self-efficacy and sexual function in postmenopausal women. These cross-sectional findings are preliminary and cannot establish causality; they may guide future longitudinal or interventional studies.