Body image concerns in individuals diagnosed with benign gynaecological conditions: scoping review and meta-synthesis

Abstract

Background: Benign gynaecological conditions (BCGs) and body image-related concerns are commonly experienced by reproductive-aged female-identified individuals. Qualitative evidence from cancer populations identifies a link between diseases of the sexual organs and body image distress encompassing appearance, sensory and functional aspects. Most BCGs and the impacts on body image have been studied separately. However, commonalities exist between these conditions including chronicity, diagnostic delays, and menstrual-related social stigma. This systematic scoping review and meta-synthesis aimed to compare and contrast the experience of body image in the benign conditions of endometriosis, polycystic ovarian cysts, uterine fibroids, and vulvar intraepithelial neoplasia. Method: Electronic databases (MEDLINE, PsycINFO, Scopus, CINAHL, Embase, and Allied and Complementary Medicine) were searched in February 2020 and relevant articles were examined to identify papers that qualitatively explored the relationship between body image and BCGs. Meta-synthesis was used to analyse the 17 papers that met the inclusion criteria. Results: Six main themes evolved from this iterative analysis: loss of control; regained control; silencemenstrual concealment; cultural differences; feeling abnormal, and functional impairment. Body image concerns were widespread although impacts on individual's lives were dependent on the unique symptom profile of each disease which interacted with socio-cultural factors, daily functioning, and feminine identity. Body image concerns were a common, but hidden, experience rarely screened in routine clinical settings despite causing significant distress. Conclusions: The chronicity and severity of individuals unique symptom profile often determined the intensity and type of body image concerns individuals described. Across conditions, body image concerns were often left untreated, were concealed, and were associated with reduced quality of life.

“My body…tends to betray me sometimes”: a Qualitative Analysis of Affective and Perceptual Body Image in Individuals Living with Endometriosis

“…Participants viewed the symptomatic disease as a burden limiting their desired daily functioning in domains including work attendance, social life, exercise, and study, corroborating findings that endometriosis-related role disruption results in frustration, disappointment, and demotivation [31]. This is consistent with prior endometriosis [5,6,22,32,33] and chronic illness [34] research, reflecting the concept of experiencing disruption versus restoring continuity [8]. Our findings extend this theoretical concept by highlighting how endometriosis creates the affective response of a sense of grieving for a desired, but seemingly unattainable, body image trajectory.…”

Co-design and Development of EndoSMS, a Supportive Text Message Intervention for Individuals Living With Endometriosis: Mixed Methods Study

“…Previous research has highlighted that people with endometriosis have a tendency to be self-critical, particularly in relation to their body appearance and function [ 23 ], presenting a further barrier to maintaining good psychological health [ 24 ]. A growing body of literature indicates that self-compassion (the ability to view oneself in a kind, compassionate manner [ 25 ]) may act as a buffer in the face of adversity [ 26 - 29 ], reducing psychological distress and symptom burden among people with endometriosis [ 30 ].…”

Cross-sectional study for derivation of a cut-off value for identification of a timely versus late diagnosis of endometriosis based on analytical and descriptive research methods

“…Some quantitative and qualitative studies have investigated possible reasons for this. A range of physician-related [7,8] and patient-related factors [9] as well as stigmatization of the topic of menstruation by society have been identi ed [10,11]. The consequences of the disease being diagnosed late (or too late) on the course of disease, the quality of life and the costs of the disease have already been documented in studies [12,13].…”