Carla Sullivan-Myers, Kerry A Sherman, Emily Kopp
Body image disturbance is a commonly experienced psychological impact of endometriosis and other chronic pelvic pain (CPP) conditions (e.g., vulvodynia). This systematic review and meta-analysis of quantitative literature aimed to describe the prevalence of body image concerns in endometriosis and other CPP conditions, and to delineate the psychosocial, demographic, and condition-specific factors associated with body image. Electronic databases (Medline, CINAHL, EMBASE, PsycINFO, Scopus, ProQuest) were searched for CPP studies with body image outcomes. Quality of included studies was assessed following the Cochrane Collaboration Risk of Bias tool and the Risk of Bias Assessment Tool for Nonrandomised Studies. The systematic search yielded 22 relevant studies (N = 7609). A high prevalence of body image disturbance was evident across CPP types. Compared to healthy control groups, the meta-analysis revealed those with CPP had significantly worse body image concerns (g = 0.50, 95% CI [0.30, 0.69], p < .001). Psychosocial factors associated with body image were anxiety, depression, loneliness, sexual dysfunction and distress across the different CPP conditions. Body functionality may be a key outcome to consider in the relationship between condition-specific symptoms (e.g., pain) and body image concerns, demonstrating potential as a target of intervention. The quality of many included studies was limited by their cross-sectional design and minimal use of theory to interpret findings, highlighting the need for better quality research. Future research in CPP conditions is needed that uses validated measures of body image and expands understanding of constructs such as body functionality, that may be highly relevant for chronic pain conditions.