Women Have Poorer Body Image After Amputation

Lower-limb amputations can lead to depression, performance anxiety, and altered body image, relationships, and sexual well-being. While there is little published about how people experience changes to body image and their sexuality after amputation, literature exploring sexuality specifically from the female perspective remains especially minimal, according to a study published in June in the Journal of Disability and Rehabilitation. Therefore, researchers attempted to gain an understanding of women’s experience of sexuality and body image following amputation of a lower limb as a means to inform rehabilitation and clinical practice.

Semi-structured interviews were conducted with nine women with lower-limb amputations to collect rich contextual data. Qualitative data was analyzed using Interpretative Phenomenological Analysis (IPA).

Three superordinate themes emerged from IPA data analysis: “I don’t like the way I am,” which illustrated participants’ changed relationship with their embodied selves; “Broken/not wanted,” which reflected changes participants experienced in their romantic relationships; and “Same but different,” which related to participants’ changed societal roles as women.The study found that participants’ accounts highlighted experiences of decreased sexual well-being, disrupted body image, stigmatization, and resilience. These accounts point to the potential utility of compassion-focused approaches in therapeutic intervention, as well as the necessity for health professionals to involve spouses in sexual rehabilitation conversations and encourage patient-led peer support networks.

According to the study’s authors, implications for rehabilitation could include:

• Psychosexual assessment following limb loss involving open-ended questions will likely capture issues of sexual well-being as well as functioning, ensuring that interventions are comprehensive, targeted, and relevant to the individual.
• Women struggle with reconciling their post-amputation kinetic representations of their selves to new ways of functioning, which may impact body image and prosthesis uptake.
• Compassion-focused psychotherapeutic interventions could be effective in addressing problematic coping strategies after amputation such as avoidance and disengagement while enhancing more self-compassionate coping styles.
• Couples distressed about their relationship may not engage in problem-solving discussions around sexuality, highlighting the necessity for health professionals to involve spouses in sexual rehabilitation conversations and interventions.
• Supporting the creation of gendered, peer-led groups to address issues related to sexual well-being is likely to improve overall quality of life for these individuals.