title: "You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.
abstract: Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available.
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Caleb J
authors.initials: CJ
authors.lastname: Winch
authors.affiliation: Centre for Emotional Health, Department of Psychology, Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia. Electronic address: Kerry.Sherman@mq.edu.au.
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Sherman
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Katriona M
authors.initials: KM
authors.lastname: Smith
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Koelmeyer
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; Mt. Wilga Private Hospital, Sydney, New South Wales, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Mackie
authors.affiliation: Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Boyages
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001828:Body Image / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D007866:Leg; D008209:Lymphedema / Q000209:etiology / Q000523:psychology*; D008875:Middle Aged; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology; D012944:Social Support
keywords: Body image; Cancer; Chronic illness; Couples; Lymphedema; Sexuality