RESUMEN
BACKGROUND: The relationship between factors related to masturbation, sexual function, and genital self-image among women has not been fully explored in the literature. AIM: The study sought to investigate the association between masturbation frequency, feelings, and behaviors with sexual function and genital self-image in young women. METHODS: A cross-sectional survey among 110 undergraduate female students was conducted. Online self-administered questionnaires to assess sociodemographic characteristics, masturbatory frequency, feelings, and behavior were completed. Participants also answered the Brazilian version of the Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS). OUTCOMES: The outcome includes masturbation frequency and behaviors associated, as well as scores on the FSFI and FGSIS. RESULTS: Women showed higher scores in FSFI subdomains when masturbation was considered important for them, along with reported feelings of empowerment and satisfaction during this activity. However, those who experienced negative emotions during masturbation, such as shame or guilt, demonstrated a significant association with lower scores in both FSFI and FGSIS. Masturbation frequency was found to correlate with better sexual function specifically in the desire domain among women who engaged in daily masturbation. Additionally, an association was observed between higher scores in the FGSIS and increased scores in the domains of satisfaction, arousal, and orgasm within the FSFI. There was an association in the domain's satisfaction, arousal, and orgasm of the FSFI with greater scores in FGSIS. CLINICAL IMPLICATIONS: The clinical implications encompass the augmentation of understanding pertaining to female sexual function. STRENGTHS AND LIMITATIONS: The study provides valuable insights into the sexual behavior of undergraduate female students, and its methodology improves openness in responses, as it provides anonymity given the sensitive nature of the topic studied. Study limitations include the unsuitability of the FSFI questionnaire for sexually inactive women in the past 4 weeks; the participation bias and reporting bias in sexuality searches; and the unknown validity of the investigator-derived questionnaire about masturbation, as it has not been previously validated. CONCLUSION: Masturbation frequency has minimal to no impact on female sexual function, whereas harboring positive feelings toward it and maintaining a positive genital self-image may exert a positive influence on sexual function.