Many women swagger confidently through business meetings and cocktail parties. But once they shed the armor of Diane von Furstenberg dresses and True Religion jeans, they become flustered schoolgirls, ashamed of everything from scars and birthmarks to stretch marks and small breasts. And in an age when many women yearn for the airbrushed perfection of Beyonce and Jennifer Aniston, it’s easy to assume that men do, too.

“This sort of angst is very understandable,” says Dr. Emanuel Maidenberg, an associate clinical professor of psychiatry at UCLA Medical School who has treated patients with severe body image problems, known as body dysmorphic disorder. “Women are culturally more disposed to these expectations of perfection when it comes to body image.”

To compensate, some women keep their clothes on, while others apologize as they come off. At 49, Susan Greenberg (not her real name), a high-powered lawyer in Chicago, still makes excuses for her small breasts.

“I feel like I have to have a throwaway self-deprecating line,” she says. “In response, they’ll say something reassuring like, “The last thing I care about is …’ or “I never was much of a boob guy.”‘ But she’s still not reassured. “It’s just cliche upon cliche,” she says with a sigh.

The only way to get over body insecurities, Maidenberg says, is to stop focusing on them. “Calling attention to something that is small or not visible is self-defeating,” he says. And hiding a so-called flaw “may be sustainable – but there is a price to pay: tension and apprehension. In the long run, it’s likely to be counter-productive.”

Increasing body confidence, of course, is easier said than done. Caitlin Randall (not her real name), a Los Angeles-based writer, despised the 2-inch-long, 3/4-inchwide birthmark on her right hip. Otherwise lean and sinewy, she saw the brown spot as a glaring flaw on her pale white skin.

“When I would have sex, I would go through these ridiculous contortions to make sure it wasn’t seen,” says Randall, 42. “I would have my arm at my side. If I turned, I might have my hand down there. And I would lie on my right side to go to sleep.” When she did finally point it out to boyfriends, no one ever said anything more judgmental than, “How’d you get that?”

Even model lookalikes are not immune to body insecurity. Sasha Dillon (not her real name), 31, has the kind of spectacular looks that leave men dumbfounded. A dark-skinned black woman who works for a nonprofit organization in Los Angeles, she has beautiful skin and the body of a Playboy centerfold.

But she also has stretch marks.

“They go from my thighs up to my butt,” says Dillon. The result of an adolescent growth spurt, the marks look to her like “long, pale tentacles of flesh” that stand out against her brown skin. She tried tanning, exfoliating, and moisturizing. “I was the only 13-year-old who kept a vat of cocoa butter with me at all times,” she says.

When Dillon began dating, she kept up her efforts at camouflage, refusing to walk naked in front of a lover or to have the lights on during sex. But you can’t play hide-and-seek forever.

“You don’t have to love the part of your body you’re ashamed of,” Maidenberg says. “You just have to stop being ashamed of it. If you stop hiding it, it becomes a non issue.”

But what if it is an issue? Barbara Jenkins (not her real name), who works in radio promotion in Los Angeles, lost a breast to a mastectomy in 1998. She never expected her boyfriend’s pained reaction to the scar and flattened right side of her chest. “He never touched me there again,” says Jenkins, now 56. To accommodate his discomfort and hers, she wore a T-shirt when they made love. “He would lift it up on one side,” she says. In the end, the relationship didn’t last, but Jenkins emerged with a new sense of self.

Last year, when precancerous cells were found in her left breast, Jenkins had another mastectomy. Since then, she has had reconstructive surgery on both breasts. Today, she is upfront about her cancer.

On a recent date with a new man, “I said, “I’ve had breast cancer and I have implants so if that bothers you, let me know.’ He said, “Don’t worry – I’ve had cancer, too!”‘

According to Maidenberg, there is no reason that a woman should “prepare” a man to see her body. “Why do it? In the long run, it only increases anxiety,” he says. Some women conquer their self-consciousness by doing away with the object of their dissatisfaction.

Randall had her birthmark surgically removed 10years ago. “I was surprised by how easy it was,” she says. “But it was painful. There were stitches.” For Randall, this wasn’t giving in. It was taking charge of her body. “It was an act of coming into my own,” she says. “It was liberating.”

Stretch marks can’t be removed, but Dillon has cast off the cocoa butter and turned on the lights in her bedroom. She’s found security in her marriage of a year-and-a-half to a man who, as she puts it, “doesn’t make me feel like I have to back out of a room.” But when the couple began to think about starting a family, she blurted out her worst fear about pregnancy: what if her stomach becomes riddled with stretch marks like the ones she has now? Her husband looked at her quizzically. “Where do you have stretch marks?” he asked.