Female Sexual Function during Pregnancy and after Childbirth

IntroductionHealthy sexual function during pregnancy and after childbirth is one of the cornerstones for couples to evolve from partners to parents.AimThe aim of our review is to evaluate the available evidence and define present knowledge about female sexual function during pregnancy and after childbirth.MethodsPubMed was searched for articles on sexual function during pregnancy and after childbirth, published from 1960 up to date. The most relevant articles have been reviewed and included.Main Outcome MeasuresThe main outcome is the review of the effect of pregnancy, delivery, and postpartum on female sexuality.ResultsA total of 48 articles which specifically addressed this topic were included. Sexual function was found to have a significant global decline during pregnancy, particularly in the third trimester and this persisted for 3–6 months following delivery. The lack of adequate information about sex in pregnancy and concerns about the possible adverse obstetric outcomes are the most relevant factors responsible for the avoidance of sexual activity during pregnancy. Breast-feeding, dyspareunia, and postpartum pelvic floor dysfunction were reported as possible causes for the delay in resuming sexual intercourses after childbirth.ConclusionsCouples should be informed about the decline of libido, desire and orgasm, commonly encountered during pregnancy, particularly in the last trimester, and puerperium which may lead to reduction in sexual intercourse frequency. Serati M, Salvatore S, Siesto G, Cattoni E, Zanirato M, Khullar V, Cromi A, Ghezzi F, and Bolis P. Female sexual function during pregnancy and after childbirth.     

The Relationship Between Depressive/Anxiety Symptoms During Pregnancy/Postpartum and Sexual Life Decline after Delivery

IntroductionSeveral factors have been found to be independently associated with decline in sexual activity after delivery. However, the association between depression in pregnancy/postpartum and sexual problems is less clear.AimTo prospectively evaluate the relationship between depressive/anxiety symptoms (DAS) during the perinatal period and sexual life in the postpartum period.MethodsA prospective cohort study conducted between May 2005 and March 2007 included 831 pregnant women recruited from primary care clinics of the public sector in São Paulo, Brazil. Four groups with DAS during antenatal and postpartum periods were identified using the Self Report Questionnaire (SRQ‐20): absence of both antenatal and postpartum DAS; presence of antenatal DAS only; presence of postpartum DAS only; and presence of both antenatal and postpartum DAS. The primary outcome was perception of sexual life decline (SLD) before and after pregnancy/delivery. Crude and adjusted risk ratios (RR), with 95% confidence intervals (95% CI), were calculated using Poisson regression to examine the associations between DAS and SLD.Main Outcome MeasureThe main outcome measure of this study is the perception of SLD before and after pregnancy/delivery.ResultsSLD occurred in 21.1% of the cohort. In the multivariable analysis, the following variables were independently associated with SLD: DAS during both pregnancy and postpartum (RR: 3.17 [95% CI: 2.18–4.59]); DAS during only the postpartum period (RR: 3.45 [95% CI: 2.39–4.98]); a previous miscarriage (RR: 1.54 [95% CI: 1.06–2.23]); and maternal age (RR: 2.11 [95% CI: 1.22–3.65]).ConclusionsPostpartum women with DAS have an increased likelihood for SLD up to 18 months after delivery. Efforts to improve the rates of recognition and treatment of perinatal depression/anxiety in primary care settings have the potential to preserve sexual functioning for low‐income mothers.     

Associations Between Depressive Symptoms and Sexual Risk Behavior in a Diverse Sample of Female Adolescents

Study ObjectiveTo determine associations between depressive symptoms, locus of control, and sexual outcomes in a predominantly African-American cohort of female adolescents.DesignA computerized assessment was administered to participants as part of a larger randomized clinical trial. We assessed sexual risk behaviors (SRBs) via self-report, and we assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale. We used multivariate regression to determine associations between depressive symptoms and outcomes while controlling for covariates.SettingThis was a secondary analysis of baseline data collected during a randomized clinical trial intended to prevent unintended pregnancy and sexually transmitted infections (STIs).Participants572 adolescent females, ages 13 to 21 years, were recruited via a hospital-based adolescent clinic and community-wide advertisements.Main Outcome MeasuresParticipants reported on prior sexual intercourse, number of lifetime partners, frequency of intercourse, history of pregnancies and STIs, and locus of control.ResultsTwo thirds of the sample had been sexually active. In a model that controlled for all covariates, those with a high level of depressive symptoms had higher odds of having had intercourse (adjusted OR = 2.29; 95% CI = 1.18–4.43). High levels of depressive symptoms were also independently associated with increased numbers of lifetime sexual partners and an external locus of control. However, when depression and locus of control were included in the same model, locus of control was not independently associated with SRBs.ConclusionThese findings support other literature demonstrating an association between depression and SRBs, particularly in a largely African-American population. They further suggest that perceived control does not fully explain the relationship between depression and SRBs.     

Changes in the Sexual Function During Pregnancy

IntroductionThe physiological changes during each trimester of pregnancy have a significant impact on women's sexual behavior.AimThe aim of the work was to assess changes in the sexual function during pregnancy.MethodsThe prospective study encompassed 520 pregnant women aged between 18 and 45, of whom 168 were qualified for the final analysis. The research tool was a purpose‐designed research questionnaire and the standardized Female Sexual Function Index.Main Outcome MeasuresTo assess changes in the sexual function among pregnant women aged 18–45 in the three pregnancy trimesters.ResultsAll the studied parameters, i.e., desire, arousal, lubrication, orgasm, satisfaction, and pain, decreased significantly with the progression of pregnancy. Analyzing the frequency of sexual intercourse in the studied group before and during pregnancy, a statistically significant decrease (P < 0.000001) was observed. Sexual desire changed statistically significantly (P = 0.0004). The direction of change concerned decreased sexual desire in the three trimesters compared with the situation before pregnancy. Statistical significance was demonstrated for: decreased sexual desire (P = 0.00007), partner's reluctance (P = 0.002), and pregnancy‐related changes in appearance (P = 0.03).ConclusionsSexual function was compromised and sexual activity decreased as the pregnancy progressed. Changes in the domains of arousal, lubrication, and orgasm were particularly notable in primaparae in the third trimester of pregnancy. Unsatisfying partner relationship was a significant factor affecting the quality of sexual life during pregnancy. Gałązka I, Drosdzol‐Cop A, Naworska B, Czajkowska M, and Skrzypulec‐Plinta V. Changes in the sexual function during pregnancy. J Sex Med 2015;12:445–454‥     

Prenatal Depressive Symptoms and Postpartum Sexual Risk Among Young Urban Women of Color

Study ObjectiveTo determine whether prenatal depressive symptoms are associated with postpartum sexual risk among young, urban women of color.DesignParticipants completed surveys during their second trimester of pregnancy and at 1 year postpartum. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression Scale, excluding somatic items because women were pregnant. Logistic and linear regression models adjusted for known predictors of sexual risk and baseline outcome variables were used to assess whether prenatal depressive symptoms make an independent contribution to sexual risk over time.SettingFourteen community health centers and hospitals in New York City.ParticipantsThe participants included 757 predominantly black and Latina (91%, n = 692) pregnant teens and young women aged 14-21 years.Interventions and Main Outcome MeasuresThe main outcome measures were number of sex partners, condom use, exposure to high-risk sex partners, diagnosis of a sexually transmitted disease, and repeat pregnancy.ResultsHigh levels of prenatal depressive symptoms were significantly associated with increased number of sex partners (β = 0.17; standard error, 0.08), decreased condom use (β = −7.16; standard error, 3.08), and greater likelihood of having had sex with a high-risk partner (odds ratio = 1.84; 95% confidence interval, 1.26-2.70), and repeat pregnancy (odds ratio = 1.72; 95% confidence interval, 1.09-2.72), among participants who were sexually active (all P < .05). Prenatal depressive symptoms were not associated with whether participants engaged in postpartum sexual activity or sexually transmitted disease incidence.ConclusionScreening and treatment for depression should be available routinely to women at risk for antenatal depression.     

Nausea and Vomiting in Early Pregnancy of Adolescents: Relationship with Depressive Symptoms

Study ObjectiveTo determine the relationship between severity of nausea and vomiting during pregnancy (NVP) and depressive symptoms in pregnant adolescents.DesignProspective cross-sectional study.SettingA maternity research hospital outpatient clinic, Ankara, Turkey.ParticipantsA total of 200 pregnant adolescents.Interventions and Main Outcome MeasuresDemographic features and obstetric histories of the participants were assessed. The Rhodes test was performed to determine nausea and vomiting severity in a face-to-face interview, and the self-reported Edinburgh Postnatal Depression Scale was administered with supervision.ResultsThe Rhodes test results showed that 52/200 patients (26%) were classified with none, 83/200 patients (41.5%) with mild, 48/200 patients (24.0%) with moderate, and 17/200 patients (8.5%) with severe symptoms. The mean depression score in the severe vomiting group was significantly higher than that in the no NVP and mild NVP groups (P = .028 and .041, respectively). No differences were found between the other groups.ConclusionSevere nausea and vomiting was associated with greater depressive symptom severity in pregnant adolescents.     

Physical Activity Prior to and During Pregnancy and Risk of Postpartum Depressive Symptoms

Objective: To examine the relationship between physical activity before and during the last trimester of pregnancy and postpartum depressive symptoms.
Design: Secondary analysis of data from the 2004 and 2005 Pregnancy Risk Assessment Monitoring System.
Settings: Mailed questionnaire or telephone interview of new mothers in North Carolina.
Patients/Participants: Female residents of North Carolina, ages 18 to 45 ( n =2,169), who had given birth to a live infant in the past 2 to 6 months.
Methods: Information on physical activity and depressive symptoms was self-reported. Logistic regression was used to examine the physical activity-depressive symptom associations while controlling for confounding variables.
Results: After adjustment for confounders, there were no statistically significant associations between being physically active before and/or during pregnancy and feeling depressed or "down." However, participants who were physically active both prepregnancy and during the last trimester had decreased odds of having little interest or pleasure compared with participants who were not physically active, after adjustment for age and marital status (odds ratio =0.66, 95% confidence interval: 0.49, 0.87).
Conclusion: Although regular physical activity is recommended for healthy women during pregnancy, additional studies are needed to investigate the physical activity-depressive symptoms association. If confirmed in other studies, physical activity may be an additional option for women who want to ease postpartum depressive symptoms.     

Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress

IntroductionAppearance dissatisfaction is a sensitive issue and has been tied to depression, dissatisfaction in romantic relationships, and reduced sexual satisfaction.AimThis study sought to examine associations between appearance satisfaction and specific sexual problems and related distress, testing also the moderating role of relationship satisfaction.MethodsA large web-sample of Norwegians in romantic relationships (N = 2,903) completed a one-time survey.OutcomesParticipants reported on their experience of five different sexual problems and associated level of distress.ResultsWe found that appearance satisfaction was associated with reporting fewer sexual problems, and specifically, with a smaller likelihood of experiencing problems with lack of enjoyment, lack of excitement, and lack of climax. Furthermore, appearance satisfaction was unrelated to overall sexual problem-related distress, but was associated with feeling less distress about lack of excitement and lack of climax. Relationship satisfaction did not serve as a moderator of the associations.Clinical TranslationThese findings suggest the importance of attending to appearance satisfaction when working with clients with multiple sexual problems, particularly those related to excitement and enjoyment.Strengths and LimitationsStrengths of the study include a large sample of partnered adults and assessment of specific sexual problems and associated distress. A limitation is that outcomes were assessed using single items, rather than multi-item scales.ConclusionThe study highlights the importance of examining the presence of sexual problems and associated distress separately, and to consider appearance satisfaction as a predictor of sexual functioning. Øverup CS, Strizzi JM, Cipric A, et al. Appearance Satisfaction as a Predictor of Specific Sexual Problems and Associated Distress. J Sex Med 2021;18:1532–1544.     

Perceived Discrimination and Depressive Symptoms,Smoking, and Recent Alcohol Use in Pregnancy

Abstract: Background: Perceived discrimination is associated with poor mental health and health‐compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low‐income pregnant women. Methods: Face‐to‐face interviews were conducted in English or Spanish with 4,454 multiethnic, low‐income, inner‐city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES‐D ≥ 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients’ self‐report. Results: Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38–1.79; high = PR of 1.82, 95% CI: 1.49–2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05–1.36; high = PR of 1.41, 95% CI: 1.15–1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12–1.36). However, major discrimination was not independently associated with these outcomes. Conclusions: This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health‐compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low‐income women. (BIRTH 37:2 June 2010)     

Sexual Motivation in Women as a Function of Age

IntroductionWomen's motivations to engage in sex are likely influenced by their past sexual experiences, the type of relationship in which they are involved in, and numerous lifestyle factors such as career and family demands. The influences of these factors undoubtedly change as women age.AimThis study aimed to examine potential differences in sexual motivation between three distinct age groups of premenopausal women.MethodsWomen aged 18–22 years (N = 137), 23–30 years (N = 103), and 31–45 years (N = 87) completed an online survey that assessed the proportion with which they had engaged in sexual intercourse for each of 140 distinct reasons.Main Outcome MeasuresThe YSEX? Questionnaire by Meston and Buss [1] was used to measure sexual motivation. The items of this questionnaire were composed of four primary sexual motivation factors (physical, goal attainment, emotional, insecurity), and 13 subfactors.ResultsWomen aged 31–45 years reported a higher proportion of engaging in sex compared with one or both of the younger age groups of women for nine of the 13 YSEX? subfactors: stress reduction, physical desirability, experience seeking, resources, social status, revenge, expression, self‐esteem boost, and mate guarding. At an item level, the top 25 reasons for having sex were virtually identical across age groups.ConclusionWomen aged 31–45 have more motives for engaging in sex than do women aged 18–30, but the primary reasons for engaging in sex do not differ within this age range. Women aged 18–45 have sex primarily for pleasure, and love and commitment. The implications for diagnosis and treatment of women with sexual dysfunctions were discussed. Meston CM, Hamilton LD, and Harte CB. Sexual motivation in women as a function of age.     

Relationships among Depressive Symptoms,Sexually Transmitted Infections,and Pregnancy in African-American Adolescent Girls

Study ObjectiveTo explore relationships among depressive symptoms, sexually transmitted infections (STI), and pregnancy in African-American adolescent girls.DesignRetrospective chart review.SettingA hospital-based outpatient practice serving primarily African-American patients.ParticipantsA total of 126 female patients ages 13–19 years who had ligase chain reaction (LCR) for N. gonorrhoeae and C. trachomatis.MethodsCharts were reviewed for history of STI, history of pregnancy, LCR results, and a history of depressive symptoms as indicated by standardized provider notes and patient self-administered questionnaire. Data are compared using Fisher's exact test.ResultsMean age was 16.6 years (±1.6 years); 19.8% of participants had a history of depressive symptoms, 40.5% had a history of STI, 8.7% had a prior pregnancy, and 18.2% had a positive LCR. Of patients with a history of depressive symptoms, 64% had a history of STI compared to 34.6% of those without depressive symptoms (P = 0.01). A positive LCR was found in 20% of patients with a history of depressive symptoms and 17.8% of patients without (P = 0.78). Of patients with a history of depressive symptoms, 12% had a prior pregnancy compared to 7.9% without such history (P = 0.45).ConclusionsAfrican-American adolescent females in our clinic with a history of depressive symptoms were more likely to have a history of STI. A greater percentage of patients with a history of depressive symptoms also had prior pregnancies and/or current STI. Sexually active adolescent girls should be screened for depressive symptoms as part of their evaluation for sexual risk behaviors.     

Changes in Sexual Function after Medical or Surgical Termination of Pregnancy

IntroductionVoluntary termination of pregnancy (TOP) is a social issue; however, even if it is one of the most common procedures performed in the world, few studies evaluated sexual function changes after medical or surgical TOP.AimThe aim of this study was to evaluate how first trimester TOP by either surgical (group 1) or medical procedure (group 2) affects sexual function.MethodsThis prospective observational study included 211 patients (132 in group 1 and 79 in group 2) who requested first trimester TOP between September 2010 and May 2012. Medical TOP (mifepristone and misoprostol) was offered to patients up to 49 days of gestation. Surgical TOP was performed up to 12 weeks. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before TOP, after 1, 3, and 6 months from TOP.Main Outcome MeasuresChanges in the FSFI values and number of sexual active patients after 1, 3, and 6 months from the TOP and the self‐reported quality of sexual life at 6 months, with the two different procedures, were the main outcome measures.ResultsAt 4‐week follow‐up, 23.6% of women in group 1 did not resume sexual intercourse compared with 5.4% of women in group 2 (P = 0.003). At 6 months, 3.3% of women in the group 1 and no women in the group 2 did not resume sexual intercourses (P = 0.123). Compared with women in group 2, those in group 1 had lower FSFI score and number of sexual intercourses at 1, 3, and 6 months follow‐up (P < 0.001).ConclusionsThis study shows that the number of sexually active women and the overall FSFI are reduced in women undergoing surgical TOP compared with those undergoing medical TOP. Counseling regarding sexual function changes should be included in the discussion of morbidity related to medical or surgical TOP. Morotti M, Calanni L, Gianola G, Anserini P, Venturini PL, and Ferrero S. Changes in sexual function after medical or surgical termination of pregnancy. J Sex Med 2014;11:1495–1504.     

Effect of Sexual Function on Health-Related Quality of Life Mediated by Depressive Symptoms in Cardiac Rehabilitation. Findings of the SPARK Project in 493 Patients

IntroductionEmpirical evidence suggests associations between cardiovascular diseases, sexual functioning, depressive symptoms, and quality of life. However, to date, the interrelation of these constructs has not been examined simultaneously in a structural analysis.AimTo estimate the prevalence of sexual disorders and depressive symptoms and to examine the association between sexual disorders, depressive symptoms, and quality of life in patients in the rehabilitation of cardiovascular disorders.AimA postal survey in five German inpatient rehabilitation centers for cardiovascular diseases was conducted. Prevalence of sexual disorders and depressive symptoms were assessed using psychometrically sound instruments. To analyze complex associations, structural equation modeling was used.Main Outcome MeasuresFor epidemiological questions, proportions with 95% confidence intervals were calculated. The strength of association in structural equation models was expressed as a standardized regression coefficient.ResultsData from 493 patients were analyzed (response rate 22.7%). At least moderate erectile dysfunction proved to be present in 20.3% of men. The prevalence of female sexual dysfunction lay at 43.1%. At least moderate depressive symptoms were present in 14.4% of men and 16.5% of women. A considerable association between sexual functioning and quality of life was found in both sexes, which was largely mediated by depressive symptoms. Major drawbacks of the study are imprecision of the estimates due to limited sample size and questionable generalizability of the findings due to possible self-selection bias.ConclusionsConsidering the high prevalence of depressive symptoms and their role as a mediating factor between sexual functioning and quality of life, it is recommended to routinely screen for depression in men and women with cardiac disease. Kriston L, Günzler C, Agyemang A, Bengel J, and Berner MM. Effect of sexual function on health-related quality of life mediated by depressive symptoms in cardiac rehabilitation. Findings of the SPARK project in 493 patients.     

The Effect of Vilazodone on Sexual Function During the Treatment of Major Depressive Disorder

IntroductionSexual dysfunction is common in major depressive disorder (MDD), and many serotonergic antidepressants adversely affect sexual function. Vilazodone, a novel serotonin (5‐HT) reuptake inhibitor and 5‐HT_1A partial agonist approved for MDD, exerts its effects at the 5‐HT transporter and at both presynaptic and postsynaptic 5‐HT_1A receptors. This mechanism may limit sexual dysfunction.AimTo summarize effects of vilazodone (40 mg/day, with food) on sexual function in adults with MDD.MethodsData sources were three Phase III studies: two 8‐week, placebo‐controlled studies (NCT00285376 and NCT00683592) and a 52‐week open‐label study (NCT00644358). Sexual function was assessed by analyzing changes from baseline to end of treatment (EOT) using validated measures.Main Outcome MeasureArizona Sexual Experience Scale or Changes in Sexual Functioning Questionnaire.ResultsPopulation included 869 patients (vilazodone, 436; placebo, 433) from placebo‐controlled studies and 599 patients from the open‐label study. Sexual dysfunction prevalence was high (50%, men; 68%, women) before treatment and declined during treatment in vilazodone and placebo groups, indicating improvement on average. At EOT, stable/improved sexual function was observed in ≥91% of patients in placebo‐controlled studies; treatment group differences in sexual dysfunction at EOT were not statistically significant for either sex. Differences vs. placebo in changes from baseline of sexual function scores were small and were generally not statistically significant; effect sizes (Cohen's D) were generally of low magnitude. In the placebo‐controlled studies, 8.0% of vilazodone‐treated patients and 0.9% of placebo‐treated patients reported ≥1 sexual‐function‐related treatment‐emergent adverse event (P < 0.001).Conclusion.Half of men and two thirds of women with MDD had sexual dysfunction at baseline; sexual function improved on average in both vilazodone and placebo groups. Results suggest that vilazodone may have a small adverse impact on sexual function in adults with MDD relative to the high prevalence of sexual dysfunction at baseline. Clayton AH, Kennedy SH, Edwards JB, Gallipoli S, and Reed CR. The effect of vilazodone on sexual function during the treatment of major depressive disorder. J Sex Med 2013;10:2465–2476.     

Effects of Testosterone Supplementation on Depressive Symptoms and Sexual Dysfunction in Hypogonadal Men with the Metabolic Syndrome

IntroductionLow testosterone levels in men are associated with the metabolic syndrome (MetS) as well as with depressive symptoms, low vitality, and sexual dysfunction.AimTo assess the effects of testosterone administration on these subjective symptoms, which have not extensively been studied in hypogonadal men with the MetS.Main Outcome MeasuresThe Beck Depression Inventory (BDI-IA), Aging Males' Symptoms (AMS) scale, and International Index of Erectile Function 5-item (IIEF-5) scale at baseline, 18 and 30 weeks were analysed using multilevel analysis.MethodsIn a randomized, placebo-controlled, double-blind, phase III trial (ClinicalTrials.gov identifier: NCT00696748), 184 men suffering from both the MetS and hypogonadism were included. They were treated for 30 weeks with either parenteral testosterone undecanoate (TU; 1,000 mg IM TU, at baseline, and after 6 and 18 weeks; Nebido®) or placebo injections, 105 (92.9%) men receiving TU and 65 (91.5%) receiving placebo completed the 30-week trial.ResultsThe 184 men were aged mean 52.1 years old (standard deviation [SD] 9.6; range 35–69), with a mean body mass index of 35.5 kg/m² (SD 6.7; range 25.1–54.8), and a mean total testosterone level of 8.0 nmol/L (SD 4.0). There were significant improvements in BDI-IA (mean difference vs. placebo after 30 weeks: ?2.5 points; 95% confidence interval [CI]: ?0.9; ?4.1; P = 0.003), AMS (?7.4 points; 95% CI: ?4.3; ?10.5; P < 0.001), and IIEF-5 (+3.1 points; 95% CI: +1.8; +4.4; P < 0.001). The effects on the BDI-IA, AMS, and IIEF-5 were strongest in men with baseline total testosterone levels <7.7 mmol/L (i.e., median value).ConclusionsTU administration may improve depressive symptoms, aging male symptoms and sexual dysfunction in hypogonadal men with the MetS. The beneficial effects of testosterone were most evident in men with the lowest baseline total testosterone levels. Giltay EJ, Tishova YA, Mskhalaya GJ, Gooren LJG, Saad F, and Kalinchenko SY. Effects of testosterone supplementation on depressive symptoms and sexual dysfunction in hypogonadal men with the metabolic syndrome.     

The Role of Pregnancy Awareness on Female Sexual Function in Early Gestation

IntroductionFemale sexual function is negatively influenced by pregnancy due to the physical and emotional changes. Although the most significant effect is seen in the third trimester of pregnancy, a considerable decrease in the frequency of intercourse and sexual desire in the first trimester has also been shown.AimTo investigate the factors that affect sexuality in early pregnancy and the impact of awareness of pregnancy on female sexual function in the first trimester of pregnancy using two self‐reported questionnaires.MethodsIn this cross‐sectional study, 130 healthy, married pregnant women who were admitted to the Gynecology Clinic between the 4th and 10th week of gestation were asked to complete a self‐administered questionnaire and the Female Sexual Function Index (FSFI).Main Outcome MeasuresThe factors associated with FSFI score and monthly sexual activity frequency in the first trimester, as well as the differences in sexual activity frequency and FSFI scores between the women who were previously aware of their pregnancy and those who were yet unaware of their pregnancy.ResultsWomen who were unaware of their pregnancy had significantly higher coitus frequency in comparison with the aware group (P = 0.002). Total FSFI score was 21.99 ± 8.13 in the aware group and 24.66 ± 3.76 in the unaware group (P = 0.02). None of the obstetric and sociodemographic variables had an influence on desire and pain scores. Arousal, lubrication, and satisfaction scores were adversely affected by awareness of pregnancy. Orgasm scores were influenced negatively by awareness and positively by love marriage; however, in multivariate linear regression analysis none of these were defined as independent factor for orgasm scores. Overall FSFI scores and monthly frequency of sexual activity were only affected by awareness.ConclusionThe results of this study suggest that in early gestation, awareness of pregnancy is associated with lower female sexual function. Furthermore, obstetric and sociodemographic factors seem to be ineffective on sexual function in early pregnancy. Corbacioglu A, Bakir VL, Akbayir O, Cilesiz Goksedef BP, and Akca A. The role of pregnancy awareness on female sexual function in early gestation. J Sex Med 2012;9:1914–1920.     

Female Sexual Function,Dysfunction, and Pregnancy: Implications for Practice

Women's sexual function is a complex and dynamic interplay of variables that involve physical, emotional, and psychosocial states. Sexual dysfunction may occur at any level, and diagnosing such issues begins with careful assessment through a sexual health history. However, discussions about female sexual health and function are often deficient in the primary care setting. This article reviews the published research on female sexual function, sexual dysfunction, and sexual function in pregnancy to gain a better understanding of how these aspects of a woman's life impact the health care services she receives. The evaluation of female sexual function is in need of consistent measurement tools and more dialogue during health care visits. Women's health care practitioners have an opportunity to advance patient satisfaction and overall health by evaluating and communicating with female patients about their sexual function.