Postpartum female sexual function does not appear to be affected by mode of delivery or perineal injury, suggests a recent Journal of Sexual Medicine study.
Women’s expectations of postpartum sexuality don’t affect their actual sexual function either, aside from breastfeeding concerns, the researchers reported.
An estimated 80% to 95% of women resume sexual activity within 3 months of childbirth. However, many face sexual changes, at least temporarily. Drops in estrogen levels can lead to vaginal dryness, uncomfortable sex, and reduced sexual interest. The fatigue and stress of caring for a newborn may also dampen libido.
In this study, researchers investigated whether mode of delivery, perineal injury, or expectations about sexuality after childbirth affected women’s sexual function.
They collected data from 522 women between the ages of 18 and 47 who gave birth at one medical center in Germany. About 47% had not given birth before, and 52% had had at least one child. At the time of her hospitalization, each woman was asked about her expectations about postpartum sexual health.
The women completed two questionnaires at various time points. One was the Female Sexual Function Index (FSFI), which assesses the domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. The other was the Sexual Activity Questionnaire, which evaluates sexual activity, perception of desire and pleasure, and possible sexual complaints.
At the first assessment, the women were asked to reflect on their sexual function 4 weeks before pregnancy. The questionnaires were again completed 3, 6, and 12 months after delivery. (Note: Only two-thirds of the original group completed follow-up assessments.)
The women were also divided into three groups based on their mode of delivery: spontaneous vaginal delivery (SVD – 263 women), operative vaginal delivery (OVD – 41 women), and cesarean section (CS – 218 women). Women who had vaginal deliveries were further categorized based on their degree of perineal injury.
The researchers found that the women’s sexual function declined at the 3- and 6-month follow up points, but improved to pre-pregnancy levels by the 12-month mark. In general, results were similar regardless of the mode of delivery or degree of perineal injury.
About 37% of the women said they had been “afraid” of sexual changes after delivery, but most (92%) said that anticipated changes in sexuality had not influenced their decision to have a vaginal or cesarean birth.
About 35% of the participants did expect breastfeeding to negatively affect their sexuality. However, for 89% of the group, sexuality had no impact on their decision to breastfeed.
“Deciphering the potential influence of patient expectations as well as pregnancy- and childbirth-related aspects on female postpartum sexuality will help in the effort to improve women’s postpartum sexual health,” the authors wrote.
Resources
The Journal of Sexual Medicine
Spaich, Saskia, MD, et al.
“Influence of Peripartum Expectations, Mode of Delivery, and Perineal Injury on Women’s Postpartum Sexuality”
(Full-text. Published: June 10, 2020)
https://www.jsm.jsexmed.org/article/S1743-6095(20)30600-7/fulltext