Postpartum Female Sexual Function: Risk Factors for Postpartum Sexual Dysfunction

Abstract

Introduction: Women's sexual health is a vital and important part of life at any age. In particular, pregnancy and childbirth bring biological, psychological, and social changes which may influence sexual health. It has been shown that sexual function declines during pregnancy and does not return to its baseline levels during the postpartum period. Despite the complexity and significance of this subject, health providers often neglect sexual aspects during pregnancy and postpartum. Aim: We believe that clarifying the risk factors will help open conversations and improvements in sexual function. Methods: In this review, we focus on how postpartum sexual function is affected by mode of delivery, perineal trauma during delivery, episiotomy, and lactation. Concclusions: We conclude that the mode of delivery has no significant effect on short-and long-term postpartum sexual function. On the other hand, 3rd and 4th degree tears are strongly associated with postpartum sexual dysfunction. We found that episiotomy does not adversely affect sexual function, and lactation has a slightly negative effect. We believe that shedding light on this topic will lead to a better understanding for pregnant and postpartum women and the obstetrician. Further studies may elucidate more useful treatment approaches.

Associations of Maternal Complaints to Levator Ani Muscle Trauma Within 9 Months After Vaginal Birth – A Prospective Observational Cohort Study

“…Hence, pelvic oor training cannot completely compensate the anatomical defect set by a CAV, but maybe can improve the extent and rate of prolapse in this group. 85-91% of women had sexual intercourse 6-9 months after birth, which is comparable with other studies showing that 89% of women resume sexual activity within 6 months of giving birth (30). Of those women, 60-83% reported an unchanged situation regarding sexual satisfaction.…”

“…Other studies report that sexual function after birth is not altered by pelvic oor muscle strength or mode of delivery, but by the presence of high-grade perineal tears (30,32,33). The association of sexual function and satisfaction to the presence of a LAM avulsion remains controversial (29,34).…”

The Effect of Body Image Satisfaction on Women’s Sexual Function in Postpartum Period

“…Similarly, Gutzeit et al showed that delivery mode had no significant effect on short-and long-term SF. Furthermore, episiotomy did not have a favorable impact on the women's sexual performance, whereas breastfeeding was found to have a little unfavorable impact on women's SF [18]. A meta-analytical study also confirms the finding [19].…”

Relationship of the type of breastfeeding in the sexual function of women

“…When data between breastfeeding and non-breastfeeding women are compared, the results show that those who are breastfeeding are more likely to experience pain during intercourse and poor vaginal lubrication 6 , 15 . A possible justification for the low vaginal lubrication in breastfeeding women can be the physiological absence of the estrogen hormone during breastfeeding 6 .…”

“…Considering the variety of existing assessment methods, there is international consensus that the prevalence of female dysfunction, regardless of age, is 40% to 50% 2 , 5 . When considering the pregnant puerperal cycle, recent studies show a high prevalence of sexual dysfunction ranging from 41% to 83% in the first three months 6 and around 60% in the first postpartum year 3 , 7 .…”