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Bhandari Randhawa S, Rizkallah A, Nelson DB, Duryea EL, Spong CY, Pruszynski JE, Rahn DD. Factors associated with persistent sexual dysfunction and pain 12 months postpartum. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 41:101001. [PMID: 38991483 DOI: 10.1016/j.srhc.2024.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 06/23/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVE Identify factors associated with persistent sexual dysfunction and pain 12-months postpartum in an underserved population. METHODS Extending Maternal Care After Pregnancy (eMCAP) is a program addressing health needs/disparities of patients at risk for worse perinatal outcomes. Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Urinary Distress Index (UDI-6) 12-months postpartum. The PISQ-12 was dichotomized with scores < 32.5 indicating sexual dysfunction. Urinary incontinence (UI) was defined as at-least-somewhat bothersome (vs. none or not-at-all bothersome) urgency urinary incontinence (UUI) or stress urinary incontinence (SUI). Screening for anxiety and depression was completed using Generalized Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariable logistic regression analyses were performed for sexual dysfunction vs. normal-function, and pain vs. no-pain, using demographic, peri/postpartum, and social-determinant-of-health variables as correlating factors. RESULTS 328 sexually active patients provided data. On bivariate analysis, sexual dysfunction (n = 31, 9.5%) vs. normal function (n = 297, 90.5%) groups showed no differences in age, BMI, parity, mode of delivery, episiotomy/laceration types, or breastfeeding. Sexual dysfunction was significantly associatedwith both UUI and SUI: 12 (39%) vs. 46 (15%) had UUI, p = 0.001, and 20 (65%) vs. 97 (33%) had SUI, P < 0.001; the dysfunction group also had higher GAD-7 and EPDS scores and greater overall stress levels. On multivariable analysis, SUI and stress remained significantly associated: OR (95% CI) 2.45 (1.02-6.03) and 1.81 (1.32-2.49), respectively. Comparing pain (n = 45, 13.7%) vs. no-pain (n = 283, 86.2%), dyspareunia patients endorsed greater stress levels. CONCLUSION The interplay between sexual health, incontinence, and mental health deserves further study, and all three should be routinely addressed in postpartum care.
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Affiliation(s)
- Sonia Bhandari Randhawa
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States.
| | - Andrea Rizkallah
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
| | - David B Nelson
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
| | - Elaine L Duryea
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
| | - Catherine Y Spong
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
| | - Jessica E Pruszynski
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
| | - David D Rahn
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Dallas, TX, United States
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2
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Szablewska AW, Michalik A, Czerwińska-Osipiak A, Zdończyk SA, Śniadecki M, Bukato K, Kwiatkowska W. Breastfeeding vs. Formula Feeding and Maternal Sexuality among Polish Women: A Preliminary Report. Healthcare (Basel) 2023; 12:38. [PMID: 38200943 PMCID: PMC10779107 DOI: 10.3390/healthcare12010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/10/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Although postpartum sexual problems are common, there is a poor understanding of the underlying influencing factors and the impact of the infant feeding method on the mother's sexual life. A cross-sectional control study was conducted with a group of 253 women during their postpartum period. This study aimed to investigate the effects of different infant feeding methods on female sexual life after childbirth. The study followed the STROBE guidelines for cross-sectional control analysis. The study design included a questionnaire characterizing sociodemographic, obstetric and breastfeeding variables and the PL-FSFI (Female Sexual Function Index). The authors collected the data in compliance with the CAWI (Computer-Assisted Web Interview) research methodology-an interview conducted via an Internet channel. Each respondent received and completed the survey provided to them via the same online link. This study included women in the postpartum period: 170 breastfeeding women (study group) and 83 formula-feeding women (control group). There were statistically significant difference between the groups that practiced different types of breastfeeding. Out of all the PL-FSFI-assessing domains, the highest average score for the whole group correlated with satisfaction and the lowest score correlated with lubrication use. Our findings indicate that women practicing only breastfeeding are more likely to develop sexual problems. In order to maintain sexual health and promote long-term breastfeeding, extensive and professional counseling is needed for couples about postpartum sexuality and the factors that affect it, such as breastfeeding.
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Affiliation(s)
- Anna Weronika Szablewska
- Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland; (A.M.); (A.C.-O.); (W.K.)
| | - Anna Michalik
- Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland; (A.M.); (A.C.-O.); (W.K.)
| | - Agnieszka Czerwińska-Osipiak
- Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland; (A.M.); (A.C.-O.); (W.K.)
| | - Sebastian Artur Zdończyk
- Department of General Pedagogy and Fundamentals of Education, Institute of Pedagogy, Pomeranian University in Słupsk, Arciszewskiego 22a, 76-200 Słupsk, Poland;
- Department of Hematology and Bone Marrow Transplantation, Provincial Specialist Hospital Named after J. Korczak in Słupsk sp. z o.o., Hubalczyków 1, 76-200 Słupsk, Poland
| | - Marcin Śniadecki
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Marian Smoluchowski 17, 80-214 Gdańsk, Poland; (M.Ś.); (K.B.)
| | - Katarzyna Bukato
- Department of Gynecology, Gynecologic Endocrinology and Gynecologic Oncology, Medical University of Gdańsk, Marian Smoluchowski 17, 80-214 Gdańsk, Poland; (M.Ś.); (K.B.)
| | - Wanda Kwiatkowska
- Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland; (A.M.); (A.C.-O.); (W.K.)
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Zeleke FT, Ezedin S, Aleminew F, Alem KG, Tefera DT, Demissie M, Beriso Jima G, Endeshaw F, Belay A, Ayele A, Andebet D, Zegeye AM. Sexual dysfunction and its associated factors among reproductive-age women at Gurage Zone, Southern Ethiopia, 2023. BMC Public Health 2023; 23:2029. [PMID: 37853332 PMCID: PMC10583327 DOI: 10.1186/s12889-023-16938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
INTRODUCTION Female sexual dysfunction is commonly neglected, under-investigated, and under-treated in Ethiopia. Therefore, this study aimed to determine the prevalence and its associated factors of female sexual dysfunction among reproductive-aged women at Gurage zone hospitals, in southern Ethiopia. METHODS An institutional-based cross-sectional study was conducted among 424 reproductive-age group women. A systematic random sampling method was employed and structured questionnaires were used to collect the data through a face-to-face interview. Data were entered into EpiData version 4.6 and analyzed by SPSS version 25.0. Descriptive statistics, and bivariable, and multivariable logistic regression were conducted. Statistical significance was declared at a p-value of < 0.05. RESULT Four hundred two participants completed the interview with a response rate of 94.8%. Arousal dysfunction 91.0% and pain during sexual intercourse 39.3% were the most and the least prevalent domains of female sexual dysfunction respectively. Overall 32.1% of the respondents had female sexual dysfunction. Body mass index (AOR = 3.6; 95% CI: 1.2, 10.8), history of pelvic surgery (AOR = 3.5; 95% CI: 1.3, 9.2), marriage satisfaction (AOR = 3.9; 95% CI: 1.4, 1o.6), a satisfaction of spouses' sex ability (AOR = 3.1; 95% CI: 1.2, 8.5), breastfeeding (AOR = 3.3; 95% CI: 1.6, 7.0), and mode of delivery [vaginal delivery with tear and episiotomy (AOR = 3.7; 95% CI: 1.6, 8.8), instrument assisted vaginal delivery (AOR = 7.0; 95% CI: 1.2, 39.8)], were statistically associated with female sexual dysfunction. All-encompassing professional counseling addressing psychological and interpersonal acts and weight management interventions are needed for couples to maintain sexual functioning.
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Affiliation(s)
- Fentahun Tamene Zeleke
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
| | - Semer Ezedin
- Wolkite University Specialized Hospital, Wolkite, Ethiopia
| | - Fentahun Aleminew
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kassa Genetu Alem
- Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Daniel Tsega Tefera
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Mebratu Demissie
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Gudeta Beriso Jima
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fikremariam Endeshaw
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Aynalem Belay
- Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Alemitu Ayele
- College of Health Sciences, Department of Midwifery, Madawalabu University, Robe, Ethiopia
| | - Demeke Andebet
- Department of Midwifery, Hailu Alemu College, Gojjam, Ethiopia
| | - Ambaye Minayehu Zegeye
- Department of Midwifery, College of Medicine and Health Sciences, Asossa University, Asossa, Ethiopia
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Smetanina D, Awar SA, Khair H, Alkaabi M, Das KM, Ljubisavljevic M, Statsenko Y, Zaręba KT. Risk of sexual dysfunctions in breastfeeding females: protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e074630. [PMID: 37527888 PMCID: PMC10394553 DOI: 10.1136/bmjopen-2023-074630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Epidemiological studies do not provide accurate statistics on the percentage of breastfeeding women experiencing sexual dysfunctions and restraining from sexual activity. The data vary between 40% and 83% in the first group and 20-50% in the second one. Despite excessive studies on contributors to intimacy changes, breast feeding received little attention from researchers. The relationship between lactation and postpartum sexual dysfunctions remains unclear. This systematic review and meta-analysis will synthesise available data and establish the link between breast feeding and sexuality problems. METHODS AND ANALYSIS A comprehensive literature search will be performed in biomedical databases PubMed/Medline, Scopus, Web of Science, EMBASE and CINAHL. We will extract peer-reviewed original studies written in English, Arabic or Polish from 2000 to June 2023. We will also search for reports from international health organisations and local health authorities. The preliminary search was performed on 04 April 2023. The studies must provide data on dysfunction prevalence/incidence and the strength of the relationship between breast feeding and sexuality in generally healthy women. The Covidence software will be used to perform literature screening, data extraction and quality assessment of individual studies. We will use a random-effects model meta-analysis to calculate pooled weighted frequency measures and effect size. Between-study heterogeneity will be assessed with the I2 test. ETHICS AND DISSEMINATION This meta-analysis does not require ethical approval because it synthesises data from previously published original studies. The final work will be published in a peer-reviewed journal and presented at scientific conferences. PROSPERO REGISTRATION NUMBER CRD42023411053.
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Affiliation(s)
- Darya Smetanina
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Medical Imaging Platform, ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Shamsa Al Awar
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Howaida Khair
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Meera Alkaabi
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
| | - Karuna M Das
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
| | - Milos Ljubisavljevic
- Department of Physiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Neuroscience Platform, ASPIRE Precision Medicine Institute in Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Yauhen Statsenko
- Department of Radiology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, Abu Dhabi Emirate, UAE
- Medical Imaging Platform, ASPIRE Precision Medicine Research Institute Abu Dhabi, Al Ain, Abu Dhabi Emirate, UAE
| | - Kornelia Teresa Zaręba
- Department of Obstetrics & Gynecology, United Arab Emirates University College of Medicine and Health Sciences, Al Ain, UAE
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Kul Uçtu A, Karakoç H. Breastfeeding Sexual Lives of First-Time Mothers: A Qualitative Explorative Study. Breastfeed Med 2022; 17:1025-1033. [PMID: 36475936 DOI: 10.1089/bfm.2022.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Problems with sexuality are experienced in the first 6 months at the most, and often in the first 12 months after birth. Although there are studies reporting negative effects of breastfeeding on sexuality, the evidence is limited. Objective: This study was conducted with the aim of exploring the breastfeeding sexual lives of first-time mothers. Materials and Methods: The research was carried out in Turkey between October 2020 and December 2021. The study was conducted with 41 women who met the inclusion criteria. Participants were selected by the "snowball" sampling procedure among nonprobability sampling methods. A qualitative approach was used to gather data through semistructured interviews. Content analysis was used for data analysis as described by Graneheim and Lundman. Data analysis was performed using NVivo software (Version 11). Results: According to the results of the content analysis, three themes were created: factors affecting sexuality in the breastfeeding process, sexual interaction with the spouse during the breastfeeding process, and understood expectations. The theme, titled factors affecting sexuality in the breastfeeding process, consists of five categories: physical, psychological, sociocultural, infant-related, and health professionals-related factors. The theme of "understood expectations" consists of desires for improving sexual satisfaction and satisfaction during lactation, and sexual communication categories. The contact of sexual interaction with spouse during breastfeeding consists of positive interaction and negative interaction categories. Conclusions: It has been concluded that the sexual intercourse of women is adversely affected during the breastfeeding period and that women have expectations to increase their sexual satisfaction. Sexual problems during the breastfeeding process cause problems in the spousal relationship.
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Affiliation(s)
- Arzu Kul Uçtu
- Department of Midwifery, Faculty of Gulhane Health Sciences, Health Sciences University, Ankara, Turkey
| | - Hediye Karakoç
- Department of Midwifery, College of Health Science, KTO Karatay University, Konya, Turkey
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Ghasemi V, Beheshti Nasab M, Saei Ghare Naz M, Shahsavari S, Banaei M. Estimating the prevalence of dyspareunia according to mode of delivery: a systematic review and meta-analysis. J OBSTET GYNAECOL 2022; 42:2867-2878. [PMID: 35980976 DOI: 10.1080/01443615.2022.2110461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The present study aimed to examine the prevalence of dyspareunia in the post-partum period in relation to the mode of delivery. In this systematic review and meta-analysis, published articles until February 2020 were searched through the related key term based on mesh term in national and international databases. In the initial search, 1391 articles were found that after removing duplicate, unrelated or non-English and non-Persian articles, finally 20 studies with a sample size of 11354 of women who had given birth were introduced in this study. The prevalence of dyspareunia following vaginal delivery, C-section, and instrumental delivery with 95%CI was 42%(31-56%), 26%(19-34%), and 37%(28-46%) respectively. In addition, the prevalence of dyspareunia in primiparous was higher than multiparous (34%vs.24%), in breastfeeding women was higher than non-breastfeeding women (48%vs.33%), in women who non-used hormonal contraceptive methods were higher than who used hormonal contraceptive methods (43%vs.35%) and its prevalence was similar in women with and without episiotomy. The results indicated that vaginal delivery, breastfeeding, used hormonal contraceptive and primiparity have an impact on dyspareunia. Thus, considering the high prevalence of dyspareunia, and its impact on the quality of life of couples in the postpartum period, attention to, planning, and designing effective interventions in this regard are essential.IMPACT STATEMENTWhat is already known on this subject? Dyspareunia is one of the common experiences of women in the post-partum period. One of the most important factors affecting dyspareunia in the post-partum period is the mode of delivery.What do the results of this study add? The present study adds to examine the prevalence of dyspareunia in the postpartum period in terms of the mode of delivery. So far, no study has been found which comprehensively and systematically estimating the prevalence of dyspareunia in relation to the type of delivery mode in women who have given birth recently. In addition to the type of delivery the prevalence of dyspareunia was estimated based on parity, breastfeeding, episiotomy and consumption of hormonal contraceptive status.What are the implications of these findings for clinical practice and/or further research? This finding will be a small step to familiarise physicians and midwives as well as people with the relationship between delivery mode and dyspareunia. In addition, in the absence of medical indications and the possibility of choosing the mode of delivery selectively, help them decide and choose the appropriate method of termination of labour and ultimately improve the mental and physical health of the birthing person, family and community.
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Affiliation(s)
- Vida Ghasemi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Maryam Beheshti Nasab
- Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeideh Shahsavari
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mojdeh Banaei
- Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Korzeniewski R, Kiemle G, Slade P. Mothers’ experiences of sex and sexual intimacy in the first postnatal year: a systematic review. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2019.1671969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Gundi Kiemle
- Clinical Psychology Training Programme, University of Liverpool, Liverpool, UK
| | - Pauline Slade
- Clinical Psychology Training Programme, University of Liverpool, Liverpool, UK
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Abstract
Background: Although postpartum sexual problems are common, the impact of the infant feeding method on sexual life is still unclear. The aim of this study was to investigate the effects of different infant feeding methods and other influencing factors on female sexual life 3 months postpartum. Materials and Methods: Three hundred women from three obstetrical institutes were enrolled in this cross-sectional study. An online questionnaire was administered 3 months postpartum. Women were categorized into three groups: exclusive breastfeeding (n = 180), mixed feeding (n = 75), and formula-feeding (n = 45) groups. The infant feeding method was assessed by self-constructed questions. Sexual dysfunctions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). Results: Of the women, 50.55% reported sexual dysfunction in the exclusive breastfeeding group, 42.66% in the mixed feeding group, and 31.11% in the formula-feeding group. Lack of sexual desire was the most prevalent dysfunction regardless of the infant feeding method. Significantly lower median scores were found in the exclusive breastfeeding group compared with the formula-feeding group for the total FSFI score (p = 0.002), arousal (p = 0.034), lubrication (p = 0.020), orgasm (p = 0.015), and pain (p = 0.021) subgroups. Breastfeeding (p = 0.032) and the quality of prepregnancy sexual life (p < 0.001) were significant factors, whereas prepregnancy dyspareunia, parity, age, income, and educational level did not predict women's postpartum sexual function. Conclusions: Our findings indicate that exclusive breastfeeding women have an increased likelihood of sexual problems 3 months postpartum. Extensive and professional counseling is needed for couples about postpartum sexuality and influencing factors such as breastfeeding to maintain sexual health and promote long-term breastfeeding.
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Affiliation(s)
- Katalin Szöllősi
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,School of PhD Studies, Semmelweis University, Budapest, Hungary
| | - László Szabó
- Department of Family Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,School of PhD Studies, Semmelweis University, Budapest, Hungary.,Heim Pál Children's Hospital, Department of Pediatrics, Budapest, Hungary
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The effect of ear acupressure (auriculotherapy) on sexual function of lactating women: protocol of a randomized sham controlled trial. Trials 2020; 21:729. [PMID: 32819441 PMCID: PMC7441618 DOI: 10.1186/s13063-020-04663-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 08/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lactation has a negative effect on female sexual function. Hormonal changes during lactation cause changes which might lead to dyspareunia, lack of libido, and anorgasmia. There are various pharmacological and non-pharmacological approaches to treat sexual dysfunction. While pharmacological treatment has multiple unwanted side effects, non-pharmacological therapies such as complementary medicine are a potential safer alternative. The aim of this study is to evaluate the effect of ear acupressure on sexual function of lactating women. METHODS/DESIGN This is a randomized clinical trial with a parallel sham control group. In this study, 76 lactating women between 6 months and 1 year after childbirth were referred to health care centers in Qazvin City and would be invited to participate. Participants will be divided into intervention (n = 38) and control (n = 38) groups using simple block randomization. Both intervention and sham control groups will be visited over 10 sessions within a 4-day interval. At each visit, the adhesives containing Vaccaria seed will be adhered for the intervention group, while non-latex-based adhesives with no Vaccaria seeds will be placed on the same ear acupoints for the sham control group. Selected ear acupoints include genitalia (two ear points), pelvic point, master shoulder, and posterior pituitary gland. The women will be asked to hold the seeds on their ears for 3 days and press each ear point three times a day for 20 s. After 3 days, they will be asked to remove the seeds from their ears and rest for 1 day. Sexual function as primary outcome in both groups will be assessed using the Female Sexual Function Index before and immediately after 1 and 2 months after the intervention. Also, Sexual Quality of Life as secondary outcome will be assessed using Sexual Quality of Life-Female (SQOL-F) before and 2 months after intervention. Data will be analyzed using repeated measure ANOVA at the significant level of 0.05. DISCUSSION This study is expected to support the impact of ear channel ear acupressure on sexual function in lactating women. TRIAL REGISTRATION Iranian Clinical Trial Registration Center IRCT20190626044028N1 . Registered on 16 August 2019.
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10
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Gutzeit O, Levy G, Lowenstein L. Postpartum Female Sexual Function: Risk Factors for Postpartum Sexual Dysfunction. Sex Med 2020; 8:8-13. [PMID: 31837965 PMCID: PMC7042171 DOI: 10.1016/j.esxm.2019.10.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/17/2019] [Accepted: 10/29/2019] [Indexed: 11/30/2022] Open
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. Ola Gutzeit, Gali Levy, Lior Lowenstein. Postpartum Female Sexual Function: Risk Factors for Postpartum Sexual Dysfunction. Sex Med 2019;8:8-13.
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Affiliation(s)
- Ola Gutzeit
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
| | - Gali Levy
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel
| | - Lior Lowenstein
- Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
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Cappell J, Bouchard KN, Chamberlain SM, Byers-Heinlein A, Chivers ML, Pukall CF. Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births. J Sex Med 2019; 17:257-272. [PMID: 31859234 DOI: 10.1016/j.jsxm.2019.11.264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 10/29/2019] [Accepted: 11/03/2019] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although postpartum sexual concerns are common, limited data exist on postpartum sexual response. Furthermore, the physiological process of vaginal birth may negatively impact genital response compared with unlabored cesarean section (C-section), but this hypothesis has yet to be tested. AIM To (i) compare genital and subjective sexual response and sexual concordance by mode of delivery with inclusion of a control group, (ii) compare groups on self-reported sexual function over the past month, (iii) examine the relationship between laboratory measurement of sexual response and self-reported sexual function, and (iv) investigate association between obstetrical factors and breastfeeding and between sexual response and self-reported sexual function. METHODS 3 groups of cisgender women were recruited from the community: primiparous women who delivered via vaginal birth within the past 2 years (VB group; n = 16), primiparous women who delivered via unlabored C-section within the past 2 years (CS group, n = 15), and age-matched nulliparous women (NP group, n = 18). Laser Doppler imaging was used to assess genital response while participants watched a neutral and erotic film. MAIN OUTCOME MEASURES The main outcome measures were change in flux units from neural to erotic video as a measure of genital response, subjective sexual arousal rated continuously throughout films, perceived genital response rated after films, and Female Sexual Function Index (FSFI). RESULTS Women in the VB group had significantly lower change in flux units than women in the CS (P = .005, d = 1.39) and NP (P < .001, d = 1.80) groups. Groups did not differ on their subjective indices of sexual response or in sexual concordance. Women in both postpartum groups reported lower FSFI scores than women in the NP group. No relationship was determined between FSFI scores and sexual response in the laboratory. Results suggested that genital trauma and breastfeeding may negatively impact FSFI scores, but they were not related to genital response or subjective sexual arousal as measured in the laboratory. CLINICAL IMPLICATIONS Results underscore the importance of balancing objective and subjective indices of sexual response and function, especially considering the biopsychosocial nature of postpartum sexuality. STRENGTHS & LIMITATIONS The present study is the first to apply modern sexual psychophysiological methodology to the study of postpartum sexuality. Cross-sectional methodology limits the ability to make causal inferences, and the strict inclusion criteria limits generalizability. CONCLUSION Physiological changes as a result of labor and delivery may have a detrimental impact on genital response; however, these physiological differences may not impact women's subjective experience of postpartum sexuality. Cappell J, Bouchard KN, Chamberlain SM, et al. Is Mode of Delivery Associated With Sexual Response? A Pilot Study of Genital and Subjective Sexual Arousal in Primiparous Women With Vaginal or Cesarean Section Births. J Sex Med 2020; 17:257-272.
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Affiliation(s)
- Jackie Cappell
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | | | | | - Alyssa Byers-Heinlein
- Community Midwives of Kingston, Kingston, ON, Canada; School of Nursing, Queen's University, Kingston, ON, Canada
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Fuentealba-Torres M, Cartagena-Ramos D, Fronteira I, Lara LA, Arroyo LH, Arcoverde MAM, Yamamura M, Nascimento LC, Arcêncio RA. What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open 2019; 9:e025833. [PMID: 31028040 PMCID: PMC6502039 DOI: 10.1136/bmjopen-2018-025833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/06/2019] [Accepted: 03/07/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This study determined the prevalence and factors associated with sexual dysfunction in breastfeeding women. DESIGN Cross-sectional analytical study. SETTING Population-based study of individuals living in the northeast region of São Paulo state, Brazil. PARTICIPANTS From May to August 2017, 372 women aged ≥18 years were selected who gave exclusive, predominant or complementary breast feeding up to 23 months postpartum, and who did not have contraindications for the resumption of intercourse. Pregnant women, those diagnosed with mental health problems, users of medications that affect sexual function (antihypertensives, antidepressants or antipsychotics) and women unable to read or understand the instructions for the study were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES The breastfeeding women completed the Female Sexual Function Index, the EUROHIS-QOL 8-item index and a questionnaire to collect participants' sociodemographic, clinical and interpersonal data. A bivariate analysis was performed, and variables with p values<0.20 were analysed by multivariate logistic regression. RESULTS Sexual dysfunction was present in 58.3% of the study population. Factors significantly associated with female sexual dysfunction (FSD) included placing a low importance on sexual intercourse (adjusted OR [AOR]=2.49, 95% CI=1.22 to 5.09), limited communication with the partner (AOR=2.64, 95% CI=1.43 to 4.86), decreased frequency of sexual intercourse (AOR=2.17, 95% CI=1.30 to 3.61) and low quality of life (AOR=2.23, 95% CI=1.33 to 3.74). CONCLUSIONS The prevalence of FSD appears with a great magnitude in breastfeeding women. The risk factors for sexual dysfunction are biopsychosocial and these findings may lead to improved counselling for prenatal and postnatal care.
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Affiliation(s)
| | - Denisse Cartagena-Ramos
- Maternal-Infant and Public Health, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Inês Fronteira
- Department of International Public Health and Biostatistics, Universidade Nova de Lisboa Escola Nacional de Saude Publica, Lisboa, Lisboa, Portugal
| | - Lúcia Alves Lara
- Departament of Gynecology and Obstetrics, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Luiz Henrique Arroyo
- Maternal-Infant and Public Health, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | | | - Mellina Yamamura
- Maternal-Infant and Public Health, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
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The influence of partnership quality and breastfeeding on postpartum female sexual function. Arch Gynecol Obstet 2018; 299:69-77. [PMID: 30327862 DOI: 10.1007/s00404-018-4925-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Female sexual dysfunction is known to have a huge impact on quality of life and is highly prevalent during the peripartum period. Several influencing variables were found to be associated with impaired sexual function postpartum, among them breastfeeding and partnership quality. However, little is known about the predictive value of these variables. Therefore, this longitudinal cohort study aimed to examine prospectively the influence of the two variables on sexual function 4-month postpartum. MATERIALS AND METHODS Questionnaires were administered to 330 women prenatally (TI, third trimester) and postpartum (TII, 1 week; TIII, 4 months). Medical data were collected from the respondents' hospital records. The Female Sexual Function Index (FSFI) was used to determine overall sexual function, desire, arousal, lubrication, orgasm, satisfaction, and pain perinatally. RESULTS At all timepoints, mean FSFI scores were below the critical FSFI-score of 26.55. Partnership quality, breastfeeding, high maternal education, and maternal depressive symptoms correlated significantly with FSFI scores postpartum. Further analyses confirmed antenatal partnership quality and breastfeeding behavior as strong predictors of sexual function 4-month postpartum, explaining 24.3% of variance. Women who stopped breastfeeding or never breastfed at all showed the highest FSFI scores. CONCLUSION Our findings indicate that exclusively breastfeeding women and those who report low partnership quality have an increased likelihood of sexual functioning problems 4-month postpartum. Health-care providers need to be encouraged to counsel on postpartum sexuality and influencing factors during prenatal classes to de-pathologize those changes and to foster a positive approach to peripartum sexuality.
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Fuentealba-Torres M, Cartagena-Ramos D, Sierra JC, Lara LA, Okano SP, Berra TZ, Alves LS, Leite ACAB, Yamamura M, Silva IA, Nascimento LC, Arcêncio RA. What are the factors that contribute to the development of sexual dysfunction in breastfeeding women? A systematic scoping review protocol. BMJ Open 2018; 8:e022863. [PMID: 30166306 PMCID: PMC6119408 DOI: 10.1136/bmjopen-2018-022863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/23/2018] [Accepted: 07/27/2018] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Female sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women. METHODS AND ANALYSIS The systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION As it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.
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Affiliation(s)
- Miguel Fuentealba-Torres
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Denisse Cartagena-Ramos
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Juan Carlos Sierra
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), University of Granada, Granada, Spain
| | - Lúcia Alves Lara
- Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Sérgio Pires Okano
- Department of Gynecology and Obstetrics, University of São Paulo, Ribeirão Preto, Brazil
| | - Thaís Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Luana Seles Alves
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Mellina Yamamura
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
| | - Isília Aparecida Silva
- Department of Maternal-Infant and Psychiatric Nursing, University of São Paulo, São Paulo, Brazil
| | | | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, University of São Paulo, Ribeirão Preto, Brazil
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Filipino Women’s Preferences for Male Voice Pitch: Intra-Individual, Life History, and Hormonal Predictors. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2018. [DOI: 10.1007/s40750-018-0087-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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16
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Banaei M, Moridi A, Dashti S. Sexual Dysfunction and its Associated Factors After Delivery: Longitudinal Study in Iranian Women. Mater Sociomed 2018; 30:198-203. [PMID: 30515059 PMCID: PMC6195409 DOI: 10.5455/msm.2018.30.198-203] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction Considering physical and emotional changes affecting women's sexual function in postpartum period. Aim This study was conducted to determine the sexual dysfunction and postpartum-related factors in Bandar Abbas women in 2016. Material and Methods This analytical cross-sectional study used systematic random sampling on 432 postpartum women referred to Bandar Abbas Healthcare Centers. Data were collected by Demographic and Obstetrics Questionnaire and Female Sexual Function Index (FSFI) Questionnaire through interview and were analyzed by using SPSS ver.22 method. Results The overall rate of sexual dysfunction was reported 85.95%. The most common postpartum sexual dysfunction was pain sexual dysfunction during sexual intercourse. The mean score of all types of sexual dysfunction increased over time after delivery except sexual satisfaction so that the mean score of sexual satisfaction did not show significant differences over time. There was a significant relationship between sexual dysfunction with factors such as duration of marriage (p< 0.001), number of children (p<0.001), familial relationship (p=0.028), episiotomy status (P=0.002) and contraceptive method (p=0.001). Conclusion Considering the high prevalence of sexual disorders in this study, healthcare systems need to pay more attention to this area. In order to promote the health status of the family and ultimate of the society, attention to sexual health as well as the early diagnosis and treatment of sexual dysfunction of couples are important, especially during pregnancy and after childbirth.
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Affiliation(s)
- Mojdeh Banaei
- Faculty Member of Midwifery, Faculty of Nursing and Midwifery, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azam Moridi
- Faculty Member of Midwifery, Faculty of Nursing and Midwifery, Mother and Child Welfare Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sareh Dashti
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia
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Triviño-Juárez JM, Romero-Ayuso D, Nieto-Pereda B, Forjaz MJ, Oliver-Barrecheguren C, Mellizo-Díaz S, Avilés-Gámez B, Arruti-Sevilla B, Criado-Álvarez JJ, Soto-Lucía C, Plá-Mestre R. Resumption of intercourse, self-reported decline in sexual intercourse and dyspareunia in women by mode of birth: A prospective follow-up study. J Adv Nurs 2017; 74:637-650. [DOI: 10.1111/jan.13468] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 01/23/2023]
Affiliation(s)
| | - Dulce Romero-Ayuso
- Department of Physical Therapy; Faculty of Health Science; University of Granada (UGR); Granada Spain
| | - Beatriz Nieto-Pereda
- Preventive Medicine Service; Hospital General Universitario Gregorio Marañón; Gregorio Marañón Health Research Institute (IiSGM); Madrid Spain
| | - Maria João Forjaz
- National School of Public Health; Carlos III Institute of Health and REDISSEC; Carlos III Institute of Health; Madrid Spain
| | - Cristina Oliver-Barrecheguren
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | - Sonia Mellizo-Díaz
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | | | | | | | - Consuelo Soto-Lucía
- Obstetrics and Gynecology Service; Hospital General Universitario Gregorio Marañon; Gregorio Marañon Health Research Institute (IiSGM); Madrid Spain
| | - Rosa Plá-Mestre
- Preventive Medicine Service; Hospital General Universitario Gregorio Marañón; Gregorio Marañón Health Research Institute (IiSGM); Madrid Spain
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18
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Saydam BK, Demireloz Akyuz M, Sogukpinar N, Ceber Turfan E. Effect of delivery method on sexual dysfunction. J Matern Fetal Neonatal Med 2017; 32:568-572. [DOI: 10.1080/14767058.2017.1387243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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McBride HL, Kwee JL. Sex After Baby: Women’s Sexual Function in the Postpartum Period. CURRENT SEXUAL HEALTH REPORTS 2017. [DOI: 10.1007/s11930-017-0116-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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20
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Lagaert L, Weyers S, Van Kerrebroeck H, Elaut E. Postpartum dyspareunia and sexual functioning: a prospective cohort study. EUR J CONTRACEP REPR 2017; 22:200-206. [PMID: 28447919 DOI: 10.1080/13625187.2017.1315938] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Sexual functioning is an important concern for women in the postpartum period. The aim of this research was to investigate the prevalence and determinants of dyspareunia and sexual dysfunction before and after childbirth. METHODS Between November 2013 and April 2014, 109 women in their third trimester of pregnancy were enrolled in a prospective cohort study at Ghent University Hospital. Dyspareunia, sexual functioning and quality of life (QOL) were evaluated at enrolment and again 6 weeks and 6 months postpartum. Sexual functioning and QOL were assessed using validated self-report questionnaires: the Female Sexual Function Index and the Short Form-36 health survey. Dyspareunia was evaluated by a specific self-developed questionnaire. RESULTS One hundred and nine women were enrolled; respectively, 71 (65.1%), 66 (60.6%) and 64 (58.7%) women returned the questionnaires prepartum, and 6 weeks and 6 months postpartum. Sexual functioning at 6 weeks was predictive of sexual functioning at 6 months postpartum (rs = 0.345, p = .015). The prevalence of dyspareunia in the third trimester of pregnancy, and 6 weeks and 6 months postpartum was, respectively, 32.8%, 51.0% and 40.7%. The severity of pain decreased significantly between 6 weeks and 6 months postpartum (p = .003). In the first 6 weeks postpartum, the degree of dyspareunia was significantly associated with breastfeeding (p = .045) and primiparity (p = .020). At 6 months, only the association with primiparity remained significant (p = .022). CONCLUSIONS The impaired postpartum sexual functioning, the high prevalence of dyspareunia postpartum and their impact on QOL indicate the need for further investigation and extensive counselling of pregnant women, especially primiparous women, about sexuality after childbirth.
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Affiliation(s)
- Liesbet Lagaert
- a Department of Medicine, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.,b Department of Obstetrics and Gynaecology , Ghent University Hospital , Ghent , Belgium
| | - Steven Weyers
- b Department of Obstetrics and Gynaecology , Ghent University Hospital , Ghent , Belgium
| | - Helena Van Kerrebroeck
- b Department of Obstetrics and Gynaecology , Ghent University Hospital , Ghent , Belgium
| | - Els Elaut
- c Centre for Sexuality and Gender, Ghent University Hospital , Ghent , Belgium
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Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study. Arch Gynecol Obstet 2017; 295:873-883. [PMID: 28251311 DOI: 10.1007/s00404-017-4305-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/10/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors. METHODS Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB). RESULTS The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains. CONCLUSIONS Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.
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Rezaei N, Azadi A, Sayehmiri K, Valizadeh R. Postpartum Sexual Functioning and Its Predicting Factors among Iranian Women. Malays J Med Sci 2017; 24:94-103. [PMID: 28381932 DOI: 10.21315/mjms2017.24.1.10] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 12/03/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Many women experience sexual dysfunction following childbirth but this has not been well investigated in Iran. The aim of this study was to evaluate women's sexual function in the postpartum period in Iran. It also sought to determine predicting factors associated with their sexual function. METHODS This was a cross-sectional study among 380 postpartum women attending 10 urban health centers in Ilam province in southwestern Iran. Participants were selected using random cluster sampling. Data was collected using the female sexual function index (FSFI) and a checklist of socio-demographic and maternal status for each of the women. Sexual dysfunction was classified according to an FSFI score of ≤ 28. Data were analysed using SPSS version 22. RESULTS The majority of participants (76.3%) had sexual dysfunction. Primiparity (adjusted odds ratio (aOR): 1.78 (95% Confidence Interval (CI): 1.11, 2.94); P = 0.006) and exclusive breastfeeding (aOR: 2.47 (95% CI: 1.21, 5.03); P = 0.012) were associated with increased odds of experiencing sexual dysfunction in the postpartum period. Other factors such as age, type of delivery, education, time since delivery and family income did not predict women's postpartum sexual function. CONCLUSION This study confirmed findings of previous studies on factors that may have an adverse effect on new mothers' sexual function in the postpartum period. However the effect of type of delivery on postpartum sexual function remains unclear.
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Affiliation(s)
- Nazanin Rezaei
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Arman Azadi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Kourosh Sayehmiri
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Valizadeh
- Psychiatry Department, Schools of Medicine, Ilam University of Medical Sciences, Ilam, Iran
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Schlagintweit HE, Bailey K, Rosen NO. A New Baby in the Bedroom: Frequency and Severity of Postpartum Sexual Concerns and Their Associations With Relationship Satisfaction in New Parent Couples. J Sex Med 2016; 13:1455-65. [PMID: 27592145 DOI: 10.1016/j.jsxm.2016.08.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION New parents are faced with many novel stressors, including possible changes to their sexual relationships. Although postpartum sexual concerns appear to be pervasive in new parents, little is known about the severity of these concerns or how they relate to new mothers' and fathers' relationship satisfaction. AIM To describe the frequency and severity of postpartum sexual concerns and examine associations between frequency and severity of postpartum sexual concerns and relationship satisfaction in new-parent couples. METHODS Participants were 239 new-parent couples of a healthy infant 3 to 12 months old. Both members of the parenting couple completed an online survey within 1 month of each other. MAIN OUTCOME MEASURES Frequency and severity of postpartum sexual concerns were assessed using a 20-item Likert-type questionnaire adapted from a previously validated measurement. Relationship satisfaction was assessed with the Couples Satisfaction Index. RESULTS A wide range of postpartum sexuality concerns was highly prevalent and moderately distressing in new mothers and fathers alike. New fathers' greater severity of postpartum sexual concerns was associated with their own and new mothers' decreased relationship satisfaction, whereas new mothers' greater severity of postpartum sexual concerns was associated only with lower relationship satisfaction in new fathers. In addition, new mothers' greater frequency of postpartum sexual concerns was associated with their own and new fathers' lower relationship satisfaction, whereas new fathers' frequency of postpartum sexual concerns was unrelated to the couples' relationship satisfaction. CONCLUSION Postpartum sexual concerns are pervasive and moderately distressing in new parents. The increased frequency and severity of these concerns were associated with decreased relationship well-being in both members of the couple. New mothers might need more assistance adjusting to the number of sexual concerns that they are experiencing, whereas new fathers might need more help adjusting to distress related to sexual issues.
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Affiliation(s)
- Hera E Schlagintweit
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kristen Bailey
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada; Department of Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada.
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Cappell J, MacDonald TK, Pukall CF. For new mothers, the relationship matters: Relationship characteristics and postpartum sexuality. CANADIAN JOURNAL OF HUMAN SEXUALITY 2016. [DOI: 10.3138/cjhs.252-a5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Postpartum sexuality has traditionally been studied using a biomedical framework, which focuses on how the physical and biological changes that occur during pregnancy and childbirth affect the resumption of pain-free intercourse. The current study sought to use a more inclusive and contextual approach by investigating how relationship characteristics are related to postpartum sexual desire and predict the resumption of a variety of sexual activities. A total of 188 new mothers who were within one year postpartum completed an online study. The Sexual Desire Inventory was used to measure solitary and dyadic sexual desire. Relationship satisfaction was measured using the Relationship Assessment Scale and perception of partner's sexual desire was measured using three modified questions from the Sexual Desire Inventory. New mothers were also asked to report when they resumed a variety of sexual activities in the postpartum period. Relationship satisfaction and perceptions of partner's desire were negatively correlated with solitary sexual desire, and relationship satisfaction was positively correlated with dyadic sexual desire. Birth-related factors were not related to postpartum sexual desire. New mothers' perception of their partner's desire predicted the resumption of most sexual activities in the postpartum (i.e., manual stimulation of new mother's and partner's genitals, oral stimulation of partner's genitals, penile-vaginal intercourse). Relationship satisfaction predicted the resumption of oral stimulation of the new mother's genitals. The results of this study support the incorporation of contextual factors, such as relationship characteristics, and the inclusion of non-penetrative sexual activities in the study of postpartum sexuality.
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Affiliation(s)
- Jaclyn Cappell
- Department of Psychology, Queen's University, Kingston, ON
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25
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[What do we know about perinatal sexuality? A scoping review on sexoperinatality - Part 2]. ACTA ACUST UNITED AC 2016; 45:809-820. [PMID: 26989006 DOI: 10.1016/j.jgyn.2015.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/30/2015] [Accepted: 11/04/2015] [Indexed: 02/04/2023]
Abstract
The intimate and sexual dimension of future and new parenting couples' relationship is the most affected and the most vulnerable during the transition to parenthood. The purpose of this scoping review is to present the portrait of perinatal sexuality through 123 empirical articles published in the last 15 years. This second article in a series of two is about sexuality during labor and birth, during the postpartum, and in relation to breastfeeding. A total of 29 sexual variables were analyzed. Sexuality during the intrapartal and postnatal periods is very diversified. Some recurring items, however, can be identified: a period of non-sexuality in the first postnatal months, followed by a gradual return of sexuality from 3 to 6 months postpartum and continuing until 12 months or more. Sexuality during the intrapartum is considered taboo and couples' experiences can be at opposite ends: some couples' experiences are sensual and erotic during childbirth, while others experience birth trauma with a negative sexual impact postnatally. Sexuality during breastfeeding is also taboo with a negative impact on women's sexuality. In all of these circumstances, women's and men's sexuality are affected and a multitude of simultaneous physiological and psychological factors affect their experiences. Fluctuations in the intimate and sexual dimensions of the conjugal relationship are considered as a natural phenomenon but temporary. Sexoperinatal interventions should be part of holistic perinatal health care in order to help couples maintain a positive intimate and sexual relationship.
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Barbara G, Pifarotti P, Facchin F, Cortinovis I, Dridi D, Ronchetti C, Calzolari L, Vercellini P. Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs Cesarean Section. J Sex Med 2016; 13:393-401. [DOI: 10.1016/j.jsxm.2016.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 11/20/2015] [Accepted: 11/22/2015] [Indexed: 02/01/2023]
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Khajehei M, Doherty M, Tilley PJM, Sauer K. Prevalence and risk factors of sexual dysfunction in postpartum Australian women. J Sex Med 2015; 12:1415-26. [PMID: 25963126 DOI: 10.1111/jsm.12901] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Female sexual dysfunction is highly prevalent and reportedly has adverse impacts on quality of life. Although it is prevalent after childbirth, women rarely seek advice or treatment from health care professionals. AIM The aim of this study was to assess the sexual functioning of Australian women during the first year after childbirth. METHODS Postpartum women who had given birth during the previous 12 months were invited to participate in this cross-sectional study. A multidimensional online questionnaire was designed for this study. This questionnaire included a background section, the Female Sexual Function Index, the Patient Health Questionnaire (PHQ-8), and the Relationship Assessment Scale. Responses from 325 women were analyzed. RESULTS Almost two-thirds of women (64.3%) reported that they had experienced sexual dysfunction during the first year after childbirth, and almost three-quarters reported they experienced sexual dissatisfaction (70.5 %). The most prevalent types of sexual dysfunction reported by the affected women were sexual desire disorder (81.2%), orgasmic problems (53.5%), and sexual arousal disorder (52.3%). The following were significant risk factors for sexual dysfunction: fortnightly or less frequent sexual activity, not being the initiator of sexual activity with a partner, late resumption of postnatal sexual activity (at 9 or more weeks), the first 5 months after childbirth, primiparity, depression, and relationship dissatisfaction. CONCLUSION Sexual satisfaction is important for maintaining quality of life for postpartum women. Health care providers and postpartum women need to be encouraged to include sexual problems in their discussions.
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Affiliation(s)
- Marjan Khajehei
- Department of Sexology, School of Public Health, Curtin University, Perth, WA, Australia
| | - Maryanne Doherty
- Department of Sexology, School of Public Health, Curtin University, Perth, WA, Australia
| | - P J Matt Tilley
- Department of Sexology, School of Public Health, Curtin University, Perth, WA, Australia
| | - Kay Sauer
- Department of Epidemiology and Biostatics, School of Public Health, Curtin University, Perth, WA, Australia
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Faisal-Cury A, Menezes PR, Quayle J, Matijasevich A, Diniz SG. The Relationship Between Mode of Delivery and Sexual Health Outcomes after Childbirth. J Sex Med 2015; 12:1212-20. [DOI: 10.1111/jsm.12883] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chayachinda C, Titapant V, Ungkanungdecha A. Dyspareunia and Sexual Dysfunction after Vaginal Delivery in Thai Primiparous Women with Episiotomy. J Sex Med 2015; 12:1275-82. [DOI: 10.1111/jsm.12860] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Colson MH. [Female sexuality and parenthood]. ACTA ACUST UNITED AC 2014; 42:714-20. [PMID: 25262091 DOI: 10.1016/j.gyobfe.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 06/27/2014] [Indexed: 10/24/2022]
Abstract
From the child conception to the early years of life, couples generally present less sexual activity. Parenthood constraints are a burden for the couple's relationships. Generally, persistent sexual difficulties six months after delivery, despite those generated by depression or altered health raise the question of an alteration in the quality of the couple's relationships and lack of satisfaction of the mother with her partner's involvement in family life. Numerous parameters can be implied, especially with persistent trouble of desire, such as fatigue, body image problems and libido lessening of the partner due to modifications of his status. Women who presented sexual difficulties before pregnancy remain the same. In all cases, appropriate information can avoid the intimacy's difficulties and contribute to maintain pleasure and intimacy even when vaginal penetration remains difficult.
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Affiliation(s)
- M-H Colson
- Hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France.
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Enderle CDF, Kerber NPDC, Lunardi VL, Nobre CMG, Mattos L, Rodrigues EF. Constraints and/or determinants of return to sexual activity in the puerperium. Rev Lat Am Enfermagem 2014; 21:719-25. [PMID: 23918017 DOI: 10.1590/s0104-11692013000300010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 02/19/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify factors which constrain or determine the return to sexual activity in the puerperium. METHOD exploratory and descriptive study undertaken in a university hospital in the South of Brazil. Fifteen women who had recently given birth, who received a consultation with the nurse in the period August - October 2011, took part in the study. Data was collected after the consultation had finished through semi-structured interviews, in which the women who had recently given birth were asked about the return to sexual activity and the feelings involved in this process. RESULTS the principal determinant/constraint for return to sexual activity in the post-natal period was the fear of a new pregnancy. Fear of feeling pain, permission from the health professional, shame of their own bodies and changes in libido emerged as constraining and/or determinant factors in the thematic analysis. CONCLUSION it is considered fundamental for the issue of contraception to be addressed with the woman/couple during the pre-natal consultation, so that there may be opportunities for reflection and dialog prior to the critical time itself.
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Jawed‐Wessel S, Schick V, Herbenick D. The Sexual Function Questionnaire's Medical Impact Scale (SFQ‐MIS): Validation Among a Sample of First‐time Mothers. J Sex Med 2013; 10:2715-22. [DOI: 10.1111/jsm.12307] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Malakoti J, Zamanzadeh V, Maleki A, Farshbaf Khalili A. Sexual function in breastfeeding women in family health centers of tabriz, iran, 2012. J Caring Sci 2013; 2:141-6. [PMID: 25276720 DOI: 10.5681/jcs.2013.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 02/28/2012] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION There are conflicting evidences about the effects of breastfeeding on postpartum maternal sexual functioning. With regard to the methodological weaknesses of previous studies and cultural differences affecting their issue, the present study aims to evaluate sexual functions of lactating women and its components. METHODS This is a descriptive study in which 200 eligible postpartum women were selected from eight health centers of Tabriz (25 from each center). The eligible women were called and invited to attend the health center. The evaluation was performed using the Persian version of normalized questionnaire of the Female Sexual Function Index (FSFI). The participants' sexual function scores above 28 were considered desirable (regarding the cut-off point mentioned in the Persian version of the questionnaire). RESULTS Almost all of the lactating women suffered from sexual dysfunctions. Regarding the sexual performance's components the lowest scores were for libido and sexual arousal. CONCLUSION According to the findings of the studies, in order to prevent the effects of sexual dysfunction on lactating women and their family members it is necessary to develop sexual health programs in health centers.
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Affiliation(s)
- Jamileh Malakoti
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahdieh Maleki
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf Khalili
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Rupp HA, James TW, Ketterson ED, Sengelaub DR, Ditzen B, Heiman JR. Lower sexual interest in postpartum women: relationship to amygdala activation and intranasal oxytocin. Horm Behav 2013; 63:114-21. [PMID: 23085496 PMCID: PMC3540189 DOI: 10.1016/j.yhbeh.2012.10.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 09/17/2012] [Accepted: 10/10/2012] [Indexed: 12/15/2022]
Abstract
During the postpartum period, women experience significant changes in their neuroendocrine profiles and social behavior compared to before pregnancy. A common experience with motherhood is a decrease in sexual desire. Although the lifestyle and peripheral physiological changes associated with parturition might decrease a woman's sexual interest, we hypothesized that there are also hormone-mediated changes in women's neural response to sexual and infant stimuli with altered reproductive priorities. We predicted that amygdala activation to sexually arousing stimuli would be suppressed in postpartum versus nulliparous women, and altered with intranasal oxytocin administration. To test this, we measured amygdala activation using fMRI in response to sexually arousing pictures, infant pictures, and neutral pictures in 29 postpartum and 30 nulliparous women. Half of the women received a dose of exogenous oxytocin before scanning. As predicted, nulliparous women subjectively rated sexual pictures to be more arousing, and infant pictures to be less arousing, than did postpartum women. However, nulliparous women receiving the nasal oxytocin spray rated the infant photos as arousing as did postpartum women. Right amygdala activation was lower in postpartum versus nulliparous women in response to sexual, infant, and neutral images, suggesting a generalized decrease in right amygdala responsiveness to arousing images with parturition. There was no difference in right amygdala activation with nasal spray application. Postpartum women therefore appear to experience a decrease in sexual interest possibly as a feature of a more generalized decrease in amygdala responsiveness to arousing stimuli.
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Affiliation(s)
- Heather A Rupp
- The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN 47405, USA.
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Hipp LE, Kane Low L, van Anders SM. Exploring Women's Postpartum Sexuality: Social, Psychological, Relational, and Birth‐Related Contextual Factors. J Sex Med 2012; 9:2330-41. [DOI: 10.1111/j.1743-6109.2012.02804.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Lee J, Tsai J. Transtheoretical Model‐based Postpartum Sexual Health Education Program Improves Women's Sexual Behaviors and Sexual Health. J Sex Med 2012; 9:986-96. [DOI: 10.1111/j.1743-6109.2011.02419.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Ahn Y, Sohn M, Yoo E. Breast functions perceived by Korean mothers: infant nutrition and female sexuality. West J Nurs Res 2009; 32:363-78. [PMID: 19955100 DOI: 10.1177/0193945909349252] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The descriptive cross-sectional study of 2,235 Korean postpartum women was conducted to explore (a) feeding types with related factors, (b) the perceived benefits of each feeding type, (c) the perceived sexuality-related barriers to breast-feeding, and (d) the perceived relative significance of breast functions. The most frequently utilized feeding type was breast-feeding only. The gender of infants, vaginal delivery, not being employed, having a nuclear family, previous breast-feeding experience, and previously receiving breast-feeding education were statistically significant factors of breast-feeding. Breast-feeding and mixed feeding mothers indicated that their feeding choices were based on nutritional benefits, convenience, and improving family relationships. Only breast-feeding mothers reported changes in breast shape as a perceived sexuality-related barrier to breast-feeding. All mothers reported that infant feeding was a more significant concern than female sexual functioning, but post hoc Schéffe revealed that the breast-feeding mothers appreciated infant feeding function more than female sexual functioning.
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Affiliation(s)
- Youngmee Ahn
- Department of Nursing, College of Medicine, Inha University, Incheon, South Korea
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Abstract
Childhood sexual assault (CSA) is a common experience for women. Little research has explored the breastfeeding experience of CSA survivors who successfully breastfeed. The objective of this study is to explore the experience of successful breastfeeding with mothers with a history of CSA. Eleven women are interviewed after responding to a community-based advertisement. The women self-identify as having experienced CSA by a family member. Semistructured interviews are conducted by the author. Interviews are transcribed, coded, and analyzed for themes. Four key themes are identified: enhancement of the mother- baby relationship, validation of the maternal body, splitting of the breasts' dual role as maternal and sexual objects, and exposure and control when breastfeeding in public. Healthcare professionals should be aware of these maternal issues when promoting breastfeeding and counseling breastfeeding women.
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Affiliation(s)
- Jan Coles
- Child Abuse Prevention Research Australia/Department of General Practice, Monash University, Victoria, Australia
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Postpartum female sexual function. Eur J Obstet Gynecol Reprod Biol 2009; 145:133-7. [PMID: 19481858 DOI: 10.1016/j.ejogrb.2009.04.014] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 02/04/2009] [Accepted: 04/13/2009] [Indexed: 11/22/2022]
Abstract
Although many women experience sexual problems in the postpartum period, research in this subject is under-explored. Embarrassment and preoccupation with the newborn are some of the reasons why many women do not seek help. Furthermore, there is a lack of professional awareness and expertise and recognition that a prerequisite in the definition of sexual dysfunction is that it must cause distress to the individual (not her partner). Sexual dysfunction is classified as disorders of sexual desire, arousal, orgasm and pain. However, in the postpartum period the most common disorder appears to be that of sexual pain as a consequence of perineal trauma. Health care workers need to be made aware of this silent affliction as sexual morbidity can have a detrimental effect on a women's quality of life impacting on her social, physical and emotional well-being.
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Williamson M, McVeigh C, Baafi M. An Australian perspective of fatherhood and sexuality. Midwifery 2008; 24:99-107. [PMID: 17197059 DOI: 10.1016/j.midw.2006.07.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2004] [Revised: 07/14/2006] [Accepted: 07/17/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE to describe and explore the effect that pregnancy, childbirth and adjustment to a new baby have on the sexual relationship of fathers. DESIGN a content analysis, using a qualitative approach, was undertaken on the written comments provided by fathers on a 6-week postpartum postal survey. The survey was undertaken to provide information relating to fathers' adaptation to fatherhood. The father's functional status was measured using, the Inventory of Functional Status-fathers (IFS-F) Tool. SETTING a regional location within New South Wales, Australia. Participants (fathers) were recruited through postnatal services within hospital and community settings. PARTICIPANTS volunteer study participants consisting of 204 fathers were sent a questionnaire at 6 weeks postpartum. The questionnaire was returned by 128 study participants (fathers). The participants were men experiencing fatherhood for the first time or who were adding to their existing families. FINDINGS comments by the study participants revealed that sexual relationships during pregnancy and the postnatal period undergo a variety of changes that may affect the couple's relationship. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE it is important for health-care professionals, particularly midwives, to recognise that variance in sexual activity during the childbearing period does occur, and that there is a need for the midwife to be open to individual discussion of sexual activity with the woman and her partner during pregnancy and postnatal periods. Holistic care of women and their partners in the childbearing period requires health professionals to effectively communicate current information and education on sexuality.
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Affiliation(s)
- Moira Williamson
- School of Nursing, Midwifery and Indigenous Health, University of Wollongong, Northfields Avenue, Wollongong NSW, Australia 2522.
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Johnston-Robledo I, Fred V. Self-Objectification and Lower Income Pregnant Women's Breastfeeding Attitudes1. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2007. [DOI: 10.1111/j.1559-1816.2008.00293.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee JT, Yen HW. Randomized controlled evaluation of a theory-based postpartum sexual health education programme. J Adv Nurs 2007; 60:389-401. [DOI: 10.1111/j.1365-2648.2007.04395.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pastore L, Owens A, Raymond C. Postpartum Sexuality Concerns Among First‐Time Parents from One U.S. Academic Hospital. J Sex Med 2007; 4:115-123. [PMID: 17087807 DOI: 10.1111/j.1743-6109.2006.00379.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Sexual perceptions and activities are influenced by pregnancy and childbirth due to both physical and emotional changes. AIM Our goal was to illuminate the sexuality issues of concern to first-time parents (mothers and fathers) of healthy, singleton newborns in one U.S. academic hospital. MAIN OUTCOME MEASURES Number of sexuality concerns and self-reported degree of resolution by months postpartum and gender of parent. METHODS Anonymous, cross-sectional postal survey of two first-time parent cohorts: 4 months postpartum (113 responses/404 mailed = 28.0%) and 12 months postpartum (99 responses/394 mailed = 25.1%). RESULTS Approximately half of the parents reported questions or concerns on between two and eight of 19 sexuality topics. Only 11% of participating mothers and 17% of participating fathers had one or no concerns (P = 0.27 by gender), and 17% of mothers and 9% of fathers had >13 concerns (P = 0.12 by gender). There were fewer maternal concerns if they did not live with the father (P = 0.01), slightly fewer if the delivery was vaginal vs. cesarean (P = 0.07), and no differences by forceps/vacuum use or episiotomy/vaginal tear. The top concerns at 4 months postpartum were quite similar by gender and included when to resume intercourse, birth control, and the sexual impact of physical recovery from delivery. At 12 months, mothers and fathers both frequently reported a sexuality impact from the mother's body image concerns and desire discrepancy. One year postpartum, there were three sexuality topics with fairly high prevalence (more than one-third parents had this concern) that persisted (no self-reported resolution among at least one-third of parents): child-rearing differences with spouse, greater desire by the man than the woman, and the mother's body image. CONCLUSIONS New mothers and fathers both have postpartum sexuality concerns/questions, many of which can be addressed by healthcare providers.
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Affiliation(s)
- Lisa Pastore
- Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA;.
| | - Annette Owens
- Charlottesville Sexual Health & Wellness Clinic, Charlottesville, VA, USA
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Olsson A, Lundqvist M, Faxelid E, Nissen E. Women's thoughts about sexual life after childbirth: focus group discussions with women after childbirth. Scand J Caring Sci 2006; 19:381-7. [PMID: 16324063 DOI: 10.1111/j.1471-6712.2005.00357.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the woman's sexual needs and impact on her relationship. The aim of this study was to elucidate how some women experienced their sexual life with their partner after giving birth. METHODS Twenty-seven women participated in six focus group discussions (FGDs). These discussions took place 3-24 months postdelivery. The midwives at their antenatal clinics selected them. A discussion guide with broad questions related to the subject was used and an observer took notes during the FGD. RESULTS Four themes were identified: body image after childbirth, how sexual patterns are altered following new stresses of family life, discordance of sexual desire with the partner and the necessity for reassurance. The women did not feel comfortable with the physical changes that had taken place and their body image. Childbirth meant less sleep and less free time; consequently, instead of having sex, women wanted to sleep or have time for themselves and that led to a changed sex pattern. Discordance of sexual desire with the partner was a problem but most of the women expressed confidence that their sexual desire would return shortly. Reassurance and confirmation that they were physically alright and back to normal was essential. CONCLUSION New mothers are concerned with their body image and the ability to adapt to parenting. They need sensitive, professional counselling and reassurance about their body, as well as about sexual life after childbirth. This level of professional counselling is presently not widely available to new mothers, while midwives and gynaecologists should be the key persons to provide this service.
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Affiliation(s)
- Ann Olsson
- Karolinska Institute, Danderyds Hospital, BB Stockholm AB, Sweden.
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Pacey S. Couples and the first baby: responding to new parents' sexual and relationship problems. SEXUAL AND RELATIONSHIP THERAPY 2004. [DOI: 10.1080/14681990410001715391] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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