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Figueiredo PAO, Costa TSLDM, Lima MDDA, Magalhães AG, Bezerra IFD, Driusso P, de Sousa VPS. Self-Perception of Sexual Dysfunction of Adult Brazilian Women of Reproductive Age: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2165-2173. [PMID: 38736543 PMCID: PMC11088390 DOI: 10.2147/jmdh.s442074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 05/14/2024] Open
Abstract
Introduction Sexual dysfunction (SD) comprises disorders in sexual desire, arousal, orgasm, and lubrication. The importance of self-perceived SD relies on its relation to personal values, sex education, and partnership. We aimed to analyze the association between self-perceived SD and the Female Sexual Function Index (FSFI) in adult women of reproductive age and the correlation between age and sexual function. Material and Methods This analytical cross-sectional study included 285 women aged 18 to 49 years, sexually active for at least four weeks, cisgender and heterosexual, and with Internet access. Women were divided into control (CG, control group; without SD) or study group (SG, study group; with SD) and responded to a self-applicable online survey containing a sociodemographic characterization, an interview about SD knowledge, and the FSFI test. The Chi-square test of independence (χ2) analyzed the association between self-perceived SD and FSFI-assessed SD. Pearson's correlation coefficient investigated the correlation between age and FSFI. Results Included women had a mean age of 29.57 years ± 7.11 years. Self-perceived SD showed a moderate association (Cramer's V = 0.590) with the FSFI score (χ2 [2] = 91.500; p < 0.001). A weak, negative, and significant correlation was observed between age and the FSFI desire domain (r = -0.120; p = 0.030; r2 = 1.440). Conclusion Women with self-perceived SD were 68% more likely to present FSFI-assessed SD. Regarding the FSFI desire domain, sexual function decreased with age.
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Affiliation(s)
| | | | - Mateus Dantas de Azevedo Lima
- Multicampus School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil
| | - Adriana Gomes Magalhães
- Multicampus School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Rio Grande do Norte, Brazil
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Bolsoy N, Sen S, Sezer G, Cakil M. The effect of training on women with postpartum sexual dysfunction: A randomized controlled trial. Niger J Clin Pract 2023; 26:949-956. [PMID: 37635579 DOI: 10.4103/njcp.njcp_656_22] [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] [Indexed: 08/29/2023]
Abstract
Background In the postpartum period, changes including pain during intercourse, lack of sexual desire, vaginal dryness, and failure to reach orgasm can affect a woman's sexual response cycle. Aim This research aimed to determine the effect of midwifery training on postpartum sexual dysfunction among primiparous women. Subjects and Methods This research using a single-blind randomized controlled experimental and follow-up design. The sample consisted of 70 women, divided equally into training and control groups. Research data were collected using an information form, the Female Sexual Function Index and the Arizona Sexual Experience Scale. In the first phase of our study, 306 primiparous women were interviewed. Results The mean Female Sexual Function Index score of the women was 25.18 ± 5.47 and 40.2% reported sexual dysfunction. When comparing the training and control groups before training, the total score average of the ASEX was 10.48 ± 2.13 in the training group and 11.06 ± 3.86 in the control group. The average score in the post-training was higher in the group given education (22.45 ± 2.17) than in the control group (17.08 ± 3.92) and this difference was significant (p = 0.000). It was determined that 42% of the change in the third follow-up scores of pregnant women in the training group could be explained by the education session they received. Conclusion Our data showed a positive change in the sexual dysfunction scores of women, suggesting the education program was successful.
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Affiliation(s)
- N Bolsoy
- Celal Bayar University, Faculty of Health Sciences, Midwifery Department, Turkey
| | - S Sen
- Celal Bayar University, Faculty of Health Sciences, Midwifery Department, Turkey
| | - G Sezer
- Master Student, Celal Bayar University, Health Science Institute, Turkey
| | - M Cakil
- Master Student, Celal Bayar University, Health Science Institute, Turkey
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Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, Peters LL. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5252. [PMID: 37047868 PMCID: PMC10094321 DOI: 10.3390/ijerph20075252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL. Studies that compared at least two modes of birth and used valid sexual function measures were included. Systematic reviews, unpublished articles, protocols and articles not written in English were excluded. Quality was assessed using the Newcastle Ottawa Scale. (3) Results: In the medium-term, assisted vaginal birth and vaginal birth with episiotomy were associated with worse sexual function, compared to caesarean section. In the longer-term, assisted vaginal birth was associated with worse sexual function, compared with spontaneous vaginal birth and caesarean section; and planned caesarean section was associated with worse sexual function in several domains, compared to spontaneous vaginal birth. (4) Conclusions: Sexual function, in the medium- and longer-term, can be affected by mode of birth. Women should be encouraged to seek support should their sexual function be affected after birth.
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Affiliation(s)
- Anne-Marie Fanshawe
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, 9700 AD Groningen, The Netherlands
| | - Ank De Jonge
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Nicole Ginter
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, 128 08 Prague, Czech Republic
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
| | - Morris A. Swertz
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Lilian L. Peters
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, 9713 GL Groningen, The Netherlands
- Midwifery Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
- School of Nursing and Midwifery, Western Sydney University, Blacktown, NSW 2148, Australia
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Oliveira LND, Silva Marcon S, Cazetta de Lima Vieira V, Ferraz Teston E, Marien Knupp Medeiros R, Cristina Ribeiro Furlan M, Baratieri T, Serafim D. Percepções e vivências de mulheres acerca da sexualidade durante o período de amamentação. REME: REVISTA MINEIRA DE ENFERMAGEM 2023. [DOI: 10.35699/2316-9389.2023.38302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: apreender como as mulheres percebem e vivenciam a sexualidade durante o período da amamentação. Método: estudo descritivo de abordagem qualitativa, realizado com mulheres lactantes ou que já haviam amamentado, em seis Unidades Básicas de Saúde de município da região Sul do Brasil. Os dados foram coletados no período de maio a agosto de 2018, mediante entrevistas semiestruturadas, áudio-gravadas, realizadas em local reservado nas unidades de saúde. As informantes foram 18 mulheres com filhos de até 12 meses de vida, que estava sendo ou tivesse sido amamentado ao seio por algum tempo, e que compareceram à Unidade de Saúde para puericultura ou consulta com pediatra durante o período da coleta de dados. Foram excluídas as mulheres que referiram não ter iniciado a prática sexual no período de amamentação. Os dados produzidos foram submetidos à análise de conteúdo modalidade temática. Resultados: as mulheres percebem e vivenciam a sexualidade durante a amamentação por meio de mudanças na autoimagem, na autoestima e no relacionamento com o parceiro. As modificações mamárias foram bem percebidas no período gestacional e no início da amamentação, porém, com o decorrer do tempo, algumas mulheres as perceberam de forma negativa, sobretudo aquelas que tiveram mais dificuldade na retomada do peso pré-gravídico. Os resultados mostraram também que as mulheres passaram por um período de incertezas e inseguranças em relação a sexualidade e que mudanças da dinâmica conjugal foram necessárias neste período de transição para o exercício da sexualidade, considerando necessidades do suporte nutricional e afetivo do bebê. Conclusão: as mulheres percebem e vivenciam dificuldades em conciliar a sexualidade com a amamentação, visto que a nova dinâmica familiar decorrente do nascimento de um filho, associada as alterações na estética corporal, podem repercutir de forma negativa na sexualidade.
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Pelvic floor healing milestones after obstetric anal sphincter injury: a prospective case control feasibility study. Int Urogynecol J 2023; 34:553-561. [PMID: 36098790 PMCID: PMC9469830 DOI: 10.1007/s00192-022-05348-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/01/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Severe perineal tears can predict bothersome pelvic floor disorders later in life. We have a poor understanding of pelvic floor changes during the third trimester and the first few postpartum months. We aimed to compare women with severe perineal trauma during childbirth with women who experienced minimal trauma, for condition-specific quality of life, sexual function, mental health and overall quality of life in the first 6 months postpartum. METHODS We recruited primiparous women with third- or fourth-degree tears (obstetric anal sphincter injuries, OASIS) and age-matched controls with no tears or first-degree tears in the immediate postpartum period. Participants completed validated questionnaires at baseline, 2, 4 and 6 months postpartum. Mixed effects linear regression or quantile regression adjusted for baseline score were used to compare the groups as appropriate. RESULTS A total of 74 women completed at least one questionnaire (35 OASIS, 39 controls). Both groups had similar demographics. Women with OASIS tended to have worse Pelvic Floor Distress Index-40 scores at month 2; median scores were similar in the two groups by month 6. They also had significantly lower Female Sexual Function Index scores (mean difference: -6.1; 95% CI: -11.9, -0.2, p=0.043) at month 2. There were no mental health group differences and quality of life improved over time, mainly in the OASIS group. Six-month participant attrition rate was 52%. CONCLUSIONS Women with OASIS encounter specific pelvic floor challenges during the first 6 months postpartum. Although our recruitment rate was high, the attrition rate was also high, demonstrating challenges with retention of postpartum women into longitudinal research.
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The Effect of Type of Delivery on Female Postpartum Sexual Functioning: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10071212. [PMID: 35885738 PMCID: PMC9322469 DOI: 10.3390/healthcare10071212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/18/2022] [Accepted: 06/26/2022] [Indexed: 11/22/2022] Open
Abstract
Female sexual function could be considered as multifactorial. Specific physiological structures and hormonal fluctuations postpartum, along with the psychological adjustment of women, could result in altered sexual function. The primary aim of this review was to systematically appraise the existing data on the effect of mode of delivery on female sexual function. This review was designed based on the PRISMA statement guidelines. An extensive literature search was performed in the Pubmed, Scopus, and PsycInfo databases, using prespecified inclusion/exclusion criteria, between the 20 September and 10 October 2021. Studies’ quality assessment was conducted using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Heart, Lung, and Blood Institute. The initial search involved 1592 studies. The last step of the screening procedure yielded 16 studies, including 41,441 subjects with a mean age of 29.9 years. Studies included groups with spontaneous and assisted vaginal and C-section delivery modes. No statistically significant difference between groups was found. The type of delivery appears to be irrelevant regarding this relationship. Moderating factors seemed to indirectly influence this relationship. Health professionals should educate expectant mothers and be aware of the possibility that delivery method could affect sexual function.
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Fan X, Zhou F, Li Y, Xia W, Che Y. Factors associated with postpartum resumption of sexual intercourse among women in China: A retrospective multicenter study. J Obstet Gynaecol Res 2021; 48:230-238. [PMID: 34788897 DOI: 10.1111/jog.15088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/16/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine the prevalence and factors associated with early resumption of sexual intercourse among postnatal women in China. METHOD We conducted a retrospective multicenter study of 15 834 postpartum women from 60 hospitals in 15 different locations across China. Data were obtained from questionnaires administered to the participants. All dates were analyzed using a one-way ANOVA and two-level Cox multiple linear regression models. RESULTS More than half of the participating women (55.9%) resumed sexual intercourse by 3 months postpartum. The independent variables associated with the postpartum resumption of sexual intercourse included sociodemographic characteristics (age, geographic location, educational attainment) and medical histories, including the previous abortion (incorporate with spontaneous and voluntary abortion) frequency, menstrual recovery, exclusive breastfeeding, and number of living children (p < 0.05). CONCLUSION More than half of the women in this study resumed sexual intercourse within 3 months postpartum. Women with a lower educational attainment and from the western regions of China were more likely to resume sexual intercourse earlier. Increasing age, delayed recovery of menses, and exclusive breastfeeding were associated with a delayed resumption of sexual intercourse. Women who had greater experience with abortion or the number of living children resumed sexual intercourse earlier than their counterparts.
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Affiliation(s)
- Xiaorong Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zhou
- Reproductive Medicine Department, Hubei Maternal and Child Health Hospital, Wuhan, China
| | - Yuyan Li
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China
| | - Wei Xia
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Che
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Fudan University, Shanghai, China.,NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
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Cattani L, De Maeyer L, Verbakel JY, Bosteels J, Deprest J. Predictors for sexual dysfunction in the first year postpartum: a systematic review and meta-analysis. BJOG 2021; 129:1017-1028. [PMID: 34536325 DOI: 10.1111/1471-0528.16934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnancy and childbirth increase the risk for pelvic floor dysfunction, including sexual dysfunction. So far, the mechanisms and the extent to which certain risk factors play a role remain unclear. OBJECTIVES In this systematic review of the literature we aimed to determine risk factors for sexual dysfunction in the first year after childbirth. SEARCH STRATEGY We searched MEDLINE, Embase and CENTRAL using the search strategy: sexual dysfunction AND obstetric events. SELECTION CRITERIA We included original, comparative studies, reported in English, that used validated questionnaires and the ICS/IUGA terminology for sexual dysfunction, dyspareunia and vaginal dryness. DATA COLLECTION AND ANALYSIS We assessed the quality and the risk of bias of the included studies with the Newcastle-Ottawa scale. We extracted the reported data and we performed random-effects meta-analysis to obtain the summary odds ratios (ORs) with 95% confidence intervals (95% CIs). Heterogeneity across studies was assessed using the I2 statistic. MAIN RESULTS Anal sphincter injury was associated with increased odds for both sexual dysfunction (OR 3.00, 95%CI 1.28-7.03) and dyspareunia (OR 1.92, 95% CI 1.47-2.52). Episiotomy was associated with dyspareunia (OR 1.64, 95% CI 1.25-2.14), but not with sexual dysfunction (OR 1.90, 95% CI 0.94-3.84). Compared with spontaneous birth, caesarean section reduced the odds for dyspareunia (OR 0.68, 95% CI 0.54-0.86) but not for sexual dysfunction (OR 1.14, 95% CI 0.89-1.46). Instrumental vaginal birth increased the odds for sexual dysfunction (OR 1.70, 95% CI 1.05-2.76), yet no difference was found for dyspareunia (OR 1.82, 95% CI 0.88-3.75). One study of low quality reported on vaginal dryness and found no association with obstetric events. CONCLUSIONS Perineal trauma, rather than mode of birth, increases the odds for sexual dysfunction in the first year after childbirth. TWEETABLE ABSTRACT Perineal trauma, rather than mode of birth, correlates with sexual dysfunction and dyspareunia postpartum. #dyspareunia #OASI #episiotomy.
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Affiliation(s)
- L Cattani
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - L De Maeyer
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - J Y Verbakel
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - J Bosteels
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, Belgium
| | - J Deprest
- Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences, KU Leuven, Leuven, Belgium.,Research Department of Maternal Fetal Medicine, Institute for Women's Health, University College London, London, UK
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