Department of Obstetrics and Gynecology, Universitätsfrauenklinik Heidelberg, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany.
Arch Gynecol Obstet. 2019 Jan;299(1):69-77. doi: 10.1007/s00404-018-4925-z. Epub 2018 Oct 16.
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.
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.
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.
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.
女性性功能障碍已知对生活质量有巨大影响,并且在围产期非常普遍。已经发现几个影响变量与产后性功能受损有关,其中包括母乳喂养和伴侣关系质量。然而,对于这些变量的预测价值知之甚少。因此,本纵向队列研究旨在前瞻性地检查这两个变量对产后 4 个月时性功能的影响。
在产前(T1,孕晚期)和产后(T2,1 周;T3,4 个月)向 330 名女性发放问卷。从受访者的医院记录中收集医学数据。使用女性性功能指数(FSFI)在围产期确定整体性功能、欲望、唤起、润滑、性高潮、满意度和疼痛。
在所有时间点,平均 FSFI 评分均低于临界 FSFI 评分 26.55。产后伴侣关系质量、母乳喂养、高产妇教育程度和产妇抑郁症状与 FSFI 评分显著相关。进一步分析证实,产前伴侣关系质量和母乳喂养行为是产后 4 个月性功能的强预测因素,解释了 24.3%的方差。停止母乳喂养或从未母乳喂养的女性的 FSFI 评分最高。
我们的研究结果表明,纯母乳喂养的女性和报告伴侣关系质量低的女性在产后 4 个月时更有可能出现性功能问题。需要鼓励医疗保健提供者在产前课程中就产后性生活和影响因素进行咨询,以消除这些变化的病态化,并促进对围产期性生活的积极态度。