Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ 86011, United States.
Department of Psychology, Université de Montréal, Montréal, QC, H3C 3J7, Canada.
J Sex Med. 2024 Sep 28;21(10):940-950. doi: 10.1093/jsxmed/qdae088.
Pregnancy loss affects 1 in 4 women and is linked with poorer overall health and relationship outcomes. Despite sexual well-being's importance to health, how sexual well-being changes across time after a pregnancy loss and what might predict such changes, like perinatal grief, have never been examined, leaving practitioners and couples without knowledge of what to expect.
We aimed to examine (1) how sexual satisfaction, sexual desire, sexual distress, and perinatal grief change from 10 to 25 weeks postloss for both couple members; and (2) if perinatal grief levels at 10 weeks postloss predict sexual well-being trajectories.
Women and gender-diverse individuals who were pregnant when a pregnancy loss occurred (within the last 4 months) and men, women, and gender-diverse partners who were not pregnant (N = 132 couples) independently completed 4 monthly assessments of sexual well-being and perinatal grief.
Outcomes included sexual satisfaction (Global Measure of Sexual Satisfaction), sexual desire (Sexual Desire Inventory), sexual distress (Sexual Distress Scale-Short Form), perinatal grief (Perinatal Grief Scale).
Dyadic growth curve modeling indicated that, from 10 to 25 weeks postloss, both couple members' sexual satisfaction increased, and their sexual desire remained stable; sexual distress decreased for partners but remained stable for individuals who were pregnant; and both couple members' perinatal grief decreased. Perinatal grief levels at 10 weeks postloss did not predict sexual well-being trajectories over time.
Given sexual well-being's dynamic nature, clinicians should regularly discuss sexuality with both couple members after pregnancy loss. During such discussions, clinicians could reassure couples about their sexual relationship's recovery by sharing that, on average, sexual satisfaction, sexual desire, and sexual distress tend to improve or stay the same (rather than worsen) from 10 to 25 weeks postloss. They can also share that perinatal grief tends to decrease during this time and is unrelated to trajectories of sexual satisfaction, sexual desire, and sexual distress.
This is the first study, to our knowledge, to examine how sexual well-being changes across time after a pregnancy loss and perinatal grief's role in such changes. The results may not generalize broadly, as most couples were in mixed-gender/sex relationships, identified as White, and were relatively affluent.
From 10 to 25 weeks postloss, both couple members tend to experience improvements in their overall sexual well-being and declines in their perinatal grief. Early perinatal grief levels and subsequent sexual well-being trajectories are seemingly unrelated.
妊娠丢失影响了四分之一的女性，与整体健康和关系结果较差有关。尽管性健康对健康很重要，但妊娠丢失后性健康随时间的变化以及可能预测这种变化的因素（如围产期悲伤）从未被研究过，这使得从业者和夫妇不知道会发生什么。
我们旨在检查（1）在妊娠丢失后 10 至 25 周，夫妻双方的性满意度、性欲望、性困扰和围产期悲伤如何变化；（2）如果妊娠丢失后 10 周的围产期悲伤水平是否预测性健康轨迹。
经历妊娠丢失（最近 4 个月内）的孕妇和未怀孕的男性、女性和性别多样化伴侣（N=132 对夫妻）分别完成了 4 次性健康和围产期悲伤的月度评估。
结局包括性满意度（全球性满意度量表）、性欲望（性欲望量表）、性困扰（性困扰量表-简短形式）、围产期悲伤（围产期悲伤量表）。
从妊娠丢失后 10 周到 25 周，夫妻双方的性满意度增加，性欲望保持稳定；伴侣的性困扰减少，但怀孕的个体的性困扰保持稳定；夫妻双方的围产期悲伤都减少了。妊娠丢失后 10 周的围产期悲伤水平并不能预测随时间变化的性健康轨迹。
鉴于性健康的动态性质，临床医生应在妊娠丢失后定期与夫妻双方讨论性问题。在这些讨论中，临床医生可以通过分享以下信息来安慰夫妇，即平均而言，从妊娠丢失后 10 周到 25 周，性满意度、性欲望和性困扰往往会改善或保持不变（而不是恶化）。他们还可以分享在这段时间里，围产期悲伤往往会减少，并且与性满意度、性欲望和性困扰的轨迹无关。
据我们所知，这是第一项研究，旨在检查妊娠丢失后性健康随时间的变化以及围产期悲伤在这种变化中的作用。结果可能无法广泛推广，因为大多数夫妻都是混合性别/性别的关系，自认为是白人，并且相对富裕。
从妊娠丢失后 10 周到 25 周，夫妻双方的整体性健康往往会有所改善，围产期悲伤会有所下降。早期围产期悲伤水平和随后的性健康轨迹似乎没有关系。
