Impact of Pregnancy on the Sex Life of Women: State of the Art

Liliam Renata Silveira Santiago, Lucia Alves da Silva Lara, Adriana Peterson Mariano Salata Romão, Maria Fernanda Barbirato da Mata Tiezzi, Ana Carolina Japur de Sá Rosa e Silva

Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeir?o Preto, University of S?o Paulo, Ribeir?o Preto, Brazil.

DOI: 10.4236/ijcm.2013.45045                

Abstract

Introduction: Women’s sexual function is a complex ensemble of variables that involve physical, emotional, and psychosocial states. Objective: This review aims to evaluate the evidence about the sexual behavior of women during pregnancy. Methods: Survey of PubMed for the period from 1996 to 2011 for prospective, retrospective and case-control studies, randomized clinical trials, meta-analyses and systematic reviews on the sexual function of women during pregnancy using the terms “sexual function”, “sexual dysfunction”, “sexuality”, “pregnancy”, and “pregnant woman”. Results: Changes occur in the sexual function of women during pregnancy; however, due to the heterogeneity of the studies and the incomparability of samples for lack of pairing for cultural, age, length of relationship and gestational age variables, and other methodological biases, it is not possible to characterize the sexual response of pregnant women. Conclusions: The changes observed are not sufficient to characterize sexual behavior during pregnancy as pathological. It is therefore necessary to standardize the study groups and the instruments for the assessment of sexual function, to determine the presence of distress concomitant with changes in sexual function, and to assess the sexual function of the partner and the impact of changes on the dyadic relationship before and after the gestational period.

Keywords

Sexual Function; Dysfunction; Sexuality; Pregnancy; Pregnant

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	C. V. Rudge, et al., “Design and Validity of a Questionnaire to Assess Sexuality in Pregnant Women,” Reproductive Health, Vol. 6, 2009, p. 12. doi:10.1186/1742-4755-6-12
[2]	J. Murtagh, “Female Sexual Function, Dysfunction, and Pregnancy: Implications for Practice,” Journal of Midwifery & Women’s Health, Vol. 55, No. 5, 2010, pp. 438446. doi:10.1016/j.jmwh.2009.12.006
[3]	U. Hartmann, et al., “Female Sexual Desire Disorders: Subtypes, Classification, Personality Factors and New Directions for Treatment,” World Journal of Urology, Vol. 20, No. 2, 2002, pp. 79-88. doi:10.1007/s00345-002-0280-5
[4]	P. J. Nobre, et al., “Determinants of Sexual Arousal and Accuracy of Its Self-Estimation in Sexually Functional Males,” The Journal of Sex Research, Vol. 41, No. 4, 2004, pp. 363-371. doi:10.1080/00224490409552243
[5]	J. Bancroft, J. Loftus and J. S. Long, “Distress about Sex: A National Survey of Women in Heterosexual Relationships,” Archives of Sexual Behavior, Vol. 32, No. 3, 2003, pp. 193-208. doi:10.1023/A:1023420431760
[6]	E. O. Laumann, A. Paik and R. C. Rosen, “Sexual Dysfunction in the United States: Prevalence and Predictors,” Journal of the American Medical Association, Vol. 281, No. 6, 1999, pp. 537-544. doi:10.1001/jama.281.6.537
[7]	E. Bartellas, et al., “Sexuality and Sexual Activity in Pregnancy,” British Journal of Obstetrics & Gynecology, Vol. 107, No. 8, 2000, pp. 964-968. doi:10.1111/j.1471-0528.2000.tb10397.x
[8]	W. Uwapusitanon and T. Choobun, “Sexuality and Sexual Activity in Pregnancy,” Journal of the Medical Association of Thailand, Vol. 87, No. S3, 2004, pp. S45-S49.
[9]	N. Senkumwong, et al., “The Changes of Sexuality in Thai Women during Pregnancy,” Journal of the Medical Association of Thailand, Vol. 89, No. S4, 2006, pp. S124-S129.
[10]	H. Brtnicka, P. Weiss and J. Zverina, “Human Sexuality during Pregnancy and the Postpartum Period,” Bratislavské Lekárske Listy, Vol. 110, No. 7, 2009, pp. 427-431.
[11]	R. R. Alteneder and D. Hartzell, “Addressing Couples’ Sexuality Concerns during the Childbearing Period: Use of the PLISSIT Model,” Journal of Obstetric, Gynecologic, & Neonatal Nursing, Vol. 26, No. 6, 1997, pp. 651-658. doi:10.1111/j.1552-6909.1997.tb02739.x
[12]	Y. Pujols, B. N. Seal and C. M. Meston, “The Association between Sexual Satisfaction and Body Image in Women,” The Journal of Sexual Medicine, Vol. 7, No. 2, 2010, pp. 905-916. doi:10.1111/j.1743-6109.2009.01604.x
[13]	M. A. Khamis, et al., “Influence of Gestational Period on Sexual Behavior,” The Journal of the Egyptian Public Health Association, Vol. 82, No. 1-2, 2007, pp. 65-90.
[14]	M. Fava, et al., “Psychosomatic Aspects of Hyperprolactinemia,” Psychotherapy and Psychosomatics, Vol. 40, No. 1-4, 1983, pp. 257-262. doi:10.1159/000287773
[15]	A. Kerdarunsuksri and S. Manusirivithaya, “Attitudes and Sexual Function in Thai Pregnant Women,” Journal of the Medical Association of Thailand, Vol. 93, No. 3, 2010, pp. 265-271.
[16]	G. Eryilmaz, E. Ege and H. Zincir, “Factors Affecting Sexual Life during Pregnancy in Eastern Turkey,” Gynecologic and Obstetric Investigation, Vol. 57, No. 2, 2004, pp. 103-108. doi:10.1159/000075582
[17]	W. Y. Fok, L. Y. Chan and P. M. Yuen, “Sexual Behavior and Activity in Chinese Pregnant Women,” Acta Obstetricia et Gynecologica Scandinavica, Vol. 84, No. 10, 2005, pp. 934-938.
[18]	J. R. Pauleta, N. M. Pereira and L. M. Graca, “Sexuality during Pregnancy,” The Journal of Sexual Medicine, Vol. 7, No. 1, 2010, pp. 136-142. doi:10.1111/j.1743-6109.2009.01538.x
[19]	G. Aslan, et al., “A Prospective Analysis of Sexual Functions during Pregnancy,” International Journal of Impotence Research, Vol. 17, No. 2, 2005, pp. 154-157. doi:10.1038/sj.ijir.3901288
[20]	S. R. Chang, et al., “Comparison of Overall Sexual Function, Sexual Intercourse/Activity, Sexual Satisfaction, and Sexual Desire during the Three Trimesters of Pregnancy and Assessment of Their Determinants,” The Journal of Sexual Medicine, Vol. 8, No. 10, 2011, pp. 2859-2867. doi:10.1111/j.1743-6109.2011.02420.x
[21]	B. Erol, et al., “A Cross-Sectional Study of Female Sexual Function and Dysfunction during Pregnancy,” The Journal of Sexual Medicine, Vol. 4, No. 5, 2007, pp. 1381-1387. doi:10.1111/j.1743-6109.2007.00559.x
[22]	A. P. Leite, et al., “Prevalence of Sexual Dysfunction during Pregnancy,” Revista da Associação Médica Brasileira, Vol. 55, No. 5, 2009, pp. 563-568. doi:10.1590/S0104-42302009000500020
[23]	L. M. Naldoni, et al., “Evaluation of Sexual Function in Brazilian Pregnant Women,” Journal of Sex & Marital Therapy, Vol. 37, No. 2, 2011, pp. 116-129. doi:10.1080/0092623X.2011.560537
[24]	R. N. Pauls, J. A. Occhino and V. L. Dryfhout, “Effects of Pregnancy on Female Sexual Function and Body Image: A Prospective Study,” The Journal of Sexual Medicine, Vol. 5, No. 8, 2008, pp. 1915-1922. doi:10.1111/j.1743-6109.2008.00884.x
[25]	C. Sacomori and F. L. Cardoso, “Sexual Initiative and Intercourse Behavior during Pregnancy among Brazilian Women: A Retrospective Study,” Journal of Sex & Marital Therapy, Vol. 36, No. 2, 2010, pp. 124-136. doi:10.1080/00926230903554503
[26]	E. O. Orji, I. O. Ogunlola and O. B. Fasubaa, “Sexuality among Pregnant Women in South West Nigeria,” Journal of Obstetrics and Gynaecology, Vol. 22, No. 2, 2002, pp. 166-168. doi:10.1080/01443610120113319
[27]	F. A. Bello, et al., “Effect of Pregnancy and Childbirth on Sexuality of Women in Ibadan, Nigeria,” ISRN Obstetrics and Gynecology, Vol. 2011, 2011, Article ID: 856586.
[28]	M. A. DeJudicibus and M. P. McCabe, “Psychological Factors and the Sexuality of Pregnant and Postpartum Women,” The Journal of Sex Research, Vol. 39, No. 2, 2002, pp. 94-103. doi:10.1080/00224490209552128
[29]	S. Gokyildiz and N. K. Beji, “The Effects of Pregnancy on Sexual Life,” Journal of Sex & Marital Therapy, Vol. 31, No. 3, 2005, pp. 201-215. doi:10.1080/00926230590513410
[30]	W. H. Masters and V. E. Johnson, “The Sexual Response of the Human Male. I. Gross Anatomic Considerations,” Western Journal of Surgery, Obstetrics, and Gynecology, Vol. 71, 1963, pp. 85-95.
[31]	M. Serati, et al., “Female Sexual Function during Pregnancy and after Childbirth,” The Journal of Sexual Medicine, Vol. 7, No. 8, 2010, pp. 2782-2790. doi:10.1111/j.1743-6109.2010.01893.x
[32]	R. Basson, “Human Sex-Response Cycles,” Journal of Sex & Marital Therapy, Vol. 27, No. 1, 2001, pp. 33-43. doi:10.1080/00926230152035831
[33]	S. R. Davis, et al., “Circulating Androgen Levels and Self-Reported Sexual Function in Women,” Journal of the American Medical Association, Vol. 294, No. 1, 2005, pp. 91-96. doi:10.1001/jama.294.1.91
[34]	C. E. Johnson, “Sexual Health during Pregnancy and the Postpartum,” The Journal of Sexual Medicine, Vol. 8, No. 5, 2011, pp. 1267-1284. doi:10.1111/j.1743-6109.2011.02223.x
[35]	R. Basson, “Women’s Sexual Dysfunction: Revised and Expanded Definitions,” Canadian Medical Association Journal, Vol. 172, No. 10, 2005, pp. 1327-1333. doi:10.1503/cmaj.1020174
[36]	E. A. McClintock, “Handsome Wants as Handsome Does: Physical Attractiveness and Gender Differences in Revealed Sexual Preferences,” Biodemography and Social Biology, Vol. 57, No. 2, 2011, pp. 221-257. doi:10.1080/19485565.2011.615172
[37]	S. Wannakosit and V. Phupong, “Sexual Behavior in Pregnancy: Comparing between Sexual Education Group and Nonsexual Education Group,” The Journal of Sexual Medicine, Vol. 7, No. 10, 2010, pp. 3434-3438. doi:10.1111/j.1743-6109.2010.01715.x
[38]	S. Kitzinger, “Sex before and after Childbirth,” Midwife Health Visitor, Vol. 8, No. 9, 1972, pp. 315-318.
[39]	K. von Sydow, “Sexuality during Pregnancy and after Childbirth: A Metacontent Analysis of 59 Studies,” Journal of Psychosomatic Research, Vol. 47, No. 1, 1999, pp. 27-49. doi:10.1016/S0022-3999(98)00106-8
[40]	R. Basson, et al., “Report of the International Consensus Development Conference on Female Sexual Dysfunction: Definitions and Classifications,” Journal of Urology, Vol. 163, No. 3, 2000, pp. 888-893. doi:10.1016/S0022-5347(05)67828-7
[41]	V. Polomeno, “Sex and Pregnancy: A Perinatal Educator’s Guide,” The Journal of Perinatal Education, Vol. 9, No. 4, 2000, pp. 15-27. doi:10.1624/105812400X87879
[42]	S. A. Kingsberg, et al., “A Comprehensive Approach to Enhancing Sexual Health Education in the Case Western Reserve University School of Medicine,” International Journal of Impotence Research, Vol. 15, No. S3, 2003, pp. S51-S57. doi:10.1038/sj.ijir.3901073
[43]	C. Marwick, “Survey Says Patients Expect Little Physician Help on Sex,” Journal of the American Medical Association, Vol. 281, No. 23, 1999, pp. 2173-2174