PREVALENCE OF SEXUAL DYSFUNCTION AMONG POSTPARTUM WOMEN IN ABAKALIKI: A PROSPECTIVE COHORT STUDY

Abstract

BACKGROUND: Postpartum period is a significant period in a woman’s life when there is hormonal and bodily alterations which could have major effects on sexual function and quality of life. The prevalence of sexual dysfunction in studies reviewed is quite high with prevalence of about 65% in Nigeria. Sexual function is a sensitive topic rarely discussed in our setting. There is no conclusive literature on the effect of mode of delivery on sexual function in the postpartum period. Despite its high prevalence, little attention is given to this subject in our clinics thus necessitating the need for this study.

AIM: To compare the difference in sexual function following vaginal delivery and caesarean section among postpartum women.

METHODOLOGY: This study was a prospective cohort study involving women who presented for antenatal care at AE-FUTHA and Mile 4 Hospitals. The women who met the inclusion criteria were recruited at term in 2 groups, those for planned vaginal delivery were on one arm and the second arm consisted of women who booked for elective caesarean section. Their sociodemographic characteristics, obstetric and sexual history were assessed using an interviewer structured questionnaire and sexual function was evaluated using the female sexual function index questionnaire (FSFI). Their sexual function before pregnancy was assessed on recruitment and at 6, 10 and 14 weeks postpartum.

ANALYSIS: Data was collated, tabulated and statistically analysed using SPSS version 20. Differences in continuous variables between the two groups were determined using the Students t test. Proportions were compared using Chi-square test. Analysis of variance was used to test for difference in means in more than two groups. P values of < 0.05 was considered statistically 

RESULTS: There were a total of 220 participants in the study with 110 participants in each arm. The mean age of the participants was 30.08±5.20 and 30.01±5.10 years in the vaginal delivery and caesarean section arm respectively. The mean times of resumption of sexual intercourse were 7.39±3.25 (VD) and 7.98 ±3.34 (CS) in weeks. The prevalence of sexual dysfunction was 55.5% pre-pregnancy and 89.1%, 75.5%, 63.6% at 6, 10 and 14weeks postpartum respectively in the vaginal delivery group. In the caesarean section group, the prevalence of sexual dysfunction was 59.1% pre-pregnancy and 90.9%, 78.2% and 63.6% at 6, 10 and 14 weeks postpartum respectively. There was no significant statistical difference found in the overall sexual function score in the two groups.

CONCLUSION: There was no significant relationship between the mode of delivery and changes in sexual function. Sexual intercourse could be resumed early postpartum when lochia stops as long as the woman is physically and psychologically ready.

Keywords: Sexual dysfunction, postpartum, vaginal delivery, caesarean section.