Women who have given birth vaginally are more likely to experience sexual dysfunction than women who have delivered through a planned cesarean section, according to a study in the June issue of The Journal of Sexual Medicine. In recent years, investigators have hypothesized that pregnancy and child delivery can result in changes to the pelvic floor and intra-pelvic organs. Exploring the hypothesis that “sexual function” is associated with mode of delivery is important, because sexual health is an integral part of general health.

“This study brings attention to a women’s health issue that hasn’t been addressed in the past," said Dr. Irwin Goldstein, director of sexual medicine at San Diego’s Alvarado Hospital and editor-in-chief of The Journal of Sexual Medicine.

The study found that healthy women with normal pregnancies that deliver babies vaginally are associated with the highest rate of sexual dysfunctions compared to women who deliver through planned cesarean section, who experienced the lowest rate of sexual dysfunctions.

The study was carried out measuring the relationship between mode of delivery and incidence of sexual dysfunction and impairment of quality of life both in women and their husbands. The study was conducted by using Female Sexual Function Index (FSFI), and International Index of Erectile Function (IIEF), which are brief questionnaires to measure sexual function.

A total of 912 pregnant women (ages 21-32 years-old) and their husbands were recruited for this study. The women participating in the study were healthy, low-risk and first-time mothers. The subjects were divided into five groups according to their mode of delivery, including: group A, spontaneous vaginal delivery (SVD) without injuries (group SVD, N=184); group B, vaginal delivery with episiotomy (VDE) or perineal laceration (group VDE, N =182); group C, operative vaginal delivery (OVD) (instrumental delivery) (group OVD, N=182); group D, planned cesarean section (PCS) (group PCS, N =182); and group E, emergency cesarean section (ECS) (group ECS, N=184).

Women in groups A, B, C, D, and E resumed sexual intercourse within eight weeks after delivery. Women with vaginal delivery and emergency cesarean section had statistically significant lower sexual function scores compared with women who had planned cesarean sections. Women who experienced a PCS had lowest pain scores compared to women who had operative vaginal delivery, who had highest pain scores at first sexual intercourse. The erectile function domains scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction with sex life did differ significantly between the different groups and this concerns almost all categories.

In conclusion, the findings of the study strongly support that vaginal delivery or other complicated modes of delivery are associated with the development of sexual dysfunction.

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