The impact of childbirth on women's sexuality and methods of treating its disorders
DOI:
https://doi.org/10.12775/JEHS.2023.45.01.012Keywords
Postpartum, Mode of delivery, Sexual DysfunctionAbstract
Postpartum sexual disorders can significantly impact individuals and their partner relationships, affecting a considerable percentage of women, with reduced libido being the most common symptom. Factors such as breastfeeding, postpartum depression, and communication issues with partners increase the risk of experiencing these disorders.
This review aimed to explore scientific reports on the frequency, contributing factors, and treatment options for postpartum sexual disorders. The analysis was conducted by reviewing literature available in PubMed.
The mode of delivery (natural or cesarean) does not significantly differ in its impact on postpartum sexual disorders.
Non-pharmacological treatments encompass psychotherapy, from which mindfulness-based cognitive is the most effective and physical exercises. Engaging in regular physical exercises contributes to enhanced sexual experiences, notably in terms of sexual arousal and offers other health benefits. Moreover, Kegel exercises have been demonstrated as a method to increase sexual satisfaction.
Medications used to treat libido dysfunction include flibanserin, bremelanotide, and bupropion. For women experiencing depression and sexual dysfunction, antidepressants with a lesser impact on sexual function may be considered.
Vaginal dryness can be effectively addressed with moisturizing gels, globules, and lubricants.
When considering pharmacotherapy, it is essential to evaluate the severity of symptoms, potential side effects for both the woman and her child being breastfed, and psychological discomfort. Physicians play a vital role, as women with sexual disorders may find it challenging to express their concerns. Partner support is crucial in improving a woman's sexual life.
References
Andel T, Boer H, Towns A. Gynaecological, Andrological and Urological Problems: An Ethnopharmacological Perspective. In: Ethnopharmacology. John Wiley & Sons, Ltd; 2015:199-212. doi:10.1002/9781118930717.ch18
Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women’s Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clin Proc. 2018;93(4):467-487. doi:10.1016/j.mayocp.2017.11.002
Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstetrics and gynecology. 2008;112(5):970-978. doi:10.1097/AOG.0b013e3181898cdb
Lew-Starowicz Z, Czajkowska K. Prevalence of sexual dysfunctions and associated risk factors in Poland. Archives of Medical Science. Published online July 22, 2019. doi:10.5114/aoms.2019.86794
Fuchs A, Czech I, Dulska A, Drosdzol-Cop A. The impact of motherhood on sexuality. Ginekol Pol. 2021;92(1):1-6. doi:10.5603/GP.a2020.0162
Khajehei M, Doherty M, Tilley PJM, Sauer K. Prevalence and Risk Factors of Sexual Dysfunction in Postpartum Australian Women. J Sex Med. 2015;12(6):1415-1426. doi:10.1111/jsm.12901
Fodstad K, Staff AC, Laine K. Sexual activity and dyspareunia the first year postpartum in relation to degree of perineal trauma. Int Urogynecol J. 2016;27(10):1513-1523. doi:10.1007/s00192-016-3015-7
Zyśk NDP. Wpływ macierzyństwa na seksualność kobiet. Polski Przegląd Nauk o Zdrowiu. 2015;42.
Bracken JN, Dryfhout VL, Goldenhar LM, Pauls RN. Preferences and concerns for delivery: an antepartum survey. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(11):1527-1531. doi:10.1007/s00192-008-0680-1
Cai L, Zhang B, Lin H, Xing W, Chen J. Does vaginal delivery affect postnatal coitus? Int J Impot Res. 2014;26(1):24-27. doi:10.1038/ijir.2013.25
Saleh DM, Hosam F, Mohamed TM. Effect of mode of delivery on female sexual function: A cross-sectional study. J Obstet Gynaecol Res. 2019;45(6):1143-1147. doi:10.1111/jog.13962
Alimi R, Marvi N, Azmoude E, Heidarian Miri H, Zamani M. Sexual function after childbirth: a meta-analysis based on mode of delivery. Women Health. 2023;63(2):83-96. doi:10.1080/03630242.2022.2158412
Ugwu EO, Dim CC, Eleje GU. Effects of mode of delivery on sexual functions of parturients in Nigeria: a prospective cohort study. Int Urogynecol J. 2021;32(7):1925-1933. doi:10.1007/s00192-020-04541-9
Fan D, Li S, Wang W, et al. Sexual dysfunction and mode of delivery in Chinese primiparous women: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2017;17(1):408. doi:10.1186/s12884-017-1583-2
Nikolaidou E, Antoniou E, Sarella A, Iliadou M, Orovou E, Dagla M. The Effect of Type of Delivery on Female Postpartum Sexual Functioning: A Systematic Review. Healthcare (Basel). 2022;10(7). doi:10.3390/healthcare10071212
Negrini R, da Silva Ferreira RD, Guimarães DZ. Value-based care in obstetrics: comparison between vaginal birth and caesarean section. BMC Pregnancy Childbirth. 2021;21(1):333. doi:10.1186/s12884-021-03798-2
Agarwal SK, Kim J, Korst LM, Hughes CL. Application of the estrogen threshold hypothesis to the physiologic hypoestrogenemia of lactation. Breastfeed Med. 2015;10(2):77-83. doi:10.1089/bfm.2014.0030
Fuentealba-Torres M, Cartagena-Ramos D, Fronteira I, et al. What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study. BMJ Open. 2019;9(4):e025833. doi:10.1136/bmjopen-2018-025833
Parish SJ, Hahn SR. Hypoactive Sexual Desire Disorder: A Review of Epidemiology, Biopsychology, Diagnosis, and Treatment. Sex Med Rev. 2016;4(2):103-120. doi:10.1016/j.sxmr.2015.11.009
Maseroli E, Rastrelli G, Di Stasi V, et al. Physical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much. J Sex Med. 2021;18(7):1217-1229. doi:10.1016/j.jsxm.2021.04.004
Stanton AM, Handy AB, Meston CM. The Effects of Exercise on Sexual Function in Women. Sex Med Rev. 2018;6(4):548-557. doi:10.1016/j.sxmr.2018.02.004
Lolowang NL, Afiyanti Y, Ungsianik T. Kegel’s exercise to improve sexual self-efficacy in primiparous women. Enferm Clin. 2019;29:535-540. doi:10.1016/j.enfcli.2019.04.082
Golmakani N, Zare Z, Khadem N, Shareh H, Shakeri MT. The effect of pelvic floor muscle exercises program on sexual self-efficacy in primiparous women after delivery. Iran J Nurs Midwifery Res. 2015;20(3):347-353.
Lowenstein L, Gruenwald I, Gartman I, Vardi Y. Can stronger pelvic muscle floor improve sexual function? Int Urogynecol J. 2010;21(5):553-556. doi:10.1007/s00192-009-1077-5
Goldstein I, Kim NN, Clayton AH, et al. Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc. 2017;92(1):114-128. doi:10.1016/j.mayocp.2016.09.018
Pyke RE, Clayton AH. Psychological Treatment Trials for Hypoactive Sexual Desire Disorder: A Sexual Medicine Critique and Perspective. J Sex Med. 2015;12(12):2451-2458. doi:10.1111/jsm.13056
Edwards D, Panay N. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition? Climacteric. 2016;19(2):151-161. doi:10.3109/13697137.2015.1124259
Krzystanek MKRCAPA. Farmakologiczne możliwości leczenia zaburzeń libido. Psychiatria Spersponalizowana. 2022;1/2022.
Pierrelus C, Carlson K. Flibanserin.; 2023. http://www.ncbi.nlm.nih.gov/pubmed/12383030
Pachano Pesantez GS, Clayton AH. Treatment of Hypoactive Sexual Desire Disorder Among Women: General Considerations and Pharmacological Options. Focus (Am Psychiatr Publ). 2021;19(1):39-45. doi:10.1176/appi.focus.20200039
Prescribing information produktu ADDYI wydana przez FDA: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022526lbl.pdf.
Edinoff AN, Sanders NM, Lewis KB, et al. Bremelanotide for Treatment of Female Hypoactive Sexual Desire. Neurol Int. 2022;14(1):75-88. doi:10.3390/neurolint14010006
Prescribing information produktu VYLEESI wydana przez FDA: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/210557s000lbl.pdf.
Razali NA, Sidi H, Choy CL, Roos NAC, Baharudin A, Das S. The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis. Curr Neuropharmacol. 2022;20(10):1941-1955. doi:10.2174/1570159X20666220222145735
Huecker MR, Smiley A, Saadabadi A. Bupropion.; 2023.
Baab SW, Peindl KS, Piontek CM, Wisner KL. Serum bupropion levels in 2 breastfeeding mother-infant pairs. J Clin Psychiatry. 2002;63(10):910-911. doi:10.4088/jcp.v63n1008
Briggs GG, Samson JH, Ambrose PJ, Schroeder DH. Excretion of bupropion in breast milk. Ann Pharmacother. 1993;27(4):431-433. doi:10.1177/106002809302700406
Chaudron LH, Schoenecker CJ. Bupropion and breastfeeding: a case of a possible infant seizure. J Clin Psychiatry. 2004;65(6):881-882. doi:10.4088/jcp.v65n0622f
Charakterystyka produktu leczniczego Wellbutrin XR, 150 mg, tabletki o zmodyfikowanym uwalnianiu pobrana ze strony https://rejestrymedyczne.ezdrowie.gov.pl/rpl/search/public 13.07.2023.
Atlantis E, Sullivan T. Bidirectional association between depression and sexual dysfunction: a systematic review and meta-analysis. J Sex Med. 2012;9(6):1497-1507. doi:10.1111/j.1743-6109.2012.02709.x
Zeleke BM, Bell RJ, Billah B, Davis SR. Hypoactive sexual desire dysfunction in community-dwelling older women. Menopause. 2017;24(4):391-399. doi:10.1097/GME.0000000000000767
Jing E, Straw-Wilson K. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. Ment Health Clin. 2016;6(4):191-196. doi:10.9740/mhc.2016.07.191
Chokka PR, Hankey JR. Assessment and management of sexual dysfunction in the context of depression. Ther Adv Psychopharmacol. 2018;8(1):13-23. doi:10.1177/2045125317720642
Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009;29(3):259-266. doi:10.1097/JCP.0b013e3181a5233f
Lauerma H. A case of moclobemide-induced hyperorgasmia. Int Clin Psychopharmacol. 1995;10(2):123-124. doi:10.1097/00004850-199506000-00011
Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation : practical recommendations. CNS Drugs. 2006;20(3):187-198. doi:10.2165/00023210-200620030-00002
Taylor T KD. Safety of moclobemide in pregnancy and lactation, four case reports. Birth Defects Res A Clin Mol Teratol. Published online 2008.
Buist A, Dennerstein L, Maguire KP, Norman TR. Plasma and human milk concentrations of moclobemide in nursing mothers. Human Psychopharmacology: Clinical and Experimental. 1998;13(8):579-582. doi:10.1002/(SICI)1099-1077(1998120)13:8<579::AID-HUP45>3.0.CO;2-4
Charakterystyka produktu leczniczego Aurorix 150 mg pobrana ze strony:https://rejestrymedyczne.ezdrowie.gov.pl/rpl/search/public 13.07.2023.
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