Sexual Dysfunction and Sexual Activity Related Concerns in Pregnant Women

Öz

Background: This study aimed to obtain data on sexual behavior preferences, concerns regarding sexual activity, and the prevalence of sexual dysfunction in pregnant women, as well as to identify factors associated with sexual dysfunction. Materials and Methods: Our study was conducted in a face-to-face questionnaire format with volunteers aged 18 to 50 years, whose pregnancy follow-up was performed in a training and research hospital. The questionnaire consisted of a personal information form, detailed information about sexual activity, "Female Sexual Function Scale (FSFI)”, and “Intolerance of Uncertainty Scale-12”. Results: The FSFI score of the participants was 17.32±8.15 (mean ± standard deviation). In 224 of the pregnant women (87.79%), the FSFI score was lower than the cut-off value of 26.5 for sexual dysfunction. 118 (46.5%) of the pregnant women indicated that they had concerns about sexual intercourse during pregnancy. The most important reason for concern (48.4%) was the thought that it would adversely affect her own or the baby's health. Low level of education, number of births, and concerns about sexual activity during pregnancy were found to be associated with low FSFI. It was observed that 173 participants (68.11%) scored above the threshold value on IUS-12. There is no relationship between IUS-12 and FSFI scale scores. Conclusion: Our study found that sexual desire decreases during pregnancy, and concerns related to sexual activity are common, most frequently associated with the health of the mother and the baby. The prevalence of sexual dysfunction among pregnant women was found to be high; lower educational level, higher parity, and concerns about sexual activity during pregnancy were associated with this dysfunction. Although a considerable proportion of participants exhibited intolerance of uncertainty, no significant relationship was found between intolerance of uncertainty and sexual dysfunction. These findings highlight the need for further research to better understand the psychological, social, cultural, and other factors influencing sexual health during pregnancy.

Anahtar Kelimeler

• Sexual activity
• Pregnancy
• FSFI
• IUS-12

Etik Beyan

This study was approved by the Ethics Committee of Şehit Prof. Dr. İlhan Varank Training and Research Hospital (approval no: 2022/146, date: December 14, 2022).

Gebelerde Cinsel İşlev Bozukluğu ve Cinsel Aktiviteyle İlgili Endişeler

Öz

Amaç: Bu çalışma, gebe kadınlarda cinsel davranış tercihleri, cinsel aktiviteye ilişkin endişeler ve cinsel işlev bozukluğu prevalansı hakkında veri elde etmeyi ve cinsel işlev bozukluğu ile ilişkili faktörleri belirlemeyi amaçlamaktadır. Materyal ve metot: Çalışmamız bir eğitim ve araştırma hastanesinde gebelik takibi yapılan 18-50 yaş aralığındaki gönüllülerle yüz yüze anket formatında yürütülmüştür. Anket; kişisel bilgi formu, cinsel aktivite hakkında detaylı bilgi, “Kadın Cinsel Fonksiyon Ölçeği (FSFI)” ve “Belirsizliğe Tahammülsüzlük Ölçeği-12 (IUS-12)”den oluşmuştur. Bulgular: Katılımcıların FSFI skoru 17,32±8,15 (ortalama ± standart sapma) idi. Gebelerin 224’ünde (%87,79) FSFI skoru cinsel işlev bozukluğu için belirlenen 26,5 eşik değerinden düşüktü. Gebelerin 118’i (%46,5) gebelik sırasında cinsel ilişki konusunda endişeleri olduğunu belirtti. En önemli endişe nedeni (%48,4) kendi veya bebeğin sağlığını olumsuz etkileyeceği düşüncesiydi. Düşük eğitim düzeyi, doğum sayısı ve gebelikte cinsel aktiviteye ilişkin endişeler düşük FSFI ile ilişkili bulundu. 173 katılımcının (%68,11) IUS-12 ölçeğinden eşik değer (28) üzeri puan aldığı gözlendi. IUS-12 ile FSFI ölçek puanları arasında bir ilişki saptanmadı. Sonuç: Gebelikte cinsel isteğin azaldığı, cinsel ilişkiye yönelik endişelerin yaygın olduğu ve bu kaygıların en sık anne ve bebek sağlığıyla ilişkili olduğu bulunmuştur. Gebelerde cinsel işlev bozukluğu oranı yüksek saptanmış; düşük eğitim düzeyi, yüksek doğum sayısı ve gebelikte cinsel ilişkiye dair endişeler bu bozuklukla ilişkili bulunmuştur. Katılımcıların önemli bir kısmı belirsizliğe tahammülsüzlük göstermiş olsa da, belirsizliğe tahammülsüzlük ile cinsel işlev bozukluğu arasında anlamlı bir ilişki bulunamamıştır. Bu bulgular, gebelik sırasında cinsel sağlığı etkileyen psikolojik, sosyal, kültürel ve diğer faktörleri daha iyi anlamak için daha fazla araştırma yapılması gerektiğini vurgulamaktadır.

Anahtar Kelimeler

• Cinsel aktivite
• Gebelik
• FSFI
• IUS-12

Etik Beyan

This study was approved by the Ethics Committee of Şehit Prof. Dr. İlhan Varank Training and Research Hospital (approval no: 2022/146, date: December 14, 2022).

Kaynakça

1. 1. Grussu P, Vicini B, Quatraro RM. Sexuality in the perinatal period: A systematic review of reviews and recommendations for practice. Sexual & Reproductive Healthcare. 2021;30:100668.
2. 2. Anğın AD, Özkaya E, Çetin M, Gün I, Sakin O, Ertekin LT, et al. Comparison of female sexual function and sexual function of their partners between groups of pregnant and non-pregnant women. Ginekol Pol. 2020;91(5):235-239.
3. 3. Soares PRAL, Calou CGP, Ribeiro SG, Aquino P de S, Almeida PC de, Pinheiro AKB. Sexuality and associated risk factors in pregnant women. Rev Bras Enferm. 2020;73(suppl 4):e20180786.
4. 4. Kömürcü Karuserci Ö, Sucu S. A prospective analysis of sexual behaviors of pregnant women in southeast Turkey. Journal of Clinical Obstetrics & Gynecology. 2020;30(4):131-135.
5. 5. Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7(1_Part_1):136-142.
6. 6. Dolapoğlu N, İslimye Taşkın M, Altunöz S. The relationship between pregnant women and their spouses’ belief in sexual myths during pregnancy, relationship satisfaction and sexual satisfaction. Journal of Health Sciences and Medicine. 2023;6(3):573-578.
7. 7. Dunkel Schetter C. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol. 2011;62(1):531-558.
8. 8. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208.

9. 9. Aygin D, Aslan EF. Kadın cinsel işlev ölçeği’nin türkçeye uyarlaması. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2005;3:393-399.
10. 10. Carleton RN, Norton MAPJ, Asmundson GJG. Fearing the unknown: A short version of the intolerance of uncertainty scale. J Anxiety Disord. 2007;21(1):105-117.
11. 11. Sarıçam H. Belirsizliğe tahammülsüzlük ölçeği (BTÖ-12) Türkçe formu: geçerlik ve güvenirlik çalişmasi. Route Educational and Social Science Journal. 2014;1(3):148-148.
12. 12. Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem Med (Zagreb). 2021;31(1):27–53.
13. 13. Dagar N, Nautiyal R, Mangla M. Does female sexuality decrease in pregnancy?: a cross-sectional questionnaire- based study. Current Women s Health Reviews. 2023;19(4):30-38.
14. 14. Ahmed MR, Madny EH, Sayed Ahmed WA. Prevalence of female sexual dysfunction during pregnancy among Egyptian women. Journal of Obstetrics and Gynaecology Research. 2014;40(4):1023-1029.
15. 15. Ninivaggio C, Rogers RG, Leeman L, Migliaccio L, Teaf D, Qualls C. Sexual function changes during pregnancy. Int Urogynecol J. 2017;28(6):923-929.
16. 16. Aslan G, Aslan D, Kızılyar A, İspahi Ç, Esen A. A prospective analysis of sexual functions during pregnancy. Int J Impot Res. 2005;17(2):154-157.
17. 17. Küçükdurmaz F, Efe E, Malkoç Ö, Kolus E, Amasyalı AS, Resim S. Prevalence and correlates of female sexual dysfunction among Turkish pregnant women. Turk J Urol. 2016;42(3):178-83.
18. 18. Küçükyıldız İ. Sexual dysfunction in women during COVID-19 pandemic: A hospital-based, prospective, cross-sectional comparative study. Cumhuriyet Med Journal. 2021:43(3);241-248.
19. 19. Oksuz, E., & Malhan, S. (2006). Prevalence and risk factors for female sexual dysfunction in Turkish women. The Journal of urology, 175(2), 654-658.
20. 20. Keskin İ, Yesilyurt İ, Tekin AB. The impact of physical activity level and sexual activity during pregnancy on labor. Kafkas Journal of Medical Sciences. 2024;14(2):196-201.
21. 21. Staruch M, Kucharczyk A, Zawadzka K, Wielgos M, Szymusik I. Sexual activity during pregnancy. Neuro Endocrinol Lett. 2016;37(1):53-58.
22. 22. Mansouri G, Zakeri M, Robati FK, Allahqoli L, Dehghani A. Changes in sexual activity in young women during pregnancy. APJR. 2024;13(5):213–8. 20.
23. 23. Ajinkya S, Jadhav P, Srivastava N. Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai. Ind Psychiatry J. 2013;22(1):37.
24. 24. Fawcett EJ, Fairbrother N, Cox ML, White IR, Fawcett JM. The prevalence of anxiety disorders during pregnancy and the postpartum period. J Clin Psychiatry. 2019;80(4): 18r12527.
25. 25. Shariatpanahi M, Faramarzi M, Barat S, Farghadani A, Shirafkan H. Prevalence and risk factors of prenatal anxiety disorders: A cross‐sectional study. Health Sci Rep. 2023;6(8):e1491.
26. 26. 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.
27. 27. Azin SA, Golbabaei F, Warmelink JC, Eghtedari S, Haghani S, Ranjbar F. Association of depression with sexual function in women with history of recurrent pregnancy Loss: descriptive-correlational study in Tehran, Iran. Fertil Res Pract. 2020;6(1):21.
28. 28. Waldinger MD. Psychiatric disorders and sexual dysfunction. Handb Clin Neurol. 2015;130:469-89. 29. Furtado M, Frey BN, Green SM. Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety. BMC Pregnancy Childbirth. 2021;21(1):829.
29. 30. Han L, Bai H, Lun B, Li Y, Wang Y, Ni Q. The prevalence of fear of childbirth and its association with intolerance of uncertainty and coping styles among pregnant chinese women during the covid-19 pandemic. Front Psychiatry. 2022;13:935760.
30. 31. Banaei M, Alidost F, Ghasemi E, Dashti S. A comparison of sexual function in primiparous and multiparous women. J Obstet Gynaecol (Lahore). 2020;40(3):411-418.
31. 32. McCool-Myers M, Theurich M, Zuelke A, Knuettel H, Apfelbacher C. Predictors of female sexual dysfunction: a systematic review and qualitative analysis through gender inequality paradigms. BMC Womens Health. 2018;18(1):108.
32. 33. Botros SM, Abramov Y, Miller JJ, Sand PK, Gandhi S, Nickolov A, et al. Effect of parity on sexual function. Obstetrics & Gynecology. 2006;107(4):765-770.
33. 34. Singh J, Tharyan P, Kekre N, Singh G, Gopalakrishnan G. Prevalence and risk factors for female sexual dysfunction in women attending a medical clinic in south India. J Postgrad Med. 2009;55(2):113-120.
34. 35. Chew PY, Choy CL, Sidi HB, Abdullah N, Che Roos NA, Salleh Sahimi HM, et al. The association between female sexual dysfunction and sexual dysfunction in the male partner: A systematic review and meta-analysis. J Sex Med. 2021;18(1):99-112.
35. 36. Witting K, Santtila P, Varjonen M, Jern P, Johansson A, von der Pahlen B, et al. Female sexual dysfunction, sexual distress, and compatibility with partner. J Sex Med. 2008;5(11):2587-2599.