Sexual function changes during pregnancy

Introduction and Hypothesis: We describe changes in sexual activity and function among pregnant nulliparous women. Methods: This secondary analysis evaluated sexual activity and function with the Female Sexual Function Index (FSFI) at baseline in the first (T1), second (T2) and early third (T3) trimester. Evaluation was repeated in T3 after 36 completed weeks of gestation. Data were assigned to the trimester in which they were collected and compared across trimesters. FSFI items were dichotomized into favorable and unfavorable responses. ANOVA and logistic regression models were used to compare values across trimesters, taking into account repeated measurements. Pair-wise comparisons of trimesters were done when there were significant overall differences. Significance was set at p < 0.05. We adjusted for baseline differences. Results: Of 627 women, four did not give sexual function data. Baseline data were collected in 124 women in T1, 403 in T2, and 96 in early T3. Of these 623 women, 496 (80 %) gave data again in T3. The participants’ mean age was 24.2 ± 5.1 years and 44.5 % were Hispanic. Rates of sexual activity (T1 94 %, T2 90 %, T3 77 %; p < 0.001) and mean FSFI scores decreased as pregnancy progressed (T1 26.5 ± 7.7, T2 25.6 ± 9.0, T3 21.5 ± 10.3; T1/T2 vs. T3, p < 0.001). Using the FSFI cut-off score for sexual dysfunction of 26.55, women in T3 were more likely to report dysfunction than women in T2 (57 % vs. 37 %, p < 0.001). For specific FSFI questions, the proportions of women reporting favorable responses did not change between T1 and T2 (all p > 0.05) and the proportions of women with a favorable response decreased for all questions between T2 and T3. Conclusions: As pregnancy progresses, women report poorer sexual function.