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Chapter 25 - Sex after Pelvic Floor Injuries

from Section 2 - Specific Issues

Published online by Cambridge University Press:  09 November 2022

Dan Farine
Affiliation:
Mount Sinai Hospital, Toronto
Pablo Tobías González
Affiliation:
Hospital Universitario Infanta Cristina de Parla, Madrid
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Summary

During pregnancy and the postnatal period there are many changes that can affect sexual function. In general, during pregnancy there is a decrease in sexual desire, frequency of intercourse, and capacity for orgasm and sexual satisfaction, with these changes being more evident in the first and third trimesters and less so in the second. In the postnatal period hormonal changes involve a decrease in sex hormones due to the release of prolactin for breastfeeding. This can have a negative influence on libido and the emotional state in general, but also in the genital region, causing atrophy of the vaginal epithelium, which is thinner and more fragile, with less lubrication capacity. The prevalence of postpartum sexual dysfunction is frequent. Pain is the most frequent symptom, together with low libido. The main contributing factors are perineal trauma, breastfeeding, postnatal depression, fatigue, and sleep deprivation disorders, as well as changes in body image. Individualized assessment of women must be done at 6–8 weeks postpartum, allowing the implementation of specific techniques for pelvic floor recovery, and thus contributing to the prevention of future pelvic floor dysfunction.

Type
Chapter
Information
Sex and Pregnancy
From Evidence-Based Medicine to Dr Google
, pp. 188 - 194
Publisher: Cambridge University Press
Print publication year: 2022

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References

Royal College of Obstetricians and Gynaecologists. The Management of Third- and Fourth-Degree Perineal Tears. Green-top Guideline No. 29. London: RCOG, 2015. www.rcog.org.uk/globalassets/documents/guidelines/gtg-29.pdf (accessed July 22, 2021).Google Scholar
Committee on Practice Bulletins – Obstetrics. ACOG Practice Bulletin no. 198: prevention and management of obstetric lacerations at vaginal delivery. Obstet Gynecol 2018;132:e87–102.Google Scholar
Friedman, T., Eslick, G. D., Dietz, H. P.. Delivery mode and the risk of levator muscle avulsion: a meta-analysis. Int Urogynecol J 2019;30:901–7.Google Scholar
Van Delft, K., Sultan, A. H., Thakar, R., et al. The relationship between postpartum levator ani muscle avulsion and signs and symptoms of pelvic floor dysfunction. BJOG 2014;121:1164–71.Google Scholar
Leeman, L. M., Rogers, R. G.. Sex after childbirth: postpartum sexual function. Obstet Gynecol 2012;119:647–55.Google Scholar
Anglés-Acedo, S., Ros-Cerro, C., Escura-Sancho, S., et al. Coital resumption aflter delivery among OASIS patients: differences between instrumental and spontaneous delivery. BMC Womens Health 2019;19:154–60.CrossRefGoogle ScholarPubMed
Gutzeit, O., Levy, G., Lowenstein, L.. Postpartum female sexual function: risk factors for postpartum sexual dysfunction. Sex Med 2020;8:813.CrossRefGoogle ScholarPubMed
Abdool, Z., Thakar, R., Sultan, A. H.. Postpartum female sexual function. Eur J Obstet Gynecol Reprod Biol 2009;145:133–7.Google Scholar
Jiang, H., Qian, X., Carroli, G., Garner, P.. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev 2017;(2):CD000081.Google Scholar
Signorello, L. B., Harlow, B. L., Chekos, A. K., Repke, J. T.. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol 2001;184:881–8.Google Scholar
Radestad, R., Olsson, A., Nissen, E., Rubertsson, C.. Tears in the vagina, perineum, sphincter ani, and rectum and first sexual intercourse after childbirth: a nationwide follow-up. Birth 2008;35:98106.Google Scholar
Hannah, M. E., Whyte, H., Hannah, W. J., et al. Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: the international randomized Term Breech Trial. Am J Obstet Gynecol 2004;191:917–27.Google Scholar
Griffiths, A., Watermeyer, S., Sidhu, K., Amso, N. N., Nix, B.. Female genital tract morbidity and sexual function following vaginal delivery or lower segment caesarean section. J Obstet Gynaecol 2006;26:645–9.Google Scholar
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;17:408.Google Scholar
Lukacz, E. S., Lawrence, J. M., Contreras, R., Nager, C. W., Luber, K. M.. Parity, mode of delivery and pelvic floor disorders. Obstet Gynecol 2006;107:1253–60.CrossRefGoogle ScholarPubMed
Delancey, J. O. L., Low, L. K., Miller, J. M., Patel, D. A., Tumbarello, J. A.. Graphic integration of causal factors of pelvic floor disorders: an integrated lifespan model. Am J Obstet Gynecol 2008;199:610.e1–5.Google Scholar
Sobhgol, S. S., Priddis, H., Smith, C. A., Dahlen, H. G.. The effect of pelvic floor muscle exercise on female sexual function during pregnancy and postpartum: a systematic review. Sex Med Rev 2019;7:1328.CrossRefGoogle ScholarPubMed
Brown, C. S., Bradford, J. B., Ling, F. W.. Sex and sexuality in pregnancy. Global Library of Women’s Medicine. www.glowm.com/section-view/heading/Sex%20and%20Sexuality%20in%20Pregnancy/item/111# (accessed July 22, 2021).Google Scholar
National Health Service. Sex in pregnancy. www.nhs.uk/pregnancy/keeping-well/sex (accessed July 22, 2021).Google Scholar
American College of Obstetricians and Gynecologists. Is it safe to have sex during pregnancy? www.acog.org/womens-health/experts-and-stories/ask-acog/is-it-safe-to-have-sex-during-pregnancy (accessed July 22, 2021).Google Scholar
How to deal with vaginal tearing while having sex. Enkimd, 2018. www.enkimd.com/vaginal-tearing-during-intercourse.html (accessed September 26, 2021).Google Scholar
Hickman, L.. Tears during a vaginal delivery: what you need to know. 2020. https://femalehealthawareness.org/en/tears-during-a-vaginal-delivery-what-you-need-to-know/ (accessed September 26, 2021).Google Scholar
Holland, K.. What to expect from sex after giving birth. 2019. www.healthline.com/health/pregnancy/sex-after-birth (accessed September 26, 2021).Google Scholar
What to expect when you have a 2nd degree tear. Mamamend, 2019. www.mamamend.com/postpartum-health/second-degree-tear (accessed September 26, 2021).Google Scholar

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