Several factors (physical and emotional) related to pregnancy and childbirth can make sexual dysfunction more likely.
In 2023, it was estimated that up to 70% of healthy pregnant women worldwide were at risk for sexual dysfunction. Although the prevalence of sexual dysfunction did not normally differ by trimester, some published reports suggested that a higher prevalence of these disorders in the third trimester might have been attributed to several factors, including fears that sex would harm the fetus, a woman would experience discomfort, or a woman's negative body image made her shy away from sexual activity.
Risk factors for postpartum and pregnancy-related sexual dysfunction include the following:
Trauma during childbirth: Cesarean delivery or delivery by forceps or vacuum extractor, episiotomy, or tears in the area between the opening of the vagina and the anus (perineum) can make the area near the vagina's opening painful and decrease sexual interest and the ability to be aroused.
Breastfeeding: Because estrogen levels are low during breastfeeding, the vagina may become dry, making sexual intercourse uncomfortable. Genito-pelvic pain/penetration disorder may develop.
Psychological and social stresses: Changes in family roles and relationships, sleep disruption, newborn health issues, and/or weight gain can increase stress.
Postpartum depression: Being depressed can contribute to sexual dysfunction.
Intimate partner violence: Pregnancy increases the risk of intimate partner violence (physical, psychological, and sexual). Such violence in a relationship can undermine a woman's self-confidence, reduce her self-esteem, and cause depression, posttraumatic stress disorder, other psychological disorders, and sexual dysfunction.
If sexual dysfunction, regardless of type, is present before pregnancy, sexual dysfunction after pregnancy is more likely.
Doctors recognize postpartum or pregnancy-related sexual dysfunction when a woman reports problems related to sexual intercourse during or shortly after pregnancy.
Treatment of postpartum and pregnancy-related sexual dysfunction is similar to treatment of other forms of female sexual dysfunction. For example, psychological therapies and learning about how a woman's body changes during and after pregnancy may help, such as whether intercourse is safe during pregnancy and which positions may be more comfortable (for example, side by side). Doctors may suggest types of sexual activity other than vaginal intercourse, such as masturbation, massage, oral sex, foreplay, mutual caressing, kissing, fantasy, the use of sex toys, and cuddling.
