title: Changes in sexual function after medical or surgical termination of pregnancy.
abstract: BACKGROUND
  Voluntary termination of pregnancy (TOP) is a social issue; however, even if it is one of the most common procedures performed in the world, few studies evaluated sexual function changes after medical or surgical TOP.
  
  
  OBJECTIVE
  The aim of this study was to evaluate how first trimester TOP by either surgical (group 1) or medical procedure (group 2) affects sexual function.
  
  
  METHODS
  This prospective observational study included 211 patients (132 in group 1 and 79 in group 2) who requested first trimester TOP between September 2010 and May 2012. Medical TOP (mifepristone and misoprostol) was offered to patients up to 49 days of gestation. Surgical TOP was performed up to 12 weeks. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before TOP, after 1, 3, and 6 months from TOP.
  
  
  METHODS
  Changes in the FSFI values and number of sexual active patients after 1, 3, and 6 months from the TOP and the self-reported quality of sexual life at 6 months, with the two different procedures, were the main outcome measures.
  
  
  RESULTS
  At 4-week follow-up, 23.6% of women in group 1 did not resume sexual intercourse compared with 5.4% of women in group 2 (P = 0.003). At 6 months, 3.3% of women in the group 1 and no women in the group 2 did not resume sexual intercourses (P = 0.123). Compared with women in group 2, those in group 1 had lower FSFI score and number of sexual intercourses at 1, 3, and 6 months follow-up (P < 0.001).
  
  
  CONCLUSIONS
  This study shows that the number of sexually active women and the overall FSFI are reduced in women undergoing surgical TOP compared with those undergoing medical TOP. Counseling regarding sexual function changes should be included in the discussion of morbidity related to medical or surgical TOP.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Morotti
authors.forename: Luana
authors.initials: L
authors.lastname: Calanni
authors.forename: Gaia
authors.initials: G
authors.lastname: Gianola
authors.forename: Paola
authors.initials: P
authors.lastname: Anserini
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Venturini
authors.forename: Simone
authors.initials: S
authors.lastname: Ferrero
mesh_terms: D000021:Abortifacient Agents, Steroidal; D000028:Abortion, Induced / Q000379:methods / Q000523:psychology*; D000328:Adult; D003075:Coitus / Q000523:psychology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015735:Mifepristone; D016595:Misoprostol; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies
chemical_list: D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone
keywords: Dyspareunia; Medical Abortion; Sexual Function; Surgical Abortion; Voluntary Termination of Pregnancy