title: Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study.
abstract: OBJECTIVE
  Reduced sexual activity and dysfunctional problems are highly prevalent in the perinatal period, and there is a lack of data regarding the degree of normality during pregnancy. Several risk factors have been independently associated with a greater extent of Female Sexual Dysfunction (FSD). Therefore, this study aimed to assess the prevalence of sexual inactivity and sexual dysfunctions in German women during the perinatal period and the verification of potential risk factors.
  
  
  METHODS
  Questionnaires were administered to 315 women prenatally (TI 3rd trimester) and postpartum (TII 1 week, TIII 4 months), including the Female Sexual Function Index (FSFI), the Edinburgh Postnatal Depression Scale (EPDS), and the Questionnaire of Partnership (PFB).
  
  
  RESULTS
  The frequency of sexual inactivity was 24% (TI), 40.5% (TII), and 19.9% (TIII). Overall, 26.5-34.8% of women were at risk of sexual dysfunction (FSFI score <26.55) at all measurement points. Sexual desire disorder was the most prevalent form of Female sexual dysfunction. Furthermore, especially breastfeeding and low partnership quality were revealed as significant risk factors for sexual dysfunctional problems postpartum. Depressive symptoms having a cesarean section and high maternal education were correlated with dysfunctional problems in several subdomains.
  
  
  CONCLUSIONS
  Findings indicated that women at risk of FSD differed significantly in aspects of partnership quality, breastfeeding, mode of delivery, maternal education, and depressive symptoms. Aspects of perinatal sexuality should be routinely implemented in the counseling of couples in prenatal classes.
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. Stephanie.Wallwiener@googlemail.com.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wallwiener
authors.affiliation: Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany.
authors.forename: Mitho
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Doster
authors.affiliation: Department of Gynecological Endocrinology and Fertility Disorders, University Hospital Heidelberg, INF 440, 69120, Heidelberg, Germany.
authors.forename: Ruben Jeremias
authors.initials: RJ
authors.lastname: Kuon
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Plewniok
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Feller
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
authors.affiliation: Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Reck
authors.affiliation: Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
authors.forename: Lina Maria
authors.initials: LM
authors.lastname: Matthies
authors.affiliation: Department of Women's Health, Research Institute for Women's Health, University of Tübingen, Tübingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wallwiener
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000009:adverse effects; D002585:Cesarean Section / Q000009:adverse effects; D003863:Depression; D019052:Depression, Postpartum / Q000150:complications; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D049590:Postpartum Period; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000209:etiology; D019529:Sexuality / Q000523:psychology
keywords: Breastfeeding; Delivery; Female sexual dysfunction; Partnership satisfaction; Pregnancy; Sexual activity