The effect of breastfeeding on postpartum sexual function: an observational cohort study

Postpartum women commonly experience sexual dysfunction; however, little is known regarding the effect of breastfeeding on sexual function and postpartum women's interest in treatment. We aimed to evaluate sexual function and genitourinary symptoms based on infant-feeding status and assess desire for treatment.

Cross-sectional observational study of women 5-6 months postpartum following singleton delivery was performed. Participants were grouped based on self-reported infant-feeding status: (1) primarily breastfeeding (BF) and (2) primarily formula feeding (FF). Female Sexual Function Index (FSFI) and Day-to-day Impact on Vaginal Aging (DIVA) questionnaires and interest in treatment were compared.

In total, 125 women were included with 61 (49%) breastfeeding and 64 (51%) formula feeding. Compared to FF women, BF women were less likely to identify as African American (47% vs 79%; SD 0.8) or have Medicaid (28% vs 66%; SD 0.9). No other large differences were noted. BF women had significantly lower FSFI score indicating poorer sexual function (20.8 (IQR 10, 24) BF vs 24.5 (IQR 19.5, 27.8) FF, p = 0.009). Both cohorts reported low bother from vaginal symptoms and low interest in treatment of symptoms with BF cohort reporting higher interest in use of vaginal lubricants (69% BF vs 30% FF, SD 0.8). Factors associated with lower FSFI score were BF, perineal laceration, use of progesterone long-acting reversible contraception, and single relationship status.

Both breastfeeding and formula feeding women experienced high rates of sexual dysfunction but low bother from vaginal symptoms and low interest in treatment. Further research is needed to explore these findings and assess postpartum sexual health.