Sexual Function After Vaginal Delivery in Primiparous Women: A Perspective in the First Months Postpartum

Background/Objectives: Female sexual dysfunction (FSD) involves persistent issues with desire, arousal, orgasm, or pain during intercourse. The Female Sexual Function Index (FSFI), a validated 19-item questionnaire, is widely used to assess FSD. Childbirth, particularly vaginal delivery with perineal trauma, can increase FSD risk, with 41-83% of women affected at six months postpartum. However, early postpartum FSD remains underexplored. This study examines FSD risk factors in first-time mothers delivering vaginally, using longitudinal FSFI assessments before and after the delivery. Methods: A prospective observational study was conducted involving 80 primiparous women who delivered vaginally. The FSFI questionnaire was provided before childbirth and three months postpartum. We compared the group of women who developed early FSD after delivery (N = 45) with those with a normal FSFI score (>26.6). Results: Three months after vaginal delivery, participants exhibited a significant decrease in overall FSFI scores (-9.61 [95%CI: -11.6; -7.6]; p = 0.008). A total of 45 patients (56.2%) developed early FSD. Marital status emerged as a significant factor, with marriage acting as a protective factor (OR 0.27 [95%CI 0.05-1.24]; p = 0.044). Clitoral and periclitoral tears were associated with a higher risk of FSD than high-degree perineal lacerations (OR 3.02 [95%CI 1.56-6.24]; p = 0.021). Conclusions: At three months post vaginal delivery, primiparous women face a relevant risk of developing transient sexual dysfunction. Marital status and type of perineal tears are identified as key factors influencing postpartum sexual function. Further research is warranted to explore these factors comprehensively and provide timely clinical and psychological support to couples navigating the challenges of early family life.