Low sexual desire in postpartum women: associations with psychosocial factors and sexual function

Sexual dysfunction is highly prevalent during the postpartum period but remains underdiagnosed and insufficiently addressed in clinical practice. Reduced sexual desire is one of the most frequently reported sexual complaints during the postpartum period and is commonly associated with impaired female sexual function. This study aimed to determine the prevalence of low sexual desire (LSD) and identify associated factors in postpartum women receiving care in a public healthcare setting.

This cross-sectional study was conducted in a tertiary university hospital in Brazil between February and December 2025. Data were collected through structured interviews using validated instruments, including the Female Sexual Function Index, Rosenberg Self-Esteem Scale, and Visual Analog Scale for pain. The primary outcome was the prevalence of LSD and its association with sociodemographic, clinical, psychosocial, sexual function, and self-esteem variables. Statistical analyses included parametric and non-parametric tests, post hoc power analysis, and Holm-Bonferroni adjustment for multiple comparisons.

Low sexual desire was identified in 56.25% of participants. Lower self-esteem, impaired sexual arousal, and lower overall Female Sexual Function Index scores remained significantly associated with LSD after adjustment for multiple comparisons. No significant associations were observed for age (P = .967), marital status (P = .586), mode of delivery (P = .940), or parity (P = .762).

Low sexual desire was highly prevalent among postpartum women and was primarily associated with psychosocial factors and impaired sexual function rather than sociodemographic or obstetric characteristics. Although the cross-sectional design precludes causal inference and the relatively small sample recruited from a single tertiary public healthcare center in urban Brazil may limit the generalizability of these findings beyond similar clinical settings, the results support the incorporation of routine sexual health assessment and psychosocial evaluation into postpartum care to facilitate early identification and management of women experiencing LSD.