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Childbirth and Female Sexual Function Later in Life

Fehniger, Julia E. MD; Brown, Jeanette S. MD; Creasman, Jennifer M. MSPH; Van Den Eeden, Stephen K. PhD; Thom, David H. MD, PhD; Subak, Leslee L. MD; Huang, Alison J. MD

doi: 10.1097/AOG.0b013e3182a7f3fc
Pelvic Floor Disorders Research: Original Research

OBJECTIVE: To examine relationships among parity, mode of delivery, and other parturition-related factors with women's sexual function later in life.

METHODS: Self-administered questionnaires examined sexual desire, activity, satisfaction, and problems in a multiethnic cohort of women aged 40 years and older with at least one past childbirth event. Trained abstractors obtained information on parity, mode of delivery, and other parturition-related factors from archived records. Multivariable regression models examined associations with sexual function controlling for age, race or ethnicity, partner status, diabetes, and general health.

RESULTS: Among 1,094 participants, mean (standard deviation) age was 56.3 (±8.7) years, 568 (43%) were racial or ethnic minorities (214 African American, 171 Asian, and 183 Latina), and 963 (88%) were multiparous. Fifty-six percent (n=601) reported low sexual desire; 53% (n=577) reported less than monthly sexual activity, and 43% (n=399) reported low overall sexual satisfaction. Greater parity was not associated with increased risk of reporting low sexual desire (adjusted odds ratio [OR] 1.08, confidence interval [CI] 0.96–1.21 per each birth), less than monthly sexual activity (adjusted OR 1.05, CI 0.93–1.20 per each birth), or low sexual satisfaction (adjusted OR 0.96, CI 0.85–1.09 per each birth). Compared with vaginal delivery alone, women with a history of cesarean delivery were not significantly more likely to report low desire (adjusted OR 0.71, CI 0.34–1.47), less than monthly sexual activity (adjusted OR 1.03, CI 0.46–2.32), or low sexual satisfaction (adjusted OR 0.57, CI 0.26–1.22). Women with a history of operative-assisted delivery were more likely to report low desire (adjusted OR 1.38, CI 1.04–1.83).

CONCLUSIONS: Among women with at least one childbirth event, parity and mode of delivery are not major determinants of sexual desire, activity, or satisfaction later in life.

LEVEL OF EVIDENCE: II

Parity and mode of delivery are not major determinants of sexual desire, activity, or overall satisfaction in women later in life.

Department of Obstetrics & Gynecology, University of Chicago, Chicago, Illinois; the Departments of Obstetrics, Gynecology, & Reproductive Sciences, Family & Community Medicine, and Medicine, University of California, San Francisco, San Francisco, California; and the Division of Research, Kaiser Permanente Northern California, Oakland, California.

Corresponding author: Alison J. Huang, MD, UCSF Women's Health Clinical Research Center, 1635 Divisadero Street, Suite 600, San Francisco, CA 94115; e-mail: ahuang@ucsfmed.org.

Supported by National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) grant DK53335 and the NIDDK/Office of Research on Women's Health Specialized Center of Research grant P50 DK064538 as well as a Paul Beeson Career Development Award in Aging Research from the National Institute on Aging (1K23AG038335-01A1) and the American Federation for Aging Research.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.