Article, 2024

(264) FEMALE SEXUAL HEALTH AFTER OBSTETRIC ANAL SPHINCTER INJURY (OASI): A SCOPING REVIEW

The Journal of Sexual Medicine, ISSN 1743-6095, 1743-6109, Volume 21, Supplement_4, Page qdae041.075, 10.1093/jsxmed/qdae041.075

Contributors

Gibrael, Hevy Sadraddin [1] Linhardt, Signe [2] Toldam, Nana Ernst [3] [4] Jangö, Hanna 0000-0003-0224-1425 [5] Thomsen, Louise 0000-0002-1653-7633 [6] Dreier, Sabine 0000-0002-4111-7155 [6] Giraldi, Annamaria G Elena 0000-0002-0033-8517 [4] [5] Graugaard, Christian L 0000-0003-0217-3637 [6]

Affiliations

  1. [1] Rigshospitalet
    2. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] University College Absalon
    3. [NORA names: University College Absalon; College; Denmark; Europe, EU; Nordic; OECD];
  3. [3] Aarhus University
    4. [NORA names: AU Aarhus University; University; Denmark; Europe, EU; Nordic; OECD];
  4. [4] Mental Health Services
    5. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  5. [5] University of Copenhagen
    6. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];

Abstract

Abstract Objectives Sexual health is an essential aspect of women’s well-being throughout life. However, pregnancy and childbirth cause biological, psychological, and social changes that can impact negatively on sexual health. Studies have thus indicated that sexual function often declines during pregnancy and may not fully recover to pre-pregnancy levels in the postpartum period. Unfortunately, healthcare providers often overlook addressing sexual aspects during this crucial time. With approximately 90% of women sustaining perineal tears during vaginal birth and 1-6 % being affected by obstetric anal sphincter injury (OASI), the current scoping review aims to assess the existing evidence on the associations between OASI and postpartum sexual health. Specifically, the review investigates the domains of sexual functioning, activity, and satisfaction. Methods PubMed, Embase, Scopus, Cinahl and Cochrane were systematically searched for relevant peer-reviewed papers as well as grey literature. Studies were selected in a three-stage process involving title and abstract assessment, complete article evaluation, and inclusion meeting predefined criteria. Only original quantitative studies providing statistical evidence on the impact of OASI on postpartum sexual health were included. The initial search yielded 749 articles, with 26 selected for inclusion. Results OASI impacted women's sexual health postpartum. In particular, women with OASI had delayed resumption of sexual intercourse compared to those with no or tears of lower degrees although the majority had resumed their coital activity twelve months postpartum. According to most studies, OASI increased the risk of dyspareunia, which oten persisted several years after birth. Also, these women were more likely to develop other long-term consequences, such as fecal incontinence, which can lead to, or exacerbate, sexual problems. Conclusions Women with OASI have increased risk of sexual dysfunction and low coital activity. This underscores the importance of initiating conversations with women regarding their sexual health after delivery with OASI and offer referral to physiotherapy, couples therapy, or sexological expertise when necessary. Conflicts of Interest Declaration of conflicts of interest for all authors: H. S. Gibrael: None. S. Linhardt: None.

Keywords

Abstract Assessment, CINAHL, Cochrane, Declaration, Embase, PubMed, Scopus, activity, anal sphincter injury, article, article evaluation, aspects, assessment, association, authors, birth, changes, childbirth, coital activity, conflict, consequences, conversion, couple therapy, coupling, criteria, degree, delayed resumption, delivery, domain, domains of sexual function, dysfunction, dyspareunia, essential aspect, evaluation, evidence, expertise, fecal incontinence, female sexual health, function, grey literature, health, healthcare, healthcare providers, impact, inclusion, incontinence, increased risk, increased risk of sexual dysfunction, injury, intercourse, interest, levels, life, literature, long-term consequences, low degree, months, months postpartum, obstetric anal sphincter injury, paper, peer-reviewed papers, perineal, perineal tears, period, physiotherapy, postpartum, postpartum period, postpartum sexual health, pre-pregnancy, pre-pregnancy levels, predefined criteria, pregnancy, problem, process, providers, quantitative study, referral, referral to physiotherapy, relevant peer-reviewed papers, resumption of sexual intercourse, review, risk, risk of dyspareunia, risk of sexual dysfunction, satisfaction, scope, scoping review, search, sexual aspects, sexual dysfunction, sexual function, sexual health, sexual intercourse, sexual problems, social change, sphincter injury, statistical evidence, study, tears, therapy, three-stage process, title, vaginal birth, well-being, women, women's well-being, years

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