Following obstetric fistula repair, many women experienced difficulty engaging in penetrative vaginal intercourse and reported sexual dysfunction. Management of sexual dysfunction should be part of fistula rehabilitation programs.

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Background: Pregnancy is characterized by physical, hormonal and psychological changes that could influence women's sexuality. The study aimed at ascertaining changes in the women's sexual domains as well as factors affecting their sexual responses. Methods: A total of 177 healthy heterosexual pregnant Nigerian women at term and in stable marital relationships were included in the study. Authors' designed structured questionnaire featuring socio-demographic and obstetric characteristics as well as assessment of their sexual desire, arousal, orgasm, sexual satisfaction and pain compared to the pre-pregnancy period was used to collect the information. Data was analyzed using SPSS version 16 for windows. Results: Mean age of the women was 30.9 ± 4.7 years. Majority of them reported decline in sexual desire, arousal, frequency of orgasm and sexual satisfaction compared to the pre-pregnancy period. Reduce sexual desire was marked in the first trimester but sexual desire peaked in second trimester. Women aged ≥31 years were four times more likely to experience increase frequency of orgasm (OR 4.0, 95% CI 1.9 -8.7, P = 0.02) while those with tertiary education (OR 2.2, 95% CI 1.1 -4.2, P = 0.02) and unplanned pregnancy (OR 2.4, 95% CI 1.8 -5.0, P = 0.04) were more likely to experience decreased sexual satisfaction compared to the pre-pregnancy period. Conclusions: Pregnancy is associated with decline in all domains of female sexual response cycle among the women. Older maternal age positively impacts on frequency of attainment of orgasm while tertiary educational level and unplanned pregnancy negatively affect their sexual satisfaction during pregnancy.

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