Effect of Cognitive-Behavioral Sexual Counseling on Female Sexual Function During Pregnancy: An Interventional Study

Abstract

Introduction Significant biological, psychological, and physical changes during pregnancy can affect sexual performance in women (1,2). Hormonal changes during pregnancy cause vomiting, diarrhea, breast sensitivity, and fatigue, leading to decreased sexual desire (1). However, several studies have reported that these problems are not the only causes of sexual dysfunction (3). Many non-hormonal factors (e.g., social, economic, and cultural factors) can also change the sexual behaviors of women during pregnancy. The sexual behaviors of the couples during pregnancy are affected by their value systems, traditional and religious beliefs, and fear of hurting the fetus and mother (4). According to the literature, culture plays an important role in the frequency of sexual intercourse during pregnancy, which ultimately leads to sexual dysfunction (5, 6). In addition, several studies conducted on the Iranian women indicated that the most common causes of sexual dysfunction were physical problems (e.g., backache, pain during intercourse, dyspnea, and weight gain) (7,8) and false beliefs about intercourse during pregnancy. These misbeliefs include injury to the fetus, premature delivery, or lack of attractiveness for the spouse (7). Sexual function is still regarded as a taboo subject in some societies due to the lack of sufficient knowledge as well as cultural and religious prejudices (9,10). Sexual dysfunction intervenes with women's reproductive health. This disorder is regarded as a major health problem, the negative effects of which include the reduction of self-confidence, emotional changes, stress, significant distress between spouses, and reduced quality of life (11). Different statistics have been reported about the rate of sexual dysfunction, varying from 40% (12) to 63% (8) and 79% (12). It is noteworthy that more than half of the women receive no information about sexual intercourse during pregnancy (8). This could be either due to not asking about sexual coition during pregnancy on the part of the patient or the negligence of the healthcare providers. The lack of appropriate interaction between the patients and midwives leads to receiving inadequate information related to sexual function, which is a critical issue in communities (13,14). The lack of knowledge about intercourse during

Effectiveness of cognitive-behavioral therapy on sexual function and sexual self-efficacy in pregnant women: An RCT

“…In contrast to these results, the study of Vakilian and colleagues in Iran, aimed at evaluating the effect of cognitive-behavioral approach to sexual counseling on the female sexual performance during pregnancy showed that "counseling failed to overcome the biological and psychological changes during pregnancy and could not improve the sexual function of the participants" (39).…”

Misconceptions about sexual intercourse during pregnancy: cognitive-behavioral counseling in prenatal care

“…Vakilian et al, in a randomized clinical trial study on 100 pregnant women, showed that sexual counseling during pregnancy, whereas the control group increased sexual function during pregnancy. They used a cognitive approach for improving the misbelieves of pregnant women [4]. Contrary to this, Wannakosit and Phupong didn't report any improvement in sexual function during education compared to those of the control group [15].…”

“…A qualitative study on Taiwanese women pointed towards a negative experience during vaginal sex, such as dyspareunia, uterine discomfort, dry vaginal mucosa, pain in the pelvis and fatigue [17]. Vakilian et al pointed out that counseling during pregnancy plays an important role in decreasing the discomfort of sexual intercourse during pregnancy [4].…”

“…Psychological factors, such as changes in women's mental body image, loss of physical attraction to the partner and fear of adverse situations (e.g., abortion, fetal injury and premature labor) also effect of sexual intercourse. Negative feelings about sexual intercourse during pregnancy can either deepen the marital relationship or lead to a couple's separation [3,4]. On the other hand, according to published studies, if couples have pleasurable sexual intercourse during pregnancy, their communication and behaviors will improve after the infant's birth [4][5][6][7].…”

“…Negative feelings about sexual intercourse during pregnancy can either deepen the marital relationship or lead to a couple's separation [3,4]. On the other hand, according to published studies, if couples have pleasurable sexual intercourse during pregnancy, their communication and behaviors will improve after the infant's birth [4][5][6][7]. Although pregnancy is an important stage in women's lives and women need more emotional support during this period, a couple's in adequate information about sexual intercourse during pregnancy and their negative attitude towards sexual issues in this period can cause some problems.…”