Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women

Abstract

Background: The beginning of 2020 was characterized by the COVID-19 pandemic. The world governments have adopted restrictive measures to reduce the spread of infection. These measures could affect the sexual function and quality of life of women living with their partner. Aim: The aim is to assess the impact of the social distancing measures caused by the COVID-19 pandemic on sexual function and quality of life of noninfected reproductive-age women, living with their sexual partner. Methods: Observational analysis on sexually active women, living with their partner, and without COVID-19 infection was performed. The population previously answered FSFI, FSDS, and SF-36 questionnaires. 4 weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for an evaluation during the COVID-19 outbreak. Main Outcome Measures: The primary endpoint was the assessment of the women's sex function change during the social restriction period, by analyzing the FSFI and FSDS questionnaires. The secondary endpoint was the evaluation of the impact on the quality of life calculated by the SF-36 questionnaire. Results: 89 patients were considered. The median age was 39 (28e50) years. Mean sexual intercourses/month decreased from 6.3 ± 1.9 to 2.3 ± 1.8, mean difference: À3.9 ± 1.2. FSFI decreased significantly (29.2 ± 4.2 vs 19.2 ± 3.3, mean difference: À9.7 ± 2.6) and FSDS increased significantly (9.3 ± 5.5 vs 20.1 ± 5.2, mean difference: 10.8 ± 3.4). The SF-36 showed a significant change from 82.2 ± 10.2 to 64.2 ± 11.8 4 weeks after the introduction of the restrictive measures; mean difference: À17.8 ± 6.7. The univariable analysis identified working outside the home, university educational level, and parity !1 as predictive factors of lower FSFI. In multivariable analysis, working outside the home and combination of working outside the home þ university educational level þ parity !1 were the independent factors of a lower FSFI. Clinical Implication: The negative impact of the COVID-19 epidemic period on sexual function and quality of life in women shows how acute stress might affect the psychological state. Thus, psychological or sexual support could be useful. Strengths and Limitations: To our knowledge, this study is the first that analyzes the change in sexual activity in women during the COVID-19 outbreak period. The limitations were the low number of the analyzed participants, psychological tests were not included, and no data were collected on masturbation, self-heroism, solitary, and nonpenetrative sex. Conclusion:The COVID-19 epidemic and the restrictive social distancing measures have negatively influenced the sexual function and quality of life in not-infected reproductive-age women who live with their sexual partners.

“INSIDE” Project on Sexual Health in Spain: The Impact of the Lockdown Caused by COVID-19

“…In fact, ignoring them could be a serious limitation in any research. Other studies such as those by Ibarra et al (2020), Jacob et al (2020), Lehmiller et al (2020) or Schiavi et al (2020) also take them into account, although there are clear differences among the variables evaluated by one or the other studies.…”

“…Differing from our study that reveals similar percentages for an increase or decrease in sexual satisfaction in relationships, in the study by W. , 35% (32% of men and 39% of women with signi cant differences) had a reduction in their sexual satisfaction, in 15% it increased and in 51% there were no changes. Moreover, Schiavi et al (2020) evaluated in Italy 89 women between 28-50 years who lived with their partner and who had attended a gynecological clinic. The average number of sexual relations per month also decreased from 6.3 to 2.3.…”

“…Except for this, the variables associated with a higher sexual frequency were being male, younger, being married or cohabiting with partner, consuming alcohol and a high number of days of self-isolation / social distancing. The comparison with the data from Italy is also complex (Schiavi et al, 2020) because of the dependent variable was the "female sexual function" of women who attended a gynecological clinic, which decreased among those who worked outside the home, had a university level and more children.…”

“…In addition, the use of dating apps would have decreased or the motivation to use them would have changed. Finally, studies by Taniguchi et al (2020), Yuksel & Ozgor (2020) and Schiavi et al (2020) have observed a deterioration of sexual function, sexual satisfaction and quality of life.…”

“…A third one also included an important number of participants from the United States although this was restricted to men who have sex with men (MSM) (Sanchez, Zlotorzynska, Rai, & Baral, 2020). The remaining of the published studies have only evaluated between 58 and 459 participants belonging to the general population from Bangladesh, India and Nepal (Arafat, Mohamed, Kar, Sharma, & Kabir, 2020), Japan (Taniguchi, Hisasue, & Sato, 2020) and a very small group of women from Italy (Schiavi et al, 2020) and Turkey (Yuksel & Ozgor, 2020). The only study found that has explored the impact of COVID-19 on the Spanish population is the review by Ibarra et al (2020).…”