Factors Affecting Sexual Health after Puerperium among Women in Karachi
Factors Affecting Sexual Health After Puerperium
DOI:
https://doi.org/10.54393/pjhs.v6i3.2840Keywords:
Postpartum Period, Sexual Health, Dyspareunia, Postpartum LibidoAbstract
The puerperium phase represents a critical juncture in a woman's reproductive journey, marked by significant physical, emotional, and relational adjustments. Various factors beyond the mere resumption of sexual activity influence sexual well-being during this period. However, discussions surrounding postpartum sexual health remain limited, particularly in low- and middle-income countries like Pakistan. Objectives: To explore postpartum sexual health in Pakistani women, identifying cultural, physical, and emotional factors influencing well-being. Methods: A cross-sectional study was conducted at Fazaia Ruth Pfau Medical College (FRPMC) Hospitals in Karachi from August 2022 to July 2023. Within the first three months’ post-puerperium, 263 women aged 18 to 45 participated. A comprehensive questionnaire, developed and validated through rigorous processes, assessed socio-demographic, obstetric, and sexual health factors. Statistical analyses, including chi-square tests and Kendall’s tau correlation analyses, were employed. Results: Participants exhibited diverse socio-demographic and obstetric profiles, with a notable prevalence of resumption of sexual activity (65.1%) and concerns such as dyspareunia (66.5%) and decreased libido (53.2%). Significant associations were found between various socio-demographic and obstetric factors and postpartum sexual health outcomes. Longer marriage duration was associated with higher libido levels, while the mode of delivery and the last baby's birth weight influenced coital frequency. Age, marriage duration, and parity affected postpartum libido, vaginal dryness, and dyspareunia. Conclusions: It was concluded that this study provides valuable insights into the complexity of postpartum sexual experiences among women in Karachi, Pakistan. The findings underscore the need for comprehensive, culturally sensitive interventions to support women's sexual well-being during this critical period.
References
Wood SN, Pigott A, Thomas HL, Wood C, Zimmerman LA. A Scoping Review on Women’s Sexual Health in the Postpartum Period: Opportunities for Research and Practice within Low- and Middle-Income Countries. Reproductive Health. 2022 May; 19(1): 112. doi: 10.1186/s12978-022-01399-6.
O'Malley D, Smith V, Higgins A. Women's Solutioning and Strategising in Relation to Their Postpartum Sexual Health: A Qualitative Study. Midwifery. 2019 Oct; 77: 53-9. doi: 10.1016/j.midw.2019.06.012. DOI: https://doi.org/10.1016/j.midw.2019.06.012
Ghorat F, Esfehani RJ, Sharifzadeh M, Tabarraei Y, Aghahosseini SS. Long Term Effect of Vaginal Delivery and Cesarean Section on Female Sexual Function in Primipara Mothers. Electronic Physician. 2017 Mar; 9(3): 3991. doi: 10.19082/3991. DOI: https://doi.org/10.19082/3991
Serrano Drozdowskyj E, Gimeno Castro E, Trigo López E, Bárcenas Taland I, Chiclana Actis C. Factors Influencing Couples’ Sexuality in The Puerperium: A Systematic Review. Sexual Medicine Reviews. 2020 Jan; 8(1): 38-47. doi: /10.1016/j.sxmr.2019.07.002. DOI: https://doi.org/10.1016/j.sxmr.2019.07.002
Abebe Gelaw K, Atalay YA, Yeshambel A, Adella GA, Walle BG, Zeleke LB et al. Prevalence and Factors Associated with Early Resumption of Sexual Intercourse Among Postpartum Women: Systematic Review and Meta-Analysis. Plos One. 2024 Jan; 19(1): e0288536. doi: 10.1371/journal.pone.0288536. DOI: https://doi.org/10.1371/journal.pone.0288536
Sok C, Sanders JN, Saltzman HM, Turok DK. Sexual Behavior, Satisfaction, and Contraceptive Use among Postpartum Women. Journal of Midwifery & Women's Health. 2016 Mar; 61(2): 158-65. doi: 10.1111/jmwh.12409. DOI: https://doi.org/10.1111/jmwh.12409
Hjorth S, Kirkegaard H, Olsen J, Thornton JG, Nohr EA. Mode of Birth and Long-Term Sexual Health: A Follow-Up Study of Mothers in the Danish National Birth Cohort. British Medical Journal. 2019 Nov; 9(11): e029517. doi: 10.1136/bmjopen-2019-029517. DOI: https://doi.org/10.1136/bmjopen-2019-029517
Zgliczynska M, Zasztowt‐Sternicka M, Kosinska‐Kaczynska K, Szymusik I, Pazdzior D, Durmaj A et al. Impact Of Childbirth On Women's Sexuality in the First Year After the Delivery. Journal of Obstetrics and Gynaecology Research. 2021 Mar; 47(3): 882-92. doi: 10.1111/jog.14583. DOI: https://doi.org/10.1111/jog.14583
Verbeek M and Hayward L. Pelvic Floor Dysfunction and Its Effect on Quality of Sexual Life. Sexual Medicine Reviews. 2019 Oct; 7(4): 559-64. doi: 10.1016/j.sxmr.2019.05.007. DOI: https://doi.org/10.1016/j.sxmr.2019.05.007
Khan MD, Daniyal M, Abid K, Tawiah K, Tebha SS, Essar MY. Analysis of Adolescents' Perception and Awareness Level for Sexual and Reproductive Health Rights in Pakistan. Health Science Reports. 2023 Jan; 6(1): e982. doi: 10.1002/hsr2.982. DOI: https://doi.org/10.1002/hsr2.982
Shaikh A and Ochani RK. The Need for Sexuality Education in Pakistan. Cureus. 2018 May; 10(5). doi: 10.7759/cureus.2693. DOI: https://doi.org/10.7759/cureus.2693
McDonald E, Woolhouse H, Brown SJ. Consultation About Sexual Health Issues in the Year After Childbirth: A Cohort Study. Birth. 2015 Dec; 42(4): 354-61. doi: 10.1111/birt.12193. DOI: https://doi.org/10.1111/birt.12193
Mevawala AS. Exploring Urban Pakistani Muslim Midlife Women’s Experiences of Menopause: A Focused Ethnography Study. 2020. doi: 10.7939/r3-c187-ze21.
Wood SN, Pigott A, Thomas HL, Wood C, Zimmerman LA. A Scoping Review on Women’s Sexual Health in the Postpartum Period: Opportunities for Research and Practice within Low- and Middle-Income Countries. Reproductive Health. 2022 May; 19(1): 112. doi: 10.1186/s12978-022-01399-6. DOI: https://doi.org/10.1186/s12978-022-01399-6
Asmamaw DB, Belachew TB, Negash WD. Multilevel Analysis of Early Resumption of Sexual Intercourse among Postpartum Women in Sub-Saharan Africa: Evidence from Demographic and Health Survey Data. Brihanmumbai Municipal Corporation Public Health. 2023 Apr; 23(1): 733. doi: 10.1186/s12889-023-15687-8. DOI: https://doi.org/10.1186/s12889-023-15687-8
Belay HG, Yehuala ED, Asmer Getie S, Ayele AD, Yimer TS, Berihun Erega B et al. Determinants of Early Resumption of Postpartum Sexual Intercourse in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Women's Health. 2024 Nov; 20: 17455057241302303. doi: 10.1177/17455057241302303. DOI: https://doi.org/10.1177/17455057241302303
Grøntvedt TV, Kennair LE, Mehmetoglu M. Factors Predicting the Probability of Initiating Sexual Intercourse by Context and Sex. Scandinavian Journal of Psychology. 2015 Oct; 56(5): 516-26. doi: 10.1111/sjop.12215. DOI: https://doi.org/10.1111/sjop.12215
Jambola ET, Gelagay AA, Belew AK, Abajobir AA. Early Resumption of Sexual Intercourse and Its Associated Factors Among Postpartum Women in Western Ethiopia: A Cross-Sectional Study. International Journal of Women's Health. 2020 May: 381-91. doi: 10.2147/IJWH.S231859. DOI: https://doi.org/10.2147/IJWH.S231859
Asratie MH, Andualem Z. Predictors of Early Resumption of Post-Partum Sexual Intercourse Among Post-Partum Period Women in Ethiopia: A Multilevel Analysis Based On Ethiopian Demographic and Health Survey 2016. Plos one. 2022 Sep; 17(9): e0271372. doi: 10.1371/journal.pone.0271372. DOI: https://doi.org/10.1371/journal.pone.0271372
Alum AC, Kizza IB, Osingada CP, Katende G, Kaye DK. Factors Associated with Early Resumption of Sexual Intercourse Among Postnatal Women in Uganda. Reproductive Health. 2015 Dec; 12: 1-8. doi: 10.1186/s12978-015-0089-5. DOI: https://doi.org/10.1186/s12978-015-0089-5
Iliyasu Z, Galadanci HS, Danlami KM, Salihu HM, Aliyu MH. Correlates of Postpartum Sexual Activity and Contraceptive Use in Kano, Northern Nigeria. African Journal of Reproductive Health. 2018 Apr; 22(1): 103-12.
Anglès-Acedo S, Ros-Cerro C, Escura-Sancho S, Elías-Santo-Domingo N, Palau-Pascual MJ, Espuña-Pons M. Coital Resumption After Delivery Among OASIS Patients: Differences Between Instrumental and Spontaneous Delivery. BioMed Central Women's Health. 2019 Dec; 19: 1-7. doi: 10.1186/s12905-019-0845-8. DOI: https://doi.org/10.1186/s12905-019-0845-8
Stedenfeldt M, Pirhonen J, Blix E, Wilsgaard T, Vonen B, Øian P. Anal Incontinence, Urinary Incontinence and Sexual Problems in Primiparous Women–A Comparison Between Women with Episiotomy Only and Women with Episiotomy and Obstetric Anal Sphincter Injury. BioMed Central Women's Health. 2014 Dec; 14: 1-7. doi: 10.1186/s12905-014-0157-y. DOI: https://doi.org/10.1186/s12905-014-0157-y
Okeahialam NA, Sultan AH, Thakar R. The Prevention of Perineal Trauma During Vaginal Birth. American Journal of Obstetrics and Gynecology. 2024 Mar; 230(3): S991-1004. doi: 10.1016/j.ajog.2022.06.021. DOI: https://doi.org/10.1016/j.ajog.2022.06.021
Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA et al. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. International Journal of Environmental Research and Public Health. 2023 Mar; 20(7): 5252. doi: 10.3390/ijerph20075252.
Banaei M, Kariman N, Ozgoli G, Nasiri M, Ghasemi V, Khiabani A et al. Prevalence of Postpartum Dyspareunia: A Systematic Review and Meta‐Analysis. International Journal of Gynaecology and Obstetrics. 2021 Apr; 153(1): 14-24. doi: 10.1002/ijgo.13523. DOI: https://doi.org/10.1002/ijgo.13523
Alligood-Percoco NR, Kjerulff KH, Repke JT. Risk Factors for Dyspareunia After First Childbirth. Obstetrics and Gynecology. 2016 Sep; 128(3): 512-8. doi: 10.1097/AOG.0000000000001590. DOI: https://doi.org/10.1097/AOG.0000000000001590
Fanshawe AM, De Jonge A, Ginter N, Takács L, Dahlen HG, Swertz MA, Peters LL. The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review. International Journal of Environmental Research and Public Health. 2023 Mar; 20(7): 5252. doi: 10.3390/ijerph20075252. DOI: https://doi.org/10.3390/ijerph20075252
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments