Female sexual function and satisfaction in the postpartum period: structural equation modelling analysis

BACKGROUND: After childbirth, many couples experience a decline in sexual function and satisfaction. This study aimed to investigate the relationship between the domains of the Female Sexual Function Index and sexual satisfaction during the postpartum period. METHODS: A cross-sectional study of 500 postpartum women aged 18-42 years was conducted between 1 January and 30 June 2024 in 20 health centres in Kerman, Iran. All participants had resumed sexual activity after childbirth. The data was collected using self-assessment questionnaires, including the Female Sexual Function Index and the Larson Sexual Satisfaction Questionnaire. Structural equation modelling was used for data analysis. RESULTS: The average age of participants was 30.9 ± 5.8 years. Sexual activity resumed at 9.1 weeks postpartum, with an average frequency of 6.0 times per month. The results showed a positive association between Female Sexual Function Index scores and sexual satisfaction (β = 1.231, P < 0.001). Inadequate income (P = 0.001) and moderately adequate income (P = 0.004) were negatively associated with sexual function, whereas earlier resumption of sexual activity was positively associated with sexual function (P < 0.001). Additionally, a higher number of children was significantly and negatively associated with sexual satisfaction (P = 0.028). CONCLUSION: Women's sexual satisfaction after childbirth was related to their sexual function, particularly in the areas of desire, arousal, orgasm and pain. Women who reported higher relationship satisfaction also tended to be more sexually active and had better sexual function.