Impact of Treatment of Symptomatic Vaginal Infections on Female Sexual Function: A Prospective Study

OBJECTIVE: To evaluate changes in female sexual function after treatment of symptomatic vaginitis, compare outcomes across different vaginitis etiologies, and identify predictors of persistent female sexual dysfunction. METHODS: This prospective observational study included sexually active women diagnosed with bacterial vaginosis, vulvovaginal candidiasis, or trichomoniasis between January and June 2024 at a tertiary care hospital. Female sexual function was assessed using the Female Sexual Function Index (FSFI) before treatment and 1 month after treatment. Changes in FSFI scores were analyzed, and multivariable logistic regression identified independent predictors of persistent female sexual dysfunction. RESULTS: A total of 158 women were included: 38 (24.0%) with vulvovaginal candidiasis, 75 (47.5%) with bacterial vaginosis, and 45 (28.5%) with trichomoniasis. Women with trichomoniasis were significantly younger and had lower body mass index than the other groups (both P<.001). The prevalence of FSD decreased from 80.4% to 27.2% after treatment (absolute reduction, 53.2 percentage points). Overall FSFI scores and all domain scores improved significantly (all P<.001). Daily pad use (OR=2.427, 95% CI: 1.007-5.851; P=.048) and smoking (OR=2.551, 95% CI: 1.069-6.088; P=.035) were independently associated with persistent FSD. Study limitations included the single-center design and short follow-up. CONCLUSIONS: Symptomatic vaginal infections are associated with impaired female sexual function. Appropriate treatment significantly improves sexual function and reduces the prevalence of female sexual dysfunction. Routine assessment of sexual health may contribute to more comprehensive management of women with vaginitis.