195 Sexuality of the Woman During Pregnancy: Experience of the Tunisian Woman

ABSTRACT Introduction During various life transitions, sexuality can be disturbed and must be adjusted accordingly. This is particularly the case during pregnancy. This period is full of simultaneous multidimensional upheavals of a biological, physiological, psychological, emotional, social and sexual nature for the future parents. Objective To determine the factors associated with sexual dysfunction in a population of Tunisian women during pregnancy. Methods Multicentric prospective analytic study including 300 pregnant Tunisian women using the Arabic version of the Female Sexual Function Index (FSFI). Results We found a significant decrease in sexual frequency in rural versus urban settings (p=0.002). All sexual function items were significantly impaired in rural settings, except for orgasm and satisfaction. The FSFI score was lower for rural women (p=0.001). The type of marriage also proved to be a determining factor in the sexual life of pregnant women. In fact, in couples where the marriage was traditional, we noted a greater decrease in sexual relations (p < 0.01). All sexual function items were significantly impaired compared to couples where the marriage was for love. The item most affected was arousal (p<0.001). Nevertheless, pain was less during sexual intercourse for couples who had a love marriage (p<0.001). The decrease in frequency of intercourse was estimated at 78.33% when the agreement was poor, compared to only 49.68% when the marital agreement was good. The items most affected were orgasm, desire and arousal for couples with poor agreement. The FSFI score was also significantly impaired for this category (p <0.01). Similarly, women who frequently or always talked with their husbands about sexuality showed more desire, arousal, lubrication, orgasm and satisfaction with better overall sexual function on the FSFI. Another factor that appeared to negatively influence sexual function in pregnant women was a history of instrumental forceps delivery. Indeed, it was responsible for a significant impairment of arousal, orgasm and lubrication. It was also responsible for a more marked sexual dysfunction (FSFI score at 12.21 vs 22.76 in the absence of previous forceps delivery; p=0.01). Conclusion Pregnancy is certainly a period of vulnerability for the woman and her partner, but this is not a reason for it to be a desert of several months for the intimacy of the couple. Sexuality should no longer be considered as a tool for procreation only, but rather as a source of pleasure and relaxation and a privileged moment of complicity between the partners. Adapting to the events of pregnancy and the changes that are inherent to it requires the support of the family and the medical profession. Disclosure Work supported by industry: no.