The Relationship between Frequency of Breastfeeding and Sexual Distress in Postpartum Women

The Relationship between Frequency of Breastfeeding and Sexual Distress in Postpartum Women Maryam Zamani (MSc)1, Robab Latifnejad Roudsari (PhD)2,3*, Maryam Moradi (PhD)4,3, Habibollah Esmaily (PhD)5,6 1 2 3 4 5 6 MSc, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Associate Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Assistant Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Professor, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Epidemiology and Biostatistics, School of Health, Mashhad University Medical of Medical Sciences, Mashhad, Iran ARTICLE INFO ABSTRACT Article type: Original article Background & aim: Due to frequent waking at night for breastfeeding, nursing mothers are likely to suffer from sleep deprivation, which may lead to sexual dysfunction. To the best of our knowledge, few studies have been conducted on sexual distress in nursing mothers. Thus, we sought to examine the relationship between the frequency of breastfeeding and female sexual distress during postpartum period. Methods: This descriptive correlational study was conducted on 80 women aged 18-35 years, visiting healthcare centers in Mashhad, Iran, during 2016. To select the participants, multi-stage sampling method was used. The data collection tools included demographic and fertility-related questionnaire, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Female Sexual Distress Scale-Revised (FSDS-R). To analyze the data, Kruskal-Wallis H test, Spearman’s rank-order correlation, and linear regression model were run in SPSS, version 16. Results: The mean score of postpartum sexual distress in mothers was 20.43±8.00. According to the results of the Spearman’s rank-order correlation, the frequency of nighttime breastfeeding was directly correlated with maternal sexual distress (P=0.010, r=0.26). However, there was no correlation between the frequency of daytime breastfeeding sessions and sexual distress (P=0.976, r=0.003). Conclusion: Considering the correlation between the frequency of breastfeeding at night and postpartum sexual distress in mothers, it seems necessary to adopt effective counselling approaches to overcome female sexual distress during this period. Article History: Received: 04-Sep-2017 Accepted: 01-Jan-2018 Key words: Breastfeeding Postpartum Sexual Function Please cite this paper as: Zamani M, Latifnejad Roudsari R, Moradi M, Esmaily H. The Relationship between Frequency of Breastfeeding and Sexual Distress in Postpartum Women. Journal of Midwifery and Reproductive Health. 2018; 6(4): 1447-1453. DOI: 10.22038/jmrh.2018.26061.1285 Introduction Sexual distress has been defined as depression, anxiety, and stress about sexual activity (1). According to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), identification of sexual distress is required to diagnose sexual dysfunctions (2). Moreover, in many women, sexual function can decrease during pregnancy and the postpartum period (3-6). Sexual problems experienced in the postnatal period can impose great distress on mothers and their partners, which can consequently affect their quality of physical and mental life, as well as their well-being and marital relationship (7). * Corresponding author: Robab Latifnejad Roudsari, Associate Professor, Nursing and Midwifery Care Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +989370400607; Email: Zamani M et al. JMRH In this respect, Shifren et al. (2008) noted that assessing the prevalence of sexual distress to estimate the occurrence of sexual problems requiring clinical interventions was of great importance (8). In addition, postpartum hormonal changes, as well as health recovery and potentially painful and prolonged improvement of the complications of vaginal delivery or cesarean section can influence physical and emotional health status of woman. Due to these factors, couples might struggle to have a healthy, active, and enjoyable sexual life during the postpartum period (9). In this regard, breastfeeding is considered as one of the factors affecting sexual function (10). The prevalence of sexual dysfunctions and disorders during the postpartum period in women is higher than that in the general population. Moreover, such problems are more common in month 3 and from month 9 to 12 in the postpartum period (10). In this respect, Hicks et al. (2004) estimated the overall prevalence of postnatal sexual dysfunctions in women to be 22-86% (11). Some investigations have also reported that elevated level of oxytocin due to breastfeeding could have positive effects on sexual function (12, 13). In some cases, high oxytocin levels due to breastfeeding can be associated with low libido (14). Additionally, decreased level of estrogen and high level of prolactin during the postpartum period following breastfeeding can reduce vaginal lubrication and lead to dyspareunia (14). In a report by Schlagintweit et al. (2016), it was found that breastfeeding was not correlated with the frequency and severity of postpartum sexual distress (15). LaMarre et al. (2003) also concluded that breastfeeding mothers compared with bottlefeeders tend to experience more sexual dysfunction, especially loss of libido (7). Moreover, Rowland et al. (2005) showed a strong relationship between breastfeeding and resumption of postpartum sexual intercourse, such that breastfeeding mothers had a later onset of postpartum sexual activity (16). Mothers practicing exclusive breastfeeding can also have more problems with vaginal lubrication and sexual stimulation than others (7). In some studies, sexual function was found J Midwifery Reprod Health. 2018; 6(4): 1457-1463. Frequency of breastfeeding and sexual distress in postpartum women to decrease by 55% in breastfeeding mothers, while it had scaled up by 39% in some other investigations (17). Accordingly, women reporting sexual distress are more likely to suffer from high levels of sexual and marital dissatisfaction (18). As revealed by the review of the related literature, there is contradictory evidence regarding breastfeeding and sexual function (12, 13, 16, 19, 20, 21). Due to the existing inconsistencies in the studies and given that sexual distress in the postnatal period has not been previously investigated, we aimed to investigate the correlation between the frequency of breastfeeding and maternal sexual distress in the postpartum period. Materials and Methods This descriptive correlational study was conducted in 2016 on 80 women aged 18-35 years visiting healthcare centers for neonatal vaccination and care servi (...truncated)