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The Comparison of Female Sexual Function in Nulliparous Women
Following Vaginal Delivery and Cesarean Delivery at 6 Weeks
and 3 Months
Peerawat Imakmol, Puckjira Iaocharoen, Komsun Suwannarurk*
Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: k_suwannarurk@yahoo.com
Background: Abstract
Female sexual dysfunction (FSD) altered sexual health and is caused by numerous factors
including pregnancy.
Objective: This study aimed to compare and investigate the prevalence of FSD among nulliparous
women following vaginal (NL) versus cesarean delivery (CS) at 6 weeks and 3 months and
potential factors.
Methods: This was prospective cohort study. Participants were term nulliparous pregnant women
who delivered at Thammasat University Hospital, Pathum Thani, Thailand, between August
2024 and January 2025. Subjects were divided into NL and CS groups. The Thai version of
female sexual function index (FSFI) was used for evaluation at 6 weeks and 3 months after
delivery. Obstetrics and demographic characteristics were also recruited.
Results: A total of 375 participants were recruited. There were 189 and 186 participants in the NL and
CS groups, respectively. The mean age was 31.52 years in the NL group and 30.56 years in
the CS group. Both groups had comparable demographic characteristics. Six weeks after
delivery, the average FSFI scores were similar in both groups, with the NL group scoring
22.1 and the CS group scoring 22.3. Four-fifths (295/375) of both groups were diagnosed
with FSD at 6 weeks after delivery. The prevalence of FSD in the NL and CS groups was 37%
(70/189) and 43% (80/186), respectively, without statistical significance at 6 weeks post-
partum. Only pain in the NL group was lower than in the CS group at 3 months postpartum.
Conclusion: Prevalence of postpartum FSD were 78.3% and 79% in the NL and CS groups at 6 weeks,
and 37% and 43% at 3 months. At 3 months after delivery, pain in the NL group was lower
than in the CS group.
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