Postpartum Sexual Function and Depression: a Review of Recent Literature

Purpose of review It is important to identify factors that contribute to postpartum changes in sexual function and identify women at high risk for more persistent, impaired sexual response. The aim of this review was to review recent research to evaluate the relationship between depression and sexual function in the postpartum period. Recent findings The databases of PubMed, PsychINFO, and OVID Medline were searched for relevant articles. After review for eligibility criteria, 34 articles were reviewed. Studies showed depression was related to lower sexual function in postpartum women and impairments in sexual function and mood persisted beyond the traditional 12-month postpartum period. However, several studies with multivariate models indicated that depression and sexual function did not remain significantly related, though subjective elements of sexuality (e.g., sexual satisfaction) remained associated with depression. Several studies did not find a significant association between sexual pain and depression, though catastrophizing thoughts and sexual distress were significant. Studies highlighted the role of relationship satisfaction and partner support in the association between sexual function and depression. Summary The biopsychosocial model appears appropriate when assessing and managing postpartum sexual function. Results highlight the importance of screening for depression and sexual function beyond the typical initial postpartum visit, even two to 18 years past childbirth. Subjective elements of sexual function, including sexual distress and satisfaction are important to assess. Providers may consider including partners in management of postpartum depression and sexual dysfunction, as partner support was often a protective factor. Longitudinal research studies accounting for pre-pregnancy levels of sexual function and depression are needed. Studies focusing on women diagnosed with depression, with perinatal complications, and trauma symptoms are needed. Measures of sexual function could be validated in postpartum women to identify cutpoints specific to this population.