Sexual function screening recommended in postpartum women with PTSD
New research highlights the link between postpartum posttraumatic stress disorder and sexual dysfunction, emphasizing the need for early screening and trauma-informed care.
Sexual function screening recommended in postpartum women with PTSD | Image Credit: © Microgen - © Microgen - stock.adobe.com.
Screening for distressing changes in sexual function should be performed in women reporting posttraumatic stress disorder (PTSD) symptoms postpartum, according to a recent study presented at the International Society for the Study of Women’s Sexual Health 2025 Annual Meeting in Atlanta, Georgia from February 27 to March 2, 2025.1
Importance of screening for sexual dysfunction in postpartum PTSD
Traumatic childbirth deliveries occur in 40% of birthing patients, increasing the risk of PTSD among these individuals. Intrusive symptoms are more common during postpartum PTSD, alongside influences of general postpartum changes.1
“Postpartum PTSD is under-studied and under-treated,” wrote investigators. “Untreated perinatal mood and anxiety disorders (including PTSD) are associated with poorer health outcomes for both mother and child(ren), poorer quality of life, and impairments in relationship functioning.”1
Sexual dysfunction management remains a challenge in gynecology.2 A 2024 study found a lack of female sexual dysfunction (FSD) training among providers. Only 1.4% of urology residency program websites included FSD content, with a median of 1 click to access content and a range of 0 to 2 clicks.
In comparison, FSD content was identified in 5.3% of OB-GYN websites. On these websites, FSD content was accessed with a median of 1 click and range of 0 to 3 clicks.2
Disruptions in sexual function may occur in postpartum women with PTSD that are not linked to regular postpartum changes. Therefore, investigators conducted a study to determine the impact of PTSD symptoms and perceived childbirth experiences on sexual function.1
Study methodology and results
Participants included women aged 18 to 45 years with childbirth performed within the past year. These patients completed an online survey to determine their sociodemographic and childbirth characteristics.1
Patients also completed the Sexual Function Questionnaire-Medical Impact Scale (SFQMIS), Female Sexual Distress Scale-Revised, and the City Birth Trauma Scale, which is used to measure postpartum PTSD.1
There were 74 women aged a mean 32.57 years included in the final analysis, 25.68% of whom were Black, 1.37% Asian, 62.16% White, and 4.10% Hispanic. Current marriage was reported in 24%, a positive PTSD screening in 24%, and scoring above the clinical cutoff point for sexual distress in 68%.1
A significant correlation with sexual distress was reported for PTSD symptoms (r = 0.27, p < .05), but not with SFQMIS (r = .14, p = .253). Higher PTSD scores were reported among women above the cutoff point for sexual distress, at 17.53 vs 9.19 among those below the cutoff point.1
The adverse impact of childbirth on sexual function was also increased among women above the cutoff point for sexual distress vs those below the cutoff point, at 2.90 and 1.91, respectively. This highlighted a need to screen for sexual function changes in postpartum women with PTSD symptoms, and vice versa.1
Study limitations and future directions
Investigators noted limitations in the ability of the cross-sectional survey to evaluate causal relationships. Further limitations included the small and homogenous sample.1
“A trauma-informed care approach to management of postpartum sexual dysfunction in women with comorbid PTSD may be beneficial,” wrote investigators. “Future research should use prospective designs to examine relationships over time, and assess the impact of PTSD treatment on sexual dysfunction.”1
References
- Kelley E, Mal-Sarkar T, Russell R, Shah S. Impact of childbirth on PTSD and sexual distress. Presented at: International Society for the Study of Women’s Sexual Health 2025 Annual Meeting. Atlanta, Georgia. February 27-March 2, 2025.
- Krewson C. Female sexual dysfunction education found lacking. Contemporary OB/GYN. October 16, 2024. Accessed March 3, 2025. https://www.contemporaryobgyn.net/view/female-sexual-dysfunction-education-found-lacking
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