The effect of pregnancy on sexual functions with body image and genital self-image

Aim: We aimed to reveal the effect of the first pregnancy on female sexual functions and the change during pregnancy. Secondly, we aimed to investigate the effects of each of the changes in pelvic floor functions, body image and genital self-image during the first pregnancy on female sexual functions. Materials and Method: In this study, which was designed as a prospective longitudinal controlled study, primigravid pregnant women (n=330) followed up at Ankara University, Department of Obstetrics and Gynecology Pregnancy Polyclinic between April 2021 and August 2022, and Ankara University, Obstetrics and Gynecology Department Gynecology Polyclinic sexually active women who did not become pregnant before (n=130) as a control group were included. Data on study follow-up forms, age, height, weight, body mass index, occupation, educational status, habits, personal and family history, and characteristics of sexual relations with their spouses were recorded regarding the socio-demographic and clinical characteristics of the volunteers participating in the study. Body image, genital self-image, pelvic floor functions and sexual functions of the women who were not pregnant before were analyzed and compared with the first trimester measurements of the primigravid pregnant group. The differences between trimesters of all measurements determined for all three trimesters of pregnancy were analyzed, the difference of sexual functions between trimesters was revealed, and the effects of body image, genital self-image and pelvic floor functions measured for each trimester during pregnancy on sexual functions were analyzed separately for each trimester. In order to evaluate body image, female genital self-image, pelvic floor functions and sexual functions in all three trimesters in primigravid pregnants who were volunteers and included in the study, and in the control group, sexually active volunteers who had never been pregnant before; The Turkish-validated forms of the Body-Cathexis Scale (BCS), The Female Genital Self-Image Scale (FGSIS), Pelvic Floor Distress Inventory-Short Form(PFDI-20), Female Sexual Function Index(FSFI) questionnaires were filled in. Results: The FSFI score was observed to be impaired in the primigravid pregnant group compared to the control group, and FSFI scores decreased in all trimesters of pregnancy (p<0.001, p<0.001, p<0.001, p<0.001), In the first pregnancy, it was observed that body image satisfaction decreased in the first trimester, increased in the second trimester and decreased again in the third trimester (p<0.001), genital self-image did not show a significant difference (p=0.859), and PFDI-20 scores increased as the pregnancy progressed (p=0.004). In the first and second trimesters, sexual functions were associated with body image, genital self-image and PFDI-20 (p<0.001, p=0.001 for body image; p=0.003, p=0.001 for genital self-image; p<0.001, p=0,046 for PFDI-20); It was found that it was only related to body image in the third trimester (p=0.010). Conclusion: Sexual functions are negatively affected from the first pregnancy. In our study, it was determined that sexual functions were affected by the changes in body image, genital self-image and pelvic floor functions that occurred during the first pregnancy period. Keywords: sexual functions during pregnancy, body image, genital self-image, FSFI, PFDI-20