Termination of pregnancy and women's sexuality.

Objective: To determine the influence of termination of pregnancy (TOP) on women's sexuality.

Design: Prospective qualitative and quantitative study.

Subjects: 103 women undergoing induced abortion by vacuum aspiration, interviewed 1-3 weeks before surgery and 6 months later.

Results: After TOP, patients described symptoms of fatigue (39%), feelings of guilt (35%), sadness (34%) and anxiety (29%). Thirty-one percent of women presented at least one sexual dysfunction, 18% a decrease in sexual desire, 17% orgasmic disorders, 12% vaginal dryness and 11% dyspareunia. These sexual dysfunctions were correlated with anxiety and symptoms of depression following TOP. Six months after TOP, 57% of the women reported no change in their sexual satisfaction, 17% were 'more satisfied' and 7% 'less satisfied'. Lessening of sexual satisfaction after TOP was correlated with diminished partner satisfaction (p < 0.00001), fatigue (p < 0.0009), feelings of guilt (p < 0.01), low frequency of sexual relations (p < 0.01) and anxiety over sexual relations (p < 0.02).

Conclusions: Six months after TOP some women presented persisting sexual dysfunction. This sexual dysfunction may be explained essentially by the appearance of symptoms of anxiety and depression following TOP. When the quality of the relationship was satisfying, women could cope more easily with the appearance of a sexual dysfunction.