Are cesarean sections protective versus vaginal deliveries for the development of childbirth-related female sexual dysfunction in the long-term?

摘要

Problem: Female sexual dysfunction is a topic in women's health that has recently been gaining attention. While the subject is becoming more widely researched and understood, it is believed that childbirth can have a negative impact on women's sexual function postpartum. Cesarean sections have been theorized to prevent the development of female sexual dysfunction through bypassing the birth canal and thus avoiding injury to the pelvic floor; however, the question of whether or not a cesarean section versus a vaginal delivery is truly protective against the development of sexual problems is unknown. Methods: The literature search for this review focused on postpartum sexual dysfunction between January 1995 to May 2009, via PubMed, Cochrane Library of Systematic Reviews, and Ovid. However, after the initial search, the results were limited; therefore, the references from the systematic reviews were utilized and the studies that had been reviewed specifically for sexual dysfunction were selected if they were available through the Weill Cornell Medical Library. Results: While no true consensus has been established on whether or not cesarean sections are truly protective against the development of female sexual dysfunction, the majority of studies reviewed for this literature search concluded that cesarean deliveries are not protective against the development of female sexual dysfunction versus vaginal deliveries. However, three of the studies reviewed here concluded that cesareans sections, in fact, do offer some short-term protection by preserving the perineum. Conclusions: While it seems that cesarean sections may offer some protection for the development of female sexual dysfunction in the short-term, a long-term study is needed to determine whether or not cesarean sections are effective in preventing the development of female sexual dysfunction versus vaginal deliveries in the long-term.