Marital Satisfaction Plays Key Role in Sexual Function Among Pregnant Women with Gestational Diabetes

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No significant relationship between obesity and sexual dysfunction was observed among pregnant women with gestational diabetes mellitus, according to a study published in Health Science Reports. However, marital satisfaction and body mass index (BMI) greatly impacted sexual function.

As more than half of the participants reported experiencing sexual dysfunction, the findings highlight the need for further research into the impact of obesity and gestational diabetes mellitus on sexual health.

“Sexuality is a vital aspect of overall health and well-being, influenced by multiple factors such as biology, psychology, society, culture and religion,” wrote a group of investigators from the Mazandaran University of Medical Sciences in Sari, Iran. “Sexual dysfunction, a common disorder in both men and women, receives particular attention in sexual health. However, female sexual dysfunction often goes unnoticed.”

Reports estimate that sexual dysfunction—a term used to describe a range of problems that prevent people from engaging in fulfilling sexual relationships—affects approximately 40–50% of women. Additionally, many women report reduced sexual satisfaction and desire during pregnancy due to physical and psychological changes, among other factors. Obesity is another condition that can affect sexual function of women of reproductive age, and overweight or obese pregnant women are more likely to have symptoms of depression and anxiety that can lead to reduced quality of life and increased odds of sexual dysfunction.

To determine the relationship between sexual function, gestational diabetes mellitus and obesity, the cross-sectional study, conducted in Iran, included overweight and normal-weight pregnant women with gestational diabetes mellitus between 2018 and 2021. To evaluate sexual mental health, sexual functioning and marital satisfaction, investigators used the General Health Questionnaire, the Female Sexual Function Index (FSFI) questionnaire and the Enriched Marital Satisfaction questionnaire, respectively. Demographic information included age, gestational age, duration of marriage, number of births, education level, occupation, residence data and insurance status.

Ultimately, 200 women were included in the study, with a mean age of 29.75 years and 50% had a normal BMI.

Among these patients, 56.50% exhibited sexual dysfunction based on their FSFI score, as observed in 64% of women in the second trimester and 49.5% in the third trimester. No significant differences were observed between BMI status and the total sexual function score. However, BMI status did have a significant impact on the sexual desire subscale. In the second trimester, sexual desire and vaginal moisture was significantly linked to BMI.

When investigators compared the total FSFI questionnaire score—as well as its subscales—with the level of marital satisfaction score, women with higher levels of marital satisfaction were more likely to have normal sexual function. The subgroups that were most impacted by marital satisfaction were sexual arousal and sexual satisfaction.

According to the multivariate analysis, marital satisfaction and BMI status were significantly associated with overall sexual function, which accounts for the 27% variance in the total FSFI score.

The cross-sectional study design coupled with the self-reported patient data, which may have skewed results due to social desirability bias, limited the study. Additionally, recruiting patients from a single center may have hampered the generalizability of the results. Investigators encourage future research to use a longitudinal design with both self-reported data and objective tests, such as physiological evaluations. They also suggest studying sexual function in the same women across trimesters to better understand how sexual function changes during pregnancy.

“Considering that the research in this area is very limited and the negative effects of obesity and gestational diabetes mellitus have been confirmed in many areas, including sexual desire disorder, necessary planning should be done to control these factors,” investigators concluded.