Eliane Perrin

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.

Induced abortion and psychosexuality.

Little information exists on the impact of induced abortion on psychosexuality. Negative psychological effects and psychiatric complications due to termination of pregnancy seem to be rare. The objective of this study was to review the impact of induced abortion on sexuality and couple relationships. A systematic search of the literature was performed. Studies had to report a quantitative or qualitative evaluation of sexuality after pregnancy termination. Four studies were included. In the one prospective study using a control group, no difference in sexual functioning between groups after 1 year was reported. In the remaining observational studies, sexual dysfunction was reported in up to 30% of women after termination. Women undergoing abortion had significantly more conflicts in their partnerships. This was similar in all studies. Separation occurred in about one-quarter of all couples. Some studies report sexual dysfunction after termination of pregnancy. In about half of the couples separated after termination, abortion seemed not to have led to the separation. Psychological factors, together with relationship problems, might have played a role in failed contraception. The impact of induced abortion on sexuality needs to be studied in greater detail with rigorous methodology to draw firm conclusions.

Le point de vue d'une sociologue

RésuméLes outils utilisés pour aborder la douleur dépendent étroitement des postulats de base des chercheurs. Le postulat de la médecine et des sciences dites “exactes” occidentales considère que si la douleur est universelle, les instruments de recherche doivent l’être aussi. Le postulat des sciences humaines considère que, si tous les êtres humains ressentent douleurs et souffrance, ce sont les cultures et les sociétés qui leur donnent forme et sens. Par conséquent, les instruments de recherche ne sauraint être universels. Trois exemples de recherche réalisées portant sur les douleurs de dos et sur la souffrance des joggers illustrent ce lien étroit entre postulats, manières d’aborder la douleur et résultats obtenus.SummaryTools used to study pain are closely linked to the researcher’s basic assumptions. Western medicine and “exact” sciences assume that if pain is universal, the instruments devised to measure it have to fulfil the same characteristics. Human sciences assume that if all human beings experience pain and suffering, these experiences are shaped through the societies and the cultures the individuals belong to. Therefore research tools cannot be universal. Three examples drawn from studies dealing with back pain and pain in joggers illustrate this tight link between assumptions, ways of considering pain and subsequent results.