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Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function

  • Megan Galbally (a1) (a2) (a3), Stuart J. Watson (a1) (a2), Michael Permezel (a4) and Andrew J. Lewis (a1)



There is an established relationship between depression and sexual functioning in women. However, there is limited research examining the relationship between perinatal depression and sexual functioning.


This study draws on the Mercy Pregnancy and Emotional Wellbeing Study and reports on 211 women recruited in early pregnancy and followed to 12 months postpartum. Women were assessed for depression using the Structured Clinical Interview for the DSM-IV, repeated measurement of depressive symptoms using the Edinburgh Postnatal Depression Scale and sexual functioning using the Female Sexual Functioning Inventory. Data were also collected on antidepressant use, mode of delivery, history of childhood trauma, breastfeeding and partner support.


Women showed a decline in sexual functioning over pregnancy and the first 6 months postpartum, which recovered by 12 months. For women with depression, sexual functioning was lower throughout pregnancy and continued to be lower at 6 months postpartum than those without depression. Ongoing depressive symptoms at 12 months were also associated with lower sexual functioning. Sexual functioning was not predicted by mode of delivery, antidepressant use or childhood trauma. Breastfeeding predicted lower sexual functioning only at 6 months. Higher partner support predicted higher female sexual functioning.


Pregnancy and the postpartum are a time of reduced sexual functioning for women; however, women with depression are more likely to have lower levels of sexual functioning and this was not predicted by antidepressant use. In women with perinatal depression, consideration of the impact on sexual functioning should be an integral part of care.


Corresponding author

Author for correspondence: Megan Galbally, E-mail:


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Asselmann, E, Hoyer, J, Wittchen, H-U and Martini, J (2016) Sexual problems during pregnancy and after delivery among women with and without anxiety and depressive disorders prior to pregnancy: a prospective-longitudinal study. The Journal of Sexual Medicine 13, 95104.
Australian Bureau of Statistics (2016) Australian Standard Classification of Cultural and Ethnic Groups, cat. no. 1249.0. Canberra, ACT: Commonwealth of Australia.
Bakker, MK, Kolling, P, van den Berg, PB, de Walle, HE and de Jong van den Berg, LT (2008) Increase in use of selective serotonin reuptake inhibitors in pregnancy during the last decade, a population-based cohort study from the Netherlands. British Journal of Clinical Pharmacology 65, 600606.
Bernstein, DP, Stein, JA, Newcomb, MD, Walker, E, Pogge, D, Ahluvalia, T, Stokes, J, Handelsman, L, Medrano, M, Desmond, D and Zule, W (2003) Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect 27, 169190.
Bollen, KA and Curran, PJ (2006) Latent Curve Models: a Structural Equation Perspective. Hoboken, NJ: Wiley.
Boyce, P, Stubbs, J and Todd, A (1993) The Edinburgh postnatal depression scale: validation for an Australian sample. Australian and New Zealand Journal of Psychiatry 27, 472476.
Cooper, WO, Willy, ME, Pont, SJ and Ray, WA (2007) Increasing use of antidepressants in pregnancy. American Journal of Obstetrics and Gynecology 196, 544 e1–5.
Cox, JL, Holden, JM and Sagovsky, R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. The British Journal of Psychiatry 150, 782786.
Cyranowski, JM, Frank, E, Cherry, C, Houck, P and Kupfer, DJ (2004) Prospective assessment of sexual function in women treated for recurrent major depression. Journal of Psychiatric Research 38, 267273.
De Souza, A, Dwyer, P, Charity, M, Thomas, E, Ferreira, C and Schierlitz, L (2015) The effects of mode delivery on postpartum sexual function: a prospective study. BJOG: An International Journal of Obstetrics & Gynaecology 122, 14101418.
Dias, CC and Figueiredo, B (2015) Breastfeeding and depression: a systematic review of the literature. Journal of Affective Disorders 171, 142154.
DiLillo, D (2001) Interpersonal functioning among women reporting a history of childhood sexual abuse: empirical findings and methodological issues. Clinical Psychology Review 21, 553576.
Fabre, LF and Smith, LC (2012) The effect of major depression on sexual function in women. Journal of Sexual Medicine 9, 231239.
First, M, Spitzer, R, Gibbon, M and Williams, J (1997) Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. Washington, DC and London: American Psychiatric Press, Inc.
Galbally, M, van, IM, Permezel, M, Saffery, R, Lappas, M, Ryan, J, van Rossum, E, Johnson, AR, Teti, D and Lewis, AJ (2017) Mercy Pregnancy and Emotional Well-being Study (MPEWS): understanding maternal mental health, fetal programming and child development. Study design and cohort profile. International Journal of Methods in Psychiatric Research 26, e1558.
Galbally, M, Watson, SJ, Ball, H and Lewis, AJ (2018) Breastfeeding, antidepressants, and depression in the mercy pregnancy and emotional well-being study. Journal of Human Lactation (OnlineFirst), 110.
Giallo, R, Pilkington, P, McDonald, E, Gartland, D, Woolhouse, H and Brown, S (2017) Physical, sexual and social health factors associated with the trajectories of maternal depressive symptoms from pregnancy to 4 years postpartum. Social Psychiatry and Psychiatric Epidemiology 52, 815828.
Heim, C, Newport, DJ, Mletzko, T, Miller, AH and Nemeroff, CB (2008) The link between childhood trauma and depression: insights from HPA axis studies in humans. Psychoneuroendocrinology 33, 693710.
Howard, LM, Megnin-Viggars, O, Symington, I and Pilling, S (2014) Antenatal and postnatal mental health: summary of updated NICE guidance. BMJ: British Medical Journal (Online) 349, g7394.
Hu, L-T and Bentler, PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal 6, 155.
IBM Corp. (2016) IBM SPSS Statistics for Windows. Armonk, NY: IBM Cop.
Isidori, AM, Pozza, C, Esposito, K, Giugliano, D, Morano, S, Vignozzi, L, Corona, G, Lenzi, A and Jannini, EA (2010) Development and validation of a 6-item version of the Female Sexual Function Index (FSFI) as a diagnostic tool for female sexual dysfunction. Journal of Sexual Medicine 7, 1139.
Jimenez-Solem, E, Andersen, JT, Petersen, M, Broedbaek, K, Andersen, NL, Torp-Pedersen, C and Poulsen, HE (2013) Prevalence of antidepressant use during pregnancy in Denmark, a nation-wide cohort study. PLoS ONE 8, e63034.
Kahramanoglu, I, Baktiroglu, M, Hamzaoglu, K, Kahramanoglu, O, Verit, FF and Yucel, O (2017) The impact of mode of delivery on the sexual function of primiparous women: a prospective study. Archives of Gynecology and Obstetrics 295, 907916.
McBride, HL and Kwee, JL (2017) Sex after baby: women's sexual function in the postpartum period. Current Sexual Health Reports 9, 142149.
Meyer-Bahlburg, HFL and Dolezal, C (2007) The female sexual function index: a methodological critique and suggestions for improvement. Journal of Sex & Marital Therapy 33, 217224.
Muthén, LK and Muthén, BO (1998–2012) Mplus User's Guide, Sixth Edition. Los Angeles, CA: Muthén & Muthén.
Rini, C, Schetter, CD, Hobel, CJ, Glynn, LM and Sandman, CA (2006) Effective social support: antecedents and consequences of partner support during pregnancy. Personal Relationships 13, 207229.
Rosen, CB, Heiman, J, Leiblum, S, Meston, C, Shabsigh, R, Ferguson, D and D'Agostino, R (2000). The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex & Marital Therapy 26, 191208.
Saberi, N, Akbari, SAA, Mahmoodi, Z and Nasiri, M (2017) The relationship between psychological status (Depression and Anxiety) and social support and sexual function. Advances in Nursing & Midwifery 27, 18.
Satorra, A and Bentler, PM (2010) Ensuring positiveness of the scaled difference Chi-square test statistic. Psychometrika 75, 243248.
Serati, M, Salvatore, S, Siesto, G, Cattoni, E, Zanirato, M, Khullar, V, Cromi, A, Ghezzi, F and Bolis, P (2010) Female sexual function during pregnancy and after childbirth. Journal of Sexual Medicine 7, 27822790.
Song, M, Ishii, H, Toda, M, Tomimatsu, T, Katsuyama, H, Nakamura, T, Nakai, Y and Shimoya, K (2014) Association between sexual health and delivery mode. Journal of Sexual Medicine 2, 153158.
Speilberger, CD, Goruch, RL, Luchene, PR, Vagg, PR and Jacobs, GA (1983) Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press.
Wallwiener, S, Müller, M, Doster, A, Kuon, RJ, Plewniok, K, Feller, S, Wallwiener, M, Reck, C, Matthies, LM and Wallwiener, C (2017) Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study. Archives of Gynecology and Obstetrics 295, 873883.
Yeniel, AO and Petri, E (2014) Pregnancy, childbirth, and sexual function: perceptions and facts. International Urogynecological Journal 25, 514.


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Depression across pregnancy and the postpartum, antidepressant use and the association with female sexual function

  • Megan Galbally (a1) (a2) (a3), Stuart J. Watson (a1) (a2), Michael Permezel (a4) and Andrew J. Lewis (a1)


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