Non‐pharmacologic therapies for treating sexual dysfunction during pregnancy: A systematic review and meta‐analysis

Sexual dysfunction during pregnancy is a common problem, and can occur as the result of various physical, hormonal, and emotional changes that women experience during this period. Non-pharmacologic treatments are recommended due to the restrictions on medications during this period. To summarize the evidence on non-pharmacologic interventions for treating sexual dysfunction during pregnancy. Searches were conducted in PubMed, Scopus, Web of Science, Embase, PsycINFO, PEDro, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov. We included randomized clinical trials comparing interventions for treating sexual dysfunction during pregnancy. From these search results, studies were selected, and data was extracted by two authors independently. The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). RevMan 5.4. was used for data synthesis. The Grading of Recommendations Assessment Development (GRADE) and Evaluation method was used to evaluate the strength of the evidence. We retrieved a total of 9017 articles. Twenty-four studies met the eligibility criteria and were included in the systematic review, and nine studies were included in the meta-analysis. The total number of participants was 1557, with a mean age ranging from 19.3 to 30.7 years and a gestation ranging from 8.9 to 28.3 weeks. Patients undergoing cognitive behavioral therapy (CBT) had a mean increase of 6.82 in their Female Sexual Function Index (FSFI) total score (range 1.63-12.01, P = 0.010, I2 = 3%). For the Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT) model, the mean total FSFI score was 6.07 points higher (range 3.80-8.35, P = 0.00001, I2 = 80%), and for the sex education intervention, the mean total score was 5.82 points higher (range 4.19-7.46, P = 0.00001, I2 = 81%) than the control group. CBT, the PLISSIT model, and sexual education for pregnant women can improve sexual function during the gestational period.