Covid19: consequences on women's sexual lives

From work to school to socialization, the COVID-19 it has impacted virtually every aspect of our lives, and now research from Boston University has shown that this includes what happens in the bedroom. A study of more than 2,000 cisgender women found that coronavirus disease can impair sexual function, and long-term COVID has a particularly harmful effect.

The results of research were recently published in the Journal of Sexual Medicine.

Covid19 and long covid affect women's sexual lives

“If you have COVID, you're probably less interested in sex and maybe your body is less prepared to have sex,” says Amelia M. Stanton, assistant professor of psychological and brain sciences in the BU College of Arts & Sciences. “But what may be surprising to some people is that prolonged Covid19 symptoms can actually have a physiological and psychological impact on women's sexual well-being.”

While previous research has studied the pandemic's effects on people's sexual lives, particularly men's, Stanton says this is the first study to highlight COVID's long-lasting impacts on women's sexual health. An expert in sexual and mental health, she helped conduct the study with researchers from Middlebury College, McLean Hospital and the University of Vermont.

To understand COVID's impact on intimacy, Stanton and his colleagues conducted an online survey. About half of the participating women reported never having had COVID, the rest said they had tested positive.

Participants were questioned using the Female Sexual Function Index (FSFI), a well-established tool that measures factors such as arousal and satisfaction with questions such as: “In the past 4 weeks, how often have you felt sexual desire?” Only women who had had sexual intercourse in the previous month were included in the results.

Among those who had had Covid19, levels of desire, arousal, lubrication and satisfaction were all lower than among those who had not had it; orgasm and pain scores were not significantly different between the two groups.

While women in the COVID group were still classified within the functional range of the index, participants with long COVID had “an average FSFI scale score in the dysfunctional range,” according to the researchers. They found that women with long COVID — a broad condition with cognitive and physical symptoms that persist for weeks, sometimes months, after an initial infection — had markedly worse arousal, lubrication, orgasm and pain scores.

“I hope it's valid. If women type 'Sex Long COVID,' something will come up,” says Stanton, who is also a clinical psychologist at the Fenway Institute, a Boston clinic focused on the health of sexual and gender minorities. . “Sex, sexuality and sexual function are still relatively taboo topics. But this offers something that patients can take to their providers and say, 'This is happening to me, too,' and maybe create an open dialogue about sex.”

In their article, Stanton and his colleagues say that the findings suggest “that Covid19 infection may be associated with a deterioration in both cognitive and physiological aspects of sexual function”. Just as your body and mind may need some time to get back to full swing when it comes to work, study and exercise, the same may be true for sex.

We also hypothesize that broader social changes caused by the pandemic may be a factor, with fewer social events and children staying at home reducing opportunities for shared or solitary sexual activity.

While a Covid19 infection can impact women's sexual health, previous BU research has found that vaccination does not cause infertility, reduce the chances of pregnancy or have a significant impact on menstruation.

“COVID vaccination in either partner is not related to fertility among couples trying to conceive through sexual intercourse,” Amelia Wesselink, SPH research assistant professor of epidemiology, told The Brink in 2022, discussing her study on vaccines and fertility. The same research, however, found that men who tested positive for Covid19 in the last 60 days had reduced fertility.

Stanton is the principal investigator of BU's Sexual, Reproductive and Mental Health Disparities Program, an effort to explore sexual and mental health in minority and marginalized populations, and says possible future avenues for the latest project would be to expand the study's sexual and gender minority diversity, speak to women for their qualitative experiences, and design tools to help providers better support their patients.

“I'm an interventionist, so I always think about designing the intervention as the next step,” Stanton says. In other research, he is working to develop new approaches that doctors can use to talk about sex with their patients, as well as studying how to improve sexual well-being and mental health in under-resourced communities.

“I always encourage providers to start conversations about sex,” says Stanton. “If they have someone coming in for a long period of Covid19, maybe
ask, 'How are you sexually?' Asking that question might open the door for people to say, “You know, I was embarrassed to say that all this is happening and I really need help.” In any case, we can tell people that there is hope and that there are strategies: your symptoms are significant and relevant, and it is important to talk about them.”

A further study conducted in Turkey found that women's sexual desire and frequency of intercourse increased during the Covid19 pandemic, but their quality of sexual life decreased. The results are published in the International Journal of Gynecology & Obstetrics.

In the study of 58 women, women had sex an average of 2.4 times per week during the pandemic, compared to 1.9 times in the 6 to 12 months before the pandemic. Before the pandemic, 32.7% of participants wanted to become pregnant, compared to 5.1% during the pandemic; however, contraception use has declined during the pandemic.

Menstrual disorders were more common during the pandemic than before (27.6% versus 12.1%), and participants generated worse scores on a sexual function-based questionnaire during the pandemic than scores before the pandemic.

The Lancet commentary “Centering sexual and reproductive health and justice in the global response to COVID-19” highlights the harmful impact of the global response to the Covid19 pandemic on sexual and reproductive health and rights (SRHR).

The article highlights the threat to SRH services caused by policies designating these services as non-essential and diverted resources, and calls for vigilance from the SRH community to prevent access to these services from being lost. “Global responses to the coronavirus disease 2019 (COVID-19) pandemic are converging with pervasive sexual and reproductive health and justice inequalities, disproportionately impacting the health, well-being and economic stability of women, girls and vulnerable populations,” writes Terry McGovern, chair of the Heilbrunn Department of Population and Family Health, and co-authors.

Highlighting the disproportionate social and economic burden placed on women, girls and vulnerable populations by the pandemic, the authors argue that “a sexual and reproductive health and justice framework, which places human rights at its centre, recognizes intersecting injustices, recognizes power structures and unites across identities – is essential to monitor and address the unjust gender, health and social consequences of Covid19.

The authors, a multidisciplinary group of academics and professionals, including epidemiologists, health workers, lawyers and community organizers, have experience in the provision of and access to sexual and reproductive health services, gender-based violence, global humanitarian response , in human rights, disease surveillance, stigma and the specific needs of women, girls and vulnerable populations.

“Advocates must continue to fight the exploitation of the Covid19 crisis to advance an agenda that limits access to essential sexual and reproductive health services, particularly abortion, and targets immigrants and adolescents,” she said. noted McGovern, who is also director of the Abortion Program. Global Health Justice and Governance at Columbia Mailman School.

Access to contraception has been reduced during the Covid19 pandemic. According to a study published in the Journal of Women's Health, this had a particular impact on people who experienced job and financial instability.

Megan Kavanaugh, DrPH, MPH, of the Guttmacher Institute, and coauthors identified the prevalence and patient and clinic characteristics associated with delays in accessing sexual and reproductive health care due to the COVID-19 pandemic in three states . More than half of respondents in Arizona (57%), 38% in Iowa, and 30% in Wisconsin were unable to access or indicated a delay in accessing sexual and reproductive health care or effective contraception. due to the Covid19 pandemic.

In three states, people who had experienced financial instability due to unemployment, delayed major payments, or reduced or lost jobs due to Covid19 were more likely to experience delays in sexual and reproductive health care.

“Importantly, our findings highlight only a small part of the larger picture of how individuals' reproductive autonomy has been hindered due to the pandemic,” the researchers concluded. “Further research is warranted into the extent to which these COVID-19-related delays have resulted in subsequent negative consequences for individuals, such as having to rely on less preferred contraceptive methods, forgoing contraception altogether, and/or experiencing unintended pregnancies. ”

“Although researchers demonstrated Covid-19-related delays in accessing sexual and reproductive health care linked to financial instability, the findings revealed no association between health insurance coverage and Covid-19-related delays in access.” , says the editor of the Journal of Women's Health. -in-Chief Susan G. Kornstein, MD, Executive Director of the Institute for Women's Health at Virginia Commonwealth University, Richmond, Virginia.