Pregnancy and Sex: Why the Common Test for Women's Health May Deceive

Have you ever filled out a questionnaire about your sexual health at the gynecologist? Many have heard of the Female Sexual Function Index—a test with 19 questions covering desire, arousal, lubrication, orgasm, satisfaction, and pain. It is often given to women to identify potential issues. But here's the catch: this test was designed for the general female population, not for those who are expecting a baby or have just given birth. Yet during this period, sexual difficulties are not uncommon: depending on the data, they affect between 36 and 88 percent of women. Low desire, difficulties with arousal, dryness, pain, and problems with orgasm are all typical during pregnancy and the first months after childbirth. But how much can we trust this questionnaire in such circumstances? Researchers decided to find out.

The researchers took data from women who were sexually active during pregnancy or after childbirth and analyzed how responses to the test questions functioned. What did they discover? First, the test measures six distinct domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. These domains do work—each assesses something specific. However, summing them into a single total score, as is often done in clinical practice, is not valid! The overall score was not confirmed: it does not reflect the real picture. This is important because many clinicians like to say, "Your score is 20, which is below the normal range." In reality, such a conclusion may be erroneous specifically for pregnant and postpartum women.

Another nuance: the test distinguishes well between problems in women with low and moderate levels of sexual functioning. That is, if you are struggling significantly, the questionnaire will detect it. But if you are doing fine or even excellently, the test becomes less sensitive. It seems designed to catch difficulties rather than joys. Furthermore, most items on the questionnaire effectively differentiate women who have sexual problems from those who do not. But there are two weak points: questions about arousal and satisfaction. These perform worse, so they should not be relied upon heavily.

What does this mean for you? If you are expecting a baby or recently gave birth and take such a questionnaire, remember: the total score can be misleading. Instead of panicking over a low number, ask your doctor to look at specific domains—for example, desire or pain. And do not hesitate to describe your feelings in your own words: the test is merely a guide, not a verdict. The researchers themselves acknowledge that further studies are needed to refine how best to assess sexual health during this period. Meanwhile, trust yourself and your feelings more than an impersonal score on a questionnaire.