Introduction

Women often experience more problems in sexual functioning after childbirth. Due to the high prevalence of sexual problems during the lactation period, the World Health Organization suggested measures are needed to improve women's sexual functioning during breastfeeding. The present study investigated the effect of auricular acupressure on sexual functioning among lactating women.

Methods

A randomized, sham-controlled trial was conducted between October 2019 to March 2020 in urban comprehensive health centers of Qazvin, Iran. Seventy-six women who had been lactating between six months and one year postpartum were randomly assigned to auricular acupressure group (n = 38) or sham control group (n = 38) using a balanced block randomization method. The intervention group received ear acupressure in 10 sessions (at four-day intervals) and control group also received the sham intervention at the same intervals. Sexual functioning was the primary outcome of the study (assessed using the Female Sexual Function Index) before and at three time points post-intervention (immediately after, one month after, and two months after). The secondary outcome was sexual quality of life assessed using Sexual Quality of Life-Female Version.

Results

Auricular acupressure had a large effect size on female sexual functioning at all three post-intervention time points: immediately after the intervention (adjusted mean difference [95% CI]: 8.37 [6.27; 10.46] with Cohen's d [95% CI]: 1.81[1.28; 2.34]), one month after the intervention (adjusted mean difference [95% CI]: 8.44 [6.41; 10.48] with Cohen's d [95% CI]: 2.01 [1.46; 2.56]), and two months after the intervention (adjusted mean difference [95% CI]: 7.43 [5.12; 9.71] with Cohen's d [95% CI]: 1.57 [1.06; 2.08]). The intervention significantly increased participants’ sexual quality of life on the Sexual Quality of Life-Female scale by 13.73 points in the intervention group compared to the control group (p<0.001). The effect size of intervention for female sexual quality was large (adjusted Cohen's d [95% CI]: 1.09 [0.58; 1.59]). Weekly frequency of sexual intercourse in the intervention group significantly increased compared to sham control group (p<0.001). These changes were clinically significant for sexual functioning and sexual quality of life.

Conclusion

Auricular acupressure appears to be an effective intervention for improving sexual functioning and sexual quality life of lactating women.

Clinical trial registration

Registered with the code of IRCT20190626044028N1 in the Clinical Trial Registration Center of Iran.

中文翻译：

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耳穴按摩对哺乳期妇女性功能的影响：一项随机假对照试验

介绍

女性在分娩后往往会遇到更多性功能问题。由于哺乳期性问题的发生率很高，世界卫生组织建议采取措施改善妇女在母乳喂养期间的性功能。本研究调查了耳穴按摩对哺乳期妇女性功能的影响。

方法

2019 年 10 月至 2020 年 3 月在伊朗加兹温城市综合卫生中心进行了一项随机、假对照试验。76 名产后 6 个月至 1 年间处于哺乳期的妇女被随机分配到耳穴按摩组 ( n  = 38) 或假对照组 ( n = 38) 使用平衡块随机化方法。干预组接受耳穴按摩10次（间隔四天），对照组也以相同的间隔接受假干预。性功能是该研究在干预前和干预后三个时间点（干预后立即、一个月后和两个月后）的主要结果（使用女性性功能指数评估）。次要结果是使用性生活质量女性版评估性生活质量。

结果

耳穴按摩在干预后的所有三个时间点对女性性功能都有很大影响：干预后立即（调整后平均差 [95% CI]：8.37 [6.27；10.46] 与 Cohen's d [95% CI]：1.81） [1.28; 2.34]），干预后一个月（调整后平均差 [95% CI]：8.44 [6.41；10.48] 与 Cohen's d [95% CI]：2.01 [1.46；2.56]），以及干预后两个月干预（调整平均差 [95% CI]：7.43 [5.12；9.71] 与 Cohen's d [95% CI]：1.57 [1.06；2.08]）。与对照组相比，干预组的参与者在性生活质量量表上的性生活质量显着提高了 13.73 分（p<0.001）。干预对女性性质量的影响很大（调整后的 Cohen's d [95% CI]：1.09 [0.58；1.59]）。与假手术对照组相比，干预组每周性交频率显着增加（p <0.001）。这些变化对于性功能和性生活质量具有临床意义。

结论

耳穴按摩似乎是改善哺乳期妇女性功能和性质量生活的有效干预措施。

临床试验注册

在伊朗临床试验注册中心注册，代码为IRCT20190626044028N1。