An analytic cross-sectional study of Somali women on the sexual and psychosocial status during pregnancy.

BACKGROUND: Pregnancy is associated with physical, psychological, hormonal, and social alterations that may lead to detrimental effects on sexual function and psychological well-being. This study sought to examine sexual function and psychosocial well-being of pregnant women in Somalia in comparison with their non-pregnant counterparts. METHODS: We enrolled 487 consecutive women in monogamous marriages. Data included maternal age, gravida, parity, gestational week, education status of wives and husbands, and residence area. The participants completed the Female Sexual Function Index (FSFI) and the Brief Symptom Inventory-18 (BSI-18). RESULTS: Of 487 women, 241 were pregnant, and 246 were non-pregnant. The overall incidence of sexual dysfunction was 57.7%, being 64.0% for pregnant and 51.6% for non-pregnant women (p = 0.010). Pregnant women exhibited significantly lower FSFI scores on desire, arousal, lubrication, and orgasm, and significantly higher total BSI, anxiety, depression and somatization scores. The frequencies of sexual dysfunction were 57.9%, 45.9%, and 78.9% during the first, second, and third trimesters, respectively (p = 0.0001). As compared with the first and second trimesters, and non-pregnancy, the third trimester of pregnancy was associated with a significantly lower total FSFI score and significantly decreased levels of desire, arousal, lubrication, and orgasm, as well as a significantly higher total BSI score and a significantly increased level of anxiety. In regression analysis, pregnancy was inversely associated with sexual function parameters of desire, arousal, lubrication, and orgasm, and with BSI parameters of depression, anxiety and somatization. CONCLUSION: Our findings suggest that pregnant women experience considerable sexual and psychosocial deterioration as compared with their non-pregnant counterparts.

The psychosexual and psychosocial impacts of polygamous marriages: a cross-sectional study among Somali women.

BACKGROUND: Polygamous marriages are common in many Africa countries. This study aimed to document psychosexual and psychosocial problems of Somali women engaged in monogamous or polygamous marriages. METHODS: This cross-sectional study included 607 consecutive women who had presented between June 7 and October 1, 2022, to the Department of Gynaecology of Mogadishu Somali Turkey Training and Research Hospital in Mogadishu, the capital city of Somalia. Data included maternal age, type of marriage (polygamy, monogamy, and arranged marriage), wives' education, husbands' education, husband income, residence area (rural or urban), number of marriages, living in houses (same or different), number of co-wives, and age of marriage. The participants were asked to complete three questionnaires: The Female Sexual Function Index (FSFI), the Rosenberg Self-Esteem Scale (RSE), and the Brief Symptom Inventory-18 (BSI-18). RESULTS: Of 607 women, 435 (71.7%) had monogamous marriages and 172 (28.3%) had polygamous marriages. The mean age was 29.0 ± 7.2 years (range 16-46). In polygamous marriages, the mean number of wives a husband had was 2.4 ± 0.7 women (range 2- 4). The overall incidences of sexual dysfunction, low self-esteem and arranged marriage were 59.8%, 79.4% and 64.4%, respectively. Wives in polygamous marriages differed from those in monogamous marriages with significantly higher rate of illiterateness (41.9% vs. 27.4%, p = 0.004). Increases in husband income corresponded to higher rates of polygamous marriage. Women in polygamous marriages had significantly lower scores in the desire, arousal, orgasm, and satisfaction sub-domains. Sexual dysfunction, with a significantly increased rate among women in polygamous marriages. Polygamous marriages were associated with significantly higher levels of anxiety, and depression, and a significantly higher total BSI score (p = 0.010, p = 0.004, and p = 0.020, respectively). Women in both groups had similar levels of low self-esteem (p > 0.05). In univariate analysis, polygamous marriage was in significant inverse associations with the total FSFI score and subdomain scores of desire, arousal, orgasm, satisfaction, and sexual dysfunction and in significant associations with the BSI total score and subdomain scores of anxiety and depression (p < 0.05). CONCLUSION: Our findings suggest that women in polygamous marriages experience considerably higher psychosexual and psychosocial adverse effects as compared with their monogamous counterparts.