Abortion, Spontaneous, Early Pregnancy Loss, Miscarriage, Pregnancy, Unwanted
Conditions
Keywords
abortion, sexual function, Female Sexual Function Index, FSFI, surgical abortion, medical abortion, pregnancy loss
Brief summary
This study compares the medium-term effects of surgical and medical abortion on sexual function in women who have experienced early pregnancy loss (6-12 weeks gestation). A total of 86 women (45 medical abortion, 41 surgical abortion) were followed for 6 months. Sexual function was measured using the Female Sexual Function Index (FSFI) before treatment and at 6 months after the procedure. The surgical abortion group showed a significant decline in total FSFI score at 6 months compared to baseline, with decreases observed in all six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The medical abortion group showed no significant change in total FSFI score. Between-group comparison at 6 months revealed significantly lower total FSFI scores in the surgical group compared to the medical group. These findings suggest that surgical abortion for early pregnancy loss is associated with a significant decline in sexual function that persists up to 6 months after the procedure, whereas medical abortion appears to have a neutral effect during the same period. Due to the non-randomized design, these findings should be considered hypothesis-generating.
Detailed description
This prospective, comparative cohort study was conducted at Harran University Faculty of Medicine between April 2025 and January 2026. Women aged 18-40 diagnosed with early pregnancy loss (6-12 weeks gestation) were allocated to surgical or medical abortion based on shared decision-making. The Female Sexual Function Index (FSFI) was used to evaluate sexual function before treatment and at 6 months follow-up. Statistical analyses were performed using non-parametric tests (Mann-Whitney U, Wilcoxon signed-rank) with Bonferroni correction. Effect sizes (r) were calculated for all primary outcomes.
Interventions
Participants received 200 mg oral mifepristone under supervision at the clinic, followed by 800 µg misoprostol administered at home 24-48 hours later.
PROCEDUREVacuum Aspiration
Participants underwent vacuum aspiration under local or general anesthesia in an operating room for early pregnancy loss at 6-12 weeks gestation.
Sponsors
Harran University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants were allocated to surgical or medical abortion based on shared decision-making with their physician.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* \- Diagnosis of early pregnancy loss (6-12 weeks gestation) * Planned to undergo either surgical or medical abortion * Age between 18 and 40 years * Proficiency in speaking and reading Turkish * Voluntary participation and provision of written informed consent
Exclusion criteria
* A known pre-existing diagnosis of sexual dysfunction (baseline FSFI total score ≤ 26.55) * A documented history of severe psychiatric disorders (e.g., schizophrenia, bipolar disorder) * History of chronic pelvic pain conditions (e.g., endometriosis, vulvodynia) or any other chronic medical condition known to significantly affect sexual function (e.g., unmanaged diabetes mellitus, multiple sclerosis) * Current use of medications that can impact sexual function (e.g., SSRIs, SNRIs, antipsychotics, antihypertensives) * Insufficient communication ability, defined as difficulty understanding and speaking Turkish or having cognitive/communication impairments that would prevent reliable completion of the study questionnaires
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Female Sexual Function Index (FSFI) Total Score | Baseline (pre-treatment) and 6 months post-abortion procedure | The FSFI is a 19-item, multidimensional self-report questionnaire assessing female sexual function over the past four weeks. It evaluates six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The total score is the sum of six domain scores (range 2-36). Lower scores indicate worse sexual dysfunction. A total score of ≤26.55 is the validated cutoff for female sexual dysfunction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in FSFI - Desire Domain Score | Baseline and 6 months | Desire domain consists of 2 items assessing sexual desire and interest over the past 4 weeks. Domain score range: 1.2-6.0. |
| Change in FSFI - Arousal Domain Score | Baseline and 6 months | Arousal domain consists of 4 items assessing sexual excitement and arousal over the past 4 weeks. Domain score range: 0-6.0. |
| Change in FSFI - Orgasm Domain Score | Baseline and 6 months | Orgasm domain consists of 3 items assessing ability to achieve orgasm over the past 4 weeks. Domain score range: 0-6.0. |
| Change in FSFI - Lubrication Domain Score | Baseline and 6 months | Lubrication domain consists of 4 items assessing vaginal lubrication during sexual activity over the past 4 weeks. Domain score range: 0-6.0. |
| Change in FSFI - Pain Domain Score | Baseline and 6 months | Pain domain consists of 3 items assessing pain during vaginal penetration and sexual activity over the past 4 weeks. Domain score range: 0-6.0. |
| Change in FSFI - Satisfaction Domain Score | Baseline and 6 months | Satisfaction domain consists of 3 items assessing sexual satisfaction over the past 4 weeks. Domain score range: 0.8-6.0. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORömer tammo
Harran University
Outcome results
None listed