The effect of ear acupressure on sexual functioning among lactating women: A randomized sham controlled trial

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.