Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women



      The beginning of 2020 was characterized by the COVID-19 pandemic. The world governments have adopted restrictive measures to reduce the spread of infection. These measures could affect the sexual function and quality of life of women living with their partner.


      The aim is to assess the impact of the social distancing measures caused by the COVID-19 pandemic on sexual function and quality of life of noninfected reproductive-age women, living with their sexual partner.


      Observational analysis on sexually active women, living with their partner, and without COVID-19 infection was performed. The population previously answered FSFI, FSDS, and SF-36 questionnaires. 4 weeks after the introduction of the restrictive measures, these women were invited to complete the same questionnaires by e-mail for an evaluation during the COVID-19 outbreak.

      Main Outcome Measures

      The primary endpoint was the assessment of the women's sex function change during the social restriction period, by analyzing the FSFI and FSDS questionnaires. The secondary endpoint was the evaluation of the impact on the quality of life calculated by the SF-36 questionnaire.


      89 patients were considered. The median age was 39 (28–50) years. Mean sexual intercourses/month decreased from 6.3 ± 1.9 to 2.3 ± 1.8, mean difference: −3.9 ± 1.2. FSFI decreased significantly (29.2 ± 4.2 vs 19.2 ± 3.3, mean difference: −9.7 ± 2.6) and FSDS increased significantly (9.3 ± 5.5 vs 20.1 ± 5.2, mean difference: 10.8 ± 3.4). The SF-36 showed a significant change from 82.2 ± 10.2 to 64.2 ± 11.8 4 weeks after the introduction of the restrictive measures; mean difference: −17.8 ± 6.7. The univariable analysis identified working outside the home, university educational level, and parity ≥1 as predictive factors of lower FSFI. In multivariable analysis, working outside the home and combination of working outside the home + university educational level + parity ≥1 were the independent factors of a lower FSFI.

      Clinical Implication

      The negative impact of the COVID-19 epidemic period on sexual function and quality of life in women shows how acute stress might affect the psychological state. Thus, psychological or sexual support could be useful.

      Strengths and Limitations

      To our knowledge, this study is the first that analyzes the change in sexual activity in women during the COVID-19 outbreak period. The limitations were the low number of the analyzed participants, psychological tests were not included, and no data were collected on masturbation, self-heroism, solitary, and nonpenetrative sex.


      The COVID-19 epidemic and the restrictive social distancing measures have negatively influenced the sexual function and quality of life in not-infected reproductive-age women who live with their sexual partners.
      Schiavi MC, Spina V, Zullo MA, et al. Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women. J Sex Med 2020;17:1407–1413.

      Key Words

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        • Wang C.
        • Horby P.W.
        • Hayden F.G.
        • et al.
        A novel coronavirus outbreak of global health concern.
        Lancet. 2020; 395: 470-473
        • Paules C.I.
        • Marston H.D.
        • Fauci A.S.
        Coronavirus infections-more than just the common cold.
        JAMA. 2020; ([Epub ahead of print])
      1. European Centre for Disease Prevention and Control.
        (Available at:)
        • Chen N.
        • Zhou M.
        • Dong X.
        • et al.
        Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study.
        Lancet. 2020; 395: 507-513
        • Rothe C.
        • Schunk M.
        • Sothmann P.
        • et al.
        Transmission of 2019-nCoV infection from an asymptomatic contact in Germany.
        N Engl J Med. 2020; 382: 970-971
        • Carletti F.
        • Lalle E.
        • Messina F.
        • et al.
        About the origin of the first two Sars-CoV-2 infections in Italy: inference not supported by appropriate sequence analysis.
        J Med Virol. 2020; ([Epub ahead of print])
      2. Decreto del presidente del consiglio dei ministri (DPCM).
        (Available at:)
        • Nicoli F.
        • Gasparetto A.
        Italy in a time of emergency and scarce resources: the need for embedding ethical reflection in social and clinical settings.
        J Clin Ethics. 2020; 31: 92-94
        • Wang C.
        • Pan R.
        • Wan X.
        • et al.
        Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus disease (COVID-19) epidemic among the general population in China.
        Int J Environ Res Public Health. 2020; 17: 1729
        • Van Bortel T.
        • Basnayake A.
        • Wurie F.
        • et al.
        Psychosocial effects of an Ebola outbreak at individual, community and international levels.
        Bull World Health Organ. 2016; 94: 210-214
        • Cao W.
        • Fang Z.
        • Hou G.
        • et al.
        The psychological impact of the COVID-19 epidemic on college students in China.
        Psychiatry Res. 2020; 287: 112934
        • Hamilton L.D.
        • Meston J.C.M.
        Chronic stress and sexual function in women.
        Sex Med. 2013; 10: 2443-2454
        • Both S.
        • Brauer M.
        • Weijenborg P.
        • et al.
        Effects of aversive classical conditioning on sexual response in women with dyspareunia and sexually functional controls.
        J Sex Med. 2017; 14: 687-701
        • Wallwiener S.
        • Müller M.
        • Doster A.
        • et al.
        Sexual activity and sexual dysfunction of women in the perinatal period: a longitudinal study.
        Arch Gynecol Obstet. 2017; 295: 873-883
        • Arnold M.R.
        • Thallon C.L.
        • Pitkofsky J.A.
        • et al.
        Sexual experience confers resilience to restraint stress in female rats.
        Horm Behav. 2019; 107: 61-66
        • Guo L.
        • Chen Y.X.
        • Hu Y.T.
        • et al.
        Sex hormones affect acute and chronic stress responses in sexually dimorphic patterns: consequences for depression models.
        Psychoneuroendocrinology. 2018; 95: 34-42
        • Burholt V.
        • Nash P.
        Short form 36 (SF-36) health survey questionnaire: normative data for Wales.
        J Public Health (Oxf). 2011; 33: 587-603
        • Crisp C.C.
        • Felliner A.N.
        • Pauls R.N.
        Validation of the female sexual function index (FSFI) for web-based administration.
        Int Urogynecol J. 2015; 26: 219-222
        • Derogatis L.1
        • Clayton A.
        • Lewis-D'Agostino D.
        • et al.
        Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder.
        J Sex Med. 2008; 5: 357-364
        • Lima C.K.T.
        • Carvalho P.M.M.
        • Lima I.A.A.S.
        • et al.
        The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease).
        Psychiatry Res. 2020; 287: 112915
        • Li Z.
        • Ge J.
        • Yang M.
        • et al.
        Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control.
        Brain Behav Immun. 2020; ([Epub ahead of print])
        • Duan L.
        • Zhu G.
        Psychological interventions for people affected by the COVID-19 epidemic.
        Lancet Psychiatry. 2020; 7: 300-302
        • Eplov L.
        • Giraldi A.
        • Davidsen M.
        • et al.
        Sexual desire in a nationally representative Danish population.
        J Sex Med. 2007; 4: 47-56
        • Gunst A.
        • Werner M.
        • Waldorp L.J.
        • et al.
        A network analysis of female sexual function: comparing symptom networks in women with decreased, increased, and stable sexual desire.
        Sci Rep. 2018; 8: 15815
        • Mollaioli D.
        • Ciocca G.
        • Limoncin E.
        • et al.
        Lifestyles and sexuality in men and women: the gender perspective in sexual medicine.
        Reprod Biol Endocrinol. 2020; 17: 10
        • Xiao H.
        • Zhang Y.
        • Kong D.
        • et al.
        The effects of social support on sleep quality of medical staff treating patients with Coronavirus disease 2019 (COVID-19) in January and February 2020 in China.
        Med Sci Monit. 2020; 26: e923549
        • Maasoumi R.
        • Elsous A.
        • Hussein H.
        • et al.
        Female sexual dysfunction among married women in the Gaza Strip: an internet-based survey.
        Ann Saudi Med. 2019; 39: 319-327
        • Schiavi M.C.
        • Sciuga V.
        • Giannini A.
        • et al.
        Overactive bladder syndrome treatment with ospemifene in menopausal patients with vulvovaginal atrophy: improvement of sexuality?.
        Gynecol Endocrinol. 2018; 34: 666-669
        • Ninivaggio C.
        • Rogers R.G.
        • Leeman L.
        • et al.
        Sexual function changes during pregnancy.
        Int Urogynecol J. 2017; 28: 923-929
        • Schiavi M.C.
        • DʼOria O.
        • Faiano P.
        • et al.
        Vaginal native tissue repair for posterior compartment prolapse: long-term analysis of sexual function and quality of life in 151 patients.
        Female Pelvic Med Reconstr Surg. 2018; 24: 419-423