Background: Female sexual dysfunction (FSD) is common during pregnancy and may be influenced by hormonal, psychological, and social factors. Understanding these changes can improve women’s quality of life during this period. This study aimed to evaluate sexual function in pregnant women across all trimesters and to determine the strength and direction of correlation between serum progesterone and estradiol levels and FSFI scores. Methods: A cross-sectional comparative study was conducted on 90 pregnant women attending Zagazig University Hospitals, divided into three groups by trimester (n=30 each). Data were collected using the Arabic version of the Female Sexual Function Index (FSFI). Serum progesterone and estradiol levels were measured, and socio-demographic data were recorded. Pearson's and Spearman's correlation coefficients were used to assess relationships between hormone levels and FSFI domain scores. Results: Total FSFI scores and domain scores for desire (r = -0.72 with estradiol, p=0.001), arousal (r = -0.49 with progesterone, p=0.026; r = -0.72 with estradiol, p=0.001), and orgasm (r = -0.57 with estradiol, p=0.008) were significantly lower in the first and third trimesters compared to the second (p<0.05). Serum progesterone and estradiol levels increased significantly across trimesters (p<0.001). Significant negative correlations were found between hormone levels and multiple FSFI domains, especially in early pregnancy. Conclusion: Sexual function declines among pregnant women, especially during the first and third trimesters, and is negatively influenced by rising hormonal levels as well as demographic and social factors. Comprehensive sexual health assessment should be integrated into prenatal care